Fatal Cardiac Arrhythmias During Electronic Gaming in Patients With Genetically Mediated Heart Diseases

BACKGROUND

Recently, electronic gaming has been reported as a precipitant of life-threatening cardiac arrhythmias in susceptible individuals. However, the prevalence of cardiac events in genetic heart diseases (GHDs) in the setting of electronic gaming has not been established.

OBJECTIVES

In this study, we sought to define the prevalence of cardiac events occurring in the setting of electronic gaming in GHDs.

METHODS

Retrospective review of all patients evaluated and treated at Mayo Clinic's genetic heart rhythm clinic from July 2000 to November 2022 was performed to identify patients with a history of playing electronic games at the time of their cardiac event. Cardiac event was used to define events occurring before diagnosis, and breakthrough cardiac event (BCE) was used for events occurring after diagnosis.

RESULTS

Of the 3,370 patients with a GHD (mean age at first evaluation 27 ± 19 years, 55% female), 1,079 (32%) had a cardiac event before diagnosis, with 5 patients (0.5%) having an electronic gaming-associated event (3 catecholaminergic polymorphic ventricular tachycardia, 1 long QT syndrome, and 1 premature ventricular contraction-triggered ventricular fibrillation). After diagnosis and treatment, 431 patients (13%) experienced ≥1 BCE during follow-up, of which 1 electronic gaming-associated BCE (0.2%) occurred in a patient with catecholamine-sensitive right outflow tract ventricular tachycardia.

CONCLUSIONS

Although anecdotal cases of electronic gaming-associated life-threatening arrhythmias have been reported, in this largest single-center study to date, we show that these are extremely rare occurrences. While electronic gaming can have adverse health consequences, the threat of electronic gaming-triggered sudden death should not be used to try to curb time spent gaming.

Different types of screen time are associated with low life satisfaction in adolescents across 37 European and North American countries

AIMS

Prolonged screen time (ST) is a potential concern for poor wellbeing. This study aimed to examine the associations of different types of ST with life satisfaction among adolescents.

METHODS

Data were from 380,446 adolescents (aged 11-15 years, 51% girls) across 37 European and North American countries who completed the 2010 and 2014 Health Behaviour in School-Aged Children surveys. Participants reported h/day during free time spent on television, electronic games, and computer/other devices. Life satisfaction was assessed using a 10-point scale (low life satisfaction ⩽5).

RESULTS

Generalized additive modelling showed non-linear associations for each ST type, with low life satisfaction increasing monotonically for >1 h/day of electronic gaming or computer/other device and >2 h/day of watching television. Multilevel multivariable modelling showed that >4 h/day of watching television was associated with 26% higher odds for boys (OR 1.26; 95% CI:1.21-1.32) and 52% higher odds for girls (1.52; 1.46-1.59) of low life satisfaction than for ⩽1 h/day of television. Electronic gaming >4 h/day was associated with low life satisfaction with odds 42% higher in boys (1.42, 1.36-1.48) and 69% higher in girls (1.69, 1.61-1.76). A similar association was found for >4 h/day of computer/other device for boys (1.43, 1.37-1.49) and girls (1.71, 1.65-1.77).

CONCLUSIONS

Low levels of ST may be beneficial; however, prolonged periods are associated with low life satisfaction among adolescents, in particular among girls. Results support ⩽2 h/day restriction of ST and highlight research is needed to understand underlying mechanisms of ST and wellbeing, which may not reflect active versus passive content.

The Relationship Between Electronic Gaming and Health, Social Relationships, and Physical Activity Among Males in Saudi Arabia

Physical and psychological effects of playing computer games cannot be ignored. Electronic games are considered to be an influential factor in growth, personality development, and positive sociability of children, and game duration has been associated with increased aggression, reduced mental health, and higher BMI. The aim of the present study was to explore the relationship between electronic gaming and health, social relationships, and physical activity among males aged 16-18 years in Saudi Arabia. An online survey designed by the authors containing 60 items and divided into 5 sections was used during one school semester. The sample was selected randomly from 30 high schools; 90 students were selected from each school, with 30 chosen from each of grades 9, 10, and 11. Respondents were 194 male students, aged 17.23 ± 1.52 years. The questionnaire was presented to six experts to assess validity, with Cronbach's α established at 0.87. Results showed that playing electronic games had a negative relation with health, social relationships, and physical activity among males. The most negative significant was the correlation between electronic games and physical activity (r = -.49), followed by that with social relationships (r = -.42) and BMI (r = -.31) . The lowest result was for health (r = .20). More empirical investigations are needed to explore deeper effects of electronic gaming on various groups in Saudi society, including the general population, employees, and different categories of school and university students.

Framing Mental Health Within Digital Games: An Exploratory Case Study of Hellblade

BACKGROUND

Researchers and therapists have increasingly turned to digital games for new forms of treatments and interventions for people suffering from a variety of mental health issues. Yet, the depiction of mental illness within digital games typically promotes stigmatized versions of those with mental health concerns. Recently, more games have attempted to implement more realistic and respectful depictions of mental health conditions.

OBJECTIVE

This paper presents an exploratory analysis of a contemporary game that has the potential to change the way researchers, practitioners, and game designers approach topics of mental health within the context of gaming.

METHODS

A case study of Hellblade: Senua's Sacrifice was conducted using frame analysis to show how key design choices for this game present the potential for new ways of approaching games and mental health.

RESULTS

A case study of Hellblade's development shows how research-informed collaborative design with mental health practitioners, scientists, and individuals with mental health problems can lead to a realistic depiction of mental illness in games. Furthermore, the use of frame analysis demonstrates how to harness narrative, mechanics, and technology to create embodied experiences of mental health, which has the potential to promote empathetic understanding.

CONCLUSIONS

This paper highlights an exemplary case of collaborative commercial game design for entertainment purposes in relation to mental health. Understanding the success of Hellblade's depiction of psychosis can improve serious games research and design. Further research must continue to provide deeper analysis of not only games that depict mental illness, but also the design process behind them.

Physical Wellness Among Gaming Adults: Cross-Sectional Study

BACKGROUND

Video and hobby gaming are immensely popular among adults; however, associations between gaming and health have primarily been investigated in children and adolescents. Furthermore, most research has focused on electronic gaming, despite traditional hobby gaming gaining prominence.

OBJECTIVE

To determine whether the number of platforms used, platform preference, and gaming time are associated with obesity, physical activity, sedentary behavior, and cardiovascular risk factors in an adult gaming population.

METHODS

We conducted a cross-sectional analysis using data obtained from 292 participants who attended a large Midwestern gaming convention. We collected data using a computer-based questionnaire that comprised questions on gaming behavior, demographics, physical activity (using the International Physical Activity Questionnaire), and health characteristics. In addition, we used multivariable-adjusted linear and logistic regression to model health outcomes as a function of the number of platforms used, platform preference, and weekday and weekend gaming time quartile.

RESULTS

After adjusting for covariates, we observed a significant linear trend for increasing odds of being obese and higher weekend sitting time by the number of platforms used (P=.03 for both). The platform preference and weekend gaming time quartile exhibited significant associations with odds of meeting physical activity recommendations (P=.047 and P=.03, respectively). In addition, we observed higher odds of being obese among those reporting that they sat most or all of the time while gaming [odds ratio (OR) 2.69 (95% CI 1.14-6.31) and OR 2.71 (95% CI 1.06-6.93), respectively].

CONCLUSIONS

In adult gamers, the number of platforms used, which platforms they prefer to play on, and the amount of time spent gaming on weekends could have significant implications for their odds of being obese and meeting physical activity recommendations.

Sport participation, screen time, and personality trait development during childhood

This investigation explored the contribution of extracurricular sport and screen time viewing (television viewing and electronic gaming) to personality trait stability and change during childhood. Two independent samples of 3,956 young children (age 6) and 3,862 older children (age 10) were taken from the Longitudinal Study of Australian Children. Parent-reported child sport participation, screen time, and personality traits were measured at baseline and again 24 months later. Young children who were more active recorded more of a decrease in introversion, less of a decrease in persistence, and less of an increase in reactivity, than those who were less active. Older children who were more active recorded less of an increase in introversion and more of an increase in persistence than those who were less active. In addition, young children who continued participation in extracurricular sport had greater intra-individual stability of personality for introversion. These finding suggest that an active lifestyle might help to facilitate desirable personality trait stability and change during childhood.