Psychosocial correlates of internet gaming disorder: Psychopathology, life satisfaction, and impulsivity

Recent treatment and novel imaging studies evaluating treatment of internet gaming disorder: a narrative review

Internet Gaming Disorder (IGD) is an emerging public health concern; effective treatments are still under development. This mini-review focuses on summarizing the main scientific evidence from psychological, pharmacological, brain imaging, and emerging treatment approaches for IGD. We searched PubMed and Scopus databases using keywords related to IGD and treatment. Cognitive behavioral therapy (CBT) is the most extensively researched psychological treatment for IGD, supported by several randomized controlled trials (RCTs). Other promising approaches include mindfulness, relapse prevention, abstinence protocols, and family therapy. Pharmacological treatments like bupropion and escitalopram have shown benefits, especially when IGD is comorbid with conditions like major depressive disorder. However, the quality of evidence is moderate for psychological interventions but low to moderate for pharmacological approaches. Emerging treatments such as transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and electro-acupuncture have demonstrated efficacy in reducing IGD symptoms and modulating brain activity. Brain imaging techniques like functional magnetic resonance imaging (fMRI) have provided insights into the neural mechanisms underlying IGD and treatment effects, although these studies lack randomized controlled designs. While multimodal approaches show promise, larger, well-designed RCTs are needed to establish effective IGD treatments.

Approach bias in individuals with Internet gaming disorder: Evidence from an event-related potential-based approach-avoid task

Individuals with Internet gaming disorder (IGD) often exhibit an approach bias towards gaming cues compared to non-gaming cues. Although previous studies suggested a positive correlation between approach bias and the severity of game use, the neuropsychological mechanisms that underpin the automatic action tendencies remain largely unexplored. The present study measured event-related potentials (ERPs) in 22 IGD and 23 healthy control (HC) participants who met the inclusion criteria, both groups conducted the Stimulus-Response Compatibility task (SRC), with their ERPs recorded during the task. Results revealed that the IGD group showed a significantly larger approach bias towards gaming cues (avoidance versus approach reaction time) compared to the HC group. The amplitude of P300 significantly increased, whereas N100 significantly decreased for game-approach compared to game-avoid for IGD compared to HC participants. The findings suggested that the enhanced integrated motivational value under compatible conditions as well as increased stimulus-response conflicts under incompatible conditions may contribute to the approach bias in IGD individuals. Further investigation on the intervention is prompted through longitudinal studies.

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.

Impulsivity and aggression as risk factors for internet gaming disorder among university students

Internet gaming addiction is a global problem, especially among young individuals. Exhibiting characteristics similar to other addictions, Internet Gaming Disorder (IGD) is linked to adverse mental health outcomes. Identified as risk factors for dependence behaviors, the association of impulsivity and aggression with IGD is relatively under-researched in the student population. The present sample of 350 university students (Mage = 21.30 years, SDage = 4.96 years) from Najran university in Saudi Arabia completed an online questionnaire that included the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), the Buss-Perry Aggression Questionnaire-Short Form, and the Barratt Impulsiveness Scale (BIS-15). Results indicated that impulsivity and aggression were positively associated with IGD severity and both personality traits explained 34.6% of the variance in IGD scores. Further bivariate analyses suggested that individuals spending 7 or more hours on internet gaming were more likely to exhibit high impulsivity and aggression, and had a relatively higher severity of IGD. These results suggest that individuals with these personality traits may be more vulnerable to developing an addiction to internet gaming. These findings need to be confirmed in future more robust studies; however, this exploratory study provides insights for potential programs to prevent IGD among young individuals.

A multi-dimensional assessment of internet gaming disorder in children and adolescents: A case-control study

BACKGROUND

Internet gaming disorder (IGD) leads to social disturbances and isolation, neglect of daily responsibilities, behavioral disorders, and physical impairments.

OBJECTIVE

This study aimed to investigate the effect of IGD on spine biomechanics, range of motion in the neck and low back, and lung functions and respiratory muscle strength in children and adolescents.

METHODS

Sixty-four children and adolescents with IGD (Group I) and 41 healthy controls (Group II) were included in the study. The outcomes were assessed with the Visual Analogue Scale (VAS), Internet Addiction Scale, active range of motion (AROM) in the neck and lumbar spine, posture and spinal alignment, lung function tests, and respiratory muscle strength.

RESULTS

There is a significant difference in pain intensity at rest, during activity, and daily sitting time between groups (p < 0.05). Craniovertebral angle, shoulder asymmetry, thoracic kyphosis angle, cervical extension and rotation, and right lumbar rotation significantly decreased in Group I than in Group II (p < 0.05). Besides, the PEF, FEF 25-75%, and respiratory muscle strength were lower in Group I than in Group II (p < 0.05). With a multiple linear regression model, MEP, FEV1, and weekly time spent playing online games were significant predictors of internet addiction intensity (R2 = 0.28; p = 0.02, p = 0.01, and p < 0.001, respectively).

CONCLUSION

Postural misalignment and increased sedentary time cause physical health deterioration and negatively affect lung functions in children and adolescents with IGD. Consequently, considering both psychological and physical health is necessary to assess the problematic nature of internet gaming. A comprehensive assessment and multidisciplinary team approach is essential to managing the IGD.

Psychometric properties of the Problematic Online Gaming Questionnaire (POGQ) in a Moroccan sample of university students

BACKGROUND

The Problematic Online Gaming Questionnaire (POGQ) instrument consists of 18 items with a six-factor structure. This questionnaire is widely utilized to measure the degree of problematic online gaming, but the scale has not, up to date, been validated in Arabic language. This study aimed to assess POGQ scale validity and reliability in Moroccan context.

METHODS

The research was conducted from April to June 2023 using an online questionnaire. The selected sample involved Moroccan university students. Data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the first sample (n1 = 143). Then, this structure was confirmed in the second sample (n2 = 313) using confirmatory factor analysis (CFA).

RESULTS

The EFA and CFA results demonstrated that the POGQ has a six-factor structure explained 72% of the total variance. The results of this analysis provided an optimal fit to the data confirming a good performance of the measurement model (χ² = 243.6; CFI = 0.981; TLI = 0.976; RMSEA = 0.048; NFI = 0.964; IFI = 0. 981; SRMR = 0.022). The instrument showed sufficient reliability and convergent validity demonstrated by acceptable values of composite reliability (CR = 0.68-0.90), and average variance extracted (AVE = 0.50-0.75), respectively. Finally, the Arabic version of POGQ was found to have a high test-retest reliability.

CONCLUSIONS

The Arabic version of POGQ revealed adequate psychometric properties. As a result, the instrument might be used to measure the degree of problematic online gaming. The use of the POGQ is expected to further promote research on online game dependence treatment and prevention.

Factor structure and psychometric properties of an Arabic version of the Internet Gaming Disorder Scale, short form (IGDS-SF9)

Background

In its most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychological Association recognized that internet gaming disorder is a psychological condition and provides nine criteria for its diagnosis, and the Internet Gaming Disorder Scale, short form (IGDS-SF9) was developed to assess individuals.

Aim

To develop and investigate the psychometric properties of an Arabic version of IGDS-SF9.

Method

A five-stage translation and verification process produced an Arabic version of IGDS-SF9, and a study was conducted using a sample of 410 respondents (45.6% females, mean age = 17.6, SD = 1.56) to assess its psychometric properties. Respondents completed the Arabic version, the Smartphone Addiction Scale, the Smartphone Application-Based Addiction Scale, the Hospital Anxiety and Depression Scale, as well as a demographic survey. Exploratory and confirmatory factor analyses, measurement invariance, item response theory, convergent, concurrent, criterion validity, and internal consistency reliability and test-retest reliability were employed to validate the scale.

Results

The exploratory factor analysis suggested the scale's unidimensional structure; the confirmatory factor analysis exhibited good model fit and factor loadings. Measurement invariance, and concurrent, convergent, and criterion validity were established, resulting in good internal consistency and test-retest reliability for the scale.

Conclusion

The Arabic version of IGDS-SF9 is a valid and reliable measure for research and diagnosis in Arabic-speaking countries.

No evidence that Chinese playtime mandates reduced heavy gaming in one segment of the video games industry

Governments around the world are considering regulatory measures to reduce young people's time spent on digital devices, particularly video games. This raises the question of whether proposed regulatory measures would be effective. Since the early 2000s, the Chinese government has been enacting regulations to directly restrict young people's playtime. In November 2019, it limited players aged under 18 to 1.5 hours of daily playtime and 3 hours on public holidays. Using telemetry data on over seven billion hours of playtime provided by a stakeholder from the video games industry, we found no credible evidence for overall reduction in the prevalence of heavy playtime following the implementation of regulations: individual accounts became 1.14 times more likely to play heavily in any given week (95% confidence interval 1.139-1.141). This falls below our preregistered smallest effect size of interest (2.0) and thus is not interpreted as a practically meaningful increase. Results remain robust across a variety of sensitivity analyses, including an analysis of more recent (2021) adjustments to playtime regulation. This casts doubt on the effectiveness of such state-controlled playtime mandates.

Pilot data findings from the Gothenburg treatment for gaming disorder: a cognitive behavioral treatment manual

Background

Gaming disorder (GD) is a new diagnosis included in the latest edition of the International Classification of Disease -11. Recently conducted international studies suggest a prevalence rate close to 2% for GD, highlighting the need for effective treatments for this patient population. Internationally there are few studies investigating effective treatments specifically designed for this condition. In this pilot study, we wanted to test a newly developed method, the Gothenburg Treatment for Gaming Disorder (GOT-TO-GO) manual; a 15-week cognitive behavioral therapy treatment for GD.

Method

This study utilized a single group design with pretest, post-test and a three- and six-month follow-up, with measures of severity of GD and mood. The participants (n = 28) were treatment-seeking adults with GD, aged 17 to 49 years.

Results

The results show a statistically significant decrease in symptoms of GD after treatment. Hours of gaming per week also decreased concomitantly with a 100% increase in non-gaming leisure hours. The decrease in symptoms of GD was maintained at the 3-months follow-up after treatment. Correspondingly we saw a decrease in both depression and anxiety that also was upheld 3 months after treatment.

Conclusion

As GD is a new diagnostic concept more research is needed, also taking psychiatric comorbidity into consideration, to arrive at evidence-based conclusions regarding effective treatments. Considering the promising results in this small pilot study with large behavioral changes and reduced symptoms of GD, upheld at least 3 months after treatment, a larger randomized controlled study is warranted.Clinical Trial Registration: https://www.clinicaltrials.gov/ct2/show/study/NCT05328596?term=NCT05328596&draw=2&rank=1, identifier NCT05328596.

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.

The Moderating Role of Well-Being in the Relationship Between Gaming Motivation and Problematic Gaming

The aim of this study was to explore the moderating role of psychosocial well-being in the relationship between gaming motivation and problematic gaming among problematic and recreational online gamers. Data from 511 online video game players (M = 24.89, SD = 6.39) were analyzed. Problematic online gaming was positively correlated with social anxiety, loneliness, and stress, as well as with social escape, competition, coping, skill development, and fantasy motives for playing online video games. Negative correlation was found between problematic gaming and life satisfaction. The results showed significant interaction terms between loneliness and social motive, life satisfaction and recreation and coping motive, and stress and fantasy motive among problematic gamers. Furthermore, results showed a significant interaction term between stress and skill development motive among recreational gamers. The results are discussed in the framework of the compensatory internet use model (Kardefelt-Winther, 2014a).

Lack of educational impact of video game addiction in children and adolescents diagnosed with ADHD: A cross-sectional study

Introduction

The use of video games has become widespread worldwide. Excessive use of video games is increasingly becoming a matter of concern, particularly in patients diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Currently, internet gaming disorder (IGD) is not included within the DSM-5-chapter Disorders related to substances and addictive disorders.

Methods

This is a post-hoc descriptive naturalistic study comparing children and adolescents diagnosed with ADHD with and without IGD. We used the 85% cut-off point of the test ADITEC-V for video game addiction to split our sample of ADHD patients into those with IGD (>=85%) and those without IGD (<85%).

Results

13 (25%) out of the 51 children and adolescents with ADHD included in our study had an IGD. Patients with IGD had a first contact with internet, smartphones, and videogames at a very early age (5.67 ± 3.31, 6.33 ± 4.60, and 7.50 ± 2.61, respectively). However, only age at first contact with the internet was statistically significantly different when comparing ADHD patients with and without IGD (8.68 ± 2.71 vs. 5.67 ± 3.31, t = 3.166, df = 47, p = 0.01). Different neurodevelopmental, clinical, and neuropsychological measures converging in impulsivity is a risk factor for IGD. Unexpectedly, we found no association between IGD and poor academic achievement.

Discussion

Future studies may include randomized controlled trials for treating IGD, the study of social adjustment as a protective factor against developing an IGD, and the role of serious and non-serious video games in the development of an IGD, among others. Additional research is clearly needed on IGD.

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.

The relationship between psycho-environmental characteristics and wellbeing in non-spending players of certain mobile games

Revenue generation in modern digital games is often dependent on in-game continuous player spending. This brings concerns that games may be including features which drive player spending in potentially harmful ways. Moreover, it is unknown what types of individuals may be vulnerable to these design-driven harms. We used player-donated, objective data of playtime and in-game spending from a sample of 295 players of games previously identified as 'designed to drive spending'. We combined this with psycho-environmental characteristics and wellbeing measures administered to the players. Quantile regression analyses did not show an interaction between player characteristics and playtime/spend as predictors of wellbeing outcomes; nor did we find a difference in wellbeing between players of these games and games with alternative monetization models. This is discussed in light of a low proportion of spenders in the sample, which may affect results pertaining to the moderating role of spend. However, it suggests that while design features in games aiming to drive player spend may be unethical and problematic, they may not necessarily cause harm to the normative player.

Internet and Video Games: Causes of Behavioral Disorders in Children and Teenagers

Even though video games have been present among children for many years, children are using them more continuously and in an abusive and indiscriminate way nowadays because of the "technological boom". It is affecting the behavior of children and adolescents. This is the reason why we are carrying out this systematic review. The main objective of this article is to investigate literature that directly connects the continuous and undifferentiated use of video games with the emergence of behavioral disorders in children and young people. The PRISMA statement was followed in the process of this article. We used SCOPUS, Web of Science and PubMed as databases, moreover, we searched studies with a scoping review. The results indisputably supported six out of seven of our hypotheses. We find that the excessive use of video games causes addiction to technology, aggressive behaviors, sleep disorders, and poor school performance. In addition, it hinders social relationships and the development of emotional intelligence. To conclude, it is necessary to correctly use video games in particular, and technologies in general, adapting their content to children's age, as well as the amount of time that they dedicate to use them.

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.

An Analysis of the Social Context of Video Games, Pathological Gaming, and Depressive Symptoms

This study addresses the relationship between the social context in which individuals play video games, pathological gaming, and depressive symptoms. A sample of 265 participants recruited through local gaming communities completed an online survey asking questions pertaining to demographics, the most common social context of their gaming, depressive symptoms, and pathological gaming. Participants also responded to the open-ended question "How do you feel gaming has impacted you socially? Why?" Many participants felt gaming helped to expand their social circle, maintain existing relationships, develop social skills, and connect with others during Covid-19 lockdowns. A small minority of participants reported that gaming displaced time they could have spent with friends and family, and sometimes damaged their social skills. Using an Ordinary Least Squares regression framework, quantitative results indicate that those who gamed primarily in-person with friends displayed lower levels of pathological gaming than all other contexts. Those who gamed in-person with friends also displayed lower levels of depressive symptoms, although this was found to be somewhat a function of time spent gaming. These results indicate that perhaps in-person gaming with friends is a protective context for gaming compared with online gaming, or solitary gaming.

Attentional biases and daily game craving dynamics: An ecological momentary assessment study

BACKGROUND AND AIMS

Theories posit that the combination of external (e.g. cue exposure) and internal (e.g. attention biases) factors contributes to the development of game craving. Nevertheless, whether different components of attentional biases (namely, engagement bias and disengagement bias) play separate roles on game craving has not been fully elucidated. We aimed to examine the associations between two facets of attentional biases and game craving dynamics under a daily life setting.

METHODS

Participants (110 regular internet game players) accomplished the modified attentional assessment task in the laboratory, after which they entered a 10-day ecological momentary assessment (EMA) to collect data on their momentary game craving and occurrence of game-related events at five different time points per day.

RESULTS

We found that occurrence of game-related events was significantly associated with increased game craving. Moreover, attentional disengagement bias, instead of engagement bias, bore on the occasional level variations of game craving as moderating variables. Specifically, attentional disengagement bias, not engagement bias, was associated with a greater increase in game craving immediately after encountering a game-related event; however, neither attentional engagement bias nor disengagement bias was associated with the craving maintenance after a relatively long period.

DISCUSSION AND CONCLUSIONS

The present study highlights the specific attentional processes involved in game craving dynamics, which could be crucial for designing interventions for attentional bias modification (ABM) in Internet Gaming Disorder (IGD) populations.

“These People Had Taken Advantage of Me”: A Grounded Theory of Problematic Consequences of Player Interaction with Mobile Games Perceived as “Designed to Drive Spending”

Many games which incorporate microtransactions—uncapped, repeated in-game purchases—are described by players as having had their 'dynamics designed to drive spending'. Such games are perceived by players as designed primarily to encourage spending, rather than with the improvement of the player experience in mind. However, it is unknown how playing these games affects players. We addressed the research question of “What consequences might there be of interaction with games perceived as having had their dynamics designed to drive spending?” considering adult players. We conducted semi-structured interviews and used a grounded theory method of analysis. Our findings revealed five life areas of problematic consequences: financial issues, problems at work and education due to distraction and lack of productivity, emotional consequences for self-perception, problems sleeping, and social consequences. These outcomes emerge from the interaction of players with certain vulnerability traits with these game mechanics. We discuss these findings in the context of gaming disorder and the gamblification of games.

Effectiveness of multimodal psychotherapeutic intervention for internet gaming disorder

BACKGROUND

Large number of studies on Internet gaming disorder (IGD) have primarily focused on ascertaining its psychological correlates. Few studies have focused on developing and assessing effectiveness of multimodal psychotherapeutic intervention programs. This intervention focused on minimizing salience, pre-occupation, conflict related to gaming and enhancing the overall quality of life, inclusive of psychological health, physical health, and environmental problems in individuals with IGD. At present, there appear to be no such studies in the Indian context.

METHODS

In this study, we developed and assessed the effectiveness of an intervention manual for IGD. The intervention program consisted of ten 60-minutes sessions with one therapist administering sessions once in each week. The interventions included motivational enhancement strategies, cognitive restructuring, behavioral strategies and relapse prevention. The outcomes from intervention were measured in terms of improvement in IGD, IAT, and overall quality of life. Our assessments, both at baseline and post-intervention consisted of Internet Addiction Test (IAT), Internet Gaming Disorder Test (IGD-20) and the Whoqol-Bref. A total sample of 40 was selected out of which 33 individuals completed the 10 sessions of multimodal psychotherapy program and post assessments.

RESULTS

A total of 40 participants (age: M = 20.25, SD = 5.39) enrolled, out of which 33 completed the entire intervention program of 10 sessions and showed significant improvements. The IAT and IGD-20 showed significant difference in the scores for before treatment (M = 52.88, SD = 16.25) and after treatment (M = 42.87, SD = 11.31; t (32) = 5.10, p = 0.000) conditions; and right before treatment (M = 56.88, SD = 19.25) and after treatment (M = 47.87, SD = 15.31; t (32) = 6.94, p = 0.000) conditions respectively. The internet addiction and internet gaming disorder scores showed a similar degree of severity reductions on the IAT and IGD-20 respectively at the end of week 8. In addition, the participants showed significant improvements in the quality of life inclusive of physical and psychological health post the completion of intervention program.

LIMITATIONS

The sample size of the study was small and assessments for evaluation of other psychological symptoms like depression, anxiety could have been conducted.

CONCLUSION

The intervention program indicated a substantial change in the IGD scores at post- assessment. A study on a larger sample to assess the validity of the manualized multimodal psychotherapy program for IGD needs to be conducted. In addition, this manualized intervention program can be useful for administering structured intervention for IGD by mental health professionals working in the area of internet gaming disorder.

Prevalence and factors associated with Internet gaming disorder among adolescents in Saudi Arabia: A cross-sectional study

This study aimed to assess the prevalence of internet gaming disorder (IGD) and its associated factors among a sample of adolescents in the Faifa governorate in the south of Saudi Arabia. This was a cross-sectional study targeting intermediate and secondary school adolescent students in the Faifa governorate. Multistage sampling was performed to reach the required sample, where 9 schools were randomly selected, followed by the distribution of the questionnaire to all students at all levels. IGD was assessed using a validated Arabic version of the 20-item IGD scale. A chi-square test was used to evaluate the presence of statistical differences between sample demographic data and IGD. Four hundred and fifty students participated in the current study, where 132 (29.3%) of them were classified as having IGD. The prevalence of IGD was associated with gender, year of study, maternal education status, and the number of hours spent online and playing with friends (P values 0.05). Analysis of the IDG items among the current sample indicated that most were at the conflict stage of IGD. The IGD level identified in our sample is high compared to the published literature. Faifa is a mountainous region and, due to its geographical nature, there are limited public entertainment areas. Adolescents tend to spend more time at home, where they may be more exposed to IGD. This suggests the need for strategies to ensure early identification of those at risk of IGD and to provide preventive and treatment options for these students.

Multiple-Kernel Support Vector Machine for Predicting Internet Gaming Disorder Using Multimodal Fusion of PET, EEG, and Clinical Features

Internet gaming disorder (IGD) has become an important social and psychiatric issue in recent years. To prevent IGD and provide the appropriate intervention, an accurate prediction method for identifying IGD is necessary. In this study, we investigated machine learning methods of multimodal neuroimaging data including Positron Emission Tomography (PET), Electroencephalography (EEG), and clinical features to enhance prediction accuracy. Unlike the conventional methods which usually concatenate all features into one feature vector, we adopted a multiple-kernel support vector machine (MK-SVM) to classify IGD. We compared the prediction performance of standard machine learning methods such as SVM, random forest, and boosting with the proposed method in patients with IGD (N = 28) and healthy controls (N = 24). We showed that the prediction accuracy of the optimal MK-SVM using three kinds of modalities was much higher than other conventional machine learning methods, with the highest accuracy being 86.5%, the sensitivity 89.3%, and the specificity 83.3%. Furthermore, we deduced that clinical variables had the highest contribution to the optimal IGD prediction model and that the other two modalities were also indispensable. We found that more efficient integration of multimodal data through kernel combination could contribute to better performance of the prediction model. This study is a novel attempt to integrate each method from different sources and suggests that integrating each method, such as self-administrated reports, PET, and EEG, improves the prediction of IGD.

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.

Obesity and individual performance: the case of eSports

BACKGROUND/OBJECTIVES

The study considers the problem of the inclusion of people with obesity in the context of the growing role of computer-based work. Negative stereotypes about people with obesity still hold even when they are irrelevant in tasks that require little physical activity.

SUBJECTS/METHODS

Using data from the realm of competitive video gaming (eSports) and image recognition-based metric of body mass index metric derived from artificial intelligence, we examine the individual performance depending on weight. The sample includes 821 players and 127,533 player performance observations.

RESULTS

For shorter tasks, individuals with normal weight performed better than individuals with obesity. For longer tasks, however, people with Class III (severe) obesity outperformed all others, and their advantage increased with task duration.

CONCLUSIONS

Our findings shed light on an understanding of how actually body features are related to objective individual performance in a competitive context.

Problematic gaming and quality of life in online competitive videogame players: Identification of motivational profiles

BACKGROUND

Online competitive practice of video games has recently known a significant worldwide expansion. However, this practice can be associated to problematic use and deterioration of quality of life depending on multiple determinants, among which motivation is central. The purpose of this study was to identify motivational clusters and to compare them regarding quality of life, problematic use of video game, and personality traits.

METHODS

Participants (N = 256) in this cross-sectional study were recruited through specialized websites to complete self-reported questionnaires assessing motivation to play online (MOGQ), personality (BFI-Fr), quality of life (WHOQOL-BREF), and problematic gaming (IGD-Scale). A hierarchical clustering analysis and intergroup comparative analyses were conducted.

FINDINGS

Three motivational clusters were identified ("recreational", "competitive" and "escapers"). "Competitive" and "escapers" players reported higher IGD scores than the "recreational" players (p <.001). However, "escapers" players had lower psychological health scores (p <.001), were more neurotic (p <.001), and less extroverted (p <.001) than the others. Based on IGD scores, "competitive" and "escapers" players were considered as problematic albeit only "escapers" exhibited a functional impairment. Therefore, engaged and problematic players cannot be differentiated with IGD scores.

DISCUSSION

IGD scores were insufficient to differentiate between players at risk of evolution toward pathological states (i.e., "escapers" players) and those whose strong engagement is not detrimental to their quality of life (i.e., "competitive" players). Consequently, considering both psychological health and motivation is necessary to assess the problematic nature of competitive videogame practice. Better definitions and assessment tools are essential in order to avoid over-diagnosis of non-pathological gaming behavior.

The Role of Impulsivity and Reward Deficiency in "Liking" and "Wanting" of Potentially Problematic Behaviors and Substance Uses

A few studies have examined the changes in substance- and behavior-related "wanting" and "liking" of human subjects, the key properties of Incentive Sensitization Theory (IST). The aim of this study was to examine the dissociation between "wanting" and "liking" as a function of usage frequency, intensity, and subjective severity in individuals across four substances (alcohol, nicotine, cannabis, and other drugs) and ten behaviors (gambling, overeating, gaming, pornography use, sex, social media use, Internet use, TV-series watching, shopping, and work). Also, the potential roles of impulsivity and reward deficiency were investigated in "wanting," "liking," and wellbeing. The sex differences between "wanting" and "liking" were also examined. Based on our findings using structural equation modeling with 749 participants (503 women, M age = 35.7 years, SD = 11.84), who completed self-report questionnaires, "wanting" increased with the severity, frequency, and intensity of potentially problematic use, while "liking" did not change. Impulsivity positively predicted "wanting," and "wanting" positively predicted problem uses/behaviors. Reward deficiency positively predicted problem uses/behaviors, and both impulsivity and problem uses/behaviors negatively predicted wellbeing. Finally, women showed higher levels of "wanting," compared to men. These findings demonstrate the potential roles of incentive sensitization in both potentially problematic substance uses and behaviors.

The effects of an early intervention on adults' gaming-related problems - a pilot study

Gaming Disorder (GD) has been recognized as an official psychiatric condition characterized by individuals' impaired control over gaming, continuous gaming despite the occurrence of negative side-effects, and gaming taking increasing priority over other important areas of life, thus leading to significant impairments in their everyday lives. To date few prevention and treatment programs have been developed. The present pilot study aimed to investigate the effects of an early psycho-educational intervention for young adults with excessive gaming behaviors. A one-group pre- and post-test design without a control group was used. A total of 22 young adults (20 males and 2 females) aged between 18 and 28 (M = 23.05, SD = 3.02) years old, engaged with the intervention. The severity of gaming-related problems, average gaming time per day, quality of life, and mental well-being were assessed at pretest and post-test stages. Participants demonstrated a slight reduction in gaming time (d = 0.13, p = .545 for weekdays, and d = 0.08, p = .714 for weekend days) and in the severity of problematic gaming (d = 0.17, p = .411) over the three-month intervention period. Changes in neither gaming-related measures nor self-assessed quality of life (p > .01) and mental well-being (d = 0.23, p = .288) reached statistical significance, however. Regardless of limitations on sample size, this study shows encouraging signs that this brief 10-session and three-month educational intervention can achieve positive effects on gaming behavior. A larger scale investigation is needed to develop the intervention further.

Effectiveness of Cognitive Behavioral Therapy-Based Intervention in Preventing Gaming Disorder and Unspecified Internet Use Disorder in Adolescents: A Cluster Randomized Clinical Trial

IMPORTANCE

Behavioral addictions were introduced as novel mental disorders in the International Classification of Diseases, 11th Revision, based on evidence that human behavior itself can become addictive, similar to addiction to substances. However, previous studies on prevention of gaming disorder and unspecified internet use disorder lacked randomization, follow-up measurements, and diagnostic interviews that assessed incidence rates; this trial was intended to fill this gap.

OBJECTIVES

To investigate whether the PROTECT (Professioneller Umgang mit technischen Medien [Professional Use of Technical Media]) intervention can reduce the symptom severity and prevent full syndrome and subthreshold onset of gaming disorder and unspecified internet use disorder in at-risk adolescents.

DESIGN, SETTING, AND PARTICIPANTS

A multicenter cluster randomized clinical trial conducted recruitment, screening, intervention delivery, and data collection among at-risk adolescents aged 12 to 18 years in 33 high schools in Germany. Inclusion criteria for the study and symptom severity analyses were elevated symptoms of gaming disorder and unspecified internet use disorder. A subsample that met the inclusion criteria for incidence analyses (no full syndrome of gaming disorder or unspecified internet use disorder, depression, or anxiety at baseline) was analyzed for illness onset. Participants were randomized to either the PROTECT intervention group or the assessment-only control group. Participants were assessed at baseline, 1-month follow-up, 4-month follow-up, and 12-month follow-up between October 1, 2015, and September 30, 2018. Based on intent-to-treat principle, data analyses were conducted from February 8, 2019, to May 7, 2021.

INTERVENTIONS

PROTECT, a theory-driven, manualized, cognitive behavioral therapy-based indicated preventive group intervention that is delivered in 4 sessions by trained psychologists. It targets changes in addictive reward processing and pathological cognitive mechanisms.

MAIN OUTCOMES AND MEASURES

The primary outcome was symptom severity (measured by CSAS [Computerspielabhängigkeitsskala], a modified German video game dependency scale with a score range of 0-56 [higher scores indicating greater pathology]) along with incidence rates (assessed by a structured clinical interview) after 12 months. Secondary outcomes were comorbid psychopathology and problem behaviors.

RESULTS

A total of 422 at-risk adolescents (mean [SD] age, 15.11 [2.01] years; 229 female participants [54.3%]) were randomized to either the PROTECT intervention group (n = 167; mean [SD] risk score, 29.05 [6.98]) or the assessment-only control group (n = 255; mean [SD] risk score, 26.21 [5.01]) and were included in the symptom severity analyses. Compared with the control group, the PROTECT group showed a significantly greater reduction in symptom severity of gaming disorder or unspecified internet use disorder (γ11 = -0.128; 95% CI, -0.246 to -0.011; P = .03), reflecting a 39.8% vs 27.7% reduction of symptoms with an effect size of Cohen d = 0.67 (baseline vs 12-month follow-up) for the PROTECT group. Differences in incidence rates did not reach statistical significance. The PROTECT group showed a significantly greater decrease in procrastination (γ11 = -0.458; 95% CI, -0.735 to -0.180; P < .001) over 12 months, but no significant differences were found for other secondary outcomes.

CONCLUSIONS AND RELEVANCE

Results of this trial showed that the PROTECT intervention effectively reduced symptoms of gaming disorder and unspecified internet use disorder over 12 months. The intervention did not change incidence rates of gaming disorder or unspecified internet use disorder.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02907658.

Evidence on Problematic Online Gaming and Social Anxiety over the Past Ten Years: a Systematic Literature Review

Purpose of Review

The present study aimed to review the literature concerning the relationship between problematic online gaming (POG) and social anxiety, taking into account the variables implicated in this relationship. This review included studies published between 2010 and 2020 that were indexed in major databases with the following keywords: Internet gaming, disorder, addiction, problematic, social phobia, and social anxiety.

Recent Findings

In recent years, scientific interest in POG has grown dramatically. Within this prolific research field, difficulties associated with social anxiety have been increasingly explored in relation to POG. Indeed, evidence showed that individuals who experience social anxiety are more exposed to the risk of developing an excessive or addictive gaming behavior.

Summary

A total of 30 studies satisfied the initial inclusion criteria and were included in the present literature review. Several reviewed studies found a strong association between social anxiety and online gaming disorder. Furthermore, the relationships among social anxiety, POG, age, and psychosocial and comorbid factors were largely explored. Overall, the present review showed that socially anxious individuals might perceive online video games as safer social environments than face-to-face interactions, predisposing individuals to the POG. However, in a mutually reinforcing relationship, individuals with higher POG seem to show higher social anxiety. Therefore, despite online gaming might represent an activity able to alleviate psychopathological symptoms and/or negative emotional states, people might use online gaming to counterbalance distress or negative situations in everyday life, carrying out a maladaptive coping strategy.

The Relation of Motivation Factors for Online Games With Personality Disorders, Addiction, Shyness, and Loneliness in Kuwait

Drawing on the Self-Development Theory (SDT), this study examines the relation between the factors that motivate online gaming and the effects of addiction, shyness, and loneliness. We have modified the SDT theory by adding intrinsic and extrinsic factors to measure the degree of its effect on addiction in online gaming settings. Next, we develop a special instrument to measure gamers’ experience and their level of addiction. The sample is 671 online gamers who participated in an online survey. A confirmatory factor analysis and structured equation modeling tests are conducted to identify reliable factors and the goodness of fit of the research model. The findings show that the effect of addiction on shyness and loneliness is minor. Furthermore, loneliness is affected mostly by anxiety of others. In addition, the challenge of meeting the goals of gaming has the greatest effect on addiction. The study offers important implications for decision makers among family members such as parents and among society in general such as policy makers to avoid side effects of online gaming.

Digital risks and adolescents: The relationships between digital game addiction, emotional eating, and aggression

Nowadays, weight gain and obesity are major health-threatening issues for children. Emotional eating, a negative health condition that can lead to obesity in children, is a defence mechanism for coping with negative emotions. This cross-sectional study aimed to evaluate the relationships between emotional eating behaviour and digital game addiction, which can cause stress and aggression in adolescents. This study was conducted with 856 adolescents from the Mediterranean region of Turkey. The data were collected using a personal information form, the Buss-Perry Aggression Questionnaire (BPAQ), the Digital Game Addiction Scale (DGAS-7), and the Emotional Eating Scale (EES). In this study, 32.4% of the adolescents were addicted to digital games. The male adolescents had higher BPAQ, DGAS, and EES mean scores. There was also a relationship between digital game addiction, aggressive behaviour, and emotional eating. This is a significant study because it shows that digital game addiction and aggressive behaviour are important determinants of emotional eating. The results of this study indicate that emotional eating is a component of digital game addiction that increases the risk of adolescent obesity.

Adolescents with Internet Gaming Disorder are more likely to have Lower Score of Cognitive Function: A Cross-sectional Study among Junior High School Students in Yogyakarta, Indonesia

BACKGROUND: Internet Gaming Disorder (IGD) has emerged as a rapidly rising public health problem mostly affecting children and adolescent worldwide, as a result of massive growth of technology and internet usage in recent years. Adolescents are the most vulnerable age group to problematic internet gaming use due to lack of cognitive control. AIM: This study aims to investigate the association between IGD and cognitive function among junior high school- students in Indonesia. METHODS: The subjects of this cross-sectional study were students at two randomly selected junior high schools in Yogyakarta, Indonesia. The Game Addiction Scale-7 Indonesian version and the Modified Mini Mental State Examination for Children-Indonesian version were used to assess IGD and cognitive function, respectively. Multivariate analysis with linear regression was used to determine the relationship between IGD and cognitive function. RESULTS: There were 142 subjects with a mean age of 14 years. Students with IGD significantly had lower score of cognitive function, particularly for domains of attention (p = 0.000), recall memory (p = 0.000), and language (p = 0.002), compared with the counterpart group. Furthermore, multivariate analysis showed that students with IGD were more likely to have lower cognitive function score by 1.40 points than those without IGD (B = –1.40, 95% CI -2.51–-0.29, R2 = 0.469). CONCLUSIONS: IGD was negatively associated with cognitive function. Junior high school students with IGD in Indonesia had lower score of cognitive function compared with students without IGD, particularly in the domains of attention, recall memory, and language. Clinicians, teachers, and parents should be more aware of the detrimental effect of IGD. Further study with larger sample size, diverse subjects, and wider age range is still needed.

Effects of massively multiplayer online role-playing games on psychological health and inter-personal relationships of the male youth: A cross-sectional study in sub-urban Kolkata, West Bengal, India

Gaming related experiences and addictive behaviours are emerging causes of adverse psycho-social health such as depression, anxiety, in adolescents and young adults around the world. Nonetheless, there remains a dearth of information relating to adolescents and young adults in India, a country which has millions of gamers.

Present study examined the effects of massively multiplayer online role-playing games on the psychological health and inter-personal relationships of adolescents and young male adults of sub-urban Kolkata, West Bengal, India.

Questionnaires were used to collect data on socio-economic and lifestyle traits, psychological health and inter-personal relationships were obtained from both gamers (n = 150) and non-gamers (n = 150). Data on gaming experiences and addiction were obtained only from gamers. MANCOVA and linear regression were performed to understand the effects of socio-economic and lifestyle traits, gaming experience and addiction traits on psychological health and inter-personal relationships of gamers.

Study findings revealed that both gamers and non-gamers derived from a similar age group (mean age = 19.94 years) and socio-economic cluster. Disparities in psychological health in terms of depression, anxiety and stress and inter-personal relationship in terms of parent and peer attachments were present across social groups and between gamers and non-gamers. Various problematic gaming experiences and gaming related addictive behaviours resulted in poor psychological health and inter-personal relationship with parents and peers.

Male gamers were at high risk to develop adverse psychological health and poor inter-personal relationships with parents and peers due to problematic gaming experience and gaming addiction. Proper education and counselling regarding the beneficial and detrimental sides of gaming may ensure better psycho-social health of adolescents and young adults in India.

Decision-making, cognitive functions, impulsivity, and media multitasking expectancies in high versus low media multitaskers

In several studies, individuals who reported to frequently multitask with different media displayed reduced cognitive performance, for example in fluid intelligence and executive functioning. These cognitive functions are relevant for making advantageous decisions under both objective risk (requiring reflection and strategical planning) and ambiguous risk (requiring learning from feedback). Thus, compared to low media multitaskers (LMMs), high media multitaskers (HMMs) may perform worse in both types of decision situations. The current study investigated HMMs and LMMs in a laboratory setting with the Game of Dice Task (GDT; objective risk), the Iowa Gambling Task (IGT; ambiguous risk), various tests quantifying cognitive functions (logical reasoning, working memory, information processing, general executive functions), and self-report measures of impulsivity, media multitasking expectancies, and problematic Internet use. From 182 participants, 25 HMMs and 19 LMMs were identified using the Media Multitasking Index. Results show that HMMs compared to LMMs performed weaker on the IGT but not on the GDT. Furthermore, HMMs had slightly decreased performance in tests of logical reasoning and working memory capacity. HMMs tended to increased information processing speed but this difference was not significant. Furthermore, HMMs have more positive expectancies regarding media multitasking and reported higher tendencies toward problematic Internet use. HMMs and LMMs did not differ significantly with respect to impulsivity and executive functions. The results give a first hint that HMMs may have difficulties in decision-making under ambiguous but not under objective risk. HMMs may be more prone to errors in tasks that require feedback processing. However, HMMs appear not to be impaired in aspects of long-term strategic decision-making.

The relationship between mental well-being and dysregulated gaming: a specification curve analysis of core and peripheral criteria in five gaming disorder scales

Gaming disorder (also known as dysregulated gaming) has received significant research and policy attention based on concerns that certain patterns of play are associated with decreased mental well-being and/or functional impairment. In this study, we use specification curve analysis to examine analytical flexibility and the strength of the relationship between dysregulated gaming and well-being in the form of general mental health, depressive mood and life satisfaction. Dutch and Flemish gamers (n = 424) completed an online survey containing five unique dysregulated gaming measures (covering nine scale variants) and three well-being measures. We find a consistent negative relationship; across 972 justifiable regression models, the median standardized regression coefficient was -0.39 (min: -0.54, max: -0.19). Data show that the majority of dysregulated gaming operationalizations converge upon highly similar estimates of well-being. However, variance is introduced by the choice of well-being measure; results indicate that dysregulated gaming is more strongly associated with depressive mood than with life satisfaction. Weekly game time accounted for little to no unique variance in well-being in the sample. We argue that research on this topic should compare a broad range of psychosocial well-being outcomes and explore possible simplifications of the DSM-5 gaming disorder criteria. Given somewhat minute differences between dysregulated gaming scales when used in survey-based studies and largely equivalent relationships with mental health indicators, harmonization of measurement should be a priority.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

The Mediating Role of Impulsivity and the Moderating Role of Gender Between Fear of Missing Out and Gaming Disorder Among a Sample of Chinese University Students

The role of fear of missing out (FoMO) in addictive behaviors has recently attracted growing attention. In view of negative effects of gaming disorder (GD) among adolescents and emerging adults, research examining the relationship between FoMO and GD is needed, alongside the roles of impulsivity and gender in the relationship between FoMO and GD. This study examined whether impulsivity as a mediator and gender as a moderator impacted on the relationship between FoMO and GD among a sample of Chinese university students. A sample of 1,288 Chinese university students from three universities completed an online survey through the Wenjuanxing platform. The Chinese Trait-State Fear of Missing Out Scale, the Barratt Impulsiveness Scale-Brief, and the Chinese Gaming Disorder Scale were used in this study. The model results indicated that impulsivity partially mediated the relationship between FoMO and GD, and that there was a larger effect size between impulsivity and GD among males. High levels of FoMO among individuals may impact on executive functions leading to more impulsivity, and are associated with GD. Gender may moderate the relationship between impulsivity and GD. This study deepens the understanding of the relationship between FoMO and GD, and provides new perspectives for practitioners to incorporate into health prevention programs to help regulate emotion, control impulsivity, and decrease GD.

Online Videogames Use and Anxiety in Children during the COVID-19 Pandemic

Videogames use has constantly increased among children and adolescents, with uncertain consequences on their health. This study aimed to assess the prevalence of videogames use and addiction in a sample of Italian children during the COVID-19 pandemic and their association with anxiety symptoms. One hundred and sixty-two children (M/F:78/84; age range: 8–10 years; average age 9.4 ± 0.7 years) completed the Videogame Addiction Scale for Children (VASC), the Test of Anxiety and Depression (TAD) and the Children’s Anxiety Meter—State (CAM-S). Demographic variables and data on the access to electronic tools and games preferences were also collected. Overall, 96.3% of the study participants stated to have access to one or more device. They reported a low risk of videogame addiction (VASC score (mean ± SD): 46.7 ± 15.4), a moderate level of trait anxiety (TAD score (mean ± SD): 135 ± 16.8) and a low state anxiety (CAM-S score (mean ± SD): 2.2 ± 2.1). Males reported to spend more time on videogames, to perceive higher self-control and to be more influenced by reinforcement mechanisms; females described higher levels of trait anxiety. In the regression analysis, state anxiety was a predictor of videogame use and addiction (p = 0.01). Further research is needed to confirm these data and to maximize the developmentally positive effects of videogames and preventing the negative consequences.

The Influence of Parental Knowledge and Basic Psychological Needs Satisfaction on Peer Victimization and Internet Gaming Disorder among Chinese Adolescents: A Mediated Moderation Model

Ample evidence indicates that peer victimization is a crucial risk factor for adolescent internet gaming disorder (IGD); however, little is known about the mechanisms underlying this association. Based on the risk-buffering model and self-determination theory, this study tested whether parental knowledge moderated the relationship between peer victimization and adolescent IGD and whether this moderating effect was mediated by basic psychological needs satisfaction (BPNS). A sample of 3080 adolescents (Mean_age = 14.51; SD = 1.97) anonymously responded to a set of questionnaires. The results revealed that the positive association between peer victimization and adolescent IGD was stronger among adolescents with parents who had low-level parental knowledge than for those with high-level parental knowledge. Moreover, this moderating effect was mediated by BPNS. These findings highlight that parental knowledge is an important protective factor against IGD for adolescents who experience peer victimization and BPNS is one mechanism that explains how this effect works.

The recognition of gaming disorder in China: a case series of 223 patients

Background

Internet gaming disorder (IGD) was listed in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a condition requiring further study in 2013, and gaming disorder (GD) was considered a mental disorder and listed in the 11th International Classification of Diseases Manual (ICD-11) in 2018. The study aims to obtain preliminary knowledge of the recognition of GD in China.

Methods

A total of 223 Chinese patients who met both the ICD-11 and DSM-5 criteria for GD participated in the study, and a self-administered questionnaire was used to collect demographic information, gaming use characteristics, and previous diagnoses.

Results

The average age of patients with GD was 20.5 years, and 71.3% were male. Most patients were diagnosed with emotion-related disorders at their first psychiatric visit: mood disorders (59.2%), bipolar affective disorder (18.4%), depressive episode (12.6%), and anxiety disorder (4.9%). Among the adolescent patients with a first diagnosis of mood disorders, 71.2% and 33.3% were diagnosed with bipolar affective disorder and personality disorders, respectively, at subsequent visits. Overall, after the first visit, the most common diagnosis was bipolar affective disorder (61.0%), followed by personality disorders (34.1%), mood disorders (17.0%), depressive episode (17.0%), and other disorders. Only three patients had Internet overuse.

Conclusion

The identification rate of GD is extremely low in routine psychiatric clinical practice in China. Most patients with GD were previously misdiagnosed with emotion-related disorders. Psychiatrists should be trained to improve their ability to recognize and manage GD.

Internet Gaming Disorder Increases Mind-Wandering in Young Adults

As a primary symptom defining Internet gaming disorder (IGD), preoccupation indicates a mind state in which gamers think about a gaming activity so much that other things appear less important and/or interesting to them. Previous studies have examined the negative impacts of IGD on both cognitive and affective functions, yet no study has investigated the influence of IGD on daily mind state changes that interfere with ongoing tasks. The current study hypothesized that more IGD symptoms lead to a higher frequency of mind state shift in terms of mind-wandering. As social anxiety is related to both IGD and mind-wandering, we further hypothesized that social anxiety would partially contribute to the relationship. Survey data were collected from 632 young adults who were divided into two groups based on whether they reported playing games or not. In the player group, the number of IGD symptoms present was positively related to mind-wandering (r = 0.269, p < 0.001) and social anxiety (r = 0.235, p < 0.001), with the latter two showing a positive correlation in both players (r = 0.37, p < 0.001) and non-players (r = 0.57, p < 0.001). A mediation analysis for the players showed a partial mediation effect of social anxiety on the relationship between IGD and mind-wandering (mediation effect: PM = 0.292, p < 0.001), and the model was replicated in an independent sample. This study suggests that excessive gaming behavior may increase mind-wandering and a shift towards such a non-productive mind state could exert long-term detrimental effects in adolescents and young adults.