Gaming addiction, definition and measurement: A large-scale empirical study

Gaming Disorders: Navigating the Fine Line between Entertainment and Addiction-Gaming History, Health Risks, Social Consequences, and Pathways to Prevention

The number of people immersed in excessive gaming has increased in this age of rapid digitalization. The World Health Organization and American Psychiatric Association Organization recognize a gaming disorder as a condition that results in significant problems in daily life as a result of excessive gaming. Both organizations emphasize the similarities to behavioral addictions such as gambling. We examined the appropriate usage of video games from the perspectives of health and management in this study. For the general population, video games provide positive impacts such as stress alleviation and memory improvement. Game playing leads to a loss of time and money for the individual. It also has a negative impact on the individual's family and social life, evolving into a social problem. Gaming addiction is often accompanied by psychological disorders and other addictions, and long-term medical treatment, including approaches to the individual's psychological background and cognitive-behavioral therapy, is necessary. Therefore, the prevention of gaming disorder is essential. From a societal standpoint, action is required in three contexts: the government, game developers, and within the household as a whole. Simultaneously, the public needs to understand the positive potential of gaming, such as e-sports.

Effects of internet addiction and academic satisfaction on mental health among college students after the lifting of COVID-19 restrictions in China

Background

Internet addiction (IA) among students, worsened by Coronavirus disease 2019 (COVID-19) pandemic, has become a social problem with the digitalization of school learning and many aspects of daily life. However, few studies on IA have been conducted among students after the lifting of COVID-19 restrictions in China.

Method

This large-sample, cross-sectional, online survey was conducted to explore the characteristics of IA and the association among IA, academic satisfaction, and mental health problems from December 14, 2022 to February 28, 2023 in Sichuan, China. All participants (N = 22,605) were students in colleges and universities, recruited via their teachers and professors.

Results

Of all the participants, 14,921 (66.0%) participants had IA. Participants with IA were more likely to have depression symptom, anxiety symptom, insomnia, and lifetime suicidal ideation. In addition, participants with severe IA had significantly higher rates of mental health problems (e.g., depression, anxiety, insomnia, and suicidal ideation) than those with mild IA. A significant IA-by-academic satisfactory-interaction on mental health was identified: participants with higher level of IA showed particularly severe symptom of depression, anxiety and insomnia when affected by low satisfactory of academy (p < 0.001).

Conclusion

This study reveals that IA has a significantly negative impact on mental health among college students after the lifting of COVID-19 restrictions in China. IA and academic satisfaction have interactive impacts on mental health problems among students. Further educational and health policies and psychosocial interventions should be developed to reduce IA and enhance academic satisfaction for improving students' mental health.

Examining the Predictors of Video Game Addiction According to Expertise Levels of the Players: The Role of Time Spent on Video Gaming, Engagement, Positive Gaming Perception, Social Support and Relational Health Indices

This study aimed to examine the predictive relationship between video gaming addiction (VGA) and the level of video gaming competency among video gamers. Additionally, the role of time spent playing video games, video game engagement (VGE), video game positive perception (VGPP), social support and quality of relationships with peers were examined. We recruited 227 participants using the purposive sampling method. Of the participants, 50.20% self-identified as Novice-Amateur video gamers while 49.80% indicated being a regular-expert level players. We collected data from participants utilizing a personal and video games information form and five scales and (video game positive perception, videogame addiction scale, video engagement scale, multidimensional scale of perceived social support and relational health indices). These scales are valid and reliable instruments suitable for research purposes. The primary data analysis method was the Partial least squares- structural equation modeling (PLS-SEM). Our results demonstrated that the relationship between VGA and VGE differs based on the participants' video gaming competency level. Another important result is that VGPP has a significant positive relationship with VGA (p < 0.001), VGE (p < 0.001) and video game playing and watching activities (p < 0.001). Furthermore, an increase in the time spent on watching Twitch content is associated with an increased VGA level (p < 0.05). Finally, the time spent on playing video games has different patterns with perceptions of social support according to the level of expertise of the players. This study indicates that VGPP plays a crucial role in predicting VGA and VE and highlights the importance of considering the level of players when examining the relationship between VGA and VE. The conclusions also exhibit that the increasing popularity of esports and video game content tracking may significantly impact VGA. The role of social support in video gaming behaviors varies based on the player's level of expertise.

Systematic literature review online gaming addiction among children and young adults: A framework and research agenda

Online gaming addiction refers to a persistent and recurrent use of internet to engage in games leading to significant impairment or distress in a person's life. With the current pandemic, media reports suggest that the greater access of online devices among children and young adults has intensified online gaming addiction. However, the domain of online gaming addiction is a relatively new phenomenon with disparate studies examining various facets of it. Hence, the purpose of this research is to analyze the existing literature in order to identify the emerging trends in this area and to provide a systematic review that can be used as guidance for future research in this emerging field. Starting from the gaps that this review highlights, the proposed directions will help scholars find issues and gaps not sufficiently explored that can constitute the bases for further research pathways.

Online Gambling Activity, Pay-to-Win Payments, Motivation to Gamble and Coping Strategies as Predictors of Gambling Disorder Among e-sports Bettors

Research on esports activity usually captures it from the perspective of involvement in gaming. This study presents the results of the first research in Poland (N = 438) on esports betting (ESB). ESB is compared to other forms of e-gambling and involvement in pay-to-win games. The aim was to build a predictive model of gambling disorder among people betting on esports. A predictive model of gambling disorder based on ordinal regression was built, including sociodemographic variables, involvement in esports betting, involvement in other Internet activities connected to ESB, as well as psychological variables-motivation to gamble and coping strategies. The results showed that gambling disorder among esports bettors is associated with time spent on one game session, placing other forms of online gambling bets once a week or more often, and paying in pay-to-win games. Gambling disorder was also predicted by escape coping strategies and lower engaged strategies as well as financial and coping motivation to bet on esports results. The results show the crucial role of psychological factors (motivation, coping) in the development of esports betting addiction. Esports betting is an activity associated with both gambling and gaming-involvement in both activities explains the development of ESB addiction. There is a need for further research focused on the specificity of esports betting behavior to discover the direction of links among gaming, gambling, and esports gambling.

EEG response to game-craving according to personal preference for games

Recently, the World Health Organization included ‘gaming disorder’ in its latest revision of the international classification of diseases (ICD-11). Despite extensive research on internet gaming disorder (IGD), few studies have addressed game-related stimuli eliciting craving, which plays an important role in addiction. Particularly, most previous studies did not consider personal preferences in games presented to subjects as stimuli. In this study, we compared neurophysiological responses elicited for favorite game (FG) videos and non-favorite game (NFG) videos. We aimed to demonstrate neurophysiological characteristics according to the game preference in the IGD group. We measured participants’ electroencephalogram (EEG) while they watched FG, NFG and neutral videos. For FG videos, the parieto-occipital theta power (TP_PO) were significantly increased compared with those for NFG videos (P < 0.05, paired t-test). TP_PO also differed significantly between the healthy control and IGD groups only on FG videos controlling covariate (TP_PO on neutral videos) (P < 0.05, analysis of covariance [ANCOVA]). And TP_PO was significantly correlated to self-reported craving score only on FG videos (r = 0.334, P < 0.05). In the present study, we demonstrate that FG videos induce higher TP_PO than that induced by NFG videos in the IGD group and TP_PO is a reliable EEG feature associated with craving for gaming.

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.

Predictors of Habitual and Addictive Smartphone Behavior in Problematic Smartphone Use

OBJECTIVE

Smartphones have become common, and problematic smartphone use (PSU) is increasing. Predictors of PSU should be identified to prevent it. Little is known about the role of content types of smartphone use as predictors of PSU. Therefore, we aimed to evaluate the predictors of two proposed concepts of PSU, namely habitual smartphone behavior (SB) and addictive SB, within the context of the application (app) categories.

METHODS

We studied 1,039 smartphone users using online surveys conducted between January 2 and 31, 2019. We employed multiple regression analysis to identify the predictors of habitual and addictive SB. We controlled for sex and age (mean=39.20).

RESULTS

Common predictors of habitual and addictive SB were the use of social networking services, games, entertainment apps, and average weekend smartphone usage time. The predictors of habitual SB were the use of web and lifestyle apps, weekly usage frequency, and sex (female) and the predictors of addictive SB were the use of shopping apps and sleep duration.

CONCLUSION

This study revealed the need to consider habitual and addictive SB in evaluating PSU. The predictors in terms of the content types of smartphone usage can be used to develop monitoring and prevention services for PSU.

Differential Effects of Anxiety on Internet Gaming Disorder: A Large-Scale Cross-Sectional Survey

BACKGROUND

Internet gaming disorder (IGD) has become a serious public health problem in East Asia, and studies have reported IGD to be significantly associated with anxiety, but no causal relationship between the two has yet been demonstrated. Children are at high risk of developing IGD, however, previous studies have principally focused on the condition in adults and adolescents and reported non-clinical samples. A large-scale survey is needed to research and evaluate IGD and anxiety in children and adolescents to understand the current situation of IGD in children and explore the impact of IGD on anxiety.

METHODS

A cross-sectional study using an online questionnaire was conducted between March 1 and July 31, 2021. A total of 10,479 school children and adolescents in the western provinces of China were selected by convenience sampling. A questionnaire was used to collect data anonymously. The questionnaire covered IGD and the Revised Children's Manifest Anxiety Scale (RCMAS). Welch's ANOVA Test and Games-Howell test were used to test for differences in anxiety levels between IGD groups. Poisson regression analysis was used to further investigate the key predictors of IGD.

RESULTS

3.2% of participants (n = 334) (95% CI: 2.9-3.2%) were classified as at high risk of presenting with IGD, 71.1% (n = 7,454) (95% CI: 70.3-72.0%) were classified as low-risk players, and 25.7% (n = 2,691) (95% CI: 24.9-26.5%) were classified as non-gaming. The average RCMAS score was (7.18 ± 7.534). The high-risk group had a higher total score RCMAS, as well as scoring higher in its three dimensions. Regression analysis using gender, age, and total RCMAS score as independent variables, and risk of IGD as a dependent variable showed that the odds ratio (OR) for gender was 2.864 (95% CI: 2.267-3.618), and the OR for total RCMAS score was 1.101 (95% CI: 1.087-1.114). The OR for age was not statistically significant.

CONCLUSION

Anxiety was a predictor of IGD, with statistically significant group differences in total anxiety, as well as the dimensions of physiological anxiety, social correlation, and sensitivity. The timely assessment of anxiety in children and adolescents, training social skills, and facilitating effective integration into society could be effective ways of reducing the incidence and impact of IGD.

The frequency of impairments in everyday activities due to the overuse of the internet, gaming, or smartphone, and its relationship to health-related quality of life in Korea

BACKGROUND

This study aimed to investigate the relationships between the frequency of impairments in daily activities due to the overuse of the Internet, gaming, or smartphones (IGS) and sociodemographic characteristics, social relationships (including family) & activities, psychosocial characteristics, health status, and health-related quality of life (HRQoL) of Korean adults.

METHODS

Secondary data from the 2017 Community Health Survey, a large-scale sample survey conducted yearly in South Korea, were analyzed for 190,066 adults over 19 years of age. Three categories were created for impairment groups due to IGS overuse: No Impairment, Mild Impairment, and Moderate-to-Severe groups. And between-group differences were examined using a one-way ANOVA for health status measured with the EQ-5D-3 L and chi-square tests for all categorical dependent variables, which included sociodemographic characteristics, social relationships & activities, and psychosocial factors. The association between frequencies of daily activity impairments due to IGS overuse and the dependent variables were examined using a multivariate logistic regression analysis and a linear regression model.

RESULTS

Approximately 21,345 (11.23%) of the 190,066 participants reported experiencing impairments in daily activities due to IGS overuse at least once in the previous year and the impairments were more severe in males than females. Participants experiencing impairments in daily activities contacted their friends a significantly higher number of times (4 times or more per month) and engaged in leisure activities more frequently (more than once per month) than those without impairments. There was also a significant positive relationship between IGS overuse and stress, depression, suicidal ideation, and suicide attempts. Among participants aged 19-64, impairments in daily activities due to IGS overuse were associated with a lower HRQoL. Conversely, for those aged 65 and over, mild and moderate-to-severe impairments due to IGS overuse were associated with a significantly higher HRQoL.

CONCLUSIONS

Increased impairments in daily activities due to IGS overuse may negatively affect mental health. However, among older adults, the frequency of such impairments was positively associated with HRQoL. This finding could be considered to apply interventions with Internet usage or ICT devices for older adults to enhance their quality of life.

Gaming addiction and perceived stress among Saudi adolescents

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5% of Saudi adolescents (grade 7–12) were addicted to gaming.

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11% were suffering from a high level of stress.

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Gaming addiction was strongly associated with moderate- and high-level stress.

Introduction

Adolescents (age: 10–19 years) make up 15% of the Saudi population and have easy access to electronic gadgets and the Internet, yet data on gaming addiction among adolescents are negligible. We aimed to determine the prevalence of gaming addiction and its association with stress among Saudi school students.

Methods

In this cross-sectional survey, 2675 school students (grades 7–12) from 40 randomly selected schools in four main cities of Al-Qassim province in Saudi Arabia participated. The questionnaire inquired about demography, lifestyle, gaming addiction (7-item Game Addiction Scale), and stress (10-item Perceived Stress Scale). Multinomial logistic regression assessed the association between gaming addiction (yes, no) and stress (high, moderate, low).

Results

Participants’ mean age was 16.1 (SD = 1.6) years; 50% were female; 64% reported >3 h of daily screen time; 5% were addicted to gaming; 11.4% had high-level stress. Addiction to gaming was strongly associated with stress in the adjusted analysis (moderate OR = 6.7, 95% CI = 2.9–15.5; high OR = 11.9, 95% CI = 4.7–30.1). Additionally, those who were older, female, had poor grades, unhealthy dietary habits, an inactive lifestyle, and smoked were more likely to experience high stress.

Conclusions

Gaming addiction is strongly associated with stress among Saudi adolescents.

Smartphone and Facebook addictions share common risk and prognostic factors in a sample of undergraduate students

INTRODUCTION

To improve the comprehension of the interface between smartphone addiction (SA) and Facebook addiction (FA), we hypothesize that the occurrence of both technological addictions correlate, with higher levels of negative consequences. Moreover, we hypothesize that SA is associated with lower levels of social support satisfaction.

METHODS

We recruited a convenience sample of undergraduate students from Universidade Federal de Minas Gerais, with age ranging between 18 and 35 years. All subjects completed a self-fulfilled questionnaire comprising sociodemographic data, the Brazilian Smartphone Addiction Inventory (SPAI-BR), the Bergen Scale for Facebook Addiction, the Barrat Impulsivity Scale 11 (BIS-11), the Social Support Satisfaction Scale (SSSS), and the Brief Sensation Seeking Scale (BSSS-8). After completing the questionnaire, the interviewer conducted a Mini-International Neuropsychiatric Interview (MINI).

RESULTS

In the univariate analysis, SA associated with female gender, with ages 18 to 25 years, FA, substance abuse disorders, major depressive disorder, anxiety disorders, low scores in SSSS, high scores in BSSS-8, and high scores in BIS. The group with SA and FA presented a higher prevalence of substance abuse disorders, depression, and anxiety disorders when compared to the group with SA only.

CONCLUSION

In our sample, co-occurrence of SA and FA correlated with higher levels of negative consequences and lower levels of social support satisfaction. These results strongly suggest that SA and FA share some elements of vulnerability. Further studies are warranted to clarify the directions of these associations.

Prevalence of Internet Gaming Disorder and Its Association With Personality Traits and Gaming Characteristics Among Chinese Adolescent Gamers

Background: Internet gaming is extremely popular in China. However, some players overuse it, with negative outcomes. Knowing the prevalence rate and specific risk factors can provide a better understanding of the etiology of Internet Gaming Disorder (IGD). This study aimed to estimate the prevalence of IGD among Chinese adolescents and its association with their personality traits and Internet gaming characteristics. Methods: A cross-sectional study design was utilized in this study. Participants were recruited from 34 provincial administrative districts in China and consisted of 6,379 adolescent game players aged 15-25 (males/females = 3,701/2,678, mean age: 19.35 ± 1.61). A self-report structured questionnaire containing questions regarding demographic information and Internet gaming use characteristics, the Video Gaming Dependency Scale, and the Chinese Big Five Inventory-brief version, was used in the study. Results: The prevalence of IGD among Chinese adolescent game players was 17.0%. All participants were divided into the IGD group (males/females = 751/333, mean age: 19.74 ± 1.85) or the non-IGD group (males/females = 2,950/2,345, mean age: 19.27 ± 1.54). Specifically, twelve factors were significantly associated with IGD (p < 0.001), including neuroticism (β = 0.17), conscientiousness (β = -0.14), Internet gaming time per day (Hour) (β = 0.21), Internet gaming charge per month (Yuan) (β = 0.21), motive: escaping (β = 0.15), motive: sensation seeking (β = 0.13), motive: maintaining (β = 0.08), motive: coping (β = 0.06), having one or two long-term game partners (β = 0.06), male (β = 0.12), undergraduate and above (β = 0.04), and relationship status of couple (β = 0.04). Conclusion: Our findings offer evidence with respect to the prevalence of IGD and its relationships with specific personality traits and Internet gaming characteristics in China. It is necessary for Chinese parents, teachers, and social workers to pay more attention to adolescents' personality traits of high neuroticism and low conscientiousness, long time and high expense they spend on game, as well as their motives.

Internet Gaming Disorder: An Emergent Health Issue for Men

Internet gaming is a legitimate leisure activity worldwide; however, there are emerging concerns that vast numbers of gamers are becoming addicted. In 2013, the American Psychiatric Association (APA) classified Internet Gaming Disorder (IGD) as a condition warranting more clinical research ahead of formalizing it as a mental disorder. Proposed as a behavioral addiction, IGD shares many similarities in both physical and psychosocial manifestations with substance use disorder, including cerebral changes on functional magnetic resonance imaging (fMRI). Among the gaming population, compared to females, adolescent and adult males demonstrate far more addictive internet gaming use in terms of screen hours, craving, and negative impacts on health, which have, in isolated incidents, also caused death. The current article draws findings from a scoping review of literature related to IGD as a means to raising awareness about an emergent men's health issue. Included are three themes: (a) unveiling the nature, impacts and symptoms of IGD; (b) conceptualizing IGD through neuroscience; and (c) treatment approaches to IGD. Afforded by these themes is an overview and synthesis of the existing literature regarding IGD as a means of providing direction for much needed research on gaming addiction and orientating primary care providers (PCPs) to the specificities of IGD in men's health. The findings are applied to a discussion of the connections between IGD and masculinity and the importance of recognizing how behaviors such as social isolation and game immersion can be maladaptive coping strategies for males.

Internet gaming disorder in Lebanon: Relationships with age, sleep habits, and academic achievement

Background and aims The latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders included Internet gaming disorder (IGD) as a disorder that needs further research among different general populations. In line with this recommendation, the primary objective of this was to explore the relationships between IGD, sleep habits, and academic achievement in Lebanese adolescents. Methods Lebanese high-school students (N = 524, 47.9% males) participated in a paper survey that included the Internet Gaming Disorder Test and demographic information. The sample's mean average age was 16.2 years (SD = 1.0). Results The pooled prevalence of IGD was 9.2% in the sample. A hierarchical multiple regression analysis demonstrated that IGD was associated with being younger, lesser sleep, and lower academic achievement. While more casual online gamers also played offline, all the gamers with IGD reported playing online only. Those with IGD slept significantly less hours per night (5 hr) compared with casual online gamers (7 hr). The school grade average of gamers with IGD was the lowest among all groups of gamers, and below the passing school grade average. Conclusions These findings shed light on sleep disturbances and poor academic achievement in relation to Lebanese adolescents identified with IGD. Students who are not performing well at schools should be monitored for their IGD when assessing the different factors behind their low academic performance.

Development and Validation of Videogame Addiction Scale for Children (VASC)

The aim of the present study was to develop a valid and reliable Videogame Addiction Scale for Children (VASC). The data were derived from 780 children who completed the Videogame Addiction Scale (405 girls and 375 boys; 48.1% ranging in age from 9 to 12 years). The sample was randomly split into two different sub-samples (sample 1, n = 400; sample 2, n = 380). Sample 1 was used to perform exploratory factor analysis (EFA) to define the factorial structure of VASC. As a result of EFA, a four-factor structure comprising 21 items was obtained and explained 55% of the total variance (the four factors being “self-control,” “reward/reinforcement,” “problems,” and “involvement”). The internal consistency reliability of VASC has found 0.89. Confirmatory factor analysis (CFA) was performed to confirm the factorial structure obtained by EFA in the remaining half of sample (n = 390). The obtained fit indices from the CFA confirmed the structure of the EFA. The 21-item VASC has good psychometric properties that can be used among Turkish schoolchildren populations.

[The effects of narcissism and self-esteem on immersion in social network games and massively multiplayer online role-playing games]

Recent research has shown growing interest in the process by which narcissism triggers immersion in social network games (SNG). Highly narcissistic individuals are motivated not only by the achievement of goals and monopoly of materials (i:e., self-enhancement), but also by comparison and competition with others (i.e., social comparison) We predicted that the common rules and environments of SNG and massively multiplayer online role-playing games (MMORPG), such as systems of exchanging items and ranking players, facilitate immersion of highly narcissistic individuals during the game. Structural equation modeling of data from 378 SNG players and 150 MMORPG players recruited online showed that self-esteem inhibited game immersion, whereas narcissism increased game immersion via motivation for goal attainment. SNG players were more likely to be immersed in the game via motivation for goal attainment than MMORPG players. These findings suggest that, compared with MMORPG, the environments of SNG provide strong incentives not for those high in self-esteem who seek acceptance of others, but for those high in narcissism who are motivated by self-enhancement via competition with others.

Versatility and addiction in gaming: the number of video-game genres played is associated with pathological gaming in male adolescents

This study tested the predictive power of gaming versatility (i.e., the number of video game genres engaged in) on game addiction in male adolescents, controlling for time spent on gaming. Participants were 701 male adolescents attending high school (Mage=15.6 years). Analyses showed that pathological gaming was predicted not only by higher time spent on gaming, but also by participation in a greater number of video game genres. Specifically, the wider the array of video game genres played, the higher were the negative consequences caused by gaming. Findings show that versatility can be considered as one of the behavioral risk factors related to gaming addiction, which may be characterized by a composite and diversified experience with video games. This study suggests that educational efforts designed to prevent gaming addiction among youth may also be focused on adolescents' engagement in different video games.

Development and content validity of a screening instrument for gaming addiction in adolescents: the Gaming Addiction Identification Test (GAIT)

This study describes the development of a screening tool for gaming addiction in adolescents - the Gaming Addiction Identification Test (GAIT). Its development was based on the research literature on gaming and addiction. An expert panel comprising professional raters (n = 7), experiential adolescent raters (n = 10), and parent raters (n = 10) estimated the content validity of each item (I-CVI) as well as of the whole scale (S-CVI/Ave), and participated in a cognitive interview about the GAIT scale. The mean scores for both I-CVI and S-CVI/Ave ranged between 0.97 and 0.99 compared with the lowest recommended I-CVI value of 0.78 and the S-CVI/Ave value of 0.90. There were no sex differences and no differences between expert groups regarding ratings in content validity. No differences in the overall evaluation of the scale emerged in the cognitive interviews. Our conclusions were that GAIT showed good content validity in capturing gaming addiction. The GAIT needs further investigation into its psychometric properties of construct validity (convergent and divergent validity) and criterion-related validity, as well as its reliability in both clinical settings and in community settings with adolescents.