Increased Attentional Bias Toward Visual Cues in Internet Gaming Disorder and Obsessive-Compulsive Disorder: An Event-Related Potential Study

Problematic Gaming and Gambling: A Systematic Review of Task-Specific EEG Protocols

Even though gaming and gambling bear similar problematic behavioral aspects, there are no recognizable neurophysiological biomarkers or features characterizing and/or distinguishing these conditions. A systematic review of the literature with a focus on methods was performed in PubMed, Scopus, Web of Science (Web of Science Core Collection), EBSCOhost Research Databases (APA PsycINFO; APA PsycArticles; OpenDissertations; ERIC) databases. Following search terms were used to search the databases: ERP, "event related potential*", EP, "evoked potential*", SS, "steady state", EEG, electroencephal*; gam*. Data about the participants (total number, gender, age), main aim of the study and information about the experimental setup (experimental task description, stimuli used, ERPs measured (latency windows and placement of the electrodes), process evaluated) was extracted. A total of 24 studies were revised (problematic gaming - 16, pathological gambling - 8). The experimental protocols could be grouped into 3 main target domains (Cue-reactivity, General Information processing and Reward Processes & Risk Assessment). Sample-related limitations (small sample sizes, gender differences, differences between the groups regarding potential confounding variables) and heterogeneity regarding the experimental tasks, implementation and interpretation reviewed. Gambling-related research is highly focused on the investigation of the reward-related processes, whereas gaming-related research is mostly focused on the altered aspects of more general information processing. A vast heterogeneity regarding the ERP experimental paradigms being used and lack of clear guidelines and standardized procedures prevents identification of measures capable to reliably discriminate or characterize the population susceptible to addictive behavior or being able to diagnose and monitor these disorders.

Video game addiction is associated with early stage of inhibitory control problems: An event-related potential study using cued Go/NoGo task

Video game addiction (VGA) is associated with cognitive problems, particularly deficits in inhibitory control. The present study aimed to investigate behavioural responses and event-related potential associated with specific response inhibition using the cued Go/NoGo task to examine the effects of VGA on brain activity related to response inhibition. Twenty-five individuals addicted to video games (action video games) and 25 matched healthy controls participated in the study. The results showed that the VGA group had significantly more commission error in the NoGo trials and faster reaction time in the Go trials compared with the control group. The event-related potential analyses revealed significant reductions in amplitudes of N2 cue and N2 NoGo in the VGA group. While there was no significant difference between the N2 amplitudes of the Go and NoGo trials in the VGA group, the control group had a larger N2 amplitude in the NoGo trials. These results indicate that VGA subjects have difficulties in the early stages of response inhibition, as well as some level of impairment in proactive cognitive control.

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

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

Cue-reactivity to distal cues in individuals at risk for gaming disorder

BACKGROUND

Gaming disorder (GD) is a disorder due to addictive behaviors (ICD-11). Cue-reactivity and craving are relevant mechanisms in the development and maintenance of addictive behaviors. When confronted with cues showing in-game content (proximal cues) individuals with higher symptom severity show increased cue-reactivity. Based on conditioning and addiction theories on incentive sensitization, cue-reactivity responses may generalize to more distal cues, e.g. when individuals at risk of developing a GD are confronted with a starting page of an online game. In cue-reactivity paradigms so far, only proximal gaming cues have been used.

METHODS

We investigated the effect of distal gaming cues compared to gaming-unrelated control cues on cue-reactivity and craving in 88 individuals with non-problematic use of online games (nPGU) and 69 individuals at risk for GD (rGD). The distal cues showed the use of an electronic device (e.g., desktop PC or smartphone) whose screen showed starting pages of either games (target cues), shopping- or pornography sites (control cues) from a first-person perspective.

FINDINGS

We found significantly higher urge and arousal ratings as well as longer viewing times for gaming-related compared to gaming-unrelated control cues in rGD compared to nPGU. Valence ratings did not differ between groups.

INTERPRETATION

The results demonstrate that already distal gaming-specific cues lead to cue-reactivity and craving in rGD. This finding indicates that based on conditioning processes, cue-reactivity and craving develop during the course of GD and generalize to cues that are only moderately related to the specific gaming activity.

Playing Closer: Using Virtual Reality to Measure Approach Bias of Internet Gaming Disorder

Playing online games is gradually becoming mainstream entertainment, but some people may develop Internet gaming disorder (IGD). Like other behavioral addictive diseases, one of the main characteristics of IGD is a craving for games, which also makes people tend to approach game-related clues. Recently, a few researchers have started to use the approach-avoidance task (AAT) paradigm to study the approach bias of IGD, and they also think it is an essential characteristic of IGD. However, the traditional AAT cannot provide realistic approach-avoidance behavior to stimuli, and virtual reality has been proven to provide a highly ecological environment to measure approach bias. Therefore, this study innovatively integrates virtual reality and the AAT paradigm to measure the approach bias of IGD. We found that compared with neutral stimuli, IGD spent less time approaching game-related stimuli, which indicates that it is difficult for IGD to avoid game-related situations in the virtual environment. This study also revealed that game-related content stimuli in virtual reality alone did not increase the IGD group's craving for games. These results proved that AAT in VR could cause the approach bias of IGD and provide high ecological validity and an effective tool for the intervention of IGD in the future.

Measurement of craving among gamers with internet gaming disorder using repeated presentations of game videos: a resting-state electroencephalography study

BACKGROUND

Internet gaming disorder (IGD) is receiving increasing attention owing to its effects on daily living and psychological function.

METHODS

In this study, electroencephalography was used to compare neural activity triggered by repeated presentation of a stimulus in healthy controls (HCs) and those with IGD. A total of 42 adult men were categorized into two groups (IGD, n = 21) based on Y-IAT-K scores. Participants were required to watch repeated presentations of video games while wearing a head-mounted display, and the delta (D), theta (T), alpha (A), beta (B), and gamma (G) activities in the prefrontal (PF), central (C), and parieto-occipital (PO) regions were analyzed.

RESULTS

The IGD group exhibited higher absolute powers of D_C, D_PO, T_C, T_PO, B_C, and B_PO than HCs. Among the IGD classification models, a neural network achieves the highest average accuracy of 93% (5-fold cross validation) and 84% (test).

CONCLUSIONS

These findings may significantly contribute to a more comprehensive understanding of the neurological features associated with IGD and provide potential neurological markers that can be used to distinguish between individuals with IGD and HCs.

Neuronal underpinnings of the attentional bias toward threat in the anxiety spectrum: Meta-analytical data on P3 and LPP event-related potentials

BACKGROUND

This systematic review analyzes brain responses at later stages of neuronal processing (P3 at 300-500 ms, and LPP at 300-700 ms). Both P3 and LPP are implicated in attentional threat bias in disorders grouped into fear and distress dimensions of the anxiety spectrum described by the Hierarchical Taxonomy Model of Psychopathology (HiTOP), but there are no consistent findings so far.

METHOD

Meta-analyses with between- (32 studies, n = 1631) and within-groups design (31 studies, n = 1699) were performed for assessing P3 and LPP modulation in negative, positive, and neutral stimuli, while also considering differences between controls and anxious individuals. Relevant moderators (e.g., age, sex, task) were controlled for and negative stimuli were further decomposed in terms of category (Relevant, Fear/Threat, or Unpleasant).

RESULTS

Increased P3 and LPP amplitudes were found for negative and positive stimuli, when compared to neutral stimuli (within-subjects analysis), confirming that both components are elicited by emotionally arousing information. Within-effects for negative and positive stimuli were higher for the anxious groups. Nonetheless, between-groups analyses showed that attentional threat bias occurs only in anxious groups when negative, personally relevant-threat information is presented. The HiTOP fear dimension moderated the findings.

LIMITATIONS

Potential missed studies; ERPs time windows' heterogeneity; adult sample only; the uneven number of computed effects; categorical analyses.

CONCLUSION

Attentional bias toward disorder-congruent threatening cues can be a transdiagnostic mechanism of HiTOP fear disorders, clustered within the anxiety spectrum.

Auditory and cross-modal attentional bias toward positive natural sounds: Behavioral and ERP evidence

Recently, researchers have expanded the investigation into attentional biases toward positive stimuli; however, few studies have examined attentional biases toward positive auditory information. In three experiments, the present study employed an emotional spatial cueing task using emotional sounds as cues and auditory stimuli (Experiment 1) or visual stimuli (Experiment 2 and Experiment 3) as targets to explore whether auditory or visual spatial attention could be modulated by positive auditory cues. Experiment 3 also examined the temporal dynamics of cross-modal auditory bias toward positive natural sounds using event-related potentials (ERPs). The behavioral results of the three experiments consistently demonstrated that response times to targets were faster after positive auditory cues than they were after neutral auditory cues in the valid condition, indicating that healthy participants showed a selective auditory attentional bias (Experiment 1) and cross-modal attentional bias (Experiment 2 and Experiment 3) toward positive natural sounds. The results of Experiment 3 showed that N1 amplitudes were more negative after positive sounds than they were after neutral sounds, which further provided electrophysiological evidence that positive auditory information enhances attention at early stages in healthy adults. The results of the experiments performed in the present study suggest that humans exhibit an attentional bias toward positive natural sounds.

Influence of abstinence on automatic detection bias to gaming cues in individuals with Internet gaming disorder: Evidence from visual mismatch negativity

Internet gaming disorder (IGD) has been classified by the DSM-5 as a condition for further study, and many studies have shown that the occurrence and maintenance of IGD and the automatic detection bias to gaming cues of individuals with IGD may be significantly related. However, whether abstinence, a common intervention method in behavioral addiction, can adjust the automatic detection bias in individuals with IGD and its underlying neural mechanisms is unclear. In this study, we investigated the effects of 7 days of abstinence from gaming on automatic detection bias, negative affect and craving in individuals with IGD with event-related potential technology. A total of 50 IGD subjects were recruited in this study and randomly divided into abstinence and control groups. Visual mismatch negativity (vMMN) was induced using a standard-deviant reversed oddball paradigm, and differences in automatic detection bias, negative affect, and craving between the two groups were recorded and compared at baseline, day 3, and day 7. The results showed that compared with baseline, vMMN, negative affect and craving were significantly enhanced on day 3 and significantly diminished on day 7 in the abstinence group but not in the control group, and the changes in vMMN were significantly correlated with changes in negative affect and craving in both groups. This study demonstrates that abstinence can restore automatic detection bias in individuals with IGD and that abstinence has to last for 7 days to have a significant effect, while recovery may be related to the negative affect and craving.

Neurophysiological Markers of Internet Gaming Disorder: A Literature Review of Electroencephalography Studies

Pathological online gaming is a relatively newer psychiatric disorder. It is the second behavioral addiction (after internet gambling disorder) included in the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM), 5^th edition as “Internet Gaming Disorder” (IGD). Recent research is showing high morbidity associated with IGD, thus encouraging researchers to find valid and reliable biomarkers of IGD. So that, early diagnosis and proper treatment could limit the high disability level accompanying excessive online gaming. As electroencephalography (EEG) is a non-invasive and relatively easily available diagnostic technique, we aimed at collecting EEG studies that investigated EEG changes associated with IGD, with a specific focus on finding diagnostic and predictive neurophysiological biomarkers of IGD. We searched PubMed and Google Scholar for EEG studies of IGD. We eliminated those EEG studies that were not focused on finding biomarkers. Scale for the Assessment of Narrative Review Articles (SANRA) is followed in the writing of this review article. Our results showed that increased slow-wave resting-state activity and reduced P300 and N100 can serve as useful IGD diagnostic markers of IGD. Moreover, increased resting-state theta activity can be a predictive biomarker of IGD. Lastly, increased late low potentials (LLPs) can be specific trait markers of cue-induced cravings in IGD.

Event-related brain response to visual cues in individuals with Internet gaming disorder: relevance to attentional bias and decision-making

This study investigated attentional bias toward game-related cues in Internet gaming disorder (IGD) using electrophysiological markers of late positive potential (LPP) and identifying the sources of LPP. In addition, the association between LPP and decision-making ability was investigated. The IGD (n = 40) and healthy control (HC; n = 39) participants viewed a series of game-related and neutral pictures, while their event-related potentials (ERPs) were recorded. LPPs were calculated as the mean amplitudes between 400 and 700 ms at the centro-parietal (CP3, CP1, Cpz, CP2, and CP4) and parietal (P3, P1, Pz, P2, and P4) electrode sites. The source activations of LPP were estimated using standardized low-resolution brain electromagnetic tomography (sLORETA). In addition, decision-making ability was evaluated by the Cambridge Gambling Task. Higher LPP amplitudes were found for game-related cues in the IGD group than in the HC group. sLORETA showed that the IGD group was more active in the superior and middle temporal gyri, which are involved in social perception, than in the HC group, whereas it was less active in the frontal area. Individuals with IGD have deficits in decision-making ability. In addition, in the HC group, the lower the LPP when looking at the game-related stimuli, the better the quality of decision-making, but not in the IGD group. Enhanced LPP amplitudes are associated with emotional arousal to gaming cues and decision-making deficits in IGD. In addition, source activities suggest that patients with IGD perceive game-related cues as social stimuli. LPP can be used as a neurophysiological marker of IGD.

Incentive sensitization in binge behaviors: A mini review on electrophysiological evidence

Introduction

Binge behavior not only refers to the consumption of substances such as alcohol or food, but is also used in relation to gaming, watching and gambling. Dependent on context it makes for a widespread, benign recreational activity or can pose a serious mental health problem with deleterious consequences. Incentive sensitization theory describes the attribution of salience towards stimuli strongly associated with dopamine-mediated reward as a result of repeated consumption. The sensitized neural networks cause cue-triggered craving and excessive desire, but thus, this mechanism may also be applicable to stimulus-induced behaviors not associated with classical withdrawal symptoms. Event-related potentials (ERP) are a useful method of examining motivated attention towards incentive stimuli. This mini review aims to synthesize ERP findings from different types of binge behaviors in order to compare cue-reactivity to incentive stimuli.

Methods

Studies investigating binge drinking, binge eating as well as binge watching, gaming and gambling were screened. To limit the influence of concurrent task demands, ERP studies applying picture viewing paradigms with incentive stimuli were selected.

Results

Across binge behaviors, evidence on altered mid-latency ERPs has been mixed. However, studies investigating later stages of attentional processes more consistently find enlarged P300 and late positive potentials (LPP) amplitudes to relevant cues.

Conclusion

An altered attentional processing of incentive stimuli reflecting motivated attention is in line with incentive sensitization theory. Considering the limited number of studies, especially regarding binge behaviors not involving substances, more research is needed to attain a more thorough understanding of incentive sensitization across binge behaviors.

Impaired disengagement of attention from computer-related stimuli in Internet Gaming Disorder: Behavioral and electrophysiological evidence

BACKGROUND AND AIMS

Attentional biases contribute to the maintenance of addictive behaviors. For the problematic use of online gaming - recognized as Internet Gaming Disorder (IGD) - first evidence points to a bias towards in-game stimuli. This study aimed to provide behavioral and electrophysiological evidence for a generalized bias towards computer-related stimuli, and to identify the specific attentional processes contributing to this bias: facilitated attention deployment, impaired disengagement or failed suppression.

METHOD

Twenty participants with IGD and 23 casual gamers performed a visual search task with photographs of real-world objects. Either the target or a to-be-ignored distractor was addiction-relevant (computer-related), whereas all other items were addiction-irrelevant (related to cars or sport). Event-related potential components associated with facilitated attentional deployment to the target (NT), its post-selection processing (SPCN), and suppression of irrelevant information (PD) were analyzed.

RESULTS

Unlike casual gamers, gamers with IGD exhibited prolonged reaction times and increased SPCN amplitudes for computer-related stimuli, reflecting their continued attentional processing. At the individual level, larger SPCN amplitudes were associated with longer delays in reaction time.

DISCUSSION AND CONCLUSIONS

This pattern of results indicates that the disengagement of attention from computer-related stimuli is impaired in IGD. More generally, our findings demonstrate that conditioning processes occur in IGD, and thus open up new avenues for treatment.

Cognitive Correlates in Gaming Disorder and Social Networks Use Disorder: a Comparison

Purpose of Review

This overview aims at summarizing studies, which investigated cognitive correlates of gaming disorder and of a problematic use of social networks by using behavioral experimental paradigms and brain imaging techniques.

Recent Findings

Based on theoretical models, inhibition/inhibitory control, attentional bias, executive functions, decision-making, and working memory capabilities have been identified as cognitive components, which are assumed to play a crucial role in the development and maintenance of an addictive behavior. A systematic search shows that various studies have already examined the involvement of different cognitive components in both types of potential addictive behaviors. However, the number of studies addressing cognitive correlates of social networks use disorder is very much lower compared with gaming disorder, even if there is a positive trend in terms of new publications in recent years.

Summary

Cognitive correlates have been frequently investigated in gaming disorder, as in many other disorders due to substance use or addictive behaviors. Studies on cognitive aspects involved in a problematic social networks use are still rare, but they are needed in order to further show if this phenomenon may also deserve a classification as addictive disorder. Interactions between different cognitive and affective processes are still understudied in both gaming disorder and problematic social networks use.

Clarifying terminologies in research on gaming disorder and other addictive behaviors: distinctions between core symptoms and underlying psychological processes

There exists ongoing debate regarding the clinical validity of single symptoms of and diagnostic criteria for gaming disorder. In particular, the potential symptom of gaming disorder that addresses coping with and escaping from negative feelings has received much attention and remains a focus of intensive discussion. We argue that it is important to consider differences or distinguish between, on the one hand, symptoms of and criteria for a disorder due to addictive behaviors, such as gaming disorder, versus, on the other hand, motivations, mechanisms, and psychological processes that may be involved in promoting addictive behaviors and that may explain symptom severity and course of the addictive disorder including potential treatment responses.

Automatic detection advantage of problematic Internet users for Wi-Fi signal cues and the moderating effect of negative affect: An event-related potential study

Cognitive bias toward Internet-related cues is an important factor of the formation and maintenance of the addictive behavior of problematic Internet users (PIUs). The development of fiber-optic communication and smartphones has ushered human society into the era of wireless networks. The Wi-Fi signal, the symbol of wireless network connection, represents not only network access but also a channel for communication with others anywhere at any time. Therefore, the Wi-Fi signal cues should be an effective inducer of the addictive behaviors of PIUs. We used images of Wi-Fi signal as Internet-related cues to explore the automatic detection advantage of PIUs for these cues and to determine whether negative affect, another predisposing factor for addiction, can enhance this advantage. We utilized an intergroup design in this study. The PIU and control groups each comprised 30 participants and were randomly assigned to negative or neutral affect priming group. Mismatch negativity (MMN) was induced through the deviant-standard reverse oddball paradigm. Wi-Fi signal cues and neutral cues were used as standard and deviant stimuli, respectively. Results show that the MMN induced by Wi-Fi signal cues in the PIU group was larger than that in the control group. Meanwhile, the MMN induced by Wi-Fi signal cues was considerably enhanced in the PIU group under negative affect priming relative to that in the PIU group under neutral affect priming. Overall, PIUs have an automatic detection advantage for Wi-Fi signal cues, and negative affect can enhance this advantage. Our results suggest that the MMN elicited by Wi-Fi signal cues function as a sensitive neurobiological marker tracing the change of addiction motivation for PIUs.

Dysfunctional attentional bias and inhibitory control during anti-saccade task in patients with internet gaming disorder: An eye tracking study

BACKGROUND

Although internet gaming disorder (IGD) is considered an addictive disorder, evidence of the neurobiological underpinnings of IGD as an addictive disorder is currently lacking. We investigated whether attentional bias toward game-related stimuli was altered in IGD patients using an eye-tracking method during an anti-saccade task.

METHODS

Twenty-three IGD patients and 27 healthy control (HC) subjects participated in the anti-saccade task with game-related, neutral, and scrambled images during eye tracking. Participants rated subjective scores of valence, arousal, and craving for each image stimulus after finishing eye tracking. Mixed design analysis of variance was performed to compare the differences between eye movement latency and error rate in the pro-saccade and anti-saccade conditions according to image type across the IGD and HC groups.

RESULTS

In the anti-saccade task, the IGD group exhibited higher error rates in the case of game-related images than in neutral or scrambled images. However, ratings on valence, arousal, and craving did not vary among image types. The error rates of the HCs did not vary across image types, but higher arousal/craving and lower valence were reported with respect to the game-related images.

CONCLUSIONS

Increased error rate during anti-saccade tasks with game-related stimuli in IGD may be due to disabilities in goal-directed behavior or inhibitory control, as observed in other addictive disorders. These findings suggest that attentional bias toward game-related stimuli can be a sensitive biological marker of IGD as an addictive disorder.

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.

Automatic detection advantage of problematic Internet users for Wi-Fi signal cues and the moderating effect of negative affect: An event-related potential study

Cognitive bias toward Internet-related cues is an important factor of the formation and maintenance of the addictive behavior of problematic Internet users (PIUs). The development of fiber-optic communication and smartphones has ushered human society into the era of wireless networks. The Wi-Fi signal, the symbol of wireless network connection, represents not only network access but also a channel for communication with others anywhere at any time. Therefore, the Wi-Fi signal cues should be an effective inducer of the addictive behaviors of PIUs. We used images of Wi-Fi signal as Internet-related cues to explore the automatic detection advantage of PIUs for these cues and to determine whether negative affect, another predisposing factor for addiction, can enhance this advantage. We utilized an intergroup design in this study. The PIU and control groups each comprised 30 participants and were randomly assigned to negative or neutral affect priming group. Mismatch negativity (MMN) was induced through the deviant-standard reverse oddball paradigm. Wi-Fi signal cues and neutral cues were used as standard and deviant stimuli, respectively. Results show that the MMN induced by Wi-Fi signal cues in the PIU group was larger than that in the control group. Meanwhile, the MMN induced by Wi-Fi signal cues was considerably enhanced in the PIU group under negative affect priming relative to that in the PIU group under neutral affect priming. Overall, PIUs have an automatic detection advantage for Wi-Fi signal cues, and negative affect can enhance this advantage. Our results suggest that the MMN elicited by Wi-Fi signal cues function as a sensitive neurobiological marker tracing the change of addiction motivation for PIUs.

Altered Eye-Movement Patterns During Text Reading in Obsessive-Compulsive Disorder and Internet Gaming Disorder

Obsessive-compulsive disorder (OCD) and internet gaming disorder (IGD), which are similar in that both involve repetitive behaviors and related with cognitive dysfunctions, frequently begin in early adolescence, which is a critical period for learning. Although the deterioration in cognitive functioning caused by these conditions may have adverse effects on information processing, such as text reading, there has been no comprehensive research on the objective indicators of altered reading patterns in these patients. Therefore, we evaluated eye-movement patterns during text reading in patients with OCD or IGD. In total, 20 patients with OCD, 28 patients with IGD and 24 healthy controls (HCs) participated in the reading task using an eye tracker. We compared the fixation durations (FDs), saccade amplitudes and eye-movement regressions of the three groups during reading. We explored relationships between the parameters reflecting altered reading patterns and those reflecting the severity of clinical symptoms. The average FDs and forward saccade amplitudes did not differ significantly among the groups. There were more eye-movement regressions in patients with OCD than in patients with IGD and HCs. No correlation was found between altered eye-movement patterns during reading and the severity of clinical symptoms in any of the patient groups. The significantly increased number of regressions (NRs) in the OCD group during reading may reflect these patients’ difficulties with inferential information processing, whereas the reading pattern in the IGD group is relatively intact. These findings suggest that patients with OCD and patients with IGD have different eye-movement patterns during reading reflecting distinct cognitive impairments in the two patient groups.