Psychometric Properties of the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF): Systematic Review

The Impact of Traditional Children's Games on Internet Use, Social Skills, and Stress Level: A Cross-Sectional Design

INTRODUCTION

Traditional games are essential for children's social inclusion due to cultural values and beliefs. This study was conducted to measure the impact of traditional children's games on internet use, social skills, and stress levels.

METHODS

A cross-sectional design was carried out. Children who had parental approval and agreed to participate were included in the study (n = 314). The data were collected using a questionnaire, the Perceived Stress Questionnaire (8-11 years), and the Social Skills Assessment Scale. Linear regression and multinomial logistic regression were performed to analyze the data. Mantel-Haenszel chi-square test was performed to assess the confounding factors for playing traditional games.

RESULTS

The children's mean age was 11.58 (SD = 0.49), and 56.1% were girls. Children who did not play traditional games were more likely to use the internet than those who played traditional games (odds ratio [OR] = 2.16, p = .014). The social skills were significantly associated with daily internet use time (β = 0.164, p = .003), playing traditional games (β = 0.155, p = .008), and frequency of gaming per week (β = 0.123, p = .035). The stress levels were associated with gender (β = 0.120, p = .033) and academic level (β = 0.111, p = .048).

DISCUSSION

Traditional game playing reduced the duration of one sitting and daily internet use. Moreover, outdoor gaming, frequency of playing games, and daily internet use duration were predictors of social skills, whereas being a girl and sixth-grade student were predisposing factors of stress level. Nurses could benefit from traditional games in reducing internet use and stress and improving social skills in children.

Effectiveness and Acceptability of Cognitive Behavioral Therapy and Family Therapy for Gaming Disorder: Protocol for a Nonrandomized Intervention Study of a Novel Psychological Treatment

BACKGROUND

Gaming disorder (GD) is a new official diagnosis in the International Classification of Diseases, 11th Revision, and with its recognition, the need to offer treatment for the condition has become apparent. More knowledge is needed about the type of treatment needed for this group of patients.

OBJECTIVE

This study aims to evaluate the effectiveness and acceptability of a novel module-based psychological treatment for GD based on cognitive behavioral therapy and family therapy.

METHODS

This study is a nonrandomized intervention study, with a pretest, posttest, and 3-month follow-up design. It will assess changes in GD symptoms, psychological distress, and gaming time, alongside treatment satisfaction, working alliance, and a qualitative exploration of patients' and relatives' experiences of the treatment.

RESULTS

This study started in March 2022 and the recruitment is expected to close in August 2024.

CONCLUSIONS

This study evaluates the effectiveness and acceptability of a psychological treatment for patients with problematic gaming behavior and GD. It is an effectiveness trial and will be conducted in routine care. This study will have high external validity and ensure that the results are relevant for a diverse clinical population with psychiatric comorbidity.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06018922; https://clinicaltrials.gov/study/NCT06018922.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/56315.

Examining Anxiety and Insomnia in Internship Students and Their Association with Internet Gaming Disorder

Background: Internships are a mandatory graduation requirement to help medical students transition to the work environment. Some individuals are prone to anxiety in an unfamiliar environment, which is a public concern among young adults. Here, we investigated the mechanism between internet gaming disorder and anxiety and insomnia among internship students. Methods: A convenient sample of 267 internship students was collected in a cross-sectional study module between 17 July and 27 December 2022. The survey contained a 7-item Generalized Anxiety Disorder (GAD-7), Athens Insomnia Scale (AIS), and Internet Gaming Disorder Scale-Short-Form (IGDS9-SF). The association was estimated using Pearson's correlations, and network analysis was performed to characterize these associations. Results: Our results indicate that about 60% of participants exhibited mild to severe anxiety and insomnia, while 2.28% showed symptoms of internet gaming disorder. Also, we found a moderate association between anxiety and insomnia. An item-level analysis indicated that GAD_1 "feeling anxious" and GAD_5 "unable to sit still" are essential for gaming, and that GAD_2 "uncontrollable worrying" is crucial for insomnia. This indicated an interplay between these items, supported by our centrality analysis, where we found that GAD_1 and GAD_2 depicted high centrality. Conclusions: We found high rates of anxiety and insomnia in internship students and the association between selected symptoms of anxiety and insomnia. At the same time, low rates of internet gaming disorder could be attributed to a lack of time for entertainment and an increased awareness of its risks. Given these findings, an awareness of anxiety and insomnia risk should be emphasized.

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.

Digital Phenotypes for Early Detection of Internet Gaming Disorder in Adolescent Students: Explorative Data-Driven Study

BACKGROUND

Limited awareness, social stigma, and access to mental health professionals hinder early detection and intervention of internet gaming disorder (IGD), which has emerged as a significant concern among young individuals. Prevalence estimates vary between 0.7% and 15.6%, and its recognition in the International Classification of Diseases, 11th Revision and Diagnostic and Statistical Manual of Mental Disorders, 5th Edition underscores its impact on academic functioning, social isolation, and mental health challenges.

OBJECTIVE

This study aimed to uncover digital phenotypes for the early detection of IGD among adolescents in learning settings. By leveraging sensor data collected from student tablets, the overarching objective is to incorporate these digital indicators into daily school activities to establish these markers as a mental health screening tool, facilitating the early identification and intervention for IGD cases.

METHODS

A total of 168 voluntary participants were engaged, consisting of 85 students with IGD and 83 students without IGD. There were 53% (89/168) female and 47% (79/168) male individuals, all within the age range of 13-14 years. The individual students learned their Korean literature and mathematics lessons on their personal tablets, with sensor data being automatically collected. Multiple regression with bootstrapping and multivariate ANOVA were used, prioritizing interpretability over predictability, for cross-validation purposes.

RESULTS

A negative correlation between IGD Scale (IGDS) scores and learning outcomes emerged (r166=-0.15; P=.047), suggesting that higher IGDS scores were associated with lower learning outcomes. Multiple regression identified 5 key indicators linked to IGD, explaining 23% of the IGDS score variance: stroke acceleration (β=.33; P<.001), time interval between keys (β=-0.26; P=.01), word spacing (β=-0.25; P<.001), deletion (β=-0.24; P<.001), and horizontal length of strokes (β=-0.21; P=.02). Multivariate ANOVA cross-validated these findings, revealing significant differences in digital phenotypes between potential IGD and non-IGD groups. The average effect size, measured by Cohen d, across the indicators was 0.40, indicating a moderate effect. Notable distinctions included faster stroke acceleration (Cohen d=0.68; P=<.001), reduced word spacing (Cohen d=.57; P=<.001), decreased deletion behavior (Cohen d=0.33; P=.04), and longer horizontal strokes (Cohen d=0.34; P=.03) in students with potential IGD compared to their counterparts without IGD.

CONCLUSIONS

The aggregated findings show a negative correlation between IGD and learning performance, highlighting the effectiveness of digital markers in detecting IGD. This underscores the importance of digital phenotyping in advancing mental health care within educational settings. As schools adopt a 1-device-per-student framework, digital phenotyping emerges as a promising early detection method for IGD. This shift could transform clinical approaches from reactive to proactive measures.

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.

The relationship of game genres, in-game purchases, and playing duration with probable gaming disorder in two independent, large-scale online surveys of Japanese adults

Background and aims

Game genres, availability on smartphones, in-game purchases, and playing duration, have been thought to influence Gaming Disorder (GD). However, little research has comprehensively examined their relationships with GD. Therefore, we examined the relationship between GD, in-game purchases, gaming duration via consoles and smartphones, and genres of smartphone games. Study 1 was based on self-reports, and Study 2 included objective data to clarify these associations.

Methods

We conducted two independent online surveys that collected sociodemographic data, game use patterns, and psychopathological assessment data, including GD severity (Study 1: N = 32,690; Study 2: N = 3,163). General mental illness scores and objective gaming time were also collected in Study 2.

Results

In Study 1, in-game purchases, several gaming genres, and subjective gaming duration were positively associated with probable GD. On the other hand, interactions between card games and loot box charges were negatively related to probable GD. In Study 2, objective gaming times of most game genres were not associated with GD. Although the correlation between subjective and objective gaming duration was moderate, their correlations with GD differed.

Discussion and conclusion

These results suggest the complexity of relationships between GD and in-game purchases, genres, and gaming duration. Results of this study suggest the importance of proper assessment of GD reflecting actual functional impairment in social life. Future studies should improve and update evaluation of assessments for gaming.

Problematic Gaming in Malaysian University Students: Translation and Psychometric Evaluation of the Malay Language Versions of Gaming Disorder Test and Gaming Disorder Scale for Young Adults

As research on gaming disorder (GD) is growing globally, the need for a valid and reliable instrument to assess GD has become crucial. Therefore, the present cross-sectional study translated and evaluated the psychometric properties of Gaming Disorder Test (GDT) and Gaming Disorder Scale for Young Adults (GADIS-YA) into Malay language versions. The sample comprised 624 university students (females = 75.6%; mean age = 22.27 years) recruited via an online survey from May to August 2022, using a convenience sampling method. Participants completed both GDT and GADIS-YA scales and other relevant measures including Bergen Social Media Addiction Scale (BSMAS), Internet Gaming Disorder Scale-Short Form (IGDS9-SF), and time spent on social media and gaming. Results showed that both instruments reported satisfactory internal consistency, and confirmatory factor analysis supported the one-factor structure for GDT and two-factor structure for GADIS-YA. Both scales were strongly correlated with each other and with the IGDS9-SF, BSMAS, and time spent on social media and gaming, supporting concurrent validity. Measurement invariance of both scales was confirmed across gender and gaming time. These findings suggest that the Malay versions of GDT and GADIS-YA are reliable and valid measures of problematic gaming among Malaysian university students.

Measurement Invariance of the Lemmens Internet Gaming Disorder Scale-9 Across Age, Gender, and Respondents

Although Internet gaming disorder (IGD) has gained increased attention in scientific, clinical, and community contexts, there is still a lack of consensus regarding the best assessment tools (i.e., self-report or other reports) for assessing its symptoms. The present study aimed to investigate the reliability, validity, and measurement invariance of both versions (youth and parent) of The Lemmens Internet Gaming Disorder Scale-9. To achieve this goal, we recruited between June and October 2019 from five Romanian highschools a total of 697 adolescents (11-19 years old) and one of their parents (N = 391). The internal consistency was good in both versions of the instrument (α = 0.772 for the youth version and α = 0.781 for the parent version). Construct validity assessed through confirmatory factor analysis showed support for the one factor structure of the scales, while multigroup confirmatory factor analysis endorsed the invariance across age, gender, and respondents (i.e., parent vs. youth report). The current research identifies both IGD scales to be reliable and valid, arguing for their utility for assessing IGD symptomatology among adolescents. Implications for theory, assessment, and future directions are discussed.

Impulsivity and aggression as risk factors for internet gaming disorder among university students

Internet gaming addiction is a global problem, especially among young individuals. Exhibiting characteristics similar to other addictions, Internet Gaming Disorder (IGD) is linked to adverse mental health outcomes. Identified as risk factors for dependence behaviors, the association of impulsivity and aggression with IGD is relatively under-researched in the student population. The present sample of 350 university students (Mage = 21.30 years, SDage = 4.96 years) from Najran university in Saudi Arabia completed an online questionnaire that included the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), the Buss-Perry Aggression Questionnaire-Short Form, and the Barratt Impulsiveness Scale (BIS-15). Results indicated that impulsivity and aggression were positively associated with IGD severity and both personality traits explained 34.6% of the variance in IGD scores. Further bivariate analyses suggested that individuals spending 7 or more hours on internet gaming were more likely to exhibit high impulsivity and aggression, and had a relatively higher severity of IGD. These results suggest that individuals with these personality traits may be more vulnerable to developing an addiction to internet gaming. These findings need to be confirmed in future more robust studies; however, this exploratory study provides insights for potential programs to prevent IGD among young individuals.

Problematic Use of Internet Associates with Poor Quality of Life via Psychological Distress in Invididuals with ADHD

Background

Problematic use of internet (PUI) may have negative impacts on psychological distress and quality of life (QoL). This situation might be more profound in people with attention-deficit/hyperactivity disorder (ADHD) due to poorer behavioral control and regulatory capacity. However, there is little evidence regarding mediated effects in the associations between PUI, psychological distress, and QoL in people with ADHD.

Aims

To investigate mediating effects of psychological distress in the associations of problematic smartphone use (PSPU), problematic use of social media (PUSM), and problematic gaming (PG) with QoL in individuals with ADHD.

Methods and Procedures

PUI behaviors of participants with ADHD (n = 99) were assessed using the Smartphone Application-Based Addiction Scale, Bergen Social Media Addiction Scale, and Internet Gaming Disorder-Short Form. Psychological distress was assessed using the Depression, Anxiety, Stress Scale and QoL using the Kid-KINDL.

Outcomes and Results

Psychological distress mediated the associations between PUI and different domains of QoL, except for self-esteem QoL. There were also positively direct effects between PG and physical QoL, PUSM and friends' QoL, and PSPU and physical QoL.

Conclusions and Implications

PUI may associate with poor QoL in people with ADHD via psychological distress. Programs on reducing PUI for people with ADHD are needed.

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.

Yoga as an Adjuvant with Multimodal Psychological Interventions for Excessive Use of Technology: A Randomized Controlled Trial from India

Background

Multimodal approach of psychotherapy has been found to be effective for managing the excessive use of technology. Yoga, a holistic mind-body therapy, has been observed to be a useful adjuvant in managing substance use disorders. Yoga is also known to reduce stress and enhance overall well-being. The aim of this study was to examine whether yoga as an adjuvant treatment to psychotherapy is better than psychotherapy alone in reducing dysfunction and severity due to excessive technology use.

Methods

A two-arm randomized controlled prospective study design was followed with assessor blinding and allocation concealment. Thirty consenting young adults (22 males), scoring above 36 on the Internet Addiction Test, were randomly allocated to either: Group A = psychotherapy + yoga or Group B = psychotherapy alone. Both groups received 8 sessions of psychotherapy in the 1st month. In addition, Group A received additional 10 sessions a specific yoga program (by trained professionals). After that, monthly booster sessions (supervised yoga sessions performed with direct one-on-one contact with the yoga therapist) were organized and post-assessment was conducted at 12 weeks. Each subject was assessed using the Internet Addiction Test-Short Form, Internet Gaming Disorder Scale-Short Form, Smartphone Addiction Scale-Short Version, and Kessler Psychological Distress Scale at baseline and after 12 weeks.

Results

As compared to Group B, Group A had significantly reduced Internet use (F = 5.61, P = 0.02, ηp 2 = 0.17), smartphone use (F = 4.76, P = 0.03, ηp 2 = 0.15), psychological distress (F = 7.71, P = 0.01, ηp 2 = 0.22), and weekday use (Z = -2.0, P = 0.05, ηp 2 = 0.15) along with enhanced treatment adherence and retention.

Conclusion

Yoga as an adjuvant therapy with multimodal psychological intervention for excessive use of technology was found to be effective. This carries clinical implications for mental health professionals.

Problematic Use of Internet Among Indonesia University Students: Psychometric Evaluation of Bergen Social Media Addiction Scale and Internet Gaming Disorder Scale-Short Form

OBJECTIVE

Social media addiction and internet gaming disorder may cause mental health problems among a minority of university students. The Bergen Social Media Addiction Scale (BSMAS) and the 9-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF) are commonly used worldwide. However, they have not been translated or validated into Indonesian. The present study aimed to translate and validate the BSMAS and IGDS9-SF in an Indonesian context among young adults.

METHODS

A multi-center, web-based cross-sectional study was conducted among 458 university students (74% female; mean age 22.5 years) in Indonesia from June to December 2021. The BSMAS and IGDS9-SF were translated into Indonesian. Internal consistency (using Cronbach's α and McDonald's ω) and factor structure (using confirmatory factor analysis) of the two instruments were examined. Concurrent validity of BSMAS and IGDS9-SF was examined using their correlations with two external concepts: nomophobia and psychological distress.

RESULTS

Internal consistency of the Indonesian BSMAS and IGDS9-SF were both acceptable (Cronbach's α=0.80 and 0.90; McDonald's ω=0.86 and 0.92). Both instruments were unidimensional with good factor loadings (0.54-0.78 for BSMAS; 0.63-0.79 for IGDS9-SF). Moreover, BSMAS and IGDS9-SF had stronger associations with nomophobia (r=0.58 and 0.12; p<0.001) than with psychological distress (r=0.43 and 0.15; p<0.001).

CONCLUSION

The Indonesian versions of the BSMAS and IGDS9-SF had good psychometric properties in terms of linguistic validity, unidimensionality, and reliability. The findings indicate the tools are appropriate for assessing the risk of social media addiction and internet gaming disorder among university students in Indonesia.

Problematic smartphone use and two types of problematic use of the internet and self-stigma among people with substance use disorders

BACKGROUND AND AIMS

Guided by the Interaction of Person-Affect-Cognition-Execution (I-PACE) model and a self-stigma framework, this study aimed to investigate relationships between cognitive and affective self-stigma and behavioral self-stigma, problematic use of internet (PUI), and problematic smartphone use (PSU) among people with substance use disorders (SUDs). It also examined mediating roles for affective self-stigma in the relationships between cognitive self-stigma and behavioral self-stigma/PUI/PSU.

METHODS

Using a cross-sectional design, 530 participants diagnosed with SUDs in Taiwan were recruited from a psychiatric center in Taiwan. Mediation models were investigated using the Hayes' Process Macro Model 4.

RESULTS

Mediation analyses indicated that cognitive self-stigma was directly associated with behavioral self-stigma (p < 0.001), but not with either types of PUI or PSU (p-values ranging from 0.41 to 0.76). Affective self-stigma was directly related to behavioral self-stigma (p < 0.001), two types of PUI, and PSU (β = 0.24-0.30; all p < 0.001); cognitive self-stigma was indirectly associated with behavioral self-stigma (β = 0.53; 95  % bootstrapping CI = 0.46, 0.60), two types of PUI, and PSU (β = 0.20-0.25; 95  % bootstrapping CI = 0.08-0.14, 0.31-0.37) via a mediating effect of affective self-stigma.

DISCUSSION AND CONCLUSION

Findings support the I-PACE model in a self-stigma context. The findings also suggest that addressing affective self-stigma may help prevent or reduce behavioral self-stigma, PUI, and PSU among people with SUDs. Longitudinal studies are warranted to investigate over time relationships between self-stigma and PUI/PSU in people with SUDs.

Validation of the Thai Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) among young adults

BACKGROUND

The Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) is a consistent and comprehensive instrument to assess symptoms of specific internet-use disorders including those related to gaming, shopping, pornography use disorder, social networks use and gambling considering criteria in the eleventh revision of the International Classification of Diseases (ICD-11). However, to date, there is little evidence supporting instruments assessing major types of specific internet use disorders in Thailand. The aim of this present study was to assess the psychometric properties of the ACSID-11 among Thai young adults.

METHODS

A total of 612 participants were recruited. A confirmatory factor analysis (CFA) examined construct validity of the ACSID-11. Cronbach's α and McDonald's ω were used to assess reliability of the ACSID-11. Pearson correlations examined relationships between ACSID-11 domains and Internet Gaming Disorder Scale-Short Form (IGDS9-SF) scores.

RESULTS

The CFA supported validity of the Thai version of the ACSID-11 and a four-factor structure. Specific domains of the Thai ACSID-11, particularly gaming, were positively and significantly correlated with IGDS9-SF scores.

CONCLUSIONS

Data indicate that the Thai version of the ACSID-11 is a valid and reliable instrument to assess major types of specific internet use disorders. Additional studies are needed to further examine the validity and reliability of the Thai ACSID-11.

Factor structure and psychometric properties of an Arabic version of the Internet Gaming Disorder Scale, short form (IGDS-SF9)

Background

In its most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychological Association recognized that internet gaming disorder is a psychological condition and provides nine criteria for its diagnosis, and the Internet Gaming Disorder Scale, short form (IGDS-SF9) was developed to assess individuals.

Aim

To develop and investigate the psychometric properties of an Arabic version of IGDS-SF9.

Method

A five-stage translation and verification process produced an Arabic version of IGDS-SF9, and a study was conducted using a sample of 410 respondents (45.6% females, mean age = 17.6, SD = 1.56) to assess its psychometric properties. Respondents completed the Arabic version, the Smartphone Addiction Scale, the Smartphone Application-Based Addiction Scale, the Hospital Anxiety and Depression Scale, as well as a demographic survey. Exploratory and confirmatory factor analyses, measurement invariance, item response theory, convergent, concurrent, criterion validity, and internal consistency reliability and test-retest reliability were employed to validate the scale.

Results

The exploratory factor analysis suggested the scale's unidimensional structure; the confirmatory factor analysis exhibited good model fit and factor loadings. Measurement invariance, and concurrent, convergent, and criterion validity were established, resulting in good internal consistency and test-retest reliability for the scale.

Conclusion

The Arabic version of IGDS-SF9 is a valid and reliable measure for research and diagnosis in Arabic-speaking countries.

A phubbing scale tested in Bangladesh, Iran, and Pakistan: confirmatory factor, network, and Rasch analyses

BACKGROUND

Phubbing, a phenomenon of ignoring others in face-to-face conversations due to mobile phone use, can be assessed using a Phubbing Scale (PS). Recently, the PS has been shortened into an eight-item version, the PS-8. However, psychometric properties of the PS-8 among Iranian, Bangladeshi and Pakistani individuals remain understudied, especially using advanced psychometric testing, such as Rasch and network analyses.

METHODS

Participants residing in Iran, Bangladesh, and Pakistan (n = 1902; 50.4% females; mean age = 26.3 years) completed the PS-8 and the Internet Disorder Scale-Short Form (IDS9-SF) via an online survey. Network analysis was used to examine if PS-8 items were differentiated from IDS9-SF items; confirmatory factor analysis (CFA) was used to examine the factor structure and measurement invariance of the PS-8; Rasch modeling was used to examine the dimensionality of the PS-8 and differential item functioning (DIF).

RESULTS

Network analysis showed that PS-8 items were clustered together with a distance to the IDS9-SF items. The CFA results supported a two-factor structure of the PS-8, and the two-factor structure was found to be invariant across countries and women and men. Rasch model results indicated that the two PS-8 subscales were both unidimensional and did not display DIF across countries and gender/sex.

CONCLUSION

The PS-8 is a feasible and robust instrument for healthcare providers, especially mental health professionals, to quickly assess and evaluate individuals' phubbing behaviors.

Press Play to Feel: The Role of Attachment Styles and Alexithymic Features in Problematic Gaming

Problematic gaming has been consistently associated with insecure attachment styles and alexithymia. However, there is limited knowledge regarding the impact of specific alexithymic features and insecure attachment styles on problematic gaming. The study included a sample of 358 online game players (242 males, 67.6%) between the ages of 18 and 59 (M = 28.46; SD = 8.76) who were recruited from online gaming communities. The participants completed a sociodemographic schedule and measures on attachment styles, alexithymia, and problematic gaming. The results provide evidence for a positive prediction of problematic gaming by dismissing attachment style and the alexithymic factors concerning the difficulty identifying feelings and externally oriented thinking, even when controlling for potentially confounding factors, such as age, sex, education, marital status, and self-reported time devoted to online games. Additionally, the analysis revealed a significant interaction effect between externally oriented thinking and dismissing attachment style in the prediction of problematic gaming. The interaction implies that the alexithymia factors pertaining to externally oriented thinking hold significant relevance in predicting problematic gaming behaviors, especially in cases where dismissive attachment levels are moderately to highly present. These findings emphasize the significance of considering specific insecure attachment styles and alexithymic features when studying problematic gaming behaviors.

Psychometric properties of the Persian Gaming Disorder Test and relationships with psychological distress and insomnia in adolescents

BACKGROUND

Gaming Disorder (GD) was recently included by the World Health Organization (WHO) as a psychiatric condition in the eleventh revision of the International Classification of Diseases (ICD-11) and is a concern worldwide, including in Iran. Thus, based on the ICD-11 criteria, a Persian version of the Gaming Disorder Test (GDT) was developed to facilitate assessment of GD.

METHODS

The present study used classical test theory and Rasch analysis to examine the psychometric properties of the Persian GDT. Iranian adolescents (n = 3837; 2171 [56.6%] males; mean [SD] age = 16.02 [1.4] years) completed the GDT and other instruments assessing disordered gaming, psychological distress, and insomnia.

RESULTS

Overall, the psychometric properties of the Persian GDT were satisfactory based on classical test theory (i.e., confirmatory factor analysis corroborated the unidimensional structure of GDT) and Rasch analysis (i.e., fit statistics suggested that all items were embedded in the concept of GD). Moreover, the Persian GDT was found to be sex-invariant, displaying no items with substantial differential item functioning across sexes. Additionally, it was found that GD mediated associations between time spent gaming and measures of psychological distress and insomnia.

CONCLUSION

The Persian GDT is a convenient and short instrument for assessing GD among Iranian adolescents. The mediating roles of GD in the associations between time spent gaming and psychological distress and between time spent gaming and insomnia suggest that targeting features of GD may reduce psychological distress and improve sleep for Iranian adolescents.

Circadian typologies and insomnia in individuals with internet gaming disorder comorbid with attention deficit/hyperactivity disorder

The alteration in circadian typology and insomnia were prevalent among both Individuals with IGD and those with attention deficit hyperactivity disorder (ADHD), the most comorbid psychiatric disorder of IGD. This study aimed to evaluate the relationships between circadian typologies, insomnia, and internet gaming disorder (IGD) and how ADHD affects this relationship. We recruited three groups of 69 young adults: an IGD group, a control group comprising age- and sex-matched nongamers, and a group of gamers without IGD through diagnostic interviews. The participants with IGD exhibited lower composite scale of morningness (CSM) scores and thus a higher eveningness preference In addition, the score of Pittsburgh insomnia rating scale-20-item version (PIRS_20) was significantly higher among those with IGD. The participants with IGD and ADHD exhibited lower CSM scores but higher PRIS_20 scores than the participants with IGD but without ADHD. The present findings indicate that participants with IGD exhibited a tendency of eveningness preference and experienced more severe insomnia. ADHD exacerbated the eveningness preference and insomnia of individuals with IGD. Close attention should be paid to sleep problems in individuals with IGD, particularly to those with ADHD.

Psychometric properties and development of the Chinese versions of Gaming Disorder Test (GDT) and Gaming Disorder Scale for Adolescents (GADIS-A)

Currently, six instruments have been developed using the 11th revision of the International Classification of Diseases (ICD-11) criteria for Gaming Disorder (GD). Two of these are the Gaming Disorder Test (GDT) and Gaming Disorder Scale for Adolescents (GADIS-A). The present study validated both the GDT and GADIS-A among a large sample of Chinese emerging adults. Via an online survey, 3381 participants (56.6% females; mean age = 19.56 years) completed the Chinese versions of the GDT, GADIS-A, Internet Gaming Disorder-Short Form (IGDS9-SF), and Bergen Social Media Addiction Scale (BSMAS). Confirmatory factor analysis was used to examine the factor structure of the Chinese GDT and GADIS-A. Pearson correlations were computed to examine the convergent validity (with IGDS9-SF) and divergent validity (with BSMAS) of the Chinese GDT and Chinese GADIS-A. The GDT had a unidimensional structure, which was invariant across sex and disordered gaming severity subgroups. The GADIS-A had a two-factor structure, which was also invariant across gender and gaming severity subgroups. Both the GDT and GADIS-A had significant associations with both IGDS9-SF and with BSMAS. Both the Chinese GDT and GADIS-A are valid instruments to assess GD among emerging adults in mainland China, enabling healthcare providers to adopt these tools in their efforts to prevent and examine GD severity among Chinese youth.

Problematic internet gaming and non-suicidal self-injury in Chinese adolescents: Moderating and mediating roles of anxiety

INTRODUCTION

Despite consistent reports of the association between problematic internet gaming (PIG) and non-suicidal self-injury (NSSI), an increase in PIG does not necessarily lead to increased NSSI. This apparent paradox indicates the presence of other mediators and moderators in the PIG-NSSI association. This study aimed to investigate the role of anxiety as a potential moderating and mediating factor of the PIG-NSSI association in Chinese adolescents.

METHODS

A cross-sectional study was conducted among 10,479 Chinese adolescents (50.5% male; age range, 9-18 years). Standardized self-report questionnaires were used to assess the severity of PIG, anxiety, and NSSI. Spearman correlation and multiple linear regression were applied to examine the relationships among PIG, anxiety, and NSSI. Both moderating and mediating effects of anxiety were assessed using Hayes' methods.

RESULTS

PIG, anxiety symptoms, and NSSI significantly correlated with one another. Anxiety significantly moderated the relationship between PIG and NSSI [B = 0.002, standard error (SE) = 0.000, p < 0.001], and it partially mediated the PIG-NSSI association [B = 0.017, SE = 0.001, 95% confidence interval (CI) 0.014-0.021]. Social concern and concentration were the two dimensions of anxiety that exerted the strongest mediation effect (B = 0.017, SE = 0.002, 95% CI 0.014-0.020).

CONCLUSIONS

Adolescents with PIG and high anxiety are likely to suffer more severe NSSI and may benefit from interventions to reduce anxiety symptoms.

Prevalence and Risk Factors of Internet Gaming Disorder Among Female Secondary School Students in Al-Ahsa, Kingdom of Saudi Arabia

OBJECTIVES

This study measured the prevalence and potential risk factors of Internet gaming disorder (IGD) among female secondary school students in Al-Ahsa, Kingdom of Saudi Arabia.

METHODS

This cross-sectional study was conducted between January and February 2023. A total of 400 female secondary school students in Al-Ahsa were recruited through multistage stratified cluster sampling. Data were collected by distributing a self-administered questionnaire among students. A chi-squared test was performed to compare categorical variables. The associations between IGD, depression, and anxiety scores were determined using the Pearson correlation coefficient.

RESULTS

Among the total sample, 282 were classified as "gamers" and included in our analysis. The prevalence of IGD was found to be 19%. We also found a statistically significant and moderately positive correlation between IGD and anxiety and depression scores. Spending more than four hours daily playing video games, starting to play video games at less than seven years of age, having depression, having anxiety, and playing an online game were found to be potential risk factors for IGD.

CONCLUSION

IGD among female adolescent students in Al-Ahsa is a public health concern that requires attention from the concerned parties. Health education projects on IGD, its risk factors, and its consequences should be designed for adolescents and their families.

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.

Hikikomori Syndrome and Digital Technologies: A Systematic Review

ABSTRACT

Hikikomori syndrome (HS) is a voluntary prolonged social isolation associated with personal and community impact. Previous evidence pointed out a possible relationship between this syndrome with addiction to digital technologies. Here we aim to understand the relationship between HS and digital technology use, overuse, and addictive behaviors, as well as potential therapeutic approaches.We conducted a systematic review of observational and intervention studies available in PubMed/MEDLINE, LILACS, IBECS, Embase, PsycINFO, and SciELO databases, following the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA 2020) criteria. The risk of bias was assessed with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and Consensus-based Clinical Case Reporting Guideline Development (CARE). Eligibility criteria were pre-, at-risk populations, or those with HS diagnosis, and any kind of technological overuse. Seventeen studies were included in the review, of which eight were cross-sectional, eight were case reports, and one was quasi-experimental. Hikikomori syndrome was associated with addition to digital technologies; no cultural differences were found. Environmental factors, such as a history of bullying, low self-esteem, and grief were identified as precursors of addictive behaviors. The included articles addressed addiction to digital technologies, electronic games, and social networks, among others, in HS. HS is cross-culturally associated with such addiction. The management of these patients remains challenging, and no target evidence-based treatments have been developed. The studies included in this review had several limitations, and more studies with a higher level of evidence are needed to support the results.

The Psychometric Properties of the DASS-21 and Its Association with Problematic Internet Use among Chinese College Freshmen

During transitional periods, college freshmen may experience mental health issues. The Depression, Anxiety, and Stress Scale-21-item version (DASS-21) is commonly used for mental health assessment in China. However, evidence is lacking regarding its applicability with freshmen as a demographic. Debates also exist regarding its factor structure. This study aimed to evaluate the DASS-21's psychometric properties with Chinese college freshmen and investigate its association with three kinds of problematic Internet use. A convenience sampling method was used to recruit two samples of freshmen-one of 364 (female 248; mean age 18.17 years) and the other of 956 (female 499; mean age 18.38 years) participants. McDonald's ω and confirmatory factor analysis were conducted to evaluate both the scale's internal reliability and construct validity. The results indicated acceptable reliability, with a one-factor structure inferior to a three-factor structure in terms of model fit. Furthermore, it was demonstrated that problematic Internet use was significantly and positively associated with depression, anxiety, and stress among Chinese college freshmen. Based on the prerequisite of measurement equivalence across two samples, the study also found that freshmen's problematic Internet use and psychological distress were likely to be affected by the strict measures put in place during the COVID-19 pandemic.

Effects of resourcefulness on internet game addiction among college students: The mediating role of anxiety and the moderating role of gender

Introduction

The mechanism of internet game addiction is unclear. Whether anxiety mediates between resourcefulness and internet game addiction and whether gender affect its mediation role have not been studied previously.

Methods

A total of 4,889 college students from a college in southwest China were included in this study to complete the investigation, in which three questionnaires were used for evaluation.

Results

Pearson's correlation analysis indicated a remarkable negative correlation between resourcefulness with internet game addiction and anxiety, as well as a significant positive correlation between anxiety and this addiction. The structural equation model confirmed the mediation role of anxiety. The multi-group analysis confirmed the moderating role of gender in the mediation model.

Discussion

These findings have advanced the results of existing studies, indicating the buffering effect of resourcefulness on internet game addiction and revealing the potential mechanism of this relationship.

Exploring mediational roles for self-stigma in associations between types of problematic use of internet and psychological distress in youth with ADHD

BACKGROUND

Several studies have linked the problematic use of the Internet (PUI) to psychological distress. Youth with attention deficit hyperactivity disorder (ADHD) are considered a particular disadvantaged population with a high risk of developing PUI, psychological distress, and self-stigma. Nonetheless, the interrelationships of PUI, self-stigma, and psychological distress in adolescents with ADHD are not well understood.

AIMS

This study investigated whether self-stigma mediates relationships between different forms of PUI, such as problematic gaming (PG), problematic social media use (PSMU), problematic smartphone use (PSPU), and psychological distress (i.e., depression, anxiety, and stress), in children with ADHD.

METHODS AND PROCEDURES

We recruited 100 youth with ADHD (mean age=10.80 [SD=3.07] years; 84 boys) from psychiatric outpatient clinics in Taiwan. All participants were assessed for PUI (via Internet Gaming Disorder-Short Form for PG, Bergan Social Medica Addiction Scale for PSMU, and Smartphone Application-Based Addiction Scale for PSPU), self-stigma (via Self-Stigma Short-Scale), and psychological distress (via Depression, Anxiety, Stress Scale).

OUTCOMES AND RESULTS

The results of path and bootstrapping analyses indicated that self-stigma mediated the associations between PSMU and PSPU, but not PG, and depression, anxiety, and stress.

CONCLUSIONS AND IMPLICATIONS

This study expands the extant literature by revealing that self-stigma mediates the association between specific forms of PUI and psychological distress in adolescents with ADHD. Interventions aimed at reducing self-stigma and PUI, particularly PSMU and PSPU, may help decrease psychological distress among adolescents with ADHD.

E-sports playing and its relation to lifestyle behaviors and psychological well-being: A large-scale study of collegiate e-sports players in China

BACKGROUND

The research on e-sports mainly concerns the relationship between game playing behavior and Internet addiction, especially among college students. It remained a question of how college students' e-sports playing was associated with their lifestyle behaviors and psychological well-being in China.

OBJECTIVES

Our study aimed to explore whether collegiate e-sports players' e-sports participation behaviors differ across demographic backgrounds and how their e-sports playing relates to their lifestyle behaviors and psychological well-being.

METHODS

A cross-sectional survey was conducted on 1441 collegiate e-sports players in China. The demographic characteristics of collegiate e-sports players were explored. The Bivariate Person correlation, linear and Tobit regression analyses were used to examine how students' e-sports playing was related to their lifestyle behaviors (i.e., sleep quality and physical activity) and psychological well-being (mobile phone addiction, online game addiction, satisfaction with life, and perceived stress).

RESULTS

The results of independent t-test and ANOVA analyses revealed that students from different grades, majors, family residences, and family structures differed in their e-sports participation behaviors. The results of linear regression and Tobit regression analyses also revealed that students' e-sports participation behaviors were related to their lifestyle behaviors and psychological well-being, except for sleep quality and mobile phone addiction. It is noteworthy that the length of time in playing e-sports and e-sports consumption was related to different lifestyle behaviors and psychological well-being.

CONCLUSION

The findings demonstrated that e-sports playing had penetrated college students' daily life. Appropriate time arrangement and rational e-sports consumption are crucial in promoting a healthy lifestyle and psychological well-being among college students.

Network analysis of internet gaming disorder, problematic social media use, problematic smartphone use, psychological distress, and meaning in life among adolescents

Background

Few studies have examined the connections between psychological distress, meaning in life, internet gaming disorder (IGD), problematic smartphone use (PSU), and problematic social media use (PSMU).

Methods

The central and bridging nodes of IGD, PSMU, and PSU symptoms were investigated using network analysis in China among 742 adolescents ( Mage = 15.39, SD = 1.68, range = 12–19; 53.23% female). The relationships between IGD, PSMU, and PSU and associated factors were investigated using a Directed Acyclic Graphs method.

Results

The results suggested that the central symptoms were withdrawal in IGD, mood modification in PSU, and tolerance in PSMU. Mood modification in IGD, mood modification in PSU, withdrawal in PSMU, and functional impairment in PSMU were the bridge symptoms. Males were more likely to experience symptoms of IGD than females, while females were more likely to need meaning than males. Stress is the root factor, while depression, meaning confusion, meaning anxiety, and meaning avoidance were closely associated with IGD, PSMU, and PSU.

Conclusions

The current research improved the understanding of IGD, PSMU, and PSU symptoms in teenagers and demonstrated the potential of dynamic systems perspectives on problematic use behaviors and stress/meaning-focused interventions.

Temporal associations between physical activity and three types of problematic use of the internet: A six-month longitudinal study

Background and aims

Internet use has become an important part of daily living. However, for a minority it may become problematic. Moreover, problematic use of the Internet/smartphone (PUIS) has been associated with low physical activity. The present study investigated the temporal associations between three types of PUIS (i.e., problematic smartphone use [PSPU], problematic social media use [PSMU] and problematic gaming [PG]) and physical activity among Taiwanese university students.

Methods

A six-month longitudinal survey study comprising three time points for assessments was conducted. From the original 974 participants, a total of 452 completed all three waves of an online survey comprising the International Physical Activity Questionnaire Short Form (IPAQ-SF) assessing physical activity level, Smartphone Application-Based Addiction Scale (SABAS) assessing PSPU, Bergen Social Media Addiction Scale (BSMAS) assessing PSMU, and Internet Gaming Disorder Short Form (IGDS9-SF) assessing PG.

Results

The linear mixed effects model found positive temporal associations of PSMU and PG with physical activity level (PSMU: B = 85.88, SE = 26.24; P = 0.001; PG: B = 36.81, SE = 15.17; P = 0.02). PSPU was not associated with physical activity level (B = 40.54, SE = 22.99; P = 0.08). Additionally, the prevalence rates were 44.4% for at-risk/PSPU, 24.6% for at-risk/PSMU, and 12.3% for at-risk/PG.

Discussion and Conclusions

PSMU and PG unexpectedly demonstrated correlations with higher physical activity level. The nature of these relationships warrants additional investigation into the underlying mechanisms in order to promote healthy lifestyles among university students.

Psychometric properties of three online-related addictive behavior instruments among Bangladeshi school-going adolescents

BACKGROUND

Due to the ease of access to the internet in modern society users have become more prone to experiencing addictive behaviors online. The present study aimed to develop and investigate the psychometric properties of the Bangla Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), Gaming Disorder Test (GDT), and Bergen Social Media Addiction Scale (BSMAS) due to a lack of existing sound psychometric tools in Bangladesh.

METHODS

A cross-sectional paper-and-pencil survey was carried out among 428 school-aged adolescents who were active gamers (90.89% males; Meanage: 16.13±1.85 years; age range: 10-19 years). Participants were recruited using convenience sampling across four selected schools in Dhaka City, Bangladesh. Data collected included sociodemographic information, frequency of internet use and gaming behaviors, psychological states (i.e., Patient Health Questionnaire [PHQ-9], Generalized Anxiety Disorder [GAD-7]), disordered gaming and social media use (i.e., IGDS9-SF, GDT, and BSMAS). Psychometric testing was conducted to examine the validity and reliability levels of the Bangla IGDS9-SF, GDT, and BSMAS.

RESULTS

The newly adapted Bangla IGDS9-SF, GDT, and BSMAS exhibited adequate levels of internal consistency. All total scores were significantly correlated with depression, anxiety, frequencies of internet use/online activities and gaming, supporting criterion and convergent validity. CFA indicated excellent construct validity as all instruments had a good fit to the data.

CONCLUSIONS

The findings suggest that the Bangla IGDS9-SF, GDT, and BSMAS are sound psychometric instruments due to their satisfactory psychometric properties including internal consistency, criterion validity, convergent validity, and construct validity.

Examining the Indirect Effect of Online Gaming on Depression via Sleep Inequality and Anxiety-A Serial and Parallel Mediation Analysis

Stress-related disorders are highly prevalent among first-year college students. Gaming disorder (GD) is an emerging disorder linked to physical and psychological consequences. We aimed to investigate the mechanism linking GD with anxiety, depression, and sleep disorders among first-year undergraduate students. Four hundred fifty-seven participants were recruited, and the survey included the Internet Gaming Disorder Scale Short-Form (IGDS9-SF), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pittsburgh Sleep Quality Index (PSQI). Our results showed that female students scored significantly higher than males in anxiety and depression. Furthermore, we found that depression is positively and strongly correlated to anxiety, and both are moderately associated with sleep quality. Gaming is positively related to depression, anxiety, and sleep quality. Interestingly, the health sciences tracks showed lower sleep quality than undergraduates from other tracks. There was a 64% variance in depression explained by many predictors, including anxiety, sleep quality, gaming, painkiller use, and gender. In addition, the mediation models showed that the association between gaming and depression is mediated indirectly by sleep quality, and sleep quality may be mediated directly by anxiety. The first year in college occurs at a critical developmental and professional stage, and our results highlight the need to establish support programs and conduct mental health educational workshops.

Temporal associations between problematic use of the internet and self-stigma among people with substance use disorders: A cross-lagged model across one year

Self-stigma is a common experience for people with substance use disorders (SUDs). Understanding factors associated with self-stigma may aid in intervention development. This study investigated the reciprocal relationship between three types of problematic use of the internet [PUI; i.e. problematic use of social media (PUSM), problematic smartphone use (PSPU), and problematic gaming (PG)] and self-stigma among people with SUDs. This longitudinal study involved five waves of a survey given to individuals with SUDs in Taiwan. A total of 319 participants (85% male), with a mean age of 42.2 years (SD = 8.9), were recruited. The Smartphone Application-Based Addiction Scale, Bergen Social Media Addiction Scale, Internet Gaming Disorder-Short Form, and Self-Stigma Scale-Short Form were used. No significant associations between PUI and self-stigma were found in early waves (i.e., Waves 1 and 2). The earliest significant finding was identified between Wave 2 PSPU (smartphone) and Wave 3 self-stigma. Additionally, Wave 3 PSPU (smartphone) and PG (gaming) were associated with Wave 4 self-stigma, and Wave 4 PSPU (smartphone), PG (gaming), and PUSM (social media) were associated with Wave 5 self-stigma. Therefore, all three types of PUI (internet) may elevate self-stigma at different time points for individuals with SUDs. However, the reciprocal effects between self-stigma and PUI (internet) only occurred in PUSM (social media) at a later stage (i.e., from Wave 4 to Wave 5). In conclusion, people with SUDs who have PUI (internet) are at increased likelihood of developing more self-stigma, which may then increase subsequent PUSM (social media), forming a vicious cycle.

Children's mobile-gaming preferences, online risks, and mental health

This study examined the relationships between children's mobile gaming preferences, online risks, and mental health. Data were obtained from a sample of 2,702 third and fourth grade students from 16 elementary schools in Taiwan and 9 schools in China. A self-administered questionnaire was used. The mental state of the children who participated in the study was assessed using the Strengths and Difficulties Questionnaire (SDQ), while mobile gaming addiction was assessed using the short form of the Internet Gaming Disorders Scale (IGDS9-SF). The results showed that about 54% of children played mobile games with others (multi-player), while 31% played mobile games alone, and 15% did not play mobile games. Multiple logistic regression results indicated that behaviors such as participating in multi-player games, playing violent games, a poor parent-child relationship, and living in a rural area were associated with a greater risk of mobile gaming addiction. Involvement in multi-player games, playing violent games, mobile gaming addiction, and exposure to mobile violence/pornography were associated with greater risks of cyber aggression/victimization. Multiple regression results showed that being a multi-player, playing violent games, mobile gaming addiction, exposure to violence/pornography, exposure to cyber aggression/victimization, and having a poor parent-child relationship were associated with emotional and behavioral problems.

Spending Money in Free-to-Play Games: Sociodemographic Characteristics, Motives, Impulsivity and Internet Gaming Disorder Specificities

Free-to-Play games (F2P) have spread widely all over the world in recent years. The current economic model for these games is based on microtransactions, where gamers can purchase additional items or services inside the game. The aim of the present study was (1) to describe the profiles and gaming patterns of F2P gamers, and (2) to compare F2P gamers who spend money and those who do not, in terms of sociodemographic characteristics, gaming experience, motivations, impulsivity, and risk of Internet gaming disorder (IGD), in a representative sample of 5062 French online gamers. Among the total sample, 68.6% were past-year F2P gamers. Among the F2P gamers, 26.1% had spent money in the game. Spending in the game was strongly associated with IGD (6.9% of F2P gamers were disordered gamers). Flow (gaming experience) and escape (motivation) were strongly associated with spending in the game and IGD. Negative urgency (impulsivity) was positively associated with spending in the game while positive urgency was positively associated with IGD. Given the strong association between spending in the game and IGD, these results highlight the importance of prevention and regulation in the field.

Evaluating a cross-lagged panel model between problematic internet use and psychological distress and cross-level mediation of school administrator support on problematic internet use: The serial mediating role of psychological needs thwarting of online teaching and psychological distress

Background

To reduce the transmission of COVID-19, many teachers across the globe, including teachers in China, were required to teach online. This shift to online teaching can easily result in psychological need thwarting (PNT) of teachers' psychological basic needs (autonomy, competence, and relatedness), leaving them vulnerable to negative psychological outcomes. Resulting negative emotional state may lead to problematic internet use (PIU), which can lead to further psychological distress, forming a vicious cycle.

Methods

The present study was conducted using a cross-lagged panel model (with longitudinal data) and hierarchical linear modeling (HLM) (with cross-sectional data). The aims were to investigate (i) the reciprocal relationships between two specific forms of PIU [problematic social media use (PSMU) and problematic gaming (PG)] and psychological distress among schoolteachers, and (ii) the influence of administrators' support on schoolteachers' PIU through a cross-level serial mediation model (PNT of online teaching was the first mediator and psychological distress was the second mediator affected by PNT of online teaching). Primary and secondary schoolteachers (N = 980; mean age = 34.76; 82.90% females) participated in two surveys (Time 1: mid-November 2021; Time 2: early-January 2022).

Results

Results indicated that (i) high psychological distress at Time 1 was associated with increased levels of PSMU and PG at Time 2. Inversely, PG at Time 1 was associated with increased psychological distress at Time 2, although PSMU at Time 1 did not have a significant influence on psychological distress at Time 2; (ii) during Time 1, increased administrative support contributed to alleviating teachers' psychological needs thwarting of online teaching, thereby lowering their psychological distress which, in turn, resulted in a decrease in PG.

Conclusion

PG had a stronger negative influence on teachers' psychological distress than PSMU. To relieve teachers' PG, administrative support can alleviate teachers' psychological needs thwarting of online teaching and psychological distress. Based on this finding, school managers must consider effective ways to support teachers during mandatory online teaching.

A Newly Developed Scale for Assessing Experienced and Anticipated Sexual Stigma in Health-Care Services for Gay and Bisexual Men

Gay and bisexual men's experiences and worries of sexual stigma by health-care providers may delay them from seeking health-care assistance. Our study developed the Experienced and Anticipated Sexual Stigma Scale in Health-care Services (EASSSiHS) and examined its psychometric properties. The six-item EASSSiHS was first developed on the basis of the results of focus group interviews with 24 participants. Parallel analysis was used to determine the number of factors. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the factor structure. The internal consistency was examined using McDonald's omega coefficient. Concurrent validity was examined using Pearson correlations with perceived sexual stigma from family and friends, depression, anxiety, and loneliness. The results of parallel analysis and EFA indicated that the factor structure of the EASSSiHS included two factors: experienced stigma and anticipated stigma. The result of CFA further confirmed the two-factor structure. The EASSSiHS had good internal consistency and acceptable concurrent validity. The anticipated stigma factor had stronger associations with perceived sexual stigma from family members and friends, depression, anxiety, and loneliness, when compared with the experienced stigma factor. The results of this study supported the psychometric properties of the EASSSiHS for assessing experienced and anticipated sexual stigma in health-care services among gay and bisexual men. The experience and worry of sexual stigma in health-care services were not rare among gay and bisexual men; therefore, interventions to enhance the cultural competency of health-care workers are urgently required.

Psychometric properties of the Slovenian version of Internet Disorder Scale-IDS-15

BACKGROUND

Conceptualising internet addiction and assessing its symptoms has presented a significant challenge for researchers over the past 25 years. Recently, the Internet Disorder Scale (IDS-15), which is based on the criteria for Internet Gaming Disorder (IGD) from DSM-5, has emerged as a promising instrument to assess internet addiction. The main objective of the present study was to evaluate the psychometric properties of the Slovenian IDS-15.

METHODS

The sample was recruited from the National Survey on the Use of Tobacco, Alcohol and Other Drugs that was conducted in 2018 on a nationally representative sample (N  =  16,000; age range: 15-64 years; 62.4% response rate). The final sample comprised 9,161 participants, with 80.9% reporting having used the internet at least once a week (n  =  7,413). A structured questionnaire was designed and internet addiction was assessed using the IDS-15.

RESULTS

Confirmatory Factor Analysis showed acceptable fit to the proposed four-factor structure of the IDS-15. The reliability, and criterion, convergent and discriminant validity were also found to be adequate with a notable exception of the first item of the scale, as shown by its lower factor loading and higher variability. Additionally, latent profile analysis was used to distinguish between internet users with low (n = 3,818; 51.5%), medium (n = 3,111; 42.0%) and high (n = 484; 6.4%) addiction risk. Furthermore, the high-risk class was associated with higher IDS-15 factor scores, higher frequency of internet use in leisure time, and lower age of first internet use.

CONCLUSIONS

The present study provides new insights about the strengths and shortcomings of the IDS-15. Moreover, the results provide an insight into the prevalence of internet addiction in Slovenia, as well as associations with other potential factors. The results serve as the basis for further analyses on internet addiction epidemiology, policymaking activities, and design for targeted public health interventions in Slovenia.

Measurement Invariance and Differential Item Functioning of the Health Literacy Instrument for Adults (HELIA): A Large-Scale Cross-Sectional Study in Iran

Health literacy is important for health behavior engagement. Therefore, it is important to have a good instrument assessing health literacy with a theoretical framework. The present study aimed to examine the measurement invariance and differential item functioning (DIF) of a newly developed health literacy instrument; that is, the Health Literacy Instrument for Adults (HELIA). Confirmatory factor analysis (CFA) and Rasch models were used to examine the data collected from a large Iranian sample (N = 9775; 67.3% females; mean age = 36.44 years). All the participants completed the HELIA. CFA was used to examine if the HELIA had a five-factor structure (including reading, access to information, understanding, appraisal, and decision making/behavioral intention factors) and multigroup CFA to examine if the five-factor structure of HELIA was invariant across gender, educational level, accommodation, and age subgroups. Rasch models were used to examine whether each factor of HELIA was unidimensional and DIF contrast in Rasch to examine if the HELIA items were interpreted similarly across the aforementioned subgroups. The CFA results supported the five-factor structure of HELIA, and the Rasch models verified that each HELIA factor is unidimensional. Additionally, multigroup CFA supported the measurement invariance of HELIA across the following subgroups: male vs. female; highly educated vs. poorly educated; city residents vs. suburban residents; and younger age vs. older age. The DIF contrasts in the Rasch models additionally showed that there are no substantial DIF items in the HELIA across aforementioned subgroups. Therefore, the HELIA is a feasible and comprehensive instrument assessing health literacy across different populations in Iran.

Psychometric Assessment and Gender Invariance of the Polish Version of the Gaming Disorder Test

In 2019, Gaming Disorder (GD) was officially recognised by the World Health Organization (WHO) as an official mental health disorder. Currently, the Gaming Disorder Test (GDT) is one of the most widely utilised psychometric tools to assess GD symptoms according to the WHO framework. In this context, the present study aimed to develop the Polish version of the GDT so that this tool can be used within the Polish cultural context. Additionally, the research aimed to ascertain the psychometric properties and appropriateness of the Polish GDT. To achieve this goal, the Polish GDT was investigated in terms of its validity, reliability, and gender measurement invariance through two studies. Accordingly, study 1 recruited a total of 675 gamers (340 female; Meanage = 31.74 years; SD = 7.75 years; range: 15-45 years) and study 2 comprised 575 gamers (275 female; M age = 29.45 years; SD = 4.25 years; range: 18-35 years). A Confirmatory Factor Analysis (CFA) was used to assess psychometric properties of the Polish GDT. The reliability was assessed using Cronbach's alpha, McDonald's omega, and Average Variance Extracted. Gender measurement invariance was investigated using multiple-group CFA, and the unidimensionality was tested using mean of item residual absolute loadings (MIREAL), explained common variance (ECV), and unidimensional congruence (UC). The results of the psychometric analysis showed that the Polish GDT had a one-factor structure. Additionally, the present study demonstrated that the Polish GDT exhibited adequate levels of convergent validity, reliability, and strict gender measurement invariance. These findings suggest that the Polish version of GDT is a suitable psychometric test to assess GD and facilitate research on GD.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-022-00929-4.

The Modified Yale Food Addiction Scale May Be Simplified and Diagnostically Improved: The Same Prevalence but Different Severity and Risk Factors of Food Addiction among Female and Male Students

The Yale Food Addiction Scale (YFAS) is the most commonly used scale for measuring food addiction (FA). The previous approach to the YFAS and its subsequent versions assumed dichotomization of items, separating addiction symptoms and clinical significance items, and factorial validity testing on a subset of items. In this paper, we discuss the drawbacks associated with these procedures. In addition, we present a different analytical approach to investigate the validity of the modified YFAS (mYFAS) along with an alternative scoring method that overcomes limitations related to the previous approach. After establishing the structure of the mYFAS, we investigated the potential antecedents and consequences of FA separately for men and women. The sample consisted of 1182 Polish undergraduate students (613 women, 559 men, 10 missing values on gender) with a mean age of 20.33 years (SD = 1.68; range: 18–36). They were asked to complete self-report questionnaires measuring FA, personality traits (Big Five), self-esteem, narcissism, self-efficacy, social anxiety, loneliness, and well-being indicators. Due to the low content, factorial, and clinical validity, the first three items were excluded from the Polish version of the mYFAS. The six-item mYFAS demonstrated measurement invariance, allowing for meaningful comparisons between genders and yielded almost identical prevalence rates for men and women. The hierarchical multiple regression analysis showed that, narcissism, and social anxiety predicted FA in both genders, whereas important gender differences in antecedents were also noted. In addition, FA was associated with body mass index (BMI) and most of the well-being indicators, even after controlling for relevant variables. The findings suggest that our modified analytical approach allows researchers to measure FA using a valid, useful, and simple tool.

Game-related behaviors among children and adolescents after school closure during the COVID-19 pandemic: A cross-sectional study

Aim

Increased exposure to digital gaming content among youth in recent years has raised serious health concerns. Social restrictions such as school closures, imposed worldwide because of the ongoing COVID-19 pandemic, may increase exposure to gaming and lead to addictive gaming behavior in young people. In this study, we investigated gaming behaviors among Japanese students during COVID-19 school closures.

Methods

Students completed questionnaires regarding their living conditions, game-related behaviors, diagnosis of Internet addiction, psychological difficulties, and the impact of the COVID-19 pandemic. We compared differences between the responses of potentially at risk for gaming disorder (potentially at risk for gaming disorder; defined in this paper with reference to the ICD-11 MMS criteria for gaming disorder [PGD]) students who met the criteria for a diagnosis of gaming disorder in ICD-11 MMS and those of control students. Logistic regression analysis was performed to predict the extent of factors contributing to potential gaming disorder.

Results

Four thousand and forty-eight participants completed the survey. Compared with control students (93%), potentially at risk for gaming disorder (defined in this paper with reference to the ICD-11 MMS criteria for gaming disorder, PGD) students (7%) reported playing games for longer times, spending more money on in-game purchases, were of younger age at the start of game playing, showed a tendency toward Internet dependence, practised school avoidance or absenteeism, and demonstrated the need for psychological support. Moreover, participants in the PGD group reported more anxiety about COVID-19 than control participants, as well as an increase in game-playing time and amount of money spent on games during the COVID-19 pandemic.

Conclusion

These results indicate that young people classified as having a gaming disorder not only exhibit characteristic game-related behaviors but may be psychologically and socially vulnerable and need special support, especially during the ongoing COVID-19 pandemic.

Disordered gaming in esports: Comparing professional and non-professional gamers

INTRODUCTION

The American Psychiatric Association (APA) proposed 'Internet Gaming Disorder' (IGD) as a tentative disorder (APA framework) in 2013 and in 2019 the World Health Organization (WHO) has fully recognized 'Gaming Disorder' (GD) as a mental health disorder (WHO framework). These two frameworks have not yet been jointly investigated in the context of esports. The present study aims to investigate the feasibility of the APA and WHO frameworks for disordered gaming among professional and non-professional gamers and to ascertain the suitability of existing psychometric tools for use in esports.

METHODS

A sample of 5,734 gamers (M_age = 21.47 years, SD = 6.69 years; 6.94% female) recruited through an online survey prior to the COVID-19 pandemic that included an age and gender matched group of professional (n = 2,867) and non-professional gamers (n = 2,867) was investigated. Pairwise comparisons, measurement invariance (MI), and latent mean difference tests were conducted to distinguish the two groups of gamers.

RESULTS

Overall, professional gamers showed greater time spent gaming and prevalence of disordered gaming than non-professional gamers. Additionally, MI was supported and both disordered gaming levels and latent means were significantly higher among professional gamers when compared to non-professional gamers across both APA and WHO frameworks.

CONCLUSIONS

Esports is cross-sectionally associated with greater disordered gaming vulnerability through increased time spent gaming and disordered gaming prevalence rates. Furthermore, the APA and WHO frameworks are viable in the context of esports gaming with existing assessment tools being effective in the assessment of disordered gaming in esports. The results and implications are further discussed in light of the extant literature.

Effects of sleep quality on the association between problematic internet use and quality of life in people with substance use disorder

BACKGROUND

Problematic internet use, especially in people with substance use disorder, may negatively affect their quality of life (QoL). However, it is unclear whether sleep quality is a key mediator in the association between problematic internet use and QoL among people with substance use disorder.

AIMS

This study aimed to investigate the relationship between problematic internet use and QoL and how sleep quality may mediate the association between these two variables.

METHOD

Overall, 319 people (85% male) with substance use disorder (mean age 42.2 years, s.d. 8.9) participated in a cross-sectional study in Taiwan. The Smartphone Application-Based Addiction Scale, Bergan Social Media Addiction Scale, Internet Gaming Disorder-Short Form, Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Questionnaire Brief Version were used.

RESULTS

The prevalence of sleep problems was 56%. There were significant and direct associations between sleep quality and two types of problematic internet use, and between sleep quality and different dimensions of QoL. All types of problematic internet use were significantly and negatively correlated with QoL. Mediated effects of sleep quality in relationships between the different types of problematic internet use and all dimensions of QoL were significant, except for problematic use of social media.

CONCLUSIONS

Different types of problematic internet use in people with substance use disorder may be directly associated with reduced QoL. Sleep quality as a significant mediator in this association may be an underlying mechanism to explain pathways between problematic internet use and QoL in this population.

Internet-Related Instruments (Bergen Social Media Addiction Scale, Smartphone Application-Based Addiction Scale, Internet Gaming Disorder Scale-Short Form, and Nomophobia Questionnaire) and Their Associations with Distress among Malaysian University Students

The present study evaluated the psychometric properties of four instruments related to internet use, namely the Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), (nine-item) Internet Gaming Disorder Scale Short Form (IGDS9-SF), and Nomophobia Questionnaire (NMPQ) as well as their associations with psychological distress among Malaysian university students. A total of 380 Malaysian university students (71.6% females, mean age 24.0 years) were recruited through convenience sampling and completed an online survey including questions concerning socio-demographic background, social media addiction, smartphone addiction, internet gaming disorder, and nomophobia. Confirmatory factor analysis and Rasch analysis were applied to evaluate the psychometric properties of the instruments and Cronbach’s alpha value and McDonald’s omega value were used to confirm the internal consistency reliability of the instruments. The unidimensional structure was confirmed for the BSMAS, SABAS, and IGDS9-SF while the four-factor structure was confirmed for NMPQ. All instruments showed good internal consistency reliability. Promising validity and reliability were confirmed for BSMAS, SABAS, IGDS9-SF, and NMPQ. Therefore, they are useful to assess different types of problematic internet use among university students in Malaysia. Furthermore, a significant association was observed between internet use and psychological distress. The present study is the first to investigate the validity and reliability of BSMAS, SABAS, IGDS9-SF, and NMPQ among Malaysian university students using rigorous psychometric testing methods (i.e., Rasch analysis).