Gaming-addicted teens identify more with their cyber-self than their own self: Neural evidence

Large-scale network abnormality in behavioral addiction

BACKGROUND

Researchers have endeavored to ascertain the network dysfunction associated with behavioral addiction (BA) through the utilization of resting-state functional connectivity (rsFC). Nevertheless, the identification of aberrant patterns within large-scale networks pertaining to BA has proven to be challenging.

METHODS

Whole-brain seed-based rsFC studies comparing subjects with BA and healthy controls (HC) were collected from multiple databases. Multilevel kernel density analysis was employed to ascertain brain networks in which BA was linked to hyper-connectivity or hypo-connectivity with each prior network.

RESULTS

Fifty-six seed-based rsFC publications (1755 individuals with BA and 1828 HC) were included in the meta-analysis. The present study indicate that individuals with BAs exhibit (1) hypo-connectivity within the fronto-parietal network (FN) and hypo- and hyper-connectivity within the ventral attention network (VAN); (2) hypo-connectivity between the FN and regions of the VAN, hypo-connectivity between the VAN and regions of the FN and default mode network (DMN), hyper-connectivity between the DMN and regions of the FN; (3) hypo-connectivity between the reward system and regions of the sensorimotor network (SS), DMN and VAN; (4) hypo-connectivity between the FN and regions of the SS, hyper-connectivity between the VAN and regions of the SS.

CONCLUSIONS

These findings provide impetus for a conceptual framework positing a model of BA characterized by disconnected functional coordination among large-scale networks.

The Effects of Digital Addiction on Brain Function and Structure of Children and Adolescents: A Scoping Review

The escalating prevalence of studies investigating digital addiction (DA) and its detrimental impact on the human brain's structure and functionality has been noticeable in recent years. Yet, an overwhelming majority of these reviews have been predominantly geared towards samples comprising college students or adults and have only inspected a single variant of DA, such as internet gaming disorder, internet addiction disorder, problematic smartphone use, tablet overuse, and so forth. Reviews focusing on young children and adolescents (ages 0-18), or those which amalgamate various types of DA, are decidedly scarce. Given this context, summarizing the effects of DA on brain structure and functionality during the vital developmental stage (0-18 years) is of immense significance. A scoping review, complying with the PRISMA extension for such reviews, was conducted to amalgamate findings from 28 studies spanning a decade (2013-2023) and to examine the influence of assorted forms of DA on the brains of children and adolescents (0-18 years). The synthesized evidence indicated two primary results: (1) DA exerts harmful effects on the structure and functionality of the brains of children and adolescents, and (2) the prefrontal lobe is the region most consistently reported as impacted across all research. Furthermore, this review discerned a notable void of studies investigating the neural indices of digital addiction, along with a shortage of studies focusing on young children (0-6 years old) and longitudinal evidence. This research could provide the necessary theoretical basis for the thwarting and intervention of digital addiction, a measure indispensable for ensuring healthy brain development in children and adolescents.

Neuroimaging findings in adolescent gaming disorder: a systematic review

OBJECTIVES

Gaming disorder is a growing concern affecting adolescents, exacerbated by the impact of recent COVID-19 restrictions. The World Health Organization has recently included gaming disorder in the 11th International Classification of Diseases (ICD-11). However, there is still an ongoing debate about the validity and reliability of the proposed clinical criteria, despite growing neurobiological evidence in this cohort. Systematic reviews in this area have focused mainly on adults or mixed adult/adolescent populations. Therefore, this systematic review explored the neuroimaging literature in adolescents (under 18 years old) with gaming disorder.

METHODS

Using PRISMA 2020 guidelines, 3288 primary studies were identified from PubMed, CINAHL Plus, PsycINFO and Web of Science. After applying inclusion and exclusion criteria (appropriate title, abstract, comparison group used within study, English-language, neuroimaging and mean age under 18), 24 studies were included in this review.

RESULTS

Functional and structural brain alterations in adolescent gaming disorder were noted across several imaging modalities, including electroencephalogram (EEG), functional magnetic resonance imaging (fMRI) and structural magnetic resonance imaging (MRI). Compared with healthy controls, adolescents with gaming disorder demonstrated neurological changes comparable to substance addiction, namely impairments in emotional regulation, reward-seeking, inhibition and increased risky decision-making. Positive brain adaptations in the areas of visuospatial processing and memory were observed.

CONCLUSIONS

A number of key brain regions are affected in adolescent gaming disorder. These findings can help clinicians understand adolescent presentations with gaming disorder from a neurobiological perspective. Future studies should focus on forming a robust neurobiological and clinical framework for adolescent gaming disorder.

“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

Neural correlates of problematic gaming in adolescents: A systematic review of structural and functional magnetic resonance imaging studies

Problematic gaming in adolescents is associated with neural alterations in structural and functional imaging studies. Especially frontal regions, associated with cognitive control functions, as well as temporoparietal areas, responsible for attention processes and self-concepts, and frontolimbic and subcortical regions, connected to emotion regulation and reward processing, are affected. The differences provide a further explanation for addictive disorders and emphasize the importance of interventions that address executive and cognitive-affective deficits.

Reliability of the fMRI-based assessment of self-evaluation in individuals with internet gaming disorder

The self-concept-defined as the cognitive representation of beliefs about oneself-determines how individuals view themselves, others, and their actions. A negative self-concept can drive gaming use and internet gaming disorder (IGD). The assessment of the neural correlates of self-evaluation gained popularity to assess the self-concept in individuals with IGD. This attempt, however, seems to critically depend on the reliability of the investigated task-fMRI brain activation. As first study to date, we assessed test-retest reliability of an fMRI self-evaluation task. Test-retest reliability of neural brain activation between two separate fMRI sessions (approximately 12 months apart) was investigated in N = 29 healthy participants and N = 11 individuals with pathological internet gaming. We computed reliability estimates for the different task contrasts (self, a familiar, and an unknown person) and the contrast (self > familiar and unknown person). Data indicated good test-retest reliability of brain activation, captured by the "self", "familiar person", and "unknown person" contrasts, in a large network of brain regions in the whole sample (N = 40) and when considering both experimental groups separately. In contrast to that, only a small set of brain regions showed moderate to good reliability, when investigating the contrasts ("self > familiar and unknown person"). The lower reliability of the contrast can be attributed to the fact that the constituting contrast conditions were highly correlated. Future research on self-evaluation should be cautioned by the findings of substantial local reliability differences across the brain and employ methods to overcome these limitations.

Neurobiological mechanisms underlying internet gaming disorder

This review summarizes studies on the neurobiological correlates of internet gaming disorder (IGD), presently the most direct approach to analyzing the impact of digital technology and the internet on brain mechanisms. Brain imaging studies have shown that IGD shares, to a large extent, neurobiological alterations that are typical for other addictions, such as: (i) activation in brain regions associated with reward, as evident from cue exposure and craving studies and neurotransmitter systems studies that indicate an involvement of dopamine-mediated reward mechanisms; (ii) reduced activity in impulse control areas and impaired decision making; and (iii) reduced functional connectivity in brain networks that are involved in cognitive control, executive function, motivation, and reward. Moreover, there are structural changes, mainly reduction in gray-matter volume and white-matter density. Comorbidity studies indicate that executive control networks in attention deficit-hyperactivity disorder (ADHD) may increase the susceptibility to develop IGD. Most importantly, this review also outlines findings that show the effects of excessive use of screens, here referring to the playing of computer games, which activate many brain regions associated with cognitive, motor, and sensory function and not directly involved in other forms of addiction. This review describes and summarizes comprehensively the neurobiological correlates of addictive internet use in adolescents and young adults.
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Player-avatar interactions in habitual and problematic gaming: A qualitative investigation

BACKGROUND AND AIMS

Previous studies have reported that stronger avatar identification and negative self-concept are associated with gaming disorder (GD). This study aimed to examine the value and significance of avatars based on firsthand accounts from regular and problematic gamers, and to identify any potential links between avatar-related experiences and excessive gaming.

METHODS

An online survey of 993 adult gamers yielded 3,972 text responses. Qualitative analysis of 59,059 words extracted 10 categories of avatar-related perspectives.

RESULTS

Some problem and non-problem gamers employed sentimental language (e.g., 'dear friend', 'like a child', 'part of my soul') to refer to their avatar. However, most participants perceived avatars as a means of achieving in-game goals and enabling greater interactivity (e.g., socializing). When asked to reflect on hypothetically losing their avatar, participants generally anticipated feeling temporary frustration or annoyance due to lost time and effort invested into the avatar. Although some participants reported that their avatar 'mattered', avatars were often considered as superficial ('just pixels') and peripheral to the primary reinforcement of achieving in-game rewards and objectives. Some broader psychological and identity issues such as gender dysphoria, rather than 'addiction', were cited as motivating persistent avatar-related interactions and attachment.

DISCUSSION AND CONCLUSIONS

Participants reported diverse views on the psychological value and function of avatars, but the relationship between avatars and problematic gaming or GD was largely unclear or inconsistent, and refuted by some participants. Future research with clinical samples may lead to a better understanding of player-avatar processes, including whether avatar-stimuli facilitate the development of maladaptive gaming habits, particularly among psychologically vulnerable players. Future investigations should be mindful of 'overpathologizing' avatar-related phenomena and recognize their important role in socializing, storytelling, and creative expression among gamers.

Internet gaming disorder impacts gray matter structural covariance organization in the default mode network

INTRODUCTION

Although previous studies have revealed that dysfunctional brain organization is associated with internet gamingdisorder (IGD), the neuroanatomical basis that underlies IGD remains elusive. In this work, we aimed to investigate gray matter (GM) volume alterations and structural covariance patterns in relation to IGD severity.

METHODS

Structural magnetic resonance imaging data were acquired from two hundred and thirty young adults encompassing a wide range of IGD severity. Voxel-based morphometry (VBM) analysis was applied to examine GM volume changes associated with IGD severity. Furthermore, the organization of whole-brain structural covariance network (SCN) was analyzed using the regions identified as seeds from VBM analysis.

RESULTS

Individuals with greater IGD severity had increased GM volumes in the midline components of the default mode network (DMN), namely, the right medial prefrontal cortex (mPFC) and precuneus. More importantly, the SCN results revealed impaired patterns of structural covariance between the DMN-related regions and areas associated with visuospatial attention and reward craving processing as the addiction severity of IGD worsened.

LIMITATIONS

Only young Chinese adults were enrolled in our study andthe extent to which findings generalize to samples in other age groups and diverse cultures is unclear.

CONCLUSIONS

These results showed volume expansion of the DMN components and its weakened structural association with visuospatial attention and motivational craving regions with increasing IGD severity. This study deepens our understanding of the underlying neuroanatomical correlates of IGD, which may help to explain why some individuals are more vulnerable to compulsive gaming usage than others.

Avatar identification and problematic gaming: The role of self-concept clarity

Some video-gaming activities feature customizable avatars that enable users to fulfil self-identity needs. Research evidence (e.g., fMRI and survey studies) has suggested that poorer self-concept and stronger avatar identification are associated with problematic gaming. Player-avatar relationships have thus been proposed to require attention in gaming disorder assessment and interventions. To examine the interplay of player-avatar interactions in problematic gaming, this study investigated whether avatar identification differed according to avatar characteristics and game types, and whether the association between avatar identification and problem gaming was mediated by self-concept clarity. A total of 993 adult respondents completed an online survey that assessed problematic gaming, avatar identification, and self-concept clarity. The results indicated that avatar identification scores were generally unrelated to avatar characteristics (e.g., human resemblance, degree of customizability, and in-game perspective). Avatar identification was significantly positively related to problematic gaming and significantly negatively related to self-concept clarity. There was a significant indirect relationship between avatar identification on problem gaming mediated through self-concept clarity. These findings suggest that poorer self-concept clarity may be one mechanism by which avatar identification affects problem gaming. Future research with clinical samples may help to gain a better understanding of avatar-related processes and psychological vulnerabilities related to problematic gaming.

Intrapersonal and interpersonal emotion regulation and identity: A preliminary study of avatar identification and gaming in adolescents and young adults

The aim of this study was to investigate the relationships between the process of identity formation, emotion regulation (intrapersonal and interpersonal), avatar identification, and gaming in adolescents and young adults. Data (from eight standardized questionnaires) were collected from 37 non-gamers (NGs), 133 non-problematic gamers (NPGs), and 37 problematic gamers (PGs). The results showed that PGs had higher scores in lack of emotional consciousness, lack of emotional clarity, and expressive suppression, while also having lower scores in cognitive reappraisal and interpersonal emotion regulation than NPGs or NGs. They also had higher scores in ruminative exploration and lower scores in exploration in depth. In addition, factors associated with Internet gaming disorder (IGD) differed by gender. In females, lack of emotional clarity, interpersonal emotion regulation, commitment, and in-depth exploration were associated with IGD. In males, however, negative emotions, lack of emotional consciousness, lack of emotional clarity, suppressive expression, and ruminative exploration were associated with the disorder. These results highlighted the need to consider gender specificities when caring for video game-players and using of therapies or psychotherapeutic techniques to improve their emotional processes and promote their identity-construction.

Avatar- and self-related processes and problematic gaming: A systematic review

The concept of self has become increasingly relevant to understanding the psychological mechanisms of problematic online gaming. Many gaming activities feature in-game avatars that enable the adoption of, and experimentation with, different roles and identities. Avatars enable players to compensate for perceived deficiencies in their real-world self (e.g., lack of physical strength, beauty, or social status). Currently, how avatar- and self-related processes may develop and maintain problematic gaming, including gaming disorder (GD), is unclear. This systematic review examined 18 quantitative studies of avatar- and self-related concepts and problematic gaming, including 13 survey-based and 5 neuroimaging studies. Despite variability in the conceptualization and measurement of avatar/self-related concepts, survey-based studies have consistently reported that negative self-concept, avatar identification, and large self-avatar discrepancies are significantly associated with problematic gaming. Poor self-concept appears to be a risk factor for GD, particularly for games that facilitate role-playing and identity formation. Further research and clinical evidence are needed to explain how avatar- and self-related processes may relate to the addictive mechanisms of GD (e.g., cognitive distortions, reward-seeking, inhibitory control, self-regulation systems), amid calls for problem gaming-related assessment and interventions to incorporate a focus on avatar identification.

“Who Am I” and “How Should I Be”: a Systematic Review on Self-Concept and Avatar Identification in Gaming Disorder

Purpose of Review

Gaming disorder (GD) appears to be associated with self-concept deficits and increased identification with one’s avatar. The goal of this literature review is to highlight study findings assessing psychological and neurobiological correlates of self-concept-related characteristics and avatar identification in GD.

Recent Findings

The review was based on three literature researches on GD: (1) self-esteem, (2) emotional, social, and academic self-concept domains and avatar identification, and (3) neurobiological correlates of self-concept and avatar identification. The results indicate that GD is associated with decreased self-esteem as well as deficits in physical, social, and emotional self-concept domains. A relatively stable relationship between higher avatar identification and GD was reported in addicted gamers. Furthermore, addicted gamers showed increased activation of brain regions associated with Theory-of-Mind processing while contemplating their own avatar.

Summary

The results point towards impairments in self-concept and increased identification with the virtual gaming character in addicted gamers. This virtual compensation fosters the formation of an idealized self-concept, which grows increasingly distant from their own self-image. Thus, additional empirically based psychological interventions should focus on the development of a realistic self-image by reducing the dysfunctional discrepancy between the ideal self and the real self.

The role of family and personality traits in Internet gaming disorder: A mediation model combining cognitive and attachment perspectives

BACKGROUND AND AIMS

Gaming disorder was recently recognized as a mental health disorder by the World Health Organization and included in the International Classification of Diseases. Extensive research has been conducted with regard to psychosocial correlates and comorbidity, less so for the developmental mechanisms and the processes leading to the disorder. The association between family factors, personality traits, and gaming has been studied independently but not in combination. To fill this gap in knowledge, this study examined (a) the association between parental acceptance-rejection theory and Internet gaming disorder (IGD) and (b) the mediating and moderating effect of core self-evaluations (CSE), a personality construct, on the aforementioned variables.

METHODS

The study was quantitative and involved young adults members of online gaming communities (N = 225).

RESULTS

The results showed that parental rejection is associated with the occurrence of IGD, only through the mediating effect of CSE. The moderation model was not confirmed.

DISCUSSION

Findings bridge early emotional deficits with CSE personality traits and IGD, based on two widely acknowledged theoretical frameworks. In addition, they highlight the importance of the father's role in upbringing.

CONCLUSIONS

These frameworks combine cognitive and attachment perspectives and a process-oriented approach to the development and maintenance of IGD. The implications of these findings are discussed in relation to (a) the mechanisms leading to the disorder and (b) providing an evidence base for therapeutic interventions for IGD to go beyond abstinence and include self-esteem enhancement and efficacy contingencies. Directions for future research are also provided in this study.

Mapping Internet gaming disorder using effective connectivity: A spectral dynamic causal modeling study

OBJECTS

Understanding the neural basis underlying Internet gaming disorder (IGD) is essential for the diagnosis and treatment of this type of behavioural addiction. Aberrant resting-state functional connectivity (rsFC) of the default mode network (DMN) has been reported in individuals with IGD. Since rsFC is not a directional analysis, the effective connectivity within the DMN in IGD remains unclear. Here, we employed spectral dynamic causal modeling (spDCM) to explore this issue.

METHODS

Resting state fMRI data were collected from 64 IGD (age: 22.6 ± 2.2) and 63 well-matched recreational Internet game users (RGU, age: 23.1 ± 2.5). Voxel-based mean time series data extracted from the 4 brain regions within the DMN (medial prefrontal cortex, mPFC; posterior cingulate cortex, PCC; bilateral inferior parietal lobule, left IPL/right IPL) of two groups during the resting state were used for the spDCM analysis.

RESULTS

Compared with RGU, IGD showed reduced effective connectivity from the mPFC to the PCC and from the left IPL to the mPFC, with reduced self-connection in the PCC and the left IPL.

CONCLUSIONS

The spDCM could distinguish the changes in the functional architecture between two groups more precisely than rsFC. Our findings suggest that the decreased excitatory connectivity from the mPFC to the PCC may be a crucial biomarker for IGD. Future brain-based intervention should pay attention to dysregulation in the IPL-mPFC-PCC circuits.