Depression, Internet Gaming Disorder, and the Moderating Effect of the Gamer-Avatar Relationship: an Exploratory Longitudinal Study

An Empirical Investigation of the Relationships Among Self-Esteem, Depression and Self-Serving Bias in People with Internet Gaming Disorder

Introduction

People are generally characterized by a self-serving bias which describes the tendency to ascribe positive outcomes or success to internal or personal causes (self-enhancement motivation) and ascribe negative outcomes or failure to external or situational causes (self-protection motivation). It has been found that the individuals with internet gaming disorder (IGD) who have low self-esteem and high depression exhibit an attenuated self-serving bias. However, the relationships among self-esteem, depression and self-serving bias are not clearly identified.

Methods

A sample of 138 IGD participants completed self-esteem and depression scales and a causal attribution task (Study 1) to examine the relationships among self-esteem, depression and self-serving bias (both self-enhancement and self-protection). In follow-up Study 2, 28 IGD participants were recruited to undertake self-affirmation intervention which can affirm one's sense of global self-view and bolster self-esteem to explore whether self-affirmation would trigger a reduction of depression and a raise of self-serving bias.

Results

The results of path analysis in Study 1 showed that the self-serving bias was predicted by self-esteem and depression, and the depression played a mediating role between self-esteem and self-serving bias. The results of Study 2 showed that the IGD participants reported higher self-esteem, lower depression and engaged in more self-protection motivation after affirming-self manipulation as compared with affirming-other manipulation.

Conclusion

These findings suggest that self-esteem predicts self-serving bias through depression and self-affirmation could trigger an increase of self-esteem, further decrease depression and improve self-serving bias for the individuals with IGD. The present article clearly identified the relationships among these factors and provided a new approach to promote positive self-concept in individuals with IGD. Future research is warranted to explore the lasting benefits of self-affirmation on domains of education, relationships and gaming withdrawal for the individuals with IGD among different populations.

Gaming Disorder: The role of a gamers flow profile

Digital games are widely popular and integral to contemporary entertainment. Nevertheless, a proportion of users present with disordered/excessive gaming behaviours, provisionally classified as Internet Gaming Disorder (IGD). Previous literature suggests examining the contribution of an individual's profile of immersive engagement with their gaming activity, known as online flow, for disordered gaming behaviours. Therefore, the main goals of this study were (1) to categorise gamers into distinct profiles based on their online flow experiences and (2) to investigate the differences in disordered gaming among these different flow profiles. A sample of 565 gamers (12-68 years, Mage = 29.3 years) was assessed twice over six months with the Online Flow Questionnaire (OFQ), the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), and the Gaming Disorder Test (GDT). Latent profile analysis (LPA) identified five distinct profiles encompassing 'High-Flow with High Loss of Control' (HF-HLOC; 14.0 %), 'Low Flow with Low Enjoyment' (LF-LE; 11.9 %), 'Average Flow with Low Enjoyment' (AF-LE; 17.5 %), 'Low Flow with High Enjoyment' (LF-HE; 20.2 %), and 'High Loss of Sense of Time with Low Loss of Control' groups (HLOT-LLOC; 36.5 %). As hypothesised, individuals across varying profiles evidenced differences in their concurrent and longitudinal disordered gaming behaviours. Overall, findings suggest that 'loss of sense of time' may be the most pivotal factor in differentiating flow states and profiles during gaming, advocating its consideration in disordered gaming assessment and treatment.

Examining how gamers connect with their avatars to assess their anxiety: A novel artificial intelligence approach

Research has supported that a gamer's attachment to their avatar can offer significant insights about their mental health, including anxiety. To assess this hypothesis, longitudinal data from 565 adult and adolescent participants (Mage = 29.3 years, SD = 10.6) was analyzed at two points, six months apart. Respondents were assessed using the User-Avatar Bond (UAB) scale and the Depression Anxiety Stress Scale (DASS) to measure their connection with their avatar and their risk for anxiety. The records were processed using both untuned and tuned artificial intelligence [AI] classifiers to evaluate present and future anxiety. The findings indicated that AI models are capable of accurately and autonomously discerning cases of anxiety risk based on the gamers' self-reported UAB, age, and duration of gaming, both at present and after six months. Notably, random forest algorithms surpassed other AI models in effectiveness, with avatar compensation emerging as the most significant factor in model training for prospective anxiety. The implications for assessment, prevention, and clinical practice are discussed.

Sociotropy and video game playing: Massively multiplayer online role-playing games versus other games

INTRODUCTION

Internet Gaming Disorder (IGD) is associated with several psychiatric disorders. Previous research on IGD has predominantly focused on Massively Multiplayer Online Role-playing Games (MMORPGs), considered to be pro-social games as they foster interpersonal relationships necessary for in-game progress. Sociotropy is a personality trait characterized by a cognitive approach to dealing with interpersonal relationships. Individuals with high sociotropy have a strong desire for approval from others. Beck's cognitive theory of depression posits that high sociotropy can lead to depressive symptoms when faced with interpersonal stress. We used the I-PACE model to account for the consequences of distal factors such as sociotropy on the development and maintenance of IGD. The aim of this study was therefore to compare MMORPG players with players of other game genres in terms of sociotropy, social anxiety and depression. We hypothesized that sociotropy could serve as a predictor of IGD, particularly among MMORPG players.

METHODS

A total of 233 French videogame players recruited from specialized internet gaming forums participated in the study via questionnaires. Different scales were used to assess depression and social anxiety symptoms, IGD intensity, and sociotropy and autonomy.

RESULTS & DISCUSSION

MMORPG players reported higher psychological distress than players of other game genres. For all players, sociotropy, rather than autonomy, was found to be a predictor of social anxiety symptoms and IGD intensity. Sociotropy and depression explained IGD intensity only for MMORPG players and not for players of other game genres. The social dimension appears to be more prominent among MMORPG players and could be one of the main personality traits predicting this specific internet gaming disorder. The treatment implications for internet gaming disorder are discussed.

Disorder and rehabilitation: The paradox of digital games and vulnerabilities

BACKGROUND

The impact of digital gaming on human health, both mental and physical, can be both positive and negative. However, excessive gaming can lead to gaming disorders, which are a cause for concern. With the pandemic, online classes became more common, leading to an increase in gaming-related disorders and even suicides. While the combination of education and fun in online gaming can be beneficial, it can also be a risk for gaming disorders and suicide. This study aimed to explore this paradox and provide safety measures to prevent gaming disorders.

MATERIALS AND METHODS

A qualitative research methodology with exploratory and discourse analysis was used in the study. Several real-life incidents related to the research were gathered from newspaper research articles, media, and existing theses. The researchers used textual interpretation in secondary sources to identify the paradox of digital games and vulnerabilities.

RESULTS

This research article focuses on the various benefits and harmful effects of digital games on individuals' mental and physical health. The research findings were presented based on true events that occurred in and around India. The results of the current study specified that gaming disorders were pushing individuals toward mental disorders and suicide. It is crucial to implement preventive measures to address this issue.

CONCLUSION

According to the study, people who suffer from excessive gaming disorders may experience anxiety, depression, and even suicidal thoughts, which can have negative effects on society. To address this issue, it is helpful to monitor and control individuals' digital game usage and provide informative sessions on how to use digital games properly. While it may not be possible to completely ban the use of digital games, certain restrictions can be put in place. Educating individuals on both the benefits and drawbacks of digital gaming and the rapid technological advancements is essential. Through proper education, it is possible to reduce the number of suicides among gamers and individuals.

Translating the user-avatar bond into depression risk: A preliminary machine learning study

Research has shown a link between depression risk and how gamers form relationships with their in-game figure of representation, called avatar. This is reinforced by literature supporting that a gamer's connection to their avatar may provide broader insight into their mental health. Therefore, it has been argued that if properly examined, the bond between a person and their avatar may reveal information about their current or potential struggles with depression offline. To examine whether the connection with an individuals' avatars may reveal their risk for depression, longitudinal data from 565 adults/adolescents (Mage = 29.3 years, SD = 10.6) were evaluated twice (six months apart). Participants completed the User-Avatar-Bond [UAB] scale and Depression Anxiety Stress Scale to measure avatar bond and depression risk. A series of tuned and untuned artificial intelligence [AI] classifiers analyzed their responses concurrently and prospectively. This allowed the examination of whether user-avatar bond can provide cross-sectional and predictive information about depression risk. Findings revealed that AI models can learn to accurately and automatically identify depression risk cases, based on gamers' reported UAB, age, and length of gaming involvement, both at present and six months later. In particular, random forests outperformed all other AIs, while avatar immersion was shown to be the strongest training predictor. Study outcomes demonstrate that UAB can be translated into accurate, concurrent, and future, depression risk predictions via trained AI classifiers. Assessment, prevention, and practice implications are discussed in the light of these results.

The Double-Edged Influence of Self-Expansion in the Metaverse: A Two-Wave Panel Assessment of Identity Perception, Self-Esteem, and Life Satisfaction

This study researches the impact of self-expansion experiences in the Metaverse on users' identity perception, self-esteem, and life satisfaction. To do so, the researchers conducted a two-wave panel study with a 3-month interval (N = 486) in VRChat, one of the most popular social virtual reality (VR) platforms. As predicted, the increase in self-expansion experience in VR environments positively predicted users' self-esteem and life satisfaction. However, when self-expansion led to a loss of coherency in the self-concept by causing identity disjunction or self-discrepancy, it damaged self-esteem and life satisfaction, respectively. The current findings exhibit that experimenting with and enlarging identity through immersive experiences in the Metaverse could benefit the individual, but only when it does not cause a disconnection between virtual and offline identities. This article discusses the potential opportunities and risks in the Metaverse, emphasizing the importance of advancing our understanding of the self-expansion experience in immersive media.

Effectiveness of an integrated motivational cognitive-behavioral group intervention for adolescents with gaming disorder: a randomized controlled trial

AIMS, DESIGN AND SETTING

The aim of this study was to test the efficacy of the integrated cognitive-behavioral therapy with a strength-based motivational approach [integrated cognitive-behavioral therapy (ICBT)] intervention to change gaming disorder (GD) symptoms and other outcomes and to study the therapeutic mechanism. A two-arm parallel randomized waiting-list controlled trial with 3- and 6-month follow-ups were conducted in a secondary vocational school in mainland China.

PARTICIPANTS

Participants comprised 77 Chinese adolescents with GD symptoms with a mean age of 16.36 years [standard deviation (SD) = 0.93]; 88.3% were male INTERVENTIONS: Participants were randomized into an ICBT group (n = 38) and a waiting-list control (WLC, n = 39) group. ICBT intervention comprised eight weekly sessions to encourage participants to identify their interests and strengths and set goals for developing personally meaningful real-life activities.

MEASUREMENTS AND FINDINGS

The outcomes were measured at pre-treatment (t0 ), post-treatment (t1 ), 3-month (t2 ) and 6-month (t3 ) follow-ups. The primary outcome was GD symptoms at t3. Secondary outcomes included GD symptoms at t1 and t2 , and gaming motivation, maladaptive gaming cognition, depression and anxiety symptoms at t1 , t2 and t3 . With the intention-to-treat principle, the GD scores at t3 were significantly different between the CBT and WLC groups [mean difference 62.08 (SD = 10.48) versus 73.64 (SD = 11.70); Hedges' g = 1.15, 95% confidence interval = 0.67-1.62]. Linear mixed-effects modeling showed significant group × time interaction for the secondary outcomes (P < 0.01), with a moderate to strong between-group effect size in the reduction in depression symptoms (g = 0.67-0.84) and anxiety symptoms (g = 0.6-0.64). Path analysis shows ICBT leads to GD reduction through reducing gaming motivation and maladaptive gaming cognition.

CONCLUSIONS

An integrated cognitive-behavioral therapy with strength-based motivational approach intervention reduced gaming disorder symptoms and time spent gaming over a 6-month period by decreasing maladaptive gaming motivation and cognition.

Mattering, substance use, and addictive behaviors: review, analysis, and implications for treatment and prevention

In the current article, we examine mattering to others as a relational resource and discuss how feelings of not mattering are uniquely implicated in addiction and substance use. We describe the mattering construct and how it is conceptualized, and we comprehensively review existing evidence based primarily on research with adolescents that links feelings of not mattering with addictive tendencies in general, and specific tendencies (e.g., excessive drinking and drug use and excessive social media use). A central premise of this article is the need to take race and ethnicity into account when considering the potential link between feelings of not mattering and substance use among young people with minority status and various ethnicities who may be especially prone to feeling marginalized and insignificant as a result of adverse experiences reflecting being ostracized and not socially accepted. Potential models of drinking and addictive tendencies that can easily incorporate the mattering construct are also outlined to underscore the conceptual relevance of feelings of not mattering to others. Mattering is also considered in terms of how internalization (i.e., not mattering to oneself) potentiates impulsive and risky behavior. Our article concludes with discussion of the implications for treatment and prevention in addiction and substance use and directions for future research that should further illuminate the role of feelings of not mattering to others and not mattering to oneself.

Identification with Game Characters: Theoretical Explanations, Predictors, and Psychological Outcomes

This review investigates theoretical explanations, predictors, and psychological outcomes of identification with game characters. Theoretical explanations depended on Cohen’s conceptualization of identification with media characters, wishful identification, similarity identification, embodied presence concepts, self-perception, self-discrepancy, and social identity theories. Predictors included customizability, how the character is perceived (ideal, attractive, similar, real), narrative, immersion, presence, age, time spent playing/playing history, player’s psychological characteristics, and perceived performance. Psychological outcomes included enjoyment, flow experience, addiction, problematic gaming, playing motivations, self-efficacy, competence, short-term outcomes (change in aggression, empathy), intention to continue playing, game-related spending, social identification, and in-group bias. The self-discrepancy perspective provides the most prevalent explanation, which proposes that game characters are closer to players’ ideal selves, and identification with the game character reduces their self-discrepancies. However, the social identity perspective offers more overarching explanations discussing identification with game-related groups (groups created within the game and game community) and the game character together, thus pointing to a bigger picture where players develop social identities through interaction with game-related groups. Therefore, unlike other explanations discussing game character identification as a temporary experience, the social identity perspective indicates it may be a lasting experience. Regarding predictors, only two were game-related (customizability, narrative), while most were player-related (e.g., age, time spent playing, player’s psychological characteristics), which might show that player characteristics deserve more attention than the game itself to understand the identification process. Concerning psychological outcomes, while two were positive (enjoyment, flow experience) and two were negative (addiction, problematic gaming), most had various aftermaths, such as a short-term outcome of an increase in aggression or empathy.

Positive youth development attributes and cyberbullying victimization among Chinese middle school students: A longitudinal moderated mediation model involving internet gaming disorder and depression

As an extension of traditional bullying, cyberbullying emerges with the increasing popularity of the internet, and seriously affects the health of students. However, fewer studies have explored the potential influencing mechanisms of cyberbullying victimization from a positive psychology perspective. Therefore, based on the positive youth development theory, this study will explore the potential mediator and moderator in the relationship between positive youth development (PYD) attributes and cyberbullying victimization through a longitudinal design. 719 students (Mage = 15.95 years, SD = 0.76, 45.2% boy) participated in the study and completed self-report questionnaires on relevant variables. The result found that students' level of PYD significantly and negatively predicted the level of cyberbullying victimization. Meanwhile, SEM analysis showed that PYD influenced individuals' cyberbullying victimization by affecting their internet gaming disorder (IGD), while depression levels moderated the relationship between PYD and IGD. This study examines cyberbullying victimization from a positive psychology orientation, with potential prevention and intervention value.

Pilot data findings from the Gothenburg treatment for gaming disorder: a cognitive behavioral treatment manual

Background

Gaming disorder (GD) is a new diagnosis included in the latest edition of the International Classification of Disease -11. Recently conducted international studies suggest a prevalence rate close to 2% for GD, highlighting the need for effective treatments for this patient population. Internationally there are few studies investigating effective treatments specifically designed for this condition. In this pilot study, we wanted to test a newly developed method, the Gothenburg Treatment for Gaming Disorder (GOT-TO-GO) manual; a 15-week cognitive behavioral therapy treatment for GD.

Method

This study utilized a single group design with pretest, post-test and a three- and six-month follow-up, with measures of severity of GD and mood. The participants (n = 28) were treatment-seeking adults with GD, aged 17 to 49 years.

Results

The results show a statistically significant decrease in symptoms of GD after treatment. Hours of gaming per week also decreased concomitantly with a 100% increase in non-gaming leisure hours. The decrease in symptoms of GD was maintained at the 3-months follow-up after treatment. Correspondingly we saw a decrease in both depression and anxiety that also was upheld 3 months after treatment.

Conclusion

As GD is a new diagnostic concept more research is needed, also taking psychiatric comorbidity into consideration, to arrive at evidence-based conclusions regarding effective treatments. Considering the promising results in this small pilot study with large behavioral changes and reduced symptoms of GD, upheld at least 3 months after treatment, a larger randomized controlled study is warranted.Clinical Trial Registration: https://www.clinicaltrials.gov/ct2/show/study/NCT05328596?term=NCT05328596&draw=2&rank=1, identifier NCT05328596.

A comprehensive review on emerging trends in the dynamic evolution of digital addiction and depression

Introduction

Using digital addiction as an umbrella term to cover any type of addictions to digital technologies such as the internet, smartphones, social media, or video games, the current study aimed to reveal the intellectual structure and evolution of research addressing digital addiction-depression relationship.

Methods

The study combined bibliometric and science mapping analysis methods for this purpose. Data for the study was gathered from Web of Science Core Collection after a comprehensive process of data search/extraction, and 241 articles were included in the final data set. A period-based, comparative science mapping analysis was performed using the SciMAT software.

Results

The analysis of data over three periods, Period 1 (1983-2016), Period 2 (2017-2019), and Period 3 (2020-2022) showed that internet addiction was the most significant theme across all three periods, which was followed by social media addiction. Depression, which emerged as a significant theme during Period 1, was later covered under anxiety disorder theme. Research interest was mostly on factors related to both addiction and depression such as cognitive distortion, insomnia, loneliness, self-esteem, social support, alexithymia, as well as cybervictimization or academic performance.

Discussion

The results suggested that much research is warranted on the digital addiction-depression relationship in different age cohorts, especially children and elderly. Similarly, the current analysis showed that this line of research particularly focused on internet, gaming and social media addiction, and evidence with regard to other types of digital addiction or related compulsive behaviors was almost absent. In addition, research was mostly inclined to understanding cause-effect relationships, which is significant, but preventive strategies seemed to be barely addressed. Likewise, the smartphone addiction-depression relationship arguably garnered less research interest, so future research would contribute to the field in this respect.

Relationships between psychological flexibility and internet gaming disorder among adolescents: Mediation effects of depression and maladaptive cognitions

Psychological flexibility may reduce addictive behaviours by adaptive and flexible emotional and cognitive processes. This study tested a mediation model of internet gaming disorder (IGD) in which psychological flexibility would reduce depression and maladaptive cognitions related to internet gaming and in turn lower the risk of IGD. A cross-sectional study surveyed 2102 secondary 1-4 students from seven schools during March to November 2021 in Hong Kong, China. The results showed that 12.7% and 52.2% of the students were classified as having probable IGD and depression, respectively. The proposed mediation model fitted the data well: χ2/df = 8.00, CFI = .99, NNFI = .99, RMSEA = .01. Psychological inflexibility was directly and positively associated with IGD (B = .01, β = .07, p = .003) and indirectly and positively associated with IGD via depressive symptoms (B = .01, β = .07, p = .001, PM = 23.7%) and maladaptive cognitions (B = .03, β = .15, p = .001, PM = 50.8%). Multi-group analyses showed that gender significantly moderated the associations between psychological inflexibility and maladaptive cognitions (Δχ2/Δdf = 8.69/1, p < .05), between maladaptive cognitions and IGD (Δχ2/Δdf = 4.33/1, p < .05), and between psychological inflexibility and IGD (Δχ2/Δdf = 5.46/1, p < .05). Depression and maladaptive cognitions may be significant mediators that could explain the relationship between psychological flexibility and IGD. Also, gender difference may exist. Based on the findings, intervention strategies for IGD reduction are discussed.

Coping and Co-Occurrence of Gaming Disorder and Substance Use in Recovering Substance Users

BACKGROUND

There are a wide range of negative effects associated with both substance use disorders and behavioural disorders and their co-occurrence. Understanding the way in which at-risk populations (e.g., substance-abstinent users) interact with potentially addictive behaviours (e.g., gaming) and substance use-while navigating life stressors through differing coping styles-can inform preventative strategies.

METHODS

Therefore, the present study investigated 64 clinical participants and 138 general population participants. Each cohort was required to complete a battery of psychometric scales exploring problematic behaviours, problematic substance use, co-occurrence, and coping styles. Additional exploratory direct comparisons of gamers in the clinical cohort and gamers in the general cohort were carried out.

RESULTS

The study's findings suggest that gamers from different populations (i.e., general and clinical) share similar at-risk behaviours. These problematic behaviours were more pronounced among abstinent substance use gamers, and more specifically among poly-substance use gamers.

CONCLUSIONS

The findings of the present study add to the literature and suggest that dysfunctional coping style and the co-occurrence of problematic behaviours may have an impact on the assessment and potential treatment of substance abstinent gamers. The findings offer support for an integrated treatment approach, wherein both substance use and the other problematic behaviours (e.g., gaming) are considered in tandem.

Co-Occurrence of Gaming Disorder and Other Potentially Addictive Behaviours between Australia, New Zealand, and the United Kingdom

Background: Evidence suggests that gamers can have varying experiences of disordered gaming behaviours due to coping mechanisms and how they can act as risk or protective factor in the development and/or maintenance of disordered behaviours. A particular area of interest is how this may manifest across different countries. Understanding the interplay of these potential risk and protective factors within different countries will aid identifying and preventing disordered behaviours. Methods: Three cohorts were recruited from Australia, New Zealand, and the United Kingdom. Each cohort was required to complete a battery of psychometric scales exploring problematic behaviours, problematic substance use, co-occurrence, coping styles, and personality. A latent profile analysis was conducted to examine the differences between cohorts and further investigated with additional analyses. Results: The findings suggested that a minority of gamers were affected by gaming disorder, and there appeared an at-risk cohort who utilise gaming as a maladaptive coping strategy. Other accompanying potentially addictive behaviour or substance use may be exacerbated as a result, the manifestation of which can be influenced by cultural elements. Conclusions: When considering gamers from countries which hold similar views, it is important to be cognisant of the variations found in the manifestations of disordered gaming and accompanying potentially addictive behaviours. This will allow for a more precise identification of at-risk behaviours, which will result in more favourable treatment outcomes for those who are considered at-risk or high-risk individuals.

The relationship between positive youth development and internet gaming disorder in Chinese adolescents: A moderated mediation model

Internet gaming disorder (IGD) is a social problem that cannot be ignored. Considerable research has shown that IGD can impede the healthy physical and mental development of adolescents. Based on positive youth development theory and stage-environment fit theory, the current study explored the mediating effect of depression and the moderating effect of gender to determine the association between positive youth development (PYD) and IGD. A sample of 1970 Chinese adolescents aged 11-18 years (1021 boys, 940 girls, and 10 unidentifiable individuals) completed questionnaires related to PYD, depression, IGD, and their background information. The results revealed that PYD negatively predicted IGD. After controlling for gender and age, this study found that depression mediated the relationship between PYD and IGD. Furthermore, gender moderated the relationship between depression and IGD. Boys with depressive symptoms were more likely to indulge in IGD than girls. This research contributes to a more thorough understanding of how PYD decreases the risk of IGD. These findings suggest that cultivating PYD attributes is a promising approach to prevent or reduce depression and IGD among adolescents in mainland China.

The association between level of personality organization and problematic gaming: Anxiety, depression, and motivations for playing as mediators

Problematic gaming is a topic of great clinical and social relevance, so it is particularly important to identify its protective and risk factors. Literature already showed that maladaptive personality favors problematic gaming. In the light of Kernberg's model of personality organization, the present cross-sectional study aimed to evaluate the mediational process through which low level of personality organization associates with problematic gaming, exploring the role of depressive and anxious symptoms and of motivations for playing. A sample of 1036 video gamers filled in an online survey regarding: level of personality organization; depressive and anxious symptoms; socializing, achievement, and immersion motivations for playing; problematic gaming. The path analysis showed that lower level of personality organization associated with greater problematic gaming and that depressive (but not anxious) symptoms, and socializing and achievement (but not immersion) motivations positively mediated this relationship. Furthermore, results showed that psychopathological symptoms and achievement motivations sequentially mediated the relationship between low level of personality organization and problematic gaming, highlighting that depressive symptoms secondary to a low level of personality organization could lead to a risky use of video games, i.e., they could push to use video games to self-enhance oneself, a dysfunctional strategy that exposes to problematic gaming. The study gives some indications on the variables that associate with problematic gaming and has some practical relevance, providing suggestions in the design of effective problematic gaming prevention and treatment interventions.

Prevalence and Factors Associated with Gaming Disorder in Latin America and the Caribbean: A Systematic Review

We aimed to determine the prevalence and factors associated with gaming disorder (GD) in the population of Latin America and the Caribbean (LAC). A systematic review was performed (PROSPERO protocol registration: CRD42021230565). We included studies that identified participants with GD and/or factors associated with this condition, reported the prevalence of GD, or contained data that assisted in its estimation, were published after 2013 (the year of inclusion of GD in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders) and were carried out in a population residing in an LAC country. Evaluation of the quality of the studies was carried out using the Joanna Briggs Institute Critical appraisal checklist tool. A qualitative synthesis of the data was performed. Of the total of 1567 records identified, 25 passed the full-text review phase, and 6 met the selection criteria. These studies were published between 2018 and 2021 and had a cross-sectional design (three in Brazil, one in Ecuador, Mexico, and the other was multi-country, including a LAC country [Peru]). The prevalence of GD ranged from 1.1% to 38.2%. The three studies in Brazil had the highest figures of GD prevalence (20.4-38.2%). Four studies evaluated factors associated with GD. Characteristics regarding the game (type), pattern of use (hours played), as well as gender (higher in men), tobacco and alcohol consumption, poor interpersonal relationships, and the presence of mental disorders were found to be associated with GD in LAC. Evidence on the prevalence and factors associated with GD in LAC is limited. Studies on GD in LAC evaluate different population subgroups, describing a wide prevalence of this condition (present in up to 38 out of 100 evaluated). Characteristics such as the type and hours of use of the games, sociodemographic data, lifestyles, interpersonal relationships, and the presence of mental disorders increase the probability of presenting GD.

Parental Phubbing and Internet Gaming Addiction in Children: Mediating Roles of Parent-Child Relationships and Depressive Symptoms

Mounting research has well documented that parental phubbing is significantly associated with Internet gaming addiction (IGA) in children. However, the mediating mechanisms of this relations are poorly understood. This study used a multi-informant design to investigate whether parent-child relationships (closeness and conflict) and depressive symptoms mediate the relation between parental phubbing and IGA. A total of 1,021 Chinese children (44.30 percent girls; M_age = 10.33, standard deviation = 0.98) and their mothers completed anonymous questionnaires. The results showed that parent-child conflict and depressive symptoms each played a mediating role between parental phubbing and the children's IGA, whereas parent-child closeness did not. Moreover, parental phubbing demonstrated an indirect effect on the children's IGA successively through the parent-child conflict and children's depressive symptoms. The findings suggest that improved parent-child relationships and immediate intervention for depressive symptoms can reduce the risk of IGA among children.

Childhood psychological maltreatment and internet gaming addiction in Chinese adolescents: Mediation roles of maladaptive emotion regulation strategies and psychosocial problems

BACKGROUND

Internet gaming addiction (IGA) is a global concern, especially among young children. There have been some suggestions that childhood psychological maltreatment influences the development of IGA, but evidence for this has thus far been lacking.

OBJECTIVE

The goal of this study was to investigate the association between childhood psychological maltreatment and IGA in adolescents and the mediation roles of maladaptive emotion regulation strategies and psychosocial problems (depression and social anxiety).

METHODS

This study recruited 1280 (girls = 690) middle school students with a mean age of 16.09 ± 0.98 years old. All participants undertook a standardized assessment of childhood psychological maltreatment, maladaptive emotion regulation strategies, psychosocial problems (depression and social anxiety), and IGA.

RESULTS

We examined whether the effect of childhood psychological maltreatment on IGA was mediated by maladaptive emotion regulation strategies and psychosocial problems (depression and social anxiety). Both parallel and sequential mediation analysis showed that maladaptive emotion regulation strategies and depression mediated the relationship between childhood psychological maltreatment and IGA.

CONCLUSIONS

Childhood psychological maltreatment is positively associated with IGA in adolescents. Maladaptive emotion regulation strategies and depression both significantly mediated the relationship between childhood psychological maltreatment and IGA.

Online gaming addiction in youth: Some comments on Rosendo-Rios et al. (2022)

A recent systematic review examining online gaming addiction among children and young adults was published in Addictive Behaviors (i.e., Rosendo-Rios, Trott & Shukla, 2022). However, dozens of papers were missing from the review. One of the reasons why so many studies were not in the review is likely to be because of the search terms used. None of the search terms included the words 'adolescent', 'adolescence', 'emerging adults', 'excessive gaming', 'gaming disorder', 'video game addiction' or 'problematic gaming'. Moreover, studies were also included in the review if the mean age of the total sample was 25 years or below. This meant that some studies in the review included some participants who were not children, adolescents or emerging adults. It also meant that many studies were not included that had mean ages below the age of 26 years because they were not picked up by the search strategy. Given the high number of studies that were not included in the review, readers should view this systematic review as 'suggestive' of research in the area of problematic gaming in youth rather than 'definitive'.

The role of internet gaming in the association between anxiety and depression: A preliminary cross-sectional study

BACKGROUND

Disordered Internet gaming is thought to be perpetuated by one's need to escape their real-life distress or mental health symptoms, which may in turn generate depressive feelings. Nevertheless, moderate engagement with Internet games has also been suggested to provide relief, thus improving one's mood. This study aspires to clarify the contribution of Internet gaming and gender in the association between anxiety and depression.

METHODS

A large sample of Internet gamers (N = 964) were recruited online. Disordered Internet gaming was assessed with the Internet Gaming Disorder Scale, 9 Items Short Form (IGD9S-SF). Anxiety and depression symptoms were assessed using the Depression, Anxiety and Stress Scale, 21 items (DASS-21).

RESULTS

Regression, moderation and moderated moderation analyses accounting for the effects of gender on the relationship between disordered gaming, anxiety, and depression found a significant effect for anxiety symptoms on depression symptoms and a significant interaction between anxiety and Internet gaming disorder on depression symptoms. Findings support the theory that although anxious gamers bear a higher depression risk, this is buffered with lower and exacerbated with higher disordered gaming symptoms.

CONCLUSION

Findings suggest a dual role of Internet gaming in the association between anxiety and depression, depending on the intensity of one's disordered gaming symptoms. Depression prevention and intervention protocols should be optimized by considering the effects of Internet gaming among anxious gamers by focusing on the intensity of a gamer's involvement and any gaming disorder symptoms. Further research should include clinical samples to better understand this interaction.

Developing an intense player-avatar relationship and feeling disconnected by the physical body: A pathway towards internet gaming disorder for people reporting empty feelings?

The literature suggests that alexithymia and emptiness could be risk factors for various addictive behaviors. The present study developed and tested a model that proposes a pathway leading from emptiness and difficulties in identifying emotions to Internet Gaming Disorder (IGD) symptoms via an intense gamer-avatar relationship and bodily dissociative experiences. A sample of 285 (64.2% M; mean age = 30.38 ± 7.53) online gamers using avatar-based videogames was recruited from gaming communities, and they were asked to complete a survey that included the Toronto Alexithymia Scale, the Subjective Emptiness scale, the Scale of Body Connection, the Self-Presence Questionnaire, and the Internet Gaming Disorder Scale-Short Form. The structural model evaluated produced a good fit to the data [χ2 = 175.14, df = 55, p < .001; RMSEA = 0.08 (90% C.I. =0.07–0.09), CFI = 0.96, SRMR = 0.08] explaining 28% of the total variance. Alexithymia was indirectly associated with IGD through the serial mediation of the gamer-avatar relationship and body dissociation. Emptiness was associated with IGD symptoms at the bivariate level, but did not predict IGD directly or indirectly. The current study identifies a potential pathway toward IGD by integrating different lines of research, showing the importance of considering aspects such as the difficulty in recognising and expressing one’s emotions, the gamer- avatar relationship, and the mind-body connection in the context of IGD.

Effects of Psychological Distress and Coping Resources on Internet Gaming Disorder: Comparison between Chinese and Japanese University Students

The high prevalence of Internet gaming disorder (IGD) among Asian youth indicates an urgent need to identify protective factors and examine their consistency across Asian cultures in order to facilitate cost-effective interventions. Based on the transactional theory of stress and coping, this study collected data of 1243 online gamers (45% males; 18-25 years) through an anonymous survey from universities in China and Japan and investigated whether three coping resources (i.e., mindfulness, coping flexibility, and social support) serve to protect Chinese and Japanese youth from the impact of psychological distress on IGD tendency. After adjusting for the measurement non-invariance across samples, we found that Japanese students reported higher levels of IGD tendency and psychological distress than Chinese students. The results of multiple-group SEM analyses showed that, after controlling for other predictors, mindfulness served as the strongest protective factor against IGD across samples. Moreover, the buffering effect of mindfulness on the association between psychological distress and IGD tendency of female (but not male) students was observed. Our findings highlighted the cross-cultural invariance of the impact of psychological distress and coping resources on IGD in Chinese and Japanese youth, which can be considered in future IGD prevention programs.

Sexual Differences in Internet Gaming Disorder (IGD): From Psychological Features to Neuroanatomical Networks

Internet gaming disorder (IGD) has been included in the 2013 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a condition in need of further study, and gaming disorder was recognized by the World Health Organization as a mental disorder in the International Classification of Disease (ICD-11) of 2018. IGD has different characteristics in the two sexes and is more prevalent in males than females. However, even if the female gamer population is constantly growing, the majority of available studies analyzed only males, or the data were not analyzed by sex. To better elucidate sex differences in IGD, we selectively reviewed research publications that evaluated IGD separately for males and females collected in approximately one hundred publications over the past 20 years. The available data in this narrative review indicate that IGD is strongly dimorphic by sex for both its psychological features and the involvement of different brain areas. Impulsivity, low self-control, anxiety, emotion dysregulation, and depression are some of the psychological features associated with IGD that show a sex dimorphism. At the same time, IGD and its psychological alterations are strongly correlated to dimorphic functional characteristics in relevant brain areas, as evidenced by fMRI. More research is needed to better understand sex differences in IGD. Animal models could help to elucidate the neurological basis of this disorder.

Is the proposed distinction of gaming disorder into a predominantly online vs. offline form meaningful? Empirical evidence from a large German speaking gamer sample

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Disordered gaming is distinguished by predominantly online, offline, and unspecific gaming.

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Online gamers showed the highest tendencies towards disordered gaming.

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Gaming via desktop computers was linked with the highest disordered gaming levels.

In the eleventh revision of the International Classification of Diseases (ICD-11), Gaming Disorder (GD) is distinguished between disordered gaming occurring predominantly online, offline, and unspecified. Currently, no study has investigated whether such a distinction is meaningful in diagnosing disordered gaming. Therefore, a large group of gamers with varied tendencies towards disordered gaming was recruited to examine this issue. A large sample (N = 2,768) was recruited and data were collected on disordered gaming, along with information on their preferred gaming mode and device used to play. The present study shows that the distinction between online and offline gaming mode proposed by the WHO is meaningful because online gamers presented with the highest disordered gaming scores followed by mixed gamers (those stating to equally prefer online and offline gaming), and offline gamers. Finally, it was also observed that the type of device for gaming used associated with disordered gaming levels. Specifically, those reporting mostly to use their desktop computer for gaming showed the highest disordered gaming scores. The present study lends empirical support for the consideration of both gaming mode and gaming device in the study of disordered gaming.

Parenting Styles, Depressive Symptoms, and Problematic Online Game Use in Adolescents: A Developmental Cascades Model

Abundant empirical research has demonstrated the relationship between parenting style and adolescent problematic online game use (POGU), but the direction and underlying mechanism of this association remain unclear. Using a 1-year longitudinal design across three time points, the present study explored interrelations among parenting styles, depressive symptoms, and POGU from the theoretical perspective of the developmental cascade model and examined whether depressive symptoms mediate the relationship between parenting style and POGU. A sample of 1,041 children was recruited from two junior middle schools in China, of which 46.3% were boys. Results confirmed the cascade effects and showed that the reciprocal effect of parenting style, depressive symptoms, and POGU was significant, and parental control and POGU can predict each other via depressive symptoms. Knowledge regarding the direct and underlying mechanisms between parenting style, depressive symptoms, and POGU provides reference suggestions for the prevention and intervention of adolescent depressive symptoms and problematic online game use.

Internet Gaming Disorder in Early Adolescents: Gender and Depression Differences in a Latent Growth Model

Background: Studies have shown that many Internet game players may have experienced Internet gaming disorder (IGD), which is thought to coexist with a variety of cognitive and psychological disorders, such as depression. A three-year, four-point longitudinal tracking study was conducted to examine the trajectory of IGD of Chinese early adolescents, as well as the predictive level of gender and depression for IGD. Participants (N = 316) completed questionnaires assessing IGD and depression at the time of the T1, T2, T3, and T4. This study adopted the widely used latent growth model for data analysis. The results showed that, in the early stage of adolescence, (1) the development trajectory of individual IGD was shown as a nonlinear latent variable growth model; the IGD was significantly higher than zero when teenagers were first measured (sixth grade); and, while on the rise, its growth rate is gradually slowing. (2) Gender can significantly predict the development trajectory of individual IGD. (3) Individuals with a high initial level of depression usually have a high initial level of IGD, individuals with a large range of depression display a large range of IGD, and those with a rapid rate of depression change show similar change in their IGD. In sum, this study provided an empirical basis for the prevention and intervention of IGD in early adolescents.

Joint effects of children's emotional problems and parental depressive symptoms on the occurrence of internet gaming disorder among children and adolescents: A longitudinal study

BACKGROUND AND AIMS

Parental depressive symptoms may aggravate the effects of children's emotional problems on risks for Internet gaming disorder (IGD). Here we examined the joint effects of children's emotional problems and parents' depressive symptoms on the incidence of IGD.

METHODS

A large prospective, population-based cohort tested potential interactions between children's emotional problems, parents' depressive symptoms, and incidence of high risk of IGD (HRIGD). Family dyads (n=2,031) that included children who were non-HRIGD at baseline completed assessments of childhood and parental affective symptomatology. HRIGD was assessed at baseline and 12 months. Relative excess risk due to interaction (RERI) estimated the magnitudes of interactions.

RESULTS

In terms of risk for the development of IGD, parental depression was 1.8 times greater, children's emotional problems were 2.9 times greater, and both risk factors together were 6.1 times greater than the background risk, with the last two findings reaching statistical significance. The expected risk for the development of HRIGD was RR=3.7.

DISCUSSION AND CONCLUSIONS

Children's emotional problems demonstrated a particularly strong relationship with HRIGD. Joint effects of children's emotional problems and depressive symptoms in parents on the incidence of HRIGD were stronger than the sum of the independent effects of each factor. The findings suggest that combining interventions for the treatment of children's emotional problems and parents' depressive symptoms may have extra risk reduction effects on preventing IGD in children and adolescents.

Player-avatar interactions in habitual and problematic gaming: A qualitative investigation

BACKGROUND AND AIMS

Previous studies have reported that stronger avatar identification and negative self-concept are associated with gaming disorder (GD). This study aimed to examine the value and significance of avatars based on firsthand accounts from regular and problematic gamers, and to identify any potential links between avatar-related experiences and excessive gaming.

METHODS

An online survey of 993 adult gamers yielded 3,972 text responses. Qualitative analysis of 59,059 words extracted 10 categories of avatar-related perspectives.

RESULTS

Some problem and non-problem gamers employed sentimental language (e.g., 'dear friend', 'like a child', 'part of my soul') to refer to their avatar. However, most participants perceived avatars as a means of achieving in-game goals and enabling greater interactivity (e.g., socializing). When asked to reflect on hypothetically losing their avatar, participants generally anticipated feeling temporary frustration or annoyance due to lost time and effort invested into the avatar. Although some participants reported that their avatar 'mattered', avatars were often considered as superficial ('just pixels') and peripheral to the primary reinforcement of achieving in-game rewards and objectives. Some broader psychological and identity issues such as gender dysphoria, rather than 'addiction', were cited as motivating persistent avatar-related interactions and attachment.

DISCUSSION AND CONCLUSIONS

Participants reported diverse views on the psychological value and function of avatars, but the relationship between avatars and problematic gaming or GD was largely unclear or inconsistent, and refuted by some participants. Future research with clinical samples may lead to a better understanding of player-avatar processes, including whether avatar-stimuli facilitate the development of maladaptive gaming habits, particularly among psychologically vulnerable players. Future investigations should be mindful of 'overpathologizing' avatar-related phenomena and recognize their important role in socializing, storytelling, and creative expression among gamers.

The associations between smart device use and psychological distress among secondary and high school students in Kuwait

BACKGROUND

Smart devices (SDs) are widely used among adolescents. Numerous studies have recommended further research on this topic to find out the prevalence of SD overuse among school students and to what extent this is associated with psychological distress. The present study aimed to investigate the pattern of SD use among secondary and high school students in the state of Kuwait, as well as the possible associations with psychological problems, weight, physical activity, and school performance.

MATERIALS AND METHODS

The correlational study design aimed to survey students from public schools by using a questionnaire and valid instruments, which included: Smartphone Addiction Scale-Short Version (SAS-SV) and Stress, Anxiety, and Depression Scale-(DASS-21). Pearson's correlation coefficient, t-tests, one-way ANOVA were applied to find associations or significant differences between the categorical variables, in which p < 0.05 was considered statistically significant.

RESULTS

The study included 1,993 students from secondary schools (48.9%) and high schools (51.1%), of which 47.5% were male and 52.5% were female. There were significant statistical differences in the pattern of use of SDs, addiction to SD use, stress, anxiety, and depression according to gender, school type, school performance, and sport engagement. In addition, there were positive correlations between students' addiction to SD use and stress, anxiety, and depression.

CONCLUSIONS

The findings suggest that excessive SD use is associated with addiction among secondary and high school students. In addition, levels of stress, anxiety, and depression differ according to the number of hours of SD use. Strategies should be developed at the community and school levels to avoid the overuse of SDs among school-aged students.

Depression and anxiety symptoms associated with internet gaming disorder before and during the COVID-19 pandemic: A longitudinal study

BACKGROUND

The coronavirus disease-2019 (COVID-19) pandemic has profoundly impacted aspects of human life globally. Playing videogames has been encouraged by several organizations to help individuals cope with the COVID-19 pandemic and associated restrictive measures. This longitudinal study was the first to examine gaming in the context of the pandemic and its association with depressive and anxiety symptoms.

METHODS

The sample comprised 1,778 children and adolescents (50.7% male) who were part of the Project of School Mental Health in Southwest China. Data were collected at two-time intervals: before the COVID-19 pandemic (October to November 2019 - [T1]) and during the COVID-19 pandemic (April to May 2020 - [T2]). Data were collected on perceived COVID-19 impacts, videogame use, Internet Gaming Disorder (IGD), and depressive and anxiety symptoms. Cross-lagged panel models were computed to examine longitudinal relationships.

RESULTS

The results indicated that both videogame use and IGD increased significantly for adolescents at T2. The cross-lagged panel model results suggested that depressive and anxiety symptoms at T1 positively predicted IGD and videogame use at T2 (especially for boys), but not inversely. Perceived COVID-19 impacts mediated the relationship between depressive and anxiety symptoms at T1 and IGD at T2.

CONCLUSION

Children and adolescents both increased videogame use at T2, but only adolescents significantly increased IGD severity at T2. The findings supported the compensatory hypothesis, and are consistent with the Interaction of Person-Affect-Cognition-Execution model as individual responses to COVID-19 may function as a mediator between personal predisposing variables and IGD.

Avatar identification and problematic gaming: The role of self-concept clarity

Some video-gaming activities feature customizable avatars that enable users to fulfil self-identity needs. Research evidence (e.g., fMRI and survey studies) has suggested that poorer self-concept and stronger avatar identification are associated with problematic gaming. Player-avatar relationships have thus been proposed to require attention in gaming disorder assessment and interventions. To examine the interplay of player-avatar interactions in problematic gaming, this study investigated whether avatar identification differed according to avatar characteristics and game types, and whether the association between avatar identification and problem gaming was mediated by self-concept clarity. A total of 993 adult respondents completed an online survey that assessed problematic gaming, avatar identification, and self-concept clarity. The results indicated that avatar identification scores were generally unrelated to avatar characteristics (e.g., human resemblance, degree of customizability, and in-game perspective). Avatar identification was significantly positively related to problematic gaming and significantly negatively related to self-concept clarity. There was a significant indirect relationship between avatar identification on problem gaming mediated through self-concept clarity. These findings suggest that poorer self-concept clarity may be one mechanism by which avatar identification affects problem gaming. Future research with clinical samples may help to gain a better understanding of avatar-related processes and psychological vulnerabilities related to problematic gaming.

Association Between Adolescent Internet Gaming and Adult Problematic Web-Based Board Gaming

Introduction: The results of studies comparing the characteristics of Internet gaming with those of Internet gambling have been controversial. We hypothesized that problematic web-based board gaming behaviors are associated with psychological and social interaction factors. We also hypothesized that non-problematic adolescent Internet gaming is a protective factor against problematic web-based board gaming and that problematic Internet gaming is a predictive factor for problematic web-based board gaming. Methods: We recruited 104 adults who reported engaging in web-based gaming. All participants were asked to complete the Problematic Web Board Gameplay Scale, Center for Epidemiologic Studies Depression Scale (CESD), State-Trait Anxiety Inventory (STAI), Adult Attention Deficit/Hyperactivity Disorder Self-Report Scale (K-AADHD), Family Environmental Scale (FES), Social Avoidance and Distress Scale (SADS), and questionnaires on their web-based board gaming patterns and Internet gaming history. Results: Problematic web-based board gamers showed a lower history of adolescent Internet gaming but a greater rate of problematic Internet gaming compared with healthy web-based board gamers. Moreover, problematic web-based board gamers showed an increase in CES-D, STAI, K-AADHD, and SADS scores but decreased FES scores compared with healthy web-based board gamers. Joblessness; less experience as an Internet gamer; a history of problematic Internet gaming; higher CES-D, STAI, and K-AADHD scores; and lower FES scores were significant predictors of problematic web-based board gaming. Discussion: Psychological, social, and environmental factors can positively influence problematic Web-based board gaming. Healthy Internet gaming during adolescence may play a preventive role in adult problematic web-based board gaming. However, because adolescent problematic Internet gaming tends to lead to problematic web-based board gaming, measures should be taken to prevent it.

The influence of depressive symptoms and fear of missing out on severity of problematic smartphone use and Internet gaming disorder among Chinese young adults: A three-wave mediation model

Internet gaming disorder (IGD) and problematic smartphone use (PSU) symptoms are associated with increased depression symptom severity across studies. The current study aimed to examine the fear of missing out (FoMO) as a possible mediator in this relationship. We employed a three-wave longitudinal design among 341 Chinese university students. Results indicated that depression severity was significantly related to increased symptoms of PSU and IGD symptoms. FoMO significantly mediated the linkage between depression and PSU severity. IGD symptoms also partially mediated the relation between FoMO and PSU severity. This longitudinal study demonstrates the key role of FoMO in the linkage between psychopathology symptoms and Internet-related overuse.

Attenuated self-serving bias in people with internet gaming disorder is related to altered neural activity in subcortical-cortical midline structures

BACKGROUND

To protect and maintain the positivity of self-concept, normal people usually show a self-serving bias (internal attribution of positive events and external attribution of negative events) by the motives of self-enhancement and self-protection. Additionally, self-serving assessments predominantly activate the subcortical-cortical midline structures (CMS) in healthy individuals. However, little is known about self-serving bias and its underlying neural correlates among individuals with Internet gaming disorder (IGD).

METHODS

Twenty-four participants with IGD and 25 recreational Internet gaming users (RGUs) were scanned while attributing the causes of positive/negative self- and other-related events that could occur in both the game-world and real-world contexts. Region-of-interest (within CMS regions) and parametric analysis were performed to investigate the neural correlates of self-serving bias in IGD.

RESULTS

Behaviorally, the IGD participants attributed more negative and fewer positive events to themselves than RGU participants in both contexts. Neurally, during the attributions of negative events, the IGD participants exhibited increased ventromedial prefrontal cortex (vmPFC) activation in both contexts compared with RGU participants. Higher vmPFC activation was associated with weaker self-protective motivation in the IGD group. Meanwhile, during the attributions of positive events, the IGD participants exhibited decreased precuneus/posterior cingulate cortex activation in the real world compared with RGU participants. Parametric analysis showed a reduced positive correlation between precuneus activation and self-attribution ratings of positive events in the real world in the IGD group relative to the RGU group.

CONCLUSION

These results suggest that individuals with IGD show an attenuated self-serving bias and altered brain activity within CMS regions involved in self-attribution, providing evidence for the negative self-concept and weakened abilities in both self-enhancement and self-protection in IGD.

Problematic internet use: A scoping review – longitudinal research on a contemporary social problem, 2006–2017

Background and aims:

Problematic internet use (PIU), and kindred concepts such as internet addiction (IA), make up a growing research field, partly due to the suggested inclusion of internet gaming disorder in a future DSM-6 as well as the fact that gaming disorder is on its way to being included in the ICD-11. Conclusions from research are far from unified. This study aims to synthesise the research field of problematic internet use/internet addiction/gaming disorder, with a focus on the reporting of prevalence and change.

Methods:

Longitudinal studies of PIU/IA formed the basis for a scoping review. Systematic searches of Web of Science, Scopus and Proquest, for peer-reviewed and published articles based on empirical data collected at a minimum of two time points for studies, and with an end point set at 2017, led to the inclusion of 97 studies. Endnote X7 was used to organise the results and NVivo 11 was used for synthesising the results.

Results:

Analyses focused on prevalence and change. Findings show variation among measures and prevalence as well as in reported outcomes relating to social life and other problems. Most studies reported relations between PIU/IA and other problems in life, but no specific time order could be established. Furthermore, many studies did not present data on prevalence or change even though using a longitudinal survey design.

Discussion and conclusions:

In summary, the research field is plagued by a lack of consensus and common understanding, regarding both measures, perceptions of the problem, and findings.

Proteus Effect Profiles: how Do they Relate with Disordered Gaming Behaviours?

Gamers represent themselves in online gaming worlds through their avatars. The term "Proteus Effect" (PE) defines the potential influences of the gamers' avatars on their demeanour, perception and conduct and has been linked with excessive gaming. There is a significant lack of knowledge regarding likely distinct PE profiles and whether these could be differentially implicated with disordered gaming. A normative group of 1022 World of Warcraft (WoW) gamers were assessed in the present study (Mean _age = 28.60 years). The Proteus Effect Scale (PES) was used to evaluate the possible avatar effect on gamers' conduct, and the Internet Gaming Disorder Scale-Short-Form was used to examine gaming disorder behaviors. Latent class profiling resulted in three distinct PE classes, 'non-influenced-gamers' (NIGs), 'perception-cognition-influenced-gamers' (PCIGs), and 'emotion-behaviour-influenced-gamers' (EBIGs). The NIGs reported low rates across all PES items. The PCIGs indicated higher avatar influence in their perception-experience but did not report being affected emotionally. The EBIGs indicated significantly higher avatar influence in their emotion and behaviour than the other two classes but reported stability in their perception of aspects independent of their avatar. Gaming disorder behaviours were reduced for the NIGs and progressively increased for the PCIGs and the EBIGs.

Avatar- and self-related processes and problematic gaming: A systematic review

The concept of self has become increasingly relevant to understanding the psychological mechanisms of problematic online gaming. Many gaming activities feature in-game avatars that enable the adoption of, and experimentation with, different roles and identities. Avatars enable players to compensate for perceived deficiencies in their real-world self (e.g., lack of physical strength, beauty, or social status). Currently, how avatar- and self-related processes may develop and maintain problematic gaming, including gaming disorder (GD), is unclear. This systematic review examined 18 quantitative studies of avatar- and self-related concepts and problematic gaming, including 13 survey-based and 5 neuroimaging studies. Despite variability in the conceptualization and measurement of avatar/self-related concepts, survey-based studies have consistently reported that negative self-concept, avatar identification, and large self-avatar discrepancies are significantly associated with problematic gaming. Poor self-concept appears to be a risk factor for GD, particularly for games that facilitate role-playing and identity formation. Further research and clinical evidence are needed to explain how avatar- and self-related processes may relate to the addictive mechanisms of GD (e.g., cognitive distortions, reward-seeking, inhibitory control, self-regulation systems), amid calls for problem gaming-related assessment and interventions to incorporate a focus on avatar identification.

Gaming disorder and internet addiction: A systematic review of resting-state EEG studies

Neurophysiological studies of Gaming Disorder (GD) and internet addiction (IA) are providing important insight into neurocognitive mechanisms underpinning these disorders, which will enable more accurate diagnostic classification. Electroencephalography (EEG) has been widely used to investigate addictive behaviours, and offers advantages of accessibility, low cost, and excellent temporal resolution. The present systematic review evaluates resting-state EEG studies in GD and IA. Papers (n = 7293) were identified in the PsychARTICLES, PsychINFO, Scopus, and Pubmed databases. Following inclusion/exclusion criteria, ten studies remained for evaluation. Results suggest individuals with GD have raised delta and theta activity and reduced beta activity, with coherence analysis suggesting altered brain activity in the mid-to-high frequency range. IA individuals demonstrate raised gamma activity and reduced beta and delta activity. Results suggest that the altered brain activity found in GD/IA may represent distinct underlying neurophysiological markers or traits, lending further support to their unique constructs. Results are also discussed in relation to relevant psychometric measurements and similar (higher frequency) activity found in substance addiction. Future research should focus on replicating the findings in a wider variety of cultural contexts to support the neurophysiological basis of classifying GD and IA.