Regular gaming behavior and internet gaming disorder in European adolescents: results from a cross-national representative survey of prevalence, predictors, and psychopathological correlates

Prevalence of internet addiction among Chinese adolescents: A comprehensive meta-analysis of 164 epidemiological studies

BACKGROUND

Internet Addiction (IA) among Chinese adolescents is a growing concern that is associated with considerable psychological, social, and academic problems. Although numerous past studies on IA prevalence in China have been conducted, the findings have been mixed. This meta-analysis aimed to examine the pooled IA prevalence among adolescents in China and its associated factors.

METHODS

Both English (PubMed, Web of Science, PsycINFO) and Chinese (Wan Fang, CNKI) databases were systematically searched. Pooled prevalence and study heterogeneity were analyzed using the random effects model, while the factors contributing to prevalence variation were identified using subgroup and meta-regression analyses.

RESULTS

A total of 164 studies involving 737,384 adolescents were included in the meta-analysis. The overall pooled IA prevalence was 10.3 % (95 % CI: 9.1 %-11.7 %). In the subgroup analyses, differences in IA prevalence were significantly associated with the assessment tools (Q = 32.8, p < 0.001) and publication years (Q = 20.6, p < 0.001). In the meta-regression analyses, rural residence (β = 1.82, p = 0.030) and junior student level (β = 0.26, p = 0.002) were positively associated with the prevalence of IA, while only child status (β = -1.28, p = 0.033) was negatively associated with the prevalence of IA.

CONCLUSION

In this meta-analysis, IA among adolescents in China was common and associated with rural residence, junior student level, and only-child status. Given the detrimental impacts of IA, the development of effective prevention and treatment strategies for this population is critical.

Impact of internet gaming disorder on mental well-being: prevalence and psychological distress among adolescents and young adults

INTRODUCTION

The rapid advancement of technology has led to the emergence of Internet Gaming Disorder (IGD), characterized by excessive engagement in online gaming and significant impairment in daily functioning. The addictive nature of gaming has raised concerns about its psychological impact, particularly among adolescents and young adults.

METHODOLOGY

This cross-sectional study involved 548 participants aged 15 years and older, recruited from various educational institutions. Participants were categorized into IGD and regular gamer groups who were engaged in online gaming without meeting the diagnostic criteria for IGD. Data collection included demographic information, gaming habits, and psychological assessment using the Depression, Anxiety, and Stress Scale (DASS-21).

RESULTS

Of the participants, 18.79% were identified with IGD. Significant associations were found between IGD and various factors, including gender (p = 0.049), gaming partner (p = 0.034), gaming device (p = 0.042), time spent gaming (p = 0.041), duration of gaming (p = 0.031), and sleep duration (p = 0.04). Psychological evaluations revealed a strong correlation between gaming addiction and psychological distress. Participants with IGD reported significantly higher levels of depression, anxiety, and stress, with a notable proportion falling into the "severe" and "extremely severe" categories as classified by the DASS-21.

CONCLUSION

The findings underscore the significant prevalence of IGD and its adverse psychological impacts. This study highlights the urgent need for targeted interventions and mental health support for individuals displaying symptoms of gaming addiction. Further research is warranted to explore the long-term effects of IGD and to develop effective strategies for mitigating its psychological consequences.

Altered resting-state network connectivity in internet gaming disorder

BACKGROUND

The growing popularity of internet gaming among adolescents and young adults has driven an increase in both casual and excessive gaming behavior. Nevertheless, it remains unclear how progressive increases in internet gaming engagement led to changes within and between brain networks. This study aims to investigate these connectivity alterations across varying levels of gaming involvement.

METHODS

In this cross-sectional study, 231 participants were recruited and classified into three groups according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for Internet Gaming Disorder (IGD): IGD group, highly engaged gaming(HEG) group, and lowly engaged gaming (LEG) group. Resting-state fMRI data from 217 participants (143 males, 74 females) were included in the final analysis. Independent component analysis was used to examine differences in intra- and inter-network functional connectivity (FC)across the three groups.

RESULTS

No significant differences were found in intra-network FC across the three groups. However, significant inter-network differences between the dorsal attention network(dAN)and the visual network (VN) among the three groups were observed. The HEG group exhibited significantly higher dAN-VN functional network connectivity (FNC) compared to the LEG group. Linear correlation analyses showed no significant correlation between the dAN-VN FNC values and IGD-20T scores.

CONCLUSION

Throughout the development of IGD, increasing levels of engagement are associated with a rise and subsequent decline in FNC of DAN-VN. This pattern may reflect top-down attentional regulation in the early stages of addiction, followed by attentional bias as addiction progresses.

A digital citizen science intervention to reduce HIV stigma and promote HIV testing: a randomized clinical trial among adolescents and young adults in Kazakhstan

Background Kazakhstan has a high HIV incidence among adolescents and young adults (AYA), and high HIV stigma contributing to low HIV testing uptake. We examined whether an AYA-developed digital crowdsourced intervention reduced HIV stigma compared with conventional public health materials among AYA in Almaty, Kazakhstan. Methods A total of 216 AYA (females:116/males:110) aged 16-24 years were recruited to the online study cohort and randomized 1:1 to the intervention or control arm. AYA were exposed to the crowdsourced intervention or control materials once a week for 5weeks, with equivalent exposures between arms. Outcomes included a total HIV stigma score assessed at baseline, immediately post-intervention and 2months post-intervention from January to August 2023. We conducted multilevel mixed models to compare changes over time by arm and sex. Results AYA in the intervention arm had significantly lower HIV testing stigma 2months post-intervention (adjusted mean change (AMC): -0.73 (-1.07, -0.39)) than AYA in the control arm (AMC: -0.06 (-0.42, 0.30); P =0.032). Female AYA in the intervention arm had significantly lower total HIV stigma immediately post-intervention (AMC: -4.91 (-7.25, -2.58)) and 2months post-intervention (AMC: -5.16 (-7.48, -2.84)) than females in the control arm (immediately post-intervention AMC: -0.03 (-2.63, 2.57) and 2-months post-intervention AMC: -0.07 (-2.70, 2.56); P =0.012, P =0.012). Conclusions The AYA-developed crowdsourced intervention decreased HIV testing stigma, although this effect was moderated by sex, and decreased total HIV stigma among female AYA. Crowdsourced interventions may be a promising way to engage communities to develop interventions to decrease HIV stigma.

Exploring parent-child relationships in a Swedish child and adolescent psychiatry - cohort of adolescents with internet gaming disorder

BACKGROUND

While recent studies suggest a high prevalence of Internet gaming disorder (IGD) in child and adolescent psychiatry (CAP) clinics, little is known about the factors contributing to problematic gaming among these patients. Given the well-established role of parenting and parent-child relationships in the development of problem behaviors, this study aimed to explore parent-child relationships within a Swedish cohort of CAP patients with IGD.

METHODS

A total of 72 adolescents from CAP clinics in Skane, Sweden, diagnosed with IGD based on DSM-V criteria (73% boys), aged 13 to 18 years were included in the study. The adolescents completed the Game Addiction Scale for Adolescents (GASA) and reported on aspects of parent-child communication, such as parental control and adolescent disclosure and secrecy, and family climate. Adolescents were categorized as engaged, problem or addicted gamers based on core approach. Independent sample t-tests, Pearsons's correlations, and multivariate regression analyses were used to address the study goals.

RESULTS

Independent sample t-tests revealed that girls showed lower levels of parental knowledge than boys. Bivariate correlation analyses showed that IGD-symptoms were related to lower levels of child disclosure, while multivariate regression analyses revealed that higher IGD-symptoms were predicted by high levels of child secrecy and low child disclosure.

CONCLUSION

Parent-child relationships, in particular adolescent information management to parents, plays an important role for the level of IGD-symptoms in a clinical sample of adolescents. We suggest that therapeutic interventions for IGD should integrate family-focused strategies, such as parent training programs fostering open communication between parents and their children.

Prevalence of internet gaming disorder among Chinese adolescents: A systematic review and meta-analysis

This study aimed to evaluate the prevalence of IGD among Chinese adolescents. Articles published up to April 11, 2024 were retrieved from PubMed, Wiley Online Library, Embase, Web of Science, Ebsco, CNKI, and WanFang. Random-effects models and univariate meta-regression analyses were used to calculate prevalence and heterogeneity estimates with the support of Stata17.0 software. The prevalence of IGD in Chinese adolescents was 10 % (95 %CI: 8 %-12 %). Univariate regression analyses revealed some significant moderators of IGD prevalence, including gender, sample size, and survey year. Spatiotemporal analysis showed the prevalence of IGD varied considerably across provinces in different survey years.

The effect of digital game addiction on aggression and anger levels in adolescents: A cross-sectional study

PURPOSE

In this study, it was aimed to determine the effect of digital game addiction on aggression and anger levels in adolescents.

DESIGN AND METHODS

The participants of this cross-sectional study were adolescents. Data were collected using a socio-demographic questionnaire, Game Addiction Scale, and Buss-Perry Aggression Scale. Descriptive statistics, t-test, Anova, correlation and linear regression analysis were used in the analysis of the data.

RESULTS

In this study, game addiction and aggression levels of adolescents were determined as moderate. The game type that adolescents played the most was determined as war games with 35 %. The mean score of the Game Addiction Scale for male adolescents, those with medium and high income levels, those who play digital games for >8 h a day and every day, was found to be significantly higher. In this study, a positive and moderately significant correlation was found between Game Addiction Scale and Aggression Total Scale and Anger subscale (p < 0.05). Especially male gender (β = 0.273), high income status (β = -0.089), long time playing digital games (β = 0.173) and playing digital games every day (β = 0.360) were determined as predictors that increase game addiction.

CONCLUSIONS

Digital game addiction can trigger aggression and anger in adolescents. Nurses play a crucial role in screening and identifying adolescents at risk of game addiction to prevent aggression and anger.

PRACTICE IMPLICATIONS

According to the findings of this research, it is necessary to provide training and counseling to prevent digital game addiction in schools and to plan strategies by psychiatric nurses.

Internet Gaming Disorder and Sleep Quality among Jordanian University Students: A Cross-sectional Study

Background

Internet gaming disorder is defined as "Persistent and recurrent use of the internet to engage in games, often with other players, leading to clinically significant impairment or distress." It is a new evolving disorder that affects many life aspects; therefore, it needs further investigation among different population groups. IGD was introduced for the first time in 2013 in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, and it suggested carrying out further research among different populations. In 2018, Gaming Disorder (GD) has officially become a type of addiction as the World Health Organization released the 11th revision of the International Classification of Diseases (ICD-11).

Aims

The objective of this study is to investigate the prevalence of internet gaming disorder (IGD) and its association with sleep quality and academic performance among Jordanian university students aged 18-26. Our literature review revealed a lack of research on this topic concerning this specific population and culture. Therefore, our study aims to contribute to the existing literature and to provide insights that can inform prevention, assessment, and treatment strategies for those affected.

Methods

A cross-sectional study design was used by employing convenience and snowball sampling; a total of 2473 participants completed an electronic self-administered questionnaire that included the Internet Gaming Disorder Scale-SF (IGDS9-SF) and Pittsburgh Sleep Quality Index (PSQI). Of these, 432 were excluded based on our criteria. Our inclusion criteria required participants to be Jordanian university students between the ages of 18 and 26, enrolled as undergraduates at Jordanian universities, and free of neurological or psychiatric conditions.

Results

The prevalence of IGD in this study was 15.2% and was more prevalent among males compared to females (p= <0.001). Poor sleep quality was reported by 64.6% of the study population and was more frequently observed in females. Age and academic achievements (GPA) were not associated with having IGD. When binary logistic regression was used, IGD (OR=1.882) positively predicted poor sleep quality.

Conclusion

Internet gaming disorder is common among Jordanian university students and is associated with poor sleep quality, and our findings have significant implications for policymakers, educators, and healthcare providers in raising awareness about the IGD and its impact on sleep quality.

Effectiveness and Acceptability of Cognitive Behavioral Therapy and Family Therapy for Gaming Disorder: Protocol for a Nonrandomized Intervention Study of a Novel Psychological Treatment

BACKGROUND

Gaming disorder (GD) is a new official diagnosis in the International Classification of Diseases, 11th Revision, and with its recognition, the need to offer treatment for the condition has become apparent. More knowledge is needed about the type of treatment needed for this group of patients.

OBJECTIVE

This study aims to evaluate the effectiveness and acceptability of a novel module-based psychological treatment for GD based on cognitive behavioral therapy and family therapy.

METHODS

This study is a nonrandomized intervention study, with a pretest, posttest, and 3-month follow-up design. It will assess changes in GD symptoms, psychological distress, and gaming time, alongside treatment satisfaction, working alliance, and a qualitative exploration of patients' and relatives' experiences of the treatment.

RESULTS

This study started in March 2022 and the recruitment is expected to close in August 2024.

CONCLUSIONS

This study evaluates the effectiveness and acceptability of a psychological treatment for patients with problematic gaming behavior and GD. It is an effectiveness trial and will be conducted in routine care. This study will have high external validity and ensure that the results are relevant for a diverse clinical population with psychiatric comorbidity.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06018922; https://clinicaltrials.gov/study/NCT06018922.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/56315.

Factorial structure of the Internet Gaming Disorder questionnaire in the Italian setting: a single-factored ailment or a multifaceted condition?

INTRODUCTION

Internet Gaming Disorder (IGD) according to DSM-5 is a behavioral addiction needing additional study. IGD in youth is correlated with anxiety, depression, attention problems, interpersonal problems, social phobia, behavior problems and low academic achievement. The aim of the present research is to contribute to the understanding of the disorder, by providing preliminary data on the factorial structure of the IGD Questionnaire in the Italian version.

PARTICIPANTS

612 Italian students (323 females), mean of age = 13.94 (SD = 2.44). Instruments: a survey comprising IGD Questionnaire, Internet Addiction Test (IAT), Children's Coping Strategies Checklist (CCSC-R1), Assessment of Interpersonal Relations (AIR), and Child Behavior Checklist (CBCL).

RESULTS

15.2% of participants showed a sub-clinical IGD and 2.1% met the full diagnostic criteria. Participants with IGD showed lower scores in interpersonal relationships, worse coping strategies and higher scores in externalization. The factorial structure of the IGD Questionnaire highlights 4 factors ("addiction", "gaming as coping", "impaired control" and "negative outcomes") that explain 52.14% of the variance. A single-factor solution was also tested and results seem to be coherent with the four-factor solution, explaining less variance.

CONCLUSIONS

IGD is a complex clinical condition that can be thought both as a single-factored and as a multi-faceted condition.

Appetitive conditioning with pornographic stimuli elicits stronger activation in reward regions than monetary and gaming-related stimuli

Appetitive conditioning plays an important role in the development and maintenance of pornography-use and gaming disorders. It is assumed that primary and secondary reinforcers are involved in these processes. Despite the common use of pornography and gaming in the general population appetitive conditioning processes in this context are still not well studied. This study aims to compare appetitive conditioning processes using primary (pornographic) and secondary (monetary and gaming-related) rewards as unconditioned stimuli (UCS) in the general population. Additionally, it investigates the conditioning processes with gaming-related stimuli as this type of UCS was not used in previous studies. Thirty-one subjects participated in a differential conditioning procedure in which four geometric symbols were paired with either pornographic, monetary, or gaming-related rewards or with nothing to become conditioned stimuli (CS + porn, CS + game, CS + money, and CS-) in an functional magnetic resonance imaging study. We observed elevated arousal and valence ratings as well as skin conductance responses for each CS+ condition compared to the CS-. On the neural level, we found activations during the presentation of the CS + porn in the bilateral nucleus accumbens, right medial orbitofrontal cortex, and the right ventral anterior cingulate cortex compared to the CS-, but no significant activations during CS + money and CS + game compared to the CS-. These results indicate that different processes emerge depending on whether primary and secondary rewards are presented separately or together in the same experimental paradigm. Additionally, monetary and gaming-related stimuli seem to have a lower appetitive value than pornographic rewards.

A descriptive pilot survey of behavioural addictions in an adolescent secondary school population in Ireland

OBJECTIVES

The aim of the present study was to evaluate the levels of possible internet addiction, gaming addiction, gambling addiction and associated mental health difficulties in a secondary school population in Ireland.

METHODS

An online survey containing questions related to internet addiction, gaming addiction, gambling addiction and associated mental health difficulties was administered to secondary school adolescents in Ireland. Participants were self-selecting and answered questions on the characteristics of each topic and screening questionnaires for addiction to each behaviour, as well as their respective effects on mental health.

RESULTS

A total of 234 children participated in the survey (156 males; aged 12-18 years; average age of 14.2 years; S.D. 1.60). Internet addiction as assessed using the Chen Internet Addiction Scale was present for between 11.5% and 22.6% and levels of gaming addiction as assessed using by the Internet Gaming Disorder Scale-Short Form was present for between 0.5% and 1.6%. Weak positive correlations were found between time spent on the internet and time spent gaming with internet addiction and gaming addiction, respectively. There were weak positive correlations between higher internet addiction scores, higher gaming addiction scores, and increased depression and anxiety scores. Using the South Oaks Gambling Screen-Revised for Adolescents, two participants were classed as 'at-risk' for gambling addiction and one participant was classed as a problem gambler.

CONCLUSIONS

The present study examined behavioural addictions and their effects on mental health on a self-selecting sample of schoolchildren at two schools in Ireland. A low number were identified as being at risk or problem gamblers.

Psychometric Properties of the Spanish Motives for Online Gaming Questionnaire in a Sample of College Students

This study investigates the psychometric properties of the Spanish version of the Motives for Online Gaming Questionnaire (MOGQ). We explored the factor structure and construct validity of the MOGQ through its relationships with gaming disorder symptoms (IGD-20) and impulsivity traits. We also analyzed if sociodemographic variables and gaming habits were related to gaming motives. An online cross-sectional survey was completed by 845 college students. Structure validity was examined using a combination of exploratory and confirmatory factor analyses, which supported a bifactor model composed of a general motivation factor and six uncorrelated factors (a mixed factor composed of escape and coping, competition, recreation, skill, social, and fantasy). Omega-hierarchical and omega coefficients were used to determine reliability of the MOGQ. The scale presented acceptable reliability for the general factor (ωh = .79) and the specific factor scores (social ω = .79, escape/coping ω = .81, competition ω = .79, skill ω = .84, fantasy ω = .82, and recreation ω = .70). Positive associations were observed between the MOGQ and the IGD-20 symptoms, with escape/coping (r = .48) and fantasy (r =.40) showing the strongest ones. Null or low correlations were observed with impulsivity traits. Motives to play varied significantly across genders. These findings provide evidence that the Spanish version of the MOGQ is a reliable and valid tool to assess motives to play online games.

The prevalence and possible risk factors of gaming disorder among adolescents in China

BACKGROUND

Nowadays, moderate gaming behaviors can be a pleasant and relaxing experiences among adolescents. However, excessive gaming behavior may lead to gaming disorder (GD) that disruption of normal daily life. Understanding the possible risk factors of this emerging problem would help to suggest effective at preventing and intervening. This study aimed to investigate the prevalence of GD and analyze its possible risk factors that adolescents with GD.

METHODS

Data were collected between October 2020 and January 2021. In total, a sample of 7901 students (4080 (52%) boys, 3742 (48%) girls; aged 12-18 years) completed questionnaires regarding the Gaming-Related Behaviors Survey, Gaming Disorder Symptom Questionnaire-21 (GDSQ-21); Behavioral Inhibition System and Behavioral Activation System Scale (BIS/BAS Scale); Emotion Regulation Questionnaire (ERQ); Short-form Egna Minnenav Barndoms Uppfostran for Chinese (s-EMBU-C); and Adolescent Self-Rating Life Events Checklist (ASLEC).

RESULTS

The prevalence of GD was 2.27% in this adolescent sample. The GD gamers were a little bit older (i.e., a higher proportion of senior grades), more boys, with more gaming hours per week in the last 12 months, with more reward responsiveness, maternal rejecting and occurrence of negative life events (e.g., interpersonal relationships, being punished and bereavement factors).

CONCLUSION

These possible risk factors may influence the onset of GD. Future research in clinical, public health, education and other fields should focus on these aspects for provide target prevention and early intervention strategies.

Serious educational games for children: A comprehensive framework

Introduction

Serious educational games are digital games designed to support teaching or learning objectives that have become popular among children. However, a set of principles is needed to develop a successful educational game. Therefore, this study aimed to provide a comprehensive and valid framework for designing children's serious educational games.

Methods

The conceptual framework is developed in two phases. First, a scoping review was conducted in PubMed, Ovid (APA PsycInfo), EMBASE, Scopus, Web of Science, ProQuest, and gray literature on August 1, 2022. Papers in English that reported the serious educational games' principles for children were included. Second, the extracted data from the previous step was reviewed and discussed by the research team to develop the initial framework. Then, it was distributed to 20 experts with relevant knowledge and experience in two rounds to validate and apply their comments within the framework.

Results

Of the 12916 papers identified, 15 were included in this study. In the proposed framework named CoDHP, the results were classified into four topics, including (a) content aspects, (b) design requirements, (c) highlighted attributes, and (d) children's preferences. Content aspects comprise four classes (goals and limits, child learning content, learning context, and a long-term program) with 16 principles. Design requirements contain 11 classes (stories and storylines, player characters, game mechanics, interactivity, game challenge, game rules, game help, entertaining games, user interface, accessibility, and setting) with 47 principles, of which 15 are highlighted. Regarding children's preferences for the game elements, various similarities and differences were extracted. For instance, both girls and boys prefer fun and popular games. Based on experts' comments, 21 supplementary principles were recommended to complete the content and design requirements.

Conclusion

Game designers or researchers can use the proposed framework as a formative guide to design successful serious games or evaluate children's digital games.

Behavioral Addiction from the Asian Americans Perspective: Exploration of Public and Help-Seeking Stigma

Asian Americans have been unlikely to seek mental health services despite their needs for treatment, particularly when experiencing significant gambling or Internet gaming problems. Stigma is often considered to be a barrier to seeking help. To understand how stigma impacts Asian Americans' willingness to seek mental health services, the present study used an online survey to investigate the public stigma associated with addictive behaviors and help-seeking stigma among Asian Americans. Participants (N = 431) who self-identified as Asian American, reside in the US. Using a between-groups vignette study design, it was found that the individual with a behavioral addiction received more stigma compared to the individual who experienced a financial crisis. In addition, participants were more likely to seek help if they experienced addictive behavioral problems rather than financial problems. Lastly, this study did not reveal a significant relation between public stigma attached to addictive behaviors and Asian Americans' willingness to seek help, but it found that participants' willingness to seek help was positively associated with public stigma of help seeking (β = 0.23) and negatively associated with self-stigma attached to help-seeking (β = - 0.09). Based on these findings, recommendations are provided to inform community outreach to reduce stigma and promote mental health service utilization among Asian Americans.

Measurement Invariance of the Lemmens Internet Gaming Disorder Scale-9 Across Age, Gender, and Respondents

Although Internet gaming disorder (IGD) has gained increased attention in scientific, clinical, and community contexts, there is still a lack of consensus regarding the best assessment tools (i.e., self-report or other reports) for assessing its symptoms. The present study aimed to investigate the reliability, validity, and measurement invariance of both versions (youth and parent) of The Lemmens Internet Gaming Disorder Scale-9. To achieve this goal, we recruited between June and October 2019 from five Romanian highschools a total of 697 adolescents (11-19 years old) and one of their parents (N = 391). The internal consistency was good in both versions of the instrument (α = 0.772 for the youth version and α = 0.781 for the parent version). Construct validity assessed through confirmatory factor analysis showed support for the one factor structure of the scales, while multigroup confirmatory factor analysis endorsed the invariance across age, gender, and respondents (i.e., parent vs. youth report). The current research identifies both IGD scales to be reliable and valid, arguing for their utility for assessing IGD symptomatology among adolescents. Implications for theory, assessment, and future directions are discussed.

Impulsivity and aggression as risk factors for internet gaming disorder among university students

Internet gaming addiction is a global problem, especially among young individuals. Exhibiting characteristics similar to other addictions, Internet Gaming Disorder (IGD) is linked to adverse mental health outcomes. Identified as risk factors for dependence behaviors, the association of impulsivity and aggression with IGD is relatively under-researched in the student population. The present sample of 350 university students (Mage = 21.30 years, SDage = 4.96 years) from Najran university in Saudi Arabia completed an online questionnaire that included the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), the Buss-Perry Aggression Questionnaire-Short Form, and the Barratt Impulsiveness Scale (BIS-15). Results indicated that impulsivity and aggression were positively associated with IGD severity and both personality traits explained 34.6% of the variance in IGD scores. Further bivariate analyses suggested that individuals spending 7 or more hours on internet gaming were more likely to exhibit high impulsivity and aggression, and had a relatively higher severity of IGD. These results suggest that individuals with these personality traits may be more vulnerable to developing an addiction to internet gaming. These findings need to be confirmed in future more robust studies; however, this exploratory study provides insights for potential programs to prevent IGD among young individuals.

Cognitive Patterns and Problematic Use of Video Games in Adolescents: A Cluster Analysis

BACKGROUND

Video game playing (VGP) is an increasingly common leisure activity among children and adolescents, although in some cases, it is accompanied by problems due to misuse.

METHOD

A sample of 2884 children and adolescents aged between 12 and 20, representative of the Community of Madrid (Spain), were studied using a cluster analysis to explore the existence of cognitive patterns associated with engagement, attitudes, and concurrent cognitions. We also explored the relationship between these patterns and problematic VGP, using the 2173 gamers as a reference.

RESULTS

The concurrent cognitions were not qualitatively different between the problematic users and the others. High engagement and high activation of concurrent cognitions (intensity and frequency) showed the greatest relationship with problematic VGP.

CONCLUSIONS

The results suggest the existence of different groups of gamers and the relevance to include psycho-educational aspects in intervention programs, as well as the training of specific skills, especially those related with the control of activation. Limitations related to the sample size and potential supplementary analyses are acknowledged.

Video Game Playing and Internet Gaming Disorder: A Profile of Young Adolescents

In recent times, growing concern has arisen regarding the utilization of technology, video games, and the emergence of internet gaming disorder (IGD), particularly among young adolescents. This worry arises from the ambiguity in distinguishing between "normal" and "problematic" video game behavior, despite efforts to establish clear criteria for defining both. The goal of this study is to outline distinct profiles of adolescent video game players and identify variables associated with their gaming practices that correlate with problematic gaming. The study utilizes a substantial sample of adolescents drawn from a representative cross-section of educational institutions in the city of Madrid, ranging in age from 12 to 16 years. In total, 1516 participants (75%) acknowledged engaging in video game activities. The research delves into characterizing prevailing profiles of video game participants within this cohort and scrutinizes the profile that aligns with issues of IGD. In summary, approximately three-quarters of young adolescents participate in video gaming, with males constituting the majority. Typically, participants immerse themselves in action genre games for over three days per week, with males exhibiting a higher frequency than their female counterparts. Elevated gaming frequency correlates with heightened IGD scores, particularly among females. Young adolescents show a preference for game consoles (males) and mobile phones (females) and often play alone at home. Specific factors such as the device used, online mode, company, and gaming location impact the IGD scores. These profiles aim to assist families and educators in recognizing potential risk behaviors and IGD concerns; however, it is crucial to emphasize the necessity for case-specific screening and evaluation before deliberating on such behaviors.

The latent profile analysis of Chinese adolescents' gaming disorder: examination and validation

BACKGROUND

Gaming disorder is a new disease, which is included in the disease unit of disorder caused by addiction in the 11th revision of the International Classification of Diseases. This study examined the symptom characteristics of gaming disorders in Chinese adolescents using the latent profile analysis.

METHODS

Totally, 5988 students (including 3285 boys and 2703 girls; aged 12-18 years) from junior high schools and senior high schools were enrolled. The Gaming Disorder Symptom Questionnaire-21 (GDSQ-21) was used to screen gaming disorder. A latent profile analysis was used for classifying the subgroups based on the extent of gaming usage. The relationship between adolescent gamers and demographic variables was analyzed by logistic regression.

RESULTS

The results of latent profile analysis supported the models of four latent profiles, which were defined as healthy gamers (Profile 1, 56.83%), impaired control gamers (Profile 2, 26.09%), impaired control-game priority gamers (Profile 3, 9.72%) and gamers with disorder (Profile 4, 7.36%), respectively. Logistic regression analysis found that, compared with girls, boys were more likely to be classified into the group dominated by the impaired gamers, the impaired control-game priority gamers, and the gamers with disorder.

CONCLUSIONS

This study highlighted that the latent profile analysis identified four different groups of adolescent gamers, showing a clearer conceptualization of heterogeneous gamers. Gender and average weekly gaming time can predict the latent profile of adolescents. Our findings may facilitate the design of individualized assessment and early intervention programs for adolescent gamer users based on different gaming usage symptoms.

Adolescents' Perceptions of a Relapse Prevention Treatment for Problematic Gaming-A Qualitative Study

Given the increasing prevalence of problematic gaming, in 2013, the diagnosis "Internet gaming disorder (IGD)" was included in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) as a potential diagnosis. With a new diagnosis, it is important to determine treatment options. The importance of the parent-child relationship has been emphasised in problematic gaming and its treatment. This study aims to provide more knowledge about adolescents' perceptions of a treatment for problematic gaming and understand whether such treatment may have a bearing on the parent-child relationship. We conducted individual interviews with nine adolescents who completed a treatment for problematic gaming. The interviews were analysed using thematic analysis. The analysis revealed three themes. Theme 1: adolescents' experiences of the new treatment; Theme 2: adolescents' perceptions of the effect of the treatment on their gaming behaviour; and Theme 3: adolescents' perceptions of changes in their parent-child relationships. The adolescents viewed the treatment as a way of gaining control of their gaming, a process in which a therapist played an integral part. For the majority of the adolescents in our study, the main effects of treatment were gaining insight into how their gaming and gaming-related behaviours affected other parts of their lives. The participants felt that the treatment improved their relationship with their parents through reducing everyday conflicts. This new knowledge can be used for the development of future interventions involving children and adolescents.

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

Background and aims

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

Materials and methods

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

Results

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

Discussion

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

Conclusion

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

Prevalence and Risk Factors of Internet Gaming Disorder Among Female Secondary School Students in Al-Ahsa, Kingdom of Saudi Arabia

OBJECTIVES

This study measured the prevalence and potential risk factors of Internet gaming disorder (IGD) among female secondary school students in Al-Ahsa, Kingdom of Saudi Arabia.

METHODS

This cross-sectional study was conducted between January and February 2023. A total of 400 female secondary school students in Al-Ahsa were recruited through multistage stratified cluster sampling. Data were collected by distributing a self-administered questionnaire among students. A chi-squared test was performed to compare categorical variables. The associations between IGD, depression, and anxiety scores were determined using the Pearson correlation coefficient.

RESULTS

Among the total sample, 282 were classified as "gamers" and included in our analysis. The prevalence of IGD was found to be 19%. We also found a statistically significant and moderately positive correlation between IGD and anxiety and depression scores. Spending more than four hours daily playing video games, starting to play video games at less than seven years of age, having depression, having anxiety, and playing an online game were found to be potential risk factors for IGD.

CONCLUSION

IGD among female adolescent students in Al-Ahsa is a public health concern that requires attention from the concerned parties. Health education projects on IGD, its risk factors, and its consequences should be designed for adolescents and their families.

Delayed sleep-wake phase disorder and its related sleep behaviors in the young generation

Delayed sleep-wake phase disorder (DSWPD) is a sleep disorder in which the habitual sleep-wake timing is delayed, resulting in difficulty in falling asleep and waking up at the desired time. Patients with DSWPD frequently experience fatigue, impaired concentration, sleep deprivation during weekdays, and problems of absenteeism, which may be further complicated by depressive symptoms. DSWPD is typically prevalent during adolescence and young adulthood. Although there are no studies comparing internationally, the prevalence of DSWPD is estimated to be approximately 3% with little racial differences between Caucasians and Asians. The presence of this disorder is associated with various physiological, genetic and psychological as well as behavioral factors. Furthermore, social factors are also involved in the mechanism of DSWPD. Recently, delayed sleep phase and prolonged sleep duration in the young generation have been reported during the period of COVID-19 pandemic-related behavioral restrictions. This phenomenon raises a concern about the risk of a mismatch between their sleep-wake phase and social life that may lead to the development of DSWPD after the removal of these restrictions. Although the typical feature of DSWPD is a delay in circadian rhythms, individuals with DSWPD without having misalignment of objectively measured circadian rhythm markers account for approximately 40% of the cases, wherein the psychological and behavioral characteristics of young people, such as truancy and academic or social troubles, are largely involved in the mechanism of this disorder. Recent studies have shown that DSWPD is frequently comorbid with psychiatric disorders, particularly mood and neurodevelopmental disorders, both of which have a bidirectional association with the pathophysiology of DSWPD. Additionally, patients with DSWPD have a strong tendency toward neuroticism and anxiety, which may result in the aggravation of insomnia symptoms. Therefore, future studies should address the effectiveness of cognitive-behavioral approaches in addition to chronobiological approaches in the treatment of DSWPD.

Conditional role of parental controlling mediation on the relationship between escape, daily game time, and gaming disorder

Parental mediation to protect children from gaming disorders may have unintended consequences. According to the self-determination theory, parental mediation with psychological control may exacerbate problem behavior. Therefore, investigating the indirect effects of parental controlling mediation on gaming disorders is worthwhile. This study aimed to examine the conditional effect of parental controlling mediation on the relationship between escape motivation and gaming disorder, mediated by daily game time. The following research questions were investigated: whether escape motivation has an indirect effect on gaming disorder through daily game time, and whether parental controlling mediation moderates the relationship between gaming disorder and daily gaming time. The convenience sample included 501 mid-school students (251 male and 250 female) in grades 5-7. The conditional indirect effects model was developed using Hayes's model 14 and Process Macro. The results showed that escape motivation was positively related to gaming disorder through daily game time, and parental controlling mediation had a moderating effect on the relationship between daily game time and gaming disorder. These findings suggest that parental mediation to protect children from excessive gaming may be related to gaming disorder when implemented with psychological control. Higher parental controlling mediation may be a risk factor for gaming disorder even when their children play games less frequently. These findings are discussed in light of the literature.

Gaming disorder: A summary of its characteristics and aetiology

The emergence, development, and maintenance of gaming disorder (GD) is the result of an interplay between gaming-related factors, individual factors, and environmental factors. None of these alone are sufficient to cause a disordered state, but it is the interactive co-occurrence of all these factors, which in some cases leads to GD. The goal of the present paper is to discuss in detail these three factors based on relevant and recent findings of the literature. Among gaming-related factors, we discuss online vs. offline videogames, the role of game genres, structural characteristics, game design elements, as well as some important monetization techniques. Among individual factors demographic risk factors, personality traits, motivational factors, comorbid psychopathology, genetic predisposition, and neurobiological processes are considered. Finally, among environmental factors we discuss family factors, early life experiences, the role of peers and school-related factors, as well as the broader context of culture including the popularity of esports.

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.

Internet addiction-induced brain structure and function alterations: a systematic review and meta-analysis of voxel-based morphometry and resting-state functional connectivity studies

Internet addiction (IA) is a growing social concern and has been intensively studied in recent years. Previous imaging studies have shown that IA may impair brain structure and function, but with no robust conclusions. We conducted a systematic review and meta-analysis of neuroimaging studies in IA. Two separate meta-analyses were conducted for voxel-based morphometry (VBM) studies and resting-state functional connectivity (rsFC) studies. All meta-analyses were performed using two analysis methods activation likelihood estimation (ALE) and seed-based d mapping with permutation of subject images (SDM-PSI). The ALE analysis of VBM studies revealed less gray matter volume (GMV) in the supplementary motor area (SMA) (1176 mm³), anterior cingulate cortex (ACC) (one cluster size is 744 mm³ and the other is 688 mm³), and orbitofrontal cortex (OFC) (624 mm³) in subjects with IA. The SDM-PSI analysis showed less GMV in the ACC (56 voxels). The ALE analysis of rsFC studies showed stronger rsFC from posterior cingulate cortex (PCC) (880 mm³) or insula (712 mm³) to the whole brain in subjects with IA; however, the SDM-PSI analysis revealed no obvious rsFC alteration. These changes may underlie the core symptoms of IA, which include emotional regulation disorder, distraction, and impaired executive control. Our results reflect the common features of neuroimaging studies related to IA in recent years and may potentially help inform the development of more effective diagnostic and treatment approaches.

Impact of Coding Educational Programs (CEP) on Digital Media Problematic Use (DMPU) and on Its Relationship with Psychological Dependence and Emotional Dysregulation

Alongside the positive effects linked to the introduction of digital technologies into our lives, particular dysfunctional behaviors in the use of digital tools have appeared, through which the expression of conditions such as addiction, difficulties in affective and behavioral self-regulation and mental health problems have been channeled. The present study aims to investigate, in a sample of young students aged m = 12.91 (ds = 0.56) years, whether Coding Educational Programs (CEP), deployed to 44.9% of the sample, is effective in psychological dependence, emotional self-regulation and Digital Media Problematic Use (DMPU), as self-assessed through questionnaires (DERS, DSRS, IAT, MPIQ and MPPUS). CEP had no effect on emotional dysregulation or on DMPU. They were effective in the time management of mobile phone use, with students rescheduling from daytime use on working days to daytime use on the weekend. Moreover, people who attended CEP more frequently used smartphones for orienting themselves and for obtaining information. In conclusion, CEP are effective in achieving a more functional and important use of smartphones and better time management. It is possible that CEP effect on metacognition could reduce DMPU if alternative ways to regulate emotions are available.

The Relationship Between Digital Game Addiction and Loneliness and Social Dissatisfaction in Adolescents

Background In this study, it was aimed to examine digital addiction, loneliness and social dissatisfaction among adolescents studying in Adıyaman, Turkey, and to determine the relationship with each other. Methodology Digital Game Addiction Scale for Children (DGASFC) and Loneliness and Social Dissatisfaction Questionnaire (LSDQ) were administered to 634 middle and high school students. A questionnaire form was used as a data collection tool. Results DGASFC scores and LSDQ scores were found to be higher in males, in high school students, in those whose parents' education level was high school or above, in those whose parents lived separately, in those with good economic status, in those who were younger, and in those who were not restricted by their families. A significant positive correlation was found between DGASFC and LSDQ scores. Conclusions Digital addiction should be followed closely in terms of accompanying disorders or pathologies that predispose to it. In our study, it was found that digital game addiction, loneliness and social dissatisfaction decreased with age. However, this applies separately to middle school and high school groups. Because, despite their older age, high school adolescents have been found to be more digitally dependent, lonely and socially dissatisfied than secondary school students. Contrary to the studies in the literature, the risk of digital addiction, loneliness and social dissatisfaction was found to be low in those with low economic status.

Problematic Internet Use among Adults: A Cross-Cultural Study in 15 Countries

BACKGROUND

The present study compared adult usage patterns of online activities, the frequency rate of problematic internet use (PIU), and risk factors (including the psychopathology associated with PIU, i.e., distress and impulsivity) among adults in 15 countries from Europe, America, and Asia.

METHODS

A total of 5130 adults from Belgium, Finland, Germany, Italy, Spain, France, Switzerland, Hungary, Poland, UK, Norway, Peru, Canada, US, and Indonesia completed an online survey assessing PIU and a number of psychological variables (i.e., depression, anxiety, stress, and impulsivity). The sample included more females, with a mean age of 24.71 years (SD = 8.70).

RESULTS

PIU was slightly lower in European countries (rates ranged from 1.1% in Finland to 10.1% in the UK, compared to 2.9% in Canada and 10.4% in the US). There were differences in specific PIU rates (e.g., problematic gaming ranged from 0.4% in Poland to 4.7% in Indonesia). Regression analyses showed that PIU was predicted by problematic social networking and gaming, lack of perseverance, positive urgency, and depression.

CONCLUSIONS

The differences in PIU between countries were significant for those between continental regions (Europe versus non-European countries). One of the most interesting findings is that the specific PIU risks were generally low compared to contemporary literature. However, higher levels of PIU were present in countries outside of Europe, although intra-European differences existed.

Relapse Prevention Therapy for Problem Gaming or Internet Gaming Disorder in Swedish Child and Youth Psychiatric Clinics: Protocol for a Randomized Controlled Trial

BACKGROUND

Although gaming is a common arena where children socialize, an increasing number of children are exhibiting signs of problem gaming or internet gaming disorder. An important factor to the development of problem gaming is parent-child relationships. A cognitive behavioral therapy-based form of treatment, labeled relapse prevention, has been developed as a treatment for child and adolescent problem gaming or internet gaming disorder. However, no study has evaluated the effect of this treatment among Swedish children and youth nor the role of the parent-child relationships in this treatment.

OBJECTIVE

This study aims (1) to evaluate a relapse prevention treatment for patients showing signs of problem gaming or internet gaming disorder recruited from child and youth psychiatric clinics and (2) to test whether the quality of parent-child relationships plays a role in the effect of relapse prevention treatment and vice versa-whether the relapse prevention treatment has a spillover effect on the quality of parent-child relationships. Moreover, we explore the carer's attitudes about parent-child relationships and child gaming, as well as experiences of the treatment among the children, their carers, and the clinicians who carried out the treatment.

METHODS

This study is a 2-arm, parallel-group, early-stage randomized controlled trial with embedded qualitative components. Children aged 12-18 years who meet the criteria for problem gaming or internet gaming disorder will be randomized in a 1:1 ratio to either intervention (relapse prevention treatment) or control (treatment as usual), with a total of 160 (80 + 80) participants. The primary outcomes are measures of gaming and gambling behavior before and after intervention, and the secondary outcomes include child ratings of parent-child communication and family functioning. The study is supplemented with a qualitative component with semistructured interviews to capture participants' and clinicians' experiences of the relapse prevention, as well as attitudes about parent-child relationships and parenting needs in carers whose children completed the treatment.

RESULTS

The trial started in January 2022 and is expected to end in December 2023. The first results are expected in March 2023.

CONCLUSIONS

This study will be the first randomized controlled trial evaluating relapse prevention as a treatment for child and adolescent problem gaming and internet gaming disorder in Sweden. Since problem behaviors in children interact with the family context, investigating parent-child relationships adjacent to the treatment of child problem gaming and internet gaming disorder is an important strength of the study. Further, different parties, ie, children, carers, and clinicians, will be directly or indirectly involved in the evaluation of the treatment, providing more knowledge of the treatment and its effect. Limitations include comorbidity in children with problem gaming and internet gaming disorder and challenges with the recruitment of participants.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05506384 (retrospectively registered); https://clinicaltrials.gov/ct2/show/NCT05506384.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/44318.

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.

Examination of game addiction studies conducted in Turkey: A systematic review study

The aim of this study is to examine the methodological orientations in game addiction studies in Turkey between 2019 and 2022 in a holistic way and to present suggestions for new literature studies. For this purpose, only articles written in Turkish language were reviewed on Google Scholar. Open-access quantitative studies between 2019 and 2022 were included in our study. As a result, 69 out of 257 studies were found to comply with the predetermined criteria. The number of participants in these 69 studies, with a total sample size of 26,415, varies between 60 and 987. Almost half of the studies sample group is children (n = 36). The majority of the studies examine the relationship between academic achievement, familial and social relationship problems, gaming behavior and game addiction in children and adolescents. It was found that gaming addiction was higher in male students compared to female students, especially between the ages of 14-15. Among children, male students play digital games more than girls, and they mostly prefer action-adventure, war, and racing games. Previous studies have concluded that the use of consoles and smartphones in adolescents and young adults has a high impact on digital game addiction. In the light of the findings, it is suggested that empirical studies on game addiction should be addressed with different aspects using new literature studies.

Psychological Effects of FIFA, PES, and Clash of Clans Games on Young Men at Risk of Developing Internet Gaming Disorder

BACKGROUND

The present study aimed to investigate the psychological effects of FIFA, PES, and Clash of Clans games on young men at risk of developing internet gaming disorder (IGD).

METHODS

The sample consisted of 150 young men, 50 of whom were in the FIFA and PES group, 50 in the Clash of Clans group, and 50 in the control group. Two groups of young men at risk of developing IGD were compared with a control group. The participants completed the General Health Questionnaire (GHQ), Quality of Relationships Inventory (QRI), Game Addiction Scale, and Behavior Rating Inventory of Executive Function (BRIEF).

FINDINGS

The results of the study showed that the scores of mental health problems, conflict with friends, and executive function problems in the Clash of Clans group were significantly higher than those of the FIFA, PES, and control groups. Concerning conflict with parents, the FIFA group had a higher score than the Clash of Clans and control groups. In addition, the results indicated that gaming addiction affects mental health by affecting executive functions.

CONCLUSION

The Clash of Clans game has more negative effects on psychological functions.

Prevalence of Internet Gaming Disorder among Saudi Arabian university students: relationship with psychological distress

Background and aim

Given the exponential growth of the gaming industry, Internet Gaming Disorder (IGD) merits further research. This study investigated the prevalence of IGD among Saudi Arabian university students and its relationship with the level of functioning, psychological distress, and potential for comorbid depression, as well as the effect of the COVID-19 lockdown on gaming behavior.

Materials and methods

306 participants were randomly selected from various Saudi Arabian universities and surveyed using the 20-item Internet Gaming Disorder Test (IGD-20 Test), the Patient Health Questionnaire (PHQ-9), and the 6-item Kessler Psychological Distress Scale (Kessler-6).

Results

The estimated prevalence of IGD was 10.1%, and significantly higher risk was observed among IGD and respective at risk groups with psychological distress. Moreover, 67.4% of the participants reported an increase in playtime during the COVID-19 lockdown. Based on the Kesseler-6, psychological distress was observed in 19.9% of the participants.

Conclusions

This study suggests that IGD is a growing mental health risk associated with a dysfunctional impact and psychological distress.

A typology of adolescent online gamers. Part I

Introduction: For several years now, there has been an increased interest on the part of psychiatrists, pediatricians, psychologists, specialists in education, and sociologists in the issue of so-called behavioral addictions, which include Internet addiction and computer gaming addiction. The aim of this study was to draw a typology of Internet gamers.

Material and methods: The examined group and method: The study involved 576 individuals aged 16 to 19 years. The participants were surveyed using an Inquiry Form and the Online Gaming Addiction Questionnaire designed by the present authors.

Results: The participants of this study were divided into four types of online gamers: gamers who scored the highest on the KBUGI scales and items corresponding to the DSM-5 criteria for Internet Gaming Disorder (Type 1); gamers who mostly played violent online games in which the player kills his enemies, destroys things, breaks traffic rules, and experiences power and new sensations (Type 2); individuals who played mainly to eliminate the feeling of boredom, enhance their mood and experience pleasure, new sensations and rivalry (Type 3); and people who only played occasionally and were not at risk of Internet gaming addiction (Type 4).

Conclusions: The four groups included gamers severely addicted to gaming; gamers who played violent games to satisfy their need for aggression (moderate Internet gaming addiction); gamers who played mainly to eliminate boredom and seek new stimuli (mild Internet gaming addiction); and non-addicted gamers.

Eye problems and musculoskeletal pain in Pokémon Go players

Individuals benefit from Pokémon Go (PG) gaming because this mobile augmented reality geolocation video game provides an attractive opportunity to increase physical activity outdoors and socialize. However, based on gaming and electronic media studies, intense involvement with PG is likely related to adverse phenomena, such as arm pain or eye-related problems. We aimed to test how PG use (problematic vs. non-problematic gaming and gaming time) is related to physical symptoms (pain in three body regions and computer vision syndrome). To dissect game-specific effects, we controlled for general problematic smartphone use, phubbing, and electronic media usage. PG players (N = 455) completed an online survey. We found that PG players with problematic game use reported more pain and vision problems. Problematic PG use was a better predictor of physical symptoms than PG gaming time and variables related to electronic media use. Problematic PG use and problematic smartphone use were correlated but independent predictors of physical symptoms. We conclude that the type of participation rather than the time spent playing predicts poorer physical health among PG players.

Parental Factors Associated With Internet Gaming Disorder Among First-Year High School Students: Longitudinal Study

BACKGROUND

Parents play central roles in adolescents' socialization, behavioral development, and health, including the development of internet gaming disorder (IGD). However, longitudinal research on the parental predictors of adolescent IGD is limited.

OBJECTIVE

This study aimed to investigate the reciprocal associations between various parental factors and adolescent IGD using 2-wave cross-lagged models.

METHODS

A sample of 1200 year-one high school students in central China completed a baseline assessment in 2018 (mean age 15.6 years; 633/1200, 52.8% male) and a follow-up survey in 2019. IGD was measured using the 9-item DSM-5 IGD Symptoms checklist. Perceptions related to parental variables, including psychological control, parental abuse, parental support, and the parent-child relationship, were also collected from the adolescents.

RESULTS

Of all the participants, 12.4% (148/1200) and 11.7% (140/1200) were classified as having IGD at baseline (T1) and follow-up (T2), respectively. All 4 cross-lagged models fit the data well (range for the comparative fit index .91-.95; range for the standardized root mean square residual .05-.06). Parental support (β=-.06, P=.02) and parental abuse (β=.08, P=.002) at T1 predicted IGD symptoms at T2, while parental psychological control (β=.03, P=.25) and a positive relationship with parents (β=-.05, P=.07) at T1 had nonsignificant effects on IGD symptoms at T2, when controlling for background variables. In addition, IGD symptoms at T1 did not predict parental factors at T2.

CONCLUSIONS

The findings suggest that parental factors may be significant predictors of adolescent IGD. Health interventions should consider involving parents to increase the effectiveness of treatment to prevent and reduce adolescent IGD.

The relationship between Internet addiction and childhood trauma in adolescents: The mediating role of social support

BACKGROUND

Adolescents are at high risk of Internet addiction (IA). Previous studies have shown that the occurrence of IA may be associated with childhood trauma and social support to varying degrees. This study aimed to investigate the pathogenesis of IA in adolescents. Further, to explore the potential mediating role of social support in childhood trauma and IA. This study provides theoretical support for future interventions targeting IA in adolescents.

METHODS

This study used a descriptive cross-sectional design. The Childhood Trauma Questionnaire (CTQ), Social Support Rating Scale (SSRS), and Young's Internet Addiction Test (IAT) were used to conduct an anonymous questionnaire survey among randomly selected adolescents aged less than 18 years old in two cities in southern Anhui Province. Descriptive statistics and correlation analysis were used to test the correlation between IA and other variables. A binary logistic regression model was used to explore the influencing factors of IA. Multiple regression models were examined with process macro and bootstrapping to confirm significant mediating effects.

RESULTS

A total of 844 adolescents, equally divided between males and females, participated in this study, and the prevalence of IA in the region was 23.0%. Through the mediation test, the direct effect of childhood trauma on IA was 0.20 (95% CI [0.12, 0.27], p < 0.001), and the mediating effect of social support on childhood trauma and IA was 0.09 (95% CI [0.06, 0.14]).

CONCLUSION

The study showed that childhood trauma significantly affected the incidence of IA in adolescents. Social support had a significant mediating effect on childhood trauma and IA and attenuated its negative effects.

Does Time Spent Online Affect Future Psychopathology in Adolescents?

Abstract. Theoretical background: In cross-sectional studies, high levels of online time proved to be empirically related to a higher risk of online behavioral addictions, which in turn are cross-sectionally and longitudinally associated with psychopathology. First results indicated that online behavioral addictions could predict a higher psychopathological burden. Objective: We empirically examined whether online time is also a predictor of future psychopathology in youth. Methods: In a longitudinal study, we explored whether 249 adolescents (55.0 % girls, aged 15.31 years, SD = 1.78) were at increased risk for problematic Internet use at baseline (t1) and 12-month later (t2) using standardized questionnaires regarding psychopathology (SDQ), online behavioral addictions (CIUS), and time spent online. Results: In linear regression analyses, online time was not a statistically significant predictor of any psychopathological burden 12 months later (at t2), after controlling for gender, age, online behavioral addictions, and respective symptoms of psychopathology (all at t1). Discussion and conclusion: Time spent online does not seem to predict future psychopathological strain during adolescence.

Loot boxes use, video gaming, and gambling in adolescents: Results from a path analysis before and during COVID-19-pandemic-related lockdown in Italy

Loot Boxes (LBs), i.e., virtual items embedded within video games with numerous features reminiscent of gambling, are increasingly widespread among adolescents. LB use is associated with problem gambling in youth, but few studies have been conducted on the association between LB use and gambling behavior considering adolescents. Thus, the mechanisms underlying this relationship are not clear. As LB use is a significant and positive risk factor for video gaming severity, and video gaming is associated with problem gambling, we hypothesized that LB use would be related to gambling frequency and problem gambling through the intermediary role of video gaming frequency and problem video gaming. We tested our hypothesis before COVID-19-pandemic-related lockdown and during COVID-19-pandemic-related lockdown, in Italy. Study 1 was conducted with 1,078 high school students (39% boys, mean age = 16.46, SD = 1.28) before COVID-19-pandemic-related lockdown, and Study 2 was conducted with 1,204 high school students (57% boys, mean age = 15.62, SD = 0.64) during COVID-19-pandemic-related lockdown. A path analysis was carried out to analyze the significance of indirect effects from LB use to gambling behavior and problem gambling through video gaming and problem video gaming. In both the studies, results showed that LB use exerted significant and positive direct effects on video gaming frequency, problem video gaming, and gambling frequency. Moreover, LB use had indirect significant and positive effects on problem gambling through video gaming frequency, problem video gaming, and gambling frequency. Findings attest that LB use can be related to problem gambling through a greater involvement in videogames. Thus, a specific subtype of young gamblers can develop Gambling Disorder symptoms from the use of LBs and through an intense use of video games. Practical implications for prevention and treatment are discussed.

Relationship between time spent playing internet gaming apps and behavioral problems, sleep problems, alexithymia, and emotion dysregulations in children: a multicentre study

BACKGROUND

Internet gaming addiction (IGA) is a serious condition that can significantly impact personal and social functioning. Many studies of IGA have been conducted in adolescents and young adults, but there are limited data available in children. We investigated the time spent using internet gaming apps in children and its association with behavioral problems, sleep problems, alexithymia, and emotional regulation.

METHODS

The research populations (N = 564) were categorized based on the number of hours spent using online gaming applications. The Strengths and Difficulties Questionnaire, the Children's Sleep Habits Questionnaire Abbreviated, the Children's Alexithymia Measure (CAM), and the Clinical Evaluation of Emotional Regulation-9 were used to assess all participants.

RESULTS

Compared to other groups, children who used internet gaming applications for more than 6 h had a higher proportion of abnormal responses on the emotional symptoms and hyperactivity scales. Children who used internet gaming applications for more than 6 h had the poorest sleep quality (75%), while children who used internet gaming applications for 1-2 h had the best (36.7%). Participants who used internet gaming apps for 1-2 h had significantly lower mean total scores on the emotional regulation scale and total CAM, whereas those using internet gaming apps for more than 6 h had the highest mean scores in the CAM.

CONCLUSIONS

Excessive use of internet gaming apps during childhood may be associated with hyperactivity, peer problems, high socioeconomic level, alexithymia concerns, shorter daytime sleep duration, and a delayed morning wake-up.