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Coutelle R, Balzer J, Rolling J, Lalanne L. Problematic gaming, psychiatric comorbidities, and adolescence: A systematic review of the literature. Addict Behav 2024; 157:108091. [PMID: 38901145 DOI: 10.1016/j.addbeh.2024.108091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 06/09/2024] [Accepted: 06/12/2024] [Indexed: 06/22/2024]
Abstract
Problematic gaming is particularly prevalent in adolescent and young adult populations. While numerous studies have investigated the psychiatric comorbidities of Internet Gaming Disorder in young adults, few have focused specifically on adolescents who might be especially at risk because developmental particularities related to this developmental period. Here, we conducted a review of the literature, in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, in order to highlight the types of psychiatric comorbidities found in adolescents with problematic gaming.. We selected and analyzed 30 cross-sectional and longitudinal studies which correspond to 3683 adolescents (63,27% of boys) worldwide with problematic gaming. Our results highlight the high prevalence of Attention Deficit Hyperactivity Disorder (ADHD) in adolescents with problematic gaming and the links between this addiction and inattention, anxiety, depression, behavioural and emotional problems. These psychiatric comorbidities interact with problematic gaming and predict it throughout the adolescent's development. Moreover, this interaction involves personality profile and environment, including parental education. The complexity of this interaction argues in favor of the multi-level assessment that we are promoting.
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Affiliation(s)
- Romain Coutelle
- INSERM 1329, Team Psychiatry, Psychiatric Clinic, University Hospitals of Strasbourg, Federation of Medicine of Strasbourg, 67000 Strasbourg, France; Hôpital du Hasenrain, GHRMSA, 87 Avenue d'Altkirch, 68051 Mulhouse, France.
| | - Julie Balzer
- University Hospitals of Strasbourg, Department of Psychiatry, Child and Adolescent Psychiatry Service, Centre of Excellence STRAS&ND, 67000 Strasbourg, France.
| | - Julie Rolling
- University Hospitals of Strasbourg, Department of Psychiatry, Child and Adolescent Psychiatry Service, Centre of Excellence STRAS&ND, 67000 Strasbourg, France; Regional Center for Psychotraumatism Great East, Strasbourg University Hospital, Strasbourg, France; Medico-Psychological Emergency Unit, Strasbourg University Hospital, Strasbourg, France; Department of Psychiatry, Mental Health and Addictology, Strasbourg University Hospital, Strasbourg, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France.
| | - Laurence Lalanne
- University Hospitals of Strasbourg, Department of Addiction Medicine, 67000 Strasbourg, France; INSERM 1329, Team Addictions, Strasbourg Translational Neuroscience & Psychiatry Unit, CRBS, 1 Rue Eugène Boeckel, 67000 Strasbourg, France.
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Cross L, Belshaw F, Piovesan A, Atherton G. Game Changer: Exploring the Role of Board Games in the Lives of Autistic People. J Autism Dev Disord 2024:10.1007/s10803-024-06408-0. [PMID: 38967700 DOI: 10.1007/s10803-024-06408-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 07/06/2024]
Abstract
This mixed methods paper reports findings from three studies examining the overlap between autism and hobbyist board gaming. The first was a quantitative survey of over 1600 board gamers, showing that autistic individuals are overrepresented in this hobby compared to the general population and that autistic traits measured by the AQ are significantly elevated amongst board gamers. Study 1 also assessed gamers' motivations and preferences and reported key differences as well as similarities between autistic and non-autistic gamers. The second was a qualitative study that reported the results of 13 interviews with autistic individuals who are hobbyist board gamers. Using Interpretive Phenomenological Analysis (IPA), four key themes were uncovered, including a preference for systemising, escapism and passions, the social lubrication effect of games and difficulties with deception. In the third, 28 autistic individuals were introduced to board games in groups of 5-10 over an afternoon. Subsequent focus groups were then analysed using IPA. This analysis uncovered themes around how board games are challenging but encouraged growth and how they were an alternative vehicle for forging social relationships. Through this paper, we discuss how and why board games may be a popular hobby amongst the autistic population, and its potential utility for improving autistic wellbeing.
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Affiliation(s)
- Liam Cross
- Department of Psychology, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Francesca Belshaw
- Department of Psychology, Edge Hill University, Liverpool, L39 4QP, UK
| | - Andrea Piovesan
- Department of Psychology, Edge Hill University, Liverpool, L39 4QP, UK.
| | - Gray Atherton
- Department of Psychology, University of Plymouth, Plymouth, PL4 8AA, UK
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Charnock T, Drummond A, Hall LC, Sauer JD. The associations between autistic characteristics and microtransaction spending. Sci Rep 2024; 14:14068. [PMID: 38890438 PMCID: PMC11189550 DOI: 10.1038/s41598-024-64812-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 06/13/2024] [Indexed: 06/20/2024] Open
Abstract
Microtransactions provide optional, virtual, video game goods that, for an additional cost to the player, provide additional game content and alter the gameplay experience. Loot boxes-a specific form of microtransaction-offer randomised rewards in exchange for payment, and are argued to be structurally and psychologically similar to gambling. Nascent research suggests that a link exists between autism and both problematic gaming and problematic gambling. Here, we investigated the relationships between autistic characteristics and experiences, and excessive video gaming and microtransaction expenditure. A sample of 1178 adults from Australia, Aotearoa, and The United States were recruited from Prolific Academic, and completed a survey measuring in-game expenditure, autistic characteristics and experiences, problematic gaming, problematic gambling, and risky loot box use. Analyses showed positive associations between autistic characteristics and experiences with problematic gaming and problem gambling symptomatology. However, results also showed a small, negative association between autistic characteristics and experiences and spending on loot boxes when problem gambling symptoms, problematic gaming, and risky loot box use were statistically controlled for. These results suggest that autistic gamers may be vulnerable to problematic gaming and gambling, but that this effect does not extend to the purchasing of microtransactions.
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Affiliation(s)
- Tegan Charnock
- School of Psychological Sciences, University of Tasmania, Launceston, Australia
| | - Aaron Drummond
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Lauren C Hall
- Australian Institute of Health Service Management, University of Tasmania, Hobart, Australia
| | - James D Sauer
- School of Psychological Sciences, University of Tasmania, Launceston, Australia.
- School of Psychological Sciences, University of Tasmania, Hobart, Australia.
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Zajac K, Ginley MK, Kelly LM, Flori JN, Pfund RA. Tackling internet gaming disorder: what are the challenges in its treatment? Expert Rev Neurother 2024; 24:545-547. [PMID: 38720652 PMCID: PMC11152157 DOI: 10.1080/14737175.2024.2349819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Kristyn Zajac
- Calhoun Cardiology Center, University of Connecticut School of Medicine
| | | | - Lourah M. Kelly
- Department of Psychiatry, University of Massachusetts Chan Medical School
| | - Jessica N. Flori
- Calhoun Cardiology Center, University of Connecticut School of Medicine
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Davis K, Iosif AM, Nordahl CW, Solomon M, Krug MK. Video Game Use, Aggression, and Social Impairment in Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:3567-3580. [PMID: 35821547 PMCID: PMC10465670 DOI: 10.1007/s10803-022-05649-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
We used parent report data to investigate video game playing, aggression, and social impairment in adolescents with autism spectrum disorder. Parents of autistic adolescents were more likely to report that their child plays video games as a hobby compared to parents of adolescents with typical development and also reported that their children spent more time playing video games. For autistic participants, we found no differences in aggression levels or social impairment when comparing players versus non-players. However, playing video games "more than average," as compared to "average" was associated with greater aggression and greater social impairment on "awareness" and "mannerisms" subscales. Future studies should focus on how type of video game(s) played is associated with these clinically important variables.
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Affiliation(s)
- Konnor Davis
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California Davis, Sacramento, USA
| | - Christine Wu Nordahl
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA
- Imaging Research Center, University of California Davis, Sacramento, USA
| | - Marie K Krug
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA.
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, 95817, USA.
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Influence of an Esports Program on Problematic Gaming in Children with Autistic Spectrum Disorder: A Pilot Study. Behav Sci (Basel) 2022; 12:bs12060172. [PMID: 35735382 PMCID: PMC9220122 DOI: 10.3390/bs12060172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022] Open
Abstract
Esports (electronic sports) programs are a variant of competitive gaming and have expanded worldwide in recent years. The prevalence of problematic gaming and gaming disorders (GD) is predicted to increase in adolescents. Children with autism spectrum disorder (ASD) have a high rate of digital gaming use, and their characteristics, such as social communication deficits and restricted interests, might contribute to problematic gaming. In this study, we aimed to examine whether participation in an Esports program would lead to problematic gaming or GD in children with ASD. The Internet Gaming Disorder Test (IGD-20) scores, Kid-KINDL scores, and gaming time at home were assessed in eight children with ASD before beginning the Esports program and at the three-month follow-up timepoint. The program was held once a week at the welfare service center, where the participants played a set game for 60 min. The results indicated there was no significant worsening in any of the scores after the program. Our program provided the participation time and frequency of Esports, type of game, and motivation of the participants are adequately considered. Even though this pilot study is limited by the small sample size, we concluded that the risk of these activities leading to problematic gaming might be low.
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Yang N, Hurd PL, Crespi BJ. Why iPlay: The Relationships of Autistic and Schizotypal Traits With Patterns of Video Game Use. Front Psychol 2022; 13:767446. [PMID: 35282248 PMCID: PMC8905237 DOI: 10.3389/fpsyg.2022.767446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/10/2022] [Indexed: 11/16/2022] Open
Abstract
Video games are popular and ubiquitous aspects of human culture, but their relationships to psychological and neurophysiological traits have yet to be analyzed in social-evolutionary frameworks. We examined the relationships of video game usage, motivations, and preferences with autistic and schizotypal traits and two aspects of neurophysiology, reaction time and targeting time. Participants completed the Autism Quotient, Schizotypal Personality Questionnaire, a Video Game Usage Questionnaire, and two neurophysiological tasks. We tested in particular the hypotheses, motivated by theory and previous work, that: (1) participants with higher autism scores would play video games more, and participants with higher schizotypy scores would play video games less; and (2) autism and positive schizotypy would be associated with opposite patterns of video game use, preferences and motivations. Females, but not males, with higher autism scores played more video games, and exhibited evidence of relatively male-typical video game genre preferences and motivations. By contrast, positive schizotypy was associated with reduced video game use in both genders, for several measures of game use frequency. In line with previous findings, males played video game more than females did overall, preferred action video games, and exhibited faster reaction and targeting times. Females preferred Puzzle and Social Simulation games. Faster reaction and targeting times were associated with gaming motives related to skill development and building behavior. These findings show that gaming use and patterns reflect aspects of psychology, and gender, related to social cognition and imagination, as well as aspects of neurophysiology. More generally, the results suggest that video game use is notably affected by levels of autistic and schizotypal traits, and that video games may provide an evolutionarily novel medium for imaginative play in which immersive play experiences can be decoupled from social interaction.
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Affiliation(s)
- Nancy Yang
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Pete L. Hurd
- Department of Psychology, Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Bernard J. Crespi
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, Canada
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Requirements of a Group Intervention for Adolescents with Internet Gaming Disorder in a Clinical Setting: A Qualitative Interview Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157813. [PMID: 34360106 PMCID: PMC8345715 DOI: 10.3390/ijerph18157813] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/15/2021] [Accepted: 07/21/2021] [Indexed: 12/21/2022]
Abstract
Internet gaming disorder (IGD) has become an important health concern in a significant proportion of adolescents. Intervention studies in this age group are scarce, mostly follow quantitative designs, and rarely consider adolescents' experiences. This study aimed to evaluate the requirements for a group therapy program for adolescents with IGD. A qualitative interview study was conducted in a German clinic for addictive disorders in childhood and adolescence with nine participants (seven IGD patients (12-18 years, M = 15.86, SD = 1.95) and two psychotherapists). The semi-structured interviews addressed helpful contents, general conditions, and suggestions for alterations for an effective group intervention. Data were analyzed using content structuring qualitative analysis. Patient interview data resulted in 234 codings with eight main categories. Expert interview data yielded 151 codings with six main categories. The following treatment components were described as effective by the participants and experts: psychoeducation, emotion management, behavior analysis and modification, social skills training, parent participation, and relapse prevention. Additionally, adolescents emphasized the importance of group functionality for coherence, feedback and rewards, content presentation, physical activity and fun. The results are a valuable addition to findings from quantitative studies on IGD interventions and an interesting starting point for further representative studies.
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Normand CL, Fisher MH, Simonato I, Fecteau SM, Poulin MH. A Systematic Review of Problematic Internet Use in Children, Adolescents, and Adults with Autism Spectrum Disorder. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00270-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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