Prevalence of gaming disorder: A meta-analysis

Differences in Screen Addiction in the Past 15 Years

The use of information and communication technologies (ICTs) has become widespread in recent years, leading to an increase in addiction cases. A total of 118 patients who attended the Behavioral Addictions Unit of Consorci Sanitari de Terrassa (Barcelona, Spain) between October 2005 and December 2021 were included in the study. The sample was divided into three groups according to the time period in which they started treatment: between 2005 and 2010 (before the rise in new technologies, named the pre-ICT period), between 2011 and 2019 (a time of major ICT development, named the ICT period) and between 2020 and 2021 (with massive use of the internet due to effects of the pandemic, named the COVID-19 period). We found an increase in the incidence of screen addiction cases related to the development of technology throughout the study years, and this increase was accentuated during the COVID-19 period. This increase was not equal for all types of content consumed via the internet, with patients with video game addiction increasing to a greater extent than patients with internet/social network addiction. In addition, patients with video game addiction were younger and had started gaming at a younger age than those with internet/social network addiction. These results contribute to a better understanding of the phenomenon of technology addiction and to the design of appropriate treatment protocols and preventive programs.

The emerging evidence on the association between symptoms of ADHD and gaming disorder: A systematic review and meta-analysis

The co-existence of gaming disorder (GD) with other mental health problems has been widely reported. Despite the growing research interest in the comorbidity of GD with attention-deficit/hyperactivity disorder (ADHD), to date, no quantitative synthesis has been performed. The present study comprised a systematic literature search using Scopus, Science Direct, Web of Science, and PubMed databases. Three types of studies were included in the analyses: studies reporting (i) correlation coefficients between the symptoms of GD and ADHD, (ii) means, and standard deviations for comparison of GD severity between ADHD/non-ADHD individuals, and (iii) comparison of ADHD severity between GD/non-GD individuals. The results indicated a moderate relationship between GD and ADHD symptom severity when both subdomains of ADHD were combined (r = 0.296), and also when only inattention (r = 0.306) or hyperactivity (r = 0.266) symptoms were analyzed, which was also confirmed in a structural equation model meta-analysis. Studies showed a large average difference comparing the GD symptom severity of ADHD and non-ADHD individuals (g = 0.693), or ADHD symptom severity of GD and non-GD individuals (g = 0.854). In some cases, higher estimates of association were reported among studies that (i) had a higher proportion of males, (ii) assessed problematic internet use among predominantly videogame player samples rather than assessing only GD, and (iii) had been more recently published. The present review shows that this is an emerging field demonstrating significant results in cross-sectional correlational studies. However, future research should apply more rigorous methodologies to investigate the relationship further (e.g., longitudinal studies and studies using professional/clinical ratings and diagnosis). These results suggest that screening and treatment for ADHD among individuals with gaming disorder is necessary, and individuals with ADHD should be made aware of their higher susceptibility to gaming disorder.

The Role of Self-Control Dimensions, Game Motivation, Game Genre, and Game Platforms in Gaming Disorder: Cross-Sectional and Longitudinal Findings

Introduction

Gaming disorder (GD) is the result of an interplay between gaming-related factors, individual factors, and environmental factors. Current research primarily highlights single types of factors. Consequently, the present study simultaneously analyzed the role of individual factors, such as self-control dimensions and motives for gaming, and gaming-related factors, such as game genres, and gaming platforms in GD among female and male gamers. Additionally, the study provides a comprehensive analysis of these factors in relation to GD both cross-sectionally (Study 1) and longitudinally (Study 2).

Methods

Study 1 comprised 620 active gamers (M=22.16 years; SD=2.99), and Study 2 comprised 405 active gamers (M=28.05 years; SD=4.51). The instruments used in the studies included the Gaming Disorder Test, the nine-item Internet Gaming Disorder Short-Form (IGDS9-SF), Motives for Online Gaming Questionnaire, Video Game Questionnaire, and Self-Knowledge New Sheet.

Results

The results showed that GD was associated with (i) self-control deficits associated with difficulties in implementation control and taking actions related to goals without unnecessary delay, (ii) retaining information about intentions and long-term plans, (iii) refraining from immediate, impulsive behavior, and (iv) inhibiting emotional reactions. GD was also associated primarily with escape, coping, and competition motives for gaming. However, the longitudinal study showed that social, fantasy, and skill-development motives were also related to GD development over time. The action game genres associated with GD but were not very important for GD over time. The cross-sectional study results indicated a negative relationship between GD and tablets and consoles used as gaming platforms. However, the longitudinal study showed that desktop computers and consoles use as gaming platforms were associated with the GD over time. Moreover, gaming-related factors explained only 9% of the variance in the GD model among female gamers and only 10% of the variance in the GD model among male gamers in cross-sectional study. In contrast, individual factors such as self-control dimensions and gaming motivation explained 32% of the variance in the GD model among both female and male gamers.

Conclusion

Individual factors, such as self-control dimensions and motives for gaming, were more important in explaining GD than gaming-related factors, such as game genres and gaming platforms. Moreover, self-control deficits and motivation related to escape, coping and competence can be important factors to consider in the prevention and treatment of GD.

Adverse childhood experiences on internet gaming disorder mediated through insomnia in Chinese young people

Background

Adverse childhood experiences (ACEs) have been associated with addictions such as substance use disorders. Few have examined ACEs on internet gaming disorder (IGD) as a newly established behavioral addiction, and the potential mediating role of insomnia remains unclear. We examined the associations between ACE number and types, IGD, and insomnia.

Methods

Participants included 1, 231 Chinese university students (54.5% male; 56.9% aged 18-20 years) who had played internet games at least once in the previous month. ACEs were measured using the 10-item ACE questionnaire (yes/no). Symptoms of insomnia and IGD were measured using the Insomnia Severity Index and the 9-item Internet Gaming Disorder Scale-Short-Form, respectively. Multivariable regressions examined the associations, adjusting for sex, age, maternal and paternal educational attainment, monthly household income, smoking, and alcohol drinking. The mediating role of insomnia symptoms was explored.

Results

The prevalence of ACEs≥1 was 40.0%. Childhood verbal abuse was the most prevalent (17.4%), followed by exposure to domestic violence (17.1%) and childhood physical abuse (15.5%). More ACE numbers showed an association with IGD symptoms (adjusted OR = 1.11, 95% CI 1.04, 1.17). Specifically, IGD symptoms were observed for childhood physical neglect, emotional neglect, sexual abuse, parental divorce or separation, and household substance abuse. Insomnia symptoms mediated the associations of ACE number and types with IGD symptoms (proportion of total effect mediated range 0.23-0.89).

Conclusion

The number and specific types of ACEs showed associations with IGD mediated through insomnia. Screening of ACEs is recommended in future studies on IGD. Longitudinal data are warranted to determine the causality of the observed associations.

Emotion dysregulation and Internet gaming disorder in young people: Mediating effects of negative affect and metacognitions

BACKGROUND

Recent studies have found that emotion dysregulation, negative affect, and metacognitions about online gaming are risk factors for Internet gaming disorder (IGD). However, few studies investigated the mechanisms underlying these interactions. The present study aimed to explore the relationships between emotion dysregulation and IGD, and the mediating effects of negative affect and metacognitions about online gaming.

METHODS

An online survey was conducted with young people (aged 10-24 years) who played video games. 1768 participants were included in this study. Observed variables, including emotion dysregulation, IGD, depression, anxiety, and metacognitions, were measured with self-report scales. Structural equation modeling (SEM) was used to analyze the relationships among the variables.

RESULTS

The results showed that emotion dysregulation positively predicted IGD through a fully mediated model which included the independent mediating effects of negative affect and metacognitions about online gaming and their sequential mediating effect. The model explained 76.1 % of the variance in IGD.

LIMITATIONS

This was a cross-sectional study which could not infer causality.

CONCLUSIONS

This study emphasizes that negative affect and metacognitions about online gaming mediate the effect of emotion dysregulation on IGD; moreover, metacognition may be a proximal factor of IGD. Thus, improving emotional regulation and modifying maladaptive metacognitions in young people may improve the prevention and treatment of IGD.

Effect of online game policy on smartphone game play time, addiction, and emotion in rural adolescents of China

BACKGROUND

Smartphone game addiction has emerged as a major public health problem in China and worldwide. In November 2019 and August 2021, the National Press and Publication Administration of China implemented two increasingly strict policies, as a means of preventing smartphone game addiction in adolescents aged 18 or below. This study aimed to analyze the effect of the policies on smartphone game play time, addiction, and emotion among rural adolescents in China.

METHODS

We sent the questionnaire to rural adolescents through the online survey tool Questionnaire Star, a professional online survey evaluation platform. The questionnaire included demographic data, smartphone use survey, smartphone game addiction and emotion evaluation scales. The Smartphone Addiction Scale-Short Version (SAS-SV) measured adolescents' smartphone game addiction. The Short Version of UPPS-P Impulsive Behavior Scale (SUPPS-P) and Social Anxiety Scale for Children (SASC) measured emotion. According to SAS-SV score, the enrolled rural adolescents were divided into addiction group and non-addiction group. The t-test, Chi-square test, and repeated measure ANOVA assessed the effect of the policies on adolescents' smartphone game addiction and emotion.

RESULTS

Among enrolled 459 rural adolescents with a mean age of 14.36 ± 1.37years, 151 (32.90%) were in the addiction group and 308 (67.10%) were in the non-addiction group. Adolescents in the addiction group were older, more male, and higher grade. There were time and group effects between the two groups in playtime. After a year of policies implementation, the weekly game time dropped from 3.52 ± 1.89 h to 2.63 ± 1.93 h in the addiction group and from 2.71 ± 1.75 h to 2.36 ± 1.73 h in the non-addiction group. There were also time and group effects in SAS-SV and SASC scores, but not for SUPPS-P score. In the addiction group, the SAS-SV score dropped from 41.44 ± 7.45 to 29.58 ± 12.43, which was below the cut-off value for addiction, and the level of social anxiety was consistently higher than non-addiction group.

CONCLUSIONS

The playtime of rural adolescents spent on smartphone games has decreased significantly due to the restriction of the policies rather than the lack of addiction or social anxiety. The policies had practically significant effects in reducing smartphone game play time for rural adolescents in China.

The epidemiology and effects of video game addiction: A systematic review and meta-analysis

With the increasing popularity and accessibility of video games, the public concern about their effects - positive and negative - has also increased. In this regard, this systematic review sought to identify and thematically analyze recent studies (in the last five years) and report on video games' epidemiological characteristics and outcomes. A systematic database search was done on ScienceDirect, APA PsycINFO, Emerald, and Scopus databases for articles published from January 1, 2017, to April 1, 2022. The Meta XL software - an add-in for Microsoft Excel - was used to calculate the pooled prevalence level of video game addiction. The database search yielded a total of 693 non-duplicate articles. After applying the inclusion and exclusion criteria, 27 articles were selected to be included in the systematic review. Along with this, 12 articles were considered for the final meta-analysis. The pooled prevalence level of gaming addiction was 5.0 % (95 % CI, 2.1-8.8 %). The I2 value was 99.297 with a p-value of 0.000. The factors that accompanied addictive video gaming were psychological, social, and personal. An addictive gaming behavior was characterized by spending an above-average time on gaming, doing most of the gaming online, and gaming activities interfering with sleep patterns. Some predictors of addictive gaming were emotional dependence, social detachment, increased gaming time, preference for playing online than offline, and increased emotional and psychological stress. Engaging in addictive gaming led to adverse outcomes such as lower academic scores, depression, and anxiety, as well as decreased self-esteem, life satisfaction, and social support. From the collected findings it could be concluded that extreme playing of video games can be classified as addictive. Following the identification of risk factors, appropriate corrective or interventional measures should be developed and applied coherently to newer statistical data.

Effectiveness of an integrated motivational cognitive-behavioral group intervention for adolescents with gaming disorder: a randomized controlled trial

AIMS, DESIGN AND SETTING

The aim of this study was to test the efficacy of the integrated cognitive-behavioral therapy with a strength-based motivational approach [integrated cognitive-behavioral therapy (ICBT)] intervention to change gaming disorder (GD) symptoms and other outcomes and to study the therapeutic mechanism. A two-arm parallel randomized waiting-list controlled trial with 3- and 6-month follow-ups were conducted in a secondary vocational school in mainland China.

PARTICIPANTS

Participants comprised 77 Chinese adolescents with GD symptoms with a mean age of 16.36 years [standard deviation (SD) = 0.93]; 88.3% were male INTERVENTIONS: Participants were randomized into an ICBT group (n = 38) and a waiting-list control (WLC, n = 39) group. ICBT intervention comprised eight weekly sessions to encourage participants to identify their interests and strengths and set goals for developing personally meaningful real-life activities.

MEASUREMENTS AND FINDINGS

The outcomes were measured at pre-treatment (t0 ), post-treatment (t1 ), 3-month (t2 ) and 6-month (t3 ) follow-ups. The primary outcome was GD symptoms at t3. Secondary outcomes included GD symptoms at t1 and t2 , and gaming motivation, maladaptive gaming cognition, depression and anxiety symptoms at t1 , t2 and t3 . With the intention-to-treat principle, the GD scores at t3 were significantly different between the CBT and WLC groups [mean difference 62.08 (SD = 10.48) versus 73.64 (SD = 11.70); Hedges' g = 1.15, 95% confidence interval = 0.67-1.62]. Linear mixed-effects modeling showed significant group × time interaction for the secondary outcomes (P < 0.01), with a moderate to strong between-group effect size in the reduction in depression symptoms (g = 0.67-0.84) and anxiety symptoms (g = 0.6-0.64). Path analysis shows ICBT leads to GD reduction through reducing gaming motivation and maladaptive gaming cognition.

CONCLUSIONS

An integrated cognitive-behavioral therapy with strength-based motivational approach intervention reduced gaming disorder symptoms and time spent gaming over a 6-month period by decreasing maladaptive gaming motivation and cognition.

Early maladaptive schemas and behavioural addictions: A systematic literature review

As observed in other mental health difficulties, behavioural addiction is a complex construct with several potential predisposing factors, which include biological factors (e.g., genetic predispositions), psychological factors (e.g., personality traits), and social factors (e.g., family, and social history). One factor that may play a significant role in both developing and perpetuating behavioural addiction is the activation of early maladaptive schemas (EMSs). The aim of the present review was to synthesize the evidence concerning the relationship between behavioural addiction and EMSs. A comprehensive literature search using keywords and subject headings was performed with three electronic databases, resulting in 20 studies that met the inclusion criteria. In relation to specific behavioural addiction, the 20 studies examined: binge-eating/food addiction (n = 6), sexual addiction/compulsive sexual behaviours (n = 3), multiple addictive behaviours (n = 2), internet addiction (n = 2), smartphone addiction (n = 2), social networking/Facebook addiction (n = 2), exercise dependence (n = 1), gambling (n = 1), and videogame addiction (n = 1). The patterns of association between EMS and behavioural addiction were examined in both clinical and non-clinical population. The 'Disconnection and Rejection' domain was the most strongly related schema domain across all addictive behaviours, followed by 'Impaired Limits'. The present review suggests a positive relationship between schema activation and several addictive behaviours, including addictions to gambling, gaming, social media use sex, exercise, and food. The clinical implications of the findings are discussed, but further research is needed to inform treatment plans and interventions for those who struggle with behavioural addictions.

Relapse prevention therapy for internet gaming disorder in Swedish child and adolescent psychiatric clinics: a randomized controlled trial

Objectives

To evaluate the effectiveness of relapse prevention (RP) as a treatment for internet gaming disorder (IGD).

Design

Randomized controlled trial.

Setting

Three child and adolescent psychiatry (CAP) units in Region Skåne, Sweden.

Participants

Children aged 13-18 years, coming for their first visit to CAP during 2022, were screened for gaming behavior. Those who met the proposed DSM-5 criteria for IGD were offered participation in the trial, if they had the capacity to provide written informed consent and if they spoke Swedish. A total of 111 CAP patients agreed to participate. Out of those, 11 patients were excluded due to incorrect inclusion such as young age (n = 1), or due to the absence of responses to follow-up measures (n = 9). After exclusion, 102 participants remained (intervention = 47, control = 55).

Interventions

The intervention, RP, is based on cognitive behavioral treatment (CBT) and was provided individually, comprising of five to seven 45-min sessions over a period of 5 to 7 weeks versus treatment as usual.

Outcome measures

Participants were assessed with Game Addiction Scale for Adolescents pre-treatment (GASA) (baseline), post-treatment (treatment group only), and 3 months after baseline (follow-up).

Results

The repeated measures ANOVA showed a significant interaction effect between treatment and time. Both the control group and treatment group lowered their mean GASA score from baseline to follow-up significantly, but the improvement was greater in the treatment group (mean difference in control group -5.1, p < 0.001, 95% CI = - 3.390 to -6.755, mean difference in treatment group -9.9, p < 0.001, 95% CI = -11.746 to -8.105).

Conclusion

RP was found to be superior to treatment as usual in terms of reduction of IGD symptoms. Future research should address which aspects within a given treatment are effective, who benefits from treatment, in what aspects, and why.

Trial registration number

ClinicalTrials.gov, NCT05506384 https://clinicaltrials.gov/ct2/show/NCT05506384.

Lower synaptic density associated with gaming disorder: an 18F-SynVesT-1 PET imaging study

Background

Internet gaming disorder (IGD) is an ideal model to study the mechanisms underlying synaptic deficits in addiction as it eliminates the confounding effects of substance use. Synaptic loss and deficits are hypothesised to underlie the enduring maladaptive behaviours and impaired cognitive function that contribute to IGD.

Aims

This study aimed to determine whether subjects with IGD have lower synaptic density than control subjects and the relationship between synaptic density and IGD severity.

Methods

Eighteen unmedicated subjects diagnosed with current IGD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria and 16 demographically matched healthy controls (HCs) participated in the study and underwent 18F-labelled difluoro-analogue of UCB-J (18F-SynVesT-1) positron emission tomography scans to assess the density of synaptic vesicle glycoprotein 2A (SV2A). The Internet Gaming Disorder Scale-Short Form (IGDS9-SF), Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA), Barratt Impulsiveness Scale Version 11 (BIS-11), Stroop Colour-Word Test (SCWT), stop-signal paradigms and N-back tasks were administered to all subjects.

Results

Patients with IGD had significantly higher scores on the IGDS9-SF, HAMD, HAMA and BIS-11 than HCs. HCs performed better on the two-back and SCWT tests as well as in terms of stop-signal reaction times (SSRTs) in the stop-signal paradigms than patients with IGD. Lower uptake was found in the bilateral putamen, right pregenual anterior cingulate cortex and Rolandic operculum of patients with IGD compared with HCs. Furthermore, in the IGD group, IGDS9-SF scores and daily gaming hours were negatively correlated with the standardised uptake value ratios of 18F-SynVesT-1 in the bilateral putamen. Longer SSRTs were significantly associated with lower SV2A density in the right pregenual anterior cingulate cortex and right Rolandic operculum.

Conclusions

The in vivo results in this study suggest that lower synaptic density contributes to the severity and impairments in inhibitory control of IGD. These findings may provide further incentive to evaluate interventions that restore synaptic transmission and plasticity to treat IGD.

Neuroimaging correlates of internet gaming disorder: Can we achieve the promise of translating understandings of brain functioning into clinical advances?

Objectives

Here we aimed to consider the neural factors associated with internet gaming disorder (IGD), as well as the associations between these factors and existing treatments for the disorder.

Methods

A narrative review was conducted.

Results

Pharmacological as well as psychological treatments for IGD may be associated with specific changes in multiple brain areas and circuits. In particular, fronto-striatal and subcortical regions and pathways appear relevant to IGD and its treatment.

Conclusions

Neuroimaging holds promise for identifying specific mechanisms underlying IGD interventions. However, to date, firm conclusions are difficult to draw and more research examining neural mechanisms of empirically supported treatments for IGD is needed.

Problematic online behaviors and psychopathology in Australia

This study aimed to ascertain frequency rates and predictors of six problematic online behaviors (POBs) in an Australian sample. Participants (N = 1626) completed instruments measuring problematic online gaming, cyberchondria, problematic cybersex, problematic online shopping, problematic use of social networking sites, problematic online gambling, anxiety, depression and attention deficit/hyperactivity disorder (ADHD). Each POB was presumed to be present based on the cut-off score on the corresponding instrument and at least one indicator of interference with functioning. Generalized linear model analyses were used to determine socio-demographic and psychopathological predictors of each POB. The most common POB was problematic online shopping (12.2%), followed by problematic online gambling (11.4%), problematic use of social networking sites (6.0%), problematic cybersex (5.3%), problematic online gaming (5.2%) and cyberchondria (4.6%). Age group 27-36 had the highest rates of POBs. The intensity of ADHD symptoms predicted all POBs, whereas younger age predicted all POBs except for problematic cybersex and online gambling. Female gender predicted lower scores on the measures of problematic online gaming and cybersex. These findings have implications for age- and gender-adapted education, prevention and treatment efforts and suggest that specific POBs should be investigated separately instead of lumping them together under the umbrella terms such as "Internet addiction".

Impulsivity-related right superior frontal gyrus as a biomarker of internet gaming disorder

Background

Internet gaming disorder (IGD) is a mental health issue that affects individuals worldwide. However, the lack of knowledge about the biomarkers associated with the development of IGD has restricted the diagnosis and treatment of this disorder.

Aims

We aimed to reveal the biomarkers associated with the development of IGD through resting-state brain network analysis and provide clues for the diagnosis and treatment of IGD.

Methods

Twenty-six patients with IGD, 23 excessive internet game users (EIUs) who recurrently played internet games but were not diagnosed with IGD and 29 healthy controls (HCs) performed delay discounting task (DDT) and Iowa gambling task (IGT). Resting-state functional magnetic resonance imaging (fMRI) data were also collected.

Results

Patients with IGD exhibited significantly lower hubness in the right medial orbital part of the superior frontal gyrus (ORBsupmed) than both the EIU and the HC groups. Additionally, the hubness of the right ORBsupmed was found to be positively correlated with the highest excessive internet gaming degree during the past year in the EIU group but not the IGD group; this might be the protective mechanism that prevents EIUs from becoming addicted to internet games. Moreover, the hubness of the right ORBsupmed was found to be related to the treatment outcome of patients with IGD, with higher hubness of this region indicating better recovery when undergoing forced abstinence. Further modelling analysis of the DDT and IGT showed that patients with IGD displayed higher impulsivity during the decision-making process, and impulsivity-related parameters were negatively correlated with the hubness of right ORBsupmed.

Conclusions

Our findings revealed that the impulsivity-related right ORBsupmed hubness could serve as a potential biomarker of IGD and provide clues for the diagnosis and treatment of IGD.

A Psychoanalytic Approach to Internet Gaming Disorder

BACKGROUND

Internet Gaming Disorder (IGD) is now an official diagnosis and significant public health challenges have been already identified regarding the provision of appropriate care to patients of all ages and the preparedness of mental health professionals to manage the disorder. Despite the existence of psychotherapeutic treatment modalities available for some time now, there is a paucity of any psychoanalytically driven treatments and the disorder is widely regarded and classified as being 'behavioral'. This has profound implications for patients with long-standing character pathology and psychiatric comorbidities, who are underserved by the provision of health services that could efficiently address their issues.

METHODS

This study presents a psychoanalytic perspective on IGD, based on Kohut's Self Psychology as applied in the treatment of other addictions. An outline of the theory, assessment and treatment modalities is presented with two case reports that illustrate its application.

RESULTS

The presentation outlines the challenges in treating IGD, expanding on the concept of guided imagery, resistance to treatment, selfobject transference and comorbidity with marijuana use and bipolar disorder.

CONCLUSIONS

A psychoanalytically driven protocol can be effective in treating IGD, especially in cases with marked character pathology and low motive to engage in other treatment modalities.

Gender differences and left-behind experiences in the relationship between gaming disorder, rumination and sleep quality among a sample of Chinese university students during the late stage of the COVID-19 pandemic

Background and aims

Studies have shown that gaming disorder (GD) is associated with rumination and poor sleep quality. However, the reciprocal relationship between GD, rumination and sleep quality is unclear. Moreover, the differences between gender and between left-behind experiences in the aforementioned relationship remain unknown. Therefore, the present study examined gender differences and left-behind experiences in the relationship between GD, rumination, and sleep quality among a sample of Chinese university students during the late stage of COVID-19 pandemic using a network analysis approach.

Methods

A cross-sectional online survey of 1,872 Chinese university students was conducted comprising demographic information (age, gender, and left-behind experience), gaming experience, gaming frequency, Gaming Disorder Test (GDT), Short Version of Rumination Response Scale (RRS), and Pittsburgh Sleep Quality Index (PSQI).

Results

Among Chinese university students, the prevalence of (i) GD was 3.5% and (ii) sleep disturbance was 14%. GD had positive and weak connection with rumination and sleep quality in the domain-level relational network. The network structures and global strengths both showed no significant differences between gender and between left-behind experiences. The nodes gd3 ("continuation or escalation of gaming") and gd4 ("gaming problems") had the strongest edge in the network.

Conclusion

The results suggest reciprocal relationships between GD, rumination, and sleep quality. Gender and left-behind experiences did not influence the reciprocal relationship between GD, rumination, and sleep quality during the late stage of COVID-19 pandemic. Using network analysis, the findings provide novel insights that rumination and sleep quality may have interacted with GD among Chinese students during the late stage of COVID-19 pandemic. Reducing or eliminating negative rumination may decrease GD and improve sleep quality. Moreover, good sleep quality contributes to positive rumination which may decrease the risk of GD among Chinese university students.

Motives to play videogames across seven countries: Measurement invariance of the Videogaming Motives Questionnaire

INTRODUCTION

Gaming motives appear to be an important predictor of time spent gaming and disordered gaming. The Videogaming Motives Questionnaire (VMQ) has shown adequate psychometric properties to assess gaming motives among Spanish college students. However, the utility of this measure has not yet been explored in other cultures. This research aimed to examine the structure and measurement invariance of the VMQ across seven countries and gender groups, and to provide criterion-related validity evidence for VMQ scores.

METHOD

College students who reported having played videogames in the last year (n = 5192; 59.07 % women) from the US, Canada, South Africa, Spain, Argentina, England, and Uruguay completed an online survey to measure time spent gaming, disordered gaming, and the VMQ.

RESULTS

Findings support a 24-item 8-intercorrelated factor model structure for the VMQ in the total sample. Our results also support configural, metric, and scalar invariance of the VMQ across gender groups and countries. Students from North America (US and Canada) scored higher on most gaming motives (except recreation and cognitive development) than students from the other countries. The correlations between VMQ and non-VMQ variables were similar across gender and countries, except in England where VMQ correlations with time spent gaming were stronger.

DISCUSSION

These results suggest that the VMQ is a useful measure for assessing gaming motives across young adults from different countries.

Relationships Between Gaming Disorder, Risk Factors, and Protective Factors Among a Sample of Chinese University Students Utilizing a Network Perspective

Research has demonstrated that some risk and protective factors of gaming disorder (GD) have been identified. However, the interaction of GD with risk and protective factors has rarely been examined from a network analysis perspective. Therefore, the present study examined the relationships between GD, risk factors (i.e., social anxiety and fear of missing out), and protective factors (i.e., resilience, authenticity, and family closeness) utilizing a network analysis approach among a sample of Chinese university students. A cross-sectional study with 1364 participants was performed using the Gaming Disorder Test, the short version of Social Interaction Anxiety Scale (SIAS), the Chinese Trait-State Fear of Missing Out Scale (T-SFoMOSC), the Brief Resilience Scale (BRS), the Authenticity Scale, and a single item assessing family closeness. Social anxiety, FoMO, and two factors of authenticity (i.e., self-alienation and accepting external influence) had positive relationship with GD, while resilience, authentic living, and family closeness had negative relationship with GD. Social anxiety was identified as the core node in the domain-level network. The item "continuation or escalation of gaming" (gd3) and the item "gaming problems" (gd4) constituted the highest edge weight in the facet-level network. The network comparison demonstrated there were no significant differences in relation to network structures and global strengths between gender. The findings suggest bivariate relationships among GD, risk factors (i.e., social anxiety and fear of missing out), and protective factors (i.e., resilience, authenticity, and family closeness). Interventions for GD must be considered through preventing risk factors and increasing protective factors including improving the gaming motivation and maladaptive cognition to decrease negative emotion (e.g., social anxiety and FoMO), enhancing resilience, authentic living and parent-child relationship, as well as decreasing self-alienation and accepting external influence.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-023-01049-3.

Differences between recreational gamers and Internet Gaming Disorder candidates in a sample of Animal Crossing: New Horizons players

Throughout the last decade, research has considered players' gaming motives as risk and the perceived social support (PSS) as protective factors in the context of Internet Gaming Disorder (IGD). However, the literature is lacking diversity regarding the representation of female gamers as well as of casual and console-based games. The aim of this study was to assess IGD, gaming motives, and PSS comparing recreational gamers and IGD candidates in a sample of Animal Crossing: New Horizons players. A total of 2909 ACNH players (93.7% of them female gamers) took part in an online survey which collected demographic, gaming-related, motivational, and psychopathologic data. Using the cut-off of at least five positive answers to the IGDQ, potential IGD candidates were identified. ACNH players reported a high prevalence rate for IGD (10.3%). IGD candidates differed from recreational players regarding age, sex, and game-related, motivational, and psychopathological variables. A binary logistic regression model was computed to predict membership in the potential IGD group. Age, PSS, escapism and competition motives as well as psychopathology were significant predictors. To discuss IGD in the context of casual gaming, we consider demographic, motivational, and psychopathological player characteristics as well as game design and the COVID-19 pandemic. IGD research needs to broaden its focus concerning game types as well as gamer populations.

Effective interventions for gaming disorder: A systematic review of randomized control trials

Objective

To identify effective intervention methods for gaming disorder (GD) through a rigorous assessment of existing literature.

Methods

We conducted a search of six databases (PubMed, Embase, PsycINFO, CNKI, WanFang, and VIP) to identify randomized controlled trials (RCTs) that tested GD interventions, published from database inception to December 31, 2021. Standardized mean differences with 95% confidence intervals were calculated using a random effects model. Risk of bias was assessed with the Risk of Bias 2 (RoB 2) tool.

Results

Seven studies met the inclusion criteria. Five interventions were tested in these studies: group counseling, craving behavioral intervention (CBI), transcranial direct current stimulation (tDCS), the acceptance and cognitive restructuring intervention program (ACRIP), and short-term cognitive behavior therapy (CBT). Four of the five interventions (the tDCS was excluded) were found to have a significant effect on GD. The results of the quality assessment showed that the included studies had a medium to high risk in the randomization process and a medium to high risk of overall bias.

Conclusion

Rigorous screening identified that four interventions are effective for GD: group counseling, CBI, ACRIP, and short-term CBT. Additionally, a comprehensive review of the literature revealed that improvements could be made in the conceptualization of GD, experimental design, sample representativeness, and reporting quality. It is recommended that future studies have more rigorous research designs and be based on established standards to provide more credible evidence to inform the development of GD interventions.

A randomized controlled trial to assess effectiveness of GamE- an e-Health intervention to self-manage gaming with an aim to prevent gaming disorder

Gaming disorder is a health concern associated with significant impairment. Digital technology can be helpful for implementing preventive measures for gaming disorder. This randomized trial aimed to assess the effectiveness of an e-Health intervention to prevent gaming disorder among college students. This randomized trial compared an online intervention module aimed at improving knowledge, skill and attitude of the students and empower them with self- help strategies to monitor and regulate their gaming behavior with an aim to prevent gaming disorder, with wait list control. The sample comprised of 30 cases and 33 controls. The understanding of the concept of gaming, understanding of difference between gaming and gaming disorder, understanding of adverse effects associated with gaming disorder, understanding of screening of gaming disorder and self-help techniques of regulating gaming disorder increased more in the intervention group than control. The participants most favored self-monitoring and strategies to promote healthy lifestyles for regulating gaming. Online digital intervention can be effectively used as a strategy to prevent gaming disorder among college students. Such an intervention can empower students with strategies to regulate their extent of gaming.

The Health Effects of Video Games in Children and Adolescents

Play has always been an essential part of childhood, but it looks different for modern children, who increasingly engage in virtual play. More than 90% of children older than 2 years play video games, and three-quarters of American households own a video game console. Children 8 to 17 years of age spend an average of 1.5 to 2 hours daily playing video games. Recent developments framed by decades of research have provided insight into how games influence children's physical health, mental health, social behaviors, and cognitive development. Anticipatory guidance surrounding media use is often centered on screen time, but pediatricians should have some knowledge of the unique benefits and risks associated with this nearly ubiquitous activity. In light of the recent addition of gaming disorder to the International Classification of Diseases, 11th Revision, this review includes a discussion of the epidemiology, clinical features, and diagnosis of gaming disorder, including the use of existing screening tools. As games become more popular while ever-increasing in scope and complexity, this review aims to educate the modern pediatric provider about what is known, what is uncertain, and how to use this knowledge in the management of both healthy and unhealthy video gaming in children.

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.

Relationship between Medical Students' Perceived Stress and Gaming Behavior at King Saud University

Gaming addiction has gradually developed among medical students and has been a contentious topic for nearly a decade. This study is aimed at estimating the prevalence of gaming addiction among medical students at King Saud University and examining the relationship between perceived stress levels and gaming addiction. We conducted a cross-sectional study among 370 students from 2019 to 2020 using a self-reporting questionnaire consisting of two validated test scales: the Gaming Disorder Test and the Perceived Stress Scale. The questionnaire was sent to all students through an email. Descriptive analyses and t-test statistical tests were used in this study. The prevalence rate of gaming addiction was found to be 4.6%, while the prevalence of perceived stress was confirmed at 95.9%. Students with excellent GPAs and high family income were associated (p < 0.001). Younger groups, females, and students with high family incomes showed higher levels of perceived stress than others. According to Pearson's correlation, gaming addiction was not significantly correlated with stress among medical students (p > 0.05). According to chi-square test also, no significant association was found between gaming disorder and perceived stress (χ ² = 4.412; p = 0.353). In conclusion, gaming addiction among medical students has scored low prevalence, indicating gaming is not a factor contributing to stress among this group. The high level of perceived stress among medical students should draw attention to the provision of regular psychological care.

Toward a delineation of the differences between high engagement and problem gaming

The boundary between highly engaged and problematic video gaming is often debated in the behavioral addictions field. The present study assessed whether quality of life, motivational and protective factors may differentiate high-frequency gamers (i.e., those who play 30 + hours per week) who did, and did not, meet the DSM-5 criteria for gaming disorder (GD). A total of 403 respondents completed an online survey including standard measures of GD, gaming motivation, quality of life (QOL), and protective factors for behavioral addiction (e.g., adequate sleep and healthy diet). Respondents with GD scored lower on all QOL measures and were more strongly motivated to use gaming to escape problems. Fewer protective factors were identified in GD cases, with an inability to balance gaming with sleep being the largest significant difference between the two groups. High-frequency gaming appears most likely to be problematic if it is used to escape real-world problems or prioritized over important everyday activities.

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.

Game-related behaviors among children and adolescents after school closure during the COVID-19 pandemic: A cross-sectional study

Aim

Increased exposure to digital gaming content among youth in recent years has raised serious health concerns. Social restrictions such as school closures, imposed worldwide because of the ongoing COVID-19 pandemic, may increase exposure to gaming and lead to addictive gaming behavior in young people. In this study, we investigated gaming behaviors among Japanese students during COVID-19 school closures.

Methods

Students completed questionnaires regarding their living conditions, game-related behaviors, diagnosis of Internet addiction, psychological difficulties, and the impact of the COVID-19 pandemic. We compared differences between the responses of potentially at risk for gaming disorder (potentially at risk for gaming disorder; defined in this paper with reference to the ICD-11 MMS criteria for gaming disorder [PGD]) students who met the criteria for a diagnosis of gaming disorder in ICD-11 MMS and those of control students. Logistic regression analysis was performed to predict the extent of factors contributing to potential gaming disorder.

Results

Four thousand and forty-eight participants completed the survey. Compared with control students (93%), potentially at risk for gaming disorder (defined in this paper with reference to the ICD-11 MMS criteria for gaming disorder, PGD) students (7%) reported playing games for longer times, spending more money on in-game purchases, were of younger age at the start of game playing, showed a tendency toward Internet dependence, practised school avoidance or absenteeism, and demonstrated the need for psychological support. Moreover, participants in the PGD group reported more anxiety about COVID-19 than control participants, as well as an increase in game-playing time and amount of money spent on games during the COVID-19 pandemic.

Conclusion

These results indicate that young people classified as having a gaming disorder not only exhibit characteristic game-related behaviors but may be psychologically and socially vulnerable and need special support, especially during the ongoing COVID-19 pandemic.

Prevalence and Factors Associated with Gaming Disorder in Latin America and the Caribbean: A Systematic Review

We aimed to determine the prevalence and factors associated with gaming disorder (GD) in the population of Latin America and the Caribbean (LAC). A systematic review was performed (PROSPERO protocol registration: CRD42021230565). We included studies that identified participants with GD and/or factors associated with this condition, reported the prevalence of GD, or contained data that assisted in its estimation, were published after 2013 (the year of inclusion of GD in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders) and were carried out in a population residing in an LAC country. Evaluation of the quality of the studies was carried out using the Joanna Briggs Institute Critical appraisal checklist tool. A qualitative synthesis of the data was performed. Of the total of 1567 records identified, 25 passed the full-text review phase, and 6 met the selection criteria. These studies were published between 2018 and 2021 and had a cross-sectional design (three in Brazil, one in Ecuador, Mexico, and the other was multi-country, including a LAC country [Peru]). The prevalence of GD ranged from 1.1% to 38.2%. The three studies in Brazil had the highest figures of GD prevalence (20.4-38.2%). Four studies evaluated factors associated with GD. Characteristics regarding the game (type), pattern of use (hours played), as well as gender (higher in men), tobacco and alcohol consumption, poor interpersonal relationships, and the presence of mental disorders were found to be associated with GD in LAC. Evidence on the prevalence and factors associated with GD in LAC is limited. Studies on GD in LAC evaluate different population subgroups, describing a wide prevalence of this condition (present in up to 38 out of 100 evaluated). Characteristics such as the type and hours of use of the games, sociodemographic data, lifestyles, interpersonal relationships, and the presence of mental disorders increase the probability of presenting GD.

Psychometric properties of the Farsi version of the gaming disorder scale for adolescents (GADIS-A)

BACKGROUND

Gaming disorder was added to the 11th version of the international classification of disease by the world health organization in early 2019. Adolescents are the most vulnerable group in this area. Thus, a screening tool for this age range is essential. This study aims to examine the psychometric properties of the gaming disorder scale for adolescents (GADIS-A) in an Iranian male sample.

METHODS

260 male students-7th to 12th grade-from Isfahan city in the academic year 2020-2021 were selected using convenience sampling. The participants responded to the Farsi version of the GADIS-A and problematic online game questionnaire (POGQ). Thirty participants answered the scale again to assess the validity of the retest. Pearson's correlation analysis, Cronbach's alpha, and confirmatory factor analysis were used. The data were analyzed by SPSS version 24 and R software packages psych and lavaan.

RESULTS

Confirmatory factor analysis revealed that the two-factor model, which included cognitive-behavioral symptoms and negative consequences, had good fitness indices. The GADIS-A convergent validity is confirmed by the scale's significant correlation with the POGQ. Cronbach's alpha coefficient was used to determine the scale's validity, which was 0.85 for the full scale and 0.70 and 0.75 for two factors. The validity of the retest after two weeks also showed a correlation of 0.88.

CONCLUSION

The Farsi version of the gaming disorder scale for adolescents has a two-factor structure and is valid for use in Iran.

Current Status of Internet Gaming Disorder (IGD) in Japan: New Lifestyle-Related Disease in Children and Adolescents

The World Health Organization recognizes internet gaming disorder (IGD) as a disorder that causes problems in daily life as a result of excessive interest in online games. The causes of IGD have become more apparent in recent years. Because of prolonged exposure to games, the mechanisms controlling the reward system, such as the prefrontal cortex, limbic system, and amygdala of the cerebrum, do not function properly in IGD. This mechanism is similar to that of various behavioral addictions, such as gambling addiction. IGD is particularly risky in children and adolescents because it easily causes brain dysfunction, especially in the developing brain. IGD should be regarded as a new lifestyle-related disease in younger individuals, and lifestyle modifications, including counseling and family therapy, are critical for its management.

Resource-Strengthening Training for Parents of Adolescents with Problematic Gaming (Res@t-P): A Clinical Pilot Study

Background: Problematic gaming (PG) has become an increasing mental health issue among adolescents during the preceding years. The role of parents and the family environment in the development of PG has been repeatedly emphasized. However, the structured involvement of parents in the therapy is still largely insufficient. Resource-strengthening training for parents of adolescents with PG (Res@t-P) is a new parent-centered 8-week group intervention to fill this substantial gap. The present pilot study aimed to collect first information on its potential effectiveness in improving parental and family factors. Methods: The study was conducted in a clinical setting with N = 43 parents of adolescents with PG, applying a pre- and post-follow-up design. Standardized questionnaires on psychological stress perception, family communication, family functioning, media rules, and adolescent PG symptoms were applied at three measurement points (before, at the end of, and 6 weeks after the training). Conditional growth models were estimated. Results: Over time, an improvement in parental and family aspects as well as a reduction in adolescent PG symptoms could be observed. Conclusions: The results of the present pilot study on the effectiveness of Res@t-P are promising. No causal inferences can be drawn at this stage. A randomized-controlled intervention study is highly warranted.

Item Response Theory Analyses of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Criteria Adapted to Screen Use Disorder: Exploratory Survey

Background

Screen use is part of daily life worldwide and morbidity related to excess use of screens has been reported. Some use of screens in excess could indicate a screen use disorder (ScUD). An integrative approach to ScUD could better fit the polymodal reality of screens, and concurrent problems with screens, than a split approach, activity by activity. In that paradigm, a pragmatic and operationalized approach to study a potential ScUD requires the use of common criteria, for all screens and activities done on screens, in a single questionnaire.

Objective

Our goals were (1) to describe screen uses in a general population sample and (2) to test the unidimensionality, local independence, and psychometric properties of the 9 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) internet gaming disorder (IGD) criteria adapted to screen use in a community sample. We hypothesized that the 9 DSM-5 IGD criteria adapted to ScUD would show unidimensionality, local independence, and good discrimination, with criteria distributed on the severity continuum.

Methods

This cross-sectional survey in a French suburban city targeted adults and adolescents. A self-administered questionnaire covered the main types of screens used and their use for various activities in the past month. Presence of ScUD diagnostic criteria in past 12 months was also self-evaluated in the questionnaire. Factor and 2-parameter Item Response Theory analysis were used to investigate the dimensionality, local independence, and psychometric properties of the ScUD criteria.

Results

Among the 300 participants, 171 (57.0%) were female (mean age 27 years), 297 (99.0%) used screens, 134 (44.7%) reported at least one criterion (potential problem users), and 5 (1.7%) reported 5 or more criteria and endorsed an ScUD. The most endorsed criteria were loss of control (60/300, 20.0%) and preoccupation (52/300, 17.3%). Screen types used and screen activities differed between participants with no ScUD criteria and those with at least one ScUD criterion. The latter were more likely to have a computer as the most used screen type, and more video gaming, communication/social network, and watching news and research of information as activities. Unidimensionality was confirmed by all fit indices. Local independence was confirmed by the absence of residual correlation between the items. Criteria had relatively high factor loading, with loss of interest in other recreational activities having the highest. However, criteria with the lowest factor loading all remained above the cut-offs, sanctioning unidimensionality. Most discriminating criteria were loss of interests, preoccupation, deceive/cover up, and risk/lose relationship/opportunities, which also provided the most information on the measurement of the latent trait.

Conclusions

We described screen uses in a French community sample and have shown that the adaptation of the DSM-5 IGD to “ScUD” has good psychometric validity and is discriminating, confirming our hypothesis. We suggest to use those criteria to assess potential “ScUD.” Further studies should determine if all criteria are needed and whether others should be added.

A network analysis of the Internet Disorder Scale-Short Form (IDS9-SF): A large-scale cross-cultural study in Iran, Pakistan, and Bangladesh

The Internet Disorder Scale-Short Form (IDS9-SF) is a validated instrument assessing internet disorder which modified the internet gaming disorder criteria proposed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, the relationships between the nine items in the IDS9-SF are rarely investigated. The present study used network analysis to investigate the features of the IDS9-SF among three populations in Bangladesh, Iran, and Pakistan. Data were collected (N = 1901; 957 [50.3%] females; 666 [35.0%] Pakistani, 533 [28.1%] Bangladesh, and 702 [36.9%] Iranians) using an online survey platform (e.g., Google Forms). All the participants completed the IDS9-SF. The central-stability-coefficients of the nine IDS9-SF items were 0.71, 0.89, 0.96, 0.98, 0.98, 1.00, 0.67, 0.79, and 0.91, respectively. The node centrality was stable and interpretable in the network. The Network Comparison Test (NCT) showed that the network structure had no significant differences among Pakistani, Bangladeshi, and Iranian participants (p-values = 0.172 to 0.371). Researchers may also use the IDS9-SF to estimate underlying internet addiction for their target participants and further explore and investigate the phenomenon related to internet addiction.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03284-8.

Gaming disorder and the COVID-19 pandemic: Treatment demand and service delivery challenges

Gaming activities have conferred numerous benefits during the COVID-19 pandemic. However, some individuals may be at greater risk of problem gaming due to disruption to adaptive routines, increased anxiety and/or depression, and social isolation. This paper presents a summary of 2019-2021 service data from specialist addiction centers in Germany, Switzerland, Japan, and the United Kingdom. Treatment demand for gaming disorder has exceeded service capacity during the pandemic, with significant service access issues. These data highlight the need for adaptability of gaming disorder services and greater resources and funding to respond effectively in future public health crises.

Animal Crossing and COVID-19: A Qualitative Study Examining How Video Games Satisfy Basic Psychological Needs During the Pandemic

The COVID-19 pandemic has affected the way many people live their lives. The increasing amount of time spent indoors and isolated during periods of lockdown has been accompanied by an increase in the time people spend playing video games. One such game which soared in popularity during the early stages of the pandemic was Animal Crossing: New Horizons. Through semi-structured interviews with players, and using a theory-informed qualitative analysis, we document and examine players’ motivations and experiences playing Animal Crossing: New Horizons during the pandemic. Findings suggest that playing the game helped satisfy various psychological needs—autonomy, relatedness, and competence—as described by Self-Determination Theory. Conversely, players stopped playing the game when they found that their psychological needs were thwarted or better met through other activities. Our findings offer support that video games can offer psychological relief in stressful contexts by providing opportunities for people to satisfy key psychological needs. Theoretical and practical implications are discussed.

The effects of an early intervention on adults' gaming-related problems - a pilot study

Gaming Disorder (GD) has been recognized as an official psychiatric condition characterized by individuals' impaired control over gaming, continuous gaming despite the occurrence of negative side-effects, and gaming taking increasing priority over other important areas of life, thus leading to significant impairments in their everyday lives. To date few prevention and treatment programs have been developed. The present pilot study aimed to investigate the effects of an early psycho-educational intervention for young adults with excessive gaming behaviors. A one-group pre- and post-test design without a control group was used. A total of 22 young adults (20 males and 2 females) aged between 18 and 28 (M = 23.05, SD = 3.02) years old, engaged with the intervention. The severity of gaming-related problems, average gaming time per day, quality of life, and mental well-being were assessed at pretest and post-test stages. Participants demonstrated a slight reduction in gaming time (d = 0.13, p = .545 for weekdays, and d = 0.08, p = .714 for weekend days) and in the severity of problematic gaming (d = 0.17, p = .411) over the three-month intervention period. Changes in neither gaming-related measures nor self-assessed quality of life (p > .01) and mental well-being (d = 0.23, p = .288) reached statistical significance, however. Regardless of limitations on sample size, this study shows encouraging signs that this brief 10-session and three-month educational intervention can achieve positive effects on gaming behavior. A larger scale investigation is needed to develop the intervention further.

The impacts of academic stress on college students' problematic smartphone use and Internet gaming disorder under the background of neijuan: Hierarchical regressions with mediational analysis on escape and coping motives

With sluggish economic growth in the post-pandemic era, the phenomenon "neijuan" becomes increasingly severe in many Asian countries like China. Neijuan refers to a hypercompetitive social environment wherein individuals involuntarily get involved in inhumane work or study hours, resulting in a considerable amount of tension and stress. Previous pathology research has shown that stress can trigger the overuse of Internet-based devices and services, which can subsequently lead to problematic smartphone use (PSU) and Internet gaming disorder (IGD). Provided college students are generally deemed one of the groups most susceptible to neijuan, limited attention has been given to the stimuli and the resultant psychological and behavioral ill-beings. Our study examined the impacts of academic stress on Chinese college students' PSU and IGD problems, with the inclusion of escape and coping motives as mediators. Based upon the results of hierarchical regressions and path analysis, we found that whereas academic stress increased IGD tendency mediated through escape and coping motives, excessive use of smartphone might have developed into a habitual behavior rather than effective escape and coping instruments. Demographic and academic characteristics, such as gender and whether studying at a prestigious institution, also exerted influences on college students' IGD intensity.