Online gaming addiction in children and adolescents: A review of empirical research

STAT: schema therapy for addiction treatment, a proposal for the integrative treatment of addictive disorders

The nature and origins of addictions and of their adjunctive behaviors, as well as their chronicity, call for treatments that conceptualize and treat them as the long-term and complex processes that they are. Addictions are often comorbid with personality problems and with trauma histories. Patients suffering from these disorders often show poor engagement with treatment and high rates of relapse, possibly because available treatments have yet to address the patient suffering from addiction in a more integrated or holistic manner. In particular, comprehensive treatment models for addictive disorders - like treatments for personality disorders or trauma - are likely to require the integration of behavioral, cognitive, and emotion-focused interventions within a facilitative therapeutic relationship. However, most current treatment models, including ones which are highly effective in stabilization or behavioral change, lack one or more components of treatment that could sustain longer term recovery, wellness, and health for a higher percentage of patients. In this article, I propose approaching addictions and their treatment from the perspective of schema therapy, an integrative, developmental model with a strong track record of positive outcomes in addressing personality disorder symptoms and long-standing trauma histories, commonly comorbid with addictive disorders. In advancing this proposal, I begin by providing some background tying together addictions, attachment, and personality, suggesting they be treated simultaneously to achieve improved outcomes. Then, after briefly reviewing the leading approaches to the treatment of addictions, I introduce the idea that schema therapy is well-situated - both theoretically and practically - to address many of the shortcomings of existing treatment options. In particular, I note how addictive and co-occurring colluding behaviors are deeply intertwined with both early and continued frustration of core developmental needs. I illustrate how the addictive cycle is perpetuated through the process of schema reinforcement and through the operation of schema modes. I then demonstrate how these key terms (i.e., needs, schemas, and modes) inform the patient's assessment and case formulation, guiding treatment interventions from a strong therapeutic relationship that focuses on integrating recovery behavior change, healing dysfunctional schemas and modes, and preventing relapse.

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.

Impact of mobile phones and wireless devices use on children and adolescents' mental health: a systematic review

Growing use of mobiles phones (MP) and other wireless devices (WD) has raised concerns about their possible effects on children and adolescents' wellbeing. Understanding whether these technologies affect children and adolescents' mental health in positive or detrimental ways has become more urgent following further increase in use since the COVID-19 outbreak. To review the empirical evidence on associations between use of MP/WD and mental health in children and adolescents. A systematic review of literature was carried out on Medline, Embase and PsycINFO for studies published prior to July 15th 2019, PROSPERO ID: CRD42019146750. 25 observational studies published between January 1st 2011 and 2019 were reviewed (ten were cohort studies, 15 were cross-sectional). Overall estimated participant mean age and proportion female were 14.6 years and 47%, respectively. Substantial between-study heterogeneity in design and measurement of MP/WD usage and mental health outcomes limited our ability to infer general conclusions. Observed effects differed depending on time and type of MP/WD usage. We found suggestive but limited evidence that greater use of MP/WD may be associated with poorer mental health in children and adolescents. Risk of bias was rated as 'high' for 16 studies, 'moderate' for five studies and 'low' for four studies. More high-quality longitudinal studies and mechanistic research are needed to clarify the role of sleep and of type of MP/WD use (e.g. social media) on mental health trajectories in children and adolescents.

Comparing the effectiveness of game literacy education and game coding education in improving problematic internet gaming

Objective

Problematic internet gaming by adolescents has been thought to be associated with low self-esteem, depression, anxiety, and attention problems. We hypothesized that both game literacy and coding education would effectively improve problematic internet use. However, game coding education would be more effective in enhancing self-esteem and social anxiety in adolescents than game literacy education.

Methods

A total of 733 adolescent volunteers were included and randomly assigned to either the game coding education or game literacy education programs. Both programs consisted of eight sessions, each lasting 45 minutes, over four weeks. The coding education sessions included game planning and development lessons and allowed students to create the game's characters, stages, and tutorials directly using Scratch, a free coding program. Game literacy education sessions included lessons on enjoying gaming with a healthy rationale and etiquette. Data on demographics, gaming patterns, and psychological status, including positive/negative perceptions of online games, depression, social anxiety, and self-esteem, were collected.

Results

Both game coding and game literacy education significantly improved YIAS scores compared to baseline, and there was no significant difference in the YIAS scores between the two groups after the interventions. In the hierarchical logistic regression analysis of all participants, higher YIAS scores, stronger negative perceptions of gaming, and lower attention problem scores at baseline predicted lower levels of internet gaming addiction after interventions. In the hierarchical logistic regression analysis among individuals with game coding education, higher YIAS scores, stronger negative perceptions of gaming, lower attention problem scores, and higher self-esteem scores at baseline predicted lower levels of internet gaming addiction after intervention. In addition, game coding education greatly improved negative perceptions of games, self-esteem, and social anxiety compared to game literacy education.

Conclusion

Both game literacy and game coding education effectively mitigate internet game addiction. However, game coding education effectively mitigated problematic internet gaming by improving negative perceptions of games, self-esteem, and social anxiety in adolescents. We found that the application of knowledge by students in creating their own games was more effective than simply developing a conceptual understanding of the games.

The Prevalence of Internet Gaming Disorder and its Associated Factors Among College Students in Saurashtra Region, Gujarat, India

Background

Internet gaming has become popular in the last few decades; however, very few studies have been conducted on internet gaming in India. This study aimed to investigate internet gaming disorder (IGD), its prevalence, gaming behavior, and effects as well as multiple factors associated with its emergence among college students.

Methods

This cross-sectional study involved a group of 150 college students. Data were collected using a semi-structured questionnaire containing the Internet Gaming Disorder Scale-Short Form (IGDS9-SF). Statistical analysis was done using Jamovi software.

Findings

A total of 150 college student gamers were involved with a mean age of 18.69±0.10 years. The mean IGD score was 18.74 with a standard deviation of 0.53, while the median score was 18. The prevalence of IGD was 5.3% among the participants. The IGD prevalence was higher in male students and those whose mothers had a high school diploma or higher. Gamers who spent more than2 hours a day on games had significantly higher IGD scores (P<0.05). A significant association was also found between tingling/numbness in the hand while playing and physical pain with IGD (P<0.05).

Conclusion

Spending more time playing online games was significantly associated with a higher risk of IGD. One negative consequence of IGD is the development of physical health issues. It is important to raise awareness about the physical health consequences of excessive gaming among students, parents, institutions, and concerned authorities.

Is obesity and body perception disturbance related to social media addiction among university students?

Objective The use of social networks has grown substantially over the past few years and especially during COVID-19. This study aims to investigate the possible relationship between social media addiction and obesity which may lead to disturbed body perception in university students.Participants: A total of 250 undergraduates participated.Results: Social media addiction depends on the number of years of social media use, meal skipping, and increased frequency of fast food consumption. There was a significant relationship between fast-food consumption frequency and body perception. No significant relationship was found between BMI and SMAS while there was a significant relationship between SMAS and body perception.Conclusion: The findings support, social media addiction may lead to increased risk factors for obesity and as a consequence impair body perception in young adults.

Use and Abuse of Digital Devices: Influencing Factors of Child and Adolescent Neuropsychology

The impact of technology on human life is significant, touching various aspects such as communication, economy, education, medicine, industry, and even ecosystems [...].

Association of internet gaming disorder with impulsivity: role of risk preferences

BACKGROUND

Internet gaming disorder (IGD) is a formal mental disorder leading to personal and social impairment. Although it shares similar physical and psychosocial effects to substance use disorder, the psychological mechanisms underlying IGD remain unclear, although several researches have made significant contributions to its understanding. This study aims to elucidate the correlation between IGD, impulsive personality and risk preference of medical college students in China, from a questionnaire-based investigation.

METHODS

Based on the cluster random sampling method, a questionnaire survey was conducted among medical college students in Northern Anhui, China from September 3 to October 27, 2020. The questionnaires included the Internet Gaming Disorder Scale (IGD-20), Chinese revised of Barratt Impulsiveness Scale Version 11 (BIS-11), and risk appetite index (RPI). Perform independent sample t-tests, analysis of variance (ANOVA), correlation analysis, and moderating effect analysis using SPSS 23.0. P < 0. 05 is considered statistically significant.

RESULTS

624 participants completed the survey, including 257 males (41.19%) and 367 females (58.81%). All participants were between 18 and 24 years. We found that in IGD and its six different dimensions and RPI, males scored significantly higher than females. Additionally, our finding revealed there is statistical significance in IGD and impulsiveness between gaming group with game time greater than or equal to 4 h and non-gaming group. The IGD and its six different dimensions, among which all except for mood modification are positively correlated with impulsiveness and RPI. Mediating effects indicate that RPI plays a partial mediating role between motor impulsiveness and IGD.

CONCLUSION

The findings shows that there is a certain relationship between impulsivity and RPI, as well as IGD and its dimensions. RPI may be a mediator between impulsivity and IGD, and men have higher IGD. The findings supported the compensatory hypothesis. These findings may contribute to further research and development of intervention and prevention measures for IGD.

Mapping the theories, content, and outcomes of family-based interventions for children and young people with gaming disorder: A scoping review protocol

Background  Despite the growth of gaming disorders globally, evidence of the formal involvement of family in treating gaming disorders is limited. When children are affected by gaming disorder, the family may encounter challenges in managing the behavior and in the lack of information regarding the gaming disorder, resulting in inconsistent parenting, which may further exacerbate the problem. Thus, it is essential to involve the family in formal interventions. The current scoping review plans to identify the theories, content, and outcomes of family-based interventions for children and young people with gaming disorders. Methods  This scoping review will follow the Joanna Briggs Institute (JBI) methodology. The population, Concept, and Context (PCC) were used to develop the review question. The studies published in the indexed databases will be searched systematically, and the reference list of included full texts will be searched for relevant studies. Intervention studies published in English from January 2010 to December 2022 will be included. Two independent reviewers will screen the studies against eligibility criteria. The data will be extracted and presented in a tabular and narrative style. Discussion  This scoping review will help better understand content, outcomes, and theories underpinning family-based interventions for children and young people with gaming disorders. Findings will inform the stakeholders about the current topic and guide the potential research areas. Registration details: The protocol has been registered in Open Science Framework with the DOI: https://doi.org/10.17605/OSF.IO/TXWBH.

Prevalence and associated factors of depressive and anxiety symptoms among Chinese secondary school students

BACKGROUND

Depressive and anxiety symptoms affect about one-fourth of Chinese secondary school students. However, the prevalence and correlates of mental distress among secondary school students from Western China remain largely unexplored. This study aimed to examine the prevalence and associations of depressive and anxiety symptoms with demographic, family, school, life, and behavior factors in a large, representative sample of secondary school students in Zigong, a city in Western China.

METHODS

Secondary school students were recruited using cluster sampling. The 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder Questionnaire, Multidimensional Peer-Victimization Scale, the Pittsburgh Sleep Quality Index, and Nine-Item Internet Gaming Disorder Scale-Short Form were used. Descriptive statistic was used to describe the sociodemographic characteristics of participants. The clustering effect was adjusted by the "survey" package of R to calculate weighted prevalence. Univariate and multivariate logistic regression were used to explore associated factors of depression and anxiety, respectively.

RESULTS

A total of 63,205 participants were involved, in which the weighted prevalence of depression in all subjects was 23.0% (95% CI: 19.6- 27.0%), and the weighted prevalence of anxiety was 13.9% (95% CI: 11.2- 17.0%). Logistic regression results showed girls, being single-child, non-nuclear family, peer bullying, sleep disturbance, and internet gaming disorder symptoms were positively associated with depressive and anxiety symptoms.

CONCLUSION

Depressive and anxiety symptoms were prevalent among secondary school students in Western China. Our results can guide policy strategies for the assessment, prevention, and intervention of psychological status among Chinese secondary school students.

Predictors of Problematic Video Gaming in Elementary School Boys with ADHD

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

Cross-Cultural Efficacy of the Acceptance and Cognitive Restructuring Intervention Program (ACRIP) on the Internet Gaming Disorder Symptoms of Selected Asian Adolescents

Empirical evidence shows that Internet Gaming Disorder (IGD) with poor psychological well-being increases. IGD has become an emerging issue of significant public health concern and the World Health Organization has recently recognized it as a mental health condition. This study examined the efficacy of the Acceptance and Cognitive Restructuring Intervention Program (ACRIP) in reducing the symptoms of IGD and improving the psychological well-being of adolescent gamers from select Asian cultures after proving it effective in a prior study in the Indian setting. The development of the ACRIP employed a sequential exploratory research design and randomized controlled trial on thirty participants. Internet Gaming Disorder (IGDS9-SF) and Ryff's Psychological well-being (PWB) scales were used to measure the severity of the gaming disorder and the state of psychological health of the experimental and control groups. Power analysis ascertained the study with a power of 0.90, indicating a strong probability of obtaining a statistically significant effect. Statistical analyses using paired t-test and MANOVA on post-test mean scores on IGD and PWB of the experimental group showed a significant difference which suggested that the ACRIP is efficacious and culture-free.

Nomophobia and smartphone addiction amidst COVID-19 home confinement: the parallel mediating role of digital gaming and social media tools usage across secondary school students

Introduction

With the inevitable technological boom enforced by the COVID-19 lockdowns and online emergency remote teaching practices, the prevalence of nomophobia (NMP) and smartphone addiction (SA) among adolescents has become a pressing issue, which has come under scrutiny. However, the impact of social media tools usage (SMTU) and digital gaming behavior (DGB) on these phenomena remains unclear since there is little research focusing on the complex interplay among these variables. Regarding this context, the present study aimed to explore the parallel mediating role of secondary school students' SMTU and DGB in the relation between NMP and SA.

Methods

In line with this aim, we employed a cross-sectional design with a critical case sampling strategy and collected data through an online survey from a total of 427 secondary school students in Istanbul in the 2021-2022 academic year. In order to test the parallel mediation model, we employed multiple linear regression models by utilizing PROCESS models with 5000 BC bootstrap samples and 95% CI.

Results and discussion

Results illustrated that there was an increase in the prevalence of NMP and SA during the COVID-19 home confinement as consistent with the previous research. The results also indicated that among the multiple mediators, the mediating role of SMTU was significant in the relation between NMP and SA. This means NMP has direct and indirect significant impact on SA through SMTU. However, the mediating role of DGB was found nonsignificant in this relationship. Our results are robust and hold key contributions to both theoria and praxis in educational psychology research realm by disentangling the complex underlying mechanism between NMP, SMTU, DGB, and SA. On the practical side, our results provide insightful implications for school boards and researchers in the development of effective interventions.

Predicting preschool children's digital play addiction tendency during Covid-19 pandemic: Regarding the mother-child relationship, and child- and family-related factors

Previous research about children's digital play has predominantly focused on parental perspectives and parental mediation strategies. Although research on the effects of digital play on young children's development is plentiful, there is little evidence on young children's digital play addiction tendency. Herein, preschool children's digital play addiction tendency, and the mother-child relationship perceived by mothers, examining child- and family-related factors were explored. The present study also aimed to contribute to the current research pertaining to preschool-aged children's digital play addiction tendency through an examination of the mother-child relationship, and child- and family-related factors as potential predictors of children's digital play addiction tendency. A sample of 450 mothers of children between 4 and 6 years filled out two measures that identify the mother-child relationship and children's digital play addiction tendency. Correlational analyses revealed that in general, the mother-child relationship was significantly associated with children's digital play addiction tendency. Significant differences were evident in the relationship between numerous child- and family-related factors, and children's digital play addiction tendency, as well as the mother-child relationship. Hierarchical regression analyses indicated that a negative mother-child relationship, the children's digital play usage, and the mothers' digital device usage predicted the children's digital play addiction tendency.

Computational Mechanisms of Addiction and Anxiety: A Developmental Perspective

A central goal of computational psychiatry is to identify systematic relationships between transdiagnostic dimensions of psychiatric symptomatology and the latent learning and decision-making computations that inform individuals' thoughts, feelings, and choices. Most psychiatric disorders emerge prior to adulthood, yet little work has extended these computational approaches to study the development of psychopathology. Here, we lay out a roadmap for future studies implementing this approach by developing empirically and theoretically informed hypotheses about how developmental changes in model-based control of action and Pavlovian learning processes may modulate vulnerability to anxiety and addiction. We highlight how insights from studies leveraging computational approaches to characterize the normative developmental trajectories of clinically relevant learning and decision-making processes may suggest promising avenues for future developmental computational psychiatry research.

Effects of digital game addiction on cardiovascular health behavior on secondary school students during the COVID-19 pandemic

PURPOSE

This study aimed to investigate factors affecting digital game addiction in secondary school students during the COVID-19 pandemic and the effects of digital game addiction on cardiovascular health behavior.

DESIGN AND METHODS

This descriptive, correlational, and cross-sectional study was conducted with 619 secondary school students aged 10-14 years. Study data were analyzed using World Health Organization AnthroPlus and SPSS programs. Simple linear regression and multiple linear regression methods were used in the analysis process.

RESULTS

Findings showed that 43.6% of the students played digital games for more than two hours a day. Descriptive characteristics (gender, age, basal metabolic rate, educational status of parent, income status, etc.) and digital gaming habits of the students accounted for 37.0% of the variance in digital game addiction. Digital game addiction adversely affected cardiovascular health behavior and all its sub-dimensions.

CONCLUSION

The first factor that predicted digital game addiction, in order of significance, was daily digital game playing time. Digital game addiction negatively affected the sedentary lifestyle sub-dimension of cardiovascular health behavior most. Digital game addiction may trigger an increase in the incidence of diseases such as diabetes, cancer, and especially cardiovascular diseases, at later ages.

PRACTICE IMPLICATIONS

Nurses, schools, and parents have critical responsibilities in preventing digital game addiction. Results of this research will make a remarkable contribution to the development of preventive services by revealing risk factors for digital game addiction and the effects of digital game addiction on cardiovascular health behavior.

Internet use, depression, and cognitive outcomes among Chinese adolescents

This study provides new evidence on how the growingly significant digital life shapes Chinese adolescents' cognitive and mental health outcomes based on their gender, parental education, and geographical location. Using the China Education Panel Survey, a nationally representative survey following 12-15-year-old students in 2013 and 2014, and individual fixed-effect models, we find that more time spent on the Internet is associated with higher self-reported depression scores. This negative impact on mental health is more substantial for girls, those with less-educated parents, and those living outside the city center. The link between Internet use and cognitive development is almost null. Time spent online negatively affects Chinese young adolescents' subjective well-being but has little impact on their cognitive development. The link between Internet use time and subjective well-being also depends on gender, parental education, and the geographical location of those adolescents. The heterogeneous impacts of Internet use time offer crucial new evidence to the multiple dimensions of the digital divide among adolescents in China.

Relationships between psychological flexibility and internet gaming disorder among adolescents: Mediation effects of depression and maladaptive cognitions

Psychological flexibility may reduce addictive behaviours by adaptive and flexible emotional and cognitive processes. This study tested a mediation model of internet gaming disorder (IGD) in which psychological flexibility would reduce depression and maladaptive cognitions related to internet gaming and in turn lower the risk of IGD. A cross-sectional study surveyed 2102 secondary 1-4 students from seven schools during March to November 2021 in Hong Kong, China. The results showed that 12.7% and 52.2% of the students were classified as having probable IGD and depression, respectively. The proposed mediation model fitted the data well: χ2/df = 8.00, CFI = .99, NNFI = .99, RMSEA = .01. Psychological inflexibility was directly and positively associated with IGD (B = .01, β = .07, p = .003) and indirectly and positively associated with IGD via depressive symptoms (B = .01, β = .07, p = .001, PM = 23.7%) and maladaptive cognitions (B = .03, β = .15, p = .001, PM = 50.8%). Multi-group analyses showed that gender significantly moderated the associations between psychological inflexibility and maladaptive cognitions (Δχ2/Δdf = 8.69/1, p < .05), between maladaptive cognitions and IGD (Δχ2/Δdf = 4.33/1, p < .05), and between psychological inflexibility and IGD (Δχ2/Δdf = 5.46/1, p < .05). Depression and maladaptive cognitions may be significant mediators that could explain the relationship between psychological flexibility and IGD. Also, gender difference may exist. Based on the findings, intervention strategies for IGD reduction are discussed.

Time Spent Gaming, Device Type, Addiction Scores, and Well-being of Adolescent English Gamers in the 2021 OxWell Survey: Latent Profile Analysis

BACKGROUND

The shift in the last decades to screen-based and increasingly web-based gaming activity has raised concerns about its impact on the development of children and adolescents. Despite decades of research into gaming and related psychosocial effects, the question remains how best to identify what degree or context of gaming may be a cause for concern.

OBJECTIVE

This study aimed to classify adolescents into gamer profiles based on both gaming behaviors and well-being. Once we distinguished the different gamer profiles, we aimed to explore whether membership to a specific profile could be predicted based on a range of personal characteristics and experiences that could then help identify those at risk.

METHODS

We explored gaming and well-being in an adolescent school population (aged 12-18 years) in England as part of the 2021 OxWell student survey. Self-report measures of time spent playing games on computers or consoles, time spent playing games on mobile phones, the Game Addiction Scale, and the Warwick-Edinburgh Mental Well-being Scale were used to classify adolescent heavy gamers (playing games for at least 3.5 hours a day) using latent profile analysis. We used multinomial logistic regression analysis to predict the profile membership based on a range of personal characteristics and experiences.

RESULTS

In total, 12,725 participants answered the OxWell gaming questions. Almost one-third (3970/12,725, 31.2%) indicated that they play games for at least 3.5 hours a day. The correlation between time spent playing video games overall and well-being was not significant (P=.41). The latent profile analysis distinguished 6 profiles of adolescent heavy gamers: adaptive computer gamers (1747/3970, 44%); casual computer gamers (873/3970, 22%); casual phone gamers (595/3970, 15%); unknown device gamers (476/3970, 12%); maladaptive computer gamers (238/3970, 6%); and maladaptive phone gamers (79/3970, 2%). In comparison with adaptive computer gamers, maladaptive phone gamers were mostly female (odds ratio [OR] 0.08, 95% CI 0.03-0.21) and were more likely to have experienced abuse or neglect (OR 3.18, 95% CI 1.34-7.55). Maladaptive computer gamers, who reported gaming both on their mobile phones and on the computer, were mostly male and more likely to report anxiety (OR 2.25, 95% CI 1.23-4.12), aggressive behavior (OR 2.83, 95% CI 1.65-4.88), and web-based gambling (OR 2.18, 95% CI 1.24-3.81).

CONCLUSIONS

A substantial number of adolescents are spending ≥3.5 hours gaming each day, with almost 1 in 10 (317/3970, 8%) reporting co-occurring gaming and well-being issues. Long hours gaming using mobile phones, particularly common in female gamers, may signal poorer functioning and indicate a need for additional support. Although increased time gaming might be changing how adolescents spend their free time and might thus have public health implications, it does not seem to relate to co-occurring well-being issues or mental ill-health for the majority of adolescent gamers.

The Association between Video Game Time and Adolescent Mental Health: Evidence from Rural China

As digital devices like computers become more widely available in developing countries, there is a growing need to understand how the time that adolescents spend using these devices for recreational purposes such as playing video games is linked with their mental health outcomes. We measured the amount of time that adolescents in rural China spent playing video games and the association of video game time with their mental health. We collected data from primary and junior high schools in a poor, rural province in northwest China (n = 1603 students) and used the Depression, Anxiety, and Stress Scales (DASS-21) to measure mental health symptoms. The results indicated that the average video game time was about 0.69 h per week. There was a significant association between adolescent video game time and poorer mental health. Each additional hour of playing video games also increased the chance of having moderate or above symptoms. Moreover, boys and non-left-behind children had worse mental health if they played more video games. Our study contributes to literature on the links between recreational screen time and mental health, and it sheds light on an issue addressed by recent government legislation to limit the video game time of minors in China.

The prevalence and possible risk factors of internet gaming disorder among adolescents and young adults: Systematic reviews and meta-analyses

BACKGROUND

As a spreading addictive behaviour in recent years, internet gaming disorder (IGD) has been studied a lot and the overall research results indicate that IGD has a high prevalence among adolescents and young adults (AYAs). To update the status quo of prevalence, it is necessary to conduct comprehensive analyses.

METHODS

On the premise of following the PRISMA statement, the study conducted two systematic reviews and meta-analyses to assess the global prevalence of IGD among AYAs and identify its possible risk factors. To achieve the goals, PubMed and CNKI databases were used to select the concerned studies published up to May 31, 2021. Heterogeneity was assessed using a funnel plot, Begg's test, Egger's test, and trim-and-fil method, followed by sensitivity analysis, subgroup analysis, and meta-regression analysis.

RESULTS

For the meta-analysis of prevalence, 407,620 participants from 155 reports in 33 countries were included. The pooled prevalence of IGD among AYAs was 9.9% (95% CI: 8.6%-11.3%, P = 0.000, I² = 94.4%), including 8.8% (95% CI: 7.5%-10.0%) among adolescents and 10.4% (95% CI: 8.8%-11.9%) among young adults. The following 12 factors are the possible risk factors of IGD among AYAs, which are stress, long average game time, family dysfunction, poor academic performance, being bullied, bullying, interpersonal problems, hyperactivity/inattention, anxiety, depression, emotional distress and low self-esteem.

CONCLUSIONS

This study confirms the prevalence and possible risk factors for IGD among AYAs. It's valuable in understanding the threat of IGD and finding intervention strategies for IGD among AYAs.

Do Individuals with Internet Gaming Disorder Share Personality Traits with Substance-Dependent Individuals?

(1) Background: Internet gaming disorder (IGD) shares many similarities with substance use disorder (SUD), contributing to its recognition as an addictive disorder. Nevertheless, no study has compared IGD to other addictive disorders in terms of personality traits established as highly co-occurring with SUDs. (2) Methods: We recruited a sample of gamers (massively multiplayer online role-playing games) (MMORPGs) via online in-game forums. We compared 83 individuals with IGD (MMORPG-IGD group) to 47 former heroin addicts under methadone maintenance treatment (MMT; MMT group) with regard to alexithymia, impulsivity, sensation seeking and aggressiveness assessed through self-administered scales, being TAS-20, BIS-10, Z-SSS and BDHI, respectively. (3) Results: Our results draw a relatively similar personality profile between groups but indicate that the subject traits are generally more pronounced in the MMT cohort. The overall lesser intensity of these traits in the MMORPG-IGD group might reflect the greater variability in the severity of the IGD. (4) Conclusions: IGD shares personality traits with MMT, and intensity may be influenced by the severity of the addiction or by certain direct environmental factors, and might also influence the propensity towards one behavior rather than another.

Predictors of Gaming Disorder or Protective from It, in a French Sample: A Symptomatic Approach to Self-Regulation and Pursued Rewards, Providing Insights for Clinical Practice

Gaming disorder (GD) is a new health condition still requiring a lot of evidence established around its underlying and related psychological mechanisms. In our study we focused on Massively Multiplayer Online Role Playing Games (MMORPGs), a specific very popular and engaging game genre, to determine that benefit, motivation and control aspects could be predictive of a dysfunctional engagement in gaming. In total, 313 participants were recruited from private forums of gamers between May 2009 and March 2010. They filled out a questionnaire on their socio-demographic data and their weekly gaming time. They also completed different psychometric assessments such as the DSM IV-TR criteria for substance dependence adapted to gaming such as the Dependence Adapted Scale (DAS), the external rewards they expected from gaming (External Motives), the expected internal reward they expected from gaming (Internal Motives), the Zuckerman Sensation Seeking Scale (ZSSS), and the Barratt impulsiveness Scale (BIS-10). Results showed that some psychological factors related to online gaming represented risk factors for GD in participants (i.e., competition and advancement motives, reduced anxiety, solace, greater personal satisfaction, and sense of power), whereas some others were found to be protective factors from GD (i.e., recreation, enjoyment and experience seeking) in participants. Additionally, the study found that disinhibition, boredom susceptibility, thrill and adventure seeking, and high impulsivity were correlated to GD in participants. In conclusion, not only motives for gaming and impulsivity could be predictors for GD, but maladaptive coping strategies based on experienced relief in-game from negative feelings (anxiety and boredom) or experienced improvement in-game of self-perception (personal satisfaction, sense of power) could play as well a role of negative reinforcers for GD. Some benefits from gaming, typically entertainment and enjoyment, are shown to be protective factors from GD, playing the role of positive reinforcing factors. They are worthy of being identified and promoted as functional gaming habits. These findings can feed the clinical and health promotion fields, with a more in-depth understanding of diverse psychological factors in gamers, identifying those at risk for GD and those protective from it. The current work can foster a more balanced approach towards gaming activities, taking their opportunities for mankind and controlling for their adverse effects in some individuals.

Online gaming addiction in youth: Some comments on Rosendo-Rios et al. (2022)

A recent systematic review examining online gaming addiction among children and young adults was published in Addictive Behaviors (i.e., Rosendo-Rios, Trott & Shukla, 2022). However, dozens of papers were missing from the review. One of the reasons why so many studies were not in the review is likely to be because of the search terms used. None of the search terms included the words 'adolescent', 'adolescence', 'emerging adults', 'excessive gaming', 'gaming disorder', 'video game addiction' or 'problematic gaming'. Moreover, studies were also included in the review if the mean age of the total sample was 25 years or below. This meant that some studies in the review included some participants who were not children, adolescents or emerging adults. It also meant that many studies were not included that had mean ages below the age of 26 years because they were not picked up by the search strategy. Given the high number of studies that were not included in the review, readers should view this systematic review as 'suggestive' of research in the area of problematic gaming in youth rather than 'definitive'.

The Relationship Between Early Maladaptive Schemas, Depression, Anxiety and Problematic Video Gaming Among Female and Male Gamers

The present study investigated the relationship between problematic video gaming (PVG) and early maladaptive schemas (EMSs) among male and female gamers. Additionally, the present study investigated depression and anxiety as mediators in the relationship between EMSs and PVG. The study comprised 673 videogame players (391 female gamers) aged from 18 to 38 years. PVG was assessed using the nine-item Internet Gaming Disorder Scale-Short-Form (IGDS9-SF). Depression and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). EMS dimensions were assessed using the Young Schema Questionnaire (YSQ-S3). Results suggested that EMSs such as practical incompetence/dependence were positively related to PVG. The findings showed gender differences in these relationships. The vulnerability to harm or illness, enmeshment and subjugation schemas were positively related to PVG among male gamers. However, depression and anxiety did not mediate the relationship between EMSs and PVG. These findings may contribute to a better understanding of mechanisms related to PVG development, which are associated with maladaptive schemas.

Supplementary Information

The online version contains supplementary materials available at 10.1007/s11469-022-00858-2.

Systematic literature review online gaming addiction among children and young adults: A framework and research agenda

Online gaming addiction refers to a persistent and recurrent use of internet to engage in games leading to significant impairment or distress in a person's life. With the current pandemic, media reports suggest that the greater access of online devices among children and young adults has intensified online gaming addiction. However, the domain of online gaming addiction is a relatively new phenomenon with disparate studies examining various facets of it. Hence, the purpose of this research is to analyze the existing literature in order to identify the emerging trends in this area and to provide a systematic review that can be used as guidance for future research in this emerging field. Starting from the gaps that this review highlights, the proposed directions will help scholars find issues and gaps not sufficiently explored that can constitute the bases for further research pathways.

Altered neural responses to missed chance contribute to the risk-taking behaviour in individuals with Internet gaming disorder

Missed chance is a powerful factor in shaping risk-taking behaviour. The abnormal risk-taking behaviour is an obvious feature of individuals with Internet gaming disorder (IGD). However, the relationship between the neural responses to missed chance and risk-taking behaviour in IGD individuals remains unclear. In the current fMRI study, 28 IGD subjects (12 female, 23.04 ± 2.43 years old) and 26 healthy control (HC) subjects (13 female, 23.58 ± 2.67 years old) participated in fMRI scanning during performance of a sequential risk-taking task. The general linear model and the psycho-physiological interaction analyses were conducted to explore the difference in neural responses between the two groups. The results showed that IGD subjects reported more regret for the large missed chance and took more risk than HC subjects. Moreover, compared with HC subjects, IGD subjects exhibited greater activations in brain regions like ventral striatum (VS) and superior frontal gyrus (SFG), and stronger VS-thalamus functional connectivity for the large missed chance. Additionally, among IGD subjects, the SFG activation for the large missed chance was positively correlated with the risk-taking behaviour. Together, the results revealed the altered neural responses to missed chance contributed to the risk-taking behaviour in IGD individuals. The findings could help to clearly understand why IGD individuals continue playing online games despite the risks of widely known and could provide a new perspective for the intervention of IGD.

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

OBJECTIVE

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

A Literature Review on the Efficacy and Related Neural Effects of Pharmacological and Psychosocial Treatments in Individuals With Internet Gaming Disorder

OBJECTIVE

Internet gaming disorder (IGD) has attracted considerable attention as a serious mental and public health issue worldwide. Currently, there are no established treatment guidelines for IGD. Herein, we review the latest findings on the efficacy and related neural effects of pharmacological and psychosocial treatments for individuals with IGD.

METHODS

A database search of relevant studies published between 2007 and 2020 was conducted using PubMed and Google Scholar. Twenty-seven studies were reviewed for current evidence related to the efficacy and neural effects of pharmacological and psychosocial IGD treatments.

RESULTS

Pharmacological studies suggest that bupropion may play a significant role in IGD. Additionally, nuclear imaging studies on IGD have demonstrated functional impairment of the dopamine system, providing a neurobiological basis for the efficacy of dopamineenhancing drugs. Among the various psychosocial interventions, current evidence suggests that cognitive behavioral therapy may be an effective intervention for IGD. Cognitive behavioral therapy and bupropion were found to influence resting-state functional connectivity within the cortico-subcortical circuit and default mode network, suggesting a possible neural mechanism. Innovative approaches, including virtual reality treatment, residential camps, voluntary abstinence, and transcranial direct current stimulation, have shown promising results. However, methodological limitations, such as the absence of proper controls, small sample sizes, short duration, inconsistency of inclusion criteria across studies, and self-report measures of outcome, hamper conclusions regarding the efficacy of treatments.

CONCLUSION

Ongoing basic research and clinical trials overcoming these limitations could add to the existing knowledge on IGD and contribute to the development of evidence-based treatments.

The structural characteristics of esports gaming and their behavioral implications for high engagement: A competition perspective and a cross-cultural examination

Esports has become one of the major online entertainment activities around the globe. Different from the previously dominant massively multiplayer online role-playing games, esports gaming has its unique structural characteristics, which substantially reshape the motivations, experiences, and behaviors of game users while raising new questions for research on Internet gaming disorder. In addition to identifying four structural characteristics of esports, the present study analyzed their implications from both theoretical and practical perspectives and conducted a cross-cultural examination by utilizing accurate and objective match history data of esports gamers in five different geographic regions (countries). Several findings of interest were obtained in this study. First, having in-game friend(s) in a premade team significantly increased gamers' propensity to play consecutive matches. Second, whereas Nordic and Eastern European gamers tended to play additional matches following wins, Japanese gamers were inclined to do so after experiencing losses. Third, low and high-skilled gamers were more likely to engage in consecutive play than their middle-skilled counterparts. With a focus on the competitive nature of esports, this study demonstrated that the presence of friend(s), the outcome of the previous match, and the level of gaming skill can significantly influence esports gamers' involvement.

Joint effects of children's emotional problems and parental depressive symptoms on the occurrence of internet gaming disorder among children and adolescents: A longitudinal study

BACKGROUND AND AIMS

Parental depressive symptoms may aggravate the effects of children's emotional problems on risks for Internet gaming disorder (IGD). Here we examined the joint effects of children's emotional problems and parents' depressive symptoms on the incidence of IGD.

METHODS

A large prospective, population-based cohort tested potential interactions between children's emotional problems, parents' depressive symptoms, and incidence of high risk of IGD (HRIGD). Family dyads (n=2,031) that included children who were non-HRIGD at baseline completed assessments of childhood and parental affective symptomatology. HRIGD was assessed at baseline and 12 months. Relative excess risk due to interaction (RERI) estimated the magnitudes of interactions.

RESULTS

In terms of risk for the development of IGD, parental depression was 1.8 times greater, children's emotional problems were 2.9 times greater, and both risk factors together were 6.1 times greater than the background risk, with the last two findings reaching statistical significance. The expected risk for the development of HRIGD was RR=3.7.

DISCUSSION AND CONCLUSIONS

Children's emotional problems demonstrated a particularly strong relationship with HRIGD. Joint effects of children's emotional problems and depressive symptoms in parents on the incidence of HRIGD were stronger than the sum of the independent effects of each factor. The findings suggest that combining interventions for the treatment of children's emotional problems and parents' depressive symptoms may have extra risk reduction effects on preventing IGD in children and adolescents.

Metacognitions as a predictor of online gaming in adolescents: Psychometric properties of the metacognitions about online gaming scale among Iranian adolescents

The Metacognitions about Online Gaming Scale (MOGS) measures maladaptive metacognitions about online gaming. The purpose of the present study was to evaluate psychometric properties of the MOGS, including its factor structure, reliability, and predictive validity among Iranian adolescents. The scale was administered to 769 Iranian adolescents (577 male, mean age = 16.39 ± 1.68 years) with an age range of 15-19 years. The participants completed the Persian-translated version of the MOGS, the Big Five Inventory-10, the Depression, Anxiety and Stress Scale 21, the Video-Game Related Cognitions Scale, the Motives for Online Gaming Questionnaire, and the Problematic Online Gaming Questionnaire. The results of the Exploratory Factor Analysis (n = 350) and Confirmatory Factor Analysis (n = 419) confirmed three-factors similar to the parent version, including "negative metacognitions about uncontrollability of online gaming" (N-MOGU), "negative metacognitions about dangers of online gaming" (N-MOGD), and "positive metacognitions about online gaming" (P-MOG). The Persian MOGS's reliability showed a suitable internal consistency for the P-MOG, the N-MOGU, the N-MOGD, and the total score in both confirmatory and exploratory samples (range 0.79 to 0.93). A hierarchical regression analysis showed that the Persian MOGS predicted 33.9% of the variance in problematic online gaming independently of personality traits, anxiety, depression, stress, and both gaming-related cognitions and gaming motives. Furthermore, the results of analyses of variance with follow-up Bonferroni pairwise comparisons showed that interaction between the factors of MOGS and types of game and tools of gaming was significant. The findings provide evidence that the Persian MOGS among Iranian adolescents appears psychometrically appropriate to be used by researchers and practitioners dealing with the prevention and treatment of problematic online gaming.

Disrupted prefrontal regulation of striatum-related craving in Internet gaming disorder revealed by dynamic causal modeling: results from a cue-reactivity task

BACKGROUND

Studies of Internet gaming disorder (IGD) suggest an imbalanced relationship between cognitive control and reward processing in people with IGD. However, it remains unclear how these two systems interact with each other, and whether they could serve as neurobiological markers for IGD.

METHODS

Fifty IGD subjects and matched individuals with recreational game use (RGU) were selected and compared when they were performing a cue-craving task. Regions of interests [anterior cingulate cortex (ACC), lentiform nucleus] were selected based on the comparison between brain responses to gaming-related cues and neutral cues. Directional connectivities among these brain regions were determined using Bayesian estimation. We additionally examined the posterior cingulate cortex (PCC) in a separate analysis based on data implicating the PCC in craving in addiction.

RESULTS

During fixed-connectivity analyses, IGD subjects showed blunted ACC-to-lentiform and lentiform-to-ACC connectivity relative to RGU subjects, especially in the left hemisphere. When facing gaming cues, IGD subjects trended toward lower left-hemispheric modulatory effects in ACC-to-lentiform connectivity than RGU subjects. Self-reported cue-related craving prior to scanning correlated inversely with left-hemispheric modulatory effects in ACC-to-lentiform connectivity.

CONCLUSIONS

The results suggesting that prefrontal-to-lentiform connectivity is impaired in IGD provides a possible neurobiological mechanism for difficulties in controlling gaming-cue-elicited cravings. Reduced connectivity ACC-lentiform connectivity may be a useful neurobiological marker for IGD.

Techniques of Neutralization in Narratives of Addicted Gamers: A Social Science Approach on Gaming Disorder

Due to a hegemony of psychology, the phenomenon of addicted gaming tends to be conceptualized as a chronic illness. Taking a sociological perspective requires reframing the phenomenon: As deviant behavior, and therefore as a behavior, that goes against behavioral expectations of social groups. Such change of perspective raises new questions and sheds light on aspects of the phenomenon that have been unstudied so far. The article takes one step in this direction and applies the concept of neutralization as a heuristic to study how gamers classified as addicted make sense of their deviant gaming practices. Analyses of biographical-narrative interviews with addicted gamers indicate that they use five neutralization techniques in order to carry out their deviant practices without generally questioning social norms, these are rejection of individual responsibility, trivializing revaluation, positive revaluation, revaluation of deviance as self-determined choice and condemnation of instances of social control.

The Case of a Multiplication Skills Game: Teachers’ Viewpoint on MG’s Dashboard and OSLM Features

Educational games and digital game-based learning (DGBL) provide pupils interactive, engaging, intelligent, and motivating learning environments. According to research, digital games can support students’ learning and enhance their motivation to learn. Given the central role teachers play in the learning process, their perceptions of DGBL play a significant role in the usage and effectiveness of game-based learning. This paper presents the main findings of an online research on primary school teachers’ attitudes toward DGBL. Furthermore, the research investigates teachers’ opinions about the functionalities provided by the implemented Multiplication Game (MG) and the newly incorporated teacher dashboard. The MG is an assessment and skills improvement tool that integrates an adaptation mechanism that identifies student weaknesses on the multiplication tables and in its latest version also supports a strong social parameter. Students can be informed about their own progress as well as the progress of their peers in an effort to examine if social interaction or competition can increase players’ motivation, which is a subject that raised some concerns in the teaching community. The paper describes the functional options offered by the MG dashboard and documents the outcomes of an online survey conducted with the participation of 182 primary school teachers. The survey indicated the potential usefulness of MG and the benefits it can offer as a learning tool to improve pupil multiplication skills and help teachers identify individual pupil skills and difficulties and adapt their teaching accordingly. The analysis applied has found a correlation between teachers’ perceptions about MG and their view on using digital games in general.

Measuring Problematic Internet Use, Internet Gaming Disorder and Social Media Addiction in young adults: A cross-sectional study

Background

Digital technology use is nearly ubiquitous among young adults; this use provides both benefits and risks. The risks of technology use include maladaptive technology use or technology addiction. Several conceptualizations of these addictions have emerged, each with its own assessment tools. These conditions include problematic internet use (PIU), internet gaming disorder (IGD), and social media addiction (SMA). These conditions have been associated with health outcomes such as problematic alcohol use, sleep disorders, and mental illness. These maladaptive technology conditions have been most commonly studied in isolation from each other.

Objective

The aim of this study is to examine PIU, IGD, and SMA together to better inform future research approaches and provider screening practices for young adults.

Methods

This cross-sectional survey study was conducted using Qualtrics panel-based recruitment and survey hosting. We recruited US young adults aged 18-25 years. The survey assessed PIU, IGD, and SMA. Survey measures also included assessments of problematic alcohol use, sleep, depression, and anxiety. We evaluated the frequency of and overlap in positive screening scores among PIU, IGD, and SMA and modeled each condition using multivariate logistic regression. Finally, we calculated sensitivity and specificity, as well as the positive predictive value and negative predictive value of the screening tools using the most prevalent maladaptive technology type.

Results

Our 6000 participants had an average age of 21.7 (SD 2.5) years. Of these 6000 participants, 3062 (51.03%) were female, 3431 (57.18%) were Caucasian, 1686 (28.1%) were in a 4-year college program, and 2319 (38.65%) worked full time. The mean PIU score was 3.5 (SD 3.1), and 53.58% (3215/6000) of participants met the criteria for PIU. The mean IGD score was 2.7 (SD 2.6), and 24.33% (1460/6000) of participants met the criteria for IGD. The mean SMA score was 7.5 (SD 5.7), and 3.42% (205/6000) met the criteria for SMA. Across all 3 maladaptive technology use diagnoses, there were varied associations with demographic variables and similar overlap with health outcomes. The sensitivity of PIU screening to detect IGD was 82% and to detect SMA was 93%, whereas the specificity and positive predictive value were much lower (37%-54% specificity; 6%-37% positive predictive value).

Conclusions

This cross-sectional survey screened a large national sample of adolescents and young adults for PIU, IGD, and SMA to determine prevalence and overlap, demographic associations with each, and associations between these technology-related conditions and health outcomes. There was overlap across PIU, IGD, and SMA in some associated demographic variables and health outcomes. However, the patterns in the associated variables demonstrated unique qualities of each of these conditions.

"Stop Waking the Dead": Internet Child Sexual Abuse and Perspectives on Its Disclosure

The phenomenon of Internet child sexual abuse (ICSA) has been receiving growing attention over the last decade, and studies have promoted knowledge with respect to the phenomenon's epidemiology, as well as to characteristics of the victims, perpetrators, and dynamics in these cases. The current retrospective study sought to delve into the disclosure component in cases of ICSA. The sample comprised 52 cases of adolescents who arrived at a child advocacy center (CAC) following ICSA. Analysis of these cases was targeted to capture the multifaceted nature of disclosure using those perspectives that could be documented by the CAC staff-of the practitioners, the adolescents, and their parents. Beyond the descriptive results regarding the victims and the nature of the abuse, the case analyses illustrate the disclosure process as experienced by the various parties involved, highlighting the challenging nature of this aspect of the phenomenon. For the parents, the disclosure experience can perhaps be best epitomized by the expression that was heard repeatedly-"Stop waking the dead"-an expression that indicated their wish to bring the subject to a close. The difficulty in disclosing such incidents was also illustrated by the fact that 20 children in the current sample were reluctant to collaborate during the CAC process. In fact, according to these data, most of the incidents were revealed following a police investigation rather than by a disclosure initiated by the children themselves. Focusing on this specific aspect of ICSA-that is, disclosure-enables a new perspective on it and stresses the need to further study it in such cases. A better understanding of the disclosure experience as it pertains to the individuals involved in cases of ICSA may improve and help modify future prevention and intervention efforts in the field.

Policy Recommendations for Preventing Problematic Internet Use in Schools: A Qualitative Study of Parental Perspectives

Parenting in the digital age has been characterized as one of the most challenging tasks of the modern era. Parents are ambivalent about their mediating role. However, problematic aspects of adolescent online use have not been adequately addressed in education. The present study investigated parental perceptions of intervention needs within schools to prevent excessive/problematic use, enhance parent-child communication, and reduce family conflicts. Nine interviews with parents of adolescents residing in the UK were carried out and analyzed utilizing thematic analysis. Three main themes emerged as parental proposals: (i) schools as digital education providers and prevention hubs, (ii) provision of mental health literacy to raise awareness, resolve ambiguity regarding impacts and mitigate excessive use and impacts, and (iii) psychoeducation and upskilling. The third theme related to impacts from time spent on screens (time displacement), content-related impacts, and context-related impacts. The present study offers recommendations for media literacy during adolescence beyond e-safety (i.e., addressing interpersonal communication problems, privacy vs. disclosure issues), based on parents' views, and provides new insights for media and emotional health literacy collaboration efforts. Future work should investigate the feasibility and effectiveness of such interventions to support the emotional health of young people and prevent problematic internet use escalation.

Characterizing the building blocks of Problematic Use of the Internet (PUI): The role of obsessional impulses and impulsivity traits among Italian young adults

BACKGROUND

Problematic Use of the Internet (PUI) is a considerable issue of the modern era, but its risk factors are still poorly understood. Impulsivity and obsessive-compulsive symptoms have been associated with PUI, but this relationship is still debated. In this article we focus on the relationships of PUI with obsessive-compulsive and impulsive symptoms in a cohort of Italian young adults, in order to identify possible vulnerability factors for PUI.

METHODS

A sample of 772 Italian individuals aged 18-30 (mean age 23.3 ± 3.3 years old; 38% males and 62% females) was assessed via online survey using the Internet Addiction Test (IAT), the Mini International Neuropsychiatric Interview (MINI) Screen, the Padua Inventory-Washington State University Revision (PI-WSUR) and the Barratt Impulsiveness Scale (BIS-11).

RESULTS

Ninety-seven subjects (12.6% of the sample) reported IAT scores at risk for PUI. PUI participants reported higher levels of impulsivity, obsessive-compulsive symptoms and a higher burden of co-occurrent psychiatric symptoms. In a logistic regression model, obsessional impulses to harm (OR = 1.108, p < 0.001), attentional impulsivity (OR = 1.155, p < 0.001) and depressive symptomatology (OR = 1.246, p = 0.012) had significant association with PUI. Finally, higher severity of PUI has been associated with manic/psychotic symptoms and with attentional impulsivity.

CONCLUSIONS

Our findings confirmed the role of impulsivity in PUI, while also underling the association of obsessional impulses with this pathological behavior. We could hypothesize a trigger role of obsessive impulses for the engagement in PUI, together with factors as negative affective states. Further research is needed with respect to more severe forms of PUI, also for establishing tailored interventions.

The Mediating Role of Impulsivity and the Moderating Role of Gender Between Fear of Missing Out and Gaming Disorder Among a Sample of Chinese University Students

The role of fear of missing out (FoMO) in addictive behaviors has recently attracted growing attention. In view of negative effects of gaming disorder (GD) among adolescents and emerging adults, research examining the relationship between FoMO and GD is needed, alongside the roles of impulsivity and gender in the relationship between FoMO and GD. This study examined whether impulsivity as a mediator and gender as a moderator impacted on the relationship between FoMO and GD among a sample of Chinese university students. A sample of 1,288 Chinese university students from three universities completed an online survey through the Wenjuanxing platform. The Chinese Trait-State Fear of Missing Out Scale, the Barratt Impulsiveness Scale-Brief, and the Chinese Gaming Disorder Scale were used in this study. The model results indicated that impulsivity partially mediated the relationship between FoMO and GD, and that there was a larger effect size between impulsivity and GD among males. High levels of FoMO among individuals may impact on executive functions leading to more impulsivity, and are associated with GD. Gender may moderate the relationship between impulsivity and GD. This study deepens the understanding of the relationship between FoMO and GD, and provides new perspectives for practitioners to incorporate into health prevention programs to help regulate emotion, control impulsivity, and decrease GD.

Can Worried Parents Predict Effects of Video Games on Their Children? A Case-Control Study of Cognitive Abilities, Addiction Indicators and Wellbeing

Many parents worry over their children’s gaming habits, but to what extent do such worries match any detrimental effects of excessive gaming? We attempted to answer this question by comparing children of highly concerned parents with other adolescents of the same age. A cohort of parents who identified as highly concerned over their children’s video game habits were recruited for a public study in collaboration with a national television network. Using an online experimental platform in conjunction with surveys of parents’ beliefs and attitudes, we compared their children to age-matched peers in an exploratory case-control study. The scores of children with highly concerned parents on tests of cognitive control (cued task-switching and Iowa Gambling Task) and psychological wellbeing (WHO-5) were statistically similar to controls, suggesting no selective cognitive or psychological detriments from gaming or otherwise in the cases with concerned parents. The case group, however, did spend more time gaming, and scored higher than controls on problem gaming indicators (Gaming Addiction Scale), which also correlated negatively with wellbeing. Within the case group, wellbeing effects seemed mainly to consist in issues of relaxation and sleep, and related to gaming addiction indicators of playing to forget real-world problems, and the feeling of neglecting non-gaming activities. Where most results of research staged for TV never get published, making it difficult to interpret both methods and results, this paper describes findings and participant recruitment in detail. The relationship between parental concern and children’s gaming is discussed, as is the merits and challenges of research conducted with media, such as TV programs and their recruited on-screen participants.

A cross-sectional survey of internet use among university students

The last 2 decades have seen an increase in the number of reports of excessive internet use. Therefore, this study aimed to examine internet use among university students to gain more insight into the novel phenomenon of addictive internet use (AIU). Data were collected by the means of an online questionnaire sent to 4391 students. Approximately 10% of the 4391 students could be included in the statistical analysis. Of those 483 students, almost all (99.2%) used the internet, and a quarter (24.8%) showed AIU. The students used the internet mostly for information searches, random browsing, social networking, and online shopping; however, AIU was seen most often in the areas of social networking, random browsing, information searches, gaming, and pornography. One in four of the respondents showed addictive behavior in at least one area of internet use. Students with AIU in the area of random browsing were significantly less far advanced in their studies than those without AIU, and well-being was significantly poorer across AIU groups than in those who did not show AIU. The study confirms the importance of AIU, as reflected in the high prevalence of AIU among the students and the significantly lower level of well-being in those with AIU. Undifferentiated consideration of AIU does not do justice to its various facets, and future research should consider all areas of internet use, with the aim to increase understanding of the underlying mechanisms of AIU and develop more differentiated treatment approaches.

Fear of Missing Out (FoMO) and Gaming Disorder among Chinese University Students: Impulsivity and Game Time as Mediators

BACKGROUND AND AIMS

Research into the fear of missing out (FoMO) has greatly increased in recent years. Given the negative consequences of gaming disorder (GD) among a small minority of individuals, there is an increasing need for research examining the impact of FoMO on GD. However, little is known about the roles of impulsivity and gaming time as mediators in the relationship between FoMO and GD. The present study examined whether impulsivity and gaming time mediated the relationship between FoMO (trait-FoMO and state-FoMO) and GD among Chinese university students, as well as the prevalence of GD.

METHODS

A total of 1127 university students completed an online survey including the Chinese Trait-State Fear of Missing Out Scale (T-SFoMOS-C), the Barratt Impulsiveness Scale-Brief (BIS-Brief), gaming time survey, and the Chinese Gaming Disorder Scale (CGDS).

RESULTS

The prevalence of GD was 6.4% among Chinese university students. Trait-FoMO was found to indirectly impact GD via impulsivity and gamine time, whereas the direct effect of trait-FoMO on GD and the mediation effects of gaming time were not confirmed. State-FoMO impacted on GD both directly, and indirectly via the mediation effects of impulsivity as well as impulsivity and gaming time.

CONCLUSION

Trait-FoMO on GD was fully mediated via impulsivity and gaming time, whereas state-FoMO on GD was partly mediated via impulsivity and gaming time. Individuals with high levels of FoMO were more likely to show impulsivity and spend a longer time gaming, and these factors were associated with GD. These findings provide insights to incorporate into health prevention programs to help regulate emotion, control impulsivity, and decrease GD.

The Role of Avoidance Coping and Escape Motives in Problematic Online Gaming: A Systematic Literature Review

Over the past two decades, research into Internet Gaming Disorder (IGD) has markedly increased due to worldwide spread of online videogames. The reasons and motivations for playing greatly contribute to its popularity. Escapism and avoidance coping strategies have been studied extensively and conceptualized as motives to play. A growing research base has demonstrated a strong association between these motives to play and negative gaming outcomes. Consequently, the aim of the present systematic review was to provide a comprehensive overview of the role of avoidance coping and escape motives in problematic online gaming. A systematic literature search was carried out using academic databases and a total of 26 empirical studies met the inclusion criteria. The results show that escapism and avoidance coping represent both a predictor of IGD and play a mediating role between many psychological factors (e.g., self-esteem, loneliness, self-concept, anxiety) and problematic online gaming. However, the review also highlights the paucity of longitudinal studies that hinder the determination of the causal direction of these associations. Despite this limitation, the evidence has important implication for developing more effective prevention programs and clinical interventions.