Video game addiction, ADHD symptomatology, and video game reinforcement

Evaluation of Problematic Video Game Use in Adolescents with ADHD and without ADHD: New Evidence and Recommendations

Video game addiction among adolescents, particularly those with ADHD, is a significant concern. To gather more insights into video game usage patterns in this population, we investigated levels of potentially problematic use, passion, motivations, and emotional/behavioral symptoms in adolescents with and without ADHD. Our cross-sectional, multicenter study involved 2513 subjects (Age M = 15.07; SD = 2.82) from 24 schools in Galicia (Spain), including 158 (6.3%) diagnosed with ADHD. We employed an ad hoc questionnaire covering sociodemographic data and ADHD diagnosis, the Questionnaire of Experiences Associated with Video Games (CERV), the scale of passion for video games, reasons for playing video games Questionaire (VMQ), and emotional/behavioral problems assessment (SDQ). Results indicated heightened vulnerability in adolescents with ADHD, manifesting in longer usage durations and higher problematic use scores. Interestingly, ADHD medication did not affect internet gaming disorder development. Motivations for gaming differed between groups, with the ADHD cohort showing distinctions in cognitive development, coping, and violent reward. Additionally, the ADHD group exhibited greater emotional/behavioral symptoms, hyperactivity, and reduced prosocial behavior.

The tangled ways to classify games: A systematic review of how games are classified in psychological research

In the face of the rapid evolution of the gaming market and the puzzling overlap of genres, consistency in classification seems elusive. The purpose of the present review was to explore the classification of video game genres in the context of psychological research. The aim was to address the challenges associated with creating consistent and meaningful classifications of video game genres, considering the rapid evolution of the gaming market and recent tendency to create games that could be classified into multiple genres. We performed a search in four databases according to the PRISMA guidelines and reviewed 96 full-text papers (N = 49 909). Through our findings, we reveal how researchers strive to classify genres and the numerous complications that arise from this pursuit. In the face of these challenges, we propose alternative ways of classifying genres. Our first proposal is a new classification of video game genres based on our literature review. In our second proposal, we advocate a more detailed understanding by focusing on specific gaming mechanics, and thus we introduce the innovative concept of utilizing community-based tags, such as Steam tags, as an alternative to genres in psychological research.

Adherence, frequency, and long-term follow-up of video game-based treatments in patients with attention-deficit/hyperactivity disorder: A systematic review

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children and adolescents. Recent studies show that video games have great potential for the treatment and rehabilitation of ADHD patients. The aim of the present review is to systematically review the scientific literature on the relationship between video games and ADHD, focusing on adherence to treatment, frequency of the intervention, and the long-term follow-up of video games in children and adolescents with ADHD.

METHODS

The preferred reporting items for systematic reviews and meta-analyses guidelines were adopted. The review protocol was registered in PROSPERO database. We searched in three databases, PubMed, Medline, and Web of Science to identify studies examining the association between video game interventions in ADHD patients.

RESULTS

A total of 18 empirical studies met the established inclusion criteria. The results showed that video games-based interventions can be used to improve ADHD symptoms and display high adherence to treatment. In addition, in the studies reviewed, the most common intervention frequency is 30 min three to five times per week. However, there is little evidence from studies with video games showing long-term effects in patients with ADHD.

CONCLUSION

Video games are useful and effective interventions that can complement traditional treatments in patients with ADHD.

It's not just about how long you play. Indirect gaming involvement and genre preferences in predicting gaming disorder risk: evidence from preregistered studies

Introduction

The strength of the association between gaming involvement and gaming disorder is weak to moderate. Gamers cannot be directly involved in gaming all the time, but how much they are involved in activities indirectly related to gaming during gaming-free time may play an important role. Also, specific game genres may matter. The present investigation focuses on the role of indirect gaming involvement and genres in gaming disorder risk prediction.

Methods

Two pre-registered studies were conducted. Study 1 (N = 205) was conducted online, whereas Study 2 (N = 250) was conducted in a lab. In both cases, participants reported their direct and indirect involvement in gaming (DGI and IGI, respectively) and completed a screening tool that estimates the risk of gaming disorder (Gaming Disorder Test).

Results

Both IGI and DGI were weakly to moderately correlated with gaming disorder (GD) and moderately with each other. The correlations between DGI and GD were similar to those obtained in related studies; the correlation between IGI and GD has not been previously reported. Hierarchical regression that took IGI together with DGI into account showed an increase in the percentage of explained variance, but only in Study 1. Contrary to expectations, IGI did not interact with DGI. As is consistent with previous research, some game genres were found to be more closely related to GD than others: in both studies, this was an RPG; in Study 1, this was also an MMORPG; in Study 2, driving and shooting games also predicted GD risk.

Discussion

Overall, the results clearly indicate that not only gaming time plays a role in GD risk assessment: IGI can also predict it and in some cases may allow for more accurate predictions. Gaming genres once again proved to play a role, but these and similar results should be treated with caution due to the partial lack of repeatability.

Predictors of Problematic Video Gaming in Elementary School Boys with ADHD

The aim of the study was to expand the current knowledge base on problematic video gaming and ADHD with four questions: (1) Are there differences in the length of video gaming between boys with ADHD and typically developing boys? (2) Are there differences in problematic video gaming between boys with ADHD and typically developing boys? (3) What are the predictors of problematic video gaming? (4) Does problematic video gaming affect academic performance while controlling for the effect of inattention and hyperactivity/impulsivity symptoms? Symptoms of inattention, hyperactivity/impulsivity scale (SNAP IV), the Problematic Video Game Scale, and the Video Game Patterns Questionnaire were administered to 127 parents of elementary school boys in Croatia, 57 of whom were parents of boys with a clinical ADHD diagnosis and 70 of whom were parents of typically developing boys. The results show that there are no differences in length of play and problematic video gaming between ADHD and typically developing boys. A hierarchical regression analysis showed that age, inattention symptoms, and length of play are predictors of problematic video gaming. Inattention symptoms and age are significant predictors of academic achievement whereas it seems that hyperactivity and impulsivity symptoms are not predictors of problematic video gaming and academic achievement in boys.

High-Risk Gaming Is Associated with Frequent Substance Use: An Exploratory Survey among Young Adults

INTRODUCTION

Internet gaming disorder (IGD) is an emerging condition within the field of behavioural addictions. IGD has been demonstrated to be highly comorbid with many other mental health disorders. Among these, substance use has been associated with IGD, and there are underlying similarities between behavioural addictions and substance use disorders. The main aims of the present study were (i) to investigate the association between high-risk gaming and substance use among young adults drawn from the general Italian population; and (ii) to explore the psychopathological correlates of high-risk gaming.

METHODS

Lifetime substance use, type of substances consumed, and frequency of use were investigated through an online survey in a sample of 913 adults aged 18-40 years. High-risk gaming was assessed using the ten-item Internet Gaming Disorder Test (IGDT-10). Psychopathology was assessed using the Revised 90-item Symptom Checklist (SCL-90-R).

RESULTS

High-risk gaming prevalence rate was 4.4%. High-risk gamers scored higher on all dimensions of psychopathology, confirming the association between high-risk gaming and psychiatric distress. Regarding substance use, high-risk gamers were more commonly polysubstance users and more commonly made use of psychodysleptic substances. High-risk gamers were more commonly frequent substance users, and 32.5% of high-risk gamers used or had used psychoactive substances often or everyday throughout their lives.

DISCUSSION AND CONCLUSION

The findings are in line with the concept of a common neurobiological vulnerability for both gaming and substance use. There is the need for more research to examine the phenomenology of gaming and its interplay with substance use to help develop effective interventions and prevention strategies.

A preliminary study into internet related addictions among adults with dyslexia

In recent decades, studies have investigated associations between learning disorders such as Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), and the various types of internet addictions, ranging from general internet addiction (GIA) to specific internet addictions such as social media addiction (SMA) and internet gaming disorder (IGD). However, to date, no study has investigated such internet addictions among persons with dyslexia. The present study aimed to investigate whether differences exist between adults with dyslexia and controls in terms of GIA, SMA and IGD. A total of 141 adults with dyslexia and 150 controls (all UK based) were recruited. Controlling for age, gender, marital status, employment, and income levels, it was found that adults with dyslexia had higher levels of GIA and IGD compared to controls. However, these participants did not show any significant difference in terms of SMA. The results indicate that internet addictions may have a larger ambit for learning disorders beyond just ASD and ADHD and could be a hidden problem for these individuals.

Examination of game addiction studies conducted in Turkey: A systematic review study

The aim of this study is to examine the methodological orientations in game addiction studies in Turkey between 2019 and 2022 in a holistic way and to present suggestions for new literature studies. For this purpose, only articles written in Turkish language were reviewed on Google Scholar. Open-access quantitative studies between 2019 and 2022 were included in our study. As a result, 69 out of 257 studies were found to comply with the predetermined criteria. The number of participants in these 69 studies, with a total sample size of 26,415, varies between 60 and 987. Almost half of the studies sample group is children (n = 36). The majority of the studies examine the relationship between academic achievement, familial and social relationship problems, gaming behavior and game addiction in children and adolescents. It was found that gaming addiction was higher in male students compared to female students, especially between the ages of 14-15. Among children, male students play digital games more than girls, and they mostly prefer action-adventure, war, and racing games. Previous studies have concluded that the use of consoles and smartphones in adolescents and young adults has a high impact on digital game addiction. In the light of the findings, it is suggested that empirical studies on game addiction should be addressed with different aspects using new literature studies.

Relationship of Gaming Disorder with parenting based on low affection-communication and personality trait of neuroticism in adolescents

Background

Gaming Disorder is increasingly common in adolescents. We aimed to evaluate the relationship between parenting, personality traits, and Gaming Disorder.

Methods

An observational and cross-sectional study in six secondary schools of Castelló, obtaining a final sample of 397 students.

Results

Adolescents with Gaming Disorder had lower scores in Adolescent Affection-Communication (F = 8.201; p < 0.001), Father's Warmth (F = 3.459; p = 0.028), and Father's Acceptance/Involvement (F = 5.467; p = 0.003), and higher scores in Mother's Revoking Privileges (F = 4.277; p = 0.034) and Father's Indifference (F = 7.868; p = 0.002) than healthy participants. Male sex was a risk factor for Gaming Disorder (OR = 12.221; p = 0.004), while Adolescent Affection-Communication (OR = 0.908; p = 0.001) and Agreeableness (OR = 0.903; p = 0.022) were protective factors. Data modeling described the protective effect that Adolescent Affection-Communication had on Gaming Disorder, which was both directly (B = -0.20; p < 0.001) and indirectly mediated by Neuroticism (B = -0.20; p < 0.001), while Neuroticism itself was a risk factor for Gaming Disorder (B = 0.50; p < 0.001).

Conclusion

These results reflect that Parental style with low affection and communication was directly and indirectly related to the Gaming Disorder, as well as male sex and personality trait of Neuroticism.

Children's mobile-gaming preferences, online risks, and mental health

This study examined the relationships between children's mobile gaming preferences, online risks, and mental health. Data were obtained from a sample of 2,702 third and fourth grade students from 16 elementary schools in Taiwan and 9 schools in China. A self-administered questionnaire was used. The mental state of the children who participated in the study was assessed using the Strengths and Difficulties Questionnaire (SDQ), while mobile gaming addiction was assessed using the short form of the Internet Gaming Disorders Scale (IGDS9-SF). The results showed that about 54% of children played mobile games with others (multi-player), while 31% played mobile games alone, and 15% did not play mobile games. Multiple logistic regression results indicated that behaviors such as participating in multi-player games, playing violent games, a poor parent-child relationship, and living in a rural area were associated with a greater risk of mobile gaming addiction. Involvement in multi-player games, playing violent games, mobile gaming addiction, and exposure to mobile violence/pornography were associated with greater risks of cyber aggression/victimization. Multiple regression results showed that being a multi-player, playing violent games, mobile gaming addiction, exposure to violence/pornography, exposure to cyber aggression/victimization, and having a poor parent-child relationship were associated with emotional and behavioral problems.

Development and Psychometric Validation of a Novel Self-Report Measure of ICD-11 Gaming Disorder

Video game use is associated with addiction-like behaviors in 6 to 15.6 percent of video game players. There were no formal diagnostic criteria for video game addiction until gaming disorder (GD) was added to the International Classification of Diseases 11th Edition (ICD-11), and there are no published instruments designed to diagnose GD. The aims of the current study were to develop a self-report measure of GD (using the Lee Morrell Gaming Disorder Questionnaire [LMGDQ]) and test its factor structure, reliability, validity, and relationships with participant demographic characteristics. Participants included 3,481 adult video game players (M = 25.08, SD = 7.02; 79.8 percent cisgender male; 77.4 percent Caucasian) who completed an online survey. Factor analyses suggested retaining 14 items and indicated the presence of two factors. The scale had excellent reliability (α = 0.919), and LMGDQ scores were positively correlated with existing scales measuring problematic video game use as well as video game use and age, p values <0.01. Participants who were Asian and Asian American, cisgender men, single and dating, unemployed, had completed some high school or their GED, and who played massively multiplayer online role-playing games the most reported significantly greater LMGDQ scores, p values <0.05. Results suggest that the LMGDQ is a psychometrically sound and valid measure of GD.

Prevalences of Overweight and Obesity in Children and Adolescents: The Comparison of ADHD and Other Clinical Samples

OBJECTIVE

To investigate the prevalence of overweight and obesity in children and adolescents with ADHD and compare to other clinical samples.

METHOD

A retrospective chart reviewing of 165 ADHD and 305 other clinical participants aged 6 to 18 years.

RESULTS

There was no statistically significant difference in terms of the prevalences of overweight and obesity between ADHD and other clinical participants. In ADHD group, the prevalences of overweight, obesity, and combined overweight/obesity were 15.8%, 20.0%, and 35.8%, respectively. In addition, male gender was significantly associated with increasing the prevalences of overweight and obesity in children and adolescents with ADHD.

CONCLUSION

The prevalences of overweight and obesity between ADHD and other clinical samples were not different in a clinical setting. Male gender was significantly associated with increasing the prevalences of overweight and obesity in children and adolescents with ADHD.

Developing Serious Video Games to Treat Attention Deficit Hyperactivity Disorder: Tutorial Guide

Video game–based therapeutic interventions have demonstrated some effectiveness in decreasing the symptoms of attention deficit hyperactivity disorder (ADHD). Compared with more traditional strategies within the multimodal treatment of ADHD, video games have certain advantages such as being comfortable, flexible, and cost-efficient. However, establishing the most appropriate type(s) of video games that should be used for this treatment remains a matter of debate, including the commercial existing video games or serious video games that are specifically constructed to target specific disorders. This guide represents a starting point for developing serious video games aimed at treating ADHD. We summarize the key points that need to be addressed to generate an effective and motivating game-based treatment. Following recommendations from the literature to create game-based treatments, we describe the development stages of a serious video game for treating ADHD. Game design should consider the interests of future users; game mechanics should be based on cognitive exercises; and therapeutic mechanisms must include the control of difficulty, engagement, motivation, time constraints, and reinforcement. To elaborate upon this guide, we performed a narrative review focused on the use of video games for the treatment of ADHD, and were inspired by our own experience during the development of the game “The Secret Trail of Moon.”

Associations Between Video Game Engagement and ADHD Symptoms in Early Adolescence

OBJECTIVE

We aim to investigate the direction of causality of the association between adolescent video game playing and later development of ADHD symptoms using a population-based sample of Canadian Youth.

METHOD

The present study is based on longitudinal cohort data (N = 1,467). Youth self-reported weekly hours of video game playing as well as ADHD symptoms at both 12 and 13 years of age.

RESULTS

Cross-lagged panel model were estimated to examine how adolescent video game playing prospectively contributes to ADHD symptoms while simultaneously considering how adolescent ADHD symptoms may prospectively contribute to videogame playing. Analyses revealed a significant positive association between adolescent video games playing at age 12 and ADHD symptoms at age 13. Youth ADHD symptoms at age 12 did not predict video game use at age 13.

CONCLUSION

Our results help clarify the direction of causality of the association between video game playing and ADHD symptoms and provide evidence that video game playing can represent a risk factor for the development of attention problems in early adolescence.

Attention Deficit Hyperactivity Disorder Assessment Based on Patient Behavior Exhibited in a Car Video Game: A Pilot Study

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) include excessive activity, difficulty sustaining attention, and inability to act in a reflective manner. Early diagnosis and treatment of ADHD is key but may be influenced by the observation and communication skills of caregivers, and the experience of the medical professional. Attempts to obtain additional measures to support the medical diagnosis, such as reaction time when performing a task, can be found in the literature. We propose an information recording system that allows to study in detail the behavior shown by children already diagnosed with ADHD during a car driving video game. We continuously record the participants' activity throughout the task and calculate the error committed. Studying the trajectory graphs, some children showed uniform patterns, others lost attention from one point onwards, and others alternated attention/inattention intervals. Results show a dependence between the age of the children and their performance. Moreover, by analyzing the positions by age over time using clustering, we show that it is possible to classify children according to their performance. Future studies will examine whether this detailed information about each child's performance pattern can be used to fine-tune treatment.

The role of illness representations of internet gaming disorder (IGD) in help-seeking intention among undergraduates: A longitudinal study

BACKGROUND AND AIMS

The Common-Sense Model asserts that illness representations of a health threat affect coping and behavioral reactions to it. Internet gaming disorder (IGD) is a newly defined mental disorder and leads to various health consequences. Little is known about illness representations of IGD and help-seeking for IGD among young adults who are at particular risk of IGD.

OBJECTIVE

This study investigated the roles of illness representations in intention to seek help from professionals and important others (families and friends) for IGD in college students in China.

METHODS

A two-wave longitudinal study was conducted with a convenience sample of college students in China (N = 591, 57.9% females, Mean_age = 19.10). Descriptive analyses and logistic regression analyses were conducted.

RESULTS

Approximately 10% of participants were classified as having probable IGD. However, over 70% endorsed self-diagnosed IGD. Less than 40% perceived resources of help-seeking, and most perceived shame for help-seeking. Less than 40% intended to seek help from professionals, and 26% from family and friends. Significant predictors of intention to seek professional help included probable IGD, perceived resources of help-seeking for IGD, consequence, timeline, and treatment. Significant predictors of intention to seek help from family and friends included probable IGD, self-diagnosed IGD, perceived resources of help-seeking for IGD, shame for help-seeking for IGD, timeline, treatment control, identity, concern, and emotional response. Females were more likely to seek both types of help.

DISCUSSION AND CONCLUSIONS

Perceptions of IGD and help-seeking play significant roles in help-seeking intentions. These modifiable factors can be used to guide the development of health promotion and behavioral change programs to promote help-seeking for IGD.

Serious Video Games: Angels or Demons in Patients With Attention-Deficit Hyperactivity Disorder? A Quasi-Systematic Review

OBJECTIVE

To carry out a quasi-systematic review of the use of serious video games for health as a cognitive rehabilitative tool in patients diagnosed with attention-deficit hyperactivity disorder.

METHOD

A quasi-systematic review of serious video games used as an evaluative and rehabilitative tool in patients with ADHD was conducted. It included behavioral patterns in the use of video games and addiction problems in this population. For its elaboration the PRISMA GUIDES were followed. The search was carried out in three PubMed databases, MEDLINE, and PsycInfo using the keywords: [game OR serious game OR computer game) AND (psychotherapy OR rehabilitation OR intervention OR mental disorders) AND (adhd)], [(adhd) AND (Video game addiction)]. All articles written in English, Spanish, or Portuguese from January 1970 to June 2021 were included: those in which reference was made to the use of video games and/or new technologies as a therapeutic and evaluative tool in children and adults diagnosed with ADHD, as well as those that referred to behavioral and clinical patterns in the use of video games.

RESULTS

We found 605 articles of which 128 were reviewed (44 observational studies, 26 quasi-experimental studies, 26 experimental studies, 8 systematic reviews, 9 narrative texts, 6 case reports, 7 pilot studies, 8 systematic reviews, and 2 meta-analyses). Serious video games can be used to ameliorate ADHD symptoms while improving adherence to treatment. Some serious video games show high accuracy properties assessing ADHD features.

CONCLUSION

Serious video games for health are increasingly being used as a cognitive rehabilitation tool in patients with attention-deficit hyperactivity disorder (ADHD).

SYSTEMATIC REVIEW REGISTRATION

[www.crd.york.ac.uk/prospero], identifier [CRD42021247784].

Video games for the assessment and treatment of attention-deficit/hyperactivity disorder: a systematic review

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and serious disorder among children. Video games have shown potential for aiding in child healthcare. Video games could contribute to the assessment and management of ADHD, but there are no previous reviews on this topic. Here, we systematically review the evidence about video game-based assessment tools and interventions for children diagnosed with ADHD. This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered in PROSPERO database. We searched four databases-PubMed, PsycInfo, Embase and clinicaltrials.gov-to identify original studies exploring either video game-based interventions or video game-based assessment tools in children with ADHD. After initial screening, full text revision and study selection, 22 articles were finally included in the review. Most studies used PC as platform, with a minority using a video console, pad, or 3D device. Video game-based assessment tools were generally effective in discriminating ADHD cases from controls, and in discriminating between ADHD subtypes. Video game-based therapeutic interventions were well accepted and generally effective in improving cognitive areas and decreasing ADHD symptoms. Gamification and cognitive training could be the main mechanisms underlying the usefulness and effectiveness of video game-based assessment tools and interventions. Software optimization and greater collaboration between developers and healthcare professionals are some of the priorities for future research in this area.

Investigating the relationship between personality, chronotype, computer game addiction, and sleep quality of high school students: A structural equation modelling approach

This study examines the relationship between high school students' age, gender, personality, computer game addiction, chronotype, and sleep quality using structural equation modelling. For this purpose, the study was planned according to the correlational research design, one of the most common quantitative research methods. The sample of the study consisted of 922 students who accepted to participate and completed the scales. Of the 922 high school students in the sample, 528 were girls, and 394 were boys. In the study, the Computer Game Addiction Scale for Adolescents, Sleep Quality Scale, Composite Scale of Morningness (CSM), and Big Five Inventory were used to measure the variables. Among the variables involved, personality traits, such as consciousness, neuroticism, and openness to experience, were significantly related with morningness-eveningness. Besides, gender and being evening or morning types were found to be significantly related with game addiction. However, sleep quality was predicted by computer game addiction and morningness-eveningness. It was found that the fit indices of the model have an acceptable and good fit in explaining the variables.

Factors related to the dual condition of gambling and gaming disorders: A path analysis model

BACKGROUND AND AIMS

Gaming disorder has experienced rapid growth in the last decade among youth and adult populations, in parallel to the expansion of the videogame industry. The objective of this study was to explore the underlying process to explain the dual diagnosis of gaming with gambling disorder.

METHODS

The sample included n = 117 patients who met clinical criteria for gaming disorder, recruited from a tertiary care unit specialized in the treatment of behavioral addictions. Path analysis (implemented through structural equation modeling) assessed the direct and mediational mechanisms between the dual condition of gaming + gambling disorder and sociodemographic variables and personality traits.

RESULTS

The comorbid gaming + gambling disorder was met for 14.5% of the participants (additionally, 6.0% of the sample also met criteria for problematic gambling). The dual diagnosis was directly related to an older age at onset of the addiction problems, a higher level of the novelty seeking trait and being in active work. Employment status also mediated the relationship between persistence levels and chronological age. Greater psychopathological distress was related to females, higher levels of harm avoidance and persistence and lower levels of self-directedness.

CONCLUSIONS

The results of this study provide empirical evidence for the specific factors that increase the likelihood of the dual gaming + gambling disorder. Clinical settings should consider these features to improve gaming diagnosis and treatment. Preventive programs should also be focused on the most vulnerable groups to prevent onset and progression of this comorbid condition.

Associations between Risk Factors in Late Adolescence and Problem Behaviors in Young Adulthood: A Six-Year Follow-Up of Substance Related and Behavioral Addictions in Swedish High School Seniors

INTRODUCTION

Risk factors of traditional substance use related problems in young adults are more well-known than for behavioral addictions such as gambling and gaming problems. The present study aims to provide knowledge about the longitudinal patters of substance use related and behavioral addictions in early adulthood.

METHODS

Using self-report surveys, substance-related, psychiatric, and demographic predictors were assessed in Swedish high school seniors and re-assessed six years later along with gambling and gaming problems, n = 800. Associations (Risk Ratios) between risk factors in late adolescence and problem behaviors in young adulthood were analyzed.

RESULTS

Tobacco use, illicit drug use, and hazardous drinking in young adulthood were associated with tobacco use, illicit drug use, alcohol use, conduct problems, and impaired impulse control in late adolescence. Gambling problems in young adulthood were only associated with heredity of alcohol problems, while gaming was not associated to any problem behavior in late adolescence.

CONCLUSION

It is concluded that predictors for traditional substance-related addictions differ from predictors for behavioral addictions, and that this difference is more pronounced for gaming problems than for gambling problems.

Subtyping treatment-seeking gaming disorder patients

BACKGROUND AND AIMS

Gaming Disorder (GD) is characterized by a pattern of persistent and uncontrolled gaming behavior that causes a marked impairment in important areas of functioning. The evolution of the worldwide incidence of this disorder warrants further studies focused on examining the existence of different subtypes within clinical samples, in order to tailor treatment. This study explored the existence of different profiles of patients seeking treatment for GD through a data-driven approach.

METHODS

The sample included n = 107 patients receiving treatment for GD (92% men and 8% women) ranging between 14 and 60 years old (mean age = 24.1, SD = 10). A two-step clustering analysis approach explored the existence of different underlying GD profiles based on a broad set of indicators, including sociodemographic features, clinical course of the condition (e.g., onset or evolution), psychopathological symptoms, and personality traits.

RESULTS

Two GD profiles emerged. The first cluster grouped together patients who presented with a lower psychological impact (n = 72, 66.1%), whereas the second cluster comprised patients with a higher psychological impact (n = 35, 32.7%). Cluster comparisons revealed that those patients presenting the higher impact were older, with a later onset of pathological gaming patterns, and more pronounced psychopathological symptoms and dysfunctional personality profiles.

CONCLUSIONS

GD severity is influenced by specific demographic, clinical, and psychopathological factors. The identification of two separate profiles provides empirical evidence that contributes to the conceptualization of this disorder, as well as to the development of reliable and valid screening tools and effective intervention plans focused on the precise characteristics of the treatment-seeking patients.

Relationship Between Illness Representations and Symptoms of Internet Gaming Disorder Among Young People: Cross-Lagged Model

BACKGROUND

The common-sense model of illness suggests that mental representations of health threats may affect one's behavioral reactions to them and health status. Internet gaming disorder is a newly defined mental disorder. Illness representations of internet gaming disorder may affect one's risk of internet gaming disorder. In turn, symptoms of internet gaming disorder may affect one's perceptions of the disorder.

OBJECTIVE

This study aimed to investigate the relationships between illness representations and symptoms of internet gaming disorder in college students.

METHODS

A 1-year longitudinal study was conducted with a convenience sample of Chinese college students (n=591; 342/591, 57.9% female).

RESULTS

Of the participants, 10.1% (60/591) and 9.1% (54/591) were classified as having probable internet gaming disorder at baseline (T1) and follow-up (T2), respectively. The correlations between some dimensions of illness representations regarding internet gaming disorder (ie, consequence, timeline, personal control, treatment control, and concern) at T1 and symptoms of internet gaming disorder at T2 and between symptoms of internet gaming disorder at T1 and the dimensions of illness representations at T2 (ie, consequence, timeline, personal control, and emotional response) were statistically significant. The cross-lagged model fit the data well ((χ2/df=2.28, comparative fit index=.95, root mean square error of approximation=.06) and showed that internet gaming disorder at T1 was positively associated with unfavorable illness representations at T2.

CONCLUSIONS

Individuals with more severe symptoms of internet gaming disorder had more pessimistic perceptions about the disorder. Such cognitive perceptions may affect one's emotional and behavioral reactions towards the disorder (eg, greater levels of depression and low self-control intention) and should be modified by educational programs and psychological interventions.

Profile of Treatment-Seeking Gaming Disorder Patients: A Network Perspective

The increasing presence of gaming disorder in recent years has led to major efforts to identify the specific predictors that have a high impact on the profile of people seeking treatment for this mental condition. The purpose of this study was to explore the network structure of the correlates of gaming disorder considering sociodemographic features and other clinical symptoms. Network analysis was applied to a sample of patients who met clinical criteria for gaming disorder (n = 117, of ages ranging from 15 to 70 yrs-old). Variables considered in the network included sex, age, socioeconomic position, global emotional distress, age of onset and duration of the gaming disorder, personality traits and the presence of other addictive behaviors (tobacco, alcohol and behavioral addictions). The central nodes in the network were global psychological distress, chronological age, and age of onset of gaming related problems. Linkage analysis also identified psychopathological status and age as the variables with the most valuable information in the model. The poorest relevance in the analysis was for the duration of gaming problems and socioeconomic levels. Modularity analysis grouped the nodes within four clusters. Identification of the variables with the highest centrality/linkage can be particularly useful for developing precise management plans to prevent and treat gaming disorder related problems.

A Virtual Reality Game (The Secret Trail of Moon) for Treating Attention-Deficit/Hyperactivity Disorder: Development and Usability Study

Background

Attention-deficit/hyperactivity disorder (ADHD) affects between 4% and 8% of children worldwide. The treatment of choice is multimodal treatment. Multimodal interventions for ADHD may be improved by incorporating new treatments, such as treatment via serious video games. The Secret Trail of Moon (TSTM) is a virtual reality serious video game that was designed for cognitive training related to core ADHD symptoms and executive dysfunction.

Objective

We aimed to describe the development and usability of TSTM.

Methods

The usability study included 37 children and adolescents who tested TSTM during the early usability stage (preinclusion) of a randomized controlled clinical trial for testing the effectiveness of TSTM. Chi-square tests were performed to compare patients with ADHD (ADHD combined subtype vs inattentive subtype) and to compare frequent and infrequent video game players in the second study. We used SPSS version 20 for Macintosh (IBM Corporation).

Results

A total of 31/37 (86%) and 30/37 (83%) of participants liked playing TSTM and wanted to continue playing TSTM, respectively. Further, 5/37 (14%) of participants reported that they experienced either perceived dizziness or virtual reality motion sickness. We found no statistically significant differences after comparing the ADHD combined subtype to the inattentive subtype and frequent video game players to infrequent video game players.

Conclusions

Serious video games, such as TSTM, may complement the current multimodal approach for treating ADHD.

Trial Registration

ClinicalTrials.gov NCT04355065; https://clinicaltrials.gov/ct2/show/NCT04355065

Commercial Off-The-Shelf Video Games for Reducing Stress and Anxiety: Systematic Review

BACKGROUND

Using commercial off-the-shelf video games rather than custom-made computer games could have several advantages for reducing stress and anxiety, including their low cost, advanced graphics, and the possibility to reach millions of individuals worldwide. However, it is important to emphasize that not all commercial video games are equal, and their effects strongly depend on specific characteristics of the games.

OBJECTIVE

The aim of this systematic review was to describe the literature on the use of commercial off-the-shelf video games for diminishing stress and anxiety, examining the research outcomes along with critical variables related to computer game characteristics (ie, genre, platform, time of play).

METHODS

A systematic search of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The search databases were PsycINFO, Web of Science, Medline, IEEExplore, and the Cochrane Library. The search string was: [("video game*") OR ("computer game*")] AND [("stress") OR ("anxiety") OR ("relaxation")] AND [("study") OR ("trial") OR ("training")].

RESULTS

A total of 28 studies met the inclusion criteria for the publication period 2006-2021. The findings demonstrate the benefit of commercial off-the-shelf video games for reducing stress in children, adults, and older adults. The majority of the retrieved studies recruited young adults, and fewer studies have involved children, middle-aged adults, and older adults. In addition to exergames and casual video games, other genres of commercial off-the-shelf games helped to reduce stress and anxiety.

CONCLUSIONS

Efficacy in reducing stress and anxiety has been demonstrated not only for exergames and casual video games but also for other genres such as action games, action-adventure games, and augmented reality games. Various gaming platforms, including consoles, PCs, smartphones, mobile consoles, and virtual reality systems, have been used with positive results. Finally, even single and short sessions of play had benefits in reducing stress and anxiety.

TRIAL REGISTRATION

International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY202130081; https://inplasy.com/?s=INPLASY202130081.

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

OBJECTIVE

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

METHOD

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

RESULTS

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

CONCLUSION

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

The imbalance between goal-directed and habitual systems in internet gaming disorder: Results from the disturbed thalamocortical communications

BACKGROUND

Converging evidence has identified the imbalance between goal-directed systems and habitual systems in the addiction process. The thalamocortical loop plays an important role in the habitual/goal-directed system. However, little is known about the role of the thalamus in goal-directed and habitual systems in Internet gaming disorder (IGD) patients. This study investigated whether thalamocortical circuit was disrupted and how they affected goal-directed and habitual behaviors in IGD patients.

METHODS

This is a functional magnetic resonance imaging (fMRI) study. Twenty-five IGD patients and 25 matched recreational game users (RGUs) were scanned when they were in a resting state and were performing an instrumental learning task to obtain behavioral data related to habitual/goal-directed behavior. We used the whole-brain seed-based functional connectivity (FC) of the four thalamic nuclei (bilateral) and correlation analyses to examine the thalamocortical loop difference and relationship with habitual/goal-directed performance.

RESULTS

Compared with RGUs, IGD patients demonstrated significantly increased FC between the left midline nucleus (MN) and the right postcentral gyrus (PCG), and between the pulvinar and medial frontal gyrus (MFG). Correlation results showed that within the IGD group, the correct response rates of the participants to inconsistent stimulus-result pairs were positively correlated with the FC between the pulvinar and MFG. Inhibition-control scores were negatively correlated with the FC between the left MN and the PCG.

CONCLUSIONS

IGD patients showed disrupted thalamocortical communication that could further result in an imbalance between the goal-directed and habitual systems in IGD patients. These findings provide more information about the involvement of the thalamus in the pathophysiology of IGD, and as potential circuit-level biomarkers of IGD patients, these circuit alterations may be useful in treatment development and in monitoring treatment outcomes.

„Gaming“ im Kindesalter

Hintergrund

Viele Kinder spielen Computer- und Videospiele („Gaming“). Doch übermäßiges Gaming kann sich zu einer „Gaming Disorder“ entwickeln, deren Ursachen nicht vollständig geklärt sind. Unter anderem werden elterliches Gaming und das Vorliegen einer Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung (ADHS) bei Kindern als Einflussfaktoren diskutiert.

Ziel der Arbeit

Es wurde untersucht, ob i) Zusammenhänge zwischen elterlichem und kindlichem Gaming bestehen, ii) Gaming und Tendenzen zur ADHS bei Kindern miteinander assoziiert sind, und iii) diese Assoziationen durch das Gaming-Verhalten der Eltern moderiert werden.

Material und Methoden

Es beurteilten 249 Eltern (n = 244 Frauen; Alter: 34,94 ± 4,88 Jahre) das eigene Gaming-Verhalten und das ihrer Kinder (n = 105 Mädchen, n = 144 Jungen; Alter: 5,72 ± 2,18 Jahre) mit dem Gaming Disorder Test (GDT). Mithilfe der Diagnose-Checkliste Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung (DCL-ADHS) wurden ADHS-Tendenzen der Kinder im Fremdbericht erfasst.

Ergebnisse

Gaming der Eltern und Kinder waren voneinander abhängig (χ2(1) = 15,52, p < 0,001). Die GDT-Werte der Eltern und Kinder korrelierten positiv (Jungen: ρ = 0,34, p = 0,029; Mädchen: ρ = 0,35, p = 0,047). Computerspielende Kinder hatten keine höheren ADHS-Tendenzen als Kinder, die nicht spielten, doch bei spielenden Jungen korrelierten Tendenzen zu Impulsivität (ρ = 0,23, p = 0,028) und bei spielenden Mädchen Tendenzen zu Unaufmerksamkeit (ρ = 0,38, p = 0,008) mit dem GDT-Wert. Elterliche GDT-Werte verstärkten den Zusammenhang zwischen dem GDT-Wert und der Impulsivität bei Kindern i. Allg.

Schlussfolgerung

Eltern können durch ihr eigenes Gaming-Verhalten möglicherweise das ihrer Kinder beeinflussen. Besonders bei Kindern mit einer ADHS muss problematisches Gaming frühzeitig erkannt werden, um der Entstehung einer Gaming Disorder vorbeugen zu können. Die vorgestellten Ergebnisse bedürfen längsschnittlicher Überprüfungen in größeren und heterogeneren Stichproben.

Online Learning Performances of Children and Adolescents With Attention Deficit Hyperactivity Disorder During the COVID-19 Pandemic

To investigate attention deficit hyperactivity disorder (ADHD) core symptoms that impair executive function (EF), emotional state, learning motivation, and the family and parenting environment of children and adolescents with ADHD, both with and without severe difficulties. This will be explored within an online learning environment during the period of COVID-19 pandemic. A total of 183 ADHD children diagnosed using DSM-V criteria were selected and divided into 2 groups high difficulties during online learning (HDOL) and low difficulties during online learning (LDOL) according to the answer of Home Quarantine Investigation of the Pandemic (HQIP). The participants filled out a set of questionnaires to assess their emotional state and learning motivation, and their parents also filled out the questionnaires about ADHD core symptoms, EF, and family and parenting environment. Compared with ADHD children in the LDOL group, the children in the HDOL group had significant symptoms of inattention, hyperactivity, oppositional defiant, behavioral and emotional problems according to the Swanson, Nolan, and Pelham Rating Scale (SNAP). They also had more severely impaired EF according to the Behavior Rating Inventory of Executive Function (BRIEF), more difficulties and disturbances in the family by the Chinese version of Family Environment Scale (FES-CV), and lower parenting efficacy and satisfaction by Parenting Sense of Competence (PSOC). With regard to the self-rating questionnaires of children and adolescents, the HDOL group reported lower learning motivation according to the Students Learning Motivation Scale (SLMS). By Screening for Child Anxiety-Related Emotional Disorders and Depression Self-Rating Scale for Children (DSRSC), those in HDOL presented more negative emotions. The HDOL group spent significantly more time on both video games and social software per day and significantly less time on multiple activities per week, when compared to those in the LDOL group. This study demonstrated that ADHD children and adolescents with HDOL had more inattention-related behaviors, more severe emotional problems and EF impairment, weaker learning motivation, and poorer family and parenting environment. Meanwhile, digital media use should be supervised and appropriate extracurricular activities should be encouraged by parents and schools.

Negative Affectivity and Emotion Dysregulation as Mediators between ADHD and Disordered Eating: A Systematic Review

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with disordered eating, especially addictive-like eating behavior (i.e., binge eating, food addiction, loss of control overeating). The exact mechanisms underlying this association are unclear. ADHD and addictive-like eating behavior are both associated with negative affectivity and emotion dysregulation, which we hypothesized are mediators of this relationship. The purpose of this systematic review was to review the evidence related to this hypothesis from studies assessing the relationship between childhood or adulthood ADHD symptomatology, negative affectivity, emotion dysregulation and addictive-like eating behavior. The systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations. The literature search was conducted in PubMed and PsycINFO (publication date: January 2015 to August 2020; date of search: 2 September 2020). Out of 403 potentially relevant articles, 41 were retained; 38 publications reported that ADHD and disordered eating or addictive-like eating behavior were significantly associated, including 8 articles that suggested a mediator role of negative affectivity or emotion dysregulation. Sixteen publications reported that the association between ADHD symptomatology and disordered eating or addictive-like eating behavior differed according to gender, eating behavior and ADHD symptoms (hyperactivity, impulsivity and inattention). We discuss the practical implications of these findings and directions future research.

Caracterización del trastorno por videojuegos: ¿Una problemática emergente?

Objetivo. Sistematizar la literatura actual disponible en torno a la caracterización del trastorno por videojuegos (VDJ), aportando a la comprensión de este fenómeno en el contexto latinoamericano y su incidencia en la población infanto-juvenil. Método. Se utilizó una revisión sistemática de literatura, de corte analítico. Como eje de búsqueda se consideraron las categorías: (a) uso de las TIC, (b) videojuegos, (c) adicción y (d) trastorno por videojuegos, de acuerdo con estudios publicados en las bases de datos PubMed, ScienceDirect y Google Scholar, teniendo como referencia el DSM-V y CIE-11. Resultados. Las manifestaciones clínicas descritas para su uso adictivo son aún heterogéneas. También, se pudo observar que, cuanto más temprano se empieza, mayor será la frecuencia de su uso en edades posteriores, lo que aumenta las conductas de riesgo en el futuro y su incidencia en el tiempo de ocio y la recreación cotidiana. Conclusión. Los efectos que puede generar el uso problemático de dispositivos tecnológicos en el desarrollo de las personas, se contrapone al uso de los VDJ en el tratamiento de diversos trastornos como en el plano educativo. Adicionalmente, se reafirma el desafío de construir saberes e investigaciones multidisciplinares en torno al uso problemático de estos dispositivos.

Low self-control and aggression exert serial mediation between inattention/hyperactivity problems and severity of internet gaming disorder features longitudinally among adolescents

OBJECTIVES

We examined serial mediating roles of low self-control and aggression in explaining relationships between levels of inattention and hyperactivity problems (IHPs) and severity of Internet gaming disorder (IGD) features when exposed to online games among adolescents without Attention deficit hyperactivity disorder (ADHD) stratified by gender using three-wave longitudinal study.

METHOD

The sample comprised a total of 1,732 family dyads from a study that was conducted among seventh graders without diagnoses of ADHD at baseline. Levels of IHPs were assessed by the parent reported Korean version of the ADHD rating scale at baseline (wave1). Severity of IGD features was assessed by the Internet Game Use-Elicited Symptom Screen (IGUESS) at wave3. Both levels of self-control (wave1) and aggression (wave2) were assessed by self-report. The mediating role of low self-control and aggression in the relationships between level of IHPs and severity of IGD were evaluated using serial mediation analysis separately for each gender.

RESULTS

Levels of IHPs were related directly to severity of IGD features in both genders. The indirect effects via low self-control were also significant in both genders, however, the indirect effects via aggression was significant only in women. The serial mediation effect via low self-control and aggression between levels of IHPs and IGD features was significant in both genders (men, coefficient:0.009, 95%CI 0.005-0.019; women, coefficient:0.010, 95%CI:0.005-0.026).

CONCLUSION

We revealed a possible mechanism underlying a serial mediation chain from low self-control to aggression explaining the effects of IHPs on severity of IGD features. However, this conclusion should be taken with a caution, because the effect sizes were very low.

The Many Channels of Screen Media Technology in ADHD: a Paradigm for Quantifying Distinct Risks and Potential Benefits

PURPOSE OF REVIEW

Individuals with attention-deficit hyperactivity disorder (ADHD) may be unusually sensitive to screen media technology (SMT), from television to mobile devices. Although an association between ADHD and SMT use has been confirmed, its importance is uncertain partly due to variability in the way SMT has been conceptualized and measured. Here, we identify distinct, quantifiable dimensions of SMT use and review possible links to ADHD to facilitate more precise, reproducible investigation.

RECENT FINDINGS

Display characteristics, media multitasking, device notifications, SMT addiction, and media content all may uniquely impact the ADHD phenotype. Each can be investigated with a digital health approach and counteracted with device-based interventions. Novel digital therapeutics for ADHD demonstrate that specific forms of SMT can also have positive effects. Further study should quantify how distinct dimensions of SMT use relate to ADHD. SMT devices themselves can serve as a self-monitoring study platform and deliver digital interventions.

The relationships between video game experience and cognitive abilities in adolescents

Objectives: Video games are especially popular among adolescents and young adults as a form of entertainment and the amount of time spent playing video games has increased rapidly. The main objective of this study is to assess the effect of video games on cognitive functions in adolescents. Methods: An exploratory, cross-sectional study was employed to investigate cognitive function in adolescent video game players. Cognitive functions, including memory, attention, and executive functions, were evaluated in 46 adolescents who had been playing video games regularly for at least 1 h per day, 5 days per week, for at least a year, and 31 adolescents (who played video games <5 h per week) using cognitive function assessment tests. Other data, such as demographics, medical information, video game types, and time spent playing video games were collected by questionnaires. Results: No significant difference was detected between the groups in terms of age, gender, IQ levels, and sociodemographic variables. Our findings show that visual memory results were slightly better in the playing group. Moreover, in the group that plays video games regularly, the increase in daily time spent playing games significantly increased the total error value in the Stroop Test and total interference value in California Verbal Learning Test-Children's Version test. We also found that more time is spent on online games compared with traditional games. Conclusions: In this study, we emphasize the pathological and uncontrolled consumption of video games and the possible consequences of time spent playing games. Our findings indicate the need for more extensive research. Future research should address the various implications of video game play, especially between the potentially positive and negative effects of video games.