Gaming disorder among medical college students from India: Exploring the pattern and correlates

Pattern and correlates of Internet gaming disorder among medical students - A cross-sectional study from a tertiary care health institute, Rajasthan

BACKGROUND

Internet gaming disorder (IGD) is a global problem associated with several psychological complications, such as insomnia, poor academic performance, and aggression. The present study aimed to explore the pattern and correlates of gaming disorder among a sample of medical college students from India and determine the motivational basis for it.

MATERIALS AND METHODS

An analytical cross-sectional study was conducted at a medical college in Rajasthan from January 2021 to June 2021 after obtaining approval from the Institutional Ethical Committee. The study participants were all medical undergraduate students of age 18 years or more, who were engaged in Internet gaming during the past year (i.e., the last 12 months. It was a web-based online survey in which a pre-designed, semi-structured questionnaire was used to collect information on the socio-demographic profile of the respondents, Internet Gaming Disorder Scale-Short-Form (IGDS9-SF) and Motives for Online Gaming Questionnaire (MOGQ) scale. Multivariate regression analysis was performed for the prediction of dependent variables on the basis of several independent variables like gender, substance abuse, relationship status, and weekly time and money spent on gaming.

RESULTS

The study included 864 undergraduate students, out of which 675 were engaged in Internet gaming during the last 12 months, so analyses were made on 675 students to assess the severity of IGD. The proportion of disordered gamers was 2.1%. Substance abuse [odds ratio (OR) = 7.026], owning a game console or other dedicated gaming devices (OR = 10.099), and weekly time spent on gaming (OR = 7.026) were significantly associated with higher odds of being a disordered gamer. Similarly, the weekly amount of money spent on gaming and the age of initiation of gaming were also significant predictors for IGD.

CONCLUSIONS

Substance abuse, owning a game console or other dedicated gaming devices, weekly time spent on gaming, weekly money spent on gaming, and age of initiation of gaming were independent predictors for disordered gamers. Restricting gaming activities and engaging and training in other activities can help overcome the problem.

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

Background

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

Methods

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

Findings

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

Conclusion

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

Cardiology and Neurophysiological Stimulation of Internet Gaming Disorders: A Systematic Review

BACKGROUND

Internet Gaming Disorder (IGD) is recognized as a mental health condition associated with excessive video gaming, leading to functional impairments. The inclusion of IGD in the DSM-5 has underscored the importance of comprehensively understanding its physiological and psychological effects.

OBJECTIVE

This systematic review aims to analyze and synthesize existing literature on the cardiophysiological and neurophysiological activities of individuals diagnosed with IGD, with a focus on identifying patterns, trends, and implications for clinical practice and future research.

METHODS

A systematic search was conducted in PubMed and Scopus databases to identify relevant studies published up to 2023. The search strategy included terms related to IGD, cardiophysiology, neurophysiology, and relevant measurement techniques. Inclusion criteria encompassed peer-reviewed research articles and clinical trials examining cardiophysiological (e.g., heart rate variability, blood pressure) and neurophysiological (e.g., brain imaging, electroencephalography) parameters in individuals with IGD. Exclusion criteria were applied to ensure methodological rigor and relevance to the research question.

RESULTS

The initial search yielded 1320 papers related to IGD, of which twenty studies met the eligibility criteria and were included in the review. Data extraction and synthesis focused on key cardiophysiological and neurophysiological outcomes observed in individuals with IGD compared to healthy controls. Findings revealed decreased Heart Rate Variability (HRV), increased sympathetic activity, and executive control deficits in IGD individuals based on Electrocardiogram (ECG) recordings and cognitive assessments. Neuroimaging studies demonstrated heightened brain activation in the lateral and prefrontal cortex, altered reward processing, and impulse control mechanisms among IGD subjects. Gender-specific differences were noted, with males exhibiting distinct thalamic activation striatum and decreased Regional Homogeneity (ReHo) in the right Posterior Cingulate (rPCC) compared to females.

DISCUSSION

The synthesized evidence indicates a complex interplay between excessive gaming and cardiophysiological/neurophysiological changes, highlighting the need for multidimensional assessments in diagnosing and managing IGD. Implications for clinical practice include early detection using ECG, EEG, and advanced neuroimaging techniques, as well as personalized interventions tailored to individual characteristics and gender-specific differences.

CONCLUSION

This systematic review provides a comprehensive overview of the cardiophysiological and neurophysiological activities associated with Internet Gaming Disorder. The findings underscore the need for further research to elucidate underlying mechanisms, develop standardized diagnostic protocols, and optimize targeted interventions for individuals with IGD.

Biopsychosocial factors of gaming disorder: a systematic review employing screening tools with well-defined psychometric properties

Background and aims

Considering the growing number of gamers worldwide and increasing public concerns regarding the negative consequences of problematic gaming, the aim of the present systematic review was to provide a comprehensive overview of gaming disorder (GD) by identifying empirical studies that investigate biological, psychological, and social factors of GD using screening tools with well-defined psychometric properties.

Materials and methods

A systematic literature search was conducted through PsycINFO, PubMed, RISS, and KISS, and papers published up to January 2022 were included. Studies were screened based on the GD diagnostic tool usage, and only five scales with well-established psychometric properties were included. A total of 93 studies were included in the synthesis, and the results were classified into three groups based on biological, psychological, and social factors.

Results

Biological factors (n = 8) included reward, self-concept, brain structure, and functional connectivity. Psychological factors (n = 67) included psychiatric symptoms, psychological health, emotion regulation, personality traits, and other dimensions. Social factors (n = 29) included family, social interaction, culture, school, and social support.

Discussion

When the excess amount of assessment tools with varying psychometric properties were controlled for, mixed results were observed with regards to impulsivity, social relations, and family-related factors, and some domains suffered from a lack of study results to confirm any relevant patterns.

Conclusion

More longitudinal and neurobiological studies, consensus on a diagnostic tool with well-defined psychometric properties, and an in-depth understanding of gaming-related factors should be established to settle the debate regarding psychometric weaknesses of the current diagnostic system and for GD to gain greater legitimacy in the field of behavioral addiction.

The mediating role of sleep quality on the relationship between internet gaming disorder and perceived stress and suicidal behaviour among Indian medical students

Background

In the recent digital era, individuals with internet gaming disorder (IGD) have reported a much higher prevalence of poor sleep quality, perceived stress and suicidal behaviour. However, the underlying mechanisms for these psychological problems remain unknown.

Aims

The primary aims of this study were to explore the mediating role of sleep quality on the relationship between IGD and the health outcomes of perceived stress and suicidal behaviour and to assess the prevalence and risk factors for IGD among medical students.

Methods

A cross-sectional study enrolling 795 medical students from two medical colleges in a rural area of North India was conducted from April to May 2022. The study participants were chosen using a stratified random sampling approach. A self-administered questionnaire was used to collect data, including sociodemographic and personal information and gaming characteristics. The study also included the Gaming Disorder and Hazardous Gaming Scale, the Pittsburgh Sleep Quality Index, the Perceived Stress Scale-10 and the Suicide Behaviors Questionnaire-Revised to measure IGD, sleep quality, perceived stress and suicidal behaviour, respectively. Multiple logistic regression for the risk factors and Pearson's correlation test for the relationship between variables were used. Hayes' PROCESS macro for SPSS was employed to carry out mediation analysis.

Results

Among the 348 gamers with a mean age of 21.03 (SD 3.27) years, the prevalence of IGD was 15.23% (95% confidence interval: 11.6% to 19.4%). In the correlational analysis, small to large (r: 0.32-0.72) significant relationships between scores of IGD and other health outcomes were established. The indirect effect (B=0.300) via sleep quality accounted for 30.62% of the total effect (B=0.982) of IGD on perceived stress (partially mediated), while sleep quality (B=0.174) accounted for 27.93% of the total effect (B=0.623) of IGD on suicidal behaviour (partially mediated). The factors of being male, living in a single-parent family, using the internet for other than academic purposes (1-3 hours and more than 3 hours/day), playing games for more than 3 hours/day and playing games with violent content were associated with IGD symptoms.

Conclusions

Using a dimensional measure, the results specified the relationship between IGD and perceived stress and suicidal behaviour by demonstrating that sleep quality meditated them. This modifiable mediating factor can be addressed by psychotherapy to mitigate the risk of perceived stress and suicidal behaviour among the future medical workforce.

Different Typologies of Gamers Are Associated with Mental Health: Are Students DOOMed?

(1) Background: The inclusion of Internet Gaming Disorder in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) led to a rapid development of assessment instruments based on the suggested diagnosis. However, previous studies suggest that some of the symptoms in the diagnosis reflect engagement in gaming rather than a disorder or addiction. The aim of the present cross-sectional study was to investigate mental health associations with different typologies of gamers. (2) Methods: Data stemmed from a large national survey of students (SHoT2022) that was conducted between February and April 2022 (N = 59,544). Participants were categorized into non-gamers, recreational gamers, engaged gamers, problematic gamers, and addicted gamers. Logistic regression models adjusted for age were analyzed with and without gender-stratification for mental distress and life satisfaction as dependent variables across gaming categories. (3) Results: The proportion reporting case-level mental distress was lower for recreational gamers compared to non-gamers, indicating fewer mental health problems for recreational gamers. However, after stratifying the analysis by gender, female recreational gamers had higher levels of mental distress compared to female non-gamers, reflecting Simpson's paradox. (4) Conclusions: Future studies investigating mental health and gaming should include a gender perspective.

Mental problems and risk factors for depression among medical students during the COVID-19 pandemic: A cross-sectional study

Prevalence of depression is high among medical students and several mental problems are identified as risk factors. Coronavirus disease 2019 (COVID-19) pandemic causes difficulties that could adversely affect mental health. However, data concerning prevalence of mental problems, and whether or not these problems remain risk factors for depression during the COVID-19 pandemic in medical students are scarce. To investigate the prevalence of depression, social media addiction, game addiction, sleep quality, eating disorder risk, and perceived stress among Thai medical students, risk factors for depression were investigated. Online surveys via our faculty's learning portals were advertized to medical students who engaged online learning and 224 respondents provided complete data. Study-related medical students' data were collected using the Patient Health Questionnaire-9 for depression, the Social-Media Addiction Screening Scale for social media addiction, the Game Addiction Screening Test for game addiction, the Pittsburgh Sleep Quality Index for sleep quality, the Eating Attitudes Test for eating disorder risk, and the Perceived Stress Scale for perceived stress. Depression was reported in 35.7% of medical students, social-media addiction in 22.3%, game addiction in 4.5%, eating disorder risk in 4.9%, poor sleep quality in 80.8%, and moderate-to-high perceived stress in 71.4%. The independent predictors of depression were lower grade point average, social media addiction, and moderate-to-high perceived stress. A high prevalence of depression, stress, and poor sleep was found among medical students during the COVID-19 pandemic. Medical students who are stressed, have lower grades, and/or who are addicted to social media warrant depression screening.

Patterns and Predictors of Internet Gaming Disorder: An Observational Study from Jordan

Objective:

Internet Gaming Disorder (IGD) is a rapidly growing public health problem that may have detrimental effects. The purpose of this study is to identify factors associated with IGD status.

Methods:

In this cross-sectional observational study, a convenient sample of gamers in Jordan was recruited and asked to participate in an online survey based on the nine criteria of the 20-item Internet Gaming Disorder (IGD-20) used to assess gaming disorder. Sociodemographic and psychosocial data were also obtained.

Results:

A total of 504 gamers participated in this study. The mean age of respondents was 21.6 ± 3.90 years. Using the standard IGD-20 scale, 96 participants (19%) were classified as potential IGD cases, compared to 408 (80.9%) non-disordered gamers. Males were dominant among the population, constituting 348 (69%) of gamers. Males also played significantly more hours per week [17.8 ±16.75] compared to females [13 ± 17.65]. The majority of gamers (411 (81.5%)) were students, although unemployed adults played for the highest total time [23.9 ± 30.84 hours/week]. Device type used for gaming also significantly (p <0.05) affected the time spent playing. Predictors of IGD included educational level (p< 0.05) and playing hours/week (p< 005). Conversely, no significant associations were found between IGD and gender, age, employment, or sleeping hours. IGD is increasingly being diagnosed among both genders and presents a health challenge for internet users.

Conclusion:

Establishing gamer profiles and recognizing predictors of IGD is therefore vital for guiding clinical classification and diagnosis of the disease.

The Association Between Gaming Practices and Scholastic Performance Among Medical Students in India: Case-Control Study

BACKGROUND

Gaming is a billion-dollar industry that is expanding at a compound annual growth rate of 9% to 14.3%, with the biggest market in Southeast Asian countries. The availability of low-cost smartphones and the ease at which the internet can be accessed have made gaming popular among youth, who enjoy it as a leisure activity. According to the World Health Organization, excessive indulgence in gaming can lead to gaming disorder. Medical students indulging in excessive gaming can succumb to gaming disorder, which can affect their scholastic performance.

OBJECTIVE

This study aimed to assess the association between gaming practices and scholastic performance among medical students.

METHODS

 This study used a case-control design, where 448 medical undergraduate students (first year to prefinal) were preliminarily surveyed using universal sampling on their gaming practices in the last 6 months. Out of this sample, the 91 participants who admitted to gaming in the past 6 months were recruited as cases, while participants who never engaged in gaming in the last 6 months were recruited as controls. Both the cases and controls were matched for age and gender in a 1:1 ratio. The internal assessment scores (based on 2 midterms completed in the last 6 months) of cases and controls were compared. The Snedecor F test was used to determine the association between the number of hours spent gaming and internal assessment scores (%), while the Student t test was used to determine significant differences between the internal assessment scores of cases and controls. Odds ratios were calculated to identify the risk of poor scholastic performance among cases compared to the controls. The prevalence of gaming disorder among cases was assessed using the Gaming Addiction Scale (GAS).

RESULTS

The frequency of gaming (in hours) was not associated with mean internal assessment scores (P=.13). Male cases reported significantly lower internal assessment scores compared to male controls (P=.005 vs P=.01), whereas no significant differences were observed between the internal assessment scores of female cases and controls (P=.89 vs P=.59). A negative correlation was observed between GAS scores and internal assessment scores (r=-0.02). The prevalence of gaming disorder using the GAS was observed to be 6.3% (28/448) in the study population and 31% (28/91) among cases. The risk of low scores (<50%) among gamers was observed to be 1.9 (95% CI 1.04-3.44, P=.03) times higher in the first midterm and 1.80 (95% CI 0.97-3.36, P=.06) times higher in the second midterm compared to nongamers.

CONCLUSIONS

The findings suggest that excessive gaming adversely affects the scholastic performance of male participants more than female participants. Awareness about gaming disorder needs to be created among students, parents, and teachers. Treatment services should be made available to medical students with gaming disorders.

Should Internet gaming disorder be considered a subtype of generalized problematic internet use? Findings from a study among medical college students

PURPOSE

The current study aimed to explore whether Internet gaming disorder (IGD) should be considered a subtype of generalised problematic Internet use (PIU) by assessing the degree of overlap between them and comparing their correlates. The sociodemographic profile and presence of depressive symptoms were studied as correlates for IGD and generalised PIU.

DESIGN AND METHODS

This was a self-report survey administered online among medical students (n = 306).

FINDING

Less than half of the participants with IGD (45.45%; 5 out of 11) also met the criteria for generalised PIU. Only 6.67% (5 out of 75) of subjects with generalised PIU were also classified as having IGD. Male gender and time spent on digital gaming per day were associated with greater risk of IGD; whereas the time spent on Internet per day and more frequent use of the Internet for social networking rather than academic purposes were associated with greater risk of generalised PIU. The regression models built for IGD and generalised PIU were statistically significant (F = 64.10; P < .01 and F = 80.97; P < .01, respectively). The two models explained 66.1% and 57.4% of the variance in IGDS-SF and GPIUS2 scores, respectively.

PRACTICE IMPLICATIONS

The IGD and generalised PIU appear to be conceptually distinct entities. The IGD should not be assumed as a subtype of generalised PIU. Thus, health care providers need to focus on IGD beyond and besides generalised PIU. There is a need to specifically enquire about IGD while screening for behavioural addictions involving use of Internet.

Measuring addiction to internet gaming among Indian medical students: Development and preliminary psychometric properties of a new scale

BACKGROUND

Internet gaming disorder (IGD) is emerging as an important source of behavioral addiction in young people globally.

OBJECTIVE

The aim of this study was to assess addiction to internet gaming in medical students using a self designed research instrument.

MATERIALS AND METHODS

We conducted a cross-sectional study and enrolled 264 male and 160 female MBBS students (n = 424) in Delhi, India. The study instruments included: a 2-item Internet gaming screening questionnaire (IGSQ), a 14-item self-designed Internet gaming addiction scale (IGAS) to measure addiction-like behavior associated with multiplayer Internet gaming, and the Pittsburgh Sleep Quality Index to measure sleep quality.

RESULTS

After preliminary screening, 91 male and 6 female participants were found to be multiplayer Internet gamers, and were further assessed using the 14-item IGAS. The Cronbach's alpha of the IGAS was 0.879. Principal component analysis revealed a three-component IGAS structure based on eigenvalue cutoff (>1), loading score >0.4, and inspection of the scree-plot that explained 66.71% of the total variance. The IGAS score and the average weekly gaming time of the participants showed a moderate positive correlation (r = 0.45, P < 0.001). Only 17 (4.0%) participants reported agreement/strong agreement across ≥5 domains of addiction. The mean (standard deviation) IGAS score was significantly higher in the participants reporting poor sleep quality (PQSI > 6) (P = 0.047).

CONCLUSION

IGD has low prevalence among medical students, and the problem is negligible among female students. The 14-item IGAS, in conjunction with the 2-item IGSQ, are reliable and valid tools for the assessment of IGD.