Risk and protective factors of Internet gaming disorder among Chinese people: A meta-analysis

Longitudinal Associations Between Sleep Disturbance Trajectories and Internet Gaming Disorder Mediated by Self-Control: A Six-Wave Longitudinal Investigation

Objective

The present study aims to analyze the heterogeneous trajectories of sleep disturbance (SD) among college students and to examine whether self-control mediates the association between sleep disturbance trajectories and Internet gaming disorder (IGD).

Methods

A total of 4352 students were initially invited to participate, and 4191 (M age = 19.12, SD = 0.98; 46.9% females) students were included as valid respondents at the first time-point. This study spanned six waves (from 2019 to 2022) with a six-month interval between each wave. Sleep disturbance was measured from Time 1 to Time 4, self-control was measured at Time 5, and Internet gaming disorder was measured at Time 6. Growth mixture modeling (GMM) was applied to identify latent classes of sleep disturbance over the four waves. Mediation analysis was conducted to examine the mediating role of self-control between sleep disturbance trajectories and IGD.

Results

The results of growth mixture modelling yielded a four-class solution for sleep disturbance: a stable-low group, an increasing group, a decreasing group, and a stable-high group. Additionally, the results of mediation models showed that increased sleep disturbance is associated with a higher likelihood of individuals becoming more addicted to Internet games due to decreased self-control. Conversely, improved sleep quality may decrease the likelihood of engaging in Internet games via by promoting higher levels of self-control.

Conclusion

Future prevention and intervention programs targeted at improving self-control may decrease the possibility of developing IGD.

Role of conscious awareness and Big Five in predicting the digital addiction

Introduction

Digital addiction is discussed in the literature as a type of addiction that negatively affects the personal, social, and societal lives of individuals. Digital addiction is a behavioral addiction that occurs as a result of the problematic and unconscious use of digital tools with features such as compulsive, excessive, impulsivity, and includes human-machine interaction. What is meant to be expressed with conscious awareness is to accept the facts and experiences as they are without judgment, and to be aware of them. With awareness, it is aimed to contribute to individuals to evaluate their past experiences more objectively, to get rid of automatic behavioral and emotional patterns, and to show more moderate reactions by avoiding aggressive reactions. In this context, this study examines the Big Five and Mindfulness as predictive variables for digital addiction, focusing on them as a cause and a solution variable that can be used in interventions for digital addiction. Given its prevalence and negative effects, it is important to identify and analyze the relationship patterns between digital addiction and related variables in order to define and resolve the problem. In this context, the present study aims to determine the levels of conscious awareness and digital addiction among university students and to examine the predictive effect of conscious awareness levels and Big Five variables on predicting digital addiction behaviors.

Methods

The present study is designed to employ the survey method. Data were collected from 1,664 university students selected by using the convenience sampling method, and the data obtained were analyzed by using descriptive statistics and structural equation modeling. The SPSS 25 and LISREL 8.8 software packages were used in the analysis process.

Results and discussion

The results achieved in this study revealed that university students have a moderate level of conscious awareness and that the overall level of digital addiction is generally moderate. The results achieved from the structural equation modeling for the measurement model constructed for the relationships between variables confirmed the validity of the proposed model. It was determined that the model had a good fit with the latent variables, which represent the indicator variables, and also other latent variables. In conclusion, it was found that Big Five and the level of conscious awareness have a reducing effect on digital addiction and serve a protective function against this negativity among university students.

Interaction Effects Between Low Self-Control and Meaning in Life on Internet Gaming Disorder Symptoms and Functioning in Chinese Adolescents: Cross-Sectional Latent Moderated Structural Equation Modeling Study

BACKGROUND

Internet gaming disorder (IGD) is an emerging behavioral addiction with mental health implications among adolescents. Low self-control is an established risk factor of IGD. Few studies have, however, examined the moderating role of meaning in life (MIL) on the relationships between low self-control and IGD symptoms and functioning.

OBJECTIVE

This study aimed to examine the effects of low self-control and MIL and their interaction effects on IGD symptoms and family and school functioning in a structural equation model.

METHODS

A sample of 2064 adolescents (967, 46.9% male; mean age 14.6 years) was recruited by multistage cluster random sampling from 5 middle schools in Sichuan, China, in 2022. The participants completed a self-report questionnaire with validated measures on low self-control, presence of MIL, search for MIL, IGD symptoms, school commitment, and family functioning. Construct validity, measurement invariance, and structural invariance of the measures were evaluated by confirmatory factor analysis across sex. Structural equation modeling was conducted to examine the indirect effects of low self-control and MIL on family and school functioning through IGD symptoms. Latent moderated structural equation modeling was performed to examine the interaction effects between low self-control and MIL on IGD symptoms, school commitment, and family functioning.

RESULTS

All scales showed satisfactory model fit and scalar measurement invariance by sex. Males showed significantly greater IGD symptoms and lower levels of self-control (Cohen d=0.25-1.20, P<.001) than females. IGD symptoms were significantly and positively associated with impulsivity (β=.20, P=.01), temper (β=.25, P<.001), and search for meaning (β=.11, P=.048) and significantly and negatively associated with presence of meaning (β=-.21, P<.001). Presence of MIL and impulsivity showed a significant and negative interaction effect (β=-.11, SE .05; P=.03) on IGD symptoms. The positive effect of impulsivity on IGD symptoms was stronger among adolescents with low presence of MIL than those with high presence of MIL. Temper showed significant and positive interaction effects with presence of MIL (β=.08, SE .04; P=.03) and search for MIL (β=.08, SE .04; P=.04) on family functioning. The negative effects of temper on family functioning were stronger among adolescents with low levels of MIL than among those with high levels of MIL.

CONCLUSIONS

This study provides the first findings on the interaction effects between low self-control and presence of MIL and search for MIL on IGD symptoms and functioning among a large sample of adolescents in rural China. The results have implications for targeted interventions to help male adolescents with lower self-control and presence of meaning.

Sociodemographic Factors Associated with Video Game Addiction in Schoolchildren from the South-Central Region of Chile

Video game addiction is a worldwide concern, particularly in schoolchildren where it has impact on academic, social, and emotional spheres. The objective of this study was to determine the sociodemographic factors associated with video game addiction in schoolchildren from the south-central region of Chile. Methods: An analytical cross-sectional study that included a sample of 308 schoolchildren was performed. Sociodemographic factors were analyzed and levels of video game addiction was assessed using the Video Game Addiction Test (VAT) developed by Chóliz and Marco. A general linear regression model (ANCOVA) (α = 0.05) was applied (STATA v16). The prevalence of video game use was 82.7%, while addiction reached 10%. Risk factors associated with the increased risk of addiction were as follows: being male (β = 13.99; p < 0.001); being in the care of another relative (β = 11.1; p < 0.001); a higher number of people in the household (β = 11.2; p < 0.001); the caregiver in employment (β = 12.8; p < 0.001); and not performing extracurricular physical activity (β = 9.9; p < 0.001).

Big five personality traits, gaming motives, and regular and disordered gaming: A cross-national examination among college student gamers in seven countries

INTRODUCTION

Previous research has shown that personality traits and gaming motives are important predictors for explaining regular and disordered gaming. However, the mediating role of gaming motives in the relation between personality traits and video game outcomes (e.g., time spent gaming or disordered gaming) has been scarcely studied and limited cross-national studies have addressed this issue. The present study aimed to examine the direct and indirect effects of the Big Five personality traits on weekly gaming and disordered gaming via gaming motives across seven countries.

METHOD

3540 college student gamers (59.5% women) from the U.S., Canada, Spain, Argentina, Uruguay, South Africa and England completed the online survey. Structural equation modeling was conducted to test models. Multigroup models were employed to test model invariance across countries.

RESULTS

Significant, albeit weak, relations were found between personality traits and gaming outcomes, and were mediated mostly by coping motives in predicting disordered gaming, and by social interaction and recreation (to a lesser extent) motives in predicting weekly gaming. Some minor, yet significant, differences across countries appeared and are discussed in detail.

DISCUSSION

The present findings indicate that the differential interrelations between personality traits, gaming motives, and video gaming outcomes may be generalized in college students across countries.

Comorbidity among symptoms of internet gaming disorder, social withdrawal, and depression in 3430 young people in Hong Kong: A network analysis

BACKGROUND

The present study aimed to examine the comorbidity among symptoms of internet gaming disorder (IGD), social withdrawal, and depression using the network perspective.

METHODS

An online survey recruited 3430 young people in Hong Kong (mean age = 19.4 years, 80.5 % male) via gaming channels in 2019. The participants completed the 9-item IGD Scale, Hikikomori Questionnaire, and Patient Health Questionnaire-9. Network analysis was conducted using R to estimate the central symptoms of IGD and depression in individual networks and identified the bridge symptoms in combined network of IGD, social withdrawal, and depressive symptoms.

RESULTS

All network models showed high stability. 'Withdrawal', 'Loss of control', and 'Tolerance' were the central IGD symptoms, while 'Depressed mood' and 'Self-blame/guilt' were the central depressive symptoms. The bridge symptoms were 'Gaming as escape or mood relief' from IGD cluster, 'Depressed mood' and 'Self-blame/guilt' from depression cluster, and 'Marked social isolation at home' and 'Significant distress due to social isolation' from social withdrawal cluster. The combined network showed no significant differences in network structure and global strength across gender and age groups.

LIMITATIONS

The cross-sectional sample only indicated undirected associations between the symptoms in the three clusters and could not model the intra-individual variation.

CONCLUSIONS

The present study provided the first results on the comorbidity among IGD, social withdrawal, and depression at a symptom level among Chinese young people via network analysis. The bridge symptoms highlight potential targets for interventions of comorbidity among the disorders.

Confounding analysis with gaming aspects in predicting psychological distress of esports players

This research aimed to explore the interplay between the central and peripheral aspects of gaming and their correlation with internet gaming disorder (IGD) in predicting indicators of psychological distress. The study proposed that the core and peripheral characteristics of gaming serve as confounding variables affecting the direct relationship between IGD and psychological distress. Employing a longitudinal design spanning two distinct timeframes, the research involved 100 esports players from Malaysia, all of whom had participated in at least one official tournament. The outcomes revealed that both the core and peripheral attributes of gaming significantly predicted stress, anxiety, and depression. However, IGD exhibited a significant predictive association only with stress. Notably, the study also detected the confounding effects of core and peripheral characteristics in the direct link between IGD and stress. These results imply that core and peripheral gaming traits should be interpreted as individual differences that amplify susceptibility to IGD and its associated psychological distress indicators. Moreover, the findings suggested that IGD might not be a prominent concern for esports players, potentially due to their training in performance management as athletes. The paper explores further implications stemming from these findings.

Comparing psychopathological symptoms, life satisfaction, and personality traits between the WHO and APA frameworks of gaming disorder symptoms: A psychometric investigation

INTRODUCTION

The inclusion of Internet Gaming Disorder (IGD) in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association and Gaming Disorder in the 11th revision of the International Classification of Diseases (ICD-11) by the World Health Organization requires consistent psychological measures for reliable estimates. The current study aimed to investigate the psychometric properties of the Gaming Disorder Test (GDT), the Ten-Item Internet Gaming Disorder Test (IGDT-10), and the Five-Item Gaming Disorder Test (GDT-5) and to compare the WHO and the APA frameworks of gaming disorder symptoms in terms of psychopathological symptoms, life satisfaction, and personality traits.

METHODS

A sample of 723 Swedish gamers was recruited (29.8% women, 68.3% men, 1.9% other, Mage = 29.50 years, SD = 8.91).

RESULTS

The results indicated notable differences regarding the estimated possible risk groups between the two frameworks. However, the association between gaming disorder symptoms and personality traits, life satisfaction, and psychopathological symptoms appeared consistent across the two frameworks. The results showed excellent psychometric properties in support of the one-factor model of the GDT, IGDT-10, and GDT-5, including good reliability estimates (McDonald's omega) and evidence of construct validity. Additionally, the results demonstrated full gender and age measurement invariance of the GDT, IGDT-10, and GDT-5, indicating that gaming disorder symptoms are measured equally across the subgroups.

CONCLUSION

These findings demonstrate that the IGDT-10, GDT-5, and GDT are appropriate measures for assessing gaming disorder symptoms and facilitating future research in Sweden.

An Empirical Investigation of the Relationships Among Self-Esteem, Depression and Self-Serving Bias in People with Internet Gaming Disorder

Introduction

People are generally characterized by a self-serving bias which describes the tendency to ascribe positive outcomes or success to internal or personal causes (self-enhancement motivation) and ascribe negative outcomes or failure to external or situational causes (self-protection motivation). It has been found that the individuals with internet gaming disorder (IGD) who have low self-esteem and high depression exhibit an attenuated self-serving bias. However, the relationships among self-esteem, depression and self-serving bias are not clearly identified.

Methods

A sample of 138 IGD participants completed self-esteem and depression scales and a causal attribution task (Study 1) to examine the relationships among self-esteem, depression and self-serving bias (both self-enhancement and self-protection). In follow-up Study 2, 28 IGD participants were recruited to undertake self-affirmation intervention which can affirm one's sense of global self-view and bolster self-esteem to explore whether self-affirmation would trigger a reduction of depression and a raise of self-serving bias.

Results

The results of path analysis in Study 1 showed that the self-serving bias was predicted by self-esteem and depression, and the depression played a mediating role between self-esteem and self-serving bias. The results of Study 2 showed that the IGD participants reported higher self-esteem, lower depression and engaged in more self-protection motivation after affirming-self manipulation as compared with affirming-other manipulation.

Conclusion

These findings suggest that self-esteem predicts self-serving bias through depression and self-affirmation could trigger an increase of self-esteem, further decrease depression and improve self-serving bias for the individuals with IGD. The present article clearly identified the relationships among these factors and provided a new approach to promote positive self-concept in individuals with IGD. Future research is warranted to explore the lasting benefits of self-affirmation on domains of education, relationships and gaming withdrawal for the individuals with IGD among different populations.

Effective parental strategies against problematic smartphone use among adolescents: A 6-month prospective study

Problematic Smartphone Use (PSU) among adolescents is growing problem worldwide and multiple studies investigated its associated parental risk and protective factors. The available studies, however, typically do not address the multidimensional nature of PSU. They also rely heavily on cross-sectional designs with a small number of potentially contributing variables. This 6-month prospective study examines the relationships between a large range of parental factors with the three known dimensions of PSU: social environment pressure, emotional gain, and addiction-like behaviors. Specifically the study examines whether, and to what extent, the various dimensions of current and future PSU are related to parental support giving, general quality of communication, specific communication about smartphone use, and the four common mediation strategies. The sample comprised 1187 triads of mothers, fathers, and adolescents. The data-analysis pipeline consisted of three consecutive phases: (1) analyses of parental factors at baseline, (2) analyses of parental factors change over 6-months, and (3) interaction analyses between parental factors and the time-period of the study. The pipeline elicited three factors that moderated the change in PSU over time: Communication about smartphones with mothers, parental support giving, and parental co-use. The implications of these findings are discussed in the context of the existing literature and the familial, microsystem theoretical framework. Altogether, this prospective study scrutinized key parental factors and strategies that could be utilized by parents for coping with one of the most difficult parenting challenges of the digital era. Further research may build upon these findings to develop designated interventions to reduce PSU.

Cognitive, Metacognitive, Motivational, and Emotional Predictors of the Intensity of Internet Gaming Disorder among Adolescents

Internet gaming disorder (IGD) is multifaceted and can have significant negative consequences. The present study examined the contribution of cognitive, metacognitive, motivational, and emotional factors as predictors for IGD severity. In a cross-sectional study, 703 Iranian adolescents (36.8% females, mean age = 16.98 years [SD = 1.23]) completed an online survey. Hierarchical regression analysis showed that the cognitive, metacognitive, motivational, and emotional factors predicted 7.8%, 17.4%, 1.4%, and 1.9% of the variance in IGD symptoms, respectively. The findings indicated that the cognitive factors including some maladaptive cognitions, such as cognitive salience, regret, and perfectionism, and metacognitive factors including some maladaptive metacognitions (negative metacognitions regarding the uncontrollability of online gaming and negative metacognitions regarding the dangers of online gaming) were significant predictors of IGD severity, highlighting their importance in understanding and predicting problematic gaming behaviors. Although contributing to the variance in IGD, motivational factors (escape, coping, and skill development) and emotional factors including emotion regulation (especially reappraisal) played relatively smaller roles compared to cognitive and metacognitive factors. Of the examined predictive factors, metacognitions were the most important predictor of IGD severity. Exploratory moderator analyses showed significant interactions between three predictors of IGD (reappraisal, negative metacognitions, and cognitive salience) with loneliness, stress, anxiety, and depressive symptoms. Reappraisal was the most frequent predictor and had a significant interaction with these variables. Other predictors independently impacted IGD irrespective of the level of loneliness, stress, anxiety, or depressive symptoms. Based on these findings, special attention to metacognitive, cognitive, emotional, and motivational factors is suggested in the treatment of IGD.

Emotional dysregulation in relation to substance use and behavioral addictions: Findings from five separate meta-analyses

Background/objective

Emotional dysregulation (ED) is a transdiagnostic variable underlying various psychiatric disorders, including addictive behaviors (ABs). This meta-analysis examines the relationship between ED and ABs (alcohol, tobacco, cannabis, gambling, and gaming), and indicators of AB engagement (frequency, quantity/time of use, severity, and problems).

Method

Searches were conducted in PubMed, Scopus, WoS, and PsycINFO. Five separate meta-analysis were run using random-effects models. Moderators (age, sex, continental region, and sample type; community vs. clinical), and publication bias were evaluated.

Results

A total of 189 studies (N = 78,733; 51.29 % women) were identified. ED was significantly related to all ABs. Problems and severity indicators exhibited the largest effects (r's .118-.372, all p <.023). There were larger effect sizes for cannabis problems (r = .372), cannabis severity (r = .280), gaming severity (r = .280), gambling severity (r = .245), gambling problems (r = .131), alcohol problems (r = .237), alcohol severity (r = .204), and severity of nicotine dependence (r = .118). Lack of impulse control exhibited some of the largest effects in relation to ABs. Clinical samples of cannabis users vs. community-based exhibited larger magnitude of associations.

Conclusions

Interventions targeting ABs should address lack of strategies and impulsive behaviors as an emotion regulation strategy specifically, as it is a common risk factor for ABs.

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.

Internet gaming disorder and the alternative five factor personality model: a study in a Spanish community sample

BACKGROUND

This study was designed to examine the prevalence and relationships between the Internet gaming disorder (IGD) behaviors, suggested by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and personality traits.

PARTICIPANTS AND PROCEDURE

A sample community of 1,548 subjects, 707 men and 841 women, with a mean age of 40.90 and 38.89 years, respectively, was evaluated.

RESULTS

The results showed that only 7 subjects (0.5%) exceeded the cut-off point of 75 points to be classed as "disordered gamers" proposed by Fuster et al. (2016) in Spain. This study demonstrates the unidimensionality of the IGD-20, so it can be used as an ordinal dimensional measure to study the relationship between IGD symptoms and other related variables such as personality in community samples. A multiple linear regression analysis revealed that up to 8% of the variance of the Internet Gaming Disorder-20 scale (IGD-20), as a dimensional scale, can be explained by low activity, high aggressiveness, introversion, non-planning impulsivity, sensation seeking, neuroticism and impulsiveness (attention impulsivity) using the Alternative Five Factor Model (AFFM) of personality and the Barratt Impulsivity Scale (BIS-11).

CONCLUSIONS

This study shows that the prevalence of IGD in the Spanish population is similar to that of other Western countries. The unidimensionality of the IGD-20 allows its use in correlational studies to examine the relationship between Internet gambling behaviors and personality variables. The implications of these personality profiles are discussed in relation to the psychological and clinical mechanisms involved in Internet gaming disorder.

Impact of gaming disorder on first episode psychosis patients' evolution: Protocol for a multicentered prospective study

AIMS

The objective of this study is to underline the impact of Gaming Disorder on the clinical evolution of patients with First Episode Psychosis. The specific aims of the study are to determine the prevalence of gaming disorder among those patients and assess the consequences of gaming on their clinical trajectory.

METHODS

This is a prospective multicenter cohort study that will enrol 800 patients diagnosed with a first episode psychosis, with a follow-up period of up to 3 years. Using a systematic screening procedure for gaming disorder, the clinical staff will assess patients gaming habits at admission and every 6 months thereafter. Information from patients' medical records will also be extracted using the same timeframe.

RESULTS

The patients' characteristics at admission and during follow-up will be presented in the form of descriptive statistics and compared between different subgroups of patients using uni- and multivariate logistic regression models. Repeated measures ANCOVA will also be performed to analyse the impact of gaming disorders on patients' clinical path as assessed by the Positive and Negative Syndrome Scale and the Clinical Global Impression scale, considering covariates such as psychiatric diagnosis, pharmacological treatment, age, sex/gender, and duration of untreated psychosis.

CONCLUSION

These findings will guide the development of prevention, detection, and treatment strategies for the comorbidity between gaming disorder and first episode psychosis, ultimately improving the patients' recovery.

Psychometric Properties of the Metacognitions About Online Gaming Scale in the Chinese Population and Its Relationship With Internet Gaming Disorder: Cross-Sectional Study

BACKGROUND

Metacognitions about online gaming have been shown to be correlated with Internet Gaming Disorder (IGD). Knowledge of metacognitions about online gaming can help to understand IGD. The Metacognitions about Online Gaming Scale (MOGS) is a reliable and valid tool to measure specific metacognitions about online gaming in both adults and adolescents, which is lacking in China.

OBJECTIVE

This study was conducted to assess the psychometric properties of the Chinese version of the MOGS (C-MOGS) and its relationship with IGD in the Chinese population.

METHODS

A total of 772 Chinese individuals (age: mean 21.70, SD 8.81 years; age range: 13-57 years; 458/772, 59.3% male) completed a web-based questionnaire survey, including the C-MOGS and a battery of validated scales measuring IGD, gaming motives, depression, and anxiety.

RESULTS

Through exploratory and confirmatory factor analyses, the 3-factor structure was confirmed to have adequate model fit and internal consistency reliability (Cronbach α≥.799, Guttman split-half coefficients≥0.754). Concurrent validity of the C-MOGS was supported by its correlations with IGD (P<.001), gaming motives (P<.001), depression (P<.001), and anxiety (P<.001). Furthermore, the incremental validity analysis showed that the C-MOGS predicted 13% of the variance in IGD while controlling for gender, age, weekly gaming hours, gaming motives, depression, and anxiety.

CONCLUSIONS

This study provides evidence that the psychometric properties of the C-MOGS are appropriate and emphasizes its positive association with IGD. The C-MOGS is a reliable and valid instrument for mental health workers to assess metacognitions about online gaming in the Chinese population.

Risks and protection: a qualitative study on the factors for internet addiction among elderly residents in Southwest China communities

BACKGROUND

In the global trend of actively promoting the participation of older adults in the digital age, the relevant negative issues featuring potential Internet Addiction (IA) among them has risen to be a new challenge facing the global public health. However, there is a severe lack of related research. This study aimed to gain a comprehensive understanding of the phenomenon and process of IA among the elderly. The purpose of this paper is to introduce factors that may influence IA in the demographic.

METHODS

This study employed qualitative descriptive research methods to investigate older adults' perceptions and experiences of IA. Semi-structured in-depth personal interviews were conducted between March and June 2023 with 36 senior citizens from urban communities in Chongqing, Southwest China. Data were analyzed via inductive content analysis methods.

RESULTS

Through data analysis, 2 main categories concerning IA in older adults were identified: risk factors and protective factors. The risk factor categories include 5 individual factors (e.g., Internet as the major avenue for pursuing personal hobbies and interests, etc.), 3 family factors (e.g., household WIFI increasing the risk of prolonged Internet use indoors, etc.), 2 peer factors (e.g., peer recommendation and guidance as catalysts for intensified Internet engagement, etc.), 2 socio-environmental factors (e.g., the widespread daily Internet use spurs offline intolerance, etc.), and 3 Internet platform factors (e.g., the plenitude of online content triggers endless viewing/browsing behaviors, etc.). The category of protective factors encompasses 2 individual factors (e.g., a higher level of perceived risk regarding internet health hazards, etc.) and 2 family factors (e.g., more family commitment, etc.).

CONCLUSIONS

Older adults' Internet addictive behaviors are shaped by multiple and complex internal and external factors. A higher level of online health risk perception is a key protective factor to effectively avoid the occurrence and deterioration of IA among the aged, a distinct finding from this study. It is believed that the "individual-family-peer-community" synergy strategy is expected to become an essential direction for IA intervention for older adults, in order to promote healthy Internet use among older adults.

Developmental trajectories and predictors of Internet gaming disorder across the university years: A person-centered five-wave cohort study

With a rapid rise in internet gaming, internet gaming disorder (IGD) has become a contemporary concern. However, little is known about the long-term dynamic changes in IGD over time. Using a person-centered five-wave longitudinal design, the current study explored the heterogeneous trajectories of IGD among 5787 students during their university years, and examined the role of protective and risk factors in differentiating distinct patterns of IGD. The growth mixture modeling revealed three distinct trajectories of IGD: stable-low pattern (n = 4575, 87.42 %), increasing pattern (n = 357, 6.80 %), and decreasing pattern (n = 302, 5.78 %). Additionally, the students with high self-control and self-compassion were more likely to be in the stable-low group instead of the other risk groups. Depressive symptoms and peer conflicts, as two time-varying variables, were significant risk predictors for IGD. These findings highlight the importance of identifying high-risk groups for IGD and providing them with personalized and effective mental health services to reduce their risk of developing IGD in the future.

Emotion dysregulation and Internet gaming disorder in young people: Mediating effects of negative affect and metacognitions

BACKGROUND

Recent studies have found that emotion dysregulation, negative affect, and metacognitions about online gaming are risk factors for Internet gaming disorder (IGD). However, few studies investigated the mechanisms underlying these interactions. The present study aimed to explore the relationships between emotion dysregulation and IGD, and the mediating effects of negative affect and metacognitions about online gaming.

METHODS

An online survey was conducted with young people (aged 10-24 years) who played video games. 1768 participants were included in this study. Observed variables, including emotion dysregulation, IGD, depression, anxiety, and metacognitions, were measured with self-report scales. Structural equation modeling (SEM) was used to analyze the relationships among the variables.

RESULTS

The results showed that emotion dysregulation positively predicted IGD through a fully mediated model which included the independent mediating effects of negative affect and metacognitions about online gaming and their sequential mediating effect. The model explained 76.1 % of the variance in IGD.

LIMITATIONS

This was a cross-sectional study which could not infer causality.

CONCLUSIONS

This study emphasizes that negative affect and metacognitions about online gaming mediate the effect of emotion dysregulation on IGD; moreover, metacognition may be a proximal factor of IGD. Thus, improving emotional regulation and modifying maladaptive metacognitions in young people may improve the prevention and treatment of IGD.

Effect of online game policy on smartphone game play time, addiction, and emotion in rural adolescents of China

BACKGROUND

Smartphone game addiction has emerged as a major public health problem in China and worldwide. In November 2019 and August 2021, the National Press and Publication Administration of China implemented two increasingly strict policies, as a means of preventing smartphone game addiction in adolescents aged 18 or below. This study aimed to analyze the effect of the policies on smartphone game play time, addiction, and emotion among rural adolescents in China.

METHODS

We sent the questionnaire to rural adolescents through the online survey tool Questionnaire Star, a professional online survey evaluation platform. The questionnaire included demographic data, smartphone use survey, smartphone game addiction and emotion evaluation scales. The Smartphone Addiction Scale-Short Version (SAS-SV) measured adolescents' smartphone game addiction. The Short Version of UPPS-P Impulsive Behavior Scale (SUPPS-P) and Social Anxiety Scale for Children (SASC) measured emotion. According to SAS-SV score, the enrolled rural adolescents were divided into addiction group and non-addiction group. The t-test, Chi-square test, and repeated measure ANOVA assessed the effect of the policies on adolescents' smartphone game addiction and emotion.

RESULTS

Among enrolled 459 rural adolescents with a mean age of 14.36 ± 1.37years, 151 (32.90%) were in the addiction group and 308 (67.10%) were in the non-addiction group. Adolescents in the addiction group were older, more male, and higher grade. There were time and group effects between the two groups in playtime. After a year of policies implementation, the weekly game time dropped from 3.52 ± 1.89 h to 2.63 ± 1.93 h in the addiction group and from 2.71 ± 1.75 h to 2.36 ± 1.73 h in the non-addiction group. There were also time and group effects in SAS-SV and SASC scores, but not for SUPPS-P score. In the addiction group, the SAS-SV score dropped from 41.44 ± 7.45 to 29.58 ± 12.43, which was below the cut-off value for addiction, and the level of social anxiety was consistently higher than non-addiction group.

CONCLUSIONS

The playtime of rural adolescents spent on smartphone games has decreased significantly due to the restriction of the policies rather than the lack of addiction or social anxiety. The policies had practically significant effects in reducing smartphone game play time for rural adolescents in China.

Effectiveness of an integrated motivational cognitive-behavioral group intervention for adolescents with gaming disorder: a randomized controlled trial

AIMS, DESIGN AND SETTING

The aim of this study was to test the efficacy of the integrated cognitive-behavioral therapy with a strength-based motivational approach [integrated cognitive-behavioral therapy (ICBT)] intervention to change gaming disorder (GD) symptoms and other outcomes and to study the therapeutic mechanism. A two-arm parallel randomized waiting-list controlled trial with 3- and 6-month follow-ups were conducted in a secondary vocational school in mainland China.

PARTICIPANTS

Participants comprised 77 Chinese adolescents with GD symptoms with a mean age of 16.36 years [standard deviation (SD) = 0.93]; 88.3% were male INTERVENTIONS: Participants were randomized into an ICBT group (n = 38) and a waiting-list control (WLC, n = 39) group. ICBT intervention comprised eight weekly sessions to encourage participants to identify their interests and strengths and set goals for developing personally meaningful real-life activities.

MEASUREMENTS AND FINDINGS

The outcomes were measured at pre-treatment (t0 ), post-treatment (t1 ), 3-month (t2 ) and 6-month (t3 ) follow-ups. The primary outcome was GD symptoms at t3. Secondary outcomes included GD symptoms at t1 and t2 , and gaming motivation, maladaptive gaming cognition, depression and anxiety symptoms at t1 , t2 and t3 . With the intention-to-treat principle, the GD scores at t3 were significantly different between the CBT and WLC groups [mean difference 62.08 (SD = 10.48) versus 73.64 (SD = 11.70); Hedges' g = 1.15, 95% confidence interval = 0.67-1.62]. Linear mixed-effects modeling showed significant group × time interaction for the secondary outcomes (P < 0.01), with a moderate to strong between-group effect size in the reduction in depression symptoms (g = 0.67-0.84) and anxiety symptoms (g = 0.6-0.64). Path analysis shows ICBT leads to GD reduction through reducing gaming motivation and maladaptive gaming cognition.

CONCLUSIONS

An integrated cognitive-behavioral therapy with strength-based motivational approach intervention reduced gaming disorder symptoms and time spent gaming over a 6-month period by decreasing maladaptive gaming motivation and cognition.

Longitudinal relationships between school assets, traditional bullying, and internet gaming disorder: the role of self-control and intentional self-regulation among Chinese adolescents

Introduction

Although developmental assets have been proven to be enabling factors for both adolescent traditional bullying and internet gaming disorder (IGD), there is a lack of empirical evidence that has investigated the direct relationship between school assets and both of these problematic behaviors concurrently. Based on the positive youth development (PYD) perspective, the present study aimed to explore the relationship between school assets, intentional self-regulation (ISR), self-control, traditional bullying, and IGD among Chinese adolescents.

Methods

A total of 742 middle school students (M_age = 13.88 years, SD = 1.99 years) were followed up to measure school assets, ISR, self-control, traditional bullying, and IGD in two waves that were separated by 5 months.

Results

Structural equation modeling (SEM) indicated that T1 school assets negatively predicted T2 traditional bullying and T2 IGD. T1 self-control significantly mediated the relationships between T1 school assets and T2 traditional bullying, as well as between T1 school assets and T2 IGD. Additionally, T1 ISR strengthened the positive effect of T1 school assets on T1 self-control and further moderated the two mediating paths.

Discussion

These findings show that plentiful school assets support the development of self-control and are more successful in reducing traditional bullying and IGD, particularly among students with higher ISR. As a result, schools should take measures to provide superior-quality assets for the positive development of youth, which will help to prevent and relieve traditional bullying and IGD in the school context.

Prevalence of problematic Internet use and problematic gaming in Spanish adolescents

Epidemiological studies on problematic Internet use and problematic gaming conducted so far have mainly been carried out with unrepresentative and self-selected convenience samples, resulting in unreliable prevalence rates. This study estimates the prevalence of problematic Internet use and problematic gaming in a large sample of Spanish adolescents (N = 41,507) and identifies risk and protective factors for these risky behaviours. Data were collected online using the Adolescent Problem Internet Use Scale and the Adolescent Gaming Addiction Scale. Using a cut-off approach with measurement instruments inspired by the DSM-5 framework, we found a prevalence of 33% for problematic Internet use and 3.1% for problematic gaming. With a more conservative approach inspired by the ICD-11 framework, prevalence rates decreased to 2.98% for problematic Internet use and 1.8% for problematic gaming. Female gender, higher parents' education, elevated Internet connection time, reporting being online after midnight and using the mobile phone in class predicted problematic Internet use; whereas male gender, "living situation" where families do not have a traditional structure or stable environment, elevated Internet connection time and reporting using the mobile phone in class predicted problematic gaming. A cut-off approach involving scales that recycle substance use criteria (as in the DSM-5) over-pathologize Internet use and gaming behaviours. In contrast, the ICD-11 approach seems to provide more realistic and reliable prevalence rates.

Gender differences and left-behind experiences in the relationship between gaming disorder, rumination and sleep quality among a sample of Chinese university students during the late stage of the COVID-19 pandemic

Background and aims

Studies have shown that gaming disorder (GD) is associated with rumination and poor sleep quality. However, the reciprocal relationship between GD, rumination and sleep quality is unclear. Moreover, the differences between gender and between left-behind experiences in the aforementioned relationship remain unknown. Therefore, the present study examined gender differences and left-behind experiences in the relationship between GD, rumination, and sleep quality among a sample of Chinese university students during the late stage of COVID-19 pandemic using a network analysis approach.

Methods

A cross-sectional online survey of 1,872 Chinese university students was conducted comprising demographic information (age, gender, and left-behind experience), gaming experience, gaming frequency, Gaming Disorder Test (GDT), Short Version of Rumination Response Scale (RRS), and Pittsburgh Sleep Quality Index (PSQI).

Results

Among Chinese university students, the prevalence of (i) GD was 3.5% and (ii) sleep disturbance was 14%. GD had positive and weak connection with rumination and sleep quality in the domain-level relational network. The network structures and global strengths both showed no significant differences between gender and between left-behind experiences. The nodes gd3 ("continuation or escalation of gaming") and gd4 ("gaming problems") had the strongest edge in the network.

Conclusion

The results suggest reciprocal relationships between GD, rumination, and sleep quality. Gender and left-behind experiences did not influence the reciprocal relationship between GD, rumination, and sleep quality during the late stage of COVID-19 pandemic. Using network analysis, the findings provide novel insights that rumination and sleep quality may have interacted with GD among Chinese students during the late stage of COVID-19 pandemic. Reducing or eliminating negative rumination may decrease GD and improve sleep quality. Moreover, good sleep quality contributes to positive rumination which may decrease the risk of GD among Chinese university students.

Relationships Between Gaming Disorder, Risk Factors, and Protective Factors Among a Sample of Chinese University Students Utilizing a Network Perspective

Research has demonstrated that some risk and protective factors of gaming disorder (GD) have been identified. However, the interaction of GD with risk and protective factors has rarely been examined from a network analysis perspective. Therefore, the present study examined the relationships between GD, risk factors (i.e., social anxiety and fear of missing out), and protective factors (i.e., resilience, authenticity, and family closeness) utilizing a network analysis approach among a sample of Chinese university students. A cross-sectional study with 1364 participants was performed using the Gaming Disorder Test, the short version of Social Interaction Anxiety Scale (SIAS), the Chinese Trait-State Fear of Missing Out Scale (T-SFoMOSC), the Brief Resilience Scale (BRS), the Authenticity Scale, and a single item assessing family closeness. Social anxiety, FoMO, and two factors of authenticity (i.e., self-alienation and accepting external influence) had positive relationship with GD, while resilience, authentic living, and family closeness had negative relationship with GD. Social anxiety was identified as the core node in the domain-level network. The item "continuation or escalation of gaming" (gd3) and the item "gaming problems" (gd4) constituted the highest edge weight in the facet-level network. The network comparison demonstrated there were no significant differences in relation to network structures and global strengths between gender. The findings suggest bivariate relationships among GD, risk factors (i.e., social anxiety and fear of missing out), and protective factors (i.e., resilience, authenticity, and family closeness). Interventions for GD must be considered through preventing risk factors and increasing protective factors including improving the gaming motivation and maladaptive cognition to decrease negative emotion (e.g., social anxiety and FoMO), enhancing resilience, authentic living and parent-child relationship, as well as decreasing self-alienation and accepting external influence.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-023-01049-3.

Risk and protective factor profiles predict addictive behavior among adolescents

BACKGROUND AND AIMS

Internet gaming disorder (IGD), compulsive sexual behavior (CSB), and problematic social network usage (PSNU) are prevalent disorders among adolescents. Research indicates an increase in the number of adolescents engaging in daily gaming, sex, and the use of social networks, as well as an increase in the number of adolescents diagnosed with these disorders. The current study aims to detect unique profiles of risk and protective factors and examine whether these profiles could explain the different severities of IGD, CSB, and PSNU among adolescents.

METHOD

The sample comprised 544 Jewish Israeli adolescents from the general community (age 14-18), who were asked about risk (childhood adversity, childhood trauma, depression, anxiety, stress, post-traumatic stress, self-concealment, internalized stigma) and protective (parent-adolescent communication,) factors and addictive behaviors (IGD, CSB, and PSNU).

RESULTS

Adolescents were classified into three different clusters based on their risk and protective factors: "at risk" (n = 48, 8.82%), "moderate" (n = 400, 73.53%), and "resilient" (n = 96, 17.65%). The "at risk" group had significantly greater severity of addictive behaviors (IGD, CSB, and PSNU) than did the "moderate" or "resilient" groups, and the "moderate" group had significantly greater severity of addictive behaviors than the "resilient" group.

CONCLUSIONS

The findings highlight the fact that protective and risk factor profiles are highly indicative of various addictive behaviors among adolescents. The current research expands knowledge about addictive behaviors by providing a more individualized approach to understanding addictive behaviors among adolescents.

Gaming disorder: A summary of its characteristics and aetiology

The emergence, development, and maintenance of gaming disorder (GD) is the result of an interplay between gaming-related factors, individual factors, and environmental factors. None of these alone are sufficient to cause a disordered state, but it is the interactive co-occurrence of all these factors, which in some cases leads to GD. The goal of the present paper is to discuss in detail these three factors based on relevant and recent findings of the literature. Among gaming-related factors, we discuss online vs. offline videogames, the role of game genres, structural characteristics, game design elements, as well as some important monetization techniques. Among individual factors demographic risk factors, personality traits, motivational factors, comorbid psychopathology, genetic predisposition, and neurobiological processes are considered. Finally, among environmental factors we discuss family factors, early life experiences, the role of peers and school-related factors, as well as the broader context of culture including the popularity of esports.

Impaired Control Over Gaming Scale (ICOGS): Development, confirmatory factor validation, and psychometric evaluation

Background and aims

The concept of impaired control is central to addictive disorders, including gaming disorder in the DSM-5 and ICD-11. Impaired control refers to the recurrent inability to resist impulses to engage in certain activities or behaviours and the failure to limit or stop this engagement. Although numerous screening tools for gaming disorder symptoms have been developed, these instruments have limited capacity for measuring the nature and extent of impaired control. To address this limitation, the present study reports on the creation of the Impaired Control Over Gaming Scale (ICOGS), an 8-item screening tool to assess gaming-related impaired control.

Methods

A total of 513 gamers, including 125 gamers (24.3%) who met the DSM-5 criteria for gaming disorder, were recruited from Prolific, an online crowd-sourcing platform.

Results

The ICOGS demonstrated promising psychometric properties. Exploratory and confirmatory factor analysis using two samples provided robust support for a 2-factor model and high internal consistency of the scale. ICOGS scores were significantly and positively associated with gaming disorder symptoms, gaming-related harms, gaming frequency, psychological distress, and neuroticism. Using receiver operating characteristic analysis, the ICOGS differentiated between non-problem gamers and those who met the criteria for GD.

Discussion and conclusions

Overall, the ICOGS appears to be a valid and reliable scale for use in studies of problem gaming, and may be useful for assessing outcomes of GD interventions that employ self-regulation and stopping techniques to reduce or eliminate problem gaming behavior.

Differences between recreational gamers and Internet Gaming Disorder candidates in a sample of Animal Crossing: New Horizons players

Throughout the last decade, research has considered players' gaming motives as risk and the perceived social support (PSS) as protective factors in the context of Internet Gaming Disorder (IGD). However, the literature is lacking diversity regarding the representation of female gamers as well as of casual and console-based games. The aim of this study was to assess IGD, gaming motives, and PSS comparing recreational gamers and IGD candidates in a sample of Animal Crossing: New Horizons players. A total of 2909 ACNH players (93.7% of them female gamers) took part in an online survey which collected demographic, gaming-related, motivational, and psychopathologic data. Using the cut-off of at least five positive answers to the IGDQ, potential IGD candidates were identified. ACNH players reported a high prevalence rate for IGD (10.3%). IGD candidates differed from recreational players regarding age, sex, and game-related, motivational, and psychopathological variables. A binary logistic regression model was computed to predict membership in the potential IGD group. Age, PSS, escapism and competition motives as well as psychopathology were significant predictors. To discuss IGD in the context of casual gaming, we consider demographic, motivational, and psychopathological player characteristics as well as game design and the COVID-19 pandemic. IGD research needs to broaden its focus concerning game types as well as gamer populations.

Is internet gaming disorder associated with suicidal behaviors among the younger generation? Multiple logistic regressions on a large-scale purposive sampling survey

The ubiquity of Internet gaming as part of the younger generation's (11-35 year-olds) lifestyle to-day warrants a deeper understanding of its impact on their mental health. In particular, there has been scant research investigating the link between Internet Gaming Disorder (IGD) and suicidal behaviors in this demographic group, even though several mental health symptoms of the former are known risk factors for the latter. This paper aims to establish the presence or absence of association between IGD and each of suicidal ideation, self-harm, and suicide attempt among the younger generation. A large-scale online survey on Internet gamers in Hong Kong was conducted in February 2019. 3430 respondents were recruited through purposive sampling. Study samples were stratified into distinct age groups and multiple logistic regression was conducted for each measured suicidal behavior in each age group. After controlling for sociodemographics, Internet usage, self-reported bullying perpetration and bullying victimization, social withdrawal, and self-reported psychiatric diagnoses such as depression and psychosis, analyses revealed that adolescent (11-17 year-old) gamers with IGD were more likely than their peers who had no IGD to have had suicidal ideation, self-harm, and suicide attempt in their lifetime. These associations did not hold for 18-35 year-old gamers. Findings suggest that it may be prudent to recognize IGD as a growing public mental health priority for the young populace, particularly adolescents. Existing suicide prevention efforts can be complemented through screening adolescents for IGD, and could be expanded to online gaming platforms to reach more hidden at-risk individuals.

Neural activations to loss anticipation mediates the association between difficulties in emotion regulation and screen media activities among early adolescent youth: A moderating role for depression

BACKGROUND

Screen media activities (SMAs; e.g., watching videos, playing videogames) have become increasingly prevalent among youth as ways to alleviate or escape from negative emotional states. However, neural mechanisms underlying these processes in youth are incompletely understood.

METHOD

Seventy-nine youth aged 11-15 years completed a monetary incentive delay task during fMRI scanning. Neural correlates of reward/loss processing and their associations with SMAs were explored. Next, brain activations during reward/loss processing in regions implicated in the processing of emotions were examined as potential mediating factors between difficulties in emotion regulation (DER) and engagement in SMAs. Finally, a moderated mediation model tested the effects of depressive symptoms in such relationships.

RESULT

The emotional components associated with SMAs in reward/loss processing included activations in the left anterior insula (AI) and right dorsolateral prefrontal cortex (DLPFC) during anticipation of working to avoid losses. Activations in both the AI and DLPFC mediated the relationship between DER and SMAs. Moreover, depressive symptoms moderated the relationship between AI activation in response to loss anticipation and SMAs.

CONCLUSION

The current findings suggest that DER link to SMAs through loss-related brain activations implicated in the processing of emotions and motivational avoidance, particularly in youth with greater levels of depressive symptoms. The findings suggest the importance of enhancing emotion-regulation tendencies/abilities in youth and, in particular, their regulatory responses to negative emotional situations in order to guide moderate engagement in SMAs.

Prevalence and Factors Associated with Gaming Disorder in Latin America and the Caribbean: A Systematic Review

We aimed to determine the prevalence and factors associated with gaming disorder (GD) in the population of Latin America and the Caribbean (LAC). A systematic review was performed (PROSPERO protocol registration: CRD42021230565). We included studies that identified participants with GD and/or factors associated with this condition, reported the prevalence of GD, or contained data that assisted in its estimation, were published after 2013 (the year of inclusion of GD in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders) and were carried out in a population residing in an LAC country. Evaluation of the quality of the studies was carried out using the Joanna Briggs Institute Critical appraisal checklist tool. A qualitative synthesis of the data was performed. Of the total of 1567 records identified, 25 passed the full-text review phase, and 6 met the selection criteria. These studies were published between 2018 and 2021 and had a cross-sectional design (three in Brazil, one in Ecuador, Mexico, and the other was multi-country, including a LAC country [Peru]). The prevalence of GD ranged from 1.1% to 38.2%. The three studies in Brazil had the highest figures of GD prevalence (20.4-38.2%). Four studies evaluated factors associated with GD. Characteristics regarding the game (type), pattern of use (hours played), as well as gender (higher in men), tobacco and alcohol consumption, poor interpersonal relationships, and the presence of mental disorders were found to be associated with GD in LAC. Evidence on the prevalence and factors associated with GD in LAC is limited. Studies on GD in LAC evaluate different population subgroups, describing a wide prevalence of this condition (present in up to 38 out of 100 evaluated). Characteristics such as the type and hours of use of the games, sociodemographic data, lifestyles, interpersonal relationships, and the presence of mental disorders increase the probability of presenting GD.

Can internet use become addictive?

Problematic internet use parallels drug addiction, but the mechanisms are not yet clear.

Network analyses of internet gaming disorder symptoms and their links with different types of motivation

The study used regularized partial correlation network analysis (EBICglasso) to examine the structure of DSM-5 internet gaming disorder (IGD) symptoms (network 1); and the associations of the IGD symptoms in the network with different types of motivation as defined in the self-determination theory i.e., intrinsic motivation (engaging in an activity for something unrelated to the activity), identified regulation (engaging in the activity because it aligns with one's values and/or goals), external regulation (engagement in activity being driven by external rewards and/or approval), and amotivation (engaging in an activity without often understanding why) (network 2). Participants were 968 adults from the general community. They completed self-rating questionnaires covering IGD symptoms and different types of motivation. The findings for network 1 showed mostly positive connections between the symptoms within the IGD network. The most central symptom was loss of control, followed by continuation, withdrawal symptoms, and tolerance. In general, these symptoms were more strongly connected with each other than with the rest of the IGD symptoms. The findings for network 2 showed that the different types of motivation were connected differently with the different IGD symptoms. For instance, the likeliest motivation for the preoccupation and escape symptoms is intrinsic motivation, and for negative consequences, it is low identified regulation. Overall, the findings showed a novel understanding of the structure of the IGD symptoms, and the motivations underlying them. The clinical implications of the findings for assessment and treatment of IGD are discussed.