Predicting Internet Gaming Disorder symptoms in young adolescents: A one-year follow-up study

Longitudinal associations between digital media use and ADHD symptoms in children and adolescents: a systematic literature review

Previous reviews have often shown a link between digital media ADHD symptom levels. However, longitudinal studies are needed to find stronger evidence of a causal effect as well as to determine the direction of effects. The aim of the present review (PROSPERO CRD42021262695) was therefore to provide a systematic review of studies meeting the following inclusion criteria: (1) include longitudinal data investigating associations between digital media (i.e., gaming and social media) and later ADHD symptoms or vice versa, (2) be published within the past 10 years (i.e., 2011 until June 2021), (3) be published in a peer-reviewed journal in English, and (4) include children or adolescents (age 0-17 years). After a systematic search in the Web of Science and PsycInfo databases, we included 28 studies, all with adequate or high quality. Results showed support for reciprocal associations between digital media and ADHD symptoms, with associations being more consistent for problematic use of digital media than for screen time. Thus, children with ADHD symptoms appear more vulnerable to developing high or problematic use of digital media (i.e., selection effects), and digital media also have effects on later ADHD symptom levels, either because of specific characteristics of digital media or because of indirect effects on, for example, sleep and social relations (i.e., media effects). However, it should be emphasized that further studies investigating potential moderators and mediators are needed if we are to better understand the complex associations between digital media and ADHD symptom levels.

Social norms and problematic gaming among adolescents: The role of Internet use coping motives

INTRODUCTION

Problematic gaming (PG) is a public health issue among adolescents worldwide. Although several studies have documented that peer influences constitute a relevant risk factor for adolescent problematic behaviors, little research is currently available on PG. The aim of this study was to examine the contribution of social norms and perceived friends' gaming frequency on participants' own gaming frequency and PG, by testing potential differences among groups with low vs. high motive to use the Internet (e.g., online gaming) as a coping strategy.

METHOD

A survey was administered to 470 adolescent gamers (mean age = 15.49 years; SD = 1.05 years; 77.9 % males). A theoretical model was tested through path analysis and multi-group comparisons were performed.

RESULTS

Path analysis revealed that social norms and perceived friends' gaming frequency were positively associated to participants' gaming behaviors and PG. Additionally, different patterns between groups emerged.

CONCLUSION

Our findings confirmed the relative importance of peer influences on adolescents' gaming behaviors and PG and showed that adolescents who rely more on online gaming to cope with negative affect may be more vulnerable to social influence processes than other peers. These findings may provide useful indications for prevention programs targeting adolescent PG.

The emerging evidence on the association between symptoms of ADHD and gaming disorder: A systematic review and meta-analysis

The co-existence of gaming disorder (GD) with other mental health problems has been widely reported. Despite the growing research interest in the comorbidity of GD with attention-deficit/hyperactivity disorder (ADHD), to date, no quantitative synthesis has been performed. The present study comprised a systematic literature search using Scopus, Science Direct, Web of Science, and PubMed databases. Three types of studies were included in the analyses: studies reporting (i) correlation coefficients between the symptoms of GD and ADHD, (ii) means, and standard deviations for comparison of GD severity between ADHD/non-ADHD individuals, and (iii) comparison of ADHD severity between GD/non-GD individuals. The results indicated a moderate relationship between GD and ADHD symptom severity when both subdomains of ADHD were combined (r = 0.296), and also when only inattention (r = 0.306) or hyperactivity (r = 0.266) symptoms were analyzed, which was also confirmed in a structural equation model meta-analysis. Studies showed a large average difference comparing the GD symptom severity of ADHD and non-ADHD individuals (g = 0.693), or ADHD symptom severity of GD and non-GD individuals (g = 0.854). In some cases, higher estimates of association were reported among studies that (i) had a higher proportion of males, (ii) assessed problematic internet use among predominantly videogame player samples rather than assessing only GD, and (iii) had been more recently published. The present review shows that this is an emerging field demonstrating significant results in cross-sectional correlational studies. However, future research should apply more rigorous methodologies to investigate the relationship further (e.g., longitudinal studies and studies using professional/clinical ratings and diagnosis). These results suggest that screening and treatment for ADHD among individuals with gaming disorder is necessary, and individuals with ADHD should be made aware of their higher susceptibility to gaming disorder.

Sluggish cognitive tempo (Cognitive Disengagement Syndrome) symptoms are more associated with a higher risk of internet addiction and internet gaming disorder than ADHD symptoms: A study with medical students and resident doctors

BACKGROUND & AIMS

The purpose of this study was to examine the relationships between Attention Deficit Hyperactivity Disorder (ADHD), Sluggish Cognitive Tempo (SCT), demographic factors, and Internet Addiction (IA) and internet gaming disorder (IGD) among medical students and resident doctors.

METHODS

The study included 274 medical students and resident doctors. (Ages:18-35, 70.4% female). Fisher exact test, Contingency Table analyses, Mann Whithey-U Test and structural equation model-path analysis were used for analysis. The Sociodemographic Information Form, ASRS Scale, Barkley SCT Scale, Young Internet Addiction Test-Short Form and The Digital Game Addiction Scale were utilized to collect data.

RESULTS

In the sample, 48 participants (17.51%, 22 female, 26 male) were classified as having a high-risk internet gaming disorder (IGD+), while 53 participants (19.3%, 37 female, 16 male) were classified as having a high-risk internet addiction (IA+). SCT Scale Daydreaming and Sluggishness scores, as well as ASRS Scale Inattention and Hyperactivity/Impulsivity ratings, were all substantially higher in high-risk groups (for all, p < 0.05). Instead of age, there was no difference between high and low-risk groups, but men had a significantly greater rate of high risk- IGD (%32.1 vs. 11.4; p = 0.001). Path analysis revealed that while older age has a substantial negative effect (β = -0.37, p = 0.001) on increased risk of IA, Inattention (β = 0.19, p = 0.028), Daydreaming (β = 0.62, p0.001), and Sluggishness ( β = 1.12, p0.001) had significant positive effects. On the other hand, results revealed that male gender (β = 5.08, p0.001), IA scores (β = 0.21, p0.001), and only Sluggishness ( = 0.52, p = 0.002), but not Inattention, Hyperactivity/impulsivity, or Daydreaming, have positive effects on greater risk of internet gaming disorder (IGD).

CONCLUSION & IMPLICATIONS

Our study is the first to show that SCT symptoms increase the risk of Internet addiction and Internet Gaming Disorder even when ADHD symptoms are controlled. To date, many research have highlighted the necessity of ADHD treatment when evaluating IA and IGD. However, SCT symptoms have a greater impact on people who are predisposed to these behavioral addictions, and despite high comorbidity rates, various treatment approaches for ADHD and SCT are effective. SCT should be kept in mind when assessing treatment-resistant individuals with IA and IGD.

Measurement of craving among gamers with internet gaming disorder using repeated presentations of game videos: a resting-state electroencephalography study

BACKGROUND

Internet gaming disorder (IGD) is receiving increasing attention owing to its effects on daily living and psychological function.

METHODS

In this study, electroencephalography was used to compare neural activity triggered by repeated presentation of a stimulus in healthy controls (HCs) and those with IGD. A total of 42 adult men were categorized into two groups (IGD, n = 21) based on Y-IAT-K scores. Participants were required to watch repeated presentations of video games while wearing a head-mounted display, and the delta (D), theta (T), alpha (A), beta (B), and gamma (G) activities in the prefrontal (PF), central (C), and parieto-occipital (PO) regions were analyzed.

RESULTS

The IGD group exhibited higher absolute powers of D_C, D_PO, T_C, T_PO, B_C, and B_PO than HCs. Among the IGD classification models, a neural network achieves the highest average accuracy of 93% (5-fold cross validation) and 84% (test).

CONCLUSIONS

These findings may significantly contribute to a more comprehensive understanding of the neurological features associated with IGD and provide potential neurological markers that can be used to distinguish between individuals with IGD and HCs.

Gaming disorder: A summary of its characteristics and aetiology

The emergence, development, and maintenance of gaming disorder (GD) is the result of an interplay between gaming-related factors, individual factors, and environmental factors. None of these alone are sufficient to cause a disordered state, but it is the interactive co-occurrence of all these factors, which in some cases leads to GD. The goal of the present paper is to discuss in detail these three factors based on relevant and recent findings of the literature. Among gaming-related factors, we discuss online vs. offline videogames, the role of game genres, structural characteristics, game design elements, as well as some important monetization techniques. Among individual factors demographic risk factors, personality traits, motivational factors, comorbid psychopathology, genetic predisposition, and neurobiological processes are considered. Finally, among environmental factors we discuss family factors, early life experiences, the role of peers and school-related factors, as well as the broader context of culture including the popularity of esports.

Gamers' and non-gamers' perspectives on the development of problematic video game play

Gaming Disorder was recently included in the 11th Edition of the International Classification of Diseases and Internet Gaming Disorder may be introduced in the sixth edition of The Diagnostic and Statistical Manual. Much is not understood about how problems with video games develop. This qualitative study aimed to better understand the development of problematic gaming through focus groups. Eleven young adult "frequent gamers," twelve young adult "non-frequent or non-gamers," and five older adult "non-gamers" discussed vulnerabilities and risk factors of problematic gaming. Participants across all groups believed that problematic gaming developed when people used video games as a primary means of meeting basic psychological needs that were unsatisfied, thwarted, or blocked outside of video games. Frequent and non-frequent gamers, compared to older adult non-gamers, were more likely to view video games as a healthy way to meet basic psychological needs and less likely to stereotype gamers. Video games are equipped to meet basic psychological needs for autonomy, competence, and relatedness. That is, gamers often experience a sense of agency, skill, and connection to others when playing video games. However, problematic gaming may develop when people with unmet psychological needs rely exclusively on video games to meet them. Treatment and prevention approaches to problematic gaming can benefit from greater attention to helping at risk individuals meet needs for autonomy, competence, and relatedness outside of video games.

A cross-sectional study on gaming intensity and social vulnerability in adolescents that have a chronic condition

Background

Adolescents growing up with a chronic condition might experience more social vulnerabilities compared to their healthy peers as an indirect result of their conditions. This can lead to a relatedness need frustration for these adolescents. Consequently, they might spend more time playing video games compared to their peers. Research shows that both social vulnerability and gaming intensity are predictors for problematic gaming. Therefore, we investigated if social vulnerability and gaming intensity are more pronounced in adolescents that have a chronic condition compared to the general population; and if these levels reflect the levels of a clinical group being treated for Internet Gaming Disorder (IGD).

Methods

Data on peer problems and gaming intensity were compared from three separate samples: a national representative sample of adolescents, a clinical sample of adolescents that are undergoing treatment for IGD, and a sample of adolescents diagnosed with a chronic condition.

Results

No differences were found on either peer problems or gaming intensity between the group of adolescents that have chronic conditions and the national representative group. The group with chronic conditions scored significantly lower on gaming intensity than the clinical group. No significant differences were found between these groups on peer problems. We repeated the analyses for boys only. Similar results were found for the group with chronic conditions compared to the national representative group. The group with chronic conditions now scored significantly lower on both peer problems and gaming intensity than the clinical group.

Conclusion

Adolescents growing up with a chronic condition appear similar in their gaming intensity and peer problems compared to their healthy peers.

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.

“Game (not) Over”: A Systematic Review of Video Game Disorder in Adolescents

This study aims to characterize video game use disorder in adolescents, identifying the particularities of those who present it, its effects at the brain level, related factors, and existing measurement instruments. A systematic review of the scientific publications available in Scopus was carried out, between the period 2014-2018 on video game use disorder in adolescents. Adolescents with this disorder are characterized by being mostly men, spending more time daily and weekly playing than adolescents without this disorder, showing diverse symptoms in the behavioral, affective, and cognitive areas. At brain level, it is referred that in this disorder there is an increase and decrease in the activation of specific areas of the brain. Likewise, the presence of some psychological disorder and impulsivity are considered factors that increase the risk of suffering from it. However, there are protective factors as school commitment and parental supervision, among others. How to cite: Rojas-Jara, C., Polanco-Carrasco, R., Navarro-Castillo, R., Faúndez-Castillo, F., & Chamorro-Gallardo, M. (2022). “Game (not) Over”: A Systematic Review of Video Game Disorder in Adolescents. Revista Colombiana de Psicología, 31(2), 45-64. https://doi.org/10.15446/rcp.v31n2.90741

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.

Cumulative Family Risk and Internet Gaming Disorder Among Adolescents: A Serial Mediating Model of Personal Growth Initiative and Gratitude

In the digital era, playing internet games enriches the entertainment forms for young generations. At the same time, it also raises some social issues, and internet gaming disorder (IGD) is one of them. Abundant studies demonstrate that IGD is harmful to individual physiological and psychological health. Therefore, it is necessary to figure out the reasons and mechanisms behind this phenomenon. Based on the ecological systems theory, the present study investigated the cumulative effect of family risks on adolescent IGD and the serial mediating effects of personal growth initiative (PGI) and gratitude in a chain mediation model. Using random cluster sampling, a sample of 600 Chinese adolescents was recruited to complete the questionnaire. Results of regression analysis suggested that cumulative family risks could positively predict IGD among adolescents. Moreover, PGI and gratitude mediated the relationship between cumulative family risk and IGD, separately, and sequentially. These findings may provide some guidance for the prevention and intervention to prevent or reduce IGD in adolescents.

Interaction Effects of DRD2 Genetic Polymorphism and Interpersonal Stress on Problematic Gaming in College Students

Problematic gaming has become a public concern, influenced both by genetic factors and stressful environments. Studies have reported the effects of dopamine-related genes and interpersonal stressors on problematic gaming, but gene and environment interaction (G × E) studies have not been conducted. In this study, we investigated the interaction effects of dopamine receptor D2 (DRD2) polymorphisms and interpersonal stress on problematic gaming and the mediating effect of avoidant coping to reveal the mechanism of the G × E process. We recruited 168 college students (mean age = 22; male 63.1%) and genotyped their DRD2 C957T (rs6277) and Taq1 (rs1800497) polymorphisms. The results of the mediated moderation analysis showed that, when experiencing interpersonal stressors, individuals with both the C957T T allele and the Taq1 A1 allele showed more elevated problematic gaming scores than non-carriers. Moreover, the interaction effect of the combined DRD2 polymorphisms and interpersonal stress was significantly mediated by avoidant coping. These findings suggest that the influence of interpersonal stress on problematic gaming can be changed as a function of DRD2 genotypes, which may be because of the avoidant coping styles of C957T T allele and Taq1 A1 allele carriers in response to stress.

Investigating the Role of Health Factors and Psychological Well-Being in Gaming Disorder

The recent recognition of Gaming Disorder (GD) as a mental health issue has provided a unique opportunity for researchers to advance our current understanding of the intricate relationships between GD and specific health-related factors and well-being. This study sought to investigate the role of key physical and psychological health and well-being factors in GD. To achieve this, three goals were explored. First, we tested whether GD can be predicted by health and well-being factors such as depression, anxiety, loneliness, attention problems, physical health problems (PHP), and psychological well-being (PWB). Second, we assessed the role of distress tolerance (DT) as a moderator in the relationship between PWB and GD. Third, we examined whether PWB would mediate the relationship between PHP and GD. A sample of 474 participants (Mean_age = 28.86 years; SD = 9.23; range: 18-66 years; 47 percent female) were recruited. The results of the multiple linear regression analysis indicated that age, attention problems, and PHP significantly predicted GD (R² = 0.15). In addition, the mediation findings uncovered an important direct association between PHP and GD despite the lack of mediation effects through PWB and the absence of moderating effects from DT. The present findings signify important health-related implications related to GD that are further discussed here in terms diagnosis, treatment, and prevention efforts.

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

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

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

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

Relationship Between Gaming Disorder, Self-Compensation Motivation, Game Flow, Time Spent Gaming, and Fear of Missing Out Among a Sample of Chinese University Students: A Network Analysis

Background and Aims: In previous correlational research, the relationship between gaming disorder (GD), compensation motivation, game flow, time spent gaming, and fear of missing out (FoMO) has been examined. However, network analysis has rarely been applied to explore the relationship between GD, self-compensation motivation, game flow, time spent gaming, and FoMO. Therefore, the present study used network analysis to examine the relationship between the aforementioned variables among a sample of gamers. Methods: The present study comprised gamers (N = 1,635) recruited from three Chinese universities, who completed an online survey including the Gaming Disorder Test, Self-Compensation Motivation Questionnaire, Game Flow Questionnaire, and Trait-State Fear of Missing Out Scale, as well as four items related to time spent gaming. Results: Self-compensation motivation, game flow, time spent gaming, and FoMO were all significantly and positively associated with GD. In the domain-level and facet-level networks, weekday gaming hours and weekend gaming hours had the strongest edge intensity. The domain-level, facet-level, and item-level networks analysis also showed that GD was connected with self-compensation motivation, game flow, time spent gaming, and FoMO. The network structure demonstrated a significant difference between males and females (2.33 vs. 2.81, p = 0.001) using the domain-level network comparison test (NCT). Conclusions: The results suggest that GD is closely associated with self-compensation motivation, game flow, time spent gaming, and FoMO. FoMO and gaming motivation (i.e., self-compensation and game flow) may increase time spent gaming and facilitate GD. Therefore, interventions that decrease game immersion and time spent gaming are likely to decrease GD.

Impact of attention-deficit/hyperactivity disorder comorbidity on longitudinal course in Internet gaming disorder: a 3-year clinical cohort study

BACKGROUND

Although attention-deficit/hyperactivity disorder (ADHD) symptoms were identified as a key risk factor for Internet gaming disorder (IGD), the effect of ADHD comorbidity on longitudinal course of IGD in the clinical population remains to be further examined. This study aimed to investigate whether ADHD comorbidity in IGD patients affects the recovery, recurrence rates, and trajectories of IGD symptoms, and examine the relationship between the changes in IGD and ADHD symptoms.

METHODS

The study included 128 IGD patients without any psychiatric comorbidities (pure-IGD group) and 127 IGD patients with comorbid ADHD (ADHD-IGD group) aged 11 to 42 years. IGD and ADHD were diagnosed according to DSM-5 criteria at enrollment. Participants were offered 8-week treatment with additional care provided as needed and followed up over a 3-year period. IGD diagnosis was reassessed annually and used as a dichotomous outcome. The severity of IGD and ADHD symptoms was measured using the Young Internet Addiction Scale and the Korean ADHD rating scale, respectively, at baseline and each annual follow-up.

RESULTS

The recovery rates of IGD by Year 3 were 60% and 93% in ADHD-IGD and in pure-IGD groups, respectively. The ADHD-IGD group showed lower rates of recovery, higher odds of recurrence within 1 year, and higher severity of IGD symptoms over time than the pure-IGD group. Family environment was also associated with the trajectories of IGD symptoms. The changes in ADHD symptoms were significantly associated with the changes in IGD symptoms.

CONCLUSIONS

This study found that ADHD comorbidity in IGD patients was associated with poor clinical course of IGD and that the changes in ADHD symptoms were associated with the changes in IGD symptoms over time. Our findings suggest that evaluation and treatment of ADHD symptoms and family environment in IGD patients may be important in improving the prognosis of IGD.

Factors related to Internet and game addiction among adolescents: A scoping review

Background

Understanding factors influencing Internet and game addiction in children and adolescents is very important to prevent negative consequences; however, the existing factors in the literature remain inconclusive.

Objective

This study aims to systematically map the existing literature of factors related to Internet and game addiction in adolescents.

Methods

A scoping review was completed using three databases - Science Direct, PROQUEST Dissertations and Theses, and Google Scholar, which covered the years between 2009 to July 2020. Quality appraisal and data extraction were presented. A content analysis was used to synthesize the results.

Results

Ultimately, 62 studies met inclusion criteria. There were 82 associated factors identified and grouped into 11 categories, including (1) socio-demographic characteristics, (2) parental and family factors, (3) device ownership, Internet access and location, social media, and the game itself, (4) personality/traits, psychopathology factors, self-efficacy, (5) education and school factors, (6) perceived enjoyment, (7) perceived benefits, (8) health-compromising behaviors, (9) peers/friends relationships and supports, (10) life dissatisfaction and stress, and (11) cybersafety.

Conclusion

Internet and game addiction among adolescents are multifactorial. Nurses should consider the factors identified in this study to provide strategies to prevent and reduce addiction in adolescents.

Influences of digital media use on children and adolescents with ADHD during COVID-19 pandemic

OBJECTIVE

To explore the influences of digital media use on the core symptoms, emotional state, life events, learning motivation, executive function (EF) and family environment of children and adolescents diagnosed with attention deficit hyperactivity disorder (ADHD) during the novel coronavirus disease 2019 (COVID-19) pandemic.

METHOD

A total of 192 participants aged 8-16 years who met the diagnostic criteria for ADHD were included in the study. Children scoring higher than predetermined cut-off point in self-rating questionnaires for problematic mobile phone use (SQPMPU) or Young's internet addiction test (IAT), were defined as ADHD with problematic digital media use (PDMU), otherwise were defined as ADHD without PDMU. The differences between the two groups in ADHD symptoms, EF, anxiety and depression, stress from life events, learning motivation and family environment were compared respectively.

RESULTS

When compared with ADHD group without PDMU, the group with PDMU showed significant worse symptoms of inattention, oppositional defiant, behavior and emotional problems by Swanson, Nolan, and Pelham Rating Scale (SNAP), more self-reported anxiety by screening child anxiety-related emotional disorders (SCARED) and depression by depression self-rating scale for children (DSRSC), more severe EF deficits by behavior rating scale of executive function (BRIEF), more stress from life events by adolescent self-rating life events checklist (ASLEC), lower learning motivation by students learning motivation scale (SLMS), and more impairment on cohesion by Chinese version of family environment scale (FES-CV). The ADHD with PDMU group spent significantly more time on both video game and social media with significantly less time spend on physical exercise as compared to the ADHD without PDMU group.

CONCLUSION

The ADHD children with PDMU suffered from more severe core symptoms, negative emotions, EF deficits, damage on family environment, pressure from life events, and a lower motivation to learn. Supervision of digital media usage, especially video game and social media, along with increased physical exercise, is essential to the management of core symptoms and associated problems encountered with ADHD.

Depression and anxiety symptoms associated with internet gaming disorder before and during the COVID-19 pandemic: A longitudinal study

BACKGROUND

The coronavirus disease-2019 (COVID-19) pandemic has profoundly impacted aspects of human life globally. Playing videogames has been encouraged by several organizations to help individuals cope with the COVID-19 pandemic and associated restrictive measures. This longitudinal study was the first to examine gaming in the context of the pandemic and its association with depressive and anxiety symptoms.

METHODS

The sample comprised 1,778 children and adolescents (50.7% male) who were part of the Project of School Mental Health in Southwest China. Data were collected at two-time intervals: before the COVID-19 pandemic (October to November 2019 - [T1]) and during the COVID-19 pandemic (April to May 2020 - [T2]). Data were collected on perceived COVID-19 impacts, videogame use, Internet Gaming Disorder (IGD), and depressive and anxiety symptoms. Cross-lagged panel models were computed to examine longitudinal relationships.

RESULTS

The results indicated that both videogame use and IGD increased significantly for adolescents at T2. The cross-lagged panel model results suggested that depressive and anxiety symptoms at T1 positively predicted IGD and videogame use at T2 (especially for boys), but not inversely. Perceived COVID-19 impacts mediated the relationship between depressive and anxiety symptoms at T1 and IGD at T2.

CONCLUSION

Children and adolescents both increased videogame use at T2, but only adolescents significantly increased IGD severity at T2. The findings supported the compensatory hypothesis, and are consistent with the Interaction of Person-Affect-Cognition-Execution model as individual responses to COVID-19 may function as a mediator between personal predisposing variables and IGD.

Validity and Psychometric Properties of the Internet Gaming Disorder Scale in Three Large Independent Samples of Children and Adolescents

Background: Problematic gaming has become a major health issue in children and adolescents resulting in the need for targeted valid and reliable screening instruments. This study aimed to explore the psychometric properties and criterion validity of the widely used 9-item Internet Gaming Disorder Scale (IGDS) in young gamers. Methods: Three independent samples were drawn from socio-demographically representative cross-sectional telephone surveys collected in the years 2016 (N = 762), 2017 (N = 777), and 2018 (N = 784) and analyzed separately. Results: The IGDS revealed psychometric properties suitable for screening in large samples. Cronbach’s alpha was 0.563, 0.724, and 0.778. The unidimensionality assumption was challenged. At-risk and pathological gamers compared to normal gamers reported longer digital media use and more emotional symptoms and hyperactivity/inattention with clinical relevance to medium effect sizes. The comparison of at-risk and pathological gamers indicated a partial distinction between the two problematic gaming groups. Conclusions: The IGDS could be shown to be an overall suitable and valid tool to identify pathological gamers in childhood and adolescence according to the DSM-5 criteria on a population level. However, the polythetic structure limits comparability with the recent ICD-11 criteria. At-risk gamers appeared as a heterogeneous group warranting more research.

A systematic review on the intersection of attention-deficit hyperactivity disorder and gaming disorder

INTRODUCTION

Studies of Gaming Disorder (GD) consistently identify co-morbidity with various psychiatric disorders including major depression, obsessive compulsive disorder and anxiety disorders. One of the strongest associations has been with Attention Deficit Hyperactivity Disorder (ADHD). We present a systematic review of this association by pooling and integrating available evidence.

METHODS

PubMed, EMBASE, PsychInfo and CINHAHL were searched for articles that reported a quantitative association between GD and ADHD and its dimensions, using equivalent search terms. Quality appraisal was done using criteria adapted from the Critical Appraisal Skills Package (CASP) checklists.

RESULTS

1028 articles were identified, of which 29 studies were included for systematic review (n = 56650 participants). Most of these studies were observational in nature, and were of moderate quality, with deficits particularly in the domains of generalisability and confounding. Community surveys (n = 18) of purposive samples constituted the majority, with fewer clinic-based samples (n = 11). While ADHD symptoms were consistently associated with GD, More frequent associations were displayed with inattention associations with GD than other ADHD subscales. There were no conclusive findings regarding the type of game on severity of either condition, or on completion of treatment.

CONCLUSIONS

The findings suggest an association between ADHD and GD, although the direction of the relationship is unclear. This has implications for clinical practice, policy and research. We recommend that ADHD is screened for when evaluating IGD as part of routine practice."

Internet Gaming Disorder, Risky Online Behaviour, and Mental Health in Hong Kong Adolescents: The Beneficial Role of Psychological Resilience

In the present cyber age, Internet gaming disorder (IGD) and risky online behaviour are prevalent, and adolescents are especially vulnerable to such emergent problems. Few studies have explored the protective factors that mitigate harm caused by IGD and various common risky online behaviours. This study examined the prevalence of IGD and risky online behaviour, their hypothesised associations with depressive symptoms, and the beneficial role of psychological resilience as an underlying psychological mechanism. The participants included 1,099 Chinese junior secondary school students (33% boys, mean age = 13.5 years, age range = 10-17 years) who completed a battery of validated self-report questionnaires at their schools. The results revealed that 4% of the participants were at high risk of IGD and 6% were at an overall risk level of IGD. Depressive symptoms were positively associated with IGD and risky online behaviour, and psychological resilience mediated both of these associations. These results imply that clinicians and teachers should incorporate psychological resilience training into intervention approaches to mitigate IGD and risky online behaviour.

Internet gaming disorder and psychosocial well-being: A longitudinal study of older-aged adolescents and emerging adults

The American Psychiatric Association defined Internet Gaming Disorder (IGD) within Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders as a tentative disorder requiring further research. Although cross-sectional studies have suggested that IGD is closely associated with poorer psychosocial well-being, longitudinal studies scarce, and whether poorer psychosocial well-being is the cause or effect of IGD is still unclear. To address this issue, a longitudinal study including three-wave data from older-aged adolescents and emerging adults (1,054 first-year university students, age range 17-21 years, 41.2% male) was conducted. Cross-lagged panel models were tested to examine the longitudinal association between IGD and psychosocial well-being. The results suggested that IGD negatively affects variables of psychosocial well-being (i.e., self-esteem, social support, and life satisfaction), but not vice versa. The results supported the interpersonal impairment hypothesis, which conceptualizes IGD as a maladaptive response leading to poorer psychosocial well-being. Furthermore, the results also showed that IGD was negatively associated with self-esteem and social support across all three waves with gender differences across these associations and larger correlations for males in comparison to females. In conclusion, the study findings highlight that the classification of IGD as a mental health disorder is appropriate, and that the condition is a risk factor for impaired psychosocial well-being in late adolescence and early adulthood.

The co-occurrence between symptoms of internet gaming disorder and psychiatric disorders in childhood and adolescence: prospective relations or common causes?

BACKGROUND

Internet gaming disorder (IGD) is highlighted as a condition for further study in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). Some studies indicate that IGD appears comorbid with other psychiatric disorders. We examine concurrent and prospective links between symptoms of IGD and symptoms of common psychiatric disorders in childhood and adolescence to determine whether observed comorbidity is a result of (a) reciprocal relations or (b) common underlying causes.

METHODS

A community sample (n = 702) of Norwegian children completed the Internet Gaming Disorder Interview (IGDI) to assess DSM-5 defined IGD symptoms at ages 10, 12 and 14 years. The Child and Adolescent Psychiatric Assessment (CAPA) assessed symptoms of depression, anxiety, attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) at the same time points.

RESULTS

A Random Intercept Cross-lagged Panel Model (RI-CLPM), which captures pure within-person changes and adjusts for all unmeasured time-invariant factors (e.g., genetics, parent education) revealed no associations between IGD symptoms and psychopathology, except that increased IGD symptoms at ages 10 and 12 predicted decreased symptoms of anxiety two years later.

CONCLUSIONS

No support emerged for concurrent or prospective relations between IGD and psychiatric symptoms, except in one case: increased IGD symptoms forecasted reduction in anxiety symptoms. Observed co-occurrence between IGD symptoms and mental health problems can mainly be attributed to common underlying factors.

Social and Behavioral Health Factors Associated with Violent and Mature Gaming in Early Adolescence

We examined how risk level of video games, measured by maturity and violence level, was associated with behavioral health, social impacts, and online social interactions. School-based surveys in two different cohorts assessed self-reported gaming behaviors, health, and social media use. For Study 1, our 700 participants were 52% female and 48% White (mean age 12.7). Middle school students who played the high-risk games reported higher depressive symptoms and problematic internet behaviors, less sleep, more time spent playing games, and higher frequency of checking social media than non-gaming students. Those who played high-risk games were less likely to play alone and to play with strangers than those who played minimal-risk games. For Study 2, our 772 participants were 50% female and 57% White (mean age 12.6). Similar to Study 1, we found that those who played the high-risk games spent significantly more time playing games, were more interactive with other players, and had poorer sleep outcomes than non-high-risk gamers. Additionally, playing high-risk games had significantly different social impacts of gaming compared to less-risky gaming, including spending more money on games, spending less time on homework and with family or skipping meals due to gaming. Mature and violent content of video games and amount of online social interaction associated with gaming play a strong role in behavioral health and social impacts within families. These results can inform guidelines to intervene when problematic behaviors emerge.

Inattention and Disordered Gaming: Does Culture Matter?

Problematic gaming has emerged as a contemporary concern, leading to the introduction of the diagnostic term 'Internet Gaming Disorder' (IGD; American Psychiatric Association). The present study aims to empirically assess the association between inattention and IGD, in the light of variable levels of vertical-individualism that reflects cultural inclinations towards independence, competitiveness, and hierarchy. The participants (N = 1032) comprised a normative cohort of Massively Multiplayer Online (MMO) gamers (Mage = 24 years; 48.7% male). IGD was measured with the nine-item short-form IGD Scale (IGD9-SF), inattention with the Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale, and vertical individualism with the Individualism-Collectivism Questionnaire. Complex hierarchical and moderated regressions were employed. Findings demonstrated an association between IGD and inattention, and additionally showed that this association was exacerbated by a more vertically-individualistic cultural orientation without significant gender differences. The need of differentially addressing IGD risk among inattentive gamers of diverse cultural orientation is highlighted.

An Empirical Exploration of Longitudinal Predictors for Problematic Internet Use and Problematic Gaming Behavior

Problematic gaming (PG) has been included in the DSM-5 and ICD-11. But, it is still controversially discussed, if problematic (online-) gaming is a subtype of problematic Internet use (PIU) or if both behavior patterns should be distinguished. In joint samples, the relationships between PIU and PG and correlates have so far only been investigated in cross-sectional studies. This is the first longitudinal study to determine predictors of PIU, PG, and a combined occurrence of PIU and PG (PIU + PG) together in one sample. Overall, 985 family dyads (one parent and her/his child) were interviewed twice (at t1 and t2, with one year in between) with a standardized questionnaire regarding PIU, PG and psychosocial aspects. Predictors for adolescent PIU, PG, and PIU + PG were determined with a multinomial logistic regression analysis. The following were our findings: (a) PIU (t2) was predicted by stronger emotional distress (t1) and PIU (t1); (b) PG (t2) by male gender, more self-esteem problems (t1), stronger hyperactivity/inattention (t1), and PG (t1); and (c) PIU + PG (t2) by male gender, stronger hyperactivity/inattention (t1), and PG (t1). Partly different patterns of predictors were observed for the development of PIU and PG. The results indicate not only commonalities but also differences in the etiology of these behavior patterns.

Normative, passionate, or problematic? Identification of adolescent gamer subtypes over time

BACKGROUND AND AIMS

For most youngsters, gaming is a fun and innocent leisure activity. However, some adolescents are prone to develop problematic gaming behavior. It is therefore important to have a comprehensive understanding of psychosocial and game-related characteristics that differentiate highly engaged gamers from problematic gamers. To that end, this study evaluated the stability and consistency of Internet gaming criteria (as suggested by the DSM-5) and psychosocial characteristics in a two-wave longitudinal study including 1928 young adolescents (mean age = 13.3 years, SD = 0.91, 57% boys).

METHODS

A confirmatory factor analysis revealed good stability of the Internet gaming disorder (IGD) construct over time. Latent class analyses revealed three classes for boys (recreational, engaged, and problematic) and two classes for girls (recreational and engaged).

RESULTS

Significant differences between classes emerged for problem criteria (conflict and problems in social life), gaming duration, impulsivity, social competence, and attention/hyperactivity. The absence of a problematic gaming class for girls suggests that girls are less likely to develop problematic gaming behavior.

DISCUSSION

The IGD criteria as proposed by the DSM-5 are a helpful tool to identify problematic gamers, although the results of this study suggest that using a strict cut-off point might result in false positives, particularly for boys. Problem criteria appeared to be the most sensitive and specific in identifying the problematic gamer, whereas escapism criteria were the least specific and sensitive. Careful consideration of the current proposed criteria to identify problematic gaming behavior could benefit the research and clinical field.

Assessing Online Flow Across Cultures: A Two-Fold Measurement Invariance Study

The association between online Flow and Internet Gaming Disorder (IGD) has attracted significant attention. Despite the consensus that online Flow plays a pivotal role in the development of IGD and other Internet addictive behaviors, there has been a lack of consistency in measurement scales used to assess online Flow. Even widely used measures of online Flow have not been psychometrically assessed across culturally diverse populations of gamers. Such an assessment would enhance the accuracy of cross-cultural comparisons. Attending to this need, the present study assessed the psychometric properties of the binary coded (i.e., Yes, No) Online Flow Questionnaire (OFQ), while concurrently taking into consideration country, age, language, and mode of data collection (online or face-to-face) differences. Two sequences of successive multiple group confirmatory factor analyses were used to assess the psychometric properties of the OFQ, between: (a) emergent adults from the United States of America (N = 482, Mage = 25.23, SD = 2.746) and Australia (N = 168, Mage = 23.55, SD = 3.37) and (b) adolescents from Greece (N = 1579, Mage = 16.12, SD = 0.849) and Cyprus (N = 1372, Mage = 15.54, SD = 0.656). Configural and partial metric invariance were confirmed between the United States and Australian samples. For the Greek and Cypriot samples, results indicated full configural and metric invariance. These results provide initial information to researchers and clinicians of the extent to which the OFQ maintains its consistency when used across cultures and invite for further cross-cultural studies in the field. Implications, as well as limitations, are discussed.

The impact of heavy and disordered use of games and social media on adolescents' psychological, social, and school functioning

AIM

To extend the scholarly debate on (a) whether or not the compulsive use of games and social media should be regarded as behavioral addictions (Kardefelt-Winther et al., 2017) and (b) whether the nine DSM-5 criteria for Internet gaming disorder (IGD; American Psychiatric Association [APA], 2013) are appropriate to distinguish highly engaged, non-disordered users of games and social media from disordered users, this study investigated the impact of engaged and disordered use of games and social media on the psychosocial well-being and school performances of adolescents.

METHODS

As part of the Digital Youth Project of the University of Utrecht, a three-wave longitudinal sample of 12- to 15-year-old adolescents (N = 538) was utilized. Three annual online measurements were administered in the classroom setting, including IGD, social media disorder, life satisfaction, and perceived social competence. Schools provided information on students' grade point average.

RESULTS

The symptoms of disordered use of games and social media showed to have a negative effect on adolescent's life satisfaction, and the symptoms of disordered gaming showed a negative impact on adolescents' perceived social competence. On the other hand, heavy use of games and social media predicted positive effects on adolescents' perceived social competence. However, the heavy use of social media also predicted a decrease in school performances. Several gender differences in these outcomes are discussed.

CONCLUSION

The findings propose that symptoms of disordered use of games and social media predict a decrease in the psychosocial well-being and school performances of adolescents, thereby meeting one of the core criteria of behavioral addictions.

Bidirectional Associations Between Self-Reported Gaming Disorder and Adult Attention Deficit Hyperactivity Disorder: Evidence From a Sample of Young Swiss Men

Background: Gaming disorder (GD) has been shown to co-occur with attention deficit hyperactivity disorder (ADHD), yet few studies to date have investigated their longitudinal associations. Method: The sample included 5,067 young Swiss men (mean age was 20 years at wave 1 and 25 years at wave 3). Measures were the Game Addiction Scale and the Adult ADHD Self-Report Scale (6-item screener). Longitudinal associations were tested using autoregressive cross-lagged models for binary measures of GD and ADHD, as well as continuous measures for GD score and ADHD subscales of inattention and hyperactivity. Results: ADHD at age 20 increased the risk for GD at age 25 (probit = 0.066 [0.023, 0.109]; p = 0.003). GD at age 20 also increased the risk for ADHD at wave 3 (probit = 0.058 [0.013, 0.102]; p = 0.011). Only the ADHD inattention subscale showed a bidirectional longitudinal relationship with the GD score (standardized Beta from inattention at age 20 to GD score at age 25: 0.090 [0.056, 0.124]; p < 0.001; from GD score at age 20 to inattention at age 25: 0.044 [0.016, 0.071]; p = 0.002), whereas associations between the hyperactivity subscale and GD were not significant. Discussion: GD had bidirectional longitudinal associations with ADHD, in that ADHD increased the risk for GD and GD increased the risk for ADHD, and they may reinforce each other. These associations may be linked more to the inattention ADHD component than to the hyperactivity ADHD component. Individuals with ADHD or GD should be screened for the other disorder, and preventive measures for GD should be evaluated in individuals with ADHD.