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Danielsen PA, Mentzoni RA, Låg T. Treatment effects of therapeutic interventions for gaming disorder: A systematic review and meta-analysis. Addict Behav 2024; 149:107887. [PMID: 37826910 DOI: 10.1016/j.addbeh.2023.107887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/27/2023] [Accepted: 10/06/2023] [Indexed: 10/14/2023]
Abstract
The prevalence of gaming disorder is assumed to be between 2%-5%. The treatment effect of different therapeutic interventions of gaming disorder has not been studied extensively. This systematic review and meta-analysis sought to identify all intervention studies on gaming disorder with a control group, determine the effect of the interventions, and examine moderators. Studies applying a therapeutic intervention and using an appropriate comparison group were identified by searching electronic databases, previous reviews, and reference lists. Data on type of treatment, name of outcome measurement, symptom level and other study characteristics were extracted and analyzed using meta-analysis and meta-regression. A total of 38 studies and 76 effect sizes, originating from 9524 participants were included. RoB2 and ROBINS-I risk of bias tools were used to assess within-study risk of bias. Correlational hierarchical models with robust variance estimation were fitted to effect size data and yielded a moderate summary estimate. Egger's sandwich test, funnel plot inspections, and other tests were conducted to assess risk of bias between studies. Results indicate that there may be an overall effect of therapeutic interventions for gaming disorder, but confidence in these findings is compromised by small-study effects, possible publication bias, a limited study pool, and a lack of standardization. The field needs more higher quality studies before the evidence-base can support reliable meta-analytic estimates.
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Affiliation(s)
- Paul A Danielsen
- Department of Psychology, UiT the Arctic University of Norway, Norway.
| | - Rune A Mentzoni
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway
| | - Torstein Låg
- University Library, UiT the Arctic University of Norway, Norway
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Zakaria H, Hussain I, Zulkifli NS, Ibrahim N, Noriza NJ, Wong M, Nik Jaafar NR, Mohd Salleh Sahimi H, Abd Latif MH. Internet addiction and its relationship with attention deficit hyperactivity disorder (ADHD) symptoms, anxiety and stress among university students in Malaysia. PLoS One 2023; 18:e0283862. [PMID: 37506072 PMCID: PMC10381058 DOI: 10.1371/journal.pone.0283862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 03/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND AND AIMS There is growing evidence on the contribution of psychological factors to internet addiction; yet it remains inconsistent and deserves further exploration. The aim of this study was to determine the relationship between the psychological symptoms (Attention Deficit Hyperactivity Disorder (ADHD) symptoms, stress, depression, anxiety and loneliness) and internet addiction (IA) among the university students in Malaysia. MATERIALS AND METHODS A total of 480 students from different faculties in a Malaysian public university participated in this study. They were selected by simple random sampling method. They completed self-administered questionnaires including the Malay Version of Internet Addiction Test (MVIAT)) to measure internet addiction and Adult Self-Report Scale (ASRS) Symptom Checklist, Depression Anxiety Stress Scales (DASS) and UCLA Loneliness Scale (Version 3) to assess for ADHD symptoms, depression, anxiety, stress, and loneliness respectively. RESULTS The prevalence of IA among university students was 33.33% (n = 160). The respondents' mean age was 21.01 ± 1.29 years old and they were predominantly females (73.1%) and Malays (59.4%). Binary logistic regression showed that gender (p = 0.002; OR = 0.463, CI = 0.284-0.754), ADHD inattention (p = 0.003; OR = 2.063, CI = 1.273-3.345), ADHD hyperactivity (p<0.0001; OR = 2.427, CI = 1.495-3.939), stress (p = 0.048; OR = 1.795, CI = 1.004-3.210) and loneliness (p = 0.022; OR = 1.741, CI = 1.084-2.794) were significantly associated with IA. CONCLUSION A third of university students had IA. In addition, we found that those who were at risk of IA were males, with ADHD symptoms of inattention and hyperactivity, who reported stress and loneliness. Preventive strategy to curb internet addiction and its negative sequelae may consider these factors in its development and implementation.
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Affiliation(s)
- Hazli Zakaria
- Department of Psychiatry, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Imran Hussain
- Department of Otolaryngology, Hospital Queen Elizabeth, Sabah, Malaysia
| | - Nor Sa'adah Zulkifli
- Department of Anaesthesiology, Hospital Raja Permaisuri Bainun (HRPB) Ipoh, Perak, Malaysia
| | | | | | - Michelle Wong
- Klinik Kesihatan Bawang Assan, Sibu, Sarawak, Malaysia
| | - Nik Ruzyanei Nik Jaafar
- Department of Psychiatry, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Hajar Mohd Salleh Sahimi
- Department of Psychiatry, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Muhammad Hanif Abd Latif
- Department of Psychiatry, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Diagnostic instruments for the assessment of disruptive mood dysregulation disorder: a systematic review of the literature. Eur Child Adolesc Psychiatry 2023; 32:17-39. [PMID: 34232390 PMCID: PMC9908712 DOI: 10.1007/s00787-021-01840-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
Disruptive mood dysregulation disorder (DMDD) involves non-episodic irritability and frequent severe temper outbursts in children. Since the inclusion of the diagnosis in the DSM-5, there is no established gold-standard in the assessment of DMDD. In this systematic review of the literature, we provide a synopsis of existing diagnostic instruments for DMDD. Bibliographic databases were searched for any studies assessing DMDD. The systematic search of the literature yielded K = 1167 hits, of which n = 110 studies were included. The most frequently used measure was the Kiddie Schedule for Affective Disorders and Schizophrenia DMDD module (25%). Other studies derived diagnostic criteria from interviews not specifically designed to measure DMDD (47%), chart review (7%), clinical diagnosis without any specific instrument (6%) or did not provide information about the assessment (9%). Three structured interviews designed to diagnose DMDD were used in six studies (6%). Interrater reliability was reported in 36% of studies (ranging from κ = 0.6-1) while other psychometric properties were rarely reported. This systematic review points to a variety of existing diagnostic measures for DMDD with good reliability. Consistent reporting of psychometric properties of recently developed DMDD interviews, as well as their further refinement, may help to ascertain the validity of the diagnosis.
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Salerno L, Becheri L, Pallanti S. ADHD-Gaming Disorder Comorbidity in Children and Adolescents: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101528. [PMID: 36291464 PMCID: PMC9600100 DOI: 10.3390/children9101528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/24/2022] [Accepted: 10/01/2022] [Indexed: 11/07/2022]
Abstract
Attention Deficit/Hyperactivity Disorder (ADHD) is a neurobiological condition characterized by developmentally inadequate levels of inattention, hyperactivity, and impulsivity, and a neurobiological disruption in brain neurotransmitters and circuitry causing abnormal responses to rewards. Playing electronic games generates a biological response that activates the neuronal circuits linked to pleasure and reward, and there is a growing attention to this type of activity, which can also turn into a mental health condition. The existence and the boundaries between the functional and the dysfunctional are still a source of debate, with the recognition of 'Internet Gaming Disorder' (IGD) as a condition belonging to the broader area of addiction requiring more in-depth study with respect to the DSM-5, while 'Gaming Disorder' (GD) was officially recognized as a new diagnosis by the World Health Organization (WHO) in the updated revision of the International Classification of Diseases (ICD-11). Notwithstanding, the suggested criteria for the diagnosis of Gaming Disorder are still debated. Since ADHD has been reported as a risk factor for developing addictions, this narrative review aims to provide the current state-of-the art of the knowledge about the comorbidity between ADHD and Gaming Disorder. For this aim, a literature search was conducted using a combination of specific keywords and the results are discussed within the R-Do-C framework and dimensions, and implications for treatment are considered.
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Affiliation(s)
- Luana Salerno
- INS, Istituto di Neuroscienze, 50121 Florence, Italy
| | | | - Stefano Pallanti
- INS, Istituto di Neuroscienze, 50121 Florence, Italy
- Department of Psychiatry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Correspondence:
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Yang H, Wang Z, Elhai JD, Montag C. The relationship between adolescent emotion dysregulation and problematic technology use: Systematic review of the empirical literature. J Behav Addict 2022; 11:290-304. [PMID: 35895565 PMCID: PMC9295251 DOI: 10.1556/2006.2022.00038] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/01/2022] [Accepted: 05/07/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND AIMS We aimed to systematically identify, evaluate and summarize the research on adolescent emotion dysregulation and problematic technology use. We critically appraise strengths and limitations and provide recommendations for future research. METHODS We followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and conducted a systematic review of published original reports on adolescent emotion dysregulation and problematic technology use published until March 1, 2022. A thorough search preceded the selection of studies matching prespecified criteria. Strengths and limitations of selected studies, regarding design and reporting, were identified based on current best practices. RESULTS 39 studies met inclusion criteria. All of these studies provided on the relationship between adolescent emotion dysregulation and problematic technology use severity based on self-report data. DISCUSSION There was a positive correlation between adolescent emotion dysregulation and the severity of problematic technology use. Beyond this, other variables (such as anxiety, depression, self-esteem, etc.) were also closely related to emotion dysregulation and problematic technology use. Such studies are of importance to better understand cause-effect relations regarding both variables.
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Affiliation(s)
- Haibo Yang
- Academy of Psychology and Behavior, Faculty of Psychology, Tianjin Normal University, Tianjin, 300387, China,Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin 300387, China,Corresponding author. E-mail:
| | - Zihao Wang
- Academy of Psychology and Behavior, Faculty of Psychology, Tianjin Normal University, Tianjin, 300387, China
| | - Jon D. Elhai
- Department of Psychology, University of Toledo, Toledo, OH, 43606, USA,Department of Psychiatry, University of Toledo, Toledo, OH, 43614, USA
| | - Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, 89081 Ulm, Germany
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Lampropoulou P, Siomos K, Floros G, Christodoulou N. Effectiveness of Available Treatments for Gaming Disorders in Children and Adolescents: A Systematic Review. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2022; 25:5-13. [PMID: 34665018 DOI: 10.1089/cyber.2021.0067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In 2020, the prevalence of gaming disorder (GD) was comparable with the prevalence of obsessive-compulsive disorder, thus demonstrating the necessity of addressing Internet gaming disorder (IGD) and GD in general. GD has been introduced as a psychiatric disorder by International Classification of Diseases and paving the way for treatment and prevention interventions. In this review, we researched available treatment interventions in children and adolescents. Τhe initial search resulted in 972 studies and we ended up with 16 by excluding inappropriate studies according to six inclusion criteria. The studies confirmed that cognitive-behavioral therapy (CBT) or CBT-based interventions are the most used, and in cases of comorbidity, such as depression or attention-deficit/hyperactivity disorder, the appropriate pharmaceutical intervention also was an effective option. Other interventions combined CBT with family therapy or CBT-based therapies that took place in specialized camps. Family as a supportive expedient or even treatment expedient seemed to play a major role. It is remarkable that only little knowledge exists regarding treatment interventions for children aged 8-12 years old. Therefore, more studies need to be carried out for this age range especially, with comparable efficacy to this of other interventions.
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Affiliation(s)
| | | | - Georgios Floros
- 2nd Department of Psychiatry, Aristotle University Medical School, Thessaloniki, Greece
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Lee J, Bae S, Kim BN, Han DH. Impact of attention-deficit/hyperactivity disorder comorbidity on longitudinal course in Internet gaming disorder: a 3-year clinical cohort study. J Child Psychol Psychiatry 2021; 62:1110-1119. [PMID: 33751554 DOI: 10.1111/jcpp.13380] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although attention-deficit/hyperactivity disorder (ADHD) symptoms were identified as a key risk factor for Internet gaming disorder (IGD), the effect of ADHD comorbidity on longitudinal course of IGD in the clinical population remains to be further examined. This study aimed to investigate whether ADHD comorbidity in IGD patients affects the recovery, recurrence rates, and trajectories of IGD symptoms, and examine the relationship between the changes in IGD and ADHD symptoms. METHODS The study included 128 IGD patients without any psychiatric comorbidities (pure-IGD group) and 127 IGD patients with comorbid ADHD (ADHD-IGD group) aged 11 to 42 years. IGD and ADHD were diagnosed according to DSM-5 criteria at enrollment. Participants were offered 8-week treatment with additional care provided as needed and followed up over a 3-year period. IGD diagnosis was reassessed annually and used as a dichotomous outcome. The severity of IGD and ADHD symptoms was measured using the Young Internet Addiction Scale and the Korean ADHD rating scale, respectively, at baseline and each annual follow-up. RESULTS The recovery rates of IGD by Year 3 were 60% and 93% in ADHD-IGD and in pure-IGD groups, respectively. The ADHD-IGD group showed lower rates of recovery, higher odds of recurrence within 1 year, and higher severity of IGD symptoms over time than the pure-IGD group. Family environment was also associated with the trajectories of IGD symptoms. The changes in ADHD symptoms were significantly associated with the changes in IGD symptoms. CONCLUSIONS This study found that ADHD comorbidity in IGD patients was associated with poor clinical course of IGD and that the changes in ADHD symptoms were associated with the changes in IGD symptoms over time. Our findings suggest that evaluation and treatment of ADHD symptoms and family environment in IGD patients may be important in improving the prognosis of IGD.
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Affiliation(s)
- Jung Lee
- Integrative Care Hub, Children's Hospital, Seoul National University Hospital, Seoul, Korea
| | - Sujin Bae
- Department of Psychiatry, Chung Ang University Hospital, Seoul, Korea
| | - Bung Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung Ang University Hospital, Seoul, Korea
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Werling AM, Walitza S, Drechsler R. Impact of the COVID-19 lockdown on screen media use in patients referred for ADHD to child and adolescent psychiatry: an introduction to problematic use of the internet in ADHD and results of a survey. J Neural Transm (Vienna) 2021; 128:1033-1043. [PMID: 33885969 PMCID: PMC8060336 DOI: 10.1007/s00702-021-02332-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/25/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 outbreak and lockdown have been associated with multiple consequences for mental health, including an excessive and potentially harmful increase in screen media use. The specific consequences for children, adolescents and young adults with ADHD are still unknown. In the first part of this study, a short review of problematic use of the internet (PUI) in ADHD is presented, showing that patients with ADHD are at risk for different aspects of PUI, such as excessive gaming or problematic social media use. In the second part, we report original data of an online survey on screen media use before, during and after the lockdown completed by parents of children and adolescents clinically referred for ADHD. Parents rated children's/adolescents' media-related behavior and media time on a new screening questionnaire for PUI. Each item was rated three times, referring to the observed behavior before, during and 1-2 months after the lockdown. N = 126 parents of patients referred for ADHD aged 10-18 years participated in the study. Total media time increased by 46% during the lockdown and did not completely return to pre-Corona levels afterwards. Patients with difficulties concentrating, high irritability or deterioration of ADHD problems under lockdown spent more time with screen media than those with milder or no such problems. While the effects of the lockdown on screen media use and its negative impact on everyday life appear to be largely reversible, a small proportion of patients with ADHD apparently continue to show increased media use.
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Affiliation(s)
- Anna Maria Werling
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Child and Adolescent Psychiatric Research, Neuropsychology, University Hospital of Psychiatry Zurich, University of Zurich, Eisengasse 16, 8008, Zurich, Switzerland.
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Child and Adolescent Psychiatric Research, Neuropsychology, University Hospital of Psychiatry Zurich, University of Zurich, Eisengasse 16, 8008, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Renate Drechsler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Child and Adolescent Psychiatric Research, Neuropsychology, University Hospital of Psychiatry Zurich, University of Zurich, Eisengasse 16, 8008, Zurich, Switzerland
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