Prevalence and correlates of comorbid depression in a nonclinical online sample with DSM-5 internet gaming disorder

The comorbidity mechanism of problematic internet use and depression among Chinese college students: A cross-lagged panel network analysis

Problematic internet use (PIU) and depression usually co-occur and are common among college students. According to network theory, it may be attributed to the interplay of symptoms that connect these two mental health problems. However, most studies have failed to examine complex and subtle connections at the symptom level and have not clarified how PIU and depression symptoms are intercorrelated, which symptoms serve as the source of comorbidity (i.e., the central symptoms), and whether such a comorbidity mechanism would change with higher grades. To explore these questions, this study examined four contemporaneous networks and three cross-lagged panel networks, visualizing the symptoms as nodes and the connections between symptoms as edges. A total of 2,420 college students (Mage = 18.35, SD = 0.84; 67.98 % girls) completed four annual surveys. Overall, the results of contemporaneous networks and cross-lagged panel networks indicated that (a) PIU and depression symptoms are intercorrelated; (b) the core symptoms responsible for comorbidity mostly belonged to PIU, and (c) the comorbidity mechanism would change with time. These findings explain the dynamic relation between PIU and depression and identify possible primary symptoms that comorbidity programs can mitigate at different stages of the college years.

Comprehensive analysis including in-game spending and violent game playing in patients with internet gaming disorder

AIM

Internet gaming disorder (IGD) is receiving increasing attention. In particular, violent gameplay or in-game spending affects the psychiatric conditions and economic difficulties of patients. We conducted regression analysis and path analysis to investigate the associations between a comprehensive list of factors in patients with IGD, including the degree of internet or gaming dependence, developmental problems, family background, severity of depression, sleeping habits, in-game spending, and first-person shooter (FPS) and third-person shooter (TPS) game playing.

METHODS

The participants were 47 Japanese individuals (39 males and 8 females) aged ≤20 years diagnosed with IGD with complete data from the internet addiction test, autism spectrum quotient, Quick Inventory of Depressive Symptomatology, and Pittsburgh Sleep Quality Index. All participants were asked whether their parents have divorce history, whether they have siblings, whether they play FPS or TPS games, and whether they engage in in-game spending. Firstly, we compared these factors between males and females; secondly, we conducted regression analysis and path analysis in male patients.

RESULTS

As for simple comparison between sex, female patients showed greater severity of IGD and depressive score. In regression analysis of male patients, significant associations were found between FPS or TPS game playing and in-game spending. We also created path diagrams.

CONCLUSION

The results of the comprehensive analyses suggest the possibility that bidirectional synergistic effects could be achieved by gradually reducing both violent game playing and in-game spending. The concept of internet dependence has a wide range of meanings, and for each subtype, it is important to consider the background that led to the dependence to make individualized environmental adjustments and provide psychotherapy.

Identification of patients with internet gaming disorder via a radiomics-based machine learning model of subcortical structures in high-resolution T1-weighted MRI

It is of vital importance to establish an objective and reliable model to facilitate the early diagnosis and intervention of internet gaming disorder (IGD). A total of 133 patients with IGD and 110 healthy controls (HCs) were included. We extracted radiomic features of subcortical structures in high-resolution T1-weighted MRI. Different combinations of four feature selection methods (analysis of variance, Kruskal-Wallis, recursive feature elimination and relief) and ten classification algorithms were used to identify the most robust combined models for distinguishing IGD patients from HCs. Furthermore, a nomogram incorporating radiomic signatures and independent clinical factors was developed. Calibration curve and decision curve analyses were used to evaluate the nomogram. The combination of analysis of variance selector and logistic regression classifier identified that the radiomic model constructed with 20 features from the right caudate nucleus and amygdala showed better IGD screening performance. The radiomic model produced good areas under the curves (AUCs) in the training, validation and test cohorts (AUCs of 0.961, 0.903 and 0.895, respectively). In addition, sex, internet addiction test scores and radiomic scores were included in the nomogram as independent risk factors for IGD. Analysis of the correction curve and decision curve showed that the clinical-radiomic model has good reliability (C-index: 0.987). The nomogram incorporating radiomic features of subcortical structures and clinical characteristics achieved satisfactory classification performance and could serve as an effective tool for distinguishing IGD patients from HCs.

Impaired social reward processing in individuals with Internet gaming disorder and its relationship with early face perception

Previous research has found that individuals with Internet gaming disorder (IGD) show different patterns of social function impairments in game-related and real-life social contexts. Impaired social reward processing may be the underlying mechanism according to the Social Motivation Theory. Thus, in this study, event-related potentials were recorded from 24 individuals with IGD and 24 healthy gamers during a social judgement task. We focused on reward positivity (RewP) elicited by game-related and real-life social rewards, and N170 elicited by game avatar faces and real faces. These indicators were used to explore the neurocognitive mechanism of impaired social reward processing in individuals with IGD and its relationship with early face perception. Results showed that (1) the RewP elicited by real-life social reward was considerably reduced in individuals with IGD relative to healthy gamers. (2) The N170 elicited by game avatar faces in individuals with IGD was larger than that elicited by real faces. However, the N170 was not associated with RewP in either group. (3) The score for IGD severity was correlated with the RewP elicited by real-life social reward and the N170 elicited by game avatar face. In conclusion, the present study suggests that the impaired social reward processing in individuals with IGD is mainly manifested in a decreased neural sensitivity to real-life social reward. Meanwhile, the reduced RewP elicited by real-life social reward and the enhanced N170 elicited by game avatar face might serve as potential biomarkers for IGD.

Internet gaming disorder: The prevalence and associated gaming behavior, anxiety, and depression among 8-12-year-old children of private schools in Salem city, India

BACKGROUND

The escalating concern over Internet gaming disorder (IGD) among children underscores the urgency of comprehending its determinants and links to mental health, particularly for interventions targeting school-aged children.

AIM

This study aimed to evaluate the prevalence and determinants of IGD and its association with depression, anxiety, and behavior among 8-12-year-old children attending private schools in Salem city.

SETTINGS AND DESIGN

A cross-sectional study involving 780 children aged 8-12 years from Salem district was conducted. Schools were randomly sampled, and data were collected through a self-administered questionnaire.

MATERIALS AND METHODS

Data were gathered from children without genetic, systemic, or mental disorders and brain trauma. The questionnaire, adapted from Alhamoud M A et al. (2022), encompassed sections on sociodemographic characteristics, gaming behavior, and scales for assessing IGD, depression, and anxiety. Administration occurred during school hours with a 30-35 min completion time.

STATISTICAL ANALYSIS USED

Data analysis utilized SPSS v23.0, including descriptive statistics, ANOVA, Chi-square tests for intergroup comparisons, and Pearson's correlation coefficient to determine associations.

RESULTS

The prevalence of IGD in Salem district was 1.2%, with higher rates of anxiety and depression observed among older children, particularly males.

CONCLUSIONS

A positive correlation was evident between IGD, anxiety, and depression. Urgent preventive measures have to be warranted to curb the rising trend of IGD, such as limiting screen time and promoting outdoor activities to enhance children's overall health.

Developmental trajectories and predictors of Internet gaming disorder across the university years: A person-centered five-wave cohort study

With a rapid rise in internet gaming, internet gaming disorder (IGD) has become a contemporary concern. However, little is known about the long-term dynamic changes in IGD over time. Using a person-centered five-wave longitudinal design, the current study explored the heterogeneous trajectories of IGD among 5787 students during their university years, and examined the role of protective and risk factors in differentiating distinct patterns of IGD. The growth mixture modeling revealed three distinct trajectories of IGD: stable-low pattern (n = 4575, 87.42 %), increasing pattern (n = 357, 6.80 %), and decreasing pattern (n = 302, 5.78 %). Additionally, the students with high self-control and self-compassion were more likely to be in the stable-low group instead of the other risk groups. Depressive symptoms and peer conflicts, as two time-varying variables, were significant risk predictors for IGD. These findings highlight the importance of identifying high-risk groups for IGD and providing them with personalized and effective mental health services to reduce their risk of developing IGD in the future.

The severity of addiction mediates loneliness and cortical volume in internet gaming disorder

Internet gaming disorder (IGD) subjects reported higher loneliness scores than healthy controls. However, the neural correlates underlying the association between loneliness and IGD remain unclear. Thus, the aim of this study was to explore the relationship between loneliness, online gaming addiction and brain structure. In the current study, structural MRI data were acquired from 84 IGD subjects and 103 matched recreational game users (RGUs). We assessed and compared their addiction severity, loneliness scores, and cortical volumes and analyzed the correlations among these values. Significant correlations were found between loneliness scores and brain volumes in the postcentral cortex, the medial orbitofrontal cortex, the rostral anterior cingulate cortex, and the temporal cortex. In addition, the addiction severity scores partly mediated the relationship between loneliness score and cortical volume in IGD. The results showed that participants with extreme loneliness had significant correlations with brain regions responsible for executive control, social threat surveillance and avoidance. More importantly, the severity of addiction mediates loneliness and cortical volume. The findings shed new insight into the neural mechanisms of loneliness and IGD and have implications for potential treatment.

Problematic internet use and suicide ideation among Chinese adolescents: The indirect effects of insomnia, nightmares, and social jetlag

BACKGROUND

Problematic Internet use (PIU) is related to suicide ideation (SI) in adolescents, but little is known about the potential mechanisms between them. This study aimed to examine the mediation roles of insomnia, nightmares, and social jetlag in the association of PIU with SI in adolescents.

METHODS

A total of 39,731 adolescents (mean age = 13.49 ± 0.76 years, 54.4 % males) from Shenzhen, China, participated in a cross-sectional survey. SI was assessed using the ninth item of the Patient Health Questionnaire-9. PIU was measured by the Revised Chinese Internet Addiction Scale. A self-administered questionnaire was used to assess insomnia symptoms, nightmare frequency, social jetlag, sleep duration, psychological distress, and social-demographical characteristics. Logistic regression and path analyses were performed to examine the associations between PIU, insomnia symptoms, nightmares, social jetlag, and SI.

RESULTS

The prevalence of PIU and SI were 14.9 % and 18.6 %, respectively. PIU, insomnia symptoms, frequent nightmares, and social jetlag were significantly associated with SI. Path analyses showed that the indirect effects of PIU on SI through insomnia symptoms, frequent nightmares, and social jetlag were significant. Conversely, social jetlag significantly mediated the pathway from SI to PIU. The mediation effect sizes of these sleep and circadian problems were slightly larger in females than in males.

LIMITATIONS

Cross-sectional design limited the capacity to infer causal relationships.

CONCLUSIONS

The associations between PIU and SI were mediated by sleep and circadian problems. These findings underscore the importance of assessing and intervening in sleep and circadian problems among adolescents with PIU or SI.

Why Do People Sometimes Wear an Anonymous Mask? Motivations for Seeking Anonymity Online

Anonymous environments are more accessible than ever. As such, it is important to understand not only how anonymity can change human behavior but also why people are motivated to seek anonymity in online spaces. In four studies, we investigated differences in motivations for seeking anonymity online and their associations with related dispositional factors and online behavior. We found that some people were motivated to seek anonymity to self-express or behave toxically. Both motivations to seek anonymity were associated with low self-concept clarity and high Machiavellianism but differed in their relation to traits such as self-consciousness and psychopathy. Further analyses suggested that people selectively engage in behaviors in anonymous online environments, in line with the specific gratifications they seek through anonymity. We conclude that people seek anonymity to pursue self- or other-related goals that are otherwise more difficult or costly to pursue when identifiable.

Adolescent psychiatry of Y. Kasahara and succeeding research on Hikikomori in Europe and in Japan

This paper will focus on the works of one of Japan's representative psychiatrists, Yomishi Kasahara, particularly on his works in the 1970s in which he proposed the concept of student apathy, and will discuss how this work was carried over into a contemporary topic, the study of "Hikikomori." Kasahara's well-known paper "Clinical Classification of Depression" (Kasahara and Kimura, 1975) described the present state of patients with Type III as "they do not have a complete set of symptoms as in Type I, but sometimes show dependency, strong exaggeration, complication of other neurotic symptoms, little tendency of self-reproaching, and tendency of accusing others"; the two subtypes as Type III-1 "those that remain at the neurotic level" and Type III-2 "those that transiently drop to the psychotic level." We have summarized and introduced below the case presented in the paper with this Type III-1. From today's perspective, where the concept of "Hikikomori" exists, this case could be considered as a typical case of "Hikikomori," that is, a person with a tendency to avoid social roles and responsibilities and to immerse oneself in areas with no responsibilities, such as hobbies. "Hikikomori" was discovered in the late 1980s, but to be precise, it was just that the concept emerged. The same clinical condition had already been brilliantly found by Kasahara in the 1970s under the concept of "apathy syndrome," which was distinguished from depression.

Social support as the mediator for the relationship between internet gaming disorder and psychological problems among university students

BACKGROUND

There has been increasing recognition of internet gaming disorder as a psychiatric problem that is linked with serious impairment and distress and correlated with psychological reactions and social consequences. Thus, this study proposed that psychological problems (stress, anxiety, and depression) and social support could be associated with IGD and social support had a mediating role between these psychological problems and IGD among university students in Jordan.

METHODS

A cross-sectional, descriptive correlational design was adopted. The university students (N = 1020) were selected randomly from four universities (two public and two private) in Jordan. A self-structured questionnaire was used to collect data using the Internet Gaming Disorder Test (IGD-20 Test), Depression Anxiety Stress Scales-21 (DASS-21), Multidimensional Social Support Scale (MSPSS), and sociodemographic data.

FINDINGS

Findings of this study found that the mean age of the participants was 21.38 (S.D ± 2.12) and 55.9% of them were males The prevalence of internet gaming disorder was 12.16% among the participants, where the cut-off point for internet gaming disorder was 71 out of 100. Internet gaming disorder was significantly correlated with stress, anxiety, social support, and depression. However, stress, anxiety, and social support had a direct effect on internet gaming disorder, while social support had the strongest effect on internet gaming disorder. It was found that social support had a mediating role between anxiety and stress (β = -0.172, T-Statistics = 3.92, p < 0.001; β = -0.268, T-Statistics = 5.45, p < 0.001, respectively) and internet gaming disorder (p < 0.001).

CONCLUSION

This study can help policymakers and instructors develop health education programs and/or health training programs that focus on using social support as a coping method when experiencing psychological problems including stress and anxiety and adopt social support in management programs for excessive use of internet gaming.

The Mediating Role of Positive Attitudes on the Relationship Between Esports Gaming Hours and Psychological Well-Being During the COVID-19 Pandemic

Electronic sports game (esports) gaming has seen a surge in popularity, especially during the coronavirus disease 2019 (COVID-19) pandemic, with more young people turning to it as an alternative to physical activities. However, the impact of esports gaming on mental health is a matter of concern. Previous studies have produced inconsistent findings on the relationship between gaming hours and mental health, and the moderating factors involved remain unexplored. This study aimed to investigate the moderating effect of participants' subjective attitudes toward esports gaming on the relationship between daily gaming hours and psychological well-being (PWB) among Chinese young adults during the COVID-19 lockdown. A nationwide online survey was conducted on 550 Chinese young adults using the Credamo platform. Ryff's Psychological Well-Being Scales (42-Item version) were used to assess PWB levels. The analysis included 453 participants. Gaming hours were negatively correlated with PWB scores. However, when considering the moderating effect of subjective attitudes, the association between gaming hours and PWB scores was largely positive. Our study suggests that subjective attitudes toward esports gaming outweigh gaming hours in promoting personal psychological well-being. We propose practical recommendations for healthy esports participation patterns that prioritize positive attitudes, especially in similar future scenarios like COVID-19. Our findings may inform future psychological intervention and research in the esports domain.

Internet Gaming Disorders and Early Onset Psychosis in Young People: A Case Study and Clinical Observations

BACKGROUND

Over the last ten years, the video game industry has grown exponentially, involving about 2.5 billion young adults in the world. The estimated global prevalence of gaming addiction has been reported to be 3.5% ranging from 0.21% to 57.5% in the general population. Moreover, during the recent COVID-19 pandemic period, school closures and stay-at-home measures have also further increased the opportunities for prolonged and intensified playing of video games. Little is known about the relationship between IGD and psychosis, and the literature is still scarce. Some characteristics of patients with psychosis, particularly those with a first-episode psychosis (FEP), may suggest that these individuals would be particularly liable to develop IGD.

CASE PRESENTATION

We report two cases of young patients with to Internet gaming disorder, experiencing early onset psychosis treated with antipsychotic therapy.

CONCLUSION

Although it is difficult to show the specific mechanisms underlying the psychopathological alterations in IGD, it is clear that excessive exposure to video games could be a risk factor for precipitating psychosis especially in a vulnerable age group such as adolescence. Clinicians should be aware of the possibility of a higher risk of psychotic onset associated specifically with gaming disorders in very young people.

A Bibliometric Analysis of Research into Internet Gaming Disorders in Korea

After the concept of "Internet addiction" was first proposed in 2004, "Internet gaming disorder" (IGD) was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a disorder requiring further research. IGD is prevalent in South Korea, and many studies have been conducted on the disorder. Previous studies have helped in understanding various aspects of IGD, but a comprehensive understanding of the research trends is required to identify research gaps. Therefore, we conducted a bibliometric review of all published IGD studies in South Korea. For the identification of articles, the Web of Science database was used. Data analysis was performed using Biblioshiny. A total of 330 publications were included in the analysis. The average number of citations per document was 17.12. These publications were written by a total of 658 authors, and the number of coauthors per document was 5.07. The years with the most publications were 2018 (n = 57), 2017 (n = 45), and 2019 (n = 40). The top three journals containing publications were the Journal of Behavioral Addictions (n = 46), Frontiers in Psychiatry (n = 19), and Psychiatry Investigation (n = 14). In a keyword analysis (apart from "IGD", "internet addiction", and "addiction"), the keywords "adolescent" (n = 31), "self-control" (n = 11), and "impulsivity" (n = 11) were included. T. This bibliometric analysis explores and summarizes the publications on IGD in South Korea. The results are expected to provide researchers with insights for further studies into IGD.

Internet addiction and suicidal behavior among vocational high school students in Hunan Province, China: A moderated mediation model

Background

Vocational education is an important part of high school education in China. However, there is little research on high school students' mental health. This study aimed to investigate the prevalence of suicidal behavior (SB) among this population and the mediating role of insomnia, depression, anxiety, and stress in the relationship between Internet addiction (IA) and SB using a structural equation model.

Methods

A cross-sectional questionnaire survey was conducted among several vocational high school students in Hunan Province, and 7,968 valid questionnaires were obtained. General demographic data and data from the Dual-Mode Self-Control Scale, Athens Insomnia Scale, Depression Anxiety Stress scale-21, and Revised Chen Internet Addiction Scale were collected. A structural equation model was used to explore the different pathways from IA to SB.

Results

Among the participants, 37.7, 15.7, and 21.8% reported suicidal ideation, plans, and attempts, respectively. The structural equation model confirmed that IA was indirectly related to SB and was mediated by insomnia and/or depression, anxiety, and stress.

Limitations

First, we only recruited students from vocational schools in Hunan Province, therefore, the sample may not represent the entire population of vocational students in China. Second, self-report scales were used in this study, and clinical diagnosis required professional interviews. Third, since this study had a cross-sectional design, the causal relationship between the variables could not be determined.

Conclusions

The prevalence of SB among vocational high school students in China was significantly high. The prevention of SB related to IA can be attributed to the improvement of insomnia and emotional problems.

Effective interventions for gaming disorder: A systematic review of randomized control trials

OBJECTIVE

To identify effective intervention methods for gaming disorder (GD) through a rigorous assessment of existing literature.

METHODS

We conducted a search of six databases (PubMed, Embase, PsycINFO, CNKI, WanFang, and VIP) to identify randomized controlled trials (RCTs) that tested GD interventions, published from database inception to December 31, 2021. Standardized mean differences with 95% confidence intervals were calculated using a random effects model. Risk of bias was assessed with the Risk of Bias 2 (RoB 2) tool.

RESULTS

Seven studies met the inclusion criteria. Five interventions were tested in these studies: group counseling, craving behavioral intervention (CBI), transcranial direct current stimulation (tDCS), the acceptance and cognitive restructuring intervention program (ACRIP), and short-term cognitive behavior therapy (CBT). Four of the five interventions (the tDCS was excluded) were found to have a significant effect on GD. The results of the quality assessment showed that the included studies had a medium to high risk in the randomization process and a medium to high risk of overall bias.

CONCLUSION

Rigorous screening identified that four interventions are effective for GD: group counseling, CBI, ACRIP, and short-term CBT. Additionally, a comprehensive review of the literature revealed that improvements could be made in the conceptualization of GD, experimental design, sample representativeness, and reporting quality. It is recommended that future studies have more rigorous research designs and be based on established standards to provide more credible evidence to inform the development of GD interventions.

Resting-state heart rate variability, level of stress and resilience in internet gaming disorder and alcohol use disorder

Stress and resilience are involved in the pathophysiology of addictive disorders, and heart rate variability (HRV) is an index of an individual's global capability to regulate psychological responses. In this study, we aimed to identify transdiagnostic and disorder-specific markers in people with addictive disorders by analyzing resting-state HRV and associations with the levels of stress and resilience. We compared relevant data between patients with internet gaming disorder (IGD) and/or alcohol use disorder (AUD) and healthy controls (HCs). In all, 163 adults aged 18-35 years (53 with IGD, 49 with AUD, 61 HCs) participated. The levels of stress and resilience were measured using the Psychosocial Wellbeing Index and the Connor-Davidson Resilience Scale, respectively. The HRV was obtained from each participant during a 5 min resting-state. The IGD and AUD patients exhibited increased levels of stress and decreased resilience compared to the HCs. Patients with either addictive disorder exhibited a lower standard deviation of the normal-to-normal beat interval (SDNN) index [SDNNi] compared to HCs even after adjusting for clinical variables such as depression, anxiety, and impulsivity. In multiple comparison tests among the three groups, the AUD group had lower HRV than HCs, but no differences were observed among the groups after adjusting for the clinical variables. The HRV indices were correlated with the levels of stress, resilience, and disease severity. In conclusion, IGD and AUD patients exhibit lower HRV as indicated by the SDNNi compared to HCs, revealing their vulnerability to stress as well as a common transdiagnostic marker of addiction.

Influences of Emotional Information on Response Inhibition in Gaming Disorder: Behavioral and ERP Evidence from Go/Nogo Task

BACKGROUND

Gaming disorder (GD) may impair executive functions such as response inhibition. According to the tripartite neurocognitive model, the interoceptive system generates a state of craving that exacerbates the dysfunction of GD. We speculate that emotional information may play an important role in the mechanism, which leads to impaired response inhibition in people with GD.

METHODS

A three-factor mixed experimental design was adopted in this go/nogo task. The between-subject factor was group (GD or control group), and the within-subject factors were two types of emotional information, task relevance (related or unrelated) and emotional valence (negative or positive).

RESULTS

The GD group had lower nogo accuracies than the control group in the task-unrelated condition and also in the negative condition. Parallelly, the GD group showed faster reactions and lower accuracy in the go trials than the control group under task-unrelated negative conditions. At the neural level, the GD group had smaller amplitudes of nogo-N2 and larger amplitudes of nogo-P3 than the control group in the task-unrelated condition.

CONCLUSIONS

The findings prove the hypothesis of this study that emotional information could be a factor leading to impaired response inhibition in GD individuals. The response inhibition abilities of GD are weakened when processing task-unrelated or negative information, which may be caused by failure of behavioral inhibition and weakened conflict control, resulting in more cognitive resources to complete response suppression under specific conditions. This study provides evidence for weaker response inhibition in GD individuals from the perspective of cognitive-emotional interaction and provides more detailed information for interventions for GD.

Risk factors and outcomes of internet gaming disorder identified in Korean prospective adolescent cohort study

BACKGROUND AND AIMS

Internet gaming disorder (IGD) is known to cause various psychological and physical complications. Through data collected from an adolescent prospective longitudinal cohort, we examined how IGD is related to lifestyle and physical symptoms, as well as the temporal relationship between them.

METHODS

This study was conducted as part of iCURE (Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence) in Korea between 2015 and 2019. Sleep and physical activity time, dry eye symptoms, musculoskeletal pain, and near-miss accidents were measured at baseline and followed-up after one year. IGD risk was evaluated using the Internet Game Use - Elicited Symptom Screen (IGUESS). The association between IGD risk and measured variables was analyzed, both at baseline and at follow-up after one year.

RESULTS

At baseline, the IGD risk group had significantly less physical activity time and sleep time and had more dry eye symptoms, musculoskeletal pain, and near-miss accidents than the IGD non-risk group. Additionally, in the IGD risk group at baseline, dry eye symptoms, musculoskeletal pain, and near-miss accidents occurred significantly more after one year of follow-up.

DISCUSSION AND CONCLUSION

The results of this study show that IGD is a significant risk factor that increases the probability of physical disease and trauma in adolescents. Therefore, interventions aimed at reducing IGD risk and protecting the physical and mental health of adolescents are imperative.

Considering gender differences in the study and treatment of internet gaming disorder

BACKGROUND AND AIMS

Internet gaming disorder (IGD) is a multifaceted and complex addictive disorder characterized by poor impulse control and altered reward sensitivities, among other features. IGD is a male-predominant condition, and gender-related differences may contribute importantly to the development and maintenance of, and recovery from, IGD.

METHODS

The current manuscript proposes a framework that incorporates gender-related considerations at different stages of IGD and proposes potential strategies for the prevention and treatment of IGD.

RESULTS

At the development stage, high impulsivity, impaired inhibitory control, and aggressive behaviors have been more frequently observed among males than females, suggesting potential risk factors for the development of IGD. Loneliness and other emotional dysregulation have been more frequently noted among females (than among males) with IGD. At the maintenance stage, males may be more sensitive to gaming-related rewards than females, and acute gaming behaviors may elicit higher cravings among males than among females and thus weaken their inhibitory control. In recovery, females with IGD have reported more negative mood states than males, and females' gaming behaviors have been linked with affective disorders.

DISCUSSIONS

The model proposed here highlights gender-related differences in modulating the behavioral and neural systems that contribute to a three-stage framework of IGD. Additional investigation into gender-related differences in IGD may further advance the field by uncovering complex relationships that may underlie vulnerability and provide insights into the development of gender-specific prevention and treatment strategies.

Game-related behaviors among children and adolescents after school closure during the COVID-19 pandemic: A cross-sectional study

Aim

Increased exposure to digital gaming content among youth in recent years has raised serious health concerns. Social restrictions such as school closures, imposed worldwide because of the ongoing COVID-19 pandemic, may increase exposure to gaming and lead to addictive gaming behavior in young people. In this study, we investigated gaming behaviors among Japanese students during COVID-19 school closures.

Methods

Students completed questionnaires regarding their living conditions, game-related behaviors, diagnosis of Internet addiction, psychological difficulties, and the impact of the COVID-19 pandemic. We compared differences between the responses of potentially at risk for gaming disorder (potentially at risk for gaming disorder; defined in this paper with reference to the ICD-11 MMS criteria for gaming disorder [PGD]) students who met the criteria for a diagnosis of gaming disorder in ICD-11 MMS and those of control students. Logistic regression analysis was performed to predict the extent of factors contributing to potential gaming disorder.

Results

Four thousand and forty-eight participants completed the survey. Compared with control students (93%), potentially at risk for gaming disorder (defined in this paper with reference to the ICD-11 MMS criteria for gaming disorder, PGD) students (7%) reported playing games for longer times, spending more money on in-game purchases, were of younger age at the start of game playing, showed a tendency toward Internet dependence, practised school avoidance or absenteeism, and demonstrated the need for psychological support. Moreover, participants in the PGD group reported more anxiety about COVID-19 than control participants, as well as an increase in game-playing time and amount of money spent on games during the COVID-19 pandemic.

Conclusion

These results indicate that young people classified as having a gaming disorder not only exhibit characteristic game-related behaviors but may be psychologically and socially vulnerable and need special support, especially during the ongoing COVID-19 pandemic.

Prevalence of gaming disorder in East Asia: A comprehensive meta-analysis

BACKGROUND AND AIMS

Asian countries are deemed to be high prevalence areas for gaming disorder (GD). This meta-analysis is the first to synthesize the overall prevalence of GD in East Asia and investigate characteristics that influence prevalence estimates.

METHODS

Systematic and independent searches were conducted across PubMed, Web of Science, Embase, PsycINFO, and the Cochrane Library since their inception to January 27, 2021. The Agency for Healthcare Research and Quality scale was used for quality assessment. A random effect model was used to calculate the overall GD prevalence and 95% confidence intervals (CIs).

RESULTS

In total, 22 articles (26 studies) comprising 51,525 participants were included in this meta-analysis. The overall pooled prevalence of GD in East Asia was 12%, 95% CI (10%-15%); this figure was adjusted to 6%, 95% CI (3%-9%) for a representative sample. Higher prevalence was observed in males than in females (16% vs. 8%, respectively, P < 0.05). Subgroup and meta-regression analyses revealed that studies among gamers or those without random sampling reported significantly higher prevalence rates. There were no significant differences between countries/regions, sample size, quality score, proportion of males, and scale used.

DISCUSSION AND CONCLUSIONS

The prevalence of GD in East Asia is higher than that in other world regions. Future studies should extend such epidemiological research to other regions to calculate the accurate prevalence of GD to benefit the local identification, prevention, policy formulation, and treatment efforts. Considering its negative effects, effective preventive and treatment measures for GD in East Asia need greater attention.

Exploring Internet gaming disorder: an updated perspective of empirical evidence (from 2016 to 2021)

BACKGROUND AND AIMS

Since the acceptance of Internet gaming disorder (IGD) as a "disorder due to addictive behaviors", research has proliferated exponentially. The present review focuses on the conceptualization of IGD, its diagnosis and assessment, associated factors and existing prevention and treatment plans to address it.

RESULTS AND CONCLUSIONS

The discrepancies between the diagnostic criteria for IGD proposed by the two central diagnostic entities, as well as the questioning of their clinical validity, have generated multiple proposals for the diagnosis and psychometric evaluation of IGD. Likewise, there have been numerous suggestions to prevent this pathology, with the involvement of governments, the gaming industry and health institutions. Finally, multiple treatment plans have been proposed, both pharmacological and psychological, although only the efficacy of cognitive behavioral therapy has been tested. It is essential, therefore, to delve deeper into this disorder by addressing the central limitations of the current literature.

The role of internet gaming in the association between anxiety and depression: A preliminary cross-sectional study

BACKGROUND

Disordered Internet gaming is thought to be perpetuated by one's need to escape their real-life distress or mental health symptoms, which may in turn generate depressive feelings. Nevertheless, moderate engagement with Internet games has also been suggested to provide relief, thus improving one's mood. This study aspires to clarify the contribution of Internet gaming and gender in the association between anxiety and depression.

METHODS

A large sample of Internet gamers (N = 964) were recruited online. Disordered Internet gaming was assessed with the Internet Gaming Disorder Scale, 9 Items Short Form (IGD9S-SF). Anxiety and depression symptoms were assessed using the Depression, Anxiety and Stress Scale, 21 items (DASS-21).

RESULTS

Regression, moderation and moderated moderation analyses accounting for the effects of gender on the relationship between disordered gaming, anxiety, and depression found a significant effect for anxiety symptoms on depression symptoms and a significant interaction between anxiety and Internet gaming disorder on depression symptoms. Findings support the theory that although anxious gamers bear a higher depression risk, this is buffered with lower and exacerbated with higher disordered gaming symptoms.

CONCLUSION

Findings suggest a dual role of Internet gaming in the association between anxiety and depression, depending on the intensity of one's disordered gaming symptoms. Depression prevention and intervention protocols should be optimized by considering the effects of Internet gaming among anxious gamers by focusing on the intensity of a gamer's involvement and any gaming disorder symptoms. Further research should include clinical samples to better understand this interaction.

Internet gaming disorder: Its prevalence and associated gaming behavior, anxiety, and depression among high school male students, Dammam, Saudi Arabia

BACKGROUND:

Video games have become popular in the last few decades, resulting in an increase in reported negative consequences. This study aimed to assess the prevalence of internet gaming disorder (IGD), its association with gaming behavior, depression, and anxiety in male high school students.

MATERIALS AND METHODS:

This cross-sectional study involved male high school students in Dammam. Schools were selected using stratified random sampling, and data were collected using a self-administered questionnaire. Data analyzed using SPSS v23.0; the initial analysis included descriptive statistics. Continuous and ordinal variables were compared using t-test or Mann–Whitney U test, and ANOVA or Kruskal–Wallis test, as appropriate; Chi-square test was used for categorical variables. Spearman correlation coefficient was calculated to determine the correlation between IGD score and depression and anxiety scores.

RESULTS:

A total of 726 high school gamers were involved, 87% of whom were Saudi, with a mean age of 16.92 years and 45% were from public schools. The mean IGD score was 18.12, and the prevalence of IGD was 21.85%. Students who spent ≥4 h/day on weekdays or ≥6 h/day at weekends on videogames and gamers who spent ≥200 Saudi Riyals per month on gaming had significantly higher mean IGD scores (P < 0.001). Gamers who used PC/laptop for gaming had significantly higher IGD scores compared to those who used other devices (P = 0.002). Action, fight, open-world games, and games with violence were associated with significantly higher IGD scores. Among students with IGD, 21.7% had moderately severe/severe depression and 11.4% had severe anxiety.

CONCLUSION:

IGD is a concerning psychiatric disorder in male high school students. It is associated with certain gaming behavior and other mental problems. We recommend future larger-scale research that includes females as well.

Gambling, Gaming, and Internet Behavior in a Sexual Minority Perspective. A Cross-Sectional Study in Seven European Countries

Background

Addictive behavior of gambling, gaming and internet activity is partly a new research domain and has not been well investigated with regard to sexual minority populations. Although health disparities between sexual minorities and the general population are well documented, there is a lack of inclusion of sexual minorities in both research and clinic. Among lesbian, gay and bisexual populations certain features could be present that play a role for the development of addictive behaviors, such as social isolation and increased risk of other psychiatric problems. The aim of this study was to investigate problem gambling, problem gaming and problematic internet behavior in a European context and if it is affected by sexual orientation status.

Methods

An online web-survey was distributed among web-panels in England, Poland, Switzerland, Italy, Spain, Denmark, and Sweden in 2017-2018.

Result

10 983 complete answers were collected. 7.1% of the participants had a sexual minority status (n = 774). Regression models found that there was no difference in gambling, gaming and internet behavior among heterosexual and sexual minority men. Sexual minority women were associated with problematic gambling and gaming behavior, when also controlling for age and nationality. When also controlling for psychological distress, women defining as having another sexual minority status than lesbian and bisexual remained significant for having a problematic gaming behavior (AOR = 2.3).

Conclusion

An awareness of female sexual minority perspectives is relevant in facilities treating behavioral addiction as well as in future research in behavioral addiction. More research is needed in problematic gambling and gaming behavior in different sexual minority populations with regard to psychiatric comorbidity and living conditions. An inclusion of sexual minority groups defining as other than gay and bisexual is needed in future research. No significant differences were found between heterosexual and sexual minority men in adjusted analysis in this study.

Mental Health Changes in Older Adults in Response to the COVID-19 Pandemic: A Longitudinal Study in Mexico

This study examined changes in some aspects of mental health, as well as worries and behaviors related to the COVID-19 pandemic in a sample of older adults, during three different moments of the first year of the pandemic in Mexico. The sample consisted of 2,307 older adults (38% men and 62% women). The results indicated that older adults presented less concern about the COVID-19 pandemic, as well as less adherence to preventing procedures in the first wave, compared to subsequent evaluations. In addition, greater depressive symptoms, anxiety and stress were found in older adults in the last wave; however, the proportion of older adults identified with high scores in these variables was lower than that reported in national data.

Sexual Differences in Internet Gaming Disorder (IGD): From Psychological Features to Neuroanatomical Networks

Internet gaming disorder (IGD) has been included in the 2013 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a condition in need of further study, and gaming disorder was recognized by the World Health Organization as a mental disorder in the International Classification of Disease (ICD-11) of 2018. IGD has different characteristics in the two sexes and is more prevalent in males than females. However, even if the female gamer population is constantly growing, the majority of available studies analyzed only males, or the data were not analyzed by sex. To better elucidate sex differences in IGD, we selectively reviewed research publications that evaluated IGD separately for males and females collected in approximately one hundred publications over the past 20 years. The available data in this narrative review indicate that IGD is strongly dimorphic by sex for both its psychological features and the involvement of different brain areas. Impulsivity, low self-control, anxiety, emotion dysregulation, and depression are some of the psychological features associated with IGD that show a sex dimorphism. At the same time, IGD and its psychological alterations are strongly correlated to dimorphic functional characteristics in relevant brain areas, as evidenced by fMRI. More research is needed to better understand sex differences in IGD. Animal models could help to elucidate the neurological basis of this disorder.

Association of Internet gaming disorder symptoms with anxiety and depressive symptoms and substance use: an international cross-sectional study

Background

Problematic Internet gaming is an increasingly recognized global mental health problem. This multicultural cross-sectional study examined the association between Internet gaming disorder (IGD) symptoms and anxiety and depressive symptoms and substance use within a sample of young Internet users. In total, 3529 college/university students (1260 (35.7%) males; mean age 21 ± 3 years) were surveyed online. We assessed online gaming patterns using the Internet Gaming Disorder Self-report for College/University Students (ICMH-IGD), symptoms of depression using the Patient Health Questionnaire-9, and symptoms of anxiety using the Generalized Anxiety Disorder scale-7.

Results

IGD symptoms were associated with symptoms of depression, anxiety, and substance use, independent of time spent online, psychiatric diagnosis, culture, or sociodemographic characteristics. For males, more significant IGD symptoms were associated with more extended Internet browsing per day time and higher levels of anxiety and depressive symptoms, while for females, with more extended Internet browsing per day time, marihuana use, and higher levels of depressive symptoms.

Conclusions

Our study found that more overt symptoms of IGD were associated with higher levels of anxiety and depressive symptoms and substance use. Still, these associations differed among males and females, suggesting that gender differences should be considered when planning specific treatments.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43045-022-00180-6.

Anxiety, Depression, and Stress Are Associated With Internet Gaming Disorder During COVID-19: Fear of Missing Out as a Mediator

BACKGROUND

Many teenagers suffered negative emotional states, especially anxiety and depression, during the COVID-19 outbreak, and most teenagers choose Internet games to cope with negative emotion. Previous evidence indicated that fear of missing out is related with anxiety and depression in teenagers with Internet gaming disorder, but it is unclear how fear of missing out influences depression, anxiety, or stress.

METHODS

Based on an I-PACE model, using Depression, Anxiety, Stress Scale (DASS-21), Fear of Missing Out Scale, and Internet Gaming Addiction Scale, and 324 middle school students as participants, this study explored the mediating effect of fear of missing out on depression, anxiety, or stress and Internet gaming disorder.

RESULTS

The results showed that depression and stress are significantly related to Internet gaming disorder through the partial mediating of fear of missing out. Anxiety is not significantly related to Internet gaming disorder through the full mediating of fear of missing out, and anxiety and stress have a greater predictive effect on Internet gaming disorder through fear of missing out. Results also demonstrated that students who play Honor of Kings or Player Unknown's Battlegrounds have more risk to develop Internet gaming disorder.

CONCLUSIONS

The results indicated that fear of missing out as a mediator regulates the relationship among depression, anxiety, and stress and Internet game disorder. Specifically, under the mediation of fear of missing out, teenagers with anxiety are more likely to develop Internet gaming disorder, while teenagers with depression or stress might be prone to other types of Internet use disorders.

The directionality of anxiety and gaming disorder: An exploratory analysis of longitudinal data from an Australian youth population

Gaming activities among adolescents have increased during the COVID-19 pandemic, bringing with it a growing concern for the potential harms of excessive gaming and its risk factors. Anxiety is frequently linked with gaming disorder, but studies investigating this association were mostly cross-sectional in design. Longitudinal studies that explore risk factors associated with gaming disorder are sparse and the trajectories of gaming disorder remain unclear. To address this paucity, the present study analyzed a large longitudinal dataset with a 12-month follow-up of 4,968 Australian adolescents (ages 13-14) during the pandemic. Logistic regression and multiple regression analyses were conducted to investigate the temporal relationships between anxiety, gaming frequency, the amount of money spent within video games, and gaming disorder. Prevalence rates for gaming disorder in adolescents aged 13 and 14 were 15 and 16%, respectively. The regression models indicated a bidirectional relationship between anxiety and gaming disorder symptoms, where higher levels of anxiety were associated with higher levels of gaming disorder 12 months later and vice versa. The study also found that the interaction between anxiety and higher gaming frequency could predict gaming disorder symptoms. Overall, the findings suggest that young adolescents may be more vulnerable to developing gaming disorder and highlight the importance of addressing the interactions between risk factors and gaming disorder in treatment approaches.

Gaming disorder among students of Tabriz University of Medical Sciences: The frequency and related factors

Background: Gaming disorder has been identified as a health problem. Disorders in emerging adulthood might negatively affect individuals’ attitude toward the world, their communication with others, and formation of their personal identity. Thus, the present study was performed to identify the frequency of gaming disorder and its related factors among students of Tabriz University of Medical Sciences.

Methods: A total of 813 undergraduate students of Tabriz University of Medical Sciences participated in this descriptive correlational study in 2018. All students filled the personal-social information form and Social Readjustment Rating Scale, and gamers filled gaming behaviors form and Internet gaming disorder-20 test (IGD). Data were analyzed using descriptive statistics and Pearson correlation coefficient, t- test, ANOVA, chi-square, and multiple linear regression.

Results: A total of 394 (48.5%) students were currently playing games. The mean of IGD scores among the gamers was 45.47 ±13.93, and 17 (4.3%) of them were recognized as having gaming disorder. The frequency of the disorder among all students was 17 (2.1%). Being male, playing online games, and having access to all 3 gaming devices (computer, smart phone, and tablet) were recognized as determining factors of gaming disorder.

Conclusion: This study revealed that almost half of the university students were playing video and or on line games; however, a low percentage of the gamers had addictive gaming behaviors. The results indicated the necessity of applying modifications to individuals’ gaming methods as well as implementing the individual and family-centered interventions to prevent and manage gaming disorder.

A Literature Review on the Efficacy and Related Neural Effects of Pharmacological and Psychosocial Treatments in Individuals With Internet Gaming Disorder

OBJECTIVE

Internet gaming disorder (IGD) has attracted considerable attention as a serious mental and public health issue worldwide. Currently, there are no established treatment guidelines for IGD. Herein, we review the latest findings on the efficacy and related neural effects of pharmacological and psychosocial treatments for individuals with IGD.

METHODS

A database search of relevant studies published between 2007 and 2020 was conducted using PubMed and Google Scholar. Twenty-seven studies were reviewed for current evidence related to the efficacy and neural effects of pharmacological and psychosocial IGD treatments.

RESULTS

Pharmacological studies suggest that bupropion may play a significant role in IGD. Additionally, nuclear imaging studies on IGD have demonstrated functional impairment of the dopamine system, providing a neurobiological basis for the efficacy of dopamineenhancing drugs. Among the various psychosocial interventions, current evidence suggests that cognitive behavioral therapy may be an effective intervention for IGD. Cognitive behavioral therapy and bupropion were found to influence resting-state functional connectivity within the cortico-subcortical circuit and default mode network, suggesting a possible neural mechanism. Innovative approaches, including virtual reality treatment, residential camps, voluntary abstinence, and transcranial direct current stimulation, have shown promising results. However, methodological limitations, such as the absence of proper controls, small sample sizes, short duration, inconsistency of inclusion criteria across studies, and self-report measures of outcome, hamper conclusions regarding the efficacy of treatments.

CONCLUSION

Ongoing basic research and clinical trials overcoming these limitations could add to the existing knowledge on IGD and contribute to the development of evidence-based treatments.

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.

Internet Gaming Disorder in Early Adolescents: Gender and Depression Differences in a Latent Growth Model

Background: Studies have shown that many Internet game players may have experienced Internet gaming disorder (IGD), which is thought to coexist with a variety of cognitive and psychological disorders, such as depression. A three-year, four-point longitudinal tracking study was conducted to examine the trajectory of IGD of Chinese early adolescents, as well as the predictive level of gender and depression for IGD. Participants (N = 316) completed questionnaires assessing IGD and depression at the time of the T1, T2, T3, and T4. This study adopted the widely used latent growth model for data analysis. The results showed that, in the early stage of adolescence, (1) the development trajectory of individual IGD was shown as a nonlinear latent variable growth model; the IGD was significantly higher than zero when teenagers were first measured (sixth grade); and, while on the rise, its growth rate is gradually slowing. (2) Gender can significantly predict the development trajectory of individual IGD. (3) Individuals with a high initial level of depression usually have a high initial level of IGD, individuals with a large range of depression display a large range of IGD, and those with a rapid rate of depression change show similar change in their IGD. In sum, this study provided an empirical basis for the prevention and intervention of IGD in early adolescents.

Gaming to relieve tension or anxiety and associations with health functioning, substance use and physical violence in high school students

Gaming is popular among youth and gaming disorders have been introduced recently into psychiatric nomenclature systems. Motivations underlying gaming may include involvement to reduce negative emotional states and thus may link to psychiatric and overall health. Thus, the extent to which adolescents engage in gaming to relieve anxiety warrants additional investigation. Data from 2005 Connecticut high-school students were used to examine how adolescents who reported gaming to relieve tension or anxiety differed from those who reported gaming but not to relieve tension or anxiety on measures of demographics, academic performance, general health, extracurricular activities, dysphoria/depression symptoms, substance use, and aggressive or violent behaviors. Chi-square analyses and binomial and multinomial logistic regression models were conducted. Gaming to relieve anxiety was more prevalent in boys and Hispanic and Asian adolescents and associated with less extracurricular involvement, poorer academic performance, increased cigarette and other drug use, problematic internet use, and depression. Participants with gaming to relieve tension or anxiety were also more likely to report weapon-carrying, missing school because they felt unsafe, having been threatened with a weapon, having engaged in physical fights, and having experienced injuries from fights. As gaming to relieve anxiety was related to mental-health- and functioning-related measures, additional research is needed to examine the precise natures of these relationships and to translate the information into improved intervention strategies.

Estimated Prevalence of Unreported IGD Cases in Routine Outpatient Children and Adolescent Psychotherapy

Internet Gaming Disorder (IGD) has been included in the DSM-5 as a diagnosis for further study, and Gaming Disorder as a new diagnosis in the ICD-11. Nonetheless, little is known about the clinical prevalence of IGD in children and adolescents. Additionally, it is unclear if patients with IGD are already identified in routine psychotherapy, using the ICD-10 diagnosis F 63.8 (recommended classification of IGD in ICD-10). This study investigated N = 358 children and adolescents (self and parental rating) of an outpatient psychotherapy centre in Germany using the Video Game Dependency Scale. According to self-report 4.0% of the 11- to 17-year-old patients met criteria for a tentative IGD diagnosis and 14.0% according to the parental report. Of the 5- to 10-year-old patients, 4.1% were diagnosed with tentative IGD according to parental report. Patients meeting IGD criteria were most frequently diagnosed with hyperkinetic disorders, followed by anxiety disorders, F 63.8, conduct disorders, mood disorders and obsessive-compulsive disorders (descending order) as primary clinical diagnoses. Consequently, this study indicates that a significant amount of the clinical population presents IGD. Meaning, appropriate diagnostics should be included in routine psychological diagnostics in order to avoid “hidden” cases of IGD in the future.

Effectiveness of a Brief Group Intervention Program for Young Adults with Gaming-Related Problems

Excessive digital gaming can have unfavorable effects on gamers’ well-being and everyday functioning. The aims of this study were to investigate the effects of a novel group intervention “Limitless Gaming Bootcamp” on (i) gaming disorder (GD) tendencies, (ii) the amount of time spent on leisure activities, and (iii) subjective well-being among Finnish young adults, and to determine the persistence of the intervention’s influence over time. A one-group pre- and post-test design with no control group was used. Thirty-seven participants were enrolled in the study. The inclusion criteria were being between the ages of 18 and 29; self-reported excessive gaming; a willingness to get support in monitoring one’s gaming behaviour; and a fluency in Finnish. Participants completed a 10-session group intervention designed to enhance conscious gaming behavior and well-being. Baseline, post-test, and six month follow-up measurements were conducted to gather data. Variables measured included background variables, gaming disorder tendencies (Problematic Online Gaming Questionnaire, POGQ), self-reported time spent on various leisure activities, and subjective well-being (Short Form of the Clinical Outcomes in Routine Evaluation Outcome Measure, CORE-SF/A). The time spent on gaming decreased from pre- to post-intervention measurement and further to the six month follow-up, and participants exhibited less severe GD symptoms during the post-intervention phase and six months after the intervention. Gradual improvements in subjective well-being were also observed. The group intervention was found to be particularly effective at reducing the severity of GD symptoms.

The Influence of Action Video Gaming Experience on the Perception of Emotional Faces and Emotional Word Meaning

Action video gaming (AVG) experience has been found related to sensorimotor and attentional development. However, the influence of AVG experience on the development of emotional perception skills is still unclear. Using behavioral and ERP measures, this study examined the relationship between AVG experience and the ability to decode emotional faces and emotional word meanings. AVG experts and amateurs completed an emotional word-face Stroop task prior to (the pregaming phase) and after (the postgaming phase) a 1 h AVG session. Within-group comparisons showed that after the 1 h AVG session, a more negative N400 was observed in both groups of participants, and a more negative N170 was observed in the experts. Between-group comparisons showed that the experts had a greater change of N170 and N400 amplitudes across phases than the amateurs. The results suggest that both the 1 h and long-term AVG experiences may be related to an increased difficulty of emotional perception. Furthermore, certain behavioral and ERP measures showed neither within- nor between-group differences, suggesting that the relationship between AVG experience and emotional perception skills still needs further research.

Distress, Depression, Anxiety, and Concerns and Behaviors Related to COVID-19 during the First Two Months of the Pandemic: A Longitudinal Study in Adult MEXICANS

We examined longitudinal differences in the severity of distress, depression, anxiety, and concerns and behaviors related to COVID-19 during the first two months of this pandemic, correlations between these variables, and interactions of distress with significant sociodemographics across waves. A longitudinal online survey was conducted in the State of Mexico, from 8 April to 27 May, 2020, in a sample of men and women between 18 and 60 years old, using: Impact of Event Scale-6, Patient Health Questionnaire-9, General Anxiety Disoder-7, and a questionnaire of concerns and behaviors related to COVID-19. Six hundred seventy participants were analyzed. Only a mild difference in distress was observed between the two waves and mild correlations of this variable with contagion in oneself and in a relative. Having a high-risk medical condition proved a considerable effect on distress within both waves. Perception of usefulness of preventive measures, concerns of contagion in a relative, and financial and security situations scored high within our questionnaire but did not change in the follow-up. We hypothesize that habituation to distressful events in the Mexican population (emergent resilience) might explain the absence of meaningful differences. Our research adds to the monitoring of mental health in Mexicans during the COVID-19 pandemic; its findings can serve to perform comparisons in other studies and for further meta-analyses.

Person-centred interventions for problem gaming: a stepped care approach

BACKGROUND

Problem gaming is reported by approximately 1-3% of the population and is associated with decreased health and wellbeing. Research on optimal health responses to problem gaming remains limited. This study aimed to identify and describe the key components of a person-centred approach to interventions for problem gaming for individuals who voluntary seek assistance.

METHODS

Online interviews were conducted with 20 adults (90% male; M_age = 23y) currently seeking help for problem gaming. The interview protocol was guided by a health care access framework which investigated participants' experiences and needs related to accessing professional support. Transcripts were analysed in NVivo using qualitative content analysis to systematically classify participant data into the themes informed by this framework.

RESULTS

Participants had mixed views on how the negative consequences of problem gaming could be best addressed. Some indicated problems could be addressed through self-help resources whereas others suggested in-person treatment with a health professional who had expertise in gaming. Participants described the essential components of an effective health service for problem gaming as including: valid and reliable screening tools; practitioners with specialist knowledge of gaming; and access to a multimodal system of intervention, including self-help, internet and in-person options that allow gamers to easily transition between types and intensity of support.

CONCLUSION

A comprehensive health care approach for interventions for problem gaming is in its infancy, with numerous service access and delivery issues still to be resolved. This study highlights the importance of involving individuals with gaming-related problems in developing solutions that are fit for purpose and address the spectrum of individual preferences and needs. These findings recommend a stepped healthcare system that adheres to evidence-based practice tailored to each individual and the implementation of standard assessment and routine outcome monitoring.

Stress, anxiety and depression among healthcare workers facing COVID-19 pandemic in Egypt: a cross-sectional online-based study

OBJECTIVE

This study assessed perceived stress, anxiety and depression among healthcare workers facing the COVID-19 pandemic in Egypt.

SETTING

This was an online study where a Google form was prepared including sociodemographic and occupational data as well as three validated questionnaires to assess perceived stress, anxiety and depression, respectively. The form was distributed online to all social media groups including healthcare workers all across the country, and responses were collected until the sample size of 262.

PARTICIPANTS

Healthcare workers (physicians, dentists, pharmacists, physiotherapists, nurses, technicians and administrators) working in governmental or educational hospitals from all Egyptian governorates who are members of social media groups. The mean age of participants was 33.4±5.9 years, 70% were women, about 70% were married and 66% were physicians.

OUTCOMES

The frequency of perceived stress, anxiety and depression observed among the study participants according to the results of their questionnaires. Then the frequencies were compared between different sociodemographic characteristics.

RESULTS

Only 1.3% showed low perceived stress while 98.5% showed moderate to severe stress. About 9.5% did not experience generalised anxiety, while the remaining 90.5% had different degrees of anxiety as mild anxiety showed the highest per cent affecting about 40% of participants followed by moderate anxiety about 32% then severe anxiety, 18.5%. With regard to depression, 94% of participants showed mild to severe depression.

CONCLUSION

This study showed a high prevalence of perceived stress, anxiety and depression among healthcare workers during the COVID-19 pandemic that affected all workers regardless of different sociodemographic characteristics.