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Yu Y, Wu AMS, Fong VWI, Zhang J, Li JB, Lau JTF. Association Between Internet Gaming Disorder and Suicidal Ideation Mediated by Psychosocial Resources and Psychosocial Problems Among Adolescent Internet Gamers in China: Cross-Sectional Study. JMIR Serious Games 2024; 12:e48439. [PMID: 39298753 PMCID: PMC11450365 DOI: 10.2196/48439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 10/23/2023] [Accepted: 07/18/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Adolescent internet gaming disorder (IGD) was associated with severe harm, including suicidal ideation. While suicidal ideation was predictive of completed suicides, further research is required to clarify the association between IGD and suicidal ideation among adolescents, as well as the mechanisms involved. OBJECTIVE This study aimed to investigate the understudied association between IGD and suicidal ideation, as well as novel mechanisms associated with it, among Chinese adolescent internet gamers through psychosocial coping resources and psychosocial problems. METHODS An anonymous, self-administered, cross-sectional survey was conducted among secondary school students who had played internet games in the past year in Guangzhou and Chengdu, China (from October 2019 to January 2020). In total, 1693 adolescent internet gamers were included in this study; the mean age was 13.48 (SD 0.80) years, and 60% (n=1016) were males. IGD was assessed by the 9-item Internet Gaming Disorder Checklist of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]), while a single item assessed suicidal ideation: "Have you ever considered committing suicide in the past 12 months?" Univariate and multivariate logistic regression associations were conducted to test the significance and directions of the potential factors for suicidal ideation. The mediation mechanism was examined by structural equation modeling. RESULTS Among all participants, the prevalence of IGD and suicidal ideation was 16.95% (287/1693) and 43.06% (729/1693), respectively. IGD cases were 2.42 times more likely than non-IGD cases to report suicidal ideation (adjusted odds ratio [OR] 2.42, 95% CI 1.73-3.37). Other significant factors of suicidal ideation included psychosocial coping resources (resilience and social support, both adjusted OR 0.97, 95% CI 0.96-0.98) and psychosocial problems (social anxiety: adjusted OR 1.07, 95% CI 1.05-1.09; loneliness, adjusted OR 1.13, 95% CI 1.10-1.16). The association between IGD and suicidal ideation was partially mediated by 3 indirect paths, including (1) the 2-step path that IGD reduced psychosocial coping resources, which in turn increased suicidal ideation; (2) the 2-step path that IGD increased psychosocial problems, which in turn increased suicidal ideation; and (3) the 3-step path that IGD reduced psychosocial coping resources which then increased psychosocial problems, which in turn increased suicidal ideation, with effect sizes of 10.7% (indirect effect/total effect: 0.016/0.15), 30.0% (0.05/0.15), and 13.3% (0.02/0.15), respectively. The direct path remained statistically significant. CONCLUSIONS IGD and suicidal ideation were alarmingly prevalent. Evidently and importantly, IGD was a significant risk factor for suicidal ideation. The association was partially explained by psychosocial coping resources of resilience and social support and psychosocial problems of social anxiety and loneliness. Longitudinal studies are needed to confirm the findings. Pilot randomized controlled trials are recommended to evaluate the effectiveness of interventions in reducing suicidal ideation by reducing IGD, improving psychosocial coping resources, and reducing psychosocial problems investigated in this study.
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Affiliation(s)
- Yanqiu Yu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Anise M S Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China
- Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, China
| | - Vivian W I Fong
- Center for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Jianxin Zhang
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Ji-Bin Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Joseph T F Lau
- Public Mental Health Center, School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
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Leino T, Finserås TR, Skogen JC, Pallesen S, Kristensen JH, Mentzoni RA, Sivertsen B. Examining the relationship between non-suicidal self-harm and suicidality within the past 12-months and gaming problems in Norwegian full-time students. BMC Psychiatry 2024; 24:234. [PMID: 38549054 PMCID: PMC10976819 DOI: 10.1186/s12888-024-05694-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Although gaming problems are associated with poor mental health, few population-based studies have examined its association with self-harm and suicidality. This study investigates the association between gaming problems, non-suicidal self-harm and suicidality within the past year, stratified by sex among Norwegian full-time students. METHODS Data derived from the Norwegian Students' Health and Wellbeing Study 2022 (N = 59,544). The respondents were categorized into non-gamers, recreational gamers, engaged gamers, problematic gamers, and addicted gamers based on the Game Addiction Scale for Adolescents. Log-link binomial regression models, stratified by sex, adjusted for age, were used to estimate the risk ratio of non-suicidal self-harm (ideation and behavior) and suicidal behaviors (ideation and attempt) across different levels of gaming problems. RESULTS Among females, the risk of non-suicidal self-harm and suicidal ideation increased from non-gamer to problem gamer, with no differences between problem and addicted gamers. Among males, the risk of non-suicidal self-harm increased from non-gamers to engaged gamers, but no differences were observed between engaged, problematic, and addicted gamers. No sex × gaming category interaction was observed for suicide attempts. Engaged and addicted gamers had higher risks of suicide attempt than non-gamers and recreational gamers. CONCLUSIONS Gaming problems are associated with increased risk of non-suicidal self-harm and suicidal ideation among females. Among males, no differences were observed between engaged, problem and addicted gamers. The results highlight sex when studying health related outcomes and their association to level of gaming problems. Longitudinal studies are warranted to uncover the temporal mechanisms between IGD, non-suicidal self-harm and suicidality.
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Affiliation(s)
- Tony Leino
- Department of Psychosocial Science, University of Bergen, Bergen, 5015, Norway.
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, 5015, Norway.
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, 5015, Norway.
| | - Turi Reiten Finserås
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, 5015, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, 5015, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, 0473, Norway
- Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, 4068, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, 5015, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, 5015, Norway
| | - Joakim Hellumbråten Kristensen
- Department of Psychosocial Science, University of Bergen, Bergen, 5015, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, 5015, Norway
| | - Rune Aune Mentzoni
- Department of Psychosocial Science, University of Bergen, Bergen, 5015, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, 5015, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, 5015, Norway
- Department of Research and Innovation, Helse Fonna HF, Haugesund, 5525, Norway
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Chamarro A, Díaz-Moreno A, Bonilla I, Cladellas R, Griffiths MD, Gómez-Romero MJ, Limonero JT. Stress and suicide risk among adolescents: the role of problematic internet use, gaming disorder and emotional regulation. BMC Public Health 2024; 24:326. [PMID: 38291407 PMCID: PMC10826210 DOI: 10.1186/s12889-024-17860-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/23/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Previous studies have associated videogame playing and social media use with suicidal behaviors together with lower stress coping or poor emotion regulation strategies. Due to the inconclusive evidence regarding the factors associated with suicidal behavior, the present study aimed to overcome the limitations of previous research and explored the relationship between adolescent stress, problematic internet use (PIU), gaming disorder (GD), and emotional regulation (ER) in a cross-section design. It was hypothesized that stress would have a direct effect on suicide risk (SR) as well as being mediated by PIU, GD, and ER. METHODS The participants comprised 430 adolescents (58.4% male) aged between 16 and 19 years. They completed an online survey including the Mobile-Related Experiences Questionnaire, Internet Gaming Disorder Scale-Short Form, Meta-Mood Trait Repair Scale, and Spanish version of the Suicidal Behaviors Questionnaire. RESULTS A total of 34.2% of the adolescents (N = 147) were at risk for SR. Results also indicated that 30,7% had experienced suicidal ideation at some point in their life, 12.1% had at least one plan to die by suicide, and 5.1% had attempted suicide. Results of path analysis confirmed that stress appeared to be a risk factor for suicide, but that its effects were not mediated by PIU. However, ER and GD mediated the effect of stress on SR. The results suggest that stress is a main risk factor for suicide, especially among adolescents with poor emotional regulation or problematic gaming. CONCLUSIONS Considering the prevalence of suicide among adolescents, the results of the present study suggest that suicide prevention programs should include emotional regulation strategies, stress coping, and videogaming management skills in the early stages of high school. Providing these protective resources to adolescents will help them face the stressful and changing situations typical of adolescence and will help them to attain greater well-being and satisfaction with life.
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Affiliation(s)
- Andrés Chamarro
- Stress & Health Research Group. Faculty of Psychology, Autonomous University of Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Adrian Díaz-Moreno
- Stress & Health Research Group. Faculty of Psychology, Autonomous University of Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Ivan Bonilla
- Stress & Health Research Group. Faculty of Psychology, Autonomous University of Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Ramon Cladellas
- Stress & Health Research Group. Faculty of Psychology, Autonomous University of Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Mark D Griffiths
- International Gaming Unit, Nottingham Trent University, Nottingham, England
| | - Maria José Gómez-Romero
- Stress & Health Research Group. Faculty of Psychology, Autonomous University of Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
- Psychology Unit, Egarsat, Mutua Colaboradora con la Seguridad Social nº 276, Barcelona, Spain
| | - Joaquín T Limonero
- Stress & Health Research Group. Faculty of Psychology, Autonomous University of Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.
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Zhou J, Zhao H, Wang L, Zhu D. The vicious cycle of family dysfunction and problematic gaming and the mediating role of self-concept clarity among early adolescents: A within-person analysis using random intercept cross-lagged panel modeling. J Behav Addict 2023; 12:920-937. [PMID: 38141062 PMCID: PMC10786229 DOI: 10.1556/2006.2023.00054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/28/2023] [Accepted: 09/10/2023] [Indexed: 12/24/2023] Open
Abstract
Backgrounds and aims Family dysfunction is a significant risk factor for adolescent problematic gaming, yet few studies have investigated the bidirectional relations between changes in family dysfunction and adolescent problematic gaming and potential mediating mechanisms. This study thus examined the bidirectional relations between family dysfunction and adolescent problematic gaming and the mediating role of self-concept clarity within this relation. Methods Participants included 4,731 Chinese early adolescents (44.9% girls; M age = 10.91 years, SD = 0.72) who were surveyed at four time points 6 months apart. Results Random intercept cross-lagged panel modeling found (a) family dysfunction directly predicts increased problematic gaming, (b) adolescent problematic gaming directly predicts increased experience of family dysfunction, (c) family dysfunction indirectly predicts problematic gaming via self-concept clarity, and (d) adolescent problematic gaming indirectly predicts family dysfunction via self-concept clarity. Discussion and conclusions The present study suggests that adolescents may be trapped in a vicious cycle between family dysfunction and problematic gaming either directly or indirectly through impairing their self-concept clarity. Findings indicate fostering youth self-concept clarity is essential to break the vicious circle between dysfunctional experiences in the family and problematic gaming among adolescents.
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Affiliation(s)
- Jianhua Zhou
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Haiyan Zhao
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Li'an Wang
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Dandan Zhu
- School of Psychology, Northwest Normal University, Lanzhou, China
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Garg S, Kharb A, Verma D, Antil R, Khanna B, Sihag R, Lamba D. The mediating role of sleep quality on the relationship between internet gaming disorder and perceived stress and suicidal behaviour among Indian medical students. Gen Psychiatr 2023; 36:e100997. [PMID: 37304212 PMCID: PMC10254597 DOI: 10.1136/gpsych-2022-100997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/27/2023] [Indexed: 06/13/2023] Open
Abstract
Background In the recent digital era, individuals with internet gaming disorder (IGD) have reported a much higher prevalence of poor sleep quality, perceived stress and suicidal behaviour. However, the underlying mechanisms for these psychological problems remain unknown. Aims The primary aims of this study were to explore the mediating role of sleep quality on the relationship between IGD and the health outcomes of perceived stress and suicidal behaviour and to assess the prevalence and risk factors for IGD among medical students. Methods A cross-sectional study enrolling 795 medical students from two medical colleges in a rural area of North India was conducted from April to May 2022. The study participants were chosen using a stratified random sampling approach. A self-administered questionnaire was used to collect data, including sociodemographic and personal information and gaming characteristics. The study also included the Gaming Disorder and Hazardous Gaming Scale, the Pittsburgh Sleep Quality Index, the Perceived Stress Scale-10 and the Suicide Behaviors Questionnaire-Revised to measure IGD, sleep quality, perceived stress and suicidal behaviour, respectively. Multiple logistic regression for the risk factors and Pearson's correlation test for the relationship between variables were used. Hayes' PROCESS macro for SPSS was employed to carry out mediation analysis. Results Among the 348 gamers with a mean age of 21.03 (SD 3.27) years, the prevalence of IGD was 15.23% (95% confidence interval: 11.6% to 19.4%). In the correlational analysis, small to large (r: 0.32-0.72) significant relationships between scores of IGD and other health outcomes were established. The indirect effect (B=0.300) via sleep quality accounted for 30.62% of the total effect (B=0.982) of IGD on perceived stress (partially mediated), while sleep quality (B=0.174) accounted for 27.93% of the total effect (B=0.623) of IGD on suicidal behaviour (partially mediated). The factors of being male, living in a single-parent family, using the internet for other than academic purposes (1-3 hours and more than 3 hours/day), playing games for more than 3 hours/day and playing games with violent content were associated with IGD symptoms. Conclusions Using a dimensional measure, the results specified the relationship between IGD and perceived stress and suicidal behaviour by demonstrating that sleep quality meditated them. This modifiable mediating factor can be addressed by psychotherapy to mitigate the risk of perceived stress and suicidal behaviour among the future medical workforce.
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Affiliation(s)
- Sunny Garg
- Psychiatry, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
| | - Aakanksha Kharb
- Psychiatry, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
| | - Deepika Verma
- MBBS Internship, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
| | - Ritu Antil
- MBBS Student Final Prof, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
| | - Binika Khanna
- MBBS Student Final Prof, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
| | - Ritika Sihag
- MBBS Student Final Prof, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
| | - Divya Lamba
- MBBS Student Final Prof, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
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Xie Y, Yang Q, Lei F. The Relationship of Internet Gaming Addiction and Suicidal Ideation among Adolescents: The Mediating Role of Negative Emotion and the Moderating Role of Hope. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3375. [PMID: 36834070 PMCID: PMC9961121 DOI: 10.3390/ijerph20043375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/04/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Recently, internet gaming addiction and suicide have been global public health issues among adolescents. This study used convenience sampling and surveyed 1906 Chinese adolescents to investigate the relationship between internet gaming addiction and suicidal ideation and the role of negative emotion and hope in the relationship between the two. The results showed that the detection rate of internet gaming addiction among adolescents was 17.16% and the detection rate of suicidal ideation was 16.37%. Moreover, there was a significant positive correlation between internet gaming addiction and suicidal ideation. Negative emotion partially mediated the relationship between internet gaming addiction and suicidal ideation. In addition, hope moderated the relationship between negative emotion and suicidal ideation. The effect of negative emotion on suicidal ideation decreased as hope increased. These findings suggest that the role of emotion and hope in coping with adolescent internet gaming addiction and suicidal ideation should be emphasized.
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Affiliation(s)
- Yuntian Xie
- Department of Applied Psychology, Changsha Normal University, Changsha 410100, China
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What Constitutes ‘Gaming’ in the Gaming Disorder?: Observations and Recommendations. Indian J Psychol Med 2023; 45:297-303. [PMID: 37152383 PMCID: PMC10159567 DOI: 10.1177/02537176221150601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Kaya A, Türk N, Batmaz H, Griffiths MD. Online Gaming Addiction and Basic Psychological Needs Among Adolescents: The Mediating Roles of Meaning in Life and Responsibility. Int J Ment Health Addict 2023:1-25. [PMID: 36643385 PMCID: PMC9831379 DOI: 10.1007/s11469-022-00994-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 01/12/2023] Open
Abstract
Individuals whose basic needs are naturally satisfied are much less dependent on their environment and more autonomous. Basic psychological needs (i.e., the general motivators of human actions) are significant predictors of online gaming addiction. Moreover, it has been posited that meaning and responsibility in life are at the center of life from an existential point of view. Therefore, a hypothetical model was tested to examine the relationships between basic psychological needs (autonomy, competence, relatedness), online gaming addiction, responsibility, and meaning in life. Data were collected from a sample of 546 participants. Mediation analysis was conducted, and the results indicated that basic psychological needs, online gaming addiction, responsibility, and meaning in life had significant negative and positive relationships. The findings indicated that responsibility and meaning in life had a serial mediating effect in the relationship between basic psychological needs and online gaming addiction. The findings also showed that the inverse relationship between online gaming addiction and basic psychological needs was at least partially explained by meaning in life and responsibility. The results of the present study are of great importance and suggest that interventions to satisfy the basic psychological needs of adolescents may help prevent online gaming addiction.
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Affiliation(s)
- Alican Kaya
- Department of Guidance and Psychological Counselling, Ağrı İbrahim Çeçen University, Ağrı, Turkey
| | - Nuri Türk
- Department of Guidance and Psychological Counselling, Siirt University, Siirt, Turkey
| | - Hasan Batmaz
- Department of Guidance and Psychological Counselling, Sakarya University PhD Student, Sakarya, Turkey
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ UK
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