Gaming Disorder Across the Lifespan: a Scoping Review of Longitudinal Studies

Alexithymia in gaming addiction and engagement

BACKGROUND

It has been suggested that alexithymia plays a significant role in substance and behavioral addictions. However, only a handful of studies investigated this construct in relation to gaming addiction, and no study analyzed its differential effect on gaming engagement and addiction.

METHODS

A total of u adult gamers (Mage = 26.04, SD = 5.78, 94 % male) completed a questionnaire that included the Toronto Alexithymia Scale (and its subscales of difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking), the Addiction-Engagement Questionnaire, and additional questions about gender, age, and time spent gaming. Structural equation modeling was used as the main analytical strategy.

RESULTS

Difficulty identifying feelings (β = 0.28) and externally oriented thinking (β = 0.19) showed a significant positive effect on gaming addiction. Contrary to addiction, externally oriented thinking showed a significant negative effect (β = -0.21) on gaming engagement. No other alexithymia subscales were significant. The model with alexithymia explained 32.7 % of the variance in gaming addiction while only 10.4 % of gaming engagement.

CONCLUSIONS

Alexithymia is a strong predictor of gaming addiction. Gaming engagement seems to be a qualitatively different phenomenon that shows an opposite association with alexithymia than gaming addiction. However, both are related to increased time spent gaming. This suggests a need to distinguish between problematic vs. non-problematic excessive gaming as they have different associations with affect dysregulation.

Gaming disorder test: Assessing psychometric properties, prevalence, temporal stability, and invariance using a Czech two-time-point longitudinal sample

In 2019, Gaming Disorder (GD) was acknowledged as an official diagnosis by the World Health Organization. The Gaming Disorder Test (GDT) is the most widely used tool to measure GD; however, due to its novelty, various measurement properties are still unexplored, and the number of validated language variants is still limited. The present study is the first to assess the psychometric properties of the Czech version of the GDT. Further, it focuses on its temporal prevalence and stability, gaming genre invariance, and criterion validity. A large-scale sample of adult Czech gamers collected at two points within nine months was analysed - T1 N = 5356; T2 N = 6077; longitudinal sample N = 1430. Confirmatory factor analysis (CFA), structural equation modelling (SEM), and multigroup CFA were employed to assess the measurement invariance. The study confirmed the one-factor structure of the GDT and showed that it is invariant across preferred gaming genres and the time of data collection. It showed a negative relationship with life satisfaction and a positive relationship with anxiety, even when controlling for their mutual relationships. The prevalence in the longitudinal sample was equal to or below 1.9% in each wave, but only 0.5% in the longitudinal sample (hence n = 7 participants fulfilled in both waves the criteria for GD). The study suggests that the Czech version of the GDT has good psychometric properties, including temporal stability and invariance across gaming genres, so it is suitable for the survey type and epidemiological investigation of the ICD-11's Gaming Disorder.

Developmental trajectories and predictors of Internet gaming disorder across the university years: A person-centered five-wave cohort study

With a rapid rise in internet gaming, internet gaming disorder (IGD) has become a contemporary concern. However, little is known about the long-term dynamic changes in IGD over time. Using a person-centered five-wave longitudinal design, the current study explored the heterogeneous trajectories of IGD among 5787 students during their university years, and examined the role of protective and risk factors in differentiating distinct patterns of IGD. The growth mixture modeling revealed three distinct trajectories of IGD: stable-low pattern (n = 4575, 87.42 %), increasing pattern (n = 357, 6.80 %), and decreasing pattern (n = 302, 5.78 %). Additionally, the students with high self-control and self-compassion were more likely to be in the stable-low group instead of the other risk groups. Depressive symptoms and peer conflicts, as two time-varying variables, were significant risk predictors for IGD. These findings highlight the importance of identifying high-risk groups for IGD and providing them with personalized and effective mental health services to reduce their risk of developing IGD in the future.

The Role of Self-Control Dimensions, Game Motivation, Game Genre, and Game Platforms in Gaming Disorder: Cross-Sectional and Longitudinal Findings

Introduction

Gaming disorder (GD) is the result of an interplay between gaming-related factors, individual factors, and environmental factors. Current research primarily highlights single types of factors. Consequently, the present study simultaneously analyzed the role of individual factors, such as self-control dimensions and motives for gaming, and gaming-related factors, such as game genres, and gaming platforms in GD among female and male gamers. Additionally, the study provides a comprehensive analysis of these factors in relation to GD both cross-sectionally (Study 1) and longitudinally (Study 2).

Methods

Study 1 comprised 620 active gamers (M=22.16 years; SD=2.99), and Study 2 comprised 405 active gamers (M=28.05 years; SD=4.51). The instruments used in the studies included the Gaming Disorder Test, the nine-item Internet Gaming Disorder Short-Form (IGDS9-SF), Motives for Online Gaming Questionnaire, Video Game Questionnaire, and Self-Knowledge New Sheet.

Results

The results showed that GD was associated with (i) self-control deficits associated with difficulties in implementation control and taking actions related to goals without unnecessary delay, (ii) retaining information about intentions and long-term plans, (iii) refraining from immediate, impulsive behavior, and (iv) inhibiting emotional reactions. GD was also associated primarily with escape, coping, and competition motives for gaming. However, the longitudinal study showed that social, fantasy, and skill-development motives were also related to GD development over time. The action game genres associated with GD but were not very important for GD over time. The cross-sectional study results indicated a negative relationship between GD and tablets and consoles used as gaming platforms. However, the longitudinal study showed that desktop computers and consoles use as gaming platforms were associated with the GD over time. Moreover, gaming-related factors explained only 9% of the variance in the GD model among female gamers and only 10% of the variance in the GD model among male gamers in cross-sectional study. In contrast, individual factors such as self-control dimensions and gaming motivation explained 32% of the variance in the GD model among both female and male gamers.

Conclusion

Individual factors, such as self-control dimensions and motives for gaming, were more important in explaining GD than gaming-related factors, such as game genres and gaming platforms. Moreover, self-control deficits and motivation related to escape, coping and competence can be important factors to consider in the prevention and treatment of GD.

Experiencing stress impact on adolescent repetitive nonsuicidal self-injury: The Mediating role of emotion dysregulation and maladaptive cognitive schemas

BACKGROUND

Repetitive nonsuicidal self-injury (R-NSSI) is a growing concern in adolescents and is associated with various mental health problems. However, little is known about the potential psychology and addiction mechanisms of R-NSSI in adolescents. This study aimed to examine the mediating effects of emotion dysregulation and maladaptive cognitive schemas based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model and the integrated model of NSSI among adolescents who repeatedly engage in NSSI.

METHODS

This longitudinal study was conducted in two waves with 6-month lags. A total of 3925 adolescents (Mage = 13.22 ± 0.86 years, 42 % female) were recruited from three middle schools. Relevant questionnaires were used to evaluate stressful life events, emotion dysregulation, maladaptive cognitive schemas, NSSI, and NSSI addictive features. The structural equation modeling approach was conducted separately for adolescents who engaged in occasional NSSI (O-NSSI) and those who engaged in R-NSSI.

RESULTS

Results showed that emotion dysregulation played a significant mediating role in the associations between stressful life events and NSSI frequency, and both maladaptive cognitive schemas and emotion dysregulation played a significant mediating role in the associations between stressful life events and NSSI addictive features in adolescents who engaged in R-NSSI but not in those who engaged in O-NSSI.

LIMITATIONS

The main limiting factor is self-reported data.

CONCLUSIONS

These findings contribute to the understanding of the psychological and addictive mechanisms involved in R-NSSI. Both emotion dysregulation and maladaptive cognitive schemas could be a suitable therapeutic target to reduce R-NSSI in the context of stress during adolescence.

Press Play to Feel: The Role of Attachment Styles and Alexithymic Features in Problematic Gaming

Problematic gaming has been consistently associated with insecure attachment styles and alexithymia. However, there is limited knowledge regarding the impact of specific alexithymic features and insecure attachment styles on problematic gaming. The study included a sample of 358 online game players (242 males, 67.6%) between the ages of 18 and 59 (M = 28.46; SD = 8.76) who were recruited from online gaming communities. The participants completed a sociodemographic schedule and measures on attachment styles, alexithymia, and problematic gaming. The results provide evidence for a positive prediction of problematic gaming by dismissing attachment style and the alexithymic factors concerning the difficulty identifying feelings and externally oriented thinking, even when controlling for potentially confounding factors, such as age, sex, education, marital status, and self-reported time devoted to online games. Additionally, the analysis revealed a significant interaction effect between externally oriented thinking and dismissing attachment style in the prediction of problematic gaming. The interaction implies that the alexithymia factors pertaining to externally oriented thinking hold significant relevance in predicting problematic gaming behaviors, especially in cases where dismissive attachment levels are moderately to highly present. These findings emphasize the significance of considering specific insecure attachment styles and alexithymic features when studying problematic gaming behaviors.

A Psychoanalytic Approach to Internet Gaming Disorder

BACKGROUND

Internet Gaming Disorder (IGD) is now an official diagnosis and significant public health challenges have been already identified regarding the provision of appropriate care to patients of all ages and the preparedness of mental health professionals to manage the disorder. Despite the existence of psychotherapeutic treatment modalities available for some time now, there is a paucity of any psychoanalytically driven treatments and the disorder is widely regarded and classified as being 'behavioral'. This has profound implications for patients with long-standing character pathology and psychiatric comorbidities, who are underserved by the provision of health services that could efficiently address their issues.

METHODS

This study presents a psychoanalytic perspective on IGD, based on Kohut's Self Psychology as applied in the treatment of other addictions. An outline of the theory, assessment and treatment modalities is presented with two case reports that illustrate its application.

RESULTS

The presentation outlines the challenges in treating IGD, expanding on the concept of guided imagery, resistance to treatment, selfobject transference and comorbidity with marijuana use and bipolar disorder.

CONCLUSIONS

A psychoanalytically driven protocol can be effective in treating IGD, especially in cases with marked character pathology and low motive to engage in other treatment modalities.

A longitudinal study on the impact of Internet gaming disorder on self-perceived health, academic performance, and social life of first-year college students

BACKGROUND AND OBJECTIVES

Internet gaming disorder (IGD) is associated with health, social, and academic problems but whether these are consequences of the disorder rather than precursors or correlates is unclear. We aimed to evaluate whether IGD in the 1st year of university predicts health, academic and social problems 1 year later, controlling for baseline health, academic and social problems, demographics, and mental health symptoms.

METHODS

In a prospective cohort study, 1741 university students completed both a baseline online survey in their 1st year and a follow-up survey 1 year later. Log-binomial models examined the strength of prospective associations between baseline predictor variables (IGD, baseline health, academic and social problems, sex, age, and mental health symptoms) and occurrence of health, academic and social problems at follow-up.

RESULTS

When extensively adjusted by the corresponding outcome at baseline, any mental disorder symptoms, sex, and age, baseline IGD was associated only with severe school impairment and poor social life (risk ratio [RR] = 1.77; 95% confidence interval [CI] = 1.14-2.75, p = .011; RR = 1.22; 95% CI = 1.07-1.38, p = .002, respectively).

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

University authorities and counselors should consider that incoming 1st-year students that meet criteria for IGD are likely to have increased academic and social impairments during their 1st year for which they may want to intervene. This study adds to the existing literature by longitudinally examining a greater array of negative outcomes of IGD than previously documented.

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.

Impaired Control Over Gaming Scale (ICOGS): Development, confirmatory factor validation, and psychometric evaluation

Background and aims

The concept of impaired control is central to addictive disorders, including gaming disorder in the DSM-5 and ICD-11. Impaired control refers to the recurrent inability to resist impulses to engage in certain activities or behaviours and the failure to limit or stop this engagement. Although numerous screening tools for gaming disorder symptoms have been developed, these instruments have limited capacity for measuring the nature and extent of impaired control. To address this limitation, the present study reports on the creation of the Impaired Control Over Gaming Scale (ICOGS), an 8-item screening tool to assess gaming-related impaired control.

Methods

A total of 513 gamers, including 125 gamers (24.3%) who met the DSM-5 criteria for gaming disorder, were recruited from Prolific, an online crowd-sourcing platform.

Results

The ICOGS demonstrated promising psychometric properties. Exploratory and confirmatory factor analysis using two samples provided robust support for a 2-factor model and high internal consistency of the scale. ICOGS scores were significantly and positively associated with gaming disorder symptoms, gaming-related harms, gaming frequency, psychological distress, and neuroticism. Using receiver operating characteristic analysis, the ICOGS differentiated between non-problem gamers and those who met the criteria for GD.

Discussion and conclusions

Overall, the ICOGS appears to be a valid and reliable scale for use in studies of problem gaming, and may be useful for assessing outcomes of GD interventions that employ self-regulation and stopping techniques to reduce or eliminate problem gaming behavior.

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.

Which is more stable and specific: DSM-5 internet gaming disorder or ICD-11 gaming disorder? A longitudinal study

AIM

The high comorbidity rates of internet gaming disorder (IGD) and gaming disorder (GD) with other psychiatric disorders are concerning. A follow-up study of gamers from clinical and nonclinical samples with and without diagnoses of IGD or GD was conducted to investigate the changes in diagnoses over a 1-year period, compare their diagnostic stability, and examine the patterns of co-occurrence between IGD and GD with other psychiatric disorders over the same period.

METHODS

Baseline and 1-year follow-up data of 279 participants, including 120 problematic gaming patients and 159 gamers from the general population, were analyzed. Information on demographics, gaming habits, and self-reported psychological status was collected. Additionally, a structured interview was conducted using the Gaming Diagnostic Interview and the Mini-International Neuropsychiatric Interview.

RESULTS

Although there was no significant difference between the changes in IGD/GD diagnosis during the 1-year period, 34.7% of the participants had a change in IGD diagnosis, while the number of GD cases increased to 60.4%. When evaluating the fixed effects of comorbidity on IGD and GD, attention-deficit/hyperactivity disorder had the highest odds ratio for both IGD (75.23; 95% confidence interval [CI], 10.67-530.61) and GD (117.02 × 10⁶ ; 95% CI, 2.23 × 10⁶ -6132.64 × 10⁶ ).

CONCLUSION

These results reveal that a GD diagnosis might be more prone to change than an IGD diagnosis. GD was also found to be more affected by comorbid psychiatric disorders.

Examining the Indirect Effect of Online Gaming on Depression via Sleep Inequality and Anxiety-A Serial and Parallel Mediation Analysis

Stress-related disorders are highly prevalent among first-year college students. Gaming disorder (GD) is an emerging disorder linked to physical and psychological consequences. We aimed to investigate the mechanism linking GD with anxiety, depression, and sleep disorders among first-year undergraduate students. Four hundred fifty-seven participants were recruited, and the survey included the Internet Gaming Disorder Scale Short-Form (IGDS9-SF), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pittsburgh Sleep Quality Index (PSQI). Our results showed that female students scored significantly higher than males in anxiety and depression. Furthermore, we found that depression is positively and strongly correlated to anxiety, and both are moderately associated with sleep quality. Gaming is positively related to depression, anxiety, and sleep quality. Interestingly, the health sciences tracks showed lower sleep quality than undergraduates from other tracks. There was a 64% variance in depression explained by many predictors, including anxiety, sleep quality, gaming, painkiller use, and gender. In addition, the mediation models showed that the association between gaming and depression is mediated indirectly by sleep quality, and sleep quality may be mediated directly by anxiety. The first year in college occurs at a critical developmental and professional stage, and our results highlight the need to establish support programs and conduct mental health educational workshops.

Parental Factors Associated With Internet Gaming Disorder Among First-Year High School Students: Longitudinal Study

Background

Parents play central roles in adolescents’ socialization, behavioral development, and health, including the development of internet gaming disorder (IGD). However, longitudinal research on the parental predictors of adolescent IGD is limited.

Objective

This study aimed to investigate the reciprocal associations between various parental factors and adolescent IGD using 2-wave cross-lagged models.

Methods

A sample of 1200 year-one high school students in central China completed a baseline assessment in 2018 (mean age 15.6 years; 633/1200, 52.8% male) and a follow-up survey in 2019. IGD was measured using the 9-item DSM-5 IGD Symptoms checklist. Perceptions related to parental variables, including psychological control, parental abuse, parental support, and the parent-child relationship, were also collected from the adolescents.

Results

Of all the participants, 12.4% (148/1200) and 11.7% (140/1200) were classified as having IGD at baseline (T1) and follow-up (T2), respectively. All 4 cross-lagged models fit the data well (range for the comparative fit index .91-.95; range for the standardized root mean square residual .05-.06). Parental support (β=–.06, P=.02) and parental abuse (β=.08, P=.002) at T1 predicted IGD symptoms at T2, while parental psychological control (β=.03, P=.25) and a positive relationship with parents (β=–.05, P=.07) at T1 had nonsignificant effects on IGD symptoms at T2, when controlling for background variables. In addition, IGD symptoms at T1 did not predict parental factors at T2.

Conclusions

The findings suggest that parental factors may be significant predictors of adolescent IGD. Health interventions should consider involving parents to increase the effectiveness of treatment to prevent and reduce adolescent IGD.

Parental Depression and Leisure Activity Engagement on Children's Gaming Disorder: A Dyadic Study

Nowadays, playing both online and offline video games is a popular leisure activity among youngsters, but excessive gaming activity engagement may lead to gaming disorder that disrupts daily functioning. Identifying risk and protective factors of this emerging problem is thus essential for devising prevention and intervention strategies. This mixed-method, cross-sectional study aimed to examine the roles of parental depressive symptoms and children’s leisure activity engagement on children’s gaming disorder symptoms. Furthermore, the moderating roles of risky and protective leisure activity engagement were investigated. The sample comprised 104 parent-child dyads recruited from a population-based survey (parents: M_age = 45.59 years, SD = 6.70; children: M_age = 11.26 years; SD = 4.12). As predicted, parental depressive symptoms and children’s gaming activity engagement were positively associated with children’s gaming disorder symptoms, whereas children’s literacy activity engagement was negatively associated with these symptoms. Moreover, engagement in these two types of leisure activity moderated the association between parental depressive symptoms and children’s gaming disorder symptoms in distinct manners, further indicating literacy activities as beneficial and gaming activities as risk-enhancing. These new findings imply that parental depressive symptoms and children’s leisure activity engagement should be considered when designing parent-based programs for gaming disorder prevention and intervention.

Association between relationship adaptation and Internet gaming disorder among first-year secondary school students in China: Mediation effects via social support and loneliness

Adolescents encounter numerous challenges and need to restructure their social relationships when they enter secondary schools. Relationship adaptation is critical and failure in adaptation may be associated with Internet gaming disorder (IGD). This novel study investigated the association between relationship adaptation and IGD and related mediation mechanisms via social support and loneliness among first-year secondary school students in Shanghai and Xi'an, China in 2018. Of 2573 participants, the prevalence of IGD was 13.1%. Relationship adaptation, social support, and loneliness were all significantly associated with IGD. The association between relationship adaptation and IGD was fully mediated by three indirect paths, including relationship adaptation → social support → IGD (effect size = 35.5%), relationship adaptation → loneliness → IGD (effect size = 34.3%), and relationship adaptation → social support → loneliness → IGD (effect size = 6.1%). In conclusion, the observed high prevalence of IGD among first-year secondary school students in China was associated with poor relationship adaptation. The full mediation effects via social support and loneliness suggest that modification of these two psychosocial attributes may effectively reduce the harmful impacts of poor relationship adaptation on adolescent IGD. Future longitudinal studies are warranted to confirm the findings.

Associations between Risk Factors in Late Adolescence and Problem Behaviors in Young Adulthood: A Six-Year Follow-Up of Substance Related and Behavioral Addictions in Swedish High School Seniors

INTRODUCTION

Risk factors of traditional substance use related problems in young adults are more well-known than for behavioral addictions such as gambling and gaming problems. The present study aims to provide knowledge about the longitudinal patters of substance use related and behavioral addictions in early adulthood.

METHODS

Using self-report surveys, substance-related, psychiatric, and demographic predictors were assessed in Swedish high school seniors and re-assessed six years later along with gambling and gaming problems, n = 800. Associations (Risk Ratios) between risk factors in late adolescence and problem behaviors in young adulthood were analyzed.

RESULTS

Tobacco use, illicit drug use, and hazardous drinking in young adulthood were associated with tobacco use, illicit drug use, alcohol use, conduct problems, and impaired impulse control in late adolescence. Gambling problems in young adulthood were only associated with heredity of alcohol problems, while gaming was not associated to any problem behavior in late adolescence.

CONCLUSION

It is concluded that predictors for traditional substance-related addictions differ from predictors for behavioral addictions, and that this difference is more pronounced for gaming problems than for gambling problems.

Draconian policy measures are unlikely to prevent disordered gaming

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

Individual and Interpersonal Factors Associated with the Incidence, Persistence, and Remission of Internet Gaming Disorders Symptoms in an Adolescents Sample

Video game playing behavior has serious consequences for adolescents on a personal, family, social, and academic level. This research aimed to examine risk and protective factors involving incidence, persistence, and remission of gaming disorders symptoms (IGDs) in Spanish adolescents after nine months of follow-up. Data were drawn from self-administered questionnaires completed on two occasions: at the beginning (T1) and end of the academic year (T2). A total of 950 adolescents aged from 11 to 20 years (M = 14, SD = 1.52, 48.5% female) completed the questionnaire at T1, while 550 adolescents aged from 11 to 18 years (M = 13.43, SD = 1.23, 48.9% female) took part in the follow-up study (T2). The incidence, persistence, and remission rates were 6%, 2.7%, and 4.2%, respectively. Significant relationships with IGDs were found between the male gender and studying at a private school in T1 and T2. The findings show that the time spent playing video games during T1 was positively associated with IGDs in T1 and T2. The incidence of IGDs was associated with emotional problems and low family affection. The persistence of IGDs was linked to higher motor impulsivity, agreeableness, and lower family resolve. Remission was related to a decrease in anxiety and hostility as well as an increase in the emotional stability of adolescents. These findings imply that emotional well-being and family adjustment could be relevant for the effective management of gaming behaviors.

Addictive Internet Gaming Usage among Korean Adolescents before and after the Outbreak of the COVID-19 Pandemic: A Comparison of the Latent Profiles in 2018 and 2020

Since the outbreak of the COVID-19 pandemic, the heightened risk of school closures and mental disorders has made adolescents particularly vulnerable to developing internet gaming disorder (IGD). There have been reports of increased time spent playing games on the internet among adolescents during the pandemic, and the risk of developing IGD may be higher for adolescents in South Korea as the majority of them play games on the internet. However, to the best of our knowledge, no studies have examined the impact of the pandemic on adolescents' internet gaming behavior in South Korea. This study aimed to explore the different profiles of addictive internet gaming behavior among adolescents before and after the outbreak of the COVID-19 pandemic and examine how the pandemic influenced addictive internet gaming usage and time spent playing games on the internet. Nationally representative survey data from the Ministry of Gender Equality and Family with 3040 and 2906 responses from 2018 and 2020, respectively, were analyzed. Using seven factors of a maladaptive gaming usage scale (tolerance, withdrawal, excessive usage, control impairment, compulsive usage, neglecting daily activity, and gaming despite negative consequence), a four-profile model was selected in both 2018 and 2020 for latent profile analysis: 'casual' gamer, 'moderate' gamer, 'potential-risk' gamer and 'addictive' gamer. The results from the two-way ANCOVA showed significant interaction between the cohorts (2018 cohort vs. 2020 cohort) and the four profiles on addictive internet gaming usage (F = 119.747, p < 0.001, η2 = 0.05), including time spent playing internet games on a PC (F = 22.893, p < 0.001, η2 = 0.013), and time spent playing games on a mobile phone (F = 3.245, p < 0.05, η2 = 0.02). The results indicated that the increase of addictive internet gaming usage and gameplay time differed by profile. The results imply that the increase in gameplay time was higher for profiles with higher scores in addictive internet gaming usage for internet games played on a PC while the relationship was not obvious for games played on a mobile phone. Despite the statistical significance, there was only 1.2% to 4.9% of mean difference in addictive internet gaming usage between the 2018 and 2020 cohorts, which implies little clinical significance. While adolescents of the four profiles showed no significant signs of increased addictive internet gaming usage, the addictive gamer profile demonstrated a significant increase in game time after COVID-19.

Bullying Victimization and Problem Video Gaming: The Mediating Role of Externalizing and Internalizing Problems

Background: Adolescent victims of bullying are more likely to experience a range of mental health problems. Although research has investigated the relationship between bullying victimization and various addictive behaviors, the impact of bullying on problem video gaming (PVG) remains largely unexplored. The purpose of this study is to investigate the relationship between bullying victimization and PVG as mediated by the presence of internalizing and externalizing problems. Methods: Survey responses were collected from 6353 high-school students aged 12 to 18. Measures include bullying victimization (physical, verbal, cyber and indirect), internalizing (e.g., anxious and depressive symptoms) and externalizing (e.g., aggressive and delinquent problems) problems, and PVG (measured by the Internet Gaming Disorder Scale–Short Form). Results: Mediation analyses indicated that the relationship between verbal bullying and PVG was completely mediated by the presence of internalizing and externalizing problems. The relationship between physical bullying and PVG was completely mediated by externalizing problems and the relationship between cyberbullying and PVG was completely mediated by internalizing problems. Lastly, the relationship between indirect bullying and PVG was partially mediated by externalizing and internalizing problems. Conclusions: Results suggest that different types of bullying victimization are differentially associated with PVG, with mental health symptoms significantly mediating this relationship.