A Systematic Review of the Co-occurrence of Gaming Disorder and Other Potentially Addictive Behaviors

Depression, anxiety, and stress in young adult gamers and their relationship with addictive behaviors: A latent profile analysis

BACKGROUND

There is limited research examining latent profiles of gamers based on emotional variables, which has implications for prevention efforts. The study sought to identify young adult gamer profiles based on depression, anxiety, and stress, and to examine differences between the latent profiles in other addictive behaviors (i.e., tobacco, alcohol, cannabis, illegal substance use, gaming, and gambling).

METHODS

A total of 1209 young adults (Mage = 19.37, SD = 1.62; 55.3%males) reported past-year gaming. A latent profile analysis (LPA) was performed to identify distinct profiles, and a set of ANOVA and chi-square analyses characterized the profiles in terms of sociodemographic, addictive behaviors, and emotional variables.

RESULTS

LPA suggested a three-profile solution: profile 1 (n = 660, 'low emotional distress'), profile 2 (n = 377, 'moderate emotional distress'), and profile 3 (n = 172, 'high emotional distress'). Participants with 'moderate' and 'high emotional distress' were mostly women, showed greater gaming severity, higher prevalence of past-month substance use (i.e., tobacco and illegal drugs), and greater consequences of alcohol use.

LIMITATIONS

The cross-sectional nature of the study and sample being university students.

CONCLUSION

Findings revealed three distinct profiles of gamers, which differed in emotional, gaming, and substance use severity. Transdiagnostic prevention programs have the potential to provide significant benefits to college students by addressing the core processes (e.g., emotion regulation) that underlie substance use and gaming.

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.

Understanding the Emergence of Comorbidity between Problematic Online Gaming and Gambling: A Network Analysis Approach

BACKGROUND/OBJECTIVES

Problematic online gaming and gambling tend to co-occur. The exact mechanisms underlying this phenomenon and the potential effects of gender differences remain unknown. This study aimed to identify the early clustering patterns of problematic online gaming and gambling in a community sample of young adults without a lifetime history of psychiatric treatment.

METHODS

Data were collected through an online survey and analyzed using partial correlations and Bayesian networks.

RESULTS

Altogether, 1441 individuals (aged 18-40 years, 51.4% females) participated in the survey. Both problematic online behaviors were weakly interrelated, suggesting that they serve as distinct constructs. Men's networks appeared to be more complex and had significantly higher global connectivity. Moreover, men and women differed with respect to the specific nodes that bridged both constructs. In men, the bridge nodes were "being criticized because of betting or being told about gambling problems", "loss of previous interests due to gaming", "deceiving other people because of gaming", and "health consequences of gambling". Among women, the bridge nodes were "feeling guilty because of gambling", "loss of previous interests because of gaming", "social consequences of gaming", and "continued gaming problems with other people". In men, the strongest edge was found between "borrowing money/selling anything to gamble" and "financial problems because of gambling", while in women, the strongest edge appeared between "betting more than afforded to be lost" and "tolerance symptoms of gambling".

CONCLUSIONS

The findings indicate that problematic online gaming and gambling tend to emerge in different ways among men and women. Therapeutic interventions should be planned considering gender differences.

Associations between Adverse Childhood Experiences and Gambling Severity in Youth Online Gamblers: The Mediating Roles of Internalizing, Attention and Externalizing Problems

BACKGROUND

This study examined the association between Adverse Childhood Experiences (ACEs) and Gambling Severity (gambling severity), considering the mediating roles of internalizing, externalizing, and attention among youth online gamblers.

METHODS

762 youth (agemean±SD= 15.03 ± 2.40; agerange = 10-18 years; 75.3% boys) completed the Persian Gambling Disorder Screening Questionnaire (GDSQ-P), Pediatric Symptom Checklist - Youth Report (Y-PSC), and Behavioral Risk Factor Surveillance System Questionnaire (ACE's section, modified by authors). The analysis was done using the SMART PLS software.

RESULTS

The reliability and discriminant validity of the provided model were assessed using Partial Least Squares-Structural Equation Modeling (PLS-SEM). According to the results of the PLS-SEM analysis, the present model demonstrated suitable levels of reliability and validity. Adverse Childhood Experiences (ACEs) significantly affected attention, internalizing, externalizing problems, and gambling severity. Additionally, the level of gambling was directly correlated with ACEs. Moreover, the indirect influence of the independent variable on the dependent variable via the mediators was found to be statistically significant (P < .001).These findings suggest that externalizing behaviors, attention problems, and internalizing symptoms mediate the effect of ACEs on gambling severity. Lastly, fitness indices indicated that our proposed model fit the data well (SRMR = 0.06, d_ULS = 1.15, Chi-square = 1291.461, and NFI = 0.71).

CONCLUSION

Our study found that ACEs significantly influence gambling severity among youth online gamblers, with internalizing, externalizing, and attention problems mediating this relationship. Practical implications include integrating ACE screening and targeted interventions for associated mental health issues into youth gambling prevention programs to mitigate the risk of problematic gambling behavior.

Co-occurrence of problematic facebook and video game use: prevalence and association with mental health disorders among adolescents

INTRODUCTION

The rapid proliferation of technology and its impact on adolescents' lives have raised concerns about addictive behaviors and its potential consequences, including behavioral and mental health problems. This study investigates the prevalence and risk factors associated with the co-occurrence of Problematic Facebook Use and Problematic Video game Use among Tunisian adolescents.

METHODOLOGY

We conducted a cross-sectional study in the urban area of Sousse governorate in Tunisia during the 2018/2019 school year. We selected a representative sample of high school students enrolled in public educational institutions in Sousse. Data collection was performed through a self-administered structured questionnaire, which gathered information on sociodemographic characteristics, lifestyle behaviors, and mental health disorders. Problematic Facebook Use was assessed using the validated Arabic version of the Bergen Scale, while Problematic Video Game Use was measured using the 21-point Lemmens Scale, which was translated into Arabic. Statistical analysis was carried out using the SPSS program (version 20).

RESULTS

We enrolled a total of 1342 high school students in our study, of whom, 63.2% were female with a mean age of 17.5 ± 1.44 years. The prevalence of Problematic Facebook Use and Problematic Video Game Use was  28.3% and  13% respectively. Regarding the co-occurrence of the two problematic behaviors, 31.3% of participants faced a singular addictive behavior, either related to problematic Facebook or video game use, while 5% had both addictive behaviors simultaneously. In a multivariate analysis, risk factors for the co-occurrence of Problematic Facebook and Video Game Use, in decreasing order of significance, included severe depression (AOR = 4.527; p = 0.003), anxiety (AOR = 4.216; p = 0.001), male gender (AOR = 4.130; p < 0.001), problematic internet use (AOR = 3.477; p = 0.006), as well as moderate depression (AOR = 3.048; p = 0.007).

CONCLUSION

Our study found that Problematic Facebook and Video Game Use were prevalent among Tunisian adolescents. The co-occurrence of these disorders is strongly linked to male gender, problematic internet use, depression, and anxiety disorders. These findings underscore the urgency of implementing tailored and effective awareness and prevention programs to address these emerging challenges.

Validation of the ACSID-11 for consistent screening of specific Internet-use disorders based on ICD-11 criteria for gaming disorder: A multitrait-multimethod approach

INTRODUCTION

With the inclusion of gaming disorder in the ICD-11, diagnostic criteria were introduced for this relatively new disorder. These criteria may be applied to other potential specific Internet-use disorders. The 11-item Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) was developed for consistent screening of gaming disorder, online buying-shopping disorder, online pornography-use disorder, social networks-use disorder, and online gambling disorder. This study tested the construct validity of the ACSID-11, including convergent and divergent measures.

METHODS

The ACSID-11 measures five behavioral addictions with the same set of items by following the principles of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ACSID-11 was administered to a convenience sample of active Internet users (N = 1597) together with validated and established measures of each specific Internet-use disorder along with screeners for mental health. Included are the Ten-Item Internet Gaming Disorder Test (IGDT-10), the Bergen Shopping Addiction Scale (BSAS), the Problematic Pornography Consumption Scale (PPCS), the Bergen Social Media Addiction Scale (BSMAS) and the Berlin Inventory of Gambling behavior - Screening (BIG-S). The ACSID-11 was compared convergently and divergently through a multitrait-multimethod approach along with contingency tables with the other Internet-use disorder screeners.

RESULTS

The multitrait-multimethod results shows that each behavior assessed with the ACSID-11 has moderate to strong correlations (r's from 0.462 to 0.609) with the scores of the corresponding established measures and, furthermore, positive correlations (r's from 0.122 to 0.434) with measures of psychological distress and further shows that the ACSID-11 can be used for a comprehensive assessment of different behaviors. The contingency tables reveal large divergences between the ACSID-11 and other screening instruments concerning the classification of problematic specific Internet use based on the given cut-off values.

CONCLUSION

The current work provides additional validation for the ACSID-11. Accordingly, this tool can be considered as reliable and valid for the simultaneous assessment of different Internet-use disorders: gaming disorder, online buying-shopping disorder, online pornography use disorder, social networks use disorder, and online gambling disorder. With a subsequent clinical validation of the scale and the proposed cut-off score, the ACSID-11 will be a thoroughly validated useful screening tool for clinical practice.

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 relationship between internet gaming disorder and psychotic experiences: cyberbullying and insomnia severity as mediators

BACKGROUND

The nature of the relationship between Internet Gaming Disorder (IGD) and psychosis is unclear so far. There is evidence that greater time spent in playing video games may expose players to both insomnia and a toxic online environment with widespread cyberbullying. These two possible consequences of IGD may, in turn, be associated with greater psychotic experiences (PE). Based on this theoretical framework, the present study proposed to contribute the body of the knowledge in this area, by testing the possible indirect effects of insomnia severity, cyber-victimization and cyberbullying in the cross-sectional association between IGD and PE in a sample of Tunisian university students.

METHOD

We conducted a cross-sectional study over 4 months (February-May 2022). The Arabic versions of the Brief Symptom Inventory, the Internet Gaming disorder-20 Test, the Insomnia Severity Index, and the Revised Cyber Bullying Inventory-II were administered to a total of 851 students (mean age = 21.26 ± 1.68 years, 53.7% females).

RESULTS

We found that 25% of students were at risk of IGD, and 1.8% had an IGD. The results of the mediation analysis showed that insomnia severity fully mediated the association between IGD and paranoid ideation. Higher IGD was significantly associated with more insomnia severity, which was, in turn, significantly associated with more paranoid ideation. Cyberbullying partly mediated the association between IGD and psychoticism. Higher IGD scores were significantly associated with more cyberbullying, which was, in turn, significantly associated with more psychoticism. Finally, greater IGD was significantly and directly associated with higher psychoticism.

CONCLUSION

Our findings suggest that insomnia and cyberbullying may be regarded as potential targets for youth mental health promotion, as well as community-focused prevention and early intervention in psychosis. More particular attention should be devoted to the huge potential for engaging in cyberbullying among online gamers. Sleep deprivation should be prevented, assessed and treated in heavy gamers.

Validation of the Thai Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) among young adults

BACKGROUND

The Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) is a consistent and comprehensive instrument to assess symptoms of specific internet-use disorders including those related to gaming, shopping, pornography use disorder, social networks use and gambling considering criteria in the eleventh revision of the International Classification of Diseases (ICD-11). However, to date, there is little evidence supporting instruments assessing major types of specific internet use disorders in Thailand. The aim of this present study was to assess the psychometric properties of the ACSID-11 among Thai young adults.

METHODS

A total of 612 participants were recruited. A confirmatory factor analysis (CFA) examined construct validity of the ACSID-11. Cronbach's α and McDonald's ω were used to assess reliability of the ACSID-11. Pearson correlations examined relationships between ACSID-11 domains and Internet Gaming Disorder Scale-Short Form (IGDS9-SF) scores.

RESULTS

The CFA supported validity of the Thai version of the ACSID-11 and a four-factor structure. Specific domains of the Thai ACSID-11, particularly gaming, were positively and significantly correlated with IGDS9-SF scores.

CONCLUSIONS

Data indicate that the Thai version of the ACSID-11 is a valid and reliable instrument to assess major types of specific internet use disorders. Additional studies are needed to further examine the validity and reliability of the Thai ACSID-11.

The eleven-item Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-11): Cross-cultural psychometric evaluation across 42 countries

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is an instrument to screen substance-use-related health risks. However, little is known whether the ASSIST could be further shortened while remaining psychometrically sound across different countries, languages, gender identities, and sexual-orientation-based groups. The study aimed to validate a shortened 11-item ASSIST (ASSIST-11). Using the International Sex Survey data, 82,243 participants (M age = 32.39 years) across 42 countries and 26 languages completed questions from the ASSIST-11 regarding gender identity, sexual orientation, and other information. Confirmatory factor analysis (CFA) and multigroup CFA (MGCFA) evaluated the ASSIST-11's structure and tested measurement invariance across groups. Cronbach's α and McDonald's ω were used to examine the internal consistency. Cohen's d and independent t-tests were used to examine known-group validity. The ASSIST-11 was unidimensional across countries, languages, age groups, gender identities (i.e., men, women, and gender-diverse individuals), and sexual orientations (i.e., heterosexual and sexual minority individuals). Cronbach's α was 0.63 and McDonald's ω was 0.68 for the ASSIST-11. Known-group validity was supported by Cohen's d (range between 0.23 and 0.40) with significant differences (p-values<0.001). The ASSIST-11 is a modified instrument with a unidimensional factor structure across different languages, age groups, countries, gender identities, and sexual orientations. The low internal consistency of the ASSIST-11 might be acceptable as it assesses a broad concept (i.e., use of several different substances). Healthcare providers and researchers may use the ASSIST-11 to quickly assess substance-use information from general populations and evaluate the need to follow up with more detailed questions about substance use.

High-Risk Gaming Is Associated with Frequent Substance Use: An Exploratory Survey among Young Adults

INTRODUCTION

Internet gaming disorder (IGD) is an emerging condition within the field of behavioural addictions. IGD has been demonstrated to be highly comorbid with many other mental health disorders. Among these, substance use has been associated with IGD, and there are underlying similarities between behavioural addictions and substance use disorders. The main aims of the present study were (i) to investigate the association between high-risk gaming and substance use among young adults drawn from the general Italian population; and (ii) to explore the psychopathological correlates of high-risk gaming.

METHODS

Lifetime substance use, type of substances consumed, and frequency of use were investigated through an online survey in a sample of 913 adults aged 18-40 years. High-risk gaming was assessed using the ten-item Internet Gaming Disorder Test (IGDT-10). Psychopathology was assessed using the Revised 90-item Symptom Checklist (SCL-90-R).

RESULTS

High-risk gaming prevalence rate was 4.4%. High-risk gamers scored higher on all dimensions of psychopathology, confirming the association between high-risk gaming and psychiatric distress. Regarding substance use, high-risk gamers were more commonly polysubstance users and more commonly made use of psychodysleptic substances. High-risk gamers were more commonly frequent substance users, and 32.5% of high-risk gamers used or had used psychoactive substances often or everyday throughout their lives.

DISCUSSION AND CONCLUSION

The findings are in line with the concept of a common neurobiological vulnerability for both gaming and substance use. There is the need for more research to examine the phenomenology of gaming and its interplay with substance use to help develop effective interventions and prevention strategies.

Risk and protective factors for (internet) gaming disorder: A meta-analysis of pre-COVID studies

This large-scale meta-analysis aimed to provide the most comprehensive synthesis to date of the available evidence from the pre-COVID period on risk and protective factors for (internet) gaming disorder (as defined in the DSM-5 or ICD-11) across all studied populations. The risk/protective factors included demographic characteristics, psychological, psychopathological, social, and gaming-related factors. In total, we have included 1,586 effects from 253 different studies, summarizing data from 210,557 participants. Apart from estimating these predictive associations and relevant moderating effects, we implemented state-of-the-art adjustments for publication bias, psychometric artifacts, and other forms of bias arising from the publication process. Additionally, we carried out an in-depth assessment of the quality of underlying evidence by examining indications of selective reporting, statistical inconsistencies, the typical power of utilized study designs to detect theoretically relevant effects, and performed various sensitivity analyses. The available evidence suggests the existence of numerous moderately strong and highly heterogeneous risk factors (e.g., male gender, depression, impulsivity, anxiety, stress, gaming time, escape motivation, or excessive use of social networks) but only a few empirically robust protective factors (self-esteem, intelligence, life satisfaction, and education; all having markedly smaller effect sizes). We discuss the theoretical implications of our results for prominent theoretical models of gaming disorder and for the existing and future prevention strategies. The impact of various examined biasing factors on the available evidence seemed to be modest, yet we identified shortcomings in the measurement and reporting practices.

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 eSports Medicine: Pre-Participation Screening and Injuries Management-An Update

Recently, electronic sports (eSports) became one of the growing forms of new media due to the wide diffusion of games and online technologies. Even if there is still a debate about the definition and characterization of eSports, eAthletes train heavily, compete in tournaments, must abide by competition, association, and governing body rules, just like all other athletes. Furthermore, as in any other competitive discipline, there can be injuries. Aberrant sitting posture, repetitive movements, screen vision, prolonged playing hours, and a sedentary lifestyle can lead to several medical hazards in musculoskeletal, ophthalmology, neurological, and metabolic systems. Moreover, several cardiovascular changes occur in eAthletes. This paper aims to explore the different injuries that can occur in a professional eAthlete, suggesting how every high-level gamer could benefit from a pre-participation evaluation and a correct injury prevention strategy.

A randomized controlled trial to assess effectiveness of GamE- an e-Health intervention to self-manage gaming with an aim to prevent gaming disorder

Gaming disorder is a health concern associated with significant impairment. Digital technology can be helpful for implementing preventive measures for gaming disorder. This randomized trial aimed to assess the effectiveness of an e-Health intervention to prevent gaming disorder among college students. This randomized trial compared an online intervention module aimed at improving knowledge, skill and attitude of the students and empower them with self- help strategies to monitor and regulate their gaming behavior with an aim to prevent gaming disorder, with wait list control. The sample comprised of 30 cases and 33 controls. The understanding of the concept of gaming, understanding of difference between gaming and gaming disorder, understanding of adverse effects associated with gaming disorder, understanding of screening of gaming disorder and self-help techniques of regulating gaming disorder increased more in the intervention group than control. The participants most favored self-monitoring and strategies to promote healthy lifestyles for regulating gaming. Online digital intervention can be effectively used as a strategy to prevent gaming disorder among college students. Such an intervention can empower students with strategies to regulate their extent of gaming.

The Practice and Feasibility of Screening, Treatment, and Referral for Gaming Problems in Gambling, Alcohol and Other Drugs, and Youth Services

Screening, brief intervention, and referral to treatment (SBIRT) is a comprehensive approach to identifying people at risk of addiction, but its feasibility for gaming disorder is unknown. This study surveyed 88 clinicians from gambling, alcohol and other drugs, and youth services in New Zealand. Results indicated that the most frequent GD screening method was an unstructured interview (61%), but 74% stated they would use a standardized tool if available. Responsivity to the detection of GD was an immediate intervention (84%), and rates of referral were low (28%). Around 50% of clinicians indicated high confidence in administering motivational approaches and relapse prevention. There was strong support for screening training (85%), treatment guidelines (88%), self-help materials (92%), and access to internet-delivered CBT that could be used in conjunction with other treatment (84%). Clinicians appear motivated and willing to implement SBIRT for GD but report lacking necessary training and resources, including access to screening tools and treatment guidelines.

Co-occurrence of Common Biological and Behavioral Addictions: Using Network Analysis to Identify Central Addictions and Their Associations with Each Other

The present study used network analysis to examine the network properties (network graph, centrality, and edge weights) comprising ten different types of common addictions (alcohol, cigarette smoking, drug, sex, social media, shopping, exercise, gambling, internet gaming, and internet use) controlling for age and gender effects. Participants (N = 968; males = 64.3%) were adults from the general community, with ages ranging from 18 to 64 years (mean = 29.54 years; SD = 9.36 years). All the participants completed well-standardized questionnaires that together covered the ten addictions. The network findings showed different clusters for substance use and behavioral addictions and exercise. In relation to centrality, the highest value was for internet usage, followed by gaming and then gambling addiction. Concerning edge weights, there was a large effect size association between internet gaming and internet usage; a medium effect size association between internet usage and social media and alcohol and drugs; and several small and negligible effect size associations. Also, only 48.88% of potential edges or associations between addictions were significant. Taken together, these findings must be prioritized in theoretical models of addictions and when planning treatment of co-occurring addictions. Relatedly, as this study is the first to use network analysis to explore the properties of co-occurring addictions, the findings can be considered as providing new contributions to our understanding of the co-occurrence of common addictions.

Emotion dysregulation mediates the relationship between adverse childhood experiences and problematic gaming

Gaming disorder (i.e., gaming addiction) is a relatively common mental health disorder with a worldwide prevalence rate of 3.05%. In the present research, we examined whether emotion dysregulation mediates the relation between adverse childhood experiences and problematic gaming in two samples of current video game players. The first sample consisted of 1,262 students recruited from five universities across Canada. The second sample comprised 417 community adults residing in Canada. Both samples of participants completed an online survey which included measures of adverse childhood experiences, problematic gaming, and emotion dysregulation. A total of 45.64% (n = 576) in the university sample and 49.76% (n = 205) in the community sample met the threshold for problematic gaming. In the student sample, adverse childhood experiences were positively associated with problematic gaming. In contrast, there was no significant association between adverse childhood experiences and problematic gaming in the community sample. In both samples, adverse childhood experiences were positively associated with emotion dysregulation, and emotion dysregulation was positively associated with problematic gaming. Importantly for the present research, emotion dysregulation mediated the relationship between adverse childhood experiences and problematic gaming in both the university and community sample. Although adverse childhood experiences are distal and static risk factors for problematic gaming, emotion dysregulation is a more proximal and modifiable risk factor. The results suggest that increasing adaptive emotion regulation skills may decrease the risk of problematic gaming among individuals who have experienced an adverse childhood experience.

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.

Between- and within-person associations of mobile gaming time and total screen time with sleep problems in young adults: Daily assessment study

OBJECTIVES

To explore associations of screen time (total, mobile gaming) with sleep problems in Chinese young adults.

METHODS

This was a 4-week daily morning (completion rate = 82.1%, 909/1107) and evening (completion rate = 92.4%, 1061/1148) assessment study in 41 university students (22 female, mean age = 22.3 [SD 4.2] years). Short sleep duration < 7 h, difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, and any of these three insomnia symptoms were self-reported in the morning. Mobile gaming time was self-reported in the evening, whilst total screen time was objectively tracked. Bayesian multilevel mixed-effects modeling disaggregated between- and within-person associations.

RESULTS

Between person, longer mobile gaming time predicted short sleep duration (adjusted odds ratio [AOR] = 1.90, 95% CI 1.39, 2.69), any insomnia symptoms (AOR = 1.59, 95% CI 1.20, 2.11), difficulty initiating sleep (AOR = 3.05, 95% CI 1.51, 6.24), and difficulty maintaining sleep (AOR = 2.19, 95% CI 1.18, 3.74). Short sleep duration (adjusted b = 0.99, 95% CI 0.05, 1.95), any insomnia symptoms (adjusted b = 1.19, 95% CI 0.24, 1.94), and difficulty initiating sleep (adjusted b = 1.72, 95% CI 0.11, 3.19) reversely increased mobile gaming time. Within person, any insomnia symptoms (adjusted b = 0.17, 95% CI 0.04, 0.31) and early morning awakening (adjusted b = 0.28, 95% CI 0.08, 0.48) increased next-day mobile gaming time. Total screen time was not associated with sleep problems both between and within person.

CONCLUSIONS

Bidirectional between-person associations of mobile gaming time with short sleep duration and insomnia symptoms informed multiple-health-behavior-change interventions. Unidirectional within-person associations of insomnia symptoms with next-day mobile gaming time informed just-in-time adaptive interventions addressing daily variations in insomnia symptoms. [250/250 word limits].

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.

Content and Effectiveness of Web-Based Treatments for Online Behavioral Addictions: Systematic Review

BACKGROUND

Very few people seek in-person treatment for online behavioral addictions including gaming and gambling or problems associated with shopping, pornography use, or social media use. Web-based treatments have the potential to address low rates of help seeking due to their convenience, accessibility, and capacity to address barriers to health care access (eg, shame, stigma, cost, and access to expert care). However, web-based treatments for online behavioral addictions have not been systematically evaluated.

OBJECTIVE

This review aimed to systematically describe the content of web-based treatments for online behavioral addictions and describe their therapeutic effectiveness on symptom severity and consumption behavior.

METHODS

A database search of MEDLINE, Embase, PsycInfo, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar was conducted in June 2022. Studies were eligible if the study design was a randomized controlled trial or a pre-post study with at least 1 web-based intervention arm for an online behavioral addiction and if the study included the use of a validated measure of problem severity, frequency, or duration of online behavior. Data on change techniques were collected to analyze intervention content, using the Gambling Intervention System of CharacTerization. Quality assessment was conducted using the Effective Public Health Practice Project Quality Assessment Tool.

RESULTS

The review included 12 studies with 15 intervention arms, comprising 7 randomized controlled trials and 5 pre-post studies. The primary focus of interventions was gaming (n=4), followed by internet use inclusive of screen time and smartphone use (n=3), gambling (n=3), and pornography (n=2). A range of different technologies were used to deliver content, including websites (n=6), email (n=2), computer software (n=2), social media messaging (n=1), smartphone app (n=1), virtual reality (n=1), and videoconferencing (n=1). Interventions contained 15 different change techniques with an average of 4 per study. The techniques most frequently administered (>30% of intervention arms) were cognitive restructuring, relapse prevention, motivational enhancement, goal setting, and social support. Assessment of study quality indicated that 7 studies met the criteria for moderate or strong global ratings, but only 8 out of 12 studies evaluated change immediately following the treatment. Across included studies, two-thirds of participants completed after-treatment evaluation, and one-quarter completed follow-up evaluation. After-intervention evaluation indicated reduced severity (5/9, 56%), frequency (2/3, 67%), and duration (3/7, 43%). Follow-up evaluation indicated that 3 pre-post studies for gaming, gambling, and internet use demonstrated reduced severity, frequency, and duration of consumption. At 3-month evaluation, just 1 pre-post study indicated significant change to mental health symptoms.

CONCLUSIONS

Web-based treatments for online behavioral addictions use an array of mechanisms to deliver cognitive and behavioral change techniques. Web-based treatments demonstrate promise for short-term reduction in symptoms, duration, or frequency of online addictive behaviors. However, there is limited evidence on the effectiveness of web-based treatments over the longer term due to the absence of controlled trials.

Cross-Addiction Risk Profile Associations with COVID-19 Anxiety: a Preliminary Exploratory Study

"Cross-addiction" involves a person substituting one form of addictive behaviour for another. Indeed, cross-additive presentations have been frequently described (e.g. from drugs to alcohol, gambling to sex), and risk profiles have been assumed. Nevertheless, there has been a dearth of evidence considering the occurrence of cross-addiction risk profiles in the community. This research is imperative for informing effective prevention/intervention policies, especially under anxiety-provoking conditions, such as the current coronavirus pandemic. To address this need, a cross-sectional exploratory research design was utilized, with quantitative survey data obtained from 968 respondents (18-64; M age  = 29.5 years, SD = 9.36), who completed an online survey regarding a range of addictive behaviours (i.e. abuse of alcohol, drug, smoking, online gaming, shopping, internet, exercise, online gambling, sex, and social media) and their anxiety about the coronavirus. Latent class/profiling analyses were implemented to (a) explore profiles of cross-addiction risk, (b) describe the characteristics and the proportions of these profiles, and (c) identify their differential associations with the pandemic precipitated anxiety. Findings revealed two distinct profiles/types, the "cross-addiction low risk" (57.4%) and the "cross-addiction high risk" (42.6%). Those in the latter scored consistently higher across all behaviours assessed, were more likely to suffer from concurrent addictive problems, and reported significantly higher levels of pandemic-related anxiety. Implications for prevention, assessment, and treatment and future research are discussed.

Food Addiction and Emotional Eating Behaviors Co-Occurring with Problematic Smartphone Use in Adolescents?

Addiction in adolescence is increasing and has a significant impact on physical and mental health. Notably, addictions can be comorbid and affect each other. Despite the recent growing interest in food addiction (FA) and problematic smartphone use (PSU), few studies have investigated their association in adolescents. We investigated the relationship between FA and PSU in adolescents and the effects of eating behaviors. A total of 209 adolescents (44.5% male; mean age = 12.86 ± 0.7 years) participated in the current school-based community study. We found a positive correlation between the dimensional Yale Food Addiction Scale for Children 2.0 (dYFAS-C2.0) and the Smartphone Overdependence Scale after adjusting for age, sex, body mass index, and socioeconomic status. The high-risk PSU group accounted for 17.2% of participants. Furthermore, this group showed 2.3 times higher dYFAS-C2.0 scores than the general group. Emotional overeating and satiety responsiveness were correlated with PSU. A comprehensive evaluation of addiction symptoms is needed for proper intervention, especially in adolescents with symptoms of abnormal eating behaviors.

Assessment of Criteria for Specific Internet-use Disorders (ACSID-11): Introduction of a new screening instrument capturing ICD-11 criteria for gaming disorder and other potential Internet-use disorders

Background and aims

With the inclusion of gaming disorder in the ICD-11, diagnostic criteria were introduced for this relatively new disorder. These criteria may also be applied to other potential specific Internet-use disorders, which may be classified in ICD-11 as other disorders due to addictive behaviors, such as online buying-shopping disorder, online pornography-use disorder, social-networks-use disorder, and online gambling disorder. Due to the heterogeneity in existing instruments, we aimed to develop a consistent and economic measure of major types of (potential) specific Internet-use disorders based on ICD-11 criteria for gaming disorder.

Methods

The new 11-item Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) measures five behavioral addictions with the same set of items by following the principles of WHO's ASSIST. The ACSID-11 was administered to active Internet users (N = 985) together with an adaptation of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and screeners for mental health. We used Confirmatory Factor Analyses to analyze the factor structure of ACSID-11.

Results

The assumed four-factorial structure was confirmed and was superior to the unidimensional solution. This applied to gaming disorder and to the other specific Internet-use disorders. ACSID-11 scores correlated with IGDT-10 as well as with the measures of psychological distress.

Discussion and Conclusions

The ACSID-11 seems to be suitable for the consistent assessment of (potential) specific Internet-use disorders based on ICD-11 diagnostic criteria for gaming disorder. The ACSID-11 may be a useful and economic instrument for studying various behavioral addictions with the same items and improving comparability.

Risk Factors for Excessive Social Media Use Differ from Those of Gambling and Gaming in Finnish Youth

Purpose: Adolescents’ excessive social media use has characteristics similar to other addictive behaviours. This study aims to explore whether the same risk factors are associated with excessive social media use as with excessive gaming and gambling among Finnish adolescents. Methods: Multinomial logistic regression analyses were carried out using the European School Survey Project on Alcohol and Other Drugs data, collected from Finnish adolescents aged 15–16 in 2019 (n = 4595). Results: Excessive use of social media was more common among girls (reported by 46% of respondents) than boys of the same age (28%), whereas boys reported both excessive gaming (23%) and gambling (6%) more often than girls (4% and 1%, respectively). All differences between genders were statistically significant (p < 0.0001). Daily smoking was associated with a high risk of excessive gambling (AOR = 3.23) and low risk of excessive gaming (AOR = 0.27) but had no significant effect on excessive social media use. Cannabis use in the past 12 months was positively associated only with excessive gambling (AOR = 2.39), while past 12 months alcohol consumption increased the risk for excessive social media use (AOR = 1.25). Conclusions: Adolescent girls are at greater risk of excessive social media use than boys, while boys are at greater risk of excessive gaming and gambling. The associations with known risk factors are somewhat different for excessive use of social media as compared to excessive gambling and gaming and should be acknowledged when developing preventive measures for adolescents.

Association of Internet gaming disorder symptoms with anxiety and depressive symptoms and substance use: an international cross-sectional study

Background

Problematic Internet gaming is an increasingly recognized global mental health problem. This multicultural cross-sectional study examined the association between Internet gaming disorder (IGD) symptoms and anxiety and depressive symptoms and substance use within a sample of young Internet users. In total, 3529 college/university students (1260 (35.7%) males; mean age 21 ± 3 years) were surveyed online. We assessed online gaming patterns using the Internet Gaming Disorder Self-report for College/University Students (ICMH-IGD), symptoms of depression using the Patient Health Questionnaire-9, and symptoms of anxiety using the Generalized Anxiety Disorder scale-7.

Results

IGD symptoms were associated with symptoms of depression, anxiety, and substance use, independent of time spent online, psychiatric diagnosis, culture, or sociodemographic characteristics. For males, more significant IGD symptoms were associated with more extended Internet browsing per day time and higher levels of anxiety and depressive symptoms, while for females, with more extended Internet browsing per day time, marihuana use, and higher levels of depressive symptoms.

Conclusions

Our study found that more overt symptoms of IGD were associated with higher levels of anxiety and depressive symptoms and substance use. Still, these associations differed among males and females, suggesting that gender differences should be considered when planning specific treatments.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43045-022-00180-6.

Investigating the Role of Health Factors and Psychological Well-Being in Gaming Disorder

The recent recognition of Gaming Disorder (GD) as a mental health issue has provided a unique opportunity for researchers to advance our current understanding of the intricate relationships between GD and specific health-related factors and well-being. This study sought to investigate the role of key physical and psychological health and well-being factors in GD. To achieve this, three goals were explored. First, we tested whether GD can be predicted by health and well-being factors such as depression, anxiety, loneliness, attention problems, physical health problems (PHP), and psychological well-being (PWB). Second, we assessed the role of distress tolerance (DT) as a moderator in the relationship between PWB and GD. Third, we examined whether PWB would mediate the relationship between PHP and GD. A sample of 474 participants (Mean_age = 28.86 years; SD = 9.23; range: 18-66 years; 47 percent female) were recruited. The results of the multiple linear regression analysis indicated that age, attention problems, and PHP significantly predicted GD (R² = 0.15). In addition, the mediation findings uncovered an important direct association between PHP and GD despite the lack of mediation effects through PWB and the absence of moderating effects from DT. The present findings signify important health-related implications related to GD that are further discussed here in terms diagnosis, treatment, and prevention efforts.

Psychometric evaluation of the Russian version of the Gaming Disorder Scale for Adolescents

Problematic gaming has become an emerging global health issue. Formal recognition of gaming disorder in the ICD-11 is a new opportunity for the discipline to conduct further investigation concerning the psychological consequences of problematic gaming. The present study investigated the psychometric properties and construct structure of the recently developed Gaming Disorder for Scale for Adolescents (GADIS-A), a multi-dimensional instrument that screens for gaming disorder symptoms, among Russian adolescent gamers. The sample comprised 933 adolescent gamers (547 boys and 386 girls) recruited via a web-based platform, using a multistage sampling method. Analysis showed the GADIS-A had very good internal consistency (Cronbach's alpha coefficient = .891; Composite reliability = .89) and adequate test-retest reliability after two weeks (intraclass coefficient  =0.68 with 95% CI [0.61, 0.77]. Exploratory structural equation modeling (ESEM) showed the data fitted well. Measurement invariance testing indicated the GADIS-A was invariant by gender and gaming medium (online vs. offline). As for criterion-related validity, high scores on the GADIS-A positively correlated with scales assessing depression, anxiety, impulsivity, and difficulties in emotion regulation, and negatively correlated with social connectedness and life satisfaction. Using latent profile analysis, four groups of gamers were identified, and problematic gaming was associated with greater mental health problems. The findings indicated that psychological comorbidity (e.g., depression and anxiety) was more prevalent among gamers with higher risk of GD. The findings indicate that GADIS-A is a reliable and valid instrument to assess the symptoms and severity of gaming disorder among Russian adolescents.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-021-02575-w.

Polysubstance Use Is Positively Associated with Gaming Disorder Symptom Severity: A Latent Class Analytical Study

INTRODUCTION

The link between gaming disorder (GD) and substance use amongst adolescents is not clear. Some studies reported positive associations, whereas others suggested that alcohol and illicit drug use are not related to GD severity.

OBJECTIVES

The present study aimed to identify empirically based latent classes of alcohol and illicit drug use amongst adolescents and explore their associations with GD symptom severity and whether endorsement of specific criteria of GD is linked to the membership of latent classes of alcohol and illicit drug use.

METHODS

Data of the national sample of Hungarian adolescents from the Health Behaviour in School-aged Children survey (N = 2,768; females: 52.08%; mean age: 16.73 years) were analysed. Measures for frequency of alcohol and illicit drug use, gaming, GD symptom severity, and life satisfaction were included in the analyses.

RESULTS

Latent class analysis discriminated 4 subgroups of alcohol and illicit drug use: polysubstance users, high-risk alcohol users, moderate alcohol users, and infrequent substance users. Polysubstance users presented significantly higher levels of GD symptom severity and higher odds for endorsement of criteria of "giving up other activities" and "negative consequences."

CONCLUSIONS

Positive associations were shown between higher GD severity and the polysubstance using class. The roles of criteria of "giving up other activities" and "negative consequences" were highlighted in more severe substance use patterns. However, GD severity and criteria did not differ as a function of the level of alcohol use. These findings may imply common roots of GD and illicit drug use in adolescents.

Diminished cognitive control in Internet gaming disorder: A multimodal approach with magnetic resonance imaging and real-time heart rate variability

OBJECTIVE

Recently, the addiction to online games, classified as Internet gaming disorder (IGD) on DSM-V, has emerged as an important mental health problem. The loss of control over gaming in IGD is associated with diminished cognitive control. This study aimed to link the neurobiological mechanism reflected by brain imaging and the diminished cognitive control reflected by heart rate variability (HRV) measurements during real-time gameplay.

METHODS

HRV was assessed in 33 young males with IGD and 29 controls while playing their favorite games. Seed-based functional connectivity (FC) was evaluated in the dorsolateral prefrontal cortex, anterior cingulate cortex, and dorsal striatum. Associations between HRV and alterations in FC were tested.

RESULTS

Individuals with IGD showed a reduction of high-frequency HRV during real-time gaming, which is correlated with self-reported severity of IGD. Subjects with IGD showed decreased FC between the right dorsolateral prefrontal cortex and the right inferior frontal gyrus, corresponding to the cognitive control network. They showed decreased FC between the right anterior cingulate cortex and the superior parietal lobule. They also showed increased FC between the left dorsal putamen and the postcentral gyrus, corresponding to the sensorimotor network. Game-related high-frequency HRV was correlated with dorsolateral prefrontal cortex-inferior frontal gyrus connectivity.

CONCLUSION

The diminished cognitive control reflected by HRV measurements during real-time gameplay was associated with FC alterations, involving a weak FC in the cognitive control network. Individuals with IGD may have less cognitive control, particularly when playing games, and consequently end up playing games in a habitual manner rather than in a goal-oriented manner.

Money used in gaming is associated with problem gambling: Results of the ESPAD 2019 Finland

BACKGROUND AND AIMS

The convergence of gaming and gambling may pose a risk for adolescents. Thus, it is important to find out how these behaviours are associated with other addictive behaviours in order to develop efficient preventive measures for youth. The aim of this study was to examine 1) whether problematic gaming and money used for gaming activities are risk factors for gambling, and 2) what kind of impact adolescents' substance use along with other factors related to friends and parents have on this association.

METHODS

The European School Survey Project on Alcohol and Other Drugs data, 2019 of Finnish adolescents aged 15 to 16 (N = 4595). Cross-tabulations with Rao-Scott's chisquare tests were applied to study the associations of the background factors with gambling in the past 12 months. A multinomial logistic regression model was fitted for the outcome variable (gambling in the past 12 months) adjusted for all independent and background variables.

RESULTS

Problematic gaming alone was not associated with gambling participation, whereas using money for digital games increased the risk of gambling. Boys gamble more than girls. The use of alcohol and drugs increased the risk of gambling. Parental monitoring reduced the risk of gambling, whereas hanging around weekly with friends increased the risk.

DISCUSSION AND CONCLUSIONS

Using money on gaming sites may put some adolescents at risk of developing problems with either gaming or gambling. The link between using money in digital games and gambling participation calls for preventive measures, intervention and regulatory acts.

Gaming to relieve tension or anxiety and associations with health functioning, substance use and physical violence in high school students

Gaming is popular among youth and gaming disorders have been introduced recently into psychiatric nomenclature systems. Motivations underlying gaming may include involvement to reduce negative emotional states and thus may link to psychiatric and overall health. Thus, the extent to which adolescents engage in gaming to relieve anxiety warrants additional investigation. Data from 2005 Connecticut high-school students were used to examine how adolescents who reported gaming to relieve tension or anxiety differed from those who reported gaming but not to relieve tension or anxiety on measures of demographics, academic performance, general health, extracurricular activities, dysphoria/depression symptoms, substance use, and aggressive or violent behaviors. Chi-square analyses and binomial and multinomial logistic regression models were conducted. Gaming to relieve anxiety was more prevalent in boys and Hispanic and Asian adolescents and associated with less extracurricular involvement, poorer academic performance, increased cigarette and other drug use, problematic internet use, and depression. Participants with gaming to relieve tension or anxiety were also more likely to report weapon-carrying, missing school because they felt unsafe, having been threatened with a weapon, having engaged in physical fights, and having experienced injuries from fights. As gaming to relieve anxiety was related to mental-health- and functioning-related measures, additional research is needed to examine the precise natures of these relationships and to translate the information into improved intervention strategies.

Internet gaming disorder and its relationship with behavioral disorder and mother's parenting styles in primary school students according to gender in Iran

BACKGROUND

The problem of students' gaming addiction has been related to the individual student's characteristics and the influence of family environment. Researchers aimed to investigate if and how internet gaming disorder (IGD) of the elementary school boys and girls is related to behavioral disorder and their mother's parenting style in Iran.

METHODS

This is a descriptive correlational study, involving 657 fifth and sixth-grade elementary school students in 2019. Researchers used a multistage stratified random sampling of students, their parents and their teachers. Data were collected using internet gaming disorder questionnaire (IGD 20), Rutter teacher behavioral disorder questionnaire and Baumrind Parenting Styles questionnaire (PSI). Obtained data were analyzed using SPSS version16 for descriptive statistics and Pearson correlation coefficient test.

RESULTS

Findings showed that IGD prevalence was 5.9% among primary school students with significant relationship between IGD and behavioral disorder among all participants (r = 0.23, p = 0.04); although it was insignificant among boys (r = 0.13, p = 0.11). Also the relationship between IGD and mother's parenting style was significant in the total sample (r = 0.12, p = 0.03), in particular for girls and their mothers (r = 0.2, p = 0.001).

CONCLUSIONS

The results of this study indicate the importance of family and parental involvement in prevention and management of IGD chiefly among girls. Healthcare professionals will benefit from knowing the problematic consequences of online gaming among school-age children and try to promote safe and healthy online behavior supported by a supervised family environment.

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.

An Evaluation of Gaming-Related Harms in Relation to Gaming Disorder and Loot Box Involvement

The specific nature of harm and functional impairment in the context of gaming disorder (GD) has received limited attention. In this study, we present one of the first concerted attempts to measure the types and degree of harm experienced by people displaying signs of problem gaming. Attempts were made to assess the extent to which types of harm were attributable to gaming as opposed to other factors. The study also investigated potential behavioural indicators of harmful involvement, including exposure to loot boxes. A sample of 471 regular gamers (M = 380, F = 73), recruited through the online platform Prolific, completed a survey where problem gaming was identified using Petry et al.’s (2014) checklist. Individuals who met the cut-off for gaming disorder scored higher than the non-problem group on most dimensions of harm, with physical and psychological types being the most common issues. Loot box expenditure was low (M = $25 in 3 months, for the 10.8% of respondents who played loot boxes) but significantly positively associated with the degree of gaming-related financial harm. This study shows that problem gaming is most strongly associated with physical or psychological harm and that financial harms may manifest in gaming activities that facilitate continuous spending options.

Internet gaming disorder behaviours: a preliminary exploration of individualism and collectivism profiles

BACKGROUND

Internet Gaming Disorder (IGD) behaviours involve excessive use of Internet games to the extent that one's everyday life is compromised. It has been suggested that IGD symptoms are dependent on whether one is more individualistic or collectivistic. However, the range of potential individualism-collectivismeffects on IGD presentations remains largely unknown. The current study aims to further understanding of the role of individualistic and collectivistic tendencies in IGD, allowing us to develop more gamer centredIGD prevention and intervention strategies.

METHODS

One thousand and thirty-twocommunity participants withinternet gaming experience were measured online for IGD symptom's severity using the Internet Gaming Disorder Scale - Short Form (IGDS9-SF) andindividualism-collectivism behavioursvia the Individualism & Collectivism Scale (ICS). Latent Class Analysis (LCA) and T-Tests were performed in relation to their responses.

RESULTS

Upon inspection of the LCA output, two profiles of internet gamers were identified. These includedthe Collectivism Aversivegamers (CA; 11%) and the Collectivism Neutral gamers (CN; 89%). The CA gamers displayed significantly higher IGD behaviours overall, and, were higher inpreoccupation, withdrawal symptoms, tolerance, relapse, deception, escapism/mood modification, and functional impairment compared to CN gamers. There were no differences between CA and CN gamers in loss of interest and conflicts with others.

CONCLUSIONS

The findings suggest that one's individualism-collectivism orientation can influence the presentation of IGD. Specifically, those who are less collectivistic or are less influenced by social groups willdisplay greater IGD symptoms and present a profile that requires a different intervention from gamers who are more collectivistic. Researchers and clinicians should emphasize the value of belonging in a collective and experiencing equality with others in relation to mental health and gaming patterns.

Person-centred interventions for problem gaming: a stepped care approach

BACKGROUND

Problem gaming is reported by approximately 1-3% of the population and is associated with decreased health and wellbeing. Research on optimal health responses to problem gaming remains limited. This study aimed to identify and describe the key components of a person-centred approach to interventions for problem gaming for individuals who voluntary seek assistance.

METHODS

Online interviews were conducted with 20 adults (90% male; M_age = 23y) currently seeking help for problem gaming. The interview protocol was guided by a health care access framework which investigated participants' experiences and needs related to accessing professional support. Transcripts were analysed in NVivo using qualitative content analysis to systematically classify participant data into the themes informed by this framework.

RESULTS

Participants had mixed views on how the negative consequences of problem gaming could be best addressed. Some indicated problems could be addressed through self-help resources whereas others suggested in-person treatment with a health professional who had expertise in gaming. Participants described the essential components of an effective health service for problem gaming as including: valid and reliable screening tools; practitioners with specialist knowledge of gaming; and access to a multimodal system of intervention, including self-help, internet and in-person options that allow gamers to easily transition between types and intensity of support.

CONCLUSION

A comprehensive health care approach for interventions for problem gaming is in its infancy, with numerous service access and delivery issues still to be resolved. This study highlights the importance of involving individuals with gaming-related problems in developing solutions that are fit for purpose and address the spectrum of individual preferences and needs. These findings recommend a stepped healthcare system that adheres to evidence-based practice tailored to each individual and the implementation of standard assessment and routine outcome monitoring.

Deficits in executive functions but not in decision making under risk in individuals with problematic social-network use

BACKGROUND

The tendency to strive for immediate gratification by neglecting potential negative long-term outcomes characterizes addictive behaviors, such as substance use or gaming disorder. Problematic social-network use is currently discussed as another potential addictive behavior, which is considered to result from an imbalance between affective and cognitive processes, indicated by traits such as increased impulsivity and/or decreased executive functions and decision-making abilities.

METHODS

This study investigates the respective functions in social-network users by use of the Cards and Lottery Task (CLT) - a decision-making task under risk conditions in which options contain conflicting immediate and long-term outcomes at the same time. A sample of German and Spanish participants (N = 290) performed the CLT as well as the Modified Card Sorting Test (MCST), Barratt Impulsiveness Scale (BIS), the short Internet Addiction Test specified for social-networking (sIAT-SNS), and screeners on other potentially problematic behaviors.

RESULTS

Comparing extreme groups based on sIAT-SNS scores (1SD above/below mean), individuals with problematic social-network use (n = 56), as compared to those with non-problematic social-network use (n = 50), showed increased attentional impulsivity and reduced executive functions. No differences were observed in decision-making performance.

CONCLUSION

The findings indicate that problematic social-network use is related to attentional rather than general decision-making deficits. Furthermore, problematic social-network use is likely to co-occur with other problematic Internet-use behaviors, particularly gaming or shopping.

The New Frontier of Esports and Gaming: A Scoping Meta-Review of Health Impacts and Research Agenda

Given the rapid evolution of the gaming industry and the rising popularity of a hyper-connected, competitive esports version of online gaming, a meta-review of the impact of online competitive gaming upon health is timely. A scoping meta-review was conducted on 10 reviews that reported on any health consequences (physical, lifestyle, cognitive, mental, or social) of esports, online competitive gaming, or video gaming participation, as a player or spectator. While past reviews have examined health effects of video gaming, few have focused upon the newly evolved gaming context, incorporating both playing and streamed viewing, recognition as a professional sport, and potential career and exponential participation. Most past reviews have focused upon physical health impacts of video gaming among adolescents and young adults, but none have examined impacts of different forms of gaming participation in the new gaming era, and their potential differential health impacts. A scoping meta-review was undertaken on the physical, social, and psychological health outcomes of competitive online gaming and associated screen use, revealing a need for further review and research into lifestyle health outcomes including diet and sedentary behavior among young esports and competitive video gaming participants.