Internet gaming disorder in children and adolescents: a systematic review

Alternations voxel-wise interhemispheric and intrahemipheric functional connectivity dynamics in internet gaming disorder

BACKGROUND

Currently, numerous studies have indicated that individuals with internet gaming disorder (IGDs) have aberrant functional connection patterns between multiple brain regions and networks. However, temporal variability in the intra- and interhemispheric dynamic functional connectivity in IGDs remains unknown.

METHODS

This study investigated resting-state functional magnetic resonance data from 55 IGDs and 50 demographically matched healthy controls (HCs). Functional connectivity density (FCD) combined with sliding window analysis is employed to calculate the temporal variability of global functional connectivity. The temporal variability of dynamic functional connectivity further quantified utilizing the standard deviations of global, intra-, and interhemispheric FCD. Finally, correlation analyses were performed between dynamic FCD varience (dFCD) in differential brain regions and clinical behaviors.

RESULT

IGDs showed decreased intra- and interhemispheric dFCD variance in the visual attention network (precuneus and calcarine) and also demonstrated hemispheric-level dFCD variance abnormalities in the posterior cingulate cortex (PCC) compared to HCs. Moreover, abnormal global dFCD variability of the calcarine and ipsilateral dFCD variability of the PCC were negatively correlated with the severity of IGDs in the IGD group.

CONCLUSION

Our results demonstrate abberant intra- and interhemispheric dynamic functional connectivity in the visual attention network, which emphasizes the neurobiological basis for impaired concentration in IGDs.

Scoping review of withdrawal's role in contemporary gaming disorder research: Conceptualizations and operationalizations

The global gaming community now exceeds 3 billion players, prompting increased attention from social and medical sciences regarding gaming-related disorders. Internet Gaming Disorder (IGD) was incorporated into DSM-5 in 2013, and Gaming Disorder (GD) found its place in ICD-11 in 2019. A contentious criterion in IGD, not present in GD, revolves around withdrawal symptoms. This paper offers a theoretical foundation on gaming withdrawal symptoms in gaming-related disorders and conducts a scoping review of withdrawal operationalization and conceptualization in 40 selected studies, following PRISMA-ScR guidelines. Most studies employed a correlation framework, relying on convenience samples and self-assessment questionnaires. A smaller portion focused on clinical samples and case studies. Withdrawal was predominantly conceptualized in terms of affective components, with less emphasis on behavioural, cognitive, physical, or neurological aspects. The prevailing terminology for gaming-related disorders was IGD, with only three studies referencing GD as defined in ICD-11. Notably, just six experimental studies included abstinence control. We advocate for an expansion of research on withdrawal symptoms, particularly through experimental studies that implement abstinence within experimental groups and offer alternative operationalizations beyond dominant self-assessment measures.

Prevalence of internet gaming disorder among Chinese adolescents: A systematic review and meta-analysis

This study aimed to evaluate the prevalence of IGD among Chinese adolescents. Articles published up to April 11, 2024 were retrieved from PubMed, Wiley Online Library, Embase, Web of Science, Ebsco, CNKI, and WanFang. Random-effects models and univariate meta-regression analyses were used to calculate prevalence and heterogeneity estimates with the support of Stata17.0 software. The prevalence of IGD in Chinese adolescents was 10 % (95 %CI: 8 %-12 %). Univariate regression analyses revealed some significant moderators of IGD prevalence, including gender, sample size, and survey year. Spatiotemporal analysis showed the prevalence of IGD varied considerably across provinces in different survey years.

School Climate and School Identification as Determinants of Internet Gaming Disorder Among Chinese Adolescent Internet Gamers: Cross-Sectional Mediation Study

Background

School climate and school identification are important features of the school environment and potential determinants of adolescent internet gaming disorder (IGD).

Objective

This novel study investigated their joint effects on IGD and related mediation mechanisms via the interpersonal factor of teacher-student relationship and the individual factors of academic stress and anxiety.

Methods

A large-scale cross-sectional study was conducted among adolescent internet gamers of junior, senior, and vocational middle schools in Taizhou City, China, from February to March 2022 (N=5778). Participants self-administered an anonymous, structured questionnaire in classrooms. Adjusted logistic regression and structural equation modeling (SEM) were used for data analysis.

Results

Among all participants, the prevalence of IGD was 8% (461/5778). The 4 school climate subscales (student-student relationship subscale: adjusted odds ratio [ORa] 0.88, 95% CI 0.85-0.91; student-staff relations subscale: ORa 0.87, 95% CI 0.84-0.90; academic emphasis subscale: ORa 0.88, 95% CI 0.85-0.91; shared values approach: ORa 0.88, 95% CI 0.85-0.90), the school identification subscale (ORa 0.85, 95% CI 0.83-0.88), and teacher-student relationship (ORa 0.80, 95% CI 0.76-0.84) were significant protective factors against IGD, while academic stress (ORa 1.18, 95% CI 1.14-1.23) and anxiety (ORa 1.16, 95% CI 1.14-1.18) were risk factors of IGD. The SEM showed that the negative associations between school climate and IGD and between school identification and IGD were mediated via (1) three 2-step paths, each involving a single mediator-teacher-student relationship, academic stress, and anxiety, respectively-and (2) two 3-step paths involving 2 mediators-teacher-student relationship and academic stress first, respectively, and then anxiety. The direct effect of school climate on IGD was statistically nonsignificant (ie, full mediation with effect size ranging from 4.2% to 20.4%), while that of school identification was statistically significant (ie, partial mediation with effect size ranging from 4.5% to 38.2%).

Conclusions

The relatively high prevalence of IGD among Chinese adolescents may be reduced through school-based interventions to improve school climate and school identification. Such improvements may reduce the levels of risk factors of IGD (poor teacher-student relationship, academic stress, and anxiety) and hence the risk of IGD. Future longitudinal and intervention studies are needed to confirm the findings.

How can digital citizen science approaches improve ethical smartphone use surveillance among youth: Traditional surveys versus ecological momentary assessments

Ubiquitous use of smartphones among youth poses significant challenges related to non-communicable diseases, including poor mental health. Although traditional survey measures can be used to assess smartphone use among youth, they are subject to recall bias. This study aims to compare self-reported smartphone use via retrospective modified traditional recall survey and prospective Ecological Momentary Assessments (EMAs) among youth. This study uses data from the Smart Platform, which engages with youth as citizen scientists. Youth (N = 77) aged 13-21 years in two urban jurisdictions in Canada (Regina and Saskatoon) engaged with our research team using a custom-built application via their own smartphones to report on a range of behaviours and outcomes on eight consecutive days. Youth reported smartphone use utilizing a traditional validated measure, which was modified to capture retrospective smartphone use on both weekdays and weekend days. In addition, daily EMAs were also time-triggered over a period of eight days to capture prospective smartphone use. Demographic, behavioural, and contextual factors were also collected. Data analyses included t-test and linear regression using Python statistical software. There was a significant difference between weekdays, weekends and overall smartphone use reported retrospectively and prospectively (p-value = <0.001), with youth reporting less smartphone use via EMAs. Overall retrospective smartphone use was significantly associated with not having a part-time job (β = 139.64, 95% confidence interval [CI] = 34.759, 244.519, p-value = 0.010) and having more than two friends who are physically active (β = -114.72, 95%[CI] = -208.872, -20.569, p-value = 0.018). However, prospective smartphone use reported via EMAs was not associated with any behavioural and contextual factors. The findings of this study have implications for appropriately understanding and monitoring smartphone use in the digital age among youth. EMAs can potentially minimize recall bias of smartphone use among youth, and other behaviours such as physical activity. More importantly, digital citizen science approaches that engage large populations of youth using their own smartphones can transform how we ethically monitor and mitigate the impact of excessive smartphone use.

Emotional regulation in Gaming Disorder: A systematic review

BACKGROUND AND OBJECTIVES

Problematic video game use is a source of concern. In addictions, difficulties with emotional regulation have become an important variable of interest. However, their study in relation to problematic video game use remains insufficient.

METHODS

A systematic review was conducted following PRISMA 2020 guidelines; 322 studies were screened, resulting in a final sample of k = 18 studies. The methodological quality of these studies was rated as moderate according to the McMaster Critical Review Form for Quantitative studies (CRF-Q).

RESULTS

There is evidence of relationship between different facets of emotional regulation and the presence of problematic video game use. Particularly, video games serve as escape strategy for suppressing emotional expression. There is no consensus regarding the nature of the relationship between emotional regulation, psychopathology, and problematic video game use, with various proposals suggesting moderation and mediation. There is also no consensus regarding the mediation of gender in the relationship between emotional dysregulation and problematic video game use. The level of certainty regarding the validity of the results was moderate.

DISCUSSION AND CONCLUSIONS

Emotional dysregulation plays a role in problematic video game use, especially through strategies as emotional suppression, and lack of abilities to understand and control emotions. It is important to consider emotional regulation as a potential target for research and intervention in clinical populations.

SCIENTIFIC SIGNIFICANCE

We review the largest sample of papers on problem gaming and emotion regulation to date. Our results highlight the importance of emotion regulation and, specially, emotional suppression, or negative escapism, on problematic video game use.

A Cross-sectional Study on Internet Gaming Disorder and Its Association with Personality Traits in Engineering Students

Background

In the field of psychiatry and mental health, Internet gaming disorder (IGD) is a relatively new concept. In the past few decades, as online gaming and internet usage became increasingly prevalent, this became a topic of concern and research. Therefore, this study aims to estimate the prevalence of IGD and its association with personality traits among students.

Methods and material

The present cross-sectional study was conducted at an Engineering college in Nunna, Andhra Pradesh. The planned duration of the study was 12 months, from March 2020 to March 2021. However, it was extended until August 2021 due to the COVID-19 pandemic lockdown, as colleges were closed indefinitely until further instructions. In the current study, a total of 170 students (first year to final year) from an engineering college, aged between 19 and 25 years, were included. Students who provided informed consent or expressed willingness to participate in the study through a self-structured questionnaire and those who had internet access or experience with online gaming in the past 12 months were included. The demographic profile, including age, sex, academic year, accommodation status, and departmental course was studied. Also, the device used for gaming was examined.

Results

The gender distribution in the given population indicates that approximately 65.88% are males and 34.12% are females, for a total of 170 individuals studied. In that 18 participants (10.58%) were found to have IGD. Among 18 participants with IGD, 14 were males and 4 were females. The gender prevalence for male and female participants was calculated separately and found to be 12.5% for males, and 6.9% for females which is almost a ratio of 2:1. The summary explores the relation between the Big Five personality traits and IGD. The current study subjects were categorized as low, medium, or high for each trait based on their IGD status (positive or negative). Significant correlations were determined between extraversion and IGD (p = .02), conscientiousness and IGD (p = .02), and neuroticism and IGD (p = .02).

Conclusion

The current study findings suggest that the overall prevalence of IGD among college students is 10.58% with a higher prevalence among males, IGD is positively connected with neuroticism and negatively correlated with extraversion and conscientiousness. This implies that certain characteristics, either alone or in combination, may raise the likelihood of individuals developing an IGD.

Recurrence of internet gaming disorder in Korean adolescents: a 24-month follow-up study

Many adolescents use internet games, and some of them experience psychological and social difficulties due to excessive gaming. Although there have been many studies on the onset and associated factors of internet gaming disorder (IGD) , research focusing specifically on its relapse is scarce. Considering that addictive disorders often have a chronic course with frequent relapse, this study prospectively observed adolescents from the general population to explore IGD recurrence rate and associated factors of recurrence. In this prospective cohort study, from 1587 middle school gaming users, 1452 (91.5%) were followed up at 12 months and 24 months. The results showed that the cumulative recurrence rate of IGD was 16.1%, which was higher than the initial incidence rate of 3.6%; the adjusted incidence rate ratio was 2.43 with 95% CI 1.21-4.87 (P = 0.012). In addition, starting internet gaming before entering primary school was associated with a higher risk of relapse (P = 0.004). Limiting internet gaming for children before they enter primary school may reduce the risk of relapse of IGD that they may encounter during their adolescent years.

Family-Centered Treatment Program for Problematic Gaming and Excessive Screen Use in a Clinical Child and Youth Population (FAME): Protocol for a Feasibility Pilot Mixed Method Study

BACKGROUND

Screen time among children and adolescents has increased dramatically, raising concerns about its impact on development and mental health. While research highlights both potential benefits and risks, excessive use has been linked to issues like anxiety, depression, and gaming addiction. Despite growing concern, effective interventions are scarce. Recognizing the importance of family dynamics in child development, we propose a family-centered program to address problematic gaming and excessive screen use in a clinical population. By involving both children and parents, we aim to create a more comprehensive approach to prevention and treatment.

OBJECTIVE

This study aims to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical child and adolescent psychiatry (CAP) population. We will monitor the recruitment rate; track the retention and attendance rates of both parents and children; and assess whether each session's objectives are met, the content is delivered within the allotted time, and the necessary resources (eg, facilitators and materials) are available. Additionally, we will gather qualitative and quantitative feedback from participants through postprogram surveys and individual interviews with both children and parents.

METHODS

A total of 10 families with ongoing contact with CAP in Skåne, Sweden, will be recruited and offered participation in a family-centered group program targeting children aged 10-18 years with reported difficulties regarding screen gaming or screen use. The intervention to be tested is a newly developed, family-centered, psychoeducational, cognitive behavioral therapy-based intervention addressing both positive and negative aspects of screen use; setting boundaries; the connection between thoughts, feelings, and behaviors; conflict triggers; and sleep hygiene. The primary goal of the pilot study is to test the feasibility of the program, as well as recruitment and the analysis of participants' experiences with the program.

RESULTS

A total of 11 children and their parents were enrolled during first quarter of 2024. A 4-session pilot was delivered in first quarter of 2024, and the first results are expected in the third quarter of 2024.

CONCLUSIONS

The overarching goal of this pilot study is to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical CAP population. The insights gained from this study will guide our future research, which will focus on conducting a larger-scale evaluation of the intervention's impact on family screen time conflicts and inform future strategies for the implementation of family-centered interventions in child and youth clinics.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06098807; https://clinicaltrials.gov/study/NCT06098807.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/56387.

Relationship between awareness of digital game addiction, health literacy, and sociodemographic characteristics of mothers: A structural equation modeling analysis

AIM

Mothers' digital game addiction awareness and their health literacy levels are critical factors for addiction prevention strategies in children. Therefore, the present study is significant. This study examines the relationship between awareness of digital game addiction, health literacy, and the sociodemographic characteristics of mothers.

METHOD

This cross-sectional study was conducted with 457 mothers of children aged 5-11 years in Turkey. The data were collected using a personal information questionnaire, the Awareness of Digital Game Addiction Scale, and the Health Literacy Scale between May and September 2021.

RESULTS

This study revealed that mothers are highly aware of digital game addiction and have high health literacy. Furthermore, health literacy was determined to significantly and directly affect awareness of digital gaming addiction. Awareness of digital gaming addiction significantly and directly affects children owning their own technological devices and how much time mothers spend with their children.

CONCLUSION

The study's results confirmed that mothers' health literacy had a positive and statistically significant effect on awareness of digital gaming addiction. As the health literacy levels of mothers increased, the internal and external awareness of digital gaming addiction increased. It is recommended to design intervention programs that increase mothers' awareness of digital game addiction. These programs should be planned according to the health literacy levels of mothers.

Altered local intrinsic neural activity and molecular architecture in internet use disorders

BACKGROUND

Internet gaming disorder (IGD) is mainly characterized by its core dysfunction in higher-order brain cortices involved in inhibitory control, whose neurobiological basis remains unclear. Then, we will investigate local intrinsic neural activity (INA) alterations in IGD, ascertain whether these potential alterations are related to clinical characteristics, and further explore the underlying molecular architecture.

METHOD

In this study, we performed the fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo) derived from resting-state functional magnetic resonance imaging (rs-fMRI) to explore the impact of IGD on local INA. Correlation analysis revealed the relationship between ReHo and fALFF in terms of group differences and clinical characteristics. Moreover, correlations between fALFF, ReHo, and PET- and SPECT-driven maps were investigated to elucidate the specific molecular architecture alternations in IGD. Finally, receiver operating characteristic curve (ROC) analysis was used to show the potential abilities of fALFF and ReHo in distinguishing individuals with IGD (IGDs) from healthy controls (HCs).

RESULT

Compared with HCs, IGDs revealed increased ReHo and fALFF in the prefrontal cortex. Significantly decreased ReHo was observed in the temporal lobe, occipital lobe, and cerebellum. In addition, the ReHo values in the cerebellum_7b_R were positively correlated with internet addiction severity. ROC curve analysis showed that ReHo and fALFF-altered brain regions could effectively distinguish IGDs from HCs. More importantly, cross-modal correlations revealed local INA changes in brain regions associated with the monoamine neurotransmitter system and the less studied cholinergic/GABAergic system.

CONCLUSION

These results suggest that local functional impairments are shown in the audiovisual and inhibitory control circuits in IGDs. This may be associated with underlying neurotransmitter system alterations. Therefore, this study provides the possibility of GABAergic receptor agonists and cholinergic receptor inhibitors for the treatment of IGD.

The mediating role of social connectedness and negative cognitive emotion regulation in the association between problematic Internet use and depression among adolescents

Introduction

While the relationship between adolescent problematic Internet use (PIU) and depression has been extensively researched, few studies have investigated the role and mechanisms of social connectedness (SC) in this context. This study aimed to investigate the mediating effect of social connectedness (SC) and cognitive emotion regulation (CER) in the relationship between PIU and depression.

Methods

We conducted a cross-sectional study involving 9,407 adolescents aged 12-18 years in China from September 2022 to March 2023. We employed Young's 20-item Internet Addiction Test (IAT-20), the Social Connectedness Scale-Revised (SCS-R), the Cognitive Emotion Regulation Scale (CER), and the DSM-5 Level-2 Depression Scale to assess mental health outcomes. Logistic regression analysis was also performed to examine the independent association between the measured variables and depression. Mediation analysis was then conducted to evaluate the mediating roles of social connectedness and cognitive emotion regulation in the relationship between PIU and depression.

Results

We found that the prevalence of PIU was 21.8%. Offline SC (indirect effect: 0.112, 95% CI: 0.104-0.121) and negative CER (indirect effect: 00.140, 95% CI: 0.129-0.152) mainly played a parallel mediating role in the relationship between PIU and depression, along with online SC (on_SC) (indirect effect: 0.007, 95% CI: 0.005-0.010).

Discussion

These findings provide valuable insights into how PIU is associated with depression and highlight the importance of fostering real-life interpersonal interactions. However, the generalizability of this study's findings to other populations may be limited due to cultural factors.

Investigating the mechanisms of internet gaming disorder and developing intelligent monitoring models using artificial intelligence technologies: protocol of a prospective cohort

BACKGROUND

Internet gaming disorder (IGD), recognized by the World Health Organization (WHO), significantly impacts adolescent mental and physical health. With a global prevalence of 3.05%, rates are higher in Asia, especially among adolescents and males. The COVID-19 pandemic has exacerbated IGD due to increased gaming time from isolation and anxiety. Vulnerable groups include adolescents with poor academic performance, introverted personalities, and comorbid mental disorders. IGD mechanisms remain unclear, lacking prospective research. Based on Skinner's reinforcement theory, the purpose of this study is to explore the mechanisms of IGD from individual and environmental perspectives, incorporating age-related changes and game features, and to develop intelligent monitoring models for early intervention in high-risk adolescents.

METHODS

This prospective cohort study will investigate IGD mechanisms in middle and high school students in Shenzhen, China. Data will be collected via online surveys and Python-based web scraping, with a 3-year follow-up and assessments every 6 months. Unstructured data obtained through Python-based web scraping will be structured using natural language processing techniques. Collected data will include personal characteristics, gaming usage, academic experiences, and psycho-behavioral-social factors. Baseline data will train and test predictive models, while follow-up data will validate them. Data preprocessing, normalization, and analysis will be performed. Predictive models, including Cox proportional hazards and Weibull regression, will be evaluated through cross-validation, confusion matrix, receiver operating characteristic (ROC) curve, area under the curve (AUC), and root mean square error (RMSE).

DISCUSSION

The study aims to understand the interplay between individual and environmental factors in IGD, incorporating age-related changes and game features. Active monitoring and early intervention are critical for preventing IGD. Despite limitations in geographic scope and biological data collection, the study's innovative design and methodologies offer valuable contributions to public health, promoting effective interventions for high-risk individuals.

Resting-state brain networks alterations in adolescents with Internet Gaming Disorder associate with cognitive control impairments

Objective

Research indicates that cognitive control is compromised in individuals with internet gaming disorder (IGD). However, the neural mechanisms behind it are still unclear. This study aims to investigate alterations in resting-state brain networks in adolescents with IGD and the potential neurobiological mechanisms underlying cognitive dysfunction.

Materials and methods

A total of 44 adolescent IGD subjects (male/female: 38/6) and 50 healthy controls (male/female: 40/10) were enrolled. Participants underwent demographic assessments, Young's Internet Addiction Scale, Barratt Impulsiveness Scale 11 Chinese Revised Version, the Chinese Adolescents' Maladaptive Cognitions Scale, exploratory eye movement tests, and functional magnetic resonance imaging (fMRI). FMRI data were analyzed using the GIFT software for independent component analysis, focusing on functional connectivity within and between resting-state brain networks.

Results

In comparison to the control group, impulsivity in adolescent IGD subjects showed a positive correlation with the severity of IGD (r=0.6350, p < 0.001), linked to impairments in the Executive Control Network (ECN) and a decrease in functional connectivity between the Salience Network (SN) and ECN (r=0.4307, p=0.0021; r=-0.5147, p=0.0034). Decreased resting state activity of the dorsal attention network (DAN) was associated with attentional dysregulation of IGD in adolescents (r=0.4071, p=0.0017), and ECN increased functional connectivity with DAN. The degree of IGD was positively correlated with enhanced functional connectivity between the ECN and DAN (r=0.4283, p=0.0037).

Conclusions

This research demonstrates that changes in the ECN and DAN correlate with heightened impulsivity and attentional deficits in adolescents with IGD. The interaction between cognitive control disorders and resting-state brain networks in adolescent IGD is related.

Physiological Regularity and Synchrony in Individuals with Gaming Disorder

Individuals with gaming disorder (GD) show emotional dysregulation and autonomic dysfunction in daily life. Although studies have shown that the relaxation method of breathing exercise (BE) improves cardiopulmonary synchrony, the physiological regularity and synchrony of GD remain unclear. In this study, we investigated the regularities of pulse wave (PW), thoracic wall movement (TWM), and abdominal wall movement (AWM) using sample entropy (SE) and assessed the vascular-respiratory and TWM-AWM synchrony using cross-sample entropy (CSE). Twenty individuals with GD and 26 healthy control (HC) individuals participated in baseline, gaming, and recovery stages, both before and after BEs. The results showed that both groups had significantly higher SETWM, SEAWM, and CSETWM-AWM during gaming than baseline. Before BE, CSEPW-TWM and CSEPW-AWM during gaming were considerably higher in the GD group than in the HC group. Compared to before BE, both groups had decreased SETWM and CSETWM-AWM during gaming, particularly in the HC group. Online gaming may induce pulse wave and respiratory irregularities, as well as thoracic-abdominal wall movement asynchrony. Individuals with GD who engage in prolonged gaming periods may exhibit lower vascular-respiratory synchrony compared to the HC group. SETWM, SEAWM, CSETWM-AWM, CSEPW-TWM, and CSEPW-AWM may serve as biomarkers for assessing the risk of GD. BE may improve TWM regularity and vascular-respiratory synchrony during gaming, potentially alleviating addictive behavior.

Exploring the association between online gaming addiction and academic performance among the school-going adolescents in Bangladesh: A cross-sectional study

Background and Aims

The pervasive nature of online gaming, notably accentuated during the COVID-19 pandemic, has spurred concerns regarding gaming addiction among children. This study explores the intricate ramifications of online gaming addiction on the academic performance and social dynamics of children in Bangladesh. Our primary objective is to gauge the extent of online gaming addiction and unravel its profound effects on academic performance.

Methods

Conducting a nationwide survey from January 1, 2023, to June 30, 2023, we analyzed 502 responses from participants aged 6-17 years. The survey encompassed sociodemographic details, gaming addiction assessment, and academic performance following a simple random sampling method. We analyzed participant demographics utilizing descriptive statistics, chi-square tests, and logistic regression.

Results

Key findings revealed a majority within the 13-17 age bracket (75.50%), predominantly male (58.57%), and enrolled in secondary education (83.27%). A robust inverse relationship showed that nonaddicted students towards online gaming had higher academic performance. Therefore, it is important to implement targeted strategies to address online gaming addiction among Bangladeshi children.

Conclusion

Recommending early intervention, academic initiatives, and holistic therapy, we advocate for collaboration among educational institutions, mental health professionals, parents, and policymakers. All of these initiatives are essential to navigate the evolving challenges presented by gaming addiction. Furthermore, our call for ongoing research seeks to deepen our understanding of enduring consequences on academic and social dimensions, fostering a digitally supportive environment conducive to the holistic well-being of children.

Neuropsychological Deficits in Disordered Screen Use Behaviours: A Systematic Review and Meta-analysis

Over the last few decades, excessive and disordered screen use has become more prevalent, prompting investigations into its associated consequences. The extent to which disordered screen use behaviours impact neuropsychological functioning has been reportedly mixed and at times inconsistent. This review sought to synthesise the literature and estimate the magnitude of overall cognitive impairment across a wide range of disordered screen use behaviours. We also sought to determine the cognitive domains most impacted, and whether the observed impairments were moderated by the classification of screen-related behaviours (i.e., Internet or gaming) or the format of cognitive test administration (i.e., paper-and-pencil or computerised). A systematic search of databases (Embase, PsycINFO, MEDLINE) identified 43 cross-sectional articles that assessed neuropsychological performance in disordered screen use populations, 34 of which were included in the meta-analysis. A random-effects meta-analysis revealed significant small/medium (g = .38) cognitive deficits for individuals with disordered screen use behaviours relative to controls. The most affected cognitive domain with a significant medium effect size (g = .50) was attention and focus followed by a significant reduction in executive functioning (g = .31). The classification of disordered screen use behaviours into Internet or gaming categories or the format of cognitive testing did not moderate these deficits. Additionally, excluding disordered social media use in an exploratory analysis had little effect on the observed outcomes. This study highlights a number of methodological considerations that may have contributed to disparate findings and shows that disordered screen use can significantly impact cognitive performance. Recommendations for future research are also discussed. Data for this study can be found at https://osf.io/upeha/ .

The Relationship between video game addiction and bladder/bowel dysfunction in children

INTRODUCTION

Video games have a strong influence on children and adolescents. Video game addiction has negative effects on children's health.

OBJECTIVE

To determine the relationship between video game addiction and bladder/bowel dysfunction in children.

MATERIALS AND METHODS

Three hundred sixty-three children and their mothers who met the inclusion criteria constituted the sample of this correlational study. The data were collected using a descriptive information form, the Video Game Addiction Scale for Children, and the Childhood Bladder and Bowel Dysfunction Questionnaire.

RESULTS

We found that 72.5% of the children were nine years old and 27.5% were ten years old; 50.4% were males and 49.6% were female. While 4.7% of the children who participated in the study were underweight, 19.6% were overweight, and 17.9% were obese. The mean Video Game Addiction Scale for Children score was 50.77 ± 16.17, whereas the mean Childhood Bladder and Bowel Dysfunction Questionnaire score was 29.98 ± 8.90. The ratio of children with a mean Video Game Addiction Scale for Children scores equal to or greater than 90 was 0.8% (n = 3). We found that 3.6% (n = 13) of the children had urinary/fecal incontinence while playing video games. There was a weak positive relationship between the dimensions of the Video Game Addiction Scale for Children scores, the Childhood Bladder and Bowel Dysfunction Questionnaire scores, and children's bladder and bowel function (r = 0.220; p ˂ 0.05).

CONCLUSIONS

There is a correlation between children's video game addiction level and their bladder and bowel dysfunction grade. Higher video game addiction levels correspond to higher bladder and bowel dysfunction.

Longitudinal Dynamic Relationships Between Videogame Use and Symptoms of Gaming Disorder and Depression Among Chinese Children and Adolescents

Although previous studies have shown a close relationship between gaming disorder and depressive symptoms, few have measured normal videogame use, symptoms of gaming disorder, and depressive symptoms concurrently. The longitudinal dynamics between these variables remain unclear. This study used two demographic cohorts to examine the longitudinal relationship between gaming and depressive symptoms: children (n = 1513, 46.9% girls, Mage ± SD = 9.63 ± 0.58 years) and adolescents (n = 1757, 48.5% girls, Mage ± SD = 12.55 ± 0.70 years). Random intercept cross-lagged panel models (RI-CLPMs) were employed to distinguish between within- and between-person levels of gaming and depressive symptoms. The RI-CLPM results showed a stable link between symptoms of gaming disorder and depression at the between-person level for both children and adolescents. At the within-person level, among children, depressive symptoms positively predicted subsequent gaming disorder symptoms, but gaming disorder symptoms were not a significant predictor of depressive symptoms at this level. Among adolescents, there was no significant cross-lagged effect between symptoms of gaming disorder and depression at the within-person level. Additionally, there was no significant cross-lagged effect between normal videogame use and depressive symptoms in either cohort. These results highlight the different effects of normal videogame use and gaming disorder symptoms associated with depressive symptoms. The different effects on children and adolescents underscore the importance of considering the different developmental stages in the study of gaming and mental health outcomes.

Factorial structure of the Internet Gaming Disorder questionnaire in the Italian setting: a single-factored ailment or a multifaceted condition?

INTRODUCTION

Internet Gaming Disorder (IGD) according to DSM-5 is a behavioral addiction needing additional study. IGD in youth is correlated with anxiety, depression, attention problems, interpersonal problems, social phobia, behavior problems and low academic achievement. The aim of the present research is to contribute to the understanding of the disorder, by providing preliminary data on the factorial structure of the IGD Questionnaire in the Italian version.

PARTICIPANTS

612 Italian students (323 females), mean of age = 13.94 (SD = 2.44). Instruments: a survey comprising IGD Questionnaire, Internet Addiction Test (IAT), Children's Coping Strategies Checklist (CCSC-R1), Assessment of Interpersonal Relations (AIR), and Child Behavior Checklist (CBCL).

RESULTS

15.2% of participants showed a sub-clinical IGD and 2.1% met the full diagnostic criteria. Participants with IGD showed lower scores in interpersonal relationships, worse coping strategies and higher scores in externalization. The factorial structure of the IGD Questionnaire highlights 4 factors ("addiction", "gaming as coping", "impaired control" and "negative outcomes") that explain 52.14% of the variance. A single-factor solution was also tested and results seem to be coherent with the four-factor solution, explaining less variance.

CONCLUSIONS

IGD is a complex clinical condition that can be thought both as a single-factored and as a multi-faceted condition.

Going beyond video game consumption when considering Internet Gaming Disorder

BACKGROUND

Recognizing the crucial importance of understanding the impact of video games on health in today's gaming-dominated world, our study aimed to investigate the relationship between gaming time and Internet Gaming Disorder (IGD). Despite the widespread assumption that a connection exists between both, previous studies have revealed highly variable associations, highlighting significant weaknesses in establishing a robust link.

METHODS

To unravel this complex relationship, we recruited two independent samples of League of Legends players. We combined the collection of self-reported and actual gameplay data, together with assessments of mental health, personality traits, and cognitive abilities.

RESULTS

Surprisingly, none of the gaming variables demonstrated a robust and stable association with IGD, regardless of whether players spent less than or more than 30 hours per week gaming-a threshold suggested by the American Psychiatric Association as a potential indicator of disordered gaming. Notably, mental health factors, such as anxiety, depression and ADHD, emerged as the most influential predictors of IGD.

CONCLUSION

These findings, replicated across two independent samples, challenge the prevailing belief that limiting screen time alone effectively combats IGD. Instead, mental health factors play a crucial role in mitigating risks associated with gaming. Policies focusing solely on restricting screen time are insufficient in reducing the prevalence or symptoms of IGD. Rather, a comprehensive approach that considers mental health and key personality traits must be adopted to safeguard the well-being of individuals engaged in gaming.

Trajectories of Problem Behaviors and Information Technology Use Among Adolescents: A Latent Growth Model Using the Korean Children and Youth Panel Survey

We investigated the association between computer and mobile phone online activities and adolescents' problem behaviors (e.g., depressive symptoms, withdrawal, somatic complaints, attention deficit, and aggression) using data from the Korean Children and Youth Panel Survey and latent growth model analysis. The results demonstrated that text-related activities lowered withdrawal and attention deficit. Higher use of online communities or personal websites was associated with higher depressive symptoms, withdrawal, somatic symptoms, and aggression. Online gaming increased both attention deficit' initial value and its decrease rate. Taking photos decreased withdrawal. Watching videos increased depressive symptoms, withdrawal, and attention deficit. Listening to music lowered attention deficit' initial value and somatic symptoms' decrease rate. Accessing adult websites increased attention deficit and aggression. Educational information searches reduced attention deficit and aggression. Online transactions increased somatic symptoms. This study indicates that adolescents' problem behaviors may appear differently depending on the type of information technology use.

Cognitive-behavioral statuses in depression and internet gaming disorder of adolescents: A transdiagnostic approach

To investigate the comorbidity of adolescent depression and Internet gaming disorder (IGD) and their shared and unique cognitive-behavioral factors (i.e., self-esteem, dysfunctional attitudes, hopelessness, and coping), a large-scale school-based survey was conducted among 3147 Chinese secondary school students in Hong Kong. Probable depression and IGD were screened using the Centre for Epidemiological Studies-Depression Scale and DSM-5 IGD checklist, respectively. Multinomial logistic regression was performed to identify the associations between different condition statuses and cognitive-behavioral factors. Four groups were identified, including comorbidity group (having probable depression and IGD), IGD group (having probable IGD alone), depression group (probable depression alone), and healthy group (neither condition). Comorbidity group showed the worst cognitive-behavioral statuses, followed by depression group and then IGD group. Compared with healthy group, those with lower self-esteem and higher hopelessness and dysfunctional attitudes were more likely to be classified into depression group and comorbidity group, while maladaptive coping was positively associated with all three disorder groups. The results suggest that depression and IGD may share common cognitive-behavioral mechanisms (e.g., maladaptive coping) but also own their uniqueness regarding specific factors (e.g., hopelessness and self-esteem). A transdiagnostic intervention approach targeting the common factors may effectively address the comorbidity.

Longitudinal Relationships Between School Climate, Academic Achievement, and Gaming Disorder Symptoms Among Chinese Adolescents

Despite growing concerns regarding the development of gaming disorder symptoms among adolescents, the longitudinal relationship between school factors and gaming disorder symptoms remains far from being fully understood. This two-year longitudinal study examined the relationship between school climate perceptions, academic achievement, and gaming disorder symptoms among three distinct demographic cohorts: preadolescents (n = 1513; 46.9% girls, Mage = 10.64 years, SD = 0.56), early adolescents (n = 1771; 48.3% girls, Mage = 13.54 years, SD = 0.70), and late adolescents (n = 2385; 50.1% girls, Mage = 16.41 years, SD = 0.59). A four-wave study was conducted (six months apart) using random intercept cross-lagged panel models (RI-CLPMs) to separate the within-person (state level) from the between-person (trait level) effects. The results obtained from the RI-CLPMs indicated that fluctuations in school climate perceptions negatively predicted subsequent changes in gaming disorder symptoms among preadolescents at the within-person level, but not among early and late adolescents. Fluctuations relating to gaming disorder symptoms also negatively predicted subsequent changes regarding academic achievement in late adolescents, but not in preadolescents and early adolescents. The effect of school-related factors on gaming disorder symptoms varies across different developmental stages. While preadolescents may represent a particularly susceptible subgroup for gaming disorder in terms of being predicted by their school environment, late adolescents appear to be more vulnerable to predictors of gaming disorder symptoms. The current study also discusses the implications of school-wide programs aimed at improving school climate and preventing the development of gaming disorder symptoms during key developmental periods.

Gaming Disorder: The role of a gamers flow profile

Digital games are widely popular and integral to contemporary entertainment. Nevertheless, a proportion of users present with disordered/excessive gaming behaviours, provisionally classified as Internet Gaming Disorder (IGD). Previous literature suggests examining the contribution of an individual's profile of immersive engagement with their gaming activity, known as online flow, for disordered gaming behaviours. Therefore, the main goals of this study were (1) to categorise gamers into distinct profiles based on their online flow experiences and (2) to investigate the differences in disordered gaming among these different flow profiles. A sample of 565 gamers (12-68 years, Mage = 29.3 years) was assessed twice over six months with the Online Flow Questionnaire (OFQ), the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), and the Gaming Disorder Test (GDT). Latent profile analysis (LPA) identified five distinct profiles encompassing 'High-Flow with High Loss of Control' (HF-HLOC; 14.0 %), 'Low Flow with Low Enjoyment' (LF-LE; 11.9 %), 'Average Flow with Low Enjoyment' (AF-LE; 17.5 %), 'Low Flow with High Enjoyment' (LF-HE; 20.2 %), and 'High Loss of Sense of Time with Low Loss of Control' groups (HLOT-LLOC; 36.5 %). As hypothesised, individuals across varying profiles evidenced differences in their concurrent and longitudinal disordered gaming behaviours. Overall, findings suggest that 'loss of sense of time' may be the most pivotal factor in differentiating flow states and profiles during gaming, advocating its consideration in disordered gaming assessment and treatment.

Internet addiction among school adolescents in Jeddah-Saudi Arabia

BACKGROUND

Internet addiction is increasing among adolescents worldwide. There is a lack of research assessing internet addiction and factors contributing to it among adolescents in Jeddah city. The current study aimed to assess the rate of internet addiction among adolescents in Jeddah, Saudi Arabia, and the potential factors associated with it.

METHODS

A cross-sectional online survey, hosted by SurveyMonkey, was used to capture data on internet use from 462 adolescents aged 12-18 years between March and May 2022. Young's Internet Addiction Scale was used to assess the degree of internet addiction as perceived by adolescents. Multiple linear regression analysis was used to identify possible predictors of internet addiction among adolescents in Jeddah.

RESULTS

The mean age of the participants was 15.5 ± 1.9 years. The majority were females (75%) from public schools (63%), spent an average of six hours on the internet daily, owned smartphones (98%), accessed the internet via a smartphone (94%), and used the internet for socializing (82%). Internet addiction mean score was 39.20 ± 15.20 out of 100. More than two-thirds of the participants had mild to moderate levels of internet addiction (68%). Significant predictors contributing to internet addiction were using the internet for socialization and playing online games. The more hours spent on the internet daily, the more the internet addiction was (p ≤ 0.05).

CONCLUSIONS

The internet addiction rate is high among school adolescents in Jeddah. The majority of high school adolescents had mild to moderate levels of internet addiction. Interventional multidisciplinary programs are needed to mitigate the factors that influence internet addiction.

Disrupted inter-brain synchronization in the prefrontal cortex between adolescents and young adults with gaming disorders during the real-world cooperating video games

BACKGROUND

Gaming disorder (GD) and hazardous gaming (HG) have a high incidence among adolescents and young adults and have caused various negative consequences. Interpersonal interaction deficits are closely related to GD and HG, however, the underlying brain mechanisms are still unclear.

METHODS

The current study recruited 46 healthy subjects and 32 subjects with GD/HG. Gaming time and frequency, gaming disorder risks, life events, strengths, and difficulties were measured with scales. Subjects were randomly paired into 12 HC-HC dyads, 15 GD/HG-HC dyads, and 7 GD/HG-GD/HG dyads and in pairs completed a real-world cooperating video game - "Tied Together" with functional near-infrared spectroscopy hyperscanning recording in the prefrontal cortex. The inter-brain synchronization in each region of the PFC between dyads was calculated by wavelet to transform coherence to measure brain-to-brain synchronization.

RESULTS

We found subjects with GD/HG reported higher risks of gaming. The highest IBS in the left dorsolateral prefrontal cortex significantly decreased in the GD/HG-HC and GD/HG-GD/HG dyads compared with healthy controls. A decreasing highest IBS of the left dlPFC was related to a decreasing level of peer problems.

LIMITATIONS

We declare limitations of age gaps of samples, undistinguishing GD from HG, use of sub-samples, and the broad concept of interpersonal interaction.

CONCLUSIONS

The current study found a decreased highest IBS in the left dlPFC among adolescents and young adults with gaming diseases. It may provide new prevention and treatment insights into gaming disorders targeting disrupted interpersonal interaction.

The mediating effect of dispositional mindfulness on the association between UPPS-P impulsivity traits and gaming disorder among Asia-Pacific young adults

BACKGROUND

Little evidence is available to verify the mediating effect of dispositional mindfulness on the association between gaming disorder and various impulsivity traits. The present study aimed to investigate the mediating effect of dispositional mindfulness on the association between the five UPPS-P impulsivity traits and the risk of gaming disorder among young adults.

METHODS

It was an inter-regional cross-sectional study using online survey in Australia, Japan, The Philippines and China. Impulsivity measured by the UPPS-P Impulsive Behavior Scale-Short version; dispositional mindfulness measured by the Mindfulness Attention Awareness Scale; and the risk of gaming disorder measured by the Internet Gaming Disorder Scale were collected in the focal regions. Structural equation modeling was performed by SPSS AMOS version 26 to verify the study hypotheses. Bootstrapped 95% confidence interval was reported. Statistical significance was indicated by the p-value below 0.05.

RESULTS

Among the 1,134 returned questionnaires, about 40% of them aged 18-20 years and 21-23 years, respectively. 53.8% were male. 40.7% had been playing digital and video games for over 10 years. The prevalence of gaming disorder was 4.32%. The model fitness indices reflected that the constructed model had an acceptable model fit (χ2(118) = 558.994, p < 0.001; χ2/df = 4.737; CFI = 0.924; TLI = 0.890; GFI = 0.948; RMSEA = 0.058; SRMR = 0.0487). Dispositional mindfulness fully mediated the effect of positive urgency and negative urgency on the risk of gaming disorder. The effect of lack of premeditation on the risk of gaming disorder was partially mediated by dispositional mindfulness. However, dispositional mindfulness did not mediate the effect of sensation seeking on the risk of gaming disorder.

CONCLUSIONS

The varied associations between dispositional mindfulness and the five impulsivity traits hints that improving some impulsive traits may increase dispositional mindfulness and so lower the risk of gaming disorder. Despite further studies are needed to verify the present findings, it sheds light on the need to apply interventions on gamers based on their impulsivity profile. Interventions targeting at emotion regulation and self-control such as mindfulness-based interventions seem to be effective to help gamers with dominant features of urgency and lack of premeditation only. Other interventions shall be considered for gamers with high sensation seeking tendency to enhance the effectiveness of gaming disorder prevention.

Novel rat model of gaming disorder: assessment of social reward and sex differences in behavior and c-Fos brain activity

RATIONALE

In 2018, the International Classification of Diseases (ICD-11) classified Gaming Disorder (GD) as a mental disorder. GD mainly occurs among adolescents, who, after developing addiction, show psychopathological traits, such as social anxiety, depression, social isolation, and attention deficit. However, the different studies conducted in humans so far show several limitations, such as the lack of demographic heterogeneity and equal representation of age, differences in the type of game and in the follow-up period. Furthermore, at present, no animal models specific to GD are available.

OBJECTIVES

To address the lack of an experimental model for GD, in the present work, we proposed a new GD rat model to investigate some peculiar tracts of the disorder.

METHODS

Two-month-old Wistar Kyoto rats, both males and females, were subject to a five-week training with a new innovative touch-screen platform. After five weeks of training, rats were assessed for: (a) their attachment to the play under several conditions, (b) their hyperactivity during gaming, and (c) the maintenance of these conditions after a period of game pause and reward interruption. After sacrifice, using immunohistochemistry techniques, the immunoreactivity of c-Fos (a marker of neuronal activity) was analyzed to study different neural areas.

RESULTS

After the training, the rats subjected to GD protocol developed GD-related traits (e.g., hyperactivity, loss control), and the behavioral phenotype was maintained consistently over time. These aspects were completely absent in the control groups. Lastly, the analysis of c-Fos immunoreactivity in prelimbic cortex (PrL), orbitofrontal cortex (OFC), nucleus Accumbens, amygdala and bed nucleus of stria terminalis (BNST) highlighted significant alterations in the GD groups compared to controls, suggesting modifications in neural activity related to the development of the GD phenotype.

CONCLUSIONS

The proposal of a new GD rat model could represent an innovative tool to investigate, in both sexes, the behavioral and neurobiological features of this disorder, the possible role of external factors in the predisposition and susceptibility and the development of new pharmacological therapies.

Sociotropy and video game playing: Massively multiplayer online role-playing games versus other games

INTRODUCTION

Internet Gaming Disorder (IGD) is associated with several psychiatric disorders. Previous research on IGD has predominantly focused on Massively Multiplayer Online Role-playing Games (MMORPGs), considered to be pro-social games as they foster interpersonal relationships necessary for in-game progress. Sociotropy is a personality trait characterized by a cognitive approach to dealing with interpersonal relationships. Individuals with high sociotropy have a strong desire for approval from others. Beck's cognitive theory of depression posits that high sociotropy can lead to depressive symptoms when faced with interpersonal stress. We used the I-PACE model to account for the consequences of distal factors such as sociotropy on the development and maintenance of IGD. The aim of this study was therefore to compare MMORPG players with players of other game genres in terms of sociotropy, social anxiety and depression. We hypothesized that sociotropy could serve as a predictor of IGD, particularly among MMORPG players.

METHODS

A total of 233 French videogame players recruited from specialized internet gaming forums participated in the study via questionnaires. Different scales were used to assess depression and social anxiety symptoms, IGD intensity, and sociotropy and autonomy.

RESULTS & DISCUSSION

MMORPG players reported higher psychological distress than players of other game genres. For all players, sociotropy, rather than autonomy, was found to be a predictor of social anxiety symptoms and IGD intensity. Sociotropy and depression explained IGD intensity only for MMORPG players and not for players of other game genres. The social dimension appears to be more prominent among MMORPG players and could be one of the main personality traits predicting this specific internet gaming disorder. The treatment implications for internet gaming disorder are discussed.

[Digital media use and mental health in adolescents-a narrative review]

The opportunities and hazards of digital media, especially with regard to children and adolescents, are currently the subject of frequent family, school, and social debates.Digital platforms can support the accomplishment of adolescent developmental tasks through gaming and social exchange as well as communication and contact promotion, learning, and health promotion, and are widely used for entertainment. In Germany, almost all adolescents own a smartphone. During the COVID-19 pandemic, an intensification of the use of digital games, social media, and streaming offers by adolescents was observed. Exposure to age-uncensored content such as the depiction of violence, extreme political views, and conspiracy theories, as well as personal attacks through cyberbullying, unfiltered initiation of contact including cybergrooming, dysfunctional role models, and addiction-promoting aspects are associated with mental health risks.Cyberbullying affects about 5% of children and adolescents in Germany. A bidirectional relationship with mental health could be shown. The gaming disorder is the first digital media use disorder (DMUD) that has been included in the ICD-11 and thus internationally recognized as a mental illness. Adolescents are affected disproportionately often and experience impairments in their mental development and levels of functioning.Services are available to promote adolescent media literacy, and their expansion, structured application, and evaluation are needed. Evidence-based prevention and treatment options for DMUD are currently largely lacking. Their development, review, and dissemination should be further supported.

Comparisons of clinical subtypes, symptom severity, global functioning, emotional and behavior problems, and CPT test profiles in children and adolescents with ADHD with and without co-occurring internet gaming disorder

OBJECTIVES

This study aims to assess whether the presence of Internet Gaming Disorder (IGD) is associated with disease severity, Attention Deficit Hyperactivity Disorder(ADHD) presentation, emotional problems, behavioral problems, and CPT profile in patients with ADHD.

METHOD

Forty children with IGD and sixty-four patients without IGD were included in the study, all of whom had a diagnosis of ADHD. Comorbid psychiatric disorders were determined using The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Conners's Parent Rating Scale-Revised Short form (CPRS-RS), The Strengths and Difficulties Questionnaire (SDQ), Internet Gaming Disorder Questionnaire (IGD-20), and MOXO Continuous Performance Test (MOXO d-CPT) were performed on the children, and Clinical Global Impression (CGI), Children's Global Assessment Scale (CGAS), comorbidities and ADHD presentations were evaluated.

RESULTS

The IGD group was found to have the combined presentation of ADHD more commonly, and their CGI, CGAS, SDQ behavior problems subscale, cognitive problems, attention problems, and ADHD index in the CPRS-RS questionnaire were found to be higher (p < 0.05). No differences were found in attention, timing, impulsiveness, and hyperactivity scores in CPT between groups (p > 0.05).

CONCLUSION

Our study has shown that children with both ADHD and IGD had more severe symptoms, more behavioral problems, and differences regarding the prevalence of the ADHD presentations when compared to children having ADHD without IGD. Longitudinal studies with higher sample sizes are required to investigate this possible connection in the context of a cause-effect relationship and draw a conclusion.

Impaired control and gaming-related harm in relation to gaming Disorder

The concept of impaired control (IC) over gaming is an important element of assessment and interventions for problem gaming and gaming-related harm. Past studies have reported that gaming disorder (GD) is associated with various negative consequences, but there is limited research on the relationship between IC over gaming and negative outcomes. To address this gap, the study investigated the relationship between impaired control and gaming-related harm among individuals with self-identified gaming disorder. It was hypothesized that IC would be positively associated with gaming-related harm and harm severity. In addition, it was predicted that IC would be a significant predictor of harm when controlling for age, gender, psychological distress, and gaming urges. The current study recruited 513 participants through an online survey platform. The Impaired Control Over Gaming Scale (ICOGS) was used to measure IC, and modified items from Browne et al.'s taxonomy of gambling harms were used to assess gaming harm severity. The logistic regression results showed that IC was positively related to all forms of harm, after controlling for other variables. The predictive value of IC was similar across financial, psychological, relationship, social and work/school domains. These results supported the importance of IC as a mechanism that contributes to the experience of gaming-related harm, and the need to target IC in interventions for GD.

Internet Gaming Disorder and Mental Health Literacy: A Latent Profile Analysis of Korean Adolescents

OBJECTIVE

This study identified latent subtypes of mental health literacy (MHL) for Internet gaming disorder (IGD) and explored their characteristics and differences in various factors in adolescents.

METHODS

This study analyzed secondary data from the 2019 Youth Smart Digital Media Survey and included data from 1,936 middle and high school students (14-18 years old). Thirteen items of the MHL questionnaire were used for latent profile analysis. We compared the characteristics and predictors of the identified types using various statistical analyses, including one-way ANOVA, chi-square test, and multinomial logistic regression.

RESULTS

We identified three subtypes of MHL for IGD in adolescents: "low perception-prefer informal resources," "moderate perception-preferred resources unclear," and "high perception-prefer professional resources." Subtypes showed significant differences in sex, age, family affluence, e-learning time during weekdays, mental health risks, level of problematic smartphone use, and IGD. All variables except IGD predicted one or more latent types.

CONCLUSION

Practical interventions are required to improve IGD MHL, including customized prevention based on the differences between the three types.

Problematic video gaming is negatively associated with bone mineral density in adolescents

Adolescent bone health may be negatively impacted by problematic video gaming (PVG) due to factors such as prolonged screen time, poor sleep quality, and increased depression. Although sedentary behaviors have been linked to decreased bone mass, there is limited research on how PVG impacts bone health. We aimed to evaluate the association between PVG and bone mineral density (BMD) in adolescents by comparing the BMD z-scores of adolescents with and without PVG and by identifying PVG-related risk factors that may affect low BMD scores. This cross-sectional study took place between May 2019 and August 2021 with 110 adolescents who played video games for at least two hours per day. Data on screen time, game genre, tobacco, alcohol, caffeine consumption, and vigorous physical activity status were recorded. PVG was assessed using the Internet Gaming Disorder-Short Form (IGDS9-SF), with scores ≤ 16 comprising the control group and > 16 the PVG group. Sleep quality was assessed by Pittsburgh Sleep Quality Index, and depression was evaluated by Children's Depression Inventory. Dual-energy X-ray absorptiometry measurements of femoral neck and lumbar spine BMD were compared between the two groups. The mean age of the participants was 14.2 ± 1.8 years, and 86.4% were males. The PVG group exhibited lower femoral neck z-scores (p = 0.013) and a higher proportion of adolescents with low femoral neck BMD risk (27.8% vs 9.7%, p = 0.041). Lumber spine z-scores did not differ (p = 0.271). Despite poorer depressive symptoms and sleep quality in the PVG group, they were not associated with low BMD risk (OR 1.02, 95% CI 0.97-1.08, p = 0.398 and OR 1.00, 95% CI 0.87-1.18, p = 0.972, respectively). Among all PVG-related risk factors, video game time (aOR = 1.22, 95% CI = 1.06-1.41, p = 0.006) and vigorous physical activity amount (aOR = 2.86, 95% CI = 0.93-8.76, p = 0.080) showed the strongest associations with femoral neck z-scores.  Conclusion: The results of this study, showing a negative association between PVG and femoral neck BMD in adolescents, underscore the importance evaluating, monitoring, and supporting lower extremity bone health in adolescents with PVG. What is Known: • Adolescents with problematic video gaming are at risk for depression, impaired sleep; sedentary lifestyle; consumption of tobacco, alcohol, and drugs; and high caffeine intake. • These risk factors might lead to compromised bone health. What is New: • Problematic video gaming is associated with the low femoral neck bone mineral density risk in adolescents. • Extended video game time and reduced physical activity are found to be the primary risk factors.

Disorder and rehabilitation: The paradox of digital games and vulnerabilities

BACKGROUND

The impact of digital gaming on human health, both mental and physical, can be both positive and negative. However, excessive gaming can lead to gaming disorders, which are a cause for concern. With the pandemic, online classes became more common, leading to an increase in gaming-related disorders and even suicides. While the combination of education and fun in online gaming can be beneficial, it can also be a risk for gaming disorders and suicide. This study aimed to explore this paradox and provide safety measures to prevent gaming disorders.

MATERIALS AND METHODS

A qualitative research methodology with exploratory and discourse analysis was used in the study. Several real-life incidents related to the research were gathered from newspaper research articles, media, and existing theses. The researchers used textual interpretation in secondary sources to identify the paradox of digital games and vulnerabilities.

RESULTS

This research article focuses on the various benefits and harmful effects of digital games on individuals' mental and physical health. The research findings were presented based on true events that occurred in and around India. The results of the current study specified that gaming disorders were pushing individuals toward mental disorders and suicide. It is crucial to implement preventive measures to address this issue.

CONCLUSION

According to the study, people who suffer from excessive gaming disorders may experience anxiety, depression, and even suicidal thoughts, which can have negative effects on society. To address this issue, it is helpful to monitor and control individuals' digital game usage and provide informative sessions on how to use digital games properly. While it may not be possible to completely ban the use of digital games, certain restrictions can be put in place. Educating individuals on both the benefits and drawbacks of digital gaming and the rapid technological advancements is essential. Through proper education, it is possible to reduce the number of suicides among gamers and individuals.

Emotional dysregulation predicts problematic gaming in children and youths: a cross-sectional and longitudinal approach

Adolescents show a high vulnerability for addictive gaming patterns on the one hand and immature emotion regulation (ER) abilities as a risk factor for mental disorders on the other hand. We investigated the predictive value of ER difficulties on problematic gaming (PG) considering age groups (children vs. youths) and gender cross-sectionally and prospectively in a representative sample of German adolescents via online survey with two measurement points 14 months apart. General Poisson, logistic, and multinomial regression models were estimated to predict gaming patterns by ER difficulties controlling for age group and gender. Results revealed ER difficulties to be significantly associated with PG. Moreover, subgroup analyses indicated differing ER patterns for children vs. youths and boys vs. girls: for children, higher PG values were associated with emotional awareness and emotional clarity whereas for youths it was the acceptance of emotional responses. Moreover, gender differences implicated that boys with PG had more deficits in goal-oriented behavior as well as emotional awareness while affected girls were lacking emotional clarity and had problems with the acceptance of their emotional responses. Interestingly, procrastination was a significant predictor for PG irrespective of subgroups. Furthermore, longitudinal analyses indicated that difficulties in ER promoted PG while stronger procrastination tendencies maintained it. With the inclusion of procrastination, which can be understood as a maladaptive ER strategy, a broader picture of ER difficulties as a risk factor for PG could be drawn. The findings support a better understanding of PG etiology and the development of targeted prevention and intervention measures.

Treatment effects of therapeutic interventions for gaming disorder: A systematic review and meta-analysis

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.

Stress and suicide risk among adolescents: the role of problematic internet use, gaming disorder and emotional regulation

BACKGROUND

Previous studies have associated videogame playing and social media use with suicidal behaviors together with lower stress coping or poor emotion regulation strategies. Due to the inconclusive evidence regarding the factors associated with suicidal behavior, the present study aimed to overcome the limitations of previous research and explored the relationship between adolescent stress, problematic internet use (PIU), gaming disorder (GD), and emotional regulation (ER) in a cross-section design. It was hypothesized that stress would have a direct effect on suicide risk (SR) as well as being mediated by PIU, GD, and ER.

METHODS

The participants comprised 430 adolescents (58.4% male) aged between 16 and 19 years. They completed an online survey including the Mobile-Related Experiences Questionnaire, Internet Gaming Disorder Scale-Short Form, Meta-Mood Trait Repair Scale, and Spanish version of the Suicidal Behaviors Questionnaire.

RESULTS

A total of 34.2% of the adolescents (N = 147) were at risk for SR. Results also indicated that 30,7% had experienced suicidal ideation at some point in their life, 12.1% had at least one plan to die by suicide, and 5.1% had attempted suicide. Results of path analysis confirmed that stress appeared to be a risk factor for suicide, but that its effects were not mediated by PIU. However, ER and GD mediated the effect of stress on SR. The results suggest that stress is a main risk factor for suicide, especially among adolescents with poor emotional regulation or problematic gaming.

CONCLUSIONS

Considering the prevalence of suicide among adolescents, the results of the present study suggest that suicide prevention programs should include emotional regulation strategies, stress coping, and videogaming management skills in the early stages of high school. Providing these protective resources to adolescents will help them face the stressful and changing situations typical of adolescence and will help them to attain greater well-being and satisfaction with life.

Familial context influences media usage in 0- to 4-year old children

Background

The use of digital media (e.g., smartphones, tablets, etc.) and the Internet have become omnipresent for every age group and are part of children's and parents' everyday life. Focusing on young children, the availability of media devices, their use as well as associated problems (e.g., in social, emotional and motor development) have increased in recent years. Of particular interest for prevention of these problems in early childhood is the relationship between the familial context (parental digital media use, Problematic Internet Use, school graduation, presence of siblings) and the digital media use of infants and toddlers. The present study's goal was to describe media usage in 0-4-year-old children and to identify the potential relationship between familial context factors and child media usage.

Methods

The sample included N = 3,035 children aged 0 to 3;11 years (M = 17.37 months, SD = 13.68; 49.13% female). Recruitment took place within the framework of a restandardization study for a German developmental test. The parents of the participants answered a questionnaire on socio-demographics, on child media use, and on parental media use. Questions on parental media use included the full version of the Short Compulsive Internet Use Scale (S-CIUS).

Results

Significant increases in media usage times with child age were identified, but no significant gender differences. A multiple regression analysis revealed that increasing maternal total media usage time, a higher parental S-CIUS score, lower school leaving certificate of both mother and father, and increasing child's age led to higher child media usage time. Having siblings diminished young children's media usage in this study. Having more than one child and having children aged over a year was associated with a higher parental S-CIUS score.

Conclusion

Family factors such as maternal media use time, Problematic Internet Use and lower school graduation are significantly associated with young children's digital media use. Parents should be aware of their personal influence on their children's media use which might be due their role in terms of model learning.

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

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

Social norms and problematic gaming among adolescents: The role of Internet use coping motives

INTRODUCTION

Problematic gaming (PG) is a public health issue among adolescents worldwide. Although several studies have documented that peer influences constitute a relevant risk factor for adolescent problematic behaviors, little research is currently available on PG. The aim of this study was to examine the contribution of social norms and perceived friends' gaming frequency on participants' own gaming frequency and PG, by testing potential differences among groups with low vs. high motive to use the Internet (e.g., online gaming) as a coping strategy.

METHOD

A survey was administered to 470 adolescent gamers (mean age = 15.49 years; SD = 1.05 years; 77.9 % males). A theoretical model was tested through path analysis and multi-group comparisons were performed.

RESULTS

Path analysis revealed that social norms and perceived friends' gaming frequency were positively associated to participants' gaming behaviors and PG. Additionally, different patterns between groups emerged.

CONCLUSION

Our findings confirmed the relative importance of peer influences on adolescents' gaming behaviors and PG and showed that adolescents who rely more on online gaming to cope with negative affect may be more vulnerable to social influence processes than other peers. These findings may provide useful indications for prevention programs targeting adolescent PG.

Psychological distress and aggression among adolescents with internet gaming disorder symptoms

The present study aimed to investigate the current situation of internet gaming disorder (IGD) in Chinese adolescents and explore the impact of IGD-related factors on adolescent aggression. We hypothesized that IGD symptoms in adolescents would be associated with aggressive behavior and that risk factors for IGD symptoms could increase the aggressive tendencies of adolescents. To verify the above hypothesis, a cross-sectional survey of junior and senior high school students from southern, southwestern, central, and eastern China was conducted. A total of 9306 valid questionnaires were collected. The results showed that the prevalence of IGD symptoms was 1.78 % among Chinese adolescents. The adolescents in the disordered gamer group had the most severe IGD symptoms, with the highest levels of psychological distress and aggression. Interestingly, adolescents in the casual gamer group had the lowest psychological distress and aggression scores. Linear regression analysis further showed that higher levels of aggression were significantly associated with male sex, younger age, more severe psychological distress and IGD symptoms, and more violent game exposure. Our results suggested that excessive online gaming not only contributes to psychological distress in adolescents but also increases their levels of aggressive behavior. Apart from male sex and younger age, severe IGD symptoms and psychological distress are the most important predictors of the development of aggressive behavior.

Association between excessive screen time and school-level proportion of no family rules among elementary school children in Japan: a multilevel analysis

BACKGROUND

Excessive screen time (ST) in children is a global concern. We assessed the association between individual- and school-level factors and excessive ST in Japanese children using a multilevel analysis.

METHODS

A school-based cross-sectional study was conducted in Toyama, Japan in 2018. From 110 elementary schools in Toyama Prefecture, 13,413 children in the 4th-6th grades (boys, 50.9%; mean, 10.5 years old) participated. We assessed lifestyle, recreational ST (not for study use), psychological status, and school and family environment including family rules. We defined ≥3 hours ST as excessive. We calculated the school-level proportions of no family rules and divided them into four categories (<20%, 20% to <30%, 30% to <40%, and ≥40%). A modified multilevel Poisson regression analysis was performed.

RESULTS

In total, 12,611 children were included in the analysis (94.0%). The average school-level proportion of those with no family rules was 32.1% (SD = 9.6). The prevalence of excessive ST was 29.9% (34.9% in boys; 24.8% in girls). The regression analysis showed that excessive ST was significantly associated with both individual-level factors, such as boys (adjusted prevalence ratio (aPR); 1.39), older grades (aPR; 1.18 for 5th grades and 1.28 for 6th grades), late wakeup (aPR; 1.13), physical inactivity (aPR; 1.18 for not so much and 1.31 for rarely), late bedtime (aPR; 1.43 for 10 to 11 p.m. and 1.76 for ≥11 p.m.), frequent irritability (aPR; 1.24 for sometimes and 1.46 for often), feelings of school avoidance (aPR; 1.17 for sometimes and 1.22 for often), infrequent child-parental interaction (aPR; 1.16 for rare and 1.21 for none), no family rules (aPR; 1.56), smartphone ownership (aPR; 1.18), and the school-level proportion of no family rules (aPR; 1.20 for 20% to <30%, 1.29 for 30% to <40%, and 1.43 for ≥40%, setting <20% as reference).

CONCLUSION

Besides individual factors, a higher school-level proportion of no family rules seemed influential on excessive ST. Increasing the number of households with family rules and addressing individual factors, could be deterrents against excessive ST in children.

[Primary prevention of computer game addiction in students of educational institutions]

OBJECTIVE

To conduct the primary prevention of computer game addiction (PPCGA) in students of General education institutions (GEI), aimed at preventing the formation of CGA.

MATERIAL AND METHODS

The study included 488 students in grades 7-10 of GEI aged 12-17 years (14.6±2.4 years), of which 393 adolescents, who made up the main group, received PPCGA and 95 - control, without PPCGA.

RESULTS

Preventive measures were carried out without interrupting the educational process; they were carried out by addiction psychiatrists and medical psychologists. PPCGA was aimed at teaching students a healthy lifestyle, the development of their personal resources, the formation of skills to overcome problem situations, a change in the value attitude to computer games and the formation of alternative interests. In the main group, a decrease in the time interval spent by students at the computer was found (p<0.05). There was a decrease in the number of students (p<0.05), experiencing affective disorders when abstaining from the computer, including mild depression and subclinically expressed anxiety/depression, for whom computer games could lead to problems and negative consequences. An increase in the interval of time spent by students at the computer (p<0.05); an increase in the number of students experiencing affective disorders when abstaining from the computer (p<0.05); a trend towards the increase in the frequency of problems and delayed meetings and personal matters related to spending time at the computer; an increase in clearly uncommunicative (p<0.05) were found in the control group.

CONCLUSIONS

Primary prevention of computer gaming increase the number of students who prefer a healthy lifestyle (physical education and sports, rational nutrition, sex education, family relationships) and reduce the number of people who prefer computer games as a form of leisure.

An investigation of computer-game addiction, physical activity level, quality of life and sleep of children with a sibling with a chronic condition

BACKGROUND

It is known that chronic condition also affects siblings without chronic illness. Healthy siblings of children with a chronic condition and aged 9-14 years and healthy children with a sibling without chronic illness and their parents were included in the study.

AIM

The aim of our study was to examine the internet-game addiction, physical activity, quality of life and sleep in children with a sibling with chronic condition and compare them with their peers with a healthy sibling.

METHODS

Computer game addiction, physical activity, sleep quality and quality of life were evaluated respectively by Computer Game Addiction Scale for Children, Child Physical Activity Questionnaire, Children's Sleep Disorder Scale and Children's Quality of Life Scale.

RESULTS

While the mean age of 75 children with chronically ill siblings was 10.65 ± 1.59 years, the mean age of 75 healthy children with healthy siblings was 10.46 ± 2.09 years. It was observed that children with a sibling with a chronic condition were more tend to computer-game addiction, had lower sleep quality, lower quality of life in terms of school functionality and psychosocial health compared to children with a healthy sibling (p < 0.05).

CONCLUSIONS

It was revealed that in families with children with a chronic condition, siblings with no health problems should also be evaluated in psychosocial terms and supported by appropriate approaches, such as to increase the level of physical activity.

Association between gaming disorder and regional homogeneity in highly involved male adult gamers: A pilot resting-state fMRI study

BACKGROUND

Gaming behavior can induce cerebral changes that may be related to the neurobiological features of gaming disorder (GD). Additionally, individuals with higher levels of depression or impulsivity are more likely to experience GD. Therefore, the present pilot study explored potential neurobiological correlates of GD in the context of depression and impulsivity, after accounting for video gaming behavior.

METHODS

Using resting-state functional magnetic resonance imaging (fMRI), a cross-sectional study was conducted with 35 highly involved male adult gamers to examine potential associations between GD severity and regional homogeneity (ReHo) in the entire brain. A mediation model was used to test the role of ReHo in the possible links between depression/impulsivity and GD severity.

RESULTS

Individuals with greater GD severity showed increased ReHo in the right Heschl's gyrus and decreased ReHo in the right hippocampus (rHip). Furthermore, depression and impulsivity were negatively correlated with ReHo in the rHip, respectively. More importantly, ReHo in the rHip was found to mediate the associations between depression/impulsivity and GD.

CONCLUSIONS

These preliminary findings suggest that GD severity is related to ReHo in brain regions associated with learning/memory/mood and auditory function. Higher levels of depression or impulsivity may potentiate GD through the functional activity of the hippocampus. Our findings advance our understanding of the neurobiological differences behind GD symptoms in highly involved gamers.

Online Assessment of Social Cognition in a Population of Gamers and Gamblers: Results of the eSMILE Study

The purpose of the eSMILE study was to explore social cognition (SC) in the two behavioural addictions (BAs) included in international classifications: gaming disorder and gambling disorder. In these disorders, cognitive functioning is involved in the development and maintenance of addiction. Nevertheless, SC have received less attention than other cognitive functions. The eSMILE study was conducted online and included 105 participants (gamers and gamblers). This study included: the Penn emotion recognition task, the Condensed and Revised Multifaced Empathy Test, the Interpersonal Reactivity Index, the Chicken Game, social metacognition questions, and the Toronto Alexithymia Scale. We analysed the relationships among SC measures, addiction levels, and behaviour frequency. For gamers, we showed that the higher their level of addiction was, the lower their self-confidence following the identification of basic emotions, although the more frequently they played, the better their performance on this task. Additionally, we found lower performance on the identification of more complex emotions by gamblers, which seems to be the result of their levels of addiction rather than the frequency of their gambling behaviour. This study contributes to our understanding of the cognitive processes underlying BAs. Additionally, working on SC abilities may be an additional management mode for BAs that could be added to existing treatments.