Emotional Regulation in Young Adults with Internet Gaming Disorder

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

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

Playing for keeps or just playing with emotion? Studying tilt and emotion regulation in video games

Introduction

In video gaming, tilt is thought to relate to poor emotional control and game performance. Despite widespread recognition of tilt in video gaming, there is a lack of research examining tilt empirically.

Methods

One thousand and seven gamers took part in our online study examining gamers experience of tilt, the factors which contribute to and protect against tilt, and the emotion regulation strategies gamers employ to deal with tilt.

Results

Gamers who reported playing for more competitive reasons, were at higher risk of experiencing tilt. Additional factors associated with an increased risk of experiencing tilt were increased anger and more hours spent playing. Protective factors against experiencing tilt were also identified, inclusive of a greater number of years gaming experience and engagement in adaptive emotion regulation strategies.

Discussion

This study provides an important starting point for creating a better understanding of tilt in gaming, equipping us with new knowledge to better support gamers to improve their emotion regulation during game play performance.

Brain responses to positive and negative events in individuals with internet gaming disorder during real gaming

Objective

This study sought to investigate brain responses to positive and negative events in individuals with internet gaming disorder (IGD) during real gaming as a direct assessment of the neural features of IGD. This investigation reflects the neural deficits in individuals with IGD while playing games, providing direct and effective targets for prevention and treatment of IGD.

Methods

Thirty subjects with IGD and fifty-two matched recreational game use (RGU) subjects were scanned while playing an online game. Abnormal brain activities during positive and negative events were detected using a general linear model. Functional connectivity (FC) and correlation analyses between neural features and addiction severity were conducted to provide additional support for the underlying neural features.

Results

Compared to the RGU subjects, the IGD subjects exhibited decreased activation in the dorsolateral prefrontal cortex (DLPFC) during positive events and decreased activation in the middle frontal gyrus (MFG), precentral gyrus and postcentral gyrus during negative events. Decreased FC between the DLPFC and putamen during positive events and between the MFG and amygdala during negative events were observed among the IGD subjects. Neural features and addiction severity were significantly correlated.

Conclusions

Individuals with IGD exhibited deficits in regulating game craving, maladaptive habitual gaming behaviors and negative emotions when experiencing positive and negative events during real game-playing compared to RGU gamers. These abnormalities in neural substrates during real gaming provide direct evidence for explaining why individuals with IGD uncontrollably and continuously engage in game playing, despite negative consequences.

"I have no control over how much time I play" the metacognitions about online gaming scale: Evidence from a cross-cultural validation among Israeli adolescents

In the current study we evaluated the psychometric properties of the Metacognitions about Online Gaming Scale (MOGS), including its factor structure, reliability, and predictive validity among Israeli adolescents in a six-month prospective study. We also examined the usefulness of the MOGS as a mediator of the effect of attachment patterns on Internet Gaming Disorder (IGD), the preference for online social interactions, and the motives for online gaming. The study population included 1,056 Israeli adolescents (610 males and 446 females, M = 15.77, standard deviation (SD) = 1.43) with an age range of 13-18 years. The participants completed the translated Hebrew version of the MOGS and measures on attachment style, IGD, preference for online social interactions, emotion regulation, and motives for online gaming. The analyses indicated that the factorial structure of the Hebrew MOGS comprised the expected two factors at T1 and T2 (a six-month follow-up). We also found that positive and negative metacognitions significantly mediated the effect of attachment styles on IGD, the preference for online social interactions, and the motives for online gaming. The findings provide evidence that the Hebrew MOGS among Israeli adolescents appears psychometrically appropriate for use by researchers and practitioners dealing with the prevention and treatment of IGD.

Subgroups of internet gaming disorder based on addiction-related resting-state functional connectivity

AIMS

To identify subgroups of people with internet gaming disorder (IGD) based on addiction-related resting-state functional connectivity and how these subgroups show different clinical correlates and responses to treatment.

DESIGN

Secondary analysis of two functional magnetic resonance imaging (fMRI) data sets.

SETTING

Zhejiang province and Beijing, China.

PARTICIPANTS

One hundred and sixty-nine IGD and 147 control subjects.

MEASUREMENTS

k-Means algorithmic and support-vector machine-learning approaches were used to identify subgroups of IGD subjects. These groups were examined with respect to assessments of craving, behavioral activation and inhibition, emotional regulation, cue-reactivity and guessing-related measures.

FINDINGS

Two groups of subjects with IGD were identified and defined by distinct patterns of connectivity in brain networks previously implicated in addictions: subgroup 1 ('craving-related subgroup') and subgroup 2 ('mixed psychological subgroup'). Clustering IGD on this basis enabled the development of diagnostic classifiers with high sensitivity and specificity for IGD subgroups in 10-fold validation (n = 218) and out-of-sample replication (n = 98) data sets. Subgroup 1 is characterized by high craving scores, cue-reactivity during fMRI and responsiveness to a craving behavioral intervention therapy. Subgroup 2 is characterized by high craving, behavioral inhibition and activations scores, non-adaptive emotion-regulation strategies and guessing-task fMRI measures. Subgroups 1 and 2 showed largely opposite functional-connectivity patterns in overlapping networks.

CONCLUSIONS

There appear to be two subgroups of people with internet gaming disorder, each associated with differing patterns of brain functional connectivity and distinct clinical symptom profiles and gender compositions.

Emotion dysregulation mediates the relationship between adverse childhood experiences and problematic gaming

Gaming disorder (i.e., gaming addiction) is a relatively common mental health disorder with a worldwide prevalence rate of 3.05%. In the present research, we examined whether emotion dysregulation mediates the relation between adverse childhood experiences and problematic gaming in two samples of current video game players. The first sample consisted of 1,262 students recruited from five universities across Canada. The second sample comprised 417 community adults residing in Canada. Both samples of participants completed an online survey which included measures of adverse childhood experiences, problematic gaming, and emotion dysregulation. A total of 45.64% (n = 576) in the university sample and 49.76% (n = 205) in the community sample met the threshold for problematic gaming. In the student sample, adverse childhood experiences were positively associated with problematic gaming. In contrast, there was no significant association between adverse childhood experiences and problematic gaming in the community sample. In both samples, adverse childhood experiences were positively associated with emotion dysregulation, and emotion dysregulation was positively associated with problematic gaming. Importantly for the present research, emotion dysregulation mediated the relationship between adverse childhood experiences and problematic gaming in both the university and community sample. Although adverse childhood experiences are distal and static risk factors for problematic gaming, emotion dysregulation is a more proximal and modifiable risk factor. The results suggest that increasing adaptive emotion regulation skills may decrease the risk of problematic gaming among individuals who have experienced an adverse childhood experience.

Influences of Emotional Information on Response Inhibition in Gaming Disorder: Behavioral and ERP Evidence from Go/Nogo Task

BACKGROUND

Gaming disorder (GD) may impair executive functions such as response inhibition. According to the tripartite neurocognitive model, the interoceptive system generates a state of craving that exacerbates the dysfunction of GD. We speculate that emotional information may play an important role in the mechanism, which leads to impaired response inhibition in people with GD.

METHODS

A three-factor mixed experimental design was adopted in this go/nogo task. The between-subject factor was group (GD or control group), and the within-subject factors were two types of emotional information, task relevance (related or unrelated) and emotional valence (negative or positive).

RESULTS

The GD group had lower nogo accuracies than the control group in the task-unrelated condition and also in the negative condition. Parallelly, the GD group showed faster reactions and lower accuracy in the go trials than the control group under task-unrelated negative conditions. At the neural level, the GD group had smaller amplitudes of nogo-N2 and larger amplitudes of nogo-P3 than the control group in the task-unrelated condition.

CONCLUSIONS

The findings prove the hypothesis of this study that emotional information could be a factor leading to impaired response inhibition in GD individuals. The response inhibition abilities of GD are weakened when processing task-unrelated or negative information, which may be caused by failure of behavioral inhibition and weakened conflict control, resulting in more cognitive resources to complete response suppression under specific conditions. This study provides evidence for weaker response inhibition in GD individuals from the perspective of cognitive-emotional interaction and provides more detailed information for interventions for GD.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Abnormal psychological performance as potential marker for high risk of internet gaming disorder: An eye-tracking study and support vector machine analysis

Individuals with high risk of internet gaming disorder (HIGD) showed abnormal psychological performances in response inhibition, impulse control, and emotion regulation, and are considered the high-risk stage of internet gaming disorder (IGD). The identification of this population mainly relies on clinical scales, which are less accurate. This study aimed to explore whether these performances have highly accurate for discriminating HIGD from low-risk ones. Eye tracking based anti-saccade task, Barratt impulsiveness scale (BIS), and Wong and Law emotional intelligence scale (WLEIS) were used to evaluate psychological performances in 57 individuals with HIGD and 52 matched low risk of internet gaming disorder (LIGD). HIGD group showed significantly increased BIS total (t = −2.875, p = 0.005), attention (t = −2.139, p = 0.035), motor (t = −2.017, p = 0.046), and non-planning (t = −2.171, p = 0.032) scores, but significantly decreased WLEIS emotion regulation score (t = 2.636, p = 0.010) and correct rate of eye tracking anti-saccade task (t = 2.294, p = 0.024) compared with LIGD group. BIS total score was negatively correlated with the WLEIS total (r = −0.473, p < 0.001) and WLEIS emotion regulation (r = −0.366, p < 0.001) scores. A combination of the WLEIS emotion regulation score and the correct rate of anti-saccade task could discriminate HIGD from LIGD with 91.23% sensitivity, 82.69% specificity, and 87.16% accuracy. Participants with higher gaming hours daily were 40 times more likely to be high risk than their counterparts (p < 0.001). Hence, psychological performances were worse in HIGD. A combination of abnormal emotion regulation and response inhibition might be a potential marker to identify HIGD individuals.

Effectiveness of multimodal psychotherapeutic intervention for internet gaming disorder

BACKGROUND

Large number of studies on Internet gaming disorder (IGD) have primarily focused on ascertaining its psychological correlates. Few studies have focused on developing and assessing effectiveness of multimodal psychotherapeutic intervention programs. This intervention focused on minimizing salience, pre-occupation, conflict related to gaming and enhancing the overall quality of life, inclusive of psychological health, physical health, and environmental problems in individuals with IGD. At present, there appear to be no such studies in the Indian context.

METHODS

In this study, we developed and assessed the effectiveness of an intervention manual for IGD. The intervention program consisted of ten 60-minutes sessions with one therapist administering sessions once in each week. The interventions included motivational enhancement strategies, cognitive restructuring, behavioral strategies and relapse prevention. The outcomes from intervention were measured in terms of improvement in IGD, IAT, and overall quality of life. Our assessments, both at baseline and post-intervention consisted of Internet Addiction Test (IAT), Internet Gaming Disorder Test (IGD-20) and the Whoqol-Bref. A total sample of 40 was selected out of which 33 individuals completed the 10 sessions of multimodal psychotherapy program and post assessments.

RESULTS

A total of 40 participants (age: M = 20.25, SD = 5.39) enrolled, out of which 33 completed the entire intervention program of 10 sessions and showed significant improvements. The IAT and IGD-20 showed significant difference in the scores for before treatment (M = 52.88, SD = 16.25) and after treatment (M = 42.87, SD = 11.31; t (32) = 5.10, p = 0.000) conditions; and right before treatment (M = 56.88, SD = 19.25) and after treatment (M = 47.87, SD = 15.31; t (32) = 6.94, p = 0.000) conditions respectively. The internet addiction and internet gaming disorder scores showed a similar degree of severity reductions on the IAT and IGD-20 respectively at the end of week 8. In addition, the participants showed significant improvements in the quality of life inclusive of physical and psychological health post the completion of intervention program.

LIMITATIONS

The sample size of the study was small and assessments for evaluation of other psychological symptoms like depression, anxiety could have been conducted.

CONCLUSION

The intervention program indicated a substantial change in the IGD scores at post- assessment. A study on a larger sample to assess the validity of the manualized multimodal psychotherapy program for IGD needs to be conducted. In addition, this manualized intervention program can be useful for administering structured intervention for IGD by mental health professionals working in the area of internet gaming disorder.

Emotion Regulation Choice in Internet Addiction: Less Reappraisal, Lower Frontal Alpha Asymmetry

Individuals with internet addiction (IA) show difficulties in emotion regulation. However, they could effectively employ emotion regulation strategies when instructed. We speculate that this discrepancy might be caused by maladaptive emotion regulation choices. Recent studies indicated that decreased activity of the left frontal cortex could be a neural marker of reappraisal use. To address this problem, individuals with IA (n = 17, IA group) and healthy individuals (n = 23, healthy control [HC] group) were required to choose an emotion regulation strategy between reappraisal and distraction to regulate their emotions varying in emotional intensity and valence. We also compared the resting state frontal alpha asymmetry (FAA) of these 2 groups. The results replicated more choices of reappraisal in low- versus high-intensity emotional contexts across groups. More importantly, the IA group chose reappraisal less frequently compared with the HC group, irrespective of emotional intensity. Furthermore, we found individuals with IA have lower FAA than healthy controls, and FAA shows a positive correlation with the use of reappraisal. These findings suggest that IA alters individuals' patterns of emotion regulation choice and impairs frontal activities, causing difficulties in emotion regulation.

Parental Depression and Leisure Activity Engagement on Children's Gaming Disorder: A Dyadic Study

Nowadays, playing both online and offline video games is a popular leisure activity among youngsters, but excessive gaming activity engagement may lead to gaming disorder that disrupts daily functioning. Identifying risk and protective factors of this emerging problem is thus essential for devising prevention and intervention strategies. This mixed-method, cross-sectional study aimed to examine the roles of parental depressive symptoms and children’s leisure activity engagement on children’s gaming disorder symptoms. Furthermore, the moderating roles of risky and protective leisure activity engagement were investigated. The sample comprised 104 parent-child dyads recruited from a population-based survey (parents: M_age = 45.59 years, SD = 6.70; children: M_age = 11.26 years; SD = 4.12). As predicted, parental depressive symptoms and children’s gaming activity engagement were positively associated with children’s gaming disorder symptoms, whereas children’s literacy activity engagement was negatively associated with these symptoms. Moreover, engagement in these two types of leisure activity moderated the association between parental depressive symptoms and children’s gaming disorder symptoms in distinct manners, further indicating literacy activities as beneficial and gaming activities as risk-enhancing. These new findings imply that parental depressive symptoms and children’s leisure activity engagement should be considered when designing parent-based programs for gaming disorder prevention and intervention.

Sexual Shame and Emotion Dysregulation: Key Roles in the Association between Internalized Homonegativity and Sexual Compulsivity

Sexual minority men (SMM) are at increased risk for mental health problems due to effects of sexual minority stigma (e.g., internalized homonegativity (IH)). Both IH and emotion dysregulation are contributors to sexual compulsivity; however, the role of feelings of sexual shame have not been examined in this association. A sample of 982 HIV-negative SMM completed online surveys (Mage = 42.4, SD = 13.74). Path analyses indicated significant direct effects of IH on sexual shame (β = 0.44, p < .001), emotion dysregulation (β = 0.19, p < .001), and sexual compulsivity (β = 0.22, p < .001). Modeled simultaneously, the association between sexual shame and sexual compulsivity (β = 0.26, p < .001) was significant, as was the association between emotion dysregulation and sexual compulsivity (β = 0.27, p < .001). Finally, an indirect effect of IH on sexual compulsivity through both sexual shame (p < .001) and emotion dysregulation (p < .001) was significant, and the association between IH and sexual compulsivity was reduced to non-significant (β = 0.01, p = .74). Targeting feelings of sexual shame and emotion dysregulation in clinical interventions may help reduce the negative health impact of sexual compulsivity among SMM.

The withdrawal-related affective, gaming urge, and anhedonia symptoms of internet gaming disorder during abstinence

Aim

The study explores IGD withdrawal-related presentations, including autonomic reaction, affective symptoms, anhedonia, and gaming urge during abstinence from gaming. We prospectively evaluated these withdrawal-related symptoms (WRS) and gaming craving during abstinence from gaming.

Methods

We examined 69 individuals with IGD and 69 regular gamers and evaluated their WRS (using an exploratory questionnaire), affective and behavioral WRS (using the Questionnaire on Gaming Urge-Brief Version gaming disorder questionnaire), and heart rate. All the participants attempted to abstain from gaming before our assessment. Subsequently, some participants' WRS and gaming craving before they engaged in gaming were prospectively evaluated.

Results

In the IGD group, 85.5% experienced gaming WRS, including affective, anhedonia, and gaming urge symptoms. They could relieve these symptoms through gaming. The IGD group experienced more severe gaming WRS, gaming craving, and a higher heart rate than the regular gamer group. Gaming urge was most associated WRS of IGD. Participants with IGD experienced more severe gaming cravings when their gaming abstinence before the assessment was shorter. WRS attenuated at night and the following morning when they maintained their gaming abstinence after assessment.

Conclusion

Individuals with IGD experience withdrawal-related affective, anhedonia, and gaming urge symptoms and a higher heart rate during abstinence. The WRS attenuated in 1 day. Most participants agreed that these symptoms could be relieved through gaming. Further prospective evaluation by objective assessment in an adequate sample was required to understand gaming withdrawal symptoms comprehensively.

Exploring the Mechanism of Pathological Gaming in Adolescents: Focused on the Mediation Paths and Latent Group Comparison

Pathological gaming among adolescents has been reported to hamper the achievement of a balanced life and to threaten the development of social competencies. Despite the increasing social concerns on the adolescent users, however, the mechanism of gaming behavior of adolescents has not been sufficiently examined. This study explored the mechanism of pathological gaming among adolescents from 3-year longitudinal data of 778 Korean adolescent gamers, by analyzing the effects of negative affects (i.e., anxiety, loneliness, and academic stress) on the degree of pathological gaming through the mediation variables (i.e., aggression and self-control) based on the stimulus-organism-response (S-O-R) framework. Latent class analysis (LCA) was used to uncover potential risk groups, and through partial least squares-structural equation modeling (PLS-SEM) analysis, the mediation pathways to pathological gaming were compared between the risk group and the non-risk group. The results highlighted the key role of academic stress on the degree of pathological gaming. In the entire group, academic stress primarily increased pathological gaming through self-control. The mediation path of self-control was the most influential result in the risk group. Aggression was the key mediator between loneliness and pathological gaming in the non-risk group. The theoretical and practical implications of the results were discussed.

Impact of Action Video Gaming Behavior on Attention, Anxiety, and Sleep Among University Students

Background

Recently, there has been an increase in the prevalence of action video gaming among adolescents and young adults. This has made video gaming a topic of interest for behavioral and higher brain cognitive function researchers. The present study investigated the impact and consequences of action video gaming on human behavior—specifically, attention, anxiety levels, and sleep patterns.

Objective

The study aimed to investigate the potential associations between action video gaming and attention, anxiety, and sleep.

Methods

Recruited participants (N = 97) were asked to independently complete an online questionnaire consisting of 4 sections: demographic data, gaming behavior, 8-item Epworth Sleepiness Scale, and 7-item Generalized Anxiety Disorders Scale. Participants were further divided into 2 groups (expert and non-expert video gamers) based on the number of hours they spent on action video games. After completing the questionnaires, the patients attended an on-site session, where they completed a validated psychological online battery test that assessed their sustained attention.

Results

The mean age of the participants was 21 years. There was a significant difference in attention between expert and non-expert video gamers; when exposed to stimuli, expert gamers displayed significantly shorter reaction times than the non-expert gamers (p < 0.05). Both groups showed a non-significant decrease in attention span throughout time. The data demonstrated no statistically significant difference in anxiety levels or daytime sleepiness between expert and non-expert video gamers, and minimal to mild anxiety levels were reported in most expert and non-expert gamers.

Conclusion

Expert video gamers were significantly more attentive compared to non-expert gamers, and most participants showed low levels of generalized anxiety. Accordingly, expanding our knowledge on the effects of action video games on attention span is important for creatively using games in the field of education, especially for those who suffer from attention deficit hyperactivity disorders.

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.

Gaming to relieve tension or anxiety and associations with health functioning, substance use and physical violence in high school students

Gaming is popular among youth and gaming disorders have been introduced recently into psychiatric nomenclature systems. Motivations underlying gaming may include involvement to reduce negative emotional states and thus may link to psychiatric and overall health. Thus, the extent to which adolescents engage in gaming to relieve anxiety warrants additional investigation. Data from 2005 Connecticut high-school students were used to examine how adolescents who reported gaming to relieve tension or anxiety differed from those who reported gaming but not to relieve tension or anxiety on measures of demographics, academic performance, general health, extracurricular activities, dysphoria/depression symptoms, substance use, and aggressive or violent behaviors. Chi-square analyses and binomial and multinomial logistic regression models were conducted. Gaming to relieve anxiety was more prevalent in boys and Hispanic and Asian adolescents and associated with less extracurricular involvement, poorer academic performance, increased cigarette and other drug use, problematic internet use, and depression. Participants with gaming to relieve tension or anxiety were also more likely to report weapon-carrying, missing school because they felt unsafe, having been threatened with a weapon, having engaged in physical fights, and having experienced injuries from fights. As gaming to relieve anxiety was related to mental-health- and functioning-related measures, additional research is needed to examine the precise natures of these relationships and to translate the information into improved intervention strategies.

Large-scale network dysfunction in youths with Internet gaming disorder: a meta-analysis of resting-state functional connectivity studies

Internet gaming disorder (IGD) has been defined as a specific behavioral disorder, associated with abnormal interactions among large-scale brain networks. Researchers have sought to identify the network dysfunction in IGD using resting-state functional connectivity (rsFC). However, results across studies have not reached an agreement yet and the mechanism remains unclear. The present research aimed to investigate network dysfunction in IGD through a meta-analysis of rsFC studies. Twenty-two seed-based voxel-wise rsFC studies from 25 publications (594 individuals with IGD and 496 healthy controls) were included. By categorizing seeds into seed-networks based on their location within a prior functional network parcellations, we performed a Multilevel kernel density analysis (MKDA) within each seed-network to identify which brain systems showed abnormal interaction with particular seed-network in individuals with IGD. Compared to healthy control groups, individuals with IGD exhibited significant hypoconnectivity within the default mode network, and enhanced connectivity between the default mode network and insula within the ventral attention network. IGD was also associated with increased connectivity between the ventral attention network and somatomotor regions. Furthermore, the IGD groups showed hyperconnectivity between the limbic network and regions of the frontoparietal network. The results suggest that individuals with IGD show large-scale functional network alteration which underpins their core symptoms including poor emotional competence, cue-reactivity and craving, habitual addictive behaviors and impaired executive control. Whether the compensation mechanism exists in IGD is discussed, and further research is needed. The findings provide a neurocognitive network model of IGD, which may serve as functional biomarkers for IGD and have potentials for development of effective diagnosis and therapeutic interventions.

Gaming Disorder in Adults with Autism Spectrum Disorder

Gaming disorder (GD) is a clinical addiction to video or internet games. This study investigated whether GD symptoms are heightened in adults with autism spectrum disorder (ASD) in comparison to a control group, and explored predictors of GD in 230 adults with ASD and 272 controls. The relationship between GD and gelotophobia was examined. Measures included the Ten-Item Internet Gaming Disorder Test, GELOPH < 15 >, Autism Spectrum Quotient-10 items, Inventory of Parent and Peer attachment, Emotional Regulation Questionnaire, Social Functioning Questionnaire (SFQ) and the NEO-FFI-3. Individuals in the ASD group showed significantly higher symptoms of GD. Peer-attachment, emotional regulation and extraversion significantly predicted GD scores. Gelotophobia and GD were related to each other with a small effect size.

The frustration intolerance of internet gaming disorder and its association with severity and depression

This study aimed to evaluate the belief of frustration intolerance of individuals with internet gaming disorder (IGD) and its association with depression among them. We recruited 69 participants with IGD and 138 controls (69 regular gamers and other non-gamers). IGD is diagnosed based on DSM-5 (DSM stands for diagnostic and statistical manual of mental disorders) criteria through psychiatric interviews. They had completed the questionnaire for the belief of frustration intolerance, depression, and severity of IGD. The participant with IGD had a higher score on the frustration discomfort scale and its subscales, discomfort intolerance, entitlement, emotional intolerance, and achievement. Further regression analysis demonstrated an independent association between entitlement and IGD in control of depression. The frustration intolerance is also associated with depression and the severity of IGD among the IGD group. The discomfort intolerance and achievement were the most associated factors of depression. Frustration intolerance is a crucial irrational belief of IGD. It contributes to the severity of IGD and depression among individuals with IGD. The frustration intolerance, particularly for discomfort intolerance, entitlement, and achievement, should be assessed and intervened while treating individuals with IGD.

The gray matter volume in superior frontal gyrus mediates the impact of reflection on emotion in Internet gaming addicts

Internet gaming disorder (IGD) is becoming a prevalent mental health concern around the world. However, the relationship among brain gray matter volume (GMV), emotion induced by decision-making and the level of reflection in IGD participants has not been fully elucidated to date. The current study aimed to explore this issue by combining a sequential decision task and voxel-based morphometry. Twenty-six IGD participants and 28 demographically matched healthy controls were recruited. After collecting Rumination-Reflection questionnaire data and high-resolution T1-weighted MRI data, participants were asked to complete a sequential decision task. The results demonstrated that compared to healthy controls, IGD participants exhibited significantly decreased GMV in the superior frontal gyrus (SFG). Moreover, GMV in the SFG of IGD participants fully mediated the impact of reflection level on the emotion of loss outcome during the sequential decision task. These results indicate that IGD is associated with reduced GMV in the SFG, and this structural change in IGD contributes to a particular relationship between the level of reflection and regret emotion for loss outcome in the sequential decision task.

Problematic internet gaming in adolescents, and its relationship with emotional regulation and perceived social support

Technological developments and the increased use of the internet have created some risks for adolescents, including problematic internet gaming (PIG). The aim of this study is to investigate the role of age, gender, emotional dysregulation and perceived social support in PIG. The study was conducted with 1,291 adolescents. Participants completed the game addiction scale (GAS), difficulties in emotion regulation scale (DERS), and multidimensional scale of perceived social support (MSPSS) under the observation of their teachers. According to the results of the GAS, participants were divided into two groups: those with PIG and those without PIG. The effect of age, gender, DERS scores, and MSPSS scores on PIG was investigated using stepwise logistic regression analysis. The mean age of participants was 14.7 years and the frequency of PIG was 13.5% (n = 144). The frequency of PIG was significantly higher in males than in females. The results showed that male gender, high emotional dysregulation and low perceived social support were significantly associated with PIG. The present study indicate that PIG is highly observed in adolescents, especially in males, and as in other behavioral addictions, emotional dysregulation and perceived social support can play an important role in PIG.

The association between Emotional Regulation and Internet Gaming Disorder

PURPOSE

Lack of control over Internet gaming habits may result in negative consequences. This study aimed to evaluate the emotional regulation of adults with Internet gaming disorder (IGD) and the association of emotion regulation, depression, and hostility.

METHODS

Advertisements were used to recruit 69 young adults with IGD, 69 sex- and age-matched controls, and 69 sex- and age-matched regular gamers. The diagnosis of IGD was according to diagnostic interviews based on DSM-5 IGD research criteria. Participants completed the Affective Style Questionnaire, the center of epidemiological studies depression scale and the short-form Chinese version of Buss-Durkee Hostility Inventory.

RESULTS

In the IGD group, the emotion adjustment score was significantly lower, whereas the scores for depression, and hostility were significantly higher than in the other two groups. In addition, emotion adjustment is the most associated emotion regulation behavior of IGD, followed by emotion concealment. In IGD group, emotion adjustment had a negative correlation with depression and hostility.

CONCLUSIONS

Our study demonstrate that emotion adjustment is significantly associated with IGD. The depression and hostility mediated the association. Knowing that emotion adjustment plays a critical role in IGD, future interventions should focus on this subscale of emotion regulation.

The correlation between family relationships and brain activity within the reward circuit in adolescents with Internet gaming disorder

Disrupted reward circuits and diminished behavioural control have been suggested as the pathophysiologies of Internet gaming disorder (IGD). Family functioning is thought to play an important role in reward-related control. We hypothesized that adolescents with IGD show disrupted patterns of family relationships, which are associated with brain activity within the reward circuit. 42 adolescents with IGD without comorbidities and 41 healthy controls were assessed for family function and psychological states using the Korean Wechsler Intelligence Scale for Children (K-WISC), Korean version of DuPaul's attention deficit hyperactivity disorder (ADHD) Rating Scale (K-ARS), Young Internet Addiction Scale (YIAS), Children's Depression Inventory (CDI), Beck Anxiety Inventory (BAI), and the relationship domain of the Family Environmental Scale (FES-R). Brain activity was assessed via resting-state fMRI. Adolescents with IGD showed increased K-ARS, BAI, and YIAS scores, but decreased FES-R and FES-cohesion subscale scores; YIAS scores were negatively correlated with FES-R scores. Brain connectivity from the cingulate to the striatum was decreased, positively correlated with FES-R scores, and negatively correlated with IGD severity. Adolescents with IGD showed disrupted family relationships, which was associated with the severity of the disorder, and dis-connectivity within the reward circuit.

Maladaptive Personality Functioning and Psychopathological Symptoms in Problematic Video Game Players: A Person-Centered Approach

BACKGROUND

A need exists to increase our understanding of the association between maladaptive personality traits, psychopathological symptoms, game preference, and different types of video game use. In the present study, we used a person-centered approach to identify different subtypes of video game players and we explored how they differ in personality profiles, clinical symptoms, and video game usage.

METHODS

We assessed problematic gaming via the nine-item Internet Gaming Disorder Scale and self-reported screen time playing video games in a sample of 366 adolescents and young adult gamers. Participants also completed measures on maladaptive personality domains (Personality Inventory for DSM-5 Brief Form), alexithymia (Toronto Alexithymia Scale-20 items), and psychopathological symptoms (DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure) and reported which genre of video games they preferred.

RESULTS

Using a person-centered, cluster-analytic approach, we identified four clusters of video game players (Occasional, Passionate, Preoccupied, and Disordered) presenting peculiar combinations of problematic gaming scores and time spent online playing video games. Non-problematic gamers (Occasional and Passionate) represented the majority of the sample (62.3% of the participants). Highly involved gamers who exhibited excessive screen time playing video games (Disordered gamers) presented the highest level of maladaptive personality traits and psychopathological symptoms, and were characterized by the greatest use of Multiplayer Online Battle Arena (MOBA) games.

CONCLUSION

These results have clinical implications on suggesting the importance to determining whether or not problematic gaming activities reflect a dysfunctional emotion-focused coping strategy to avoid inner unpleasant emotional or a more generally compromised emotional and social functioning.

The Mediating Effects of Affect on Associations between Impulsivity or Resilience and Internet Gaming Disorder

Internet gaming disorder (IGD) is a new disease proposed by the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5), and has been studied extensively in relation to depression and impulsivity. The relationship between resilience and disease has been found in a variety of addictive disorders, but studies on IGD are lacking. In this study, 71 IGD patients and 78 healthy controls (HCs) were recruited. Impulsivity, resilience, affects, and the degree of internet game addiction were measured using formal tools. The measured values were analyzed by mediation analysis to evaluate the mediating role of affects on resilience and impulsivity related to IGD symptoms. The IGD group showed higher impulsivity, lower resilience, lower positive affect, and higher negative affect than the HC group. The mediation analysis showed that a positive affect was a mediator between impulsivity and the severity of addiction in both groups. Negative affect mediated impulsivity/resilience and the severity of addiction only in the IGD group. Although the results of this study are based on a narrow category of subjects, who are young male adults around 25 years of age, the results suggest that positive affect can be strengthened to prevent the IGD illness, and that illness symptoms may be alleviated by reducing negative affect.

Relationships of Internet addiction and Internet gaming disorder symptom severities with probable attention deficit/hyperactivity disorder, aggression and negative affect among university students

The aim of the present study was to evaluate relationships of Internet addiction (IA) and Internet gaming disorder (IGD) symptom severities with probable attention deficit/hyperactivity disorder (ADHD) and aggression among university students, while controlling the effects of anxiety and depressive symptoms. The study was conducted with online survey among 1509 volunteered university students in Ankara who regularly use the Internet, among whom we conducted analyses related with IA. Among these students, 987 of them, who play video games, were included in the analyses related with IGD. Correlation analyses revealed that the severities of the scale scores were mildly correlated with each other both among students who regularly use the Internet and students who play video games. Probable ADHD was associated with the severity of IA symptoms, together with depression and aggression, particularly physical aggression and hostility, in ANCOVA analyses. Similarly probable ADHD was also associated with the severity of IGD symptoms, together with depression and aggression, particularly physical aggression, anger and hostility, in ANCOVA analyses. These findings suggest that the presence of probable ADHD is related with both severity of IA and IGD symptoms, together with aggression and depression.

The Role of Cognitive Emotion Regulation Strategies in Problem Gaming Among Adolescents: A Nationally Representative Survey Study

Explanatory theoretical models have proposed an association between problematic online gaming and abilities or strategies in alleviating distress or negative emotions in times of stress as proximal non-gaming-related personality factors. However, there is little research that has targeted how emotion regulation relates to problematic online gaming-especially during adolescence when gaming behavior is most prevalent. In emotion regulation research, there has been a particular emphasis on rumination because it is strongly associated with overall psychopathology. However, it is unknown whether this putatively maladaptive strategy relates to problematic online gaming and whether it is a gender-dependent association. Consequently, the present study examined how emotion regulation strategies, and particularly rumination, related to problem gaming and tested whether gender moderated this relationship in adolescents. In a national representative adolescent sample, 46.9% of the participants (N = 1,646) reported online gaming in the past 12 months and provided information on problematic gaming, and it was these data that were used for further analysis. Their data concerning problematic online gaming and emotion regulation strategies were analyzed, including rumination along with other putatively maladaptive (e.g., catastrophizing) and adaptive (e.g., positive reappraisal) strategies, while controlling for age, gender, and game genre preference. Results of linear regression analyses showed that all the putatively maladaptive emotion regulation strategies (including self-blame, other blame, catastrophizing, and rumination) were positively related to problematic online gaming. Positive reappraisal proved to be a protective factor; it was inversely related to problematic online gaming. In addition, the relationship between rumination and online gaming was moderated by gender (i.e., the relationship was stronger among boys). Based on the results, it is argued that emotion regulation is a useful framework to study problematic online gaming. The present study highlighted that the relative predictive value of rumination for problematic online gaming varied for boys and girls, suggesting that trait rumination might be a gender-specific vulnerability factor for problematic online gaming, but this requires further investigation and replication.

Problematic video game use as an emotional coping strategy: Evidence from a sample of MMORPG gamers

BACKGROUND

A positive relationship between problematic gaming and escapism motivation to play video games has been well established, suggesting that problematic gaming may result from attempts to deal with negative emotions. However, to date, no study has examined how emotion dysregulation affects both escapism motives and problematic gaming patterns.

METHODS

Difficulties in emotion regulation, escapism, and problematic involvement with video games were assessed in a sample of 390 World of Warcraft players. A structural equation modeling framework was used to test the hypothesis that escapism mediates the relationship between emotion dysregulation and problematic gaming.

RESULTS

Statistical analyses showed that difficulties in emotion regulation predicted both escapism motives and problematic gaming, and that escapism partially mediated this relationship.

CONCLUSION

Our findings support the view that problematic players are likely to escape in online games as a maladaptive coping strategy for dealing with adverse emotional experiences.

Personality Traits, Strategies for Coping with Stress and the Level of Internet Addiction-A Study of Polish Secondary-School Students

Among the many contributing factors in addictions there are also those describing the individual characteristics and ways of dealing with various life challenges. Despite numerous studies in this area, there is still no unambiguous data on the nature and specificity of this relationship in different age groups. The aim of the study was to assess the relationship between personality dimensions and strategies of coping with stress and the level of Internet addiction. The study was funded by the Ministry of Health under grant no. 93/HM/2015. The study was carried out in a group of 383 persons aged 15 to 19 (M = 16.6, SD = 0.77) attending secondary schools. The following research tools were used: Ten Item Personality Measure, Brief Cope and Internet Addiction Test. Both specific personality traits and styles of coping with stress are related to the addiction to the analysed medium. The personality traits most strongly associated with the risky Internet use were conscientiousness and emotional stability. An association was demonstrated between Internet addiction and the use of coping strategies, such as disengagement, substance use and self-blame. The results obtained demonstrate a major role of personality-related factors in the development of Internet addiction. The attitude to difficulties seems to be the key issue. The findings presented also make it possible to delineate the areas for improvement (e.g., through psychoeducational interventions) to protect young people from the risk of developing the addiction.

Subregions of the Anterior Cingulate Cortex Form Distinct Functional Connectivity Patterns in Young Males With Internet Gaming Disorder With Comorbid Depression

Depression is one of the most common comorbid conditions in Internet Gaming Disorder (IGD). Although there have been many studies on the pathophysiology of IGD, the neurobiological basis underlying the close association between depression and IGD has not been fully clarified. Previous neuroimaging studies have demonstrated functional and structural abnormalities in the anterior cingulate cortex (ACC) in IGD patients. In this study, we explored functional connectivity (FC) abnormalities involving subregions of the ACC in IGD subjects with comorbid depression. We performed a resting state seed-based FC analysis of 21 male young adults with IGD with comorbid depression (IGDdep+ group, 23.6 ± 2.4 years), 22 male young adults without IGD with comorbid depression (IGDdep- group, 24.0 ± 1.6 years), and 20 male age-matched healthy controls (24.0 ± 2.2 years). ACC-seeded FC was evaluated using the CONN-fMRI FC toolbox. The dorsal ACC (dACC), the pregenual ACC (pgACC), and the subgenual ACC (sgACC) were selected as seed regions. Both IGD groups had stronger pgACC FC with the right precuneus, the posterior cingulate cortex, and the left inferior frontal gyrus/insula than the control group. The IGDdep+ group had stronger dACC FC with the left precuneus and the right cerebellar lobule IX than the control and IGDdep- groups. The IGDdep+ group also had weaker pgACC FC with the right dorsomedial prefrontal cortex and the right supplementary motor area and had weaker sgACC FC with the left precuneus, the left lingual gyrus, and the left postcentral gyrus than the other groups. The strength of the connectivity between the sgACC and the left precuneus correlated positively with a higher omission error rate in the continuous performance test in the IGDdep+ group. In addition, the IGDdep- group had stronger sgACC FC with the left dorsolateral prefrontal cortex than the other groups. Our findings suggest that young males with IGD comorbid with depression have FC alterations of the default mode network and diminished FC with the prefrontal cortex. This altered FC pattern may be involved in the close association of IGD and depression.