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Demko Z, Liu T, Curtis B, Green CS. Development of a Novel Method of Assessing Potential Loss of Control in Internet Gaming Disorder. TECHNOLOGY, MIND, AND BEHAVIOR 2023; 4. [PMID: 39006169 PMCID: PMC11244577 DOI: 10.1037/tmb0000119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
As video game play has increased in popularity, so too have reports that a subset of individuals play games in a way that causes negative consequences to their lives, which has resulted in the proposed inclusion of Internet Gaming Disorder (IGD) as a formal mental health diagnosis. Given the mass popularity of video games, it is critical that screening materials for this proposed disorder are sufficiently sensitive to ensure that individuals who suffer harm are identified, while those who do not are not mislabeled as such. Here we examined the extent to which participants' responses to a typical IGD questionnaire predicted academic behaviors that could be associated with harm. We recruited 42 college students and tracked their gaming and studying habits weekly over the course of one semester, taking particular note of weeks in which participants did or did not have exams. We predicted that college students overall would spend less time engaging with video games and more time with academics when they had exams, but such modulations would be smaller among individuals with more initial IGD symptoms (i.e., the "more IGD symptoms" group, as compared to the "fewer IGD symptoms" group, would show loss of control). We did not find that college students overall spent less time engaging with video games and more time with academics when they had exams, but post-hoc effect size analyses indicated that our study was underpowered. Implications of potential results using this methodology are discussed and estimates of powerful sample sizes are provided.
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Affiliation(s)
- Zachary Demko
- Department of Psychological & Brain Sciences, University of Iowa
| | - Tingting Liu
- Technology and Translational Research Unit, National Institute on Drug Abuse Intramural Research Program
- Positive Psychology Center, University of Pennsylvania
| | - Brenda Curtis
- Technology and Translational Research Unit, National Institute on Drug Abuse Intramural Research Program
| | - C Shawn Green
- Department of Psychology, University of Wisconsin - Madison
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Chang RS, Lee M, Im JJ, Choi KH, Kim J, Chey J, Shin SH, Ahn WY. Biopsychosocial factors of gaming disorder: a systematic review employing screening tools with well-defined psychometric properties. Front Psychiatry 2023; 14:1200230. [PMID: 37533885 PMCID: PMC10390702 DOI: 10.3389/fpsyt.2023.1200230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/21/2023] [Indexed: 08/04/2023] Open
Abstract
Background and aims Considering the growing number of gamers worldwide and increasing public concerns regarding the negative consequences of problematic gaming, the aim of the present systematic review was to provide a comprehensive overview of gaming disorder (GD) by identifying empirical studies that investigate biological, psychological, and social factors of GD using screening tools with well-defined psychometric properties. Materials and methods A systematic literature search was conducted through PsycINFO, PubMed, RISS, and KISS, and papers published up to January 2022 were included. Studies were screened based on the GD diagnostic tool usage, and only five scales with well-established psychometric properties were included. A total of 93 studies were included in the synthesis, and the results were classified into three groups based on biological, psychological, and social factors. Results Biological factors (n = 8) included reward, self-concept, brain structure, and functional connectivity. Psychological factors (n = 67) included psychiatric symptoms, psychological health, emotion regulation, personality traits, and other dimensions. Social factors (n = 29) included family, social interaction, culture, school, and social support. Discussion When the excess amount of assessment tools with varying psychometric properties were controlled for, mixed results were observed with regards to impulsivity, social relations, and family-related factors, and some domains suffered from a lack of study results to confirm any relevant patterns. Conclusion More longitudinal and neurobiological studies, consensus on a diagnostic tool with well-defined psychometric properties, and an in-depth understanding of gaming-related factors should be established to settle the debate regarding psychometric weaknesses of the current diagnostic system and for GD to gain greater legitimacy in the field of behavioral addiction.
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Affiliation(s)
- Rose Seoyoung Chang
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Minju Lee
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Jooyeon Jamie Im
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Jueun Kim
- Department of Psychology, Chungnam National University, Daejeon, Republic of Korea
| | - Jeanyung Chey
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Suk-Ho Shin
- Department of Child and Adolescent Psychiatry, Dr. Shin’s Neuropsychiatric Clinic, Seoul, Republic of Korea
| | - Woo-Young Ahn
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
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Razum J, Baumgartner B, Glavak-Tkalić R. Psychometric validity and the appropriateness of tolerance as a criterion for internet gaming disorder: A systematic review. Clin Psychol Rev 2023; 101:102256. [PMID: 36878146 DOI: 10.1016/j.cpr.2023.102256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 12/16/2022] [Accepted: 02/16/2023] [Indexed: 02/26/2023]
Abstract
Tolerance is a controversial but still an omnipresent criterion in measuring problematic gaming and Internet Gaming Disorder (IGD). Despite criticisms, a systematic review of its suitability has not been conducted until now. The aim of this study was to assess the evidence of psychometric validity and the appropriateness of tolerance as a criterion for IGD. A total of 61 articles were included in the review, 47 quantitative, 7 qualitative studies,plus 7 studies that introduce potential item wordings for operationalizing tolerance. Results showed that the tolerance item tends to have acceptable to high factor loadings on the single IGD factor. While tolerance sometimes did not adequately differentiate the engaged gamers from those with a probable disorder, it was endorsed at medium to high levels of IGD severity and had a good performance in the interviews. It, however, showed weak relations with distress and well-being. In qualitative studies, tolerance as currently defined by DSM-5 and measured by questionnaires (i.e., increasing amounts of time spent on gaming) was almost unequivocally rejected by gamers. The solid performance of tolerance in psychometric studies was probably due to deficiencies of the IGD construct, which also contains other disputed criteria. Tolerance lacks relevance in measuring IGD and care should be taken when using and interpreting IGD measures with this criterion.
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Affiliation(s)
- Josip Razum
- Ivo Pilar Institute of Social Sciences, Marulićev trg 19/1, 10000 Zagreb, Croatia
| | - Benedict Baumgartner
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität, Ismaningerstr. 22, 81675, München, Germany
| | - Renata Glavak-Tkalić
- Ivo Pilar Institute of Social Sciences, Marulićev trg 19/1, 10000 Zagreb, Croatia.
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Khazaal Y, El Abiddine FZ, Penzenstadler L, Berbiche D, Bteich G, Valizadeh-Haghi S, Rochat L, Achab S, Khan R, Chatton A. Evaluation of the Psychometric Properties of the Arab Compulsive Internet Use Scale (CIUS) by Item Response Theory Modeling (IRT). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12099. [PMID: 36231401 PMCID: PMC9566183 DOI: 10.3390/ijerph191912099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The psychometric properties of the Arab translation of the Compulsive Internet Use Scale (CIUS) have been previously studied by confirmatory factor analysis (CFA) with AMOS software using the asymptotically distribution-free (ADF) estimator. Unidimensionality has been achieved at the cost of correlating several item variance errors. However, several reviews of SEM software packages and estimation methods indicate that the option of robust standard errors is not present in the AMOS package and that ADF estimation may yield biased parameter estimates. We therefore explored a second analysis through item response theory (IRT) using the parametric graded response model (GRM) and the marginal maximum likelihood (MML) estimation method embedded in the LTM package of R software. Differential item functioning (DIF) or item bias across subpopulations was also explored within IRT framework as different samples were investigated. The objective of the current study is to (1) analyze the Arab CIUS scale with IRT, (2) investigate DIF in three samples, and (3) contribute to the ongoing debate on Internet-use-related addictive behaviors using the CIUS items as a proxy. METHODS We assessed three samples of people, one in Algeria and two in Lebanon, with a total of 1520 participants. RESULTS Almost three out of every five items were highly related to the latent construct. However, the unidimensionality hypothesis was not supported. Furthermore, besides being locally dependent, the scale may be weakened by DIF across geographic regions. Some of the CIUS items related to increasing priority, impaired control, continued use despite harm, and functional impairment as well as withdrawal and coping showed good discriminative capabilities. Those items were endorsed more frequently than other CIUS items in people with higher levels of addictive Internet use. CONCLUSIONS Contrary to earlier ADF estimation findings, unidimensionality of the CIUS scale was not supported by IRT parametric GRM in a large sample of Arab speaking participants. The results may be helpful for scale revision. By proxy, the study contributes to testing the validity of addiction criteria applied to Internet use related-addictive behaviors.
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Affiliation(s)
- Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, 1015 Lausanne, Switzerland
- Department of Psychiatry and Addictology, Montréal University, Montréal, QC H3T 1J4, Canada
| | - Fares Zine El Abiddine
- Laboratory Psychological and Educational Research, Department of Psychology, University Djillali Liabes of Sidi Bel Abbes, Sidi Bel Abbes 22000, Algeria
| | - Louise Penzenstadler
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Djamal Berbiche
- Charles-LeMoyne Hospital Research Centre, Sherbrooke University, Sherbrooke, QC J1K 2R1, Canada
| | - Ghada Bteich
- Faculty of Public Health, Lebanon University, Tripoli P.O. Box 6573/14, Lebanon
| | - Saeideh Valizadeh-Haghi
- Department of Medical Library and Information Sciences, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Lucien Rochat
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Sophia Achab
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Riaz Khan
- Department of Mental Health and Psychiatry, Frontier Medical College Affiliated to Bahria University Islamabad, Abbottabad 22010, Pakistan
| | - Anne Chatton
- Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
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Stein DJ, Hartford A. Health-policy approaches for problematic Internet use: lessons from substance use disorders. Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2022.101151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Adair C, Luna-Rose H. Insights from an online self-help forum for people with gaming problems. Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2022.101157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ballou N, Zendle D. “Clinically significant distress” in internet gaming disorder: An individual participant meta-analysis. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2021.107140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Swinkels LM, Veling H, van Schie HT. Playing videogames is associated with reduced awareness of bodily sensations. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Luquiens A, von Hammerstein C, Benyamina A, Perney P. Burden and Help-Seeking Behaviors Linked to Problem Gambling and Gaming: Observational Quantitative and Qualitative Analysis. JMIR Ment Health 2021; 8:e26521. [PMID: 34842562 PMCID: PMC8665394 DOI: 10.2196/26521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/22/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Models based on the uniqueness of addiction processes between behavioral addictions are highly contentious, and the inclusion of gaming disorder in the addiction nosography remains controversial. An exploratory approach could clarify a hypothesized common and subjectively identifiable process in addictive behaviors and the necessarily different expressions of the disorder due to behavior specificities, in particular the sociocultural characteristics and profiles of users. OBJECTIVE The aim of this study was to describe the nature of contacts to a help service by exploring commonality and specificities of burden and help-seeking for problem gambling or gaming. METHODS This was an observational quantitative-qualitative study. We included all contacts (ie, online questions and contacts by phone or chat when the helper completed a summary) to a helpline for gamers, gamblers, and relatives over a 7-year period. We constituted a text corpus with online questions and summaries of contacts by phone or chat. We collected basic sociodemographic data, including the device used to contact the service (phone or internet), contacting the service for oneself ("user") or being a relative of a user and type of relative, gambling (yes/no), gaming (yes/no), and age and sex of the gambler/gamer. We describe the corpus descriptively and report the computerized qualitative analysis of online questions, chat, and summary of phone calls. We performed a descendant hierarchical analysis on the data. RESULTS A total of 14,564 contacts were made to the helpline, including 10,017 users and 4547 relatives. The corpus was composed of six classes: (1) gaming specificities, (2) shared psychological distress and negative emotions, (3) the procedure for being banned from gambling, (4) the provided help, (5) gambling specificities, and (6) financial problems. CONCLUSIONS Negative emotions and shared distress linked to gambling and gaming support current scientific consensus that these behaviors can produce psychological distress in se; however, meaningful differences were observed in core symptoms of addiction between gamers and gamblers, beyond specificities related to the behavior itself: loss of control was elicited in the class corresponding to gambling specificities and not by gamers and their relatives.
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Affiliation(s)
- Amandine Luquiens
- Universitary Hospital of Nîmes, University of Montpellier, Nîmes, France.,UVSQ, CESP, INSERM, Paris-Saclay University, University of Paris-Sud, Villejuif, France
| | - Cora von Hammerstein
- Addictions Department, Paul Brousse Hospital, APHP, Paris-Saclay University, Villejuif, France.,University Research Team EA4360 APEMAC (Health Adjustment, Measurement and Assessment, Interdisciplinary Approaches), University of Lorraine, Metz, France
| | - Amine Benyamina
- Addictions Department, Paul Brousse Hospital, APHP, Paris-Saclay University, Villejuif, France
| | - Pascal Perney
- Universitary Hospital of Nîmes, University of Montpellier, Nîmes, France.,UVSQ, CESP, INSERM, Paris-Saclay University, University of Paris-Sud, Villejuif, France
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Colder Carras M, Stavropoulos V, Motti-Stefanidi F, Labrique A, Griffiths MD. Draconian policy measures are unlikely to prevent disordered gaming. J Behav Addict 2021; 10:2021.00075. [PMID: 34762067 PMCID: PMC8987421 DOI: 10.1556/2006.2021.00075] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 12/24/2022] Open
Abstract
In August of 2021, China imposed severe restrictions on children's online gaming time. We argue that such a policy may seem useful on the surface but does not reflect the current evidence concerning prevention of disordered gaming. Videogame play is normal for children worldwide, and like other leisure activities can lead to benefits for the majority and problems for a minority. Problematic or disordered play results from the interaction of multiple risk factors that are not addressed by draconian policy measures. Identifying these factors through stakeholder-engaged research and current evidence will be much more likely to succeed in preventing disordered gaming and promoting youth wellbeing.
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Affiliation(s)
- Michelle Colder Carras
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, & Johns Hopkins University Global Digital Health Initiative, Baltimore, MD, USA
| | - Vasileios Stavropoulos
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece
| | - Frosso Motti-Stefanidi
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece
| | - Alain Labrique
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, & Johns Hopkins University Global Digital Health Initiative, Baltimore, MD, USA
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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Leonhardt M, Overå S. Are There Differences in Video Gaming and Use of Social Media among Boys and Girls?-A Mixed Methods Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116085. [PMID: 34200039 PMCID: PMC8200210 DOI: 10.3390/ijerph18116085] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 11/19/2022]
Abstract
Gaming is widespread among adolescents and has typically been viewed as an activity for boys. There are however a growing number of female gamers and we need to learn more about how gender affects gaming. The aim of this study is to both quantify gaming among Norwegian adolescents and explore how gender differences are perceived. A mixed method approach was used to capture gaming experiences among boys and girls. Survey data (N = 5607) was analyzed descriptively, and five focus groups were conducted, applying thematic analysis. Statistics showed that boys from the age of 14 use video games up to 5 times more than girls, while girls are much more on social media. From the focus groups, we found that boys did not view social media as socially significant as gaming and that there is a greater social acceptance of gaming among boys than among girls. Gender differences in video gaming are not necessarily a problem per se, as they may reflect gender-specific motivations and interests. However, the study also finds that girls feel less encouraged than boys to play video games due to different gender-related experiences of video gaming. Therefore, gendered barriers in video gaming must be explored in future research.
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Stavropoulos V, Frost TMJ, Brown T, Gill P, Footitt TA, Kannis-Dymand L. Internet gaming disorder behaviours: a preliminary exploration of individualism and collectivism profiles. BMC Psychiatry 2021; 21:262. [PMID: 34016087 PMCID: PMC8139060 DOI: 10.1186/s12888-021-03245-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/28/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Internet Gaming Disorder (IGD) behaviours involve excessive use of Internet games to the extent that one's everyday life is compromised. It has been suggested that IGD symptoms are dependent on whether one is more individualistic or collectivistic. However, the range of potential individualism-collectivismeffects on IGD presentations remains largely unknown. The current study aims to further understanding of the role of individualistic and collectivistic tendencies in IGD, allowing us to develop more gamer centredIGD prevention and intervention strategies. METHODS One thousand and thirty-twocommunity participants withinternet gaming experience were measured online for IGD symptom's severity using the Internet Gaming Disorder Scale - Short Form (IGDS9-SF) andindividualism-collectivism behavioursvia the Individualism & Collectivism Scale (ICS). Latent Class Analysis (LCA) and T-Tests were performed in relation to their responses. RESULTS Upon inspection of the LCA output, two profiles of internet gamers were identified. These includedthe Collectivism Aversivegamers (CA; 11%) and the Collectivism Neutral gamers (CN; 89%). The CA gamers displayed significantly higher IGD behaviours overall, and, were higher inpreoccupation, withdrawal symptoms, tolerance, relapse, deception, escapism/mood modification, and functional impairment compared to CN gamers. There were no differences between CA and CN gamers in loss of interest and conflicts with others. CONCLUSIONS The findings suggest that one's individualism-collectivism orientation can influence the presentation of IGD. Specifically, those who are less collectivistic or are less influenced by social groups willdisplay greater IGD symptoms and present a profile that requires a different intervention from gamers who are more collectivistic. Researchers and clinicians should emphasize the value of belonging in a collective and experiencing equality with others in relation to mental health and gaming patterns.
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Affiliation(s)
| | | | - Taylor Brown
- Institute for Health and Sprot, Victoria University, Melbourne, Australia
| | - Peter Gill
- Institute for Health and Sprot, Victoria University, Melbourne, Australia
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Stevens MWR, Delfabbro PH, King DL. Prevention Strategies to Address Problematic Gaming: An Evaluation of Strategy Support Among Habitual and Problem Gamers. J Prim Prev 2021; 42:183-201. [PMID: 33710442 PMCID: PMC7970787 DOI: 10.1007/s10935-021-00629-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 01/07/2023]
Abstract
Psychosocial problems arising from excessive gaming are a public health issue across the developed world. In its most serious form, problematic gaming is recognized as gaming disorder (GD) in the ICD-11. Research has tended to focus on the value of outpatient treatment for GD, but less attention has been paid to broader prevention strategies to address less serious but nevertheless harmful gaming behaviors. Another gap in this literature has been the lack of involvement of the gaming community as stakeholders to identify feasible prevention approaches. This study investigated: (1) regular and problematic gamers' level of support for different prevention strategies within primary, secondary, and tertiary approaches; and, (2) whether self-efficacy is associated with greater support for prevention strategies, as predicted by the Health Belief Model. A total of 992 participants completed an online survey that evaluated support for problem gaming prevention strategies and included measures of self-efficacy, gaming involvement, and GD symptoms, psychological distress, and mental health help-seeking behaviors. Participants reported stronger support for primary prevention strategies, including education, screening, and warning labels, than for other prevention approaches. Overall, 61% of participants expressed support for primary prevention as compared to secondary (39%) and tertiary (36%) approaches. There was stronger support for outpatient care (48%) than inpatient services (25%). In-game shutdown features received the lowest support (65% disapproval). Contrary to the Health Belief Model, self-efficacy was not associated with prevention support. Younger, female, and less frequent gamers were more likely to support primary and secondary prevention strategies. These findings suggest that gamers may be more favorable toward prevention measures aligned with informed decision-making, autonomy, and self-directed actions. Gamers may be strongly opposed to modifications to the structure of gaming activities (e.g., shutdown features). Future research should evaluate the efficacy and cost-effectiveness of problem gaming prevention measures in different populations and regions.
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Affiliation(s)
| | - Paul H Delfabbro
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Daniel L King
- School of Psychology, The University of Adelaide, Adelaide, Australia.
- College of Education, Psychology and Social Work, Flinders University, Sturt Road, Bedford Park, SA, 5042, Australia.
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Stevens MW, Delfabbro PH, King DL. Prevention approaches to problem gaming: A large-scale qualitative investigation. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2020.106611] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Higuchi S, Nakayama H, Matsuzaki T, Mihara S, Kitayuguchi T. Application of the eleventh revision of the International Classification of Diseases gaming disorder criteria to treatment-seeking patients: Comparison with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders Internet gaming disorder criteria. J Behav Addict 2021; 10:149-158. [PMID: 33475527 PMCID: PMC8969863 DOI: 10.1556/2006.2020.00099] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/11/2020] [Accepted: 11/30/2020] [Indexed: 12/24/2022] Open
Abstract
The World Health Organization included gaming disorder (GD) in the eleventh revision of International Classification of Diseases in 2019. Due to the lack of diagnostic tools for GD, a definition has not been adequately applied. Therefore, this study aimed to apply an operationalized definition of GD to treatment-seekers. The relationship between the diagnoses of GD and Internet gaming disorder (IGD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders was also examined. Methods: Study participants comprised 241 treatment-seekers who had engaged in excessive gaming and experienced related problems. Psychiatrists applied the GD diagnostic criteria to the participants using a diagnostic form developed for this study. Information on gaming behavior and functional impairment was obtained through face-to-face interviews conducted by clinical psychologists. Results: In total, 78.4 and 83.0% of the participants fulfilled the GD and IGD diagnostic criteria, respectively. The sensitivity and specificity of GD diagnosis were both high when the IGD diagnosis was used as the gold standard. Participants with GD preferred online PC and console games, spent significantly more time gaming, and showed a higher level of functional impairment compared to those who did not fulfill the GD diagnostic criteria. Discussion and Conclusion: The definition of GD can be successfully applied to treatment-seekers with excessive gaming and related problems. A high concordance of GD and IGD diagnoses was found in those participants with relatively severe symptoms. The development and validation of a diagnostic tool for GD should be explored in future studies.
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Affiliation(s)
- Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center
,
Yokosuka, Kanagawa, 239-0841
,
Japan,
Corresponding author.
| | - Hideki Nakayama
- National Hospital Organization Kurihama Medical and Addiction Center
,
Yokosuka, Kanagawa, 239-0841
,
Japan
| | - Takanobu Matsuzaki
- National Hospital Organization Kurihama Medical and Addiction Center
,
Yokosuka, Kanagawa, 239-0841
,
Japan
| | - Satoko Mihara
- National Hospital Organization Kurihama Medical and Addiction Center
,
Yokosuka, Kanagawa, 239-0841
,
Japan
| | - Takashi Kitayuguchi
- National Hospital Organization Kurihama Medical and Addiction Center
,
Yokosuka, Kanagawa, 239-0841
,
Japan
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Shi J, van der Maas M, Turner NE, Potenza MN. Expanding on the multidisciplinary stakeholder framework to minimize harms for problematic risk-taking involving emerging technologies. •. J Behav Addict 2020; 9:886-897. [PMID: 33372914 PMCID: PMC8969719 DOI: 10.1556/2006.2020.00096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/03/2020] [Accepted: 11/03/2020] [Indexed: 12/24/2022] Open
Abstract
As new types of problematic behaviors and new forms of online risk-taking emerge, forming collaborative relationships while understanding complexities of motivations may help to promote harm reduction and intervention. While it may be too early to form a stakeholder framework without first conceptually understanding the problematic behaviors involved, we attempt to build upon a proposed multidisciplinary stakeholder framework to minimize harms for problematic risk-taking involving emerging technologies. We propose an expansion of roles for individual stakeholders and an expansion of proposed roles for family stakeholders to include partner/spouses, others living in the household, and/or those with close relationships with individuals who are experiencing problems. Empowering individuals who use emerging technologies through participatory action research and knowledge translation/dissemination may lead to improvements in the quality of research and a greater impact on policy and practice. Also, we discuss benefits of industry self-regulation and collaboration on data-sharing practices. We recommend approaches to promote global collaboration with a larger group of relevant stakeholders (including but not limited to individual consumers of technology, families, communities, treatment and welfare providers, researchers, industries, and governments) to address protection of vulnerable populations and reduce harms for users of rapidly advancing technologies.
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Affiliation(s)
- Jing Shi
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Corresponding authors.
| | - Mark van der Maas
- Center for Gambling Studies, Rutgers University, New Brunswick, NJ, USA
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Nigel E. Turner
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Marc N. Potenza
- Department of Psychiatry and Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Corresponding authors.
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18
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Colder Carras M, Carras M, Labrique AB. Stakeholders' Consensus on Strategies for Self- and Other-Regulation of Video Game Play: A Mixed Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113846. [PMID: 32481721 PMCID: PMC7313040 DOI: 10.3390/ijerph17113846] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 12/24/2022]
Abstract
Background: Little is known about strategies or mechanics to improve self-regulation of video game play that could be developed into novel interventions. This study used a participatory approach with the gaming community to uncover insider knowledge about techniques to promote healthy play and prevent gaming disorder. Methods: We used a pragmatic approach to conduct a convergent-design mixed-methods study with participants attending a science fiction and education convention. Six participants answered questions about gaming engagement and self- or game-based regulation of gaming which were then categorized into pre-determined (a priori) themes by the presenters during the presentation. The categorized themes and examples from participant responses were presented back to participants for review and discussion. Seven participants ranked their top choices of themes for each question. The rankings were analyzed using a nonparametric approach to show consensus around specific themes. Results: Participants suggested several novel potential targets for preventive interventions including specific types of social (e.g., play with others in a group) or self-regulation processes (e.g., set timers or alarms). Suggestions for game mechanics that could help included clear break points and short missions, but loot boxes were not mentioned. Conclusions: Our consensus development approach produced many specific suggestions that could be implemented by game developers or tested as public health interventions, such as encouraging breaks through game mechanics, alarms or other limit setting; encouraging group gaming; and discussing and supporting setting appropriate time or activity goals around gaming (e.g., three quests, one hour). As some suggestions here have not been addressed previously as potential interventions, this suggests the importance of including gamers as stakeholders in research on the prevention of gaming disorder and the promotion of healthy gaming. A large-scale, online approach using these methods with multiple stakeholder groups could make effective use of players’ in-depth knowledge and help speed discovery and translation of possible preventive interventions into practice and policy.
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Affiliation(s)
- Michelle Colder Carras
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. W5501, Baltimore, MD 21205, USA
- Correspondence:
| | - Matthew Carras
- Carras Consulting, 1407 Scanlan Drive, Glen Burnie, MD 21205, USA;
| | - Alain B. Labrique
- Departments of International Health, Epidemiology, and Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. W5501, Baltimore, MD 21205, USA;
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King DL, Billieux J, Carragher N, Delfabbro PH. Face validity evaluation of screening tools for gaming disorder: Scope, language, and overpathologizing issues. J Behav Addict 2020; 9:1-13. [PMID: 32359228 PMCID: PMC8935192 DOI: 10.1556/2006.2020.00001] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 12/11/2019] [Accepted: 12/25/2019] [Indexed: 11/25/2022] Open
Abstract
AIM Critics of gaming disorder (GD; i.e., Internet gaming disorder in the DSM-5; Gaming disorder in the ICD-11) have expressed concerns about the potential risks of misclassification (e.g., false positives). An important consideration of relevance to this discussion is the extent to which commonly used screening instruments contain appropriate, sensible, and relevant items. The aim of this review was to evaluate the face validity of items within current tools for GD. METHODS A systematic review of databases identified 29 instruments. An item bank (n = 417 items) was independently evaluated by three professional raters (i.e., a senior academic in clinical psychology, a senior psychometrician, and an academic/clinical psychologist) according to guidelines for defining and measuring addiction and gaming disorder. FINDINGS Evaluation of the item bank identified issues related to: scope (i.e., "scope creep" or items of questionable relevance); language (i.e., confusing language, unusual wording or syntax); and overpathologizing (i.e., pathologizing typical and/or beneficial aspects or consequences of gaming). A total of 71 items across 23 tools had at least one face validity issue. CONCLUSIONS Most items (83%) demonstrated satisfactory face validity and were consistent with either the DSM-5 or ICD-11 GD classification. However, many tests contain at least one item that may pathologize normal gaming behaviors. Such items refer to basic changes in mood when gaming, a desire to play or continue playing games, and experiencing immersion when gaming. This analysis highlights the challenges of screening for problematic behaviors that are thought to arise within the context of normal recreational activities.
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Affiliation(s)
- Daniel L. King
- College of Education, Psychology, & Social Work, Flinders University, Adelaide, Australia
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Joel Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Addictive and Compulsive Behaviors Lab, Institute for Health and Behavior, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Natacha Carragher
- Office of Medical Education, University of New South Wales (UNSW) Sydney, Australia
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Paul H. Delfabbro
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
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20
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Shi J, Renwick R, Turner NE, Kirsh B. Understanding the lives of problem gamers: The meaning, purpose, and influences of video gaming. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2019.03.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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21
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Stavropoulos V, Bamford L, Beard C, Gomez R, Griffiths MD. Test-Retest Measurement Invariance of the Nine-Item Internet Gaming Disorder Scale in Two Countries: A Preliminary Longitudinal Study. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00099-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
AbstractThe reliable longitudinal assessment of Internet Gaming Disorder (IGD) behaviors is viewed by many as a pivotal clinical and research priority. The present study is the first to examine the test-retest measurement invariance of IGD ratings, as assessed using the short-form nine-item Internet Gaming Disorder Scale (IGDS9-SF) over an approximate period of 3 months, across two normative national samples. Differences referring to the mode of the data collection (face-to-face [FtF] vs. online) were also considered. Two sequences of successive multiple group confirmatory factor analyses (CFAs) were calculated to longitudinally assess the psychometric properties of the IGDS9-SF using emergent adults, gamers from (i) the United States of America (USA; N = 120, 18–29 years, Meanage = 22.35, 51.6% male) assessed online and; and (ii) Australia (N = 61, 18–31 years, Meanage = 23.02, 75.4% male) assessed FtF. Configural invariance was established across both samples, and metric and scalar invariances were supported for the USA sample. Interestingly, only partial metric (factor loadings for Items 2 and 3 non-invariant) and partial scalar invariance (i.e., all thresholds of Items 1 and 2, and thresholds 1, 3, for Items 4, 6, 8, and 9 non-invariant) were established for the Australian sample. Findings are discussed in the light of using IGDS9-SF to assess and monitor IGD behaviors over time in both in clinical and non-clinical settings.
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22
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Generalised Versus Specific Internet Use-Related Addiction Problems: A Mixed Methods Study on Internet, Gaming, and Social Networking Behaviours. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122913. [PMID: 30572652 PMCID: PMC6313434 DOI: 10.3390/ijerph15122913] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 11/23/2018] [Accepted: 11/24/2018] [Indexed: 12/24/2022]
Abstract
The field of technological behavioural addictions is moving towards specific problems (i.e., gaming disorder). However, more evidence of generalised versus specific Internet use-related addiction problems (generalised pathological Internet use (GPIU) vs. specific pathological Internet use (SPIU)) is still needed. This mixed methods study aimed to disentangle GPIU from SPIU. A partially mixed sequential equal status study design (QUAN→QUAL) was undertaken. First, through an online survey, which adapted the compulsive Internet use scale (CIUS) for three types of problems (i.e., generalised Internet use, and specific online gaming and social networking). Second, potential problem users’ perceptions of the evolution of these problems (aetiology, development, consequences, and factors) were ascertained, through semi-structured interviews, together with their opinion on present Internet gaming disorder (IGD) criteria adapted to each problem studied. Findings showed the CIUS remains valid and reliable for GPIU and SPIUs examined; a prevalence between 10.8% and 37.4% was estimated for potential at-risk problem gamers and Internet users, respectively, who reported their preference for maintaining their virtual lives. Half of the sample had a risk of a unique or mixed profile of these problems. Moreover, device patterns, gender, and age issues emerged, such as problem gamers being proportionally equal male and female young or middle-aged adults. GPIU was highly associated with problem social networking use, and weakly with problematic gaming, but both SPIUs were independent. Concerning addictive symptoms, salience, deception, and tolerance required redefinition, especially for SPIUs, while better-valued IGD criteria applied to GPIU and SPIUs were: Risk relationships or opportunities, give up other activities, withdrawal, and continue despite problems. Thus, although problems studied are present as risk behaviours, SPIUs seem to cover the addictive symptomatology in those categorised as potential problem users, online gaming being the most severe behavioural addiction problem.
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23
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Colder Carras M, Kalbarczyk A, Wells K, Banks J, Kowert R, Gillespie C, Latkin C. Connection, meaning, and distraction: A qualitative study of video game play and mental health recovery in veterans treated for mental and/or behavioral health problems. Soc Sci Med 2018; 216:124-132. [PMID: 30257787 DOI: 10.1016/j.socscimed.2018.08.044] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 08/22/2018] [Accepted: 08/31/2018] [Indexed: 12/17/2022]
Abstract
RATIONALE Mental and behavioral health recovery includes concepts related not just to symptom improvement, but also to participating in activities that contribute to wellness and a meaningful life. Video game play can relieve stress and provide a way to connect, which may be especially important for military veterans. OBJECTIVE We examined how military veterans used video game play to further their mental and behavioral health recovery by conducting an exploratory thematic analysis of the gaming habits of 20 United States military veterans who were in treatment for mental or behavioral health problems. METHOD We conducted semi-structured interviews in 2016 and used a framework analytic approach to determine salient themes linking video gaming to mental and behavioral health recovery. RESULTS Veteran participants reported that video games helped not only with managing moods and stress, but also with three areas related to other aspects of recovery: adaptive coping (e.g. distraction, control, symptom substitution); eudaimonic well-being (confidence, insight, role functioning); and socializing (participation, support, brotherhood). Meaning derived from game narratives and characters, exciting or calming gameplay, and opportunities to connect, talk, and lead others were credited as benefits of gaming. Responses often related closely to military or veteran experiences. At times, excessive use of games led to life problems or feeling addicted, but some veterans with disabilities felt the advantages of extreme play outweighed these problems. CONCLUSION Video games seem to provide some veterans with a potent form of "personal medicine" that can promote recovery. Although reasons and results of gaming may vary within and among individuals, clinicians may wish to discuss video game play with their patients to help patients optimize their use of games to support recovery.
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Affiliation(s)
- Michelle Colder Carras
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway St., Baltimore, MD, 21205, USA; A Department of Veterans Affairs Medical Center Within the 'VA Healthcare' Veterans Integrated Service Network 4, USA.
| | - Anna Kalbarczyk
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
| | - Kurrie Wells
- A Department of Veterans Affairs Medical Center Within the 'VA Healthcare' Veterans Integrated Service Network 4, USA.
| | - Jaime Banks
- Department of Communication Studies, West Virginia University, Armstrong Hall, 94 Beechurst Ave #108, Morgantown, WV, 26505, USA.
| | | | - Colleen Gillespie
- A Department of Veterans Affairs Medical Center Within the 'VA Healthcare' Veterans Integrated Service Network 4, USA.
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway St., Baltimore, MD, 21205, USA.
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24
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Van Rooij AJ, Nijkamp LM. Addressing problematic video game use: A multimethod, dual-context perspective on leisure-time use. J Behav Addict 2018; 7:526-530. [PMID: 30010408 PMCID: PMC6426383 DOI: 10.1556/2006.7.2018.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A more integrative approach to the prevention of problematic gaming behavior is recommended in Király et al.'s review. We discuss the Dutch policy responses to problematic gaming behavior and suggest two alternatives to the dominant survey research approach to achieve this. Employing time-use/diary studies allows us to map out the full scope of leisure-time use and employing log-data analysis improves our understanding of gamer behavior within the virtual context. All of these approaches would benefit from accounting for the diversity of within-virtual context behavior. The approach is summarized as a multimethod, dual-context approach to understanding leisure-time behavior.
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Affiliation(s)
- Antonius J. Van Rooij
- Department of Youth & Risky Behavior, Trimbos Institute, Utrecht, The Netherlands,Corresponding author: Antonius J. Van Rooij, PhD; Department of Youth & Risky Behavior, Trimbos Institute, Da Costakade 45, 3521 VS, Utrecht, The Netherlands; Phone: +31 30 29 59 343; E-mail:
| | - Laura M. Nijkamp
- Department of Youth & Risky Behavior, Trimbos Institute, Utrecht, The Netherlands
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25
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Colder Carras M, Kardefelt-Winther D. When addiction symptoms and life problems diverge: a latent class analysis of problematic gaming in a representative multinational sample of European adolescents. Eur Child Adolesc Psychiatry 2018; 27:513-525. [PMID: 29368254 PMCID: PMC5895528 DOI: 10.1007/s00787-018-1108-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/08/2018] [Indexed: 01/27/2023]
Abstract
The proposed diagnosis of Internet gaming disorder (IGD) in DSM-5 has been criticized for "borrowing" criteria related to substance addiction, as this might result in misclassifying highly involved gamers as having a disorder. In this paper, we took a person-centered statistical approach to group adolescent gamers by levels of addiction-related symptoms and gaming-related problems, compared these groups to traditional scale scores for IGD, and checked how groups were related to psychosocial well-being using a preregistered analysis plan. We performed latent class analysis and regression with items from IGD and psychosocial well-being scales in a representative sample of 7865 adolescent European gamers. Symptoms and problems matched in only two groups: an IGD class (2.2%) having a high level of symptoms and problems and a Normative class (63.5%) having low levels of symptoms and problems. We also identified two classes comprising 30.9% of our sample that would be misclassified based on their report of gaming-related problems: an Engaged class (7.3%) that seemed to correspond to the engaged gamers described in previous literature, and a Concerned class (23.6%) reporting few symptoms but moderate to high levels of problems. Our findings suggest that a reformulation of IGD is needed. Treating Engaged gamers as having IGD when their poor well-being might not be gaming related may delay appropriate treatment, while Concerned gamers may need help to reduce gaming but would not be identified as such. Additional work to describe the phenomenology of these two groups would help refine diagnosis, prevention and treatment for IGD.
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Affiliation(s)
- Michelle Colder Carras
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway St, Baltimore, MD, 21205, USA.
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26
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van Rooij AJ, Ferguson CJ, Colder Carras M, Kardefelt-Winther D, Shi J, Aarseth E, Bean AM, Bergmark KH, Brus A, Coulson M, Deleuze J, Dullur P, Dunkels E, Edman J, Elson M, Etchells PJ, Fiskaali A, Granic I, Jansz J, Karlsen F, Kaye LK, Kirsh B, Lieberoth A, Markey P, Mills KL, Nielsen RKL, Orben A, Poulsen A, Prause N, Prax P, Quandt T, Schimmenti A, Starcevic V, Stutman G, Turner NE, van Looy J, Przybylski AK. A weak scientific basis for gaming disorder: Let us err on the side of caution. J Behav Addict 2018; 7:1-9. [PMID: 29529886 PMCID: PMC6035022 DOI: 10.1556/2006.7.2018.19] [Citation(s) in RCA: 144] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 02/12/2018] [Indexed: 11/19/2022] Open
Abstract
We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.
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Affiliation(s)
- Antonius J. van Rooij
- Department of Children & Risky Behavior, Trimbos Institute, Utrecht, The Netherlands
| | | | - Michelle Colder Carras
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Jing Shi
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Espen Aarseth
- Center for Computer Games Research, IT University of Copenhagen, Copenhagen, Denmark
| | - Anthony M. Bean
- Department of Psychology, Framingham State University, Framingham, MA, USA
| | | | - Anne Brus
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - Mark Coulson
- Department of Psychology, Middlesex University, London, UK
| | - Jory Deleuze
- Department of Psychology, Université Catholique de Louvain (UCL), Louvain, Belgium
| | - Pravin Dullur
- School of medicine, Western Sydney University, Penrith, NSW, Australia
| | - Elza Dunkels
- Department of Applied Educational Science, Umeå University, Umeå, Sweden
| | - Johan Edman
- Department of Criminology, Stockholm University, Stockholm, Sweden
| | - Malte Elson
- Psychology of Human Technology Interaction Group, Ruhr University Bochum, Bochum, Germany
| | | | - Anne Fiskaali
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Isabela Granic
- Developmental Psychopathology, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Jeroen Jansz
- Department of Media and Communication, ERMeCC, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Faltin Karlsen
- Westerdals Department of Film and Media, Kristiania University College, Oslo, Norway
| | - Linda K. Kaye
- Department of Psychology, Edge Hill University, Ormskirk, UK
| | - Bonnie Kirsh
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Andreas Lieberoth
- Department of Educational Psychology, Danish School of Education, Aarhus University, Aarhus, Denmark
| | - Patrick Markey
- Department of Psychology, Villanova University, Villanova, PA, USA
| | | | | | - Amy Orben
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Arne Poulsen
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | | | - Patrick Prax
- Department of Game Design, Uppsala University, Visby, Sweden
| | - Thorsten Quandt
- Department of Communication, University of Münster, Münster, Germany
| | - Adriano Schimmenti
- Department of Human and Social Sciences, UKE – Kore University of Enna, Enna, Italy
| | - Vladan Starcevic
- Discipline of Psychiatry, University of Sydney, Sydney, Australia
| | | | - Nigel E. Turner
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Jan van Looy
- Department of Communication Sciences, imec-mict-Ghent University, Ghent, Belgium
| | - Andrew K. Przybylski
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Oxford Internet Institute, University of Oxford, Oxford, UK
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