Debate: Behavioural addictions and technology use - risk and policy recommendations for problematic online gambling and gaming

What the grey literature can contribute to addictive behaviour disorder classification •

This commentary examines the proposal made by Brand et al. (2022) regarding a framework outlining relevant criteria for considering possible behavioural addictions within the current World Health Organisation's International Classification of Diseases (ICD-11) category of 'other specified disorders due to addictive behaviours'. We agree with the framework as it highlights the clinical perspective requiring agreed-upon classifications and criteria to produce effective diagnostic procedures and efficacious treatments. Additionally, we propose to add the need of recognising potential addictive behaviour through the inclusion of a fourth meta-level criterion: 'grey literature evidence'. Utilising non-academic evidence can provide validity in the social context where the behaviour takes place, and it can support authorities in taking action to prevent and treat the resultant behavioural problems. The inclusion of the proposed fourth criterion will aid comprehensibility of the current proposal and provide clarity, as indicated in the present commentary, which includes the fourth criterion analysis for problematic pornography use, shopping/buying and social networking site use.

To Be or Not to Be a Female Gamer: A Qualitative Exploration of Female Gamer Identity

The literature on online gaming has generally focused on male gamers and has been dominated by negative aspects of gaming. The present study addresses the gender gap in this field by exploring experiences of female gamers further by unravelling several positive experiences alongside some potentially harmful tendencies connected to gaming, including female gamers' wishes and ambitions for their future gaming. A total of 20 female adult gamers across Europe were interviewed and results were analysed using thematic analysis. Four main themes were identified: (i) to be or not to be a (female) gamer; (ii) improving social skills and levelling up on mental health; (iii) not always a healthy escape; and (iv) there is more to explore. The present study is one of few empirical studies regarding the construction of self-image, and experiences of female gamers. It has showed participants have a history as gamers from adolescence, but still face problems derived from the stigmatised internal gender self-image. Externally, female gamer stigmatisation may result in sexism, gender violence, harassment, and objectification. Additionally, females may decide against identifying as gamers, engaging in social gaming interaction, or hold back from online gaming in general, thereby missing out on the opportunities for recreation as well as social and psychological benefits that gaming brings. There is, therefore, urgent need for more research and actions to promote change, equity, education, and security for female gamers as well as their male counterparts. Game developers would benefit from understanding this large gamer demographic better and tailoring games for women specifically.

Prediction of problem gambling by demographics, gaming behavior and psychological correlates among gacha gamers: A cross-sectional online survey in Chinese young adults

OBJECTIVE

The objective of this study is to explore the association of problem gambling with demographics, psychological distress, and gaming behavior in young adult gacha gamers in Hong Kong.

MATERIALS AND METHODS

Cross-sectional data was collected in the first and fifth waves of COVID-19 pandemic in Hong Kong online. Participants who aged 18-25 years and had been playing gacha games over the past 12 months were recruited. Stepwise multiple regression was used to explore the association among risk of problem gambling, gaming behavior, participation in gaming activities and psychological distress. A two-sided p-value <0.05 was considered as statistical significance.

RESULTS

Three hundred and thirty-seven completed questionnaires were received with no missing data. 34.7% (n = 117) of the participants had non/low-risk of problem gambling. About 40% (n = 136) of them had moderate-risk and the remaining 25% (n = 84) were at high risk of problem gambling. A higher proportion of female participants (78.6%) were found in high-risk group as compared to 39.7% and 55.6% only in the non/low-risk and moderate-risk groups, respectively. The regression model (R ² = 0.513, F = 71.895, p < 0.001) showed that 51.3% of the variance of the total problem gambling score could be explained by stress, anxiety, monthly expenses on gacha purchases, number of motives for gacha purchase and number of gambling activities engaged.

CONCLUSION

The present study provides empirical evidence to support the association between problem gambling and microtransaction especially for gacha which is the most popular type of video game microtransaction in Asia. The established regression model suggests that gacha gamers with higher risk of problem gambling tend to have greater stress, higher anxiety level, spend more on gacha purchase, have more motives for gacha purchases and engage in more gambling activities. In contrast to the extant literature, higher proportion of female participants in high-risk group indicates that female gacha gamers are also at very high risk of becoming problem gamblers.

The Impact of Online Game Addiction on Adolescent Mental Health: A Systematic Review and Meta-analysis

Abstract: Introduction: The World Health Organization (WHO) in 2019 determined that Internet Gaming Disorders (IGD) were included as mental health disorders. Among adolescents, excessive online gaming has become a lifestyle and is associated with psychological symptoms (psychopathological symptoms and life satisfaction), social health (social interactions) and physical health (general health and body mass index). The IGD has now become a problem all over the world.   AIM: This study aims to analyze the impact of online game addiction on adolescents using the Preferred Reporting Items for Systematic Reviews (PRISMA) approach.   MATERIALS AND METHODS: Subjects were searched extensively from the Pubmed, Sage, Science Direct, and Scopus databases. The search used the keywords "online game addiction", "mental health", and "youth". The inclusive criteria for the included  literature in this study  were as follow; the literature had to be sourced from journal article, written in English, available in full text, the published between  2011-2021, and the age of the adolescent subject should be 13-18 years. We identified 81 articles of which 20 were deemed relevant for this systematic review.   RESULTS: This review study shows that problematic online gaming behavior has a strong negative correlation with various subjective health outcomes.   CONCLUSION: Early relevant prevention for  adolescents from the IGD is the appropriate use of  internet/ gadgets as the only option to avoid or to reduce the symptoms of internet addiction and online games.   Keywords : Online game addiction; Mental health; Adolescents; Good Health and Wellbeing

Editorial: Evidence, policy and practice - gold standard, good enough or doing it differently?

Welcome to the first issue of Child and Adolescent Mental Health (CAMH) in 2021 and also to my first issue as editor-in-chief. Needless to say, 2020 has been one of the most difficult years in living memory for many children and young people around the globe, and, as we discussed in our recent issues, the potential impact of COVID-19 on children's mental health is profound. The case for increased funding for child and adolescent mental health and investing in research has never been greater. Nevertheless, as we step into 2021, there are seeds of optimism as science drives forward treatment and vaccine developments.