Depression and Disordered Gaming: Does Culture Matter?

Proteus effect avatar profiles: Associations with disordered gaming and activity levels

Gaming avatars can influence users' attitudes and behaviors and manifest as the proteus effect. The present study examined proteus effect profiles among 571 gamers and their associations with disordered gaming and physical activity. Latent class analysis identified three profiles: non-influenced gamers, emotion-perception influenced gamers (highest proteus effect), and emotion-behavior influenced gamers (moderate proteus effect). The high proteus effect group exhibited significantly higher gaming disorder symptoms at baseline and 6 months compared to other profiles. Proteus effect profiles did not significantly differ in physical activity levels. However, higher disordered gaming and proteus effect predicted lower activity over time. The strong proteus effect group's avatar immersion may increase gaming disorder risks. Minimal avatar influence for the non-influenced gamers appears protective. While proteus effect profiles do not directly relate to activity, amplified disordered gaming can reduce active lifestyles. Overall, findings demonstrate how avatars differentially affect gamers' experiences and functioning through proteus-induced changes.

Screened realities: a Grounded Theory exploration of gaming disorder dynamics among Iranian male adolescents

Introduction

The increasing prevalence of gaming Disorder (GD) among adolescents has become a global concern. Despite the rising number of studies investigating GD, the cultural and socio-economic factors influencing GD with a qualitative approach are scarce. This study aims to explore the underlying factors, processes, and consequences of GD among Iranian male adolescents and contextual factors related to GD within Iran's unique socio-cultural and psychological tapestry.

Methods

The study used a qualitative design based on the Grounded Theory Method (GTM). The researchers conducted semi-structured interviews with 13 male adolescents aged 15-18 who Dignasoed according to DSM-5 and ICD-11 criteria. The interviews were transcribed and analyzed using the GTM approach, which involves open, axial, and selective coding.

Results

The study revealed nine main themes and a core category: (1) interaction seeking, (2) encounter and familiarize with games, (3) games attraction, (4) Socialization, (5) game careerism, (6) dexterity, (7) lack and compensation, (8) physical harm, territorial-cultural barrier, (9) second life, and ''life crafting'' as the core category.

Discussion

The study's findings provide valuable insights into the cultural and socio-economic factors influencing GD among Iranian male adolescents. For example, Iran's economic conditions make adolescents choose gaming as their job and try to earn money in this way, which makes them more dependent on gaming. On the other hand, communities related to games play an essential role in the identity development of adolescents with GD.

Depression and stress are associated with latent profiles of problematic social media use among college students

Background

The previous literature has demonstrated that depression, anxiety, and stress are significant predictors of problematic social media use. However, the manifestation of problematic social media use varies, and the predictive relationship between depression, anxiety, and stress with different subgroups of problematic social media use remains unclear. The aim of this research was to evaluate latent subgroups of problematic social media use among college students and to investigate the impact of depression, anxiety, and stress on these latent subgroups.

Methods

A survey was carried out among college students in China using a cross-sectional approach. A total of 955 participants were included, with a mean age of 19.50 ± 1.22 years. Participants completed questionnaires containing the Bergen Social Media Addiction Scale (BSMAS) and the Depression, Anxiety, and Stress Scale-21 (DASS-21). The study employed latent profile analysis (LPA) to investigate latent subgroups of Chinese college students with problematic social media use, and a robust three-step approach was used to develop predictive regression mixed models of depression, anxiety, and stress on latent subgroups.

Results

Problematic social media use of Chinese college students can be categorized into four latent subgroups, namely, the high-risk group, the moderate-risk with pleasure group, the moderate-risk with compulsion group, and the low-risk group. The regression model showed that there was a significant difference between the high-risk group and the low-risk group on the stress scale. There was a significant difference between the moderate-risk with pleasure group and the moderate-risk with compulsion group on the depression scale.

Conclusion

Problematic social media use is heterogeneous, with depression and stress being potentially key factors influencing problematic social media use. Depression would make college students more likely to be moderate-risk with compulsion problematic social media users than moderate-risk with pleasure problematic social media users, and stress would make college students more likely to be high-risk problematic social media users than low-risk problematic social media users.

Gaming disorder: A summary of its characteristics and aetiology

The emergence, development, and maintenance of gaming disorder (GD) is the result of an interplay between gaming-related factors, individual factors, and environmental factors. None of these alone are sufficient to cause a disordered state, but it is the interactive co-occurrence of all these factors, which in some cases leads to GD. The goal of the present paper is to discuss in detail these three factors based on relevant and recent findings of the literature. Among gaming-related factors, we discuss online vs. offline videogames, the role of game genres, structural characteristics, game design elements, as well as some important monetization techniques. Among individual factors demographic risk factors, personality traits, motivational factors, comorbid psychopathology, genetic predisposition, and neurobiological processes are considered. Finally, among environmental factors we discuss family factors, early life experiences, the role of peers and school-related factors, as well as the broader context of culture including the popularity of esports.

The Online Flow Questionnaire: An Item Response Theory Examination

Online flow refers to the rate of an individual's absorbance in an Internet activity in which they are engaged. It has been implicated with both the effectiveness of cyberhealth and online education applications, as well as excessive Internet use. One way of assessing it is the Online Flow Questionnaire (OFQ). Consequently, this study investigated the optimum measurement of online flow, as well as OFQ cutoff points, using Item Response Theory (IRT). A large sample of high school students from Greece (N = 1579, M_age = 16.12, SD_age = 0.85; 50.5 percent females) completed the OFQ and the data were analyzed using IRT procedures. The analysis indicated that items in the OFQ possess differing levels of discrimination and difficulty, although all items were generally within acceptable ranges. An OFQ cutoff score of 5 represented an extremely high level of online flow experiences. The findings suggest that the OFQ generally functions as an acceptable marker of overall online flow. However, the current format of the OFQ appears to inhibit its ability to detect variability at the extreme low and high ends of the latent trait in the population assessed. Future revisions (potentially employing computerized adaptive tests) of the OFQ response format may enhance its utility.

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.

Psychometric Assessment and Gender Invariance of the Polish Version of the Gaming Disorder Test

In 2019, Gaming Disorder (GD) was officially recognised by the World Health Organization (WHO) as an official mental health disorder. Currently, the Gaming Disorder Test (GDT) is one of the most widely utilised psychometric tools to assess GD symptoms according to the WHO framework. In this context, the present study aimed to develop the Polish version of the GDT so that this tool can be used within the Polish cultural context. Additionally, the research aimed to ascertain the psychometric properties and appropriateness of the Polish GDT. To achieve this goal, the Polish GDT was investigated in terms of its validity, reliability, and gender measurement invariance through two studies. Accordingly, study 1 recruited a total of 675 gamers (340 female; Meanage = 31.74 years; SD = 7.75 years; range: 15-45 years) and study 2 comprised 575 gamers (275 female; M age = 29.45 years; SD = 4.25 years; range: 18-35 years). A Confirmatory Factor Analysis (CFA) was used to assess psychometric properties of the Polish GDT. The reliability was assessed using Cronbach's alpha, McDonald's omega, and Average Variance Extracted. Gender measurement invariance was investigated using multiple-group CFA, and the unidimensionality was tested using mean of item residual absolute loadings (MIREAL), explained common variance (ECV), and unidimensional congruence (UC). The results of the psychometric analysis showed that the Polish GDT had a one-factor structure. Additionally, the present study demonstrated that the Polish GDT exhibited adequate levels of convergent validity, reliability, and strict gender measurement invariance. These findings suggest that the Polish version of GDT is a suitable psychometric test to assess GD and facilitate research on GD.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-022-00929-4.

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.

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 Depression Anxiety Stress Scale 8-Items Expresses Robust Psychometric Properties as an Ideal Shorter Version of the Depression Anxiety Stress Scale 21 Among Healthy Respondents From Three Continents

To examine the cultural limitations and implications in the applicability of the Depression Anxiety Stress Scale 8-items (DASS-8)-a shortened version of the DASS-21 recently introduced in an Arab sample-this study evaluated its psychometric properties, including measurement invariance, among healthy subjects from the United States, Australia, and Ghana. Confirmatory factor analysis revealed good fit of the DASS-8 relative to a 12-item version (DASS-12). Both the DASS-8 and the DASS-12 were invariant at all levels across genders, employment status, and students vs. non-students. The DASS-8/DASS-12 also expressed invariance at the configural and metric levels across all countries, albeit scalar invariance was not maintained due to misspecification of the factor loadings in the Ghanian sample. Mann-Whitney U test revealed significantly lower levels of mental symptomatology on the DASS measures among Ghanian students than in English-speaking respondents (both students and non-students). The DASS-8 expressed excellent internal consistency (coefficient alpha = 0.89), good convergent validity-noted by high values of item-total correlations (r = 0.87 to 0.88), good predictive validity-indicated by significantly strong correlation with the DASS-21 and its subscales (r = 0.95 to 0.80), and adequate discriminant validity-indicated by heterotrait-monotrait ratio of correlations <0.85. The DASS-8 correlated with the Internet Gaming Disorder-9, the Adult attention-deficit/hyperactivity disorder Self-Report Scale, and the Individualism and Collectivism Scale/Culture Orientation Scale at the same level as the DASS-21 and the DASS-12, denoting its adequate criterion validity. The DASS-8 can be used as a brief alternative to the DASS-21 to screen for mental symptomatology in English-speaking and African cultures. However, the same scores on the DASS-8 and the DASS-12 may not always indicate the same level of symptom severity in subjects from different countries. Further inter-cultural evaluations of the DASS-8 are needed.

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.

Draconian policy measures are unlikely to prevent disordered gaming

In August of 2021, China imposed severe restrictions on children's online gaming time. We argue that such a policy may seem useful on the surface but does not reflect the current evidence concerning prevention of disordered gaming. Videogame play is normal for children worldwide, and like other leisure activities can lead to benefits for the majority and problems for a minority. Problematic or disordered play results from the interaction of multiple risk factors that are not addressed by draconian policy measures. Identifying these factors through stakeholder-engaged research and current evidence will be much more likely to succeed in preventing disordered gaming and promoting youth wellbeing.

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.

Symptoms of Internet Gaming Disorder, Inattention, and Impulsivity: a Cross-Sectional Study Conducted in the United Arab Emirates

The addictive use of internet video games is now recognized as a valid diagnostic construct by both the World Health Organization and the American Psychiatric Association. A burgeoning body of preliminary evidence points to a relationship between attention deficit and hyperactivity disorder (ADHD) symptoms as being a risk factor for behaviors indicative of internet gaming disorder (IGD), however, studies have rarely examined ADHD's two diagnostic constructs, inattention and impulsivity, separately. Moreover, IGD research is non-existent in Middle Eastern contexts. Therefore, this study examined, separately, the association of IGD with inattention and impulsivity in a sample of gamers from the United Arab Emirates. A cross-sectional survey was completed by 214 participants aged 18-33 years (m_age = 20.64, SD = 4.34) who completed measures of IGD and ADHD, and self-reported daily duration of gameplay as well as a number of demographic characteristics. The pair of hierarchical linear regressions indicated that both the examined constructs, increased symptoms of inattention and impulsivity, were separately associated with elevated risk for engagement in IGD behaviors. However, these associations were not moderated by gender. These results confirm that symptoms of ADHD are indeed associated with IGD and is the first to confirm the presence of this relationship in a Middle Eastern sample.

How Passion for Playing World of Warcraft Predicts In-Game Social Capital, Loneliness, and Wellbeing

Playing digital games can nurture wellbeing by helping players recover from daily stressors, cope with life's challenges, practice emotion regulation, and engage in meaningful social interaction; however, this same leisure activity can also result in problematic gaming (i.e., harmful play at the expense of healthy behaviors), and social isolation that damages wellbeing. Research consistently demonstrates that the value or harm of gaming on wellbeing cannot be determined solely from whether and how much people play, but rather depends on contingent factors related to the player, the game, and the gaming context. In this paper, we aim to model contingent factors that differentiate between beneficial and harmful outcomes within players of the same massively multiplayer online role playing game (MMORPG). We model how passion for gaming—defined as a strong desire to engage in a beloved activity that is enjoyed and valued, in which time and energy is invested, and that ultimately integrates into a person's identity—affects loneliness and wellbeing. We employ the dualistic model that divides passion into harmonious passion (HP)—characterized by a balanced and authentic relationship with the beloved activity, and obsessive passion (OP)—characterized by preoccupation and inflexible persistence toward the loved activity. We sampled 300 frequent World of Warcraft (WoW) players, recruited from online forums, and used structural equation modeling (SEM) to investigate the effects of their passion for playing WoW on in-game social capital, loneliness, and wellbeing. We demonstrate that HP for playing WoW facilitates in-game social capital (both bridging and bonding), combats loneliness, and increases wellbeing, whereas OP also builds social capital, but these social ties do not combat loneliness, and OP is directly associated with increased loneliness. Further, the positive effect of HP on wellbeing is mediated through an increase in bonding social capital and a resulting decrease in loneliness. Our findings highlight that passion orientation is important for characterizing the relationship between gaming and wellbeing. We contribute to the conversation on combating problematic gaming, while also promoting digital gaming as an appealing leisure activity that provides enjoyment, recovery, and meaningful social interaction for the millions of gamers who benefit from its captivation.

Measurement, Profiles, Prevalence, and Psychological Risk Factors of Problematic Gaming Among the Turkish Community: A Large-scale National Study

The present study investigated the prevalence, the potential different profiles, and the associated psychological factors of disordered gaming using data from a large-scale epidemiological study (TURBAHAR [Turkey’s Addiction and Mental Health Risk Profile Map Project]) carried out in Turkey in 2018 with 24,494 participants aged 18–81 years. Participants completed a comprehensive survey comprising a demographic questionnaire, Gaming Addiction Risk Questionnaire, Brief Symptom Inventory, Personal Well-Being Index Adult Form, Positive and Negative Affect Schedule, Toronto Alexithymia Scale, and Experiences in Close Relationships-Revised Scale. Latent class analysis showed the existence of eight different game profiles, which differed in relation to the intensity and specific features of the behavior. Results showed that 1.6% of the participants were problematic gamers. Being male, being younger, lower education level, being single, using alcohol and cigarettes, psychiatric distress, positive and negative affect, and anxious adult attachment were positively associated with problematic gaming.