Internet Addiction and COVID-19 Misbeliefs Among Hungarian Online Gamers: A Cross-Sectional Study

Introduction

The internet has become a part of everyday life, and during the COVID-19 pandemic the rate of internet use has raised even higher, which increases the possibility of compulsive and problematic use leading to the acceptance of online misbeliefs and conspiration theories. This cross-sectional study aimed to explore the relationship between COVID-19-related misconceptions and internet addiction among adult recreational online gamers.

Methods

A sample of 1671 recreational video game users completed the online survey (male: n = 1522 (91.08%), mean age = 21.83, SD = 4.18; female: n = 149 (8.91%), mean age = 24.33, SD = 8.38). Demographic questions, risk factors and health-related questions, internet use and addiction were measured alongside a short questionnaire about common COVID-19-related topics, such as its origin and risk of infection.

Results

Out of all participants 248 (14.8%) answered all the COVID-19-related questions properly, thus having no misconceptions, while 545 (32.6%) had one wrong answer, 532 (31.8%) had 2 wrong answers, 251 (15.0%) had 3 wrong answers, 78 (4.7%) had 4 wrong answers and 17 (1.0%) had 5 wrong answers. Significant factors to a higher number of COVID-misconceptions were time spent studying (χ2 (35,1671) = 63.86, p = 0.002), marital status (χ2 (15,1671) = 30.65 p = 0.01) and secondary employment (χ2 (51,671) = 14.88, p = 0.01). Although 17.1% of the participants reached the threshold score for internet addiction, the predictors of COVID-19 misconceptions were marital status (β = -0.06, p = 0.01) and time spent studying (β = 0.05, p = 0.03), while neither daily internet use, internet addiction scores or risk factors predicted these misconceptions in a linear regression model.

Discussion

Our study concludes that Internet addiction did not directly influence misconceptions about the COVID-19 pandemic in this population despite the surprisingly high rate of problematic users.

Women's Experiences of Sexual Harassment in Online Gaming

To better understand the types of sexual harassment women experience in online gaming, their labeling of such experiences, and the relationship between the perpetrator and the victim, we surveyed women gamers to inquire about their experiences. Participants were 182 women from North America who played online video games. Overall, 56.6% of participants reported experiencing one or more types of sexual harassment during online gaming. Additionally, 45.6% of participants reported witnessing one or more types of sexual harassment perpetrated against other women. About half (50.5%) of participants who had experienced harassment labeled their own experiences as "sexual harassment," and 42.2% labeled the behaviors that they witnessed against someone else as "sexual harassment." Results speak to the need for prevention interventions to protect women gamers.

Practical psychiatry: Taking gaming seriously - a primer for psychiatrists on gamers and gaming culture

OBJECTIVE

Up to three billion, of the eight billion people in the world, play videogames. Gaming is a significant global sociocultural influence. This primer will aid psychiatrists in understanding sociocultural milieux of gamers, who include patients and their communities.

METHOD

A rapid narrative review.

RESULTS

Benefits include expression of personality, identity and culture through social aspects of gaming. Improved physical health, neurocognition, self-efficacy and quality of life are associated with gaming in those with certain mental health disorders including schizophrenia. Harms may include in-game discrimination, disordered gaming, as well as encouragement of online gambling. There is no longitudinal association between violent games and youth aggression.

CONCLUSIONS

Psychiatrists should enquire about gaming as part of the sociocultural milieux of patients' lives, and the perceived mental health benefits and harms of gaming.

Deep learning(s) in gaming disorder through the user-avatar bond: A longitudinal study using machine learning

Background and aims

Gaming disorder [GD] risk has been associated with the way gamers bond with their visual representation (i.e., avatar) in the game-world. More specifically, a gamer's relationship with their avatar has been shown to provide reliable mental health information about the user in their offline life, such as their current and prospective GD risk, if appropriately decoded.

Methods

To contribute to the paucity of knowledge in this area, 565 gamers (Mage = 29.3 years; SD =10.6) were assessed twice, six months apart, using the User-Avatar-Bond Scale (UABS) and the Gaming Disorder Test. A series of tuned and untuned artificial intelligence [AI] classifiers analysed concurrently and prospectively their responses.

Results

Findings showed that AI models learned to accurately and automatically identify GD risk cases, based on gamers' reported UABS score, age, and length of gaming involvement, both concurrently and longitudinally (i.e., six months later). Random forests outperformed all other AIs, while avatar immersion was shown to be the strongest training predictor.

Conclusion

Study outcomes demonstrated that the user-avatar bond can be translated into accurate, concurrent and future GD risk predictions using trained AI classifiers. Assessment, prevention, and practice implications are discussed in the light of these findings.

Health Economic Evaluation of an Online-Based Motivational Program to Reduce Problematic Media Use and Promote Treatment Motivation for Internet Use Disorder-Results of the OMPRIS Study

Internet Use Disorders (IUD) have a relevant effect on national economies. In the randomized, controlled, multicenter, prospective, and single-blinded OMPRIS study (pre-registration number DRKS00019925; Innovation Fund of the Joint Federal Committee of Germany, grant number 01VSF18043), a four-week online program to reduce media addiction symptoms, was evaluated for cost-effectiveness. The intervention group (IG) was compared to a waiting control group (WCG) from German statutory health insurance (SHI) and a societal perspective. Resource use, namely indirect and direct (non) medical costs, was assessed by a standardized questionnaire at baseline and after the intervention. Additionally, intervention costs were calculated. Determining the Reliable Change Index (RCI) based on the primary outcome, assessed by the "Scale for the Assessment of Internet and Computer Game Addiction" (AICA-S), individuals with and without reliable change (RC) were distinguished. The incremental cost-effectiveness ratio was calculated using the difference-in-difference approach. There were 169 (IG n = 81, WCG n = 88) persons included in the analysis. The mean age was 31.9 (SD 12.1) years. A total of 75.1% were male, and 1.8% diverse. A total of 65% (IG) and 27% (WCG) had an RC. The cost per person with RC was about EUR 860 (SHI) and EUR 1110 (society). The intervention leads to an improvement of media addiction symptoms at moderate additional costs.

online gaming

Although there is ample literature available on toxicity in games, as there is regarding trolling on social media, there are few to no cross-platform studies on toxicity and trolling. In other words, the extant literature focuses on one platform at a time instead of comparing and contrasting them. The present work aims to rectify this gap by analyzing interviews from a larger study of 22 self-proclaimed victims of in-game trolling to not only determine whether social media or gaming communities are considered more toxic but also to explore how definitions of the word 'trolling' change depending on the platform in question. We found that while definitions of in-game trolling behavior focused on behavioral styles of trolling (e.g., throwing one's avatar into enemy fire to disadvantage one's team, and blocking other players' avatars' movement), social media trolling is defined by more sinister actions such as misinformation spreading and 'canceling' other users. We also found that gaming is perceived as generally more toxic than social media, often due to company policies or lack thereof. Practical and theoretical implications for the study of toxicity in all online communities - gaming or social-media based - are discussed.

E-sports: What mental health professionals from low & middle-income countries must know

'E-sports' refers to organized videogames. As the number of online gamers and interest in esports continue to rise in low and middle-income countries, mental health professionals need to be aware of their possible psychological and clinical implications. Only a small fraction of esports players present with gaming addiction, but a relatively larger proportion with subtle impairment impacting domains such as self-esteem, performance-related issues, family conflict, sleep-related issues or physical health. An adequate knowledge of esports, its concept, origins, genre and current status should equip mental health professionals in developing a good rapport with these young clients and correctly evaluate them. This review provides an overview of esports and how it pertains to mental health professionals.

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

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

Is Increased Video Game Participation Associated With Reduced Sense of Loneliness? A Systematic Review and Meta-Analysis

The purpose of this systematic review was to evaluate the existing evidence in literature addressing the relationship between video game participation and loneliness. The following databases were searched on October 2, 2021: Medline, Psychinfo, SportDiscus, Web of Science, and CINAHL. The risk of bias of cross-sectional study was assessed by using the Joanna Briggs Institute (JBI) critical appraisal checklist for analytical cross-sectional studies with attrition bias added for longitudinal studies. The results of all included studies were synthesized using narrative synthesis. Meta-analysis was utilized to synthesis the findings of the studies that had sufficient degree of statistical and methodological homogeneity. Eighteen studies were included in this systematic review, which comprised of 20,372 participants. The narrative synthesis showed mixed findings on the relationship between video game participation and loneliness. Meta-analysis that was conducted to nine cross-sectional studies revealed that video game participation was positively and weakly associated with loneliness (r = 0.10, 95% CI = 0.03-0.17). Both cross-sectional and longitudinal studies demonstrated serious risk of bias with the addition of serious inconsistency of findings from cross-sectional studies. The existing literature is equivocal in terms of making a definitive judgment on the association between video game participation and loneliness. PROSPERO registration number: CRD42021283025. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021283025.

Smart and Adaptive Architecture for a Dedicated Internet of Things Network Comprised of Diverse Entities: A Proposal and Evaluation

Advances in 5G and the Internet of Things (IoT) have to cater to the diverse and varying needs of different stakeholders, devices, sensors, applications, networks, and access technologies that come together for a dedicated IoT network for a synergistic purpose. Therefore, there is a need for a solution that can assimilate the various requirements and policies to dynamically and intelligently orchestrate them in the dedicated IoT network. Thus we identify and describe a representative industry-relevant use case for such a smart and adaptive environment through interviews with experts from a leading telecommunication vendor. We further propose and evaluate candidate architectures to achieve dynamic and intelligent orchestration in such a smart environment using a systematic approach for architecture design and by engaging six senior domain and IoT experts. The candidate architecture with an adaptive and intelligent element ("Smart AAA agent") was found superior for modifiability, scalability, and performance in the assessments. This architecture also explores the enhanced role of authentication, authorization, and accounting (AAA) and makes the base for complete orchestration. The results indicate that the proposed architecture can meet the requirements for a dedicated IoT network, which may be used in further research or as a reference for industry solutions.

Sex Differences in Competitiveness in Massively Multiplayer Online Role-Playing Games (MMORPGs)

Sex differences in the use of competitive tactics have been well established. Although many factors may contribute to these sex differences, according to social role theory (SRT), stereotypes and expectations about men's and women's typical social roles are crucial. We addressed the potential impact of social roles by studying massively multiplayer online role-playing games (MMORPGs), a setting where individuals represent themselves with avatars and thus enjoy the opportunity to compete without regard to the typical expectations and behaviors associated with men's and women's roles. We surveyed players via MTurk (63 women, 191 men) and Reddit (166 women, 1,326 men) regarding their frequency of engaging in five competitive behaviors and the sex and role of their primary avatar. As expected, there were reliable sex differences in competitiveness: men were more likely than women to engage in player-versus-player duels (MTurk d = 0.19; Reddit d = 0.51), do solo runs of difficult content (0.30, 0.35), and work to acquire expensive items (0.32, 0.19); women were more likely than men to seek in-game awards (-0.38, -0.36) and spend real-world money on expensive microtransactions (-0.16, -0.27). Contrary to SRT, these sex differences in forms of competitive behavior were generally unrelated to players' chosen avatar sex or avatar role. These results instead indicate that sex differences in competitiveness largely reflect evolved predispositions.

The Associations Between Gaming Motivation and Internet Gaming Disorder: Systematic Review and Meta-analysis

BACKGROUND

There has been a surge in interest in examining internet gaming disorder (IGD) and its associations with gaming motivation. Three broad components of gaming motivation have been proposed: achievement, immersion, and social. Achievement-oriented players are motivated by gaining in-game rewards, immersion-oriented players are motivated by the experience of immersion in the virtual world, and social-oriented players are motivated by the need to socialize with other players through gaming.

OBJECTIVE

This study aimed to (1) quantitatively synthesize the growing body of literature to systematically examine the discrepancies in the magnitude of associations between various components of gaming motivation and IGD and (2) examine the moderating role of cultural dimension on the association between escapism gaming motivation and IGD.

METHODS

We conducted a systematic search of multiple databases between 2002 and 2020. Studies were included if they (1) included quantitative data, (2) used measures assessing both gaming motivation and IGD, and (3) contained sufficient information for effect size calculation.

RESULTS

The findings revealed IGD to have a stronger association with achievement motivation (r=0.32) than with immersion (r=0.22) or social motivation (r=0.20), but the strongest such association was found to be with escapism motivation (r=0.40), a subcomponent of immersion motivation. Our cross-cultural comparison further showed a stronger association between escapism motivation and IGD in studies conducted in individualistic (vs collectivistic) regions.

CONCLUSIONS

This meta-analysis highlights the importance of acknowledging the discrepancies among different components of gaming motivation with respect to their role in the development of IGD, as well as the potential cultural variations in the strength of such associations.

Corrigendum: Problematic Use of Alcohol and Online Gaming as Coping Strategies During the COVID-19 Pandemic: A Mini Review

[This corrects the article DOI: 10.3389/fpsyt.2021.685964.].

context

Online gaming has become an important practice for several audiences in the last decade. Video games like Fortnite and League of Legends are played by millions of people daily, raising concerns about both addiction and disruptive attitudes. Several analytical instruments have been deployed for exploring this phenomenon, including the Metacognitions about Online Gaming Scale (MOGS). MOGS measures the role of metacognitions toward online gaming, echoing the increasing importance of such a construct in media consumption and perception. This article presents the highlights of a study involving 690 American gamers aimed at two purposes. First, the MOGS was validated for with U.S. gamers, who represent a leading niche in the current digital entertainment and were not involved with the original MOGS development. Second, the three subscales of MOGS were analyzed as mediators of the relationship between hours spent playing online gaming and Internet Gaming Disorder (IGD). The results from Confirmatory Factor Analysis suggested the MOGS has promising reliability and validity for use with U.S. gamers. The results also indicated that three subscales of the MOGS partially mediated the relationship between hours spent on playing online gaming and Internet Gaming Disorder.

The Big Five personality traits and online gaming: A systematic review and meta-analysis

Online gaming has become an essential form of entertainment with the advent of technology and a large sway of research has been undertaken to understand its various permutations. Previous reviews have identified associations between the Big Five personality traits and online gaming, but a systematic review and meta-analysis on the association between these constructs has yet to be undertaken. In the current study we aimed to fill this gap in the literature through a systematic review and meta-analysis comprising of 17 studies and 25,634 individuals (AgeMean = 26.55, males = 75%). The findings showed that agreeableness, extraversion, openness to experience, and neuroticism were not ubiquitously associated with online gaming. The findings showed that only conscientiousness, across samples, had a protective role in online gaming. Furthermore, there were non-significant variations in the Big Five personality traits associations with online gaming when comparing gamers to the general population, younger versus older participants, casual versus 'hardcore' gamers, and high versus low traits (with the exception of neuroticism). As a result of our observations, the underlying mechanisms of individual differences in online gaming remain unclear. Limitations and future directions for research are discussed.

Psychosocial Adjustment and Mental Distress Associated With In-Game Purchases Among Japanese Junior High School Students

In-game purchases, including microtransactions and loot box spending, are the monetization systems of free-to-play online games. Although some studies have suggested that excessive in-game purchases increase the risk of psychosocial maladjustment and mental distress as well as predict future problematic gaming and gambling practices, empirical studies on problematic behavioral patterns related to in-game purchasing among adolescents are lacking. This study sought to explore whether knowing the style of in-game purchases (non-purchase, planned purchase, or unplanned purchase) could be useful when characterizing maladaptive behavior among adolescents from the perspective of psychosocial adjustment and mental distress. A total of 335 junior high school students (aged 12–15 years) participated in the survey and completed a questionnaire assessing daily online gaming usage, in-game purchases, psychosocial adjustment, and mental distress. The results showed that (1) 30.7% of students had previously made in-game purchases, and at least 14.0% had made unplanned in-game purchases; (2) 19.2% of the users who had made unplanned purchases had spent greater than or equal to their actual monthly allowance within the past month, and (3) unplanned purchase gamers exhibited more behavioral problems and peer problems regarding psychosocial adjustment compared to planned purchase gamers, and more overall difficulties compared to non-purchasers. Meanwhile, more hyperactivity/inattention was seen among in-game purchasers compared to non-purchasers, regardless of whether the purchase was planned or unplanned. These findings support that understanding whether adolescents make unplanned in-game purchases could be a useful approach to describing the characteristics of online gamers with maladaptive tendencies.

Risk and Protective Factors for Frequent Electronic Device Use of Online Technologies

A sample of 10,460 U.S. elementary schoolchildren was analyzed to identify early predictors of frequent use of online technologies (i.e., messaging, online gaming, and social networking). Children (Mage  = 67.44 months) at greater risk displayed more externalizing problem behaviors in kindergarten (messaging OR = 1.11; online gaming OR = 1.21; social networking OR = 1.12) or were Black (messaging OR = 1.65; online gaming OR = 1.64; social networking OR = 1.68). Children from higher-income families were at lower risk (online gaming OR = 0.89; social networking OR = 0.89). Boys were more frequent users of online gaming (OR = 3.35) but less frequent users of messaging (OR = 0.62) and social networking (OR = 0.80). Protective factors included specific parenting behaviors.

Young people who purchase loot boxes are more likely to have gambling problems: An online survey of adolescents and young adults living in NSW Australia

BACKGROUND AND AIMS

Loot boxes are a common feature in video games where players win, buy or are gifted a virtual box or other container that is unwrapped to reveal virtual items of value, such as skins, weapons, in-game currency or special abilities. The current study aimed to relate the use of loot boxes to gambling problems and harm.

METHODS

An online survey was conducted with 1,954 adolescents and young adults from NSW Australia, 59.9% female (aged 12-24), recruited by online panel aggregator, Qualtrics.

RESULTS

Buying and selling loot boxes was associated with higher 12-month gambling frequency and gambling problems in young adults, aged 18-24 (Problem Gambling Severity Index). Young adults who bought loot boxes additionally had more gambling-related harms (Short Gambling Harms Screen). Young women, aged 18-24, who opened, bought and/or sold loot boxes spent more money in the last 12 months on gambling. In adolescents, aged 12-17, buying loot boxes was similarly associated with gambling problems (DSM-IV-MR-J). Furthermore, adolescent girls who bought and/or sold loot boxes viewed gambling more positively than other girls (Attitudes Towards Gambling Scale). There was no evidence, however, that longer-term experience in opening or purchasing loot boxes, a differentiating feature of the survey, is associated with current gambling problems.

DISCUSSION AND CONCLUSIONS

This study suggests that loot boxes may be attractive to people who are already predisposed to engage in other gambling, and females who use loot boxes may have unique vulnerabilities to gambling problems that could be explored in future research.

Online Gaming and Prolonged Self-Isolation: Evidence from Italian Gamers During the Covid-19 Outbreak

OBJECTIVE

The self-isolation measures employed during the COVID-19 pandemic made it dificult for basic needs to be met, thus increasing emotional distress. It has been suggested that socially meaningful online gaming bufered emotional distress during the lockdown. This study aimed to test the protective effect of online gaming during the lockdown and to investigate the diferences between highly involved gamers (those who play videogames intensely without adverse consequences) and problematic gamers in this regard.

METHOD

Capitalizing on a data collection that started before the pandemic, we adopted a cross-sectional between-groups study design in which gaming patterns, gaming-related variables and levels of emotional distress were compared between a pre-COVID group (N=298) and a COVID group (N=366).

RESULTS

Compared to the pre-COVID group, high involvement in gaming was more prominent and emotional distress was decreased in the COVID group. Moderated regression analyses further revealed that the interaction between social compensation via gaming and highly involved gaming was associated with lower levels of emotional distress in the COVID-19 group. In contrast, the interaction between gaming-related relaxation and problematic gaming predicted higher emotional distress in the COVID-19 group.

CONCLUSIONS

This study suggests that gaming for social compensation might mitigate the experienced emotional distress during pandemic related self-isolation, whereas maladaptive gaming patterns could constitute a vulnerability factor deserving clinical attention.

Problematic Use of Alcohol and Online Gaming as Coping Strategies During the COVID-19 Pandemic: A Mini Review

The COVID-19 (coronavirus disease 2019) pandemic has dramatically changed our daily lives and activities, including those originally intended to serve for leisure and pleasure. Drinking and online gaming became coping behaviors used to rescue ourselves from the stress and restricted lifestyle during the COVID-19 pandemic. However, frequent drinking and gaming can result in the pathological consequences of addiction. Those affected use the stimuli not to obtain pleasure, but rather to avoid the displeasure induced by stress and previous use, often unsuccessfully. This review aims to provide an overview of recent longitudinal cohort studies on alcohol and gaming use during the COVID-19 pandemic, as well as to analyze how the pandemic has affected alcohol and gaming use. There was a substantial risk of alcohol and online gaming overuse during the lockdown, which may depend on the pandemic's duration or overuse patterns. Previous studies have shown that increased alcohol consumption and online gaming are associated with heightened stress and anxiety levels caused by social isolation/quarantine. Over time, frequent or excessive alcohol consumption and gaming could lead to an increased risk of more serious mental health problems. Every effort should be made to mitigate mental health problems and ensure adequate adaptation to these exceptional circumstances. Therefore, it would be helpful to encourage physical activity, social interaction, and collaboration to facilitate psychological and physical health.

Gaming Disorder and Well-Being Among Emirati College Women

Background: The present study examined Internet Gaming Disorder (IGD) and depressive symptom levels among a predominantly female sample of college students from the United Arab Emirates (UAE). Methods: IGD was assessed among two successive cohorts of students at the beginning of the academic year in 2016 and 2019, respectively. All participants (n = 412) completed the Internet Gaming Disorder Scale - Short-Form (IGDS9-SF) and the WHO-5 Well-being Index (WHO-5), a tool widely used for the screening and assessment of depressive symptomatology. Results: Mean IGDS9-SF scores (15.85, SD = 6.40) were fairly similar to those observed in other nations. The prevalence of IGD was 1.45%, based on the stringent cut-off score (> = 40). Prevalence of IGD rose to 18.20% when using the less stringent cut-off (> = 21). There was an increase in the rate of IGD between 2016 and 2019, although not statistically significant. Higher IGDS9-SF scores were associated with greater depressive symptomatology; those scoring above the less stringent IGD cut-off had a greater likelihood of screening positive for depression OR = 2.28, 95% CI (1.176-4.428). Conclusions: This study provides insights about IGD among a predominantly female Arab population, finding a correlation with mood disorder symptomatology and suggesting an increase in problematic gaming over time. The results are discussed with reference to the mood repair hypothesis and the possibility of IGD being a dual disorder. The association with depressive symptoms is also discussed in light of the neurobiology of addictive behaviors and sexual dimorphism.

Perceived problems with adolescent online gaming: National differences and correlations with substance use

BACKGROUND

Not much is known about the correlation between gaming problems and substance use across different countries. This paper presents cross-national analyses of different gaming indicators and their relationship to substance use.

METHODS

Based on data from the 2015 ESPAD study, differences in the relationship between gaming and substance use across 35 countries were analysed using multi-level logistic regression, using substance use as an individual level predictor, economic wealth as a country-level predictor and a combined problem gaming indicator as the outcome.

RESULTS

Multi-level logistic regressions revealed significant correlations between individual substance use and gaming problems, which varied across countries and were moderated by economic wealth. Students who used alcohol, tobacco or cannabis and who lived in high-income countries had a smaller risk of scoring positively on a combined problem gaming indicator than students who used alcohol, tobacco or cannabis and who lived in less prosperous countries.

DISCUSSION

Different gaming indicators varied substantially across countries, with self-perceived gaming problems being more common in countries with a low prevalence of gaming. Significant cross-level effects demonstrate the need to take the societal context into account when the relationship between problem gaming and substance use is analysed. Prevention measures need to take the fact into account that patterns of substance use among problem gamers vary across countries.

Psychometric Properties of the Nine-Item Korean Internet Gaming Disorder Scale: Short Form

The main objective of this study was to examine the psychometric properties of the Korean version of the Internet Gaming Disorder Scale-Short Form (K-IGDS9-SF), a brief self-report instrument developed to assess Internet gaming disorder (IGD) in accordance with the Diagnostic and Statistical Manual of Mental Disorders-5th edition criteria. A total of 594 Korean game users (average age = 23.5 years, 70.37 percent male) participated and completed questionnaires containing the K-IGDS9-SF and other measures for its validation. The K-IGDS9-SF showed good reliability (Cronbach's α = 0.86, composite reliability coefficient = 0.87). Consistent with previous studies, the K-IGDS9-SF demonstrated a single-factor structure in a confirmatory factor analysis. Moreover, the K-IGDS9-SF had significant associations with related variables (IGD, game playing variables, self-esteem, impulsivity, and loneliness) in the expected direction, supporting its concurrent, criterion, and convergent validity. Taken together, these results indicated that the K-IGDS9-SF has satisfactory psychometric properties, suggesting its utility as a unified robust instrument for studying IGD worldwide.

The psychometric properties of the Revised Illness Perception Questionnaire (IPQ-R) regarding Internet gaming disorder in a general population of Chinese adults

BACKGROUND AND AIMS

Internet gaming disorder (IGD) has been recognized as a mental illness. Cognitive and emotional illness representations affect coping and health outcomes. Very little is known about such perceptions related to IGD, in both general and diseased populations. This study examined the psychometric properties of the Revised Illness Perception Questionnaire (IPQ-R) for IGD in a general population that included mostly non-cases while a small proportion of the sample was IGD cases.

METHODS

An anonymous cross-sectional telephone survey was conducted in a random sample of 1,501 Chinese community-dwelling adults (41.3% male; mean age = 40.42, SD = 16.85) in Macao, China.

RESULTS

The confirmatory factor analysis identified a modified 6-factor model (i.e., timeline cyclical, consequences, personal control, treatment control, illness coherence, and emotional representations) of 26 items that showed satisfactory model fit and internal consistency. Criterion-related validity was supported by the constructs' significant correlations with stigma (positive correlations: timeline cyclical, consequence, emotional representations; negative correlations: illness coherence). Ever-gamers, compared to never-gamers, reported higher mean scores in the subscales of personal control and illness coherence, and lower mean scores in time cyclical, consequence, and emotional representations. Among the sampled gamers, probable IGD cases were more likely than non-IGD cases to perceive IGD as cyclical and involved more negative emotions.

CONCLUSIONS

This study shows that the revised 26-item version of IPQ-R is a valid instrument for assessing illness representation regarding IGD in a general population of Chinese adults. It can be used in future research that examines factors of incidence and prevention related to IGD.

Psychometric Evaluation and Comparison of Two Gaming Disorder Measures Derived From the DSM-5 and ICD-11 Frameworks

Gaming disorder was listed as a condition for further study in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013, and measures of the disorder have mushroomed in the years since. The Gaming Disorder Test (GDT) was developed after gaming disorder was officially included in the 11th Revision of the International Classification of Diseases (ICD-11) in 2018. However, it remains unknown whether the GDT, which is based on the ICD-11 framework, is psychometrically similar to or different from the popular nine-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF) based on the DSM-5 framework. To address this important but unexplored issue, the present study evaluated and compared the psychometric properties of the GDT and IGDS9-SF in a sample of 544 adult gamers (56.2% men; mean age = 28.8, SD = 8.55). The results revealed both measures to have good reliability, structural validity, and criterion validity, with the exception of one IGDS9-SF item with a low factor loading. Moreover, the IGDS9-SF exhibited scalar measurement invariance for gender and age but only partial metric invariance for employment status, whereas the GDT exhibited scalar measurement invariance for all three demographic characteristics. Finally, the GDT displayed incremental validity over the IGDS9-SF in explaining gaming time, but not social anxiety and depressive symptoms. This study thus contributes to the literature by comparing measures derived from distinct gaming disorder diagnostic frameworks empirically. Recommendations for the selection of gaming disorder measures by researchers and practitioners are discussed.

Online gaming and gaming disorder: more than just a trivial pursuit

Gaming disorder is set to be included in the International Statistical Classification of Diseases and Related Health Problems alongside other behavioural addictions (gambling disorder) and substance-related addictions. Given the popularity of online gaming, this is set to become an increasingly common presentation to general mental health professionals, addiction specialists, and general practitioners. This article briefly examines online gaming and describes the characteristics of gaming disorder. Some features of online gaming that have addictive potential and similarities to other addictive behaviours such as gambling disorder are discussed. Finally, the article examines treatment options available for gaming disorder and treatment going forward from an Irish perspective.

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.

The interplay among stress, frustration tolerance, mindfulness, and social support in Internet gaming disorder symptoms among Chinese working adults

INTRODUCTION

Internet gaming disorder (IGD) is a growing mental health threat across age groups, but existing literature regarding IGD mainly focuses on student populations. Empirical investigation of the risk and protective factors in adult populations is warranted. This study aimed to fill the research gap by examining whether stress and 3 positive psychology factors (ie, frustration tolerance, mindfulness, and social support) are associated with IGD symptoms in working adults. It was also the first attempt to test the buffering effects of these positive psychology factors on the relationship between stress and IGD vulnerability.

METHOD

This cross-sectional study was conducted in Shenzhen, China. We recruited 327 full-time working Chinese adults (mean age = 31.93 years), who had online gaming experience and voluntarily completed an anonymous questionnaire with DSM-5 criteria to measure their IGD symptoms.

RESULTS

Internet gaming disorder symptoms were positively correlated with stress and negatively correlated with the 3 positive psychology factors, among which mindfulness emerged as the most salient protective factor. Moreover, mindfulness, but not frustration tolerance and social support, was found to significantly alleviate the relationship between stress and IGD.

DISCUSSION

Our findings provide supportive evidence for the protective and moderating roles of positive psychology variables against IGD among Chinese working adults. Workplace-based prevention programs may take the identified factors into account to help promote individuals' personal resources to mitigate development of IGD.

Brain responses during strategic online gaming of varying proficiencies: Implications for better gaming

BACKGROUND

Online gaming is a complex and competitive activity. However, little attention has been paid to brain activities relating to gaming proficiency.

METHODS

In the current study, fMRI data were obtained from 70 subjects while they were playing online games. Based on their playing, we selected 24 clips from each subject for three levels of gaming proficiency (good, poor, and average), with each clip lasting for 8 seconds.

RESULTS

When comparing the brain responses during the three conditions, good-play trials, relative to poor- or average-play trials, were associated with greater activation of the declive, postcentral gyrus, and striatum. In post-hoc analyses taking the identified clusters as regions of interest to calculate their functional connectivity, activation of the declive during good-play conditions was associated with that in the precentral gyrus and thalamus, and activation in the striatum was associated with that in the inferior frontal gyrus and middle frontal cortex.

CONCLUSIONS

Taken together, findings suggest specific regional brain activations and functional connectivity patterns involving brain regions and circuits involved in sensory, motor, automatic and executive functioning and their coordination are associated with better gaming. Specifically, for basic functions, such as simple reaction, motor control, and motor coordination, people need to perform them automatically; for highly cognitive functions, such as plan and strategic playing, people need to engage more executive functions in finishing these works. The automatically processed basic functions spare cognitive resources for the highly cognitive functions, which facilitates their gaming behaviors.

Gaming under the influence: An exploratory study

Background and aims Association between substance use and excessive play of online games exists both in theory and research. However, no study to date examined playing online games under the influence of licit and illicit drugs. Methods We questioned a convenient online sample of 3,952 Czech online gamers on their experiences and motives of using caffeine, alcohol, tobacco, psychoactive pharmaceuticals, and illicit drugs while playing massive multiplayer online games (MMOGs). Results The results showed low prevalence of illicit drug use while playing online games. Substance use was positively associated with intensity of gaming and both addiction and engagement; psychoactive substances with stimulating effect were linked to higher engagement and gaming intensity, whereas use of sedatives was associated with higher addiction score. Substance use varied slightly with the preference of game genre. Discussion Drug use while playing appears as behavior, which is mostly not related to gaming - it concerns mostly caffeine, tobacco, alcohol, or cannabis. For some users, however, drug use was fueled by motivations toward improving their cognitive enhancement and gaming performance.

Predictors of excessive use of social media and excessive online gaming in Czech teenagers

Background and aims Young people's involvement in online gaming and the use of social media are increasing rapidly, resulting in a high number of excessive Internet users in recent years. The objective of this paper is to analyze the situation of excessive Internet use among adolescents in the Czech Republic and to reveal determinants of excessive use of social media and excessive online gaming. Methods Data from secondary school students (N = 4,887) were collected within the 2015 European School Survey Project on Alcohol and Other Drugs. Logistic regression models were constructed to describe the individual and familial discriminative factors and the impact of the health risk behavior of (a) excessive users of social media and (b) excessive players of online games. Results The models confirmed important gender-specific distinctions - while girls are more prone to online communication and social media use, online gaming is far more prevalent among boys. The analysis did not indicate an influence of family composition on both the excessive use of social media and on excessive online gaming, and only marginal effects for the type of school attended. We found a connection between the excessive use of social media and binge drinking and an inverse relation between excessive online gaming and daily smoking. Discussion and conclusion The non-existence of significant associations between family environment and excessive Internet use confirmed the general, widespread of this phenomenon across the social and economic strata of the teenage population, indicating a need for further studies on the topic.

Prevalence and Risk Factors of Internet Addiction Among Employed Adults in Japan

Background

The prevalence of Internet addiction (IA) among employed adults has not been reported using a large sample. To clarify the actual status of addictive Internet use among employed adults, this study aimed to evaluate the prevalence and the risk factors of IA and at-risk IA among employed adults in Japan.

Methods

This cross-sectional study surveyed all junior and senior high school personnel in Shimane Prefecture, a rural area in Japan. Eligible participants included 3,211 junior and senior high school personnel (1,259 men and 1,952 women). Participants completed a questionnaire on their activities and factors related to Internet use.

Results

The prevalence of IA and at-risk IA was 0.03% and 4.82%, respectively. Furthermore, game playing was shown to be the Internet activity most closely associated with at-risk IA.

Conclusions

This study showed that around 5% of school personnel in a rural area in Japan are at risk for developing addiction to the Internet and that using the Internet for game playing is related to at-risk IA. Our results suggest that employed adults should be instructed to use the Internet properly.

The Connection Between Introversion/Extraversion and Social Capital Outcomes of Playing World of Warcraft

Some studies indicated that playing online games yields a "rich-get-richer effect" and is especially socially beneficial for extraverted players, while other authors argue that online gaming could have compensational effects for introverted players. The current survey study (N = 409) investigates the connection between introversion/extraversion and social capital outcomes of playing the popular role-playing game World of Warcraft and shows that the rich-get-richer and the compensation perspective are not mutually exclusive. Path analysis revealed that extraverted players communicated and self-disclosed more extensively, more often engaged in team play, and, hence, had better chances to build up social capital than introverts. However, at least some of the introverted players used the game for social compensation. These players chose a more social playing style, which increased their chances to acquire social capital. The results demonstrate that the group of introverted players is more heterogeneous than previously thought and that the links between personality aspects and social outcomes of playing are quite complex and rather indirect than direct.

Internet Gaming Disorder and Well-Being: A Scale Validation

The overuse of online games is known to be inversely related to various indicators of well-being. This article validates the DSM-5 criteria of internet gaming disorder (IGD), and analyzes its links with five indicators of well-being: life satisfaction, loneliness, anxiety, depression, and academic performance in a French-speaking sample of 693 gamers. Exploratory and confirmatory factor analyses showed a one-factor structure of IGD criteria. The IGD scale showed satisfactory validity and reliability and was related in a consistent way with well-being measures. The IGD scale appears to be an appropriate measure to assess video game addiction and will contribute to increase the comparability of international research on video game addiction.

Altered Autonomic Functions and Distressed Personality Traits in Male Adolescents with Internet Gaming Addiction

Internet gaming addiction (IGA) has been associated with many negative health outcomes, especially for youth; however, few studies have examined the physiological parameters and personality features related to this addiction. This study aimed to identify differences in autonomic functions and distressed (type D) personality traits among Korean adolescent males with and without IGA. In a cross-sectional study, 68 adolescent males were recruited in a Korean city using convenience and snowball sampling methods. For each subject, heart rate variability (HRV) parameters were measured as autonomic functions and questionnaires were used to identify IGA and type D personality traits. Data were analyzed using descriptive analyses, t tests, χ² tests, and Pearson's correlation. Most HRV parameters significantly differed between the IGA and non-IGA groups (all p < 0.05). Type D personality total and subscale scores, including those for negative affectivity (NA) and social inhibition, were significantly higher in the IGA group (all p < 0.001). Of the 68 subjects, 46 were classified as having type D personality, with nearly twice as many in the IGA group as in the non-IGA group (p = 0.002). Type D personality total scores negatively correlated with the logarithmic value of total power and low frequency among the HRV parameters (both p < 0.05). Results showed that excessive Internet gaming was related to alterations in autonomic functions and distressed personality traits in male adolescents. These findings provide further understanding of the IGA phenomenon and highlight the need for interventions that address male adolescents with IGA.

Effectiveness of atomoxetine and methylphenidate for problematic online gaming in adolescents with attention deficit hyperactivity disorder

OBJECTIVE

There is a high prevalence of problematic online gaming in adolescents with attention deficit hyperactivity disorder (ADHD). In the current study, we compared the effectiveness of atomoxetine (ATM) and methylphenidate (MPH) on problematic online gaming in adolescents with ADHD.

METHODS

We recruited 86 adolescents diagnosed with ADHD together with Internet gaming disorder. These participants were divided into two treatment groups: 44 participants were treated with MPH for 12 weeks, and 42 participants were treated with ATM for 12 weeks.

RESULTS

During the 3-month study period, the MPH group showed greater improvement in Korean ADHD rating scale scores than the ATM group. The ATM group showed greater improvement in Child Depression Inventory scores than the MPH group. However, Young Internet Addiction Scale and Behavioral Inhibition & Activation Scales score changes did not differ significantly between the MPH and ATM groups. In both groups, changes in Young Internet Addiction Scale scores were positively correlated with the changes in Behavioral Inhibition & Activation Scales scores.

CONCLUSIONS

Both MPH and ATM reduced the severity of Internet gaming disorder symptoms, and this reduction was correlated with impulsivity reduction, which also resulted from both ADHD medications. These findings suggest impulsivity plays a critical role in the development of problematic online gaming.

Video Game Use in the Treatment of Amblyopia: Weighing the Risks of Addiction

Video games have surged in popularity due to their entertainment factor and, with recent innovation, their use in health care. This review explores the dual facets of video games in treating vision impairment in amblyopia as well as their potential for overuse and addiction. Specifically, this review examines video game addiction from a biopsychosocial perspective and relates the addictive qualities of video games with their use as a therapeutic treatment for amblyopia. Current literature supports both the identification of video game addiction as a disease, as well as the therapeutic potential of video games in clinical trials. We show the need for clinicians to be aware of the dangers associated with video game overuse and the need for future studies to examine the risks associated with their health care benefits.

College students with Internet addiction decrease fewer Behavior Inhibition Scale and Behavior Approach Scale when getting online

INTRODUCTION

The aim of the study is to compare the reinforcement sensitivity between online and offline interaction. The effect of gender, Internet addiction, depression, and online gaming on the difference of reinforcement sensitivity between online and offline were also evaluated.

METHODS

The subjects were 2,258 college students (1,066 men and 1,192 women). They completed the Behavior Inhibition Scale and Behavior Approach Scale (BIS/BAS) according to their experience online or offline. Internet addiction, depression, and Internet activity type were evaluated simultaneously.

RESULTS

The results showed that reinforcement sensitivity was lower when interacting online than when interacting offline. College students with Internet addiction decrease fewer score on BIS and BAS after getting online than did others. The higher reward and aversion sensitivity are associated with the risk of Internet addiction.

DISCUSSION

The fun seeking online might contribute to the maintenance of Internet addiction. This suggests that reinforcement sensitivity would change after getting online and would contribute to the risk and maintenance of Internet addiction.

A man who collapsed after using the internet

Recognising prolonged seated immobility as a provoking factor in the development of venous thromboembolism can influence management including duration of anticoagulation therapy.