Merging Theoretical Models and Therapy Approaches in the Context of Internet Gaming Disorder: A Personal Perspective

Translation, transcultural adaptation, and convergent validity of the Arabic version of the Mukbang addiction scale

INTRODUCTION

The present study evaluated the psychometric properties of the Arabic translation of the Mukbang Addiction Scale (MAS) among Arabic-speaking adults from the general population. Specifically, it aimed to assess the factorial structure through a confirmatory factor analysis, determine the composite reliability through Cronbach alpha and McDonald's omega scores, assess gender invariance, and evaluate the convergent validity by examining its correlation to eating addiction and psychological distress.

METHODS

A total of 370 individuals with a mean age of 21.94 ± 2.29 years participated in this study, which was conducted using an online platform. The participants were surveyed on demographic information, mukbang addiction, food addiction, and psychological distress. Translation was conducted using the forward and backward technique.

RESULTS

The findings demonstrated excellent internal consistency of the Arabic MAS (McDonald's omega coefficient = 0.93). Confirmatory factor analyses validated the one-factor structure of the scale, while establishing measurement invariance across sex at the configural, metric, and scalar levels. No sex differences were observed in the Mukbang addiction levels. Lastly, the MAS scores were significantly and positively correlated with food addiction and psychological distress, supporting their convergent validity.

CONCLUSION

The current research provides evidence supporting the reliability and validity of the Arabic version of the MAS as a self-report method for assessing addictive Mukbang watching. While further validations are needed to corroborate the present findings, this measure can be effectively utilized across different fields, including schools, mental health centers, and researchers aiming to understand this global phenomenon. Mukbang refers to individuals or hosts consuming large quantities of food while interacting with their audiences through recorded video or a live stream. The Mukbang phenomenon has gained substantial popularity among young individuals over the past years, rising concerns about its potential impact on their eating habits and health, especially when overconsumed. Overconsumption of mukbang content, or Mukbang addiction, aligns with the core features of addiction, including compulsive engagement, tolerance, and withdrawal symptoms, making it comparable to other addictive behaviors. Mukbang addiction can lead to detrimental effects on mental and physical health, including neglect of balanced nutrition, disordered eating habits, obesity, feelings of guilt, shame, poor self-esteem, distorted self-images, body dissatisfaction, heightened anxiety or depression, and social isolation. Given these significant impacts, valid and reliable tools are crucial to enable an accurate assessment of Mukbang addiction. This study proposes to translate, adapt and examine the psychometric properties of the Mukbang Addiction Scale (MAS) in a sample of Arabic-speaking individuals from the general population. Findings showed that the six MAS items loaded on a single factor with strong internal consistency and good convergent validity, preliminarily indicating its potential validity and reliability for assessing addictive mukbang-watching among Arabic-speaking individuals.

Psychometric Properties of the Spanish Motives for Online Gaming Questionnaire in a Sample of College Students

This study investigates the psychometric properties of the Spanish version of the Motives for Online Gaming Questionnaire (MOGQ). We explored the factor structure and construct validity of the MOGQ through its relationships with gaming disorder symptoms (IGD-20) and impulsivity traits. We also analyzed if sociodemographic variables and gaming habits were related to gaming motives. An online cross-sectional survey was completed by 845 college students. Structure validity was examined using a combination of exploratory and confirmatory factor analyses, which supported a bifactor model composed of a general motivation factor and six uncorrelated factors (a mixed factor composed of escape and coping, competition, recreation, skill, social, and fantasy). Omega-hierarchical and omega coefficients were used to determine reliability of the MOGQ. The scale presented acceptable reliability for the general factor (ωh = .79) and the specific factor scores (social ω = .79, escape/coping ω = .81, competition ω = .79, skill ω = .84, fantasy ω = .82, and recreation ω = .70). Positive associations were observed between the MOGQ and the IGD-20 symptoms, with escape/coping (r = .48) and fantasy (r =.40) showing the strongest ones. Null or low correlations were observed with impulsivity traits. Motives to play varied significantly across genders. These findings provide evidence that the Spanish version of the MOGQ is a reliable and valid tool to assess motives to play online games.

Using machine learning algorithms and techniques for defining the impact of affective temperament types, content search and activities on the internet on the development of problematic internet use in adolescents' population

Background

By using algorithms and Machine Learning - ML techniques, the aim of this research was to determine the impact of the following factors on the development of Problematic Internet Use (PIU): sociodemographic factors, the intensity of using the Internet, different contents accessed on the Internet by adolescents, adolescents' online activities, life habits and different affective temperament types.

Methods

Sample included 2,113 adolescents. The following instruments were used: questionnaire about: socio-demographic characteristics, intensity of the Internet use, content categories and online activities on the Internet; Facebook (FB) usage and life habits; The Internet Use Disorder Scale (IUDS). Based on their scores on the scale, subjects were divided into two groups - with or without PIU; Temperament Evaluation of Memphis, Pisa, Paris, and San Diego scale for adolescents (A-TEMPS-A).

Results

Various ML classification models on our data set were trained. Binary classification models were created (class-label attribute was PIU value). Models hyperparameters were optimized using grid search method and models were validated using k-fold cross-validation technique. Random forest was the model with the best overall results and the time spent on FB and the cyclothymic temperament were variables of highest importance for these model. We also applied the ML techniques Lasso and ElasticNet. The three most important variables for the development of PIU with both techniques were: cyclothymic temperament, the longer use of the Internet and the desire to use the Internet more than at present time. Group of variables having a protective effect (regarding the prevention of the development of PIU) was found with both techniques. The three most important were: achievement, search for contents related to art and culture and hyperthymic temperament. Next, 34 important variables that explain 0.76% of variance were detected using the genetic algorithms. Finally, the binary classification model (with or without PIU) with the best characteristics was trained using artificial neural network.

Conclusion

Variables related to the temporal determinants of Internet usage, cyclothymic temperament, the desire for increased Internet usage, anxious and irritable temperament, on line gaming, pornography, and some variables related to FB usage consistently appear as important variables for the development of PIU.

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

INTRODUCTION

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

METHODS

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

RESULTS & DISCUSSION

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

Psychometric properties of the Problematic Online Gaming Questionnaire (POGQ) in a Moroccan sample of university students

BACKGROUND

The Problematic Online Gaming Questionnaire (POGQ) instrument consists of 18 items with a six-factor structure. This questionnaire is widely utilized to measure the degree of problematic online gaming, but the scale has not, up to date, been validated in Arabic language. This study aimed to assess POGQ scale validity and reliability in Moroccan context.

METHODS

The research was conducted from April to June 2023 using an online questionnaire. The selected sample involved Moroccan university students. Data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the first sample (n1 = 143). Then, this structure was confirmed in the second sample (n2 = 313) using confirmatory factor analysis (CFA).

RESULTS

The EFA and CFA results demonstrated that the POGQ has a six-factor structure explained 72% of the total variance. The results of this analysis provided an optimal fit to the data confirming a good performance of the measurement model (χ² = 243.6; CFI = 0.981; TLI = 0.976; RMSEA = 0.048; NFI = 0.964; IFI = 0. 981; SRMR = 0.022). The instrument showed sufficient reliability and convergent validity demonstrated by acceptable values of composite reliability (CR = 0.68-0.90), and average variance extracted (AVE = 0.50-0.75), respectively. Finally, the Arabic version of POGQ was found to have a high test-retest reliability.

CONCLUSIONS

The Arabic version of POGQ revealed adequate psychometric properties. As a result, the instrument might be used to measure the degree of problematic online gaming. The use of the POGQ is expected to further promote research on online game dependence treatment and prevention.

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

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

Potential Biological Markers and Treatment Implications for Binge Eating Disorder and Behavioral Addictions

The reward system is highly relevant to behavioral addictions such as gambling disorder (GD), internet gaming disorder (IGD), and food addiction/binge eating disorder (FA/BED). Among other brain regions, the ventral striatum (VS) has been implicated in reward processing. The main objective of the present state-of-the-art review was to explore in depth the specific role of the VS in GD, IGD and FA/BED, understanding it as a possible biomarker of these conditions. Studies analyzing brain changes following interventions for these disorders, and especially those that had explored possible treatment-related changes in VS, are discussed. More evidence is needed on how existing treatments (both pharmacological and psychobehavioral) for behavioral addictions affect the activation of the VS and related circuitry.

Telemedicine as bridge to the offline world for person affected with problematic internet use or internet use disorder and concerned significant others

Introduction

Internet use disorder is a disorder of the digital age and presents a growing problem worldwide. It appears that due to structural and personal barriers, many persons affected (PA) and Concerned Significant Others (CSO) do not reach the health care system so far and thus a chronification of the pathology can proceed.

Methods

A telemedicine counseling service for PA and CSO of PA unwilling to enter treatment with two webcam-based sessions of 60 minutes for each group was created with the aim of reaching out to PA and CSO to provide a low-threshold support and refer the participants to the local health care system. Motivational interviewing for PA and CRAFT (Community Reinforcement and Family Training) for CSO were used as methods. Participants answered questions about their Internet use and sociodemographic data and six months after participation, participants were asked via email if they entered the local health care system. CSO answered the questions for themselves and in a third-party rating for PA unwilling to enter treatment.

Results

107 PA (34 years (SD = 13.64), 86% male) and 38 CSO (53 years (SD = 6.11), 28.9% male) participated in the two telemedicine sessions. After participation, 43.9% of the PA and 42.1% of the CSO reached the health care system. When there was consistency between the location of telemedicine consultation and treatment locally, over 90% of participants arrived (PA: 92.3%, CSO: 100%).

Conclusion

The results from this study reveal that telemedicine services could be a promising approach to address PA and CSO and build a bridge to the local health care system. Future studies should verify if these results can be replicated in randomized controlled trials.

Effects of exercise and psychological interventions on smartphone addiction among university students: A systematic review

Background and aims

Among the large number of studies on smartphone addiction, only a few randomized controlled trials on exercise and psychological interventions for smartphone addiction by university students have been published. This study aims to systematically investigate the impact of exercise and psychological interventions on smartphone addiction among university students.

Methods

The PRISMA guidelines were adopted for this systematic literature review. Prominent academic databases such as Web of Science, PubMed, ProQuest, Cochrane Library, China National Knowledge Infrastructure (CNKI) and PsycINFO were searched to find eligible studies published before Aug 2021. The overall quality of the articles was checked using the "QualSyst" tool by Kmet et al.

Results

From among 600 papers, 23 met the inclusion criteria and were incorporated into our systematic review. All of the studies were randomized controlled trials. The following thematic areas emerged as a result of the content analysis: study selection and design, as well as study characteristics (participants, intervention, comparisons, and outcomes).

Discussion and conclusion

The literature on exercise and psychological interventions for smartphone addiction is scarce. There is a need to introduce new interventions and to validate the effectiveness of combined interventions. Our findings suggest that exercise and psychological interventions may help to reduce smartphone addiction. This combination was more effective compare to exercise or psychological intervention on mental health and addiction among university students. Future research should combine exercise and psychological interventions, focusing on university students, especially females, who are vulnerable to smartphone addiction. Further studies should focus on the cross-section of neuropsychology, cognitive psychology, and sports science to provide combined interventions in physiological and psychological direction.

Systematic review registration

https://www.crd.york.ac.uk/prospero, identifier: CRD42021278037.

Screening, Brief Intervention, and Referral to Treatment Model Based on ICD-11 Criteria of Gaming Disorder and Hazardous Gaming During the COVID-19 Pandemic

Purpose of Review

This commentary aimed to propose the screening, brief intervention, and referral to treatment (SBIRT) model for gaming disorder (GD) and hazardous gaming (HG) on the basis of the International Classification of Disease, 11th version (ICD-11) classification.

Recent Findings

COVID-19 and its preventive measures increase the risk of GD and the treatment needs could exceed the capacities of mental health systems. Brief intervention could be provided for adolescents with HG after screening. Psychiatrists make diagnoses of GD or HG and then refer them to school counselors, specialized psychologists, or integrated teams based on the severity, comorbidity, and complication of GD.

Summary

The classification of GD and HG was suitable to develop a SBIRT model intervention. The SBIRT should work through the shortage of resources and provide a brief intervention guild to make it practical.

Evaluation of the Psychometric Properties of the Arab Compulsive Internet Use Scale (CIUS) by Item Response Theory Modeling (IRT)

INTRODUCTION

The psychometric properties of the Arab translation of the Compulsive Internet Use Scale (CIUS) have been previously studied by confirmatory factor analysis (CFA) with AMOS software using the asymptotically distribution-free (ADF) estimator. Unidimensionality has been achieved at the cost of correlating several item variance errors. However, several reviews of SEM software packages and estimation methods indicate that the option of robust standard errors is not present in the AMOS package and that ADF estimation may yield biased parameter estimates. We therefore explored a second analysis through item response theory (IRT) using the parametric graded response model (GRM) and the marginal maximum likelihood (MML) estimation method embedded in the LTM package of R software. Differential item functioning (DIF) or item bias across subpopulations was also explored within IRT framework as different samples were investigated. The objective of the current study is to (1) analyze the Arab CIUS scale with IRT, (2) investigate DIF in three samples, and (3) contribute to the ongoing debate on Internet-use-related addictive behaviors using the CIUS items as a proxy.

METHODS

We assessed three samples of people, one in Algeria and two in Lebanon, with a total of 1520 participants.

RESULTS

Almost three out of every five items were highly related to the latent construct. However, the unidimensionality hypothesis was not supported. Furthermore, besides being locally dependent, the scale may be weakened by DIF across geographic regions. Some of the CIUS items related to increasing priority, impaired control, continued use despite harm, and functional impairment as well as withdrawal and coping showed good discriminative capabilities. Those items were endorsed more frequently than other CIUS items in people with higher levels of addictive Internet use.

CONCLUSIONS

Contrary to earlier ADF estimation findings, unidimensionality of the CIUS scale was not supported by IRT parametric GRM in a large sample of Arab speaking participants. The results may be helpful for scale revision. By proxy, the study contributes to testing the validity of addiction criteria applied to Internet use related-addictive behaviors.

Technological Addictions

PURPOSE OF REVIEW

Modern methods of communication and engagement, such as social media, video games, and online shopping, use a variety of behavioral techniques to encourage and reward frequent use, opening the door to addiction. The technological addictions (TAs) are a set of disorders that accompany the technological advances that define the digital age. The TAs are an active source of research in the literature, with promising treatment options already available.

RECENT FINDINGS

There are promising therapeutic and psychopharmacologic treatments for a broad range of TAs. Stimulants, antidepressants, and cognitive therapies may all be effective for internet gaming disorder (IGD). Cognitive therapies may be effective for other TAs, such as social media addiction (SMA), online shopping addiction (OSA), and online porn addiction. Society's dependence on addictive technologies will only increase. Many of the TAs can be addressed with medication and therapy, with more research and literature developing at a rapid pace.

Technological Addictions

Modern technology rewards constant engagement and discourages sparing use, opening the door to unhealthy use and even addiction. The technological addictions (TAs) are a newly described set of disorders that come with the technological advances that define the new era. Internet gaming disorder (IGD) is already codified as a proposed diagnosis in the 5th Edition of the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association. Others, such as social media addiction (SMA), are in the earlier stages of our understanding. This article provides an overview of the more common TAs including their evaluation and treatment techniques.

The Association Between Internet Gaming Disorder and Sensation Seeking Among Arab Adolescents

Research on internet gaming disorder (IGD) has increased considerably over the last decade. Although most IGD research has focused on Western or South Asian samples, it is critical to understand and assess this disorder among other populations. The present study investigated the association between IGD and sensation seeking among Arab adolescents. An online survey consisting of the short internet gaming disorder short scale (IGDSS) and brief sensation seeking scale (B-SSS) was completed by 260 participants (mean age = 14.61, SD = 2.43). The results showed that sensation seeking behaviours were associated with higher gaming hours and greater chances of exhibiting IGD. The findings support the current perspective of understanding this disorder from a disease framework as it highlights the relevance of behavioural components in gaming addiction. Importantly, the results will further aid the development of reliable diagnosis and efficacious treatments within clinical practices.

Exploring Internet gaming disorder: an updated perspective of empirical evidence (from 2016 to 2021)

BACKGROUND AND AIMS

Since the acceptance of Internet gaming disorder (IGD) as a "disorder due to addictive behaviors", research has proliferated exponentially. The present review focuses on the conceptualization of IGD, its diagnosis and assessment, associated factors and existing prevention and treatment plans to address it.

RESULTS AND CONCLUSIONS

The discrepancies between the diagnostic criteria for IGD proposed by the two central diagnostic entities, as well as the questioning of their clinical validity, have generated multiple proposals for the diagnosis and psychometric evaluation of IGD. Likewise, there have been numerous suggestions to prevent this pathology, with the involvement of governments, the gaming industry and health institutions. Finally, multiple treatment plans have been proposed, both pharmacological and psychological, although only the efficacy of cognitive behavioral therapy has been tested. It is essential, therefore, to delve deeper into this disorder by addressing the central limitations of the current literature.

Personality traits and college students' internet addiction: The mediating roles of general health and self-esteem

This research aimed to explore the gender-related differences in Internet addiction levels, the associated factors behind Internet addiction, and the mediating roles of general health and self-esteem in the relationship between personality traits and Internet addiction among college students. A total of 318 college students in Iran participating in this study completed sociodemographic information form and self-report measures of Internet addiction, personality traits, general health, and self-esteem. The results showed higher frequencies of low and moderate-severe levels of addiction among female and male students, respectively. Further, younger age, male gender, singleness, high scores on neuroticism, poor general health, and low self-esteem might be linked to Internet addiction. The overall hypothesis that general health and self-esteem mediated the effect of neuroticism on Internet addiction was also supported. Our findings highlighted the necessity of evaluating general health and self-esteem among Internet-addicted students. Further, these variables can be targeted by psychiatrists and psychologists for effective cognitive-behavioral therapy among Internet-addicted students.

Examining the relationship between fear of COVID-19, intolerance for uncertainty, and cyberloafing: A mediational model

After the COVID-19 pandemic began, organizations had to pivot and move to online remote work. As companies moved to digital platforms and technologies for remote working, a key concern was the increase in workplace withdrawal behaviors during the pandemic, including cyberloafing, a form of workplace deviance. Cyberloafing can be described as the action of using the internet for non-work-related activities or personal use during working hours. Given its effect on organizational effectiveness and efficiency, organizations must take measures to minimize cyberloafing. We examined how two factors-fear of COVID-19 and intolerance for uncertainty-were related to cyberloafing during the third lockdown in Israel. A sample of 322 adults who were enrolled in professional courses at a university in Israel were surveyed. Based on Conservation of Resources Theory, our findings suggest that distress significantly mediated the relationship between fear of COVID-19, intolerance for uncertainty, and cyberloafing. In an attempt to deal with the stress and depletion of personal resources during the COVID-19 lockdown, individuals engaged in cyberloafing as a way to handle the stress. Our results suggest that organizations should take measures to reduce fear and uncertainty in order to decrease distress, which, in turn, will reduce cyberloafing.

Problematic use of digital media in children and adolescents with a diagnosis of attention-deficit/hyperactivity disorder compared to controls. A meta-analysis

Objective

Problematic use of digital media and problematic use of the internet (PUI) in particular are growing problems in the general population. Moreover, studies have shown links between PUI and symptoms of attention-deficit/hyperactivity disorder (ADHD). This meta-analysis investigated whether children and adolescents with ADHD are more often affected by PUI compared to control groups.

Method

Multiple databases (EBSCOhost, Pubmed) were reviewed. Studies were eligible if individuals (aged 6-18 years) were diagnosed with ADHD, assessed on PUI-related measures, and compared to non-clinical or/and clinical controls without a diagnosis of ADHD. Out of 3,859 identified studies, 14 studies assessing 2,488 participants met all inclusion criteria. Four meta-analyses examining time-based and scale-based measures, different informants and non-clinical vs. clinical controls using random-effects models were performed. Funnel plots were used to investigate publication bias.

Results

The analyses revealed significantly more severe PUI in individuals with ADHD compared to controls, both when PUI was assessed via rating scale (scaled-based) and via units for time (time-based measures). Different informants (self- vs. parent-rating) had no impact on results. Differences in PUI between groups with ADHD and non-clinical controls were significant, whereas differences between ADHD and clinical controls were not. Due to the high heterogeneity observed and the small sample sizes, these latter findings should be interpreted cautiously.

Conclusion

Children and adolescents with ADHD show more severe PUI compared to non-clinical controls without ADHD. However, the small number of studies does not allow for a systematic comparison between ADHD and groups with other psychopathologies.

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

OBJECTIVES

Effective prevention and intervention of Internet gaming disorder require the identification of risk and protective factors. This study aims to exhaustively review the risk and protective factors of Internet gaming disorder among Chinese people.

METHOD

We searched for articles published from database inception to February 2020 in MEDLINE, PsycINFO, Embase, PubMed, Web of Science and two Chinese databases, CNKI and Wanfang Data. Studies were included in the meta-analysis if they addressed Internet gaming disorder, sampled people in China, presented correlational factors of Internet gaming disorder and reported the effect sizes for correlations. Reviewers independently selected the studies, assessed their validity and extracted the data. Pooled Pearson's correlations were calculated using the random effects model.

RESULT

In the meta-analysis, 153 studies covering 115,975 subjects were included. We identified 56 risk factors and 28 protective factors. Most risk factors strongly correlated with Internet gaming disorder fell into the category of maladaptive cognitions and motivations. Other factors that showed high effect sizes fell into various categories, including psychopathological characteristics, personality traits, cognition emotion regulation style and gaming-related factors. The only protective factor strongly correlated with Internet gaming disorder was self-control. We found that the factors related to the 'environments' show modest effect sizes compared to those related to the individual. The pooled effect sizes for most factors were not influenced by outliers and publication bias.

CONCLUSION

Factors strongly correlated with Internet gaming disorder, especially maladaptive cognitions and motivations, are more likely to be proximal correlates of Internet gaming disorder and may be considered the focus of interventions. We encourage further empirical and experimental studies to examine the causal pathway and the treatment efficacy.

The effects of an early intervention on adults' gaming-related problems - a pilot study

Gaming Disorder (GD) has been recognized as an official psychiatric condition characterized by individuals' impaired control over gaming, continuous gaming despite the occurrence of negative side-effects, and gaming taking increasing priority over other important areas of life, thus leading to significant impairments in their everyday lives. To date few prevention and treatment programs have been developed. The present pilot study aimed to investigate the effects of an early psycho-educational intervention for young adults with excessive gaming behaviors. A one-group pre- and post-test design without a control group was used. A total of 22 young adults (20 males and 2 females) aged between 18 and 28 (M = 23.05, SD = 3.02) years old, engaged with the intervention. The severity of gaming-related problems, average gaming time per day, quality of life, and mental well-being were assessed at pretest and post-test stages. Participants demonstrated a slight reduction in gaming time (d = 0.13, p = .545 for weekdays, and d = 0.08, p = .714 for weekend days) and in the severity of problematic gaming (d = 0.17, p = .411) over the three-month intervention period. Changes in neither gaming-related measures nor self-assessed quality of life (p > .01) and mental well-being (d = 0.23, p = .288) reached statistical significance, however. Regardless of limitations on sample size, this study shows encouraging signs that this brief 10-session and three-month educational intervention can achieve positive effects on gaming behavior. A larger scale investigation is needed to develop the intervention further.

A meta-analytic review of Internet gaming disorder and the Big Five personality factors

Two systematic reviews have been conducted to summarize the literature on Internet Gaming Disorder (IGD) and personality. However, the data was not synthesized statistically, imposing a limit to their conclusions. The current study aimed to extend on the two reviews by conducting a series of five meta-analyses, one for each of the Big Five personality factors, to examine their relationships with IGD. A comprehensive search was conducted on the databases PsycArticles, PsycInfo, and Web of Science from inception to 29 July 2021. The data was analyzed using Meta-Essentials and the random effects model was used to obtain the pooled estimate of the effect size. A total of 12 articles were included (n = 145 to 3389). IGD was not significantly correlated with openness to experience (r = -0.05). However, IGD was negatively correlated with conscientiousness (r = -0.29), extraversion (r = -0.15), and agreeableness (r = -0.17), and positively correlated with neuroticism (r = 0.20). Age moderated the relationships between IGD and openness to experience and conscientiousness. The results were broadly consistent with the DSM-5 IGD criteria and the Big Five personality framework. Future research directions might include examining age as moderator variables, and using appropriate instruments based on the DSM-5 IGD criteria.

Increasing important roles of child and adolescent psychiatrists in the treatment of gaming disorder: Current status in Japan

BACKGROUND

Digital gaming is the most common leisure activity among children and adolescents in Japan, especially in males. Playing online gaming has become more common among school-age children over the years. As a result, excessive online gaming in younger children has become a significant social problem in Japan. Previous studies have demonstrated that excessive online gaming could cause various mental health issues in children and adolescents. At medical institutions having child and adolescent psychiatry services, there is an increasing number of children and adolescents with various problems related to excessive gaming. The aim of this study was to investigate the current practice of gaming disorder (GD) in clinical settings in Japan.

METHODS

The subjects of this study were all of 414 child and adolescent psychiatrists certified by the Japanese Society for Child and Adolescent Psychiatry (JSCAP). The study questionnaire was mailed to all subjects from the official secretariat of JSCAP. Study subjects were requested to answer the questionnaire anonymously. The survey contained three types of responses: open responses; single and multiple-choice responses; and, responses on a five-point Likert scale. The questionnaire consisted of 14 questions regarding GD.

RESULTS

We received 159 responses. The most common reason for a visit to child and adolescent psychiatry service which results in a subsequent diagnosis of GD was school refusal/absenteeism followed by disruption of sleep-awake rhythm. The most common specialized treatment for GD currently offered at child and adolescent psychiatry service is individual psychotherapy. The two most frequently experienced difficulties in the treatment of GD were low motivation to achieve recovery and a large variety of combined problems other than excessive gaming itself. With regard to the three most common psychiatric comorbidities of GD, they were autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and depression.

DISCUSSION

The results of our survey revealed that although GD is a behavioral addiction, many children and adolescents with GD first visit child and adolescent psychiatry clinics rather than specialized clinics for addiction which are usually designed and staffed for adult patients. Because it is known that GD is more prevalent among young males, including junior high and high school students, GD has become one of the most important clinical issues in child and adolescent psychiatry today. The important roles of child and adolescent psychiatrists in the treatment of GD has been increasing.

Self-control and problematic use of social networking sites: Examining distress tolerance as a mediator among Argentinian college students

Introduction

Use of Social networking sites (SNSs) is a highly prevalent behavior worldwide and, for some individuals, its use can turn maladaptive. There has been growing interest to identify which variables are associated with problematic use of SNSs.

Aim

The present study cross-sectionally examined whether the associations between different features of self-control (i.e., impulsivity-like traits, self-regulation and emotion regulation) indirectly relate to two outcomes of SNSs (hours of use and problematic use) via distress tolerance.

Methods

A sample of 509 Argentinean college students (70.3% female; Mean age = 21.15 ± 5.15) completed an online survey.

Results

Two significant indirect effects were found: a) higher negative urgency was associated with higher problematic use of SNSs via lower distress tolerance and b) higher self-regulation was associated with lower problematic use of SNSs via higher distress tolerance. Positive urgency, negative urgency and self-regulation had significant direct associations with problematic use of SNSs while neither component of emotion regulation was significantly associated with SNSs outcomes. No significant direct or indirect effects were found between any of the self-control features and time spent using SNSs.

Conclusions

The results highlight dysfunctional self-control, particularly emotion-driven impulsivity and low self-regulation, as relevant components of maladaptive SNSs that seem to operate by decreasing the perceived capacity to tolerate negative affect. In this context, interventions targeting the development and improvement of distress tolerance abilities might have a positive impact on problematic use of SNS.

[French validation of a scale evaluating Internet Gaming Disorder: the Internet Gaming Disorder-20]

BACKGROUND

The study aims to validate an online video game problematic use (Internet Gaming Disorder or IGD) scale in French language: the IGD-20. IGD-20 has been elaborated considering the discussion about the etiology of the IGD, which was included in the section III of the DSM-5. The IGD-20 is composed of 20 items split in six components based on the six components model of addiction from Griffiths.

METHODS

A total of 166 online video game players were recruited on specialized forums, playing 21.9 hours per week. The French version of the IGD-20 was validated through a confirmatory factor analysis via structural equation modeling (SEM).

RESULT

The French version of the IGD-20 showed a good validity and a six-factor structure (salience, mood modification, tolerance, withdrawal symptoms, conflict and relapse) (RMSEA = 0.063 [0.049; 0,077], CFI = 0.912, TLI = 0.909).

CONCLUSION

The validation of a French scale such as the IGD-20 shows some interest for the French-speaking population, including therapists who could use this scale to investigate the IGD-20 more precisely and for people with IGD-20 who could benefit from a more refined support.

EEG response to game-craving according to personal preference for games

Recently, the World Health Organization included ‘gaming disorder’ in its latest revision of the international classification of diseases (ICD-11). Despite extensive research on internet gaming disorder (IGD), few studies have addressed game-related stimuli eliciting craving, which plays an important role in addiction. Particularly, most previous studies did not consider personal preferences in games presented to subjects as stimuli. In this study, we compared neurophysiological responses elicited for favorite game (FG) videos and non-favorite game (NFG) videos. We aimed to demonstrate neurophysiological characteristics according to the game preference in the IGD group. We measured participants’ electroencephalogram (EEG) while they watched FG, NFG and neutral videos. For FG videos, the parieto-occipital theta power (TP_PO) were significantly increased compared with those for NFG videos (P < 0.05, paired t-test). TP_PO also differed significantly between the healthy control and IGD groups only on FG videos controlling covariate (TP_PO on neutral videos) (P < 0.05, analysis of covariance [ANCOVA]). And TP_PO was significantly correlated to self-reported craving score only on FG videos (r = 0.334, P < 0.05). In the present study, we demonstrate that FG videos induce higher TP_PO than that induced by NFG videos in the IGD group and TP_PO is a reliable EEG feature associated with craving for gaming.

How Theoretical Models Can Inspire Advances in Research and Clinical Practice: The Example of Behavioral Addictions

Abstract. Aims: In this narrative position paper, we will summarize some examples of theoretical models of behavioral addictions. We will then make some suggestions for how theoretical models may inspire both research and clinical practice in the context of behavioral addictions. Results: Current theoretical models typically distinguish between general and specific risk factors. It is commonly argued that based on conditioning processes, affective responses to specific stimuli (cue-reactivity and craving) develop within the course of behavioral addictions. Diminished control over the behavior is reflected in reductions in inhibitory control and executive functioning. Cognitive distortions, attentional biases, and behavior-related expectancies are also considerable mechanisms. Theoretical models have been used to inspire advances not only in research but also in clinical practice. For example, theoretical models have inspired the development of standardized treatment protocols. Conclusions: If theoretical models contributed more consistently to scientific studies, a better understanding of the processes underlying specific mental disorders could be facilitated, which could then promote updates and modifications of the theoretical models and improvements in clinical practice. Close connections and stimulating discussions between theorists and therapists are very important and beneficial for advances over time.

Internet-Related Behaviors and Psychological Distress Among Schoolchildren During the COVID-19 School Hiatus

This study assessed the mediating roles of problematic gaming, problematic social media use, and problematic smartphone use in the associations between psychological distress and screen time use among primary school children during the school hiatus due to the outbreak of the novel coronavirus disease 2019 (COVID-19). Students (n = 2,026; mean [standard deviation] age = 10.71 years [1.07]; 1,011 [49.9 percent] girls) in Sichuan, China completed a cross-sectional online survey, and this study was approved by the ethics committee of the Hong Kong Polytechnic University (IRB ref: HSEARS20190718001). The Internet Gaming Disorder Scale-Short Form, Bergen Social Media Addiction Scale, and Smartphone Application-Based Addiction Scale were used to assess problematic gaming, social media use, and smartphone use. The Depression, Anxiety, Stress Scale-21 was used to assess distress, and an item rated on a 0-10 scale was included to assess fear of being infected by COVID-19. Fear of being infected by COVID-19 was assessed because this could be a confounding variable in the association between psychological distress and screen time use. Increased time spent on gaming, social media, and smartphones was associated with greater problematic gaming, problematic social media use, problematic smartphone use, and psychological distress, but was not associated with fear of COVID-19 infection. Mediation analyses showed that problematic gaming, problematic social media use, and problematic smartphone use were significant mediators in the association between psychological distress and increased time spent on Internet-related activities during the COVID-19 outbreak period. Children who had psychological distress during COVID-19 outbreak might have spent longer time on Internet-related activities due to the school hiatus and problematic use of Internet-related activities. Parents/caregivers are recommended to monitor their children's use of Internet while encouraging children to engage in positive activities to ease the concern of negative psychological responses during the COVID-19 pandemic.

Problematic internet-related behaviors mediate the associations between levels of internet engagement and distress among schoolchildren during COVID-19 lockdown: A longitudinal structural equation modeling study

BACKGROUND AND AIMS

Due to the rapid spread of the novel coronavirus disease 2019 (COVID-19), policies based on the nature of "spatial distancing" have been implemented and have resulted in school suspensions and online learning among schoolchildren. In order to examine the impact of such policies on schoolchildren, the aims of the present study were to (i) assess changes in the level of engagement in three internet-related activities (smartphone use, social media use, and gaming) before and during the COVID-19 outbreak, including prolonged and problematic engagement in these activities; (ii) investigate the differences of psychological distress before and after COVID-19 outbreak; and (iii) to use structural equation modeling to investigate the mediating roles of problematic internet-related behaviors in the causal relationships of psychological distress and time spent on internet-related activities.

METHODS

Self-report measures were used to assess internet-related activities and psychological distress. Time spent on internet-related activities, problematic use of internet-related activities, and psychological distress were collected from primary school students (N = 535; 265 boys; M age = 10.32 years [SD = 0.84]). The data were first collected before the COVID-19 outbreak (i.e., early November 2019) and then collected again during the school suspension due to COVID-19 outbreak (i.e., end of March 2020) for comparisons of changes.

RESULTS

Schoolchildren spent significantly more time on the smartphone (increased 1.02 h daily; P < 0.001) and social media (increased 0.73 h daily; P < 0.001) but not gaming (increased 0.14 h daily; P = 0.07) during the school suspension compared to the baseline. Schoolchildren who increased by 15 or 30 min daily on internet-related activities showed an increased level of psychological distress. The association between problematic use of social media and psychological distress was stronger during the school suspension (β = 0.584) than at the baseline (β = 0.451; P < 0.001).

CONCLUSION

Increased problematic use of internet-related activities among schoolchildren was associated with greater psychological distress. Parents should therefore monitor internet-related activities and psychological distress of their children to support their mental health.

Trait Procrastination and Mobile Phone Addiction Among Chinese College Students: A Moderated Mediation Model of Stress and Gender

Recent studies have indicated that trait procrastination as a personality factor could lead to mobile phone addiction, however little is known about the mediating and moderating mechanisms underlying this process. The current study investigated the mediating role of stress in the relationship between trait procrastination and mobile phone addiction, and whether the mediating effect was moderated by gender. A sample including 1,004 Chinese college students completed measurements of trait procrastination, stress, mobile phone addiction, and demographic information. The results showed that trait procrastination was positively related to college students' mobile phone addiction. Mediation analyses revealed that this relationship was partially mediated by stress. Moderated mediation further indicated that the path between trait procrastination and stress was stronger for male students compared with female students. These findings broadened our knowledge of the underlying mechanisms between trait procrastination and mobile phone addiction, the implications and limitations of this study were discussed.

Identifying individuals in need of help for their uncontrolled gaming: A narrative review of concerns and comments regarding gaming disorder diagnostic criteria

OBJECTIVE

In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) included the diagnostic criteria of Internet gaming disorder (IGD). Then, in 2019, the 11th Revision of the International Classification of Diseases (ICD-11) categorized gaming disorder (GD) as an addictive disorder. This review aimed to review the raised concerns, debate, and research of IGD or GD criteria and provide suggestions to resolve them.

METHODS

A narrative review was conducted, and PubMed was searched for articles mentioning concerns and research on the DSM-5 criteria for IGD, ICD-11 criteria for GD, or criteria for other synonyms, such as problematic gaming or gaming addiction. A total of 107 articles were identified.

RESULTS

Concerns were organized into three categories: conceptual framework, moral panic, and diagnostic validity. Most argumentations supported the proposition that GD and other substance use disorders have similar presentations. A clear definition of GD and adequate public education could prevent rather than exacerbate moral panic. Several researchers reported concerns regarding the nosology, diagnostic validity, and wording of each criterion. However, the threshold, five of the nine criteria with impaired function, demonstrated adequate validity in interview studies.

CONCLUSION

The current findings support the addiction framework, functional impairment, and validity of the GD criteria. However, further prospective, experimental, and clinical studies validating these findings are warranted. Moreover, an integrative review or debate conference could contribute to the organization of the available results and concept development. Aggregating adequate scientific information could allay or resolve concerns related to the diagnosis of GD.

Gaming Disorder: How to Translate Behavioral Neuroscience Into Public Health Advances

Purpose of Review

Gaming disorder (GD), meanwhile classified as a mental disorder in both DSM-5 and ICD-11, is a current public health issue. Theoretical models assume core psychological processes, such as cue reactivity, craving, reward processing, decision-making, cognitive biases, inhibitory control, and stress relief, to be crucially involved in the development and maintenance of GD. This review summarizes neuroscientific findings on these processes in the context of GD as well as treatments and intervention programs addressing these processes.

Recent Findings

We identified overlaps regarding the involvement of neural structures and networks related to psychological processes which may be targeted by public health programs. Complex interactions between executive control, salience, reward, and habit networks are crucially linked to processes involved in GD and public health programs respectively.

Summary

We point at the difficulties of making one to one assignments of neural networks to psychological processes or interventions. Furthermore, new treatment and prevention programs of GD are discussed pointing at possible future directions for neuroscientific research and treatment programs for GD.

Internet use during coronavirus disease of 2019 pandemic: Psychiatric history and sociodemographics as predictors

Coronavirus disease of 2019 (COVID-19) pandemic and related containment measures have grossly affected the daily living and created a need for alternative ways of social communication and entertainment. The aim of this study was to explore the use of various Internet contents depending on sociodemographics and on psychiatric history of participants. This cross-sectional, population-based study is a part of a wider international multicenter study. A total of 1275 participants across Serbia (71.1% of females; average age = 41.81 ± 12.52 years) were recruited using two-level chain-referral sampling method. The participants filled in an anonymous online questionnaire that included questions on sociodemographic data, psychiatric history, and various aspects of increased Internet use since the pandemic. The data were analyzed using a series of multiple logistic regressions. About two-thirds of the sample reported using Internet more during the pandemic. All of the tested regression models, apart from models predicting browsing religion and travel/tourism, were significant, explaining from about 2% (for the contents specific for COVID-19) up to 34.4% (for the sexual content) of variance of use. Reporting a previously diagnosed psychiatric disorder was a significant predictor of greater Instagram use and browsing sexual and sport-related content since the pandemic. To the best of our knowledge, the study is the first to report on the relationship between Internet using and mental health, during COVID-19 pandemic, in the Balkan region. The findings showed various patterns of the increased use of Internet contents since the pandemic referring to both potentially positive and negative Internet influences.

Symptoms of Internet Gaming Disorder in Youth: Predictors and Comorbidity

Internet gaming disorder (IGD) was included in the Addendum to DSM-5 as a condition for further study. Studies of community samples using a diagnostic interview are lacking, and evaluations of the proposed symptoms, comorbidities, and predictors of IGD are scarce. To provide such information participants in a Norwegian prospective community study were assessed with a clinical interview at age 10 years. Symptoms of other psychiatric disorders were measured with the Child and Adolescent Psychiatric Assessment at ages 8 and 10 (n = 740). Children, parents, and teachers provided information on demographics, temperament, intelligence, executive functions, self-concept, social skills, victimization, emotion regulation, family climate, and parenting. Results indicated that IGD was present in 1.7% (95% confidence interval, 0.7–2.7) of the participants (3.0% boys and 0.5% girls). Factor analysis revealed two factors: heavy involvement and negative consequences. The positive predictive value of withdrawal, tolerance, and unsuccessful attempts to control gaming symptoms to the disorder was low. Symptoms of other common disorders correlated weakly with IGD-symptoms (i.e., from r = 0.07 to r = 0.15). Upon adjusting for gender and gaming at age 8, only limited social and emotion regulation skills at age 8 predicted more age-10 IGD symptoms. In conclusion, IGD is already present in a small percentage of Norwegian 10-year olds. At least three of the proposed symptoms -- withdrawal, tolerance and unsuccessful attempts to control gaming -- merit further study given their weak associations with the disorder. Symptoms of IGD are only marginally associated with symptoms of other psychiatric disorders and only predicted by social skills and emotion regulation deficits.

Interactions of impulsivity, general executive functions, and specific inhibitory control explain symptoms of social-networks-use disorder: An experimental study

While the use of social media and online-communication applications has become an integral part of everyday life, some individuals suffer from an excessive, uncontrolled use of social media despite experiencing negative consequences. In accordance with neuropsychological models of addiction, we assume the tendency of a social-networks-use disorder to be related to an interplay of predisposing personality traits (e.g., impulsivity), and reductions in cognitive functions (e.g., executive functions, inhibitory control). The current study makes first strides towards examining this interplay. In addition to a newly developed social-networks-specific auditory Go-NoGo paradigm, other neuropsychological paradigms were used. Impulsivity and social-networks-use-disorder symptoms were assessed by standardized questionnaires. The results show that the symptom severity of a social-networks-use disorder is mainly associated with attentional impulsivity. General executive functions and specific inhibitory control of social-networks-related cues have no direct effect on symptom severity. However, moderated regression analyses emphasize that increased symptom severity is associated with higher attentional impulsivity, especially if there are additionally reductions in executive functions or specific inhibitory control. The results complement previous findings and inform future research on social-networks-use disorder. The findings support the applicability of theoretical models of addictive behaviors to the social-networks-use disorder and point to social-networks-related specificities regarding attention-related facets.

Functional neural changes and altered cortical-subcortical connectivity associated with recovery from Internet gaming disorder

BACKGROUND AND AIMS

Although studies have suggested that individuals with Internet gaming disorder (IGD) may have impairments in cognitive functioning, the nature of the relationship is unclear given that the information is typically derived from cross-sectional studies.

METHODS

Individuals with active IGD (n = 154) and those individuals no longer meeting criteria (n = 29) after 1 year were examined longitudinally using functional magnetic resonance imaging during performance of cue-craving tasks. Subjective responses and neural correlates were contrasted at study onset and at 1 year.

RESULTS

Subjects' craving responses to gaming cues decreased significantly at 1 year relative to study onset. Decreased brain responses in the anterior cingulate cortex (ACC) and lentiform nucleus were observed at 1 year relative to onset. Significant positive correlations were observed between changes in brain activities in the lentiform nucleus and changes in self-reported cravings. Dynamic causal modeling analysis showed increased ACC-lentiform connectivity at 1 year relative to study onset.

CONCLUSIONS

After recovery from IGD, individuals appear less sensitive to gaming cues. This recovery may involve increased ACC-related control over lentiform-related motivations in the control over cravings. The extent to which cortical control over subcortical motivations may be targeted in treatments for IGD should be examined further.

Contribution of sexual desire and motives to the compulsive use of cybersex

BACKGROUND AND AIMS

Cybersex is increasingly associated with concerns about compulsive use. The aim of this study was to assess the roles of motives and sexual desire in the compulsive use of cybersex.

METHODS

The sample consisted of 306 cybersex users (150 men and 156 women). The participants were assessed using the Compulsive Internet Use Scale (CIUS) adapted for cybersex, the Cybersex Motives Questionnaire (enhancement, coping, and social motives), and the Sexual Desire Inventory-2 (dyadic and solitary sexual desire).

RESULTS

For both genders, coping motive was associated with CIUS score. For women, an additional association with social motives was found whereas an association with sexual desire was found for men.

CONCLUSION

The study showed gender differences in the contributors to sex-related CIUS scores.

Cue-induced craving and symptoms of online-buying-shopping disorder interfere with performance on the Iowa Gambling Task modified with online-shopping cues

BACKGROUND AND AIMS

Subjects with buying-shopping disorder (BSD) continue to buy offline as well as online despite negative consequences. Previous studies indicate that subjects with BSD show cue-reactivity and craving when exposed to shopping cues and have problems in long-term advantageous decision-making. The current study aimed at investigating the effect of online-shopping cues on decision-making, and whether addiction-relevant concepts such as cue-reactivity/craving and the symptom severity of BSD are related to decision-making.

METHODS

A non-clinical sample of 57 participants played a version of the modified Iowa Gambling Task (IGT), with online-shopping-related pictures shown either on the advantageous decks or on the disadvantageous decks (with control pictures on the opposing ones). Symptom severity of online-BSD and the craving to buy were assessed using questionnaires. In addition, the online-shopping pictures were rated concerning arousal, valence, and urge to buy.

RESULTS

The participants who played the IGT with the online-shopping pictures displayed on the disadvantageous decks performed significantly poorer than the other group with online-shopping pictures on the advantageous decks. The between-group differences were moderated by craving reactions and the symptom severity of online-BSD: When online-shopping pictures were displayed on the disadvantageous decks, this only interfered with IGT performance in participants who had high craving reactions towards shopping cues and/or high symptom severity of online-BSD.

CONCLUSION

Results indicate that exposure to online-shopping cues interferes with advantageous decision-making, especially in individuals with craving reactions and high symptoms of online-BSD. Results contribute to the question of why some people continue to buy despite negative consequences.

A Novel Cue-Induced Abdominal Reaction Analysis for Internet Gaming Disorder

Individuals with Internet gaming disorder (IGD) frequently play online games to achieve satisfaction. Numerous signal processing questions regarding the negative consequences and characteristic respiration in a long-term sitting posture remain unanswered. This study recruited 50 individuals with high-risk and low-risk IGD (HIGD and LIGD); these participants were taught to perform a specific respiration during game-film stimuli. The instantaneous frequencies on abdominal movement (f_DF) were calculated with ensemble empirical mode decomposition (EEMD). The difference value (Δf_DF) between rest and stimulus statuses was calculated and found that HIGD showed Δf_DF values of 0.060 during positive stimuli and 0.055 during negative stimuli before the exercise but 0.020 and 0.016, respectively, after the exercise. However, the Δf_DF value for those with LIGD during negative stimuli before the exercise was 0.013, and it increased to 0.025 after the exercise. This is the first approach to IGD discrimination toward abdominal response with EEMD.

Comparison of the Video Game Functional Assessment-Revised (VGFA-R) and Internet Gaming Disorder Test (IGD-20)

Initially labeled as internet addiction in the mid-1990s (e.g., Griffiths, 1996; Young, 1996), researchers have since focused on how specific online activities result in negative consequences for those who overuse and have problems with online applications such as online gambling and online sex (Griffiths, 2000; Potenza, 2017). More recently, this has been applied to online problematic video game play, often used synonymously with terms such as online video game addiction, online gaming addiction, and Internet gaming disorder (IGD). With the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013), IGD was identified by the APA as warranting further study. The current proposed diagnostic criterion in the DSM-5 requires the presence of five of nine symptoms over a 12-month period. These include: (a) preoccupation or obsession with Internet games, (b) withdrawal symptoms when not playing Internet games, (c) an increasing need over time to spend more and more time playing video games, (d) failed attempts to stop or curb Internet gaming, (e) loss of interest in other activities such as hobbies, (f) continued overuse of Internet games even with knowledge of the impact of overuse on their life, (g) lying about extent of Internet game usage, (h) uses Internet games to relieve anxiety or guilt, and (i) has lost or put at risk an opportunity or relationship because of Internet games (American Psychiatric Association [APA], 2013). However, it is unclear if the disorder represents addiction to the internet or if IGD evaluates specific behaviors occurring within the context of the video gaming (Starcevic and Billieux, 2017; Young and Brand, 2017).

Short abstinence from online social networking sites reduces perceived stress, especially in excessive users

Online social networking sites (SNSs), such as Facebook, provide frequent and copious social reinforcers (e.g., "likes") delivered at variable time intervals. As a result, some SNS users display excessive, maladaptive behaviors on these platforms. Excessive SNS users, and typical users alike, are often aware of their intense use and psychological dependence on these sites, which may lead to elevated stress. In fact, research has demonstrated that use of SNSs alone induces elevated stress. Other research has begun to investigate the effects of short periods of SNS abstinence, revealing beneficial effects on subjective wellbeing. We aligned these two lines of research and hypothesized that a short period of SNS abstinence would induce a reduction in perceived stress, especially in excessive users. The results confirmed our hypothesis and revealed that both typical and excessive SNS users experienced reduction in perceived stress following SNS abstinence of several days. The effects were particularly pronounced in excessive SNS users. The reduction in stress was not associated with academic performance increases. These results indicate a benefit-at least temporarily-of abstinence from SNSs and provide important information for therapists treating patients who struggle with excessive SNS use.

Cognitive-behavioral therapy for Internet gaming disorder: A systematic review and meta-analysis

OBJECTIVE

Although there is sufficient research and clinical evidence to support the inclusion of gaming disorder in the latest revision of the International Classification of Diseases, relatively little is known about the effectiveness of first-line psychological treatment for gaming disorder or internet gaming disorder (IGD) as it is listed in the Diagnostic and Statistical Manual. This systematic review employed meta-analytic techniques to determine the effectiveness of cognitive-behavioural therapy (CBT) for IGD on four key outcomes: IGD symptoms, anxiety, depression, and time spent gaming.

METHOD

A database search identified 12 independent CBT studies. Effect size estimates (Hedges' g) with associated confidence intervals, prediction intervals, and p values for each pre-post treatment outcome, were calculated. Study reporting quality was evaluated in accordance with the Consolidated Standards of Reporting Trials guidelines. Subgroup and moderator analyses were undertaken to investigate potential sources of heterogeneity.

RESULTS

CBT demonstrated high efficacy in reducing IGD symptoms (g = 0.92; [0.50, 1.34]) and depression (g = 0.80, [0.21, 1.38]), and showed moderate efficacy in reducing anxiety (g = 0.55, [0.17, 0.93]) at post-test. There was insufficient power to determine whether CBT was capable of reducing time spent gaming. Treatment gains at follow-up were nonsignificant across the four treatment outcomes.

CONCLUSIONS

The pooled findings suggest that CBT for IGD is an effective short-term intervention for reducing IGD and depressive symptoms. However, the effectiveness of CBT for reducing actual time spent gaming was unclear. Given the limitations of this evidence base, there is a need for more rigorous studies to determine the potential long-term benefits of CBT for IGD.

PUBLIC HEALTH SIGNIFICANCE STATEMENT

Given the rise in treatment demand for internet gaming disorder (IGD) and problematic gaming, it is necessary to determine which treatments are most effective for whom and under which conditions. This review shows that cognitive-behavioural therapy for IGD, which is often considered the first-line therapy, can improve IGD symptoms and comorbid depression. However, treatment gains tend to be short-term and their effect in reducing time spent gaming is unclear. Programs that target problematic gaming may be improved by additional support beyond the standard program of therapy sessions. More funding and resources are needed to support the development of a more rigorous evidence base on IGD and its treatment.

The imperative of integrating empirical and theoretical considerations when developing policy responses to Internet-gaming disorder

This commentary proposes an integrative approach of theoretical and empirical considerations when developing policy responses to Internet-gaming disorder and when evaluating their efficacy. It complements the overview by Király et al. (2018) about preventive and treatment programs by referring to a lack of inclusion of internal factors, such as individual aspects and cognitions, and missing empirical evidence. This commentary claims the integration of current research addressing individual predisposing and maintaining factors in order to evaluate existing programs and to enhance the exchange between actors including policy. This integrative approach has the potential to develop successful preventive strategies, which could be implemented realistically and socially responsible.

Personality and Cognition in Gamers: Avoidance Expectancies Mediate the Relationship Between Maladaptive Personality Traits and Symptoms of Internet-Gaming Disorder

Internet-gaming disorder (IGD) has become a clinically relevant phenomenon worth investigating with respect to its mechanisms of development and maintenance. Considering theoretical models of specific Internet-use disorders, we assumed an interaction of maladaptive personality traits as unspecific predisposing factors and experience-based, gaming-related Internet-use expectancies in predicting symptoms of IGD. Therefore, 103 male and female regular Internet gamers were investigated with questionnaires assessing maladaptive personality traits in accordance to DSM-5, gaming-related positive and avoidance Internet-use expectancies, and symptoms of IGD. The results demonstrated that negative affectivity, detachment, antagonism, disinhibition, psychoticism as well as gaming-related positive and avoidance expectancies were related to symptoms of IGD. Moreover, the relationship between maladaptive personality traits as represented by negative affectivity, detachment, and psychoticism with symptoms of IGD was mediated by avoidance expectancies. Positive gaming-related use expectancies were related to detachment, and were not a significant mediator in the hypothesized model. The findings give reason to assume that maladaptive personality traits in combination with gaming-related positive expectancies and avoidance expectancies are important factors for the development of IGD, but that positive expectancies and avoidance expectancies play a differential role regarding there mediating role between personality characteristics and symptoms of IGD.

Development of an Online and Offline Integration Hypothesis for Healthy Internet Use: Theory and Preliminary Evidence

The Internet has become an integral part of our daily life, and how to make the best use of the Internet is important to both individuals and the society. Based on previous studies, an Online and Offline Integration Hypothesis is proposed to suggest a framework for considering harmonious and balanced Internet use. The Integration Hypothesis proposes that healthier patterns of Internet usage may be achieved through harmonious integration of people's online and offline worlds. An online/offline integration is proposed to unite self-identity, interpersonal relationships, and social functioning with both cognitive and behavioral aspects by following the principles of communication, transfer, consistency, and "offline-first" priorities. To begin to test the hypothesis regarding the relationship between integration level and psychological outcomes, data for the present study were collected from 626 undergraduate students (41.5% males). Participants completed scales for online and offline integration, Internet addiction, pros and cons of Internet use, loneliness, extraversion, and life satisfaction. The findings revealed that subjects with higher level of online/offline integration have higher life satisfaction, greater extraversion, and more positive perceptions of the Internet and less loneliness, lower Internet addiction, and fewer negative perceptions of the Internet. Integration mediates the link between extraversion and psychological outcomes, and it may be the mechanism underlying the difference between the "rich get richer" and social compensation hypotheses. The implications of the online and offline integration hypothesis are discussed.