Features of Parent-Child Relationships in Adolescents with Internet Gaming Disorder

Internet gaming disorder predicts the incidence, persistence, and worsening of suicidal ideation: A population-based cohort study of 96,158 Chinese adolescents

INTRODUCTION

While cross-sectional studies suggest a strong association between internet gaming disorder (IGD) and suicidal ideation, longitudinal evidence is limited. This two-wave longitudinal study investigated whether IGD predicts the one-year incidence, persistence, and worsening of suicidal ideation.

METHODS

A total of 96,158 Chinese adolescents were assessed in November 2022 and one year later. IGD was measured using the 9-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF), categorizing participants as non-gamers, gamers without IGD, and gamers with IGD. Suicidal ideation and their severity were evaluated using the ninth item of the 9-item Patient Health Questionnaire. Baseline demographics, lifestyle factors, and internalizing and externalizing problems were collected and controlled. Multiple logistic regression models examined associations between IGD and incident, persistent, and worsening suicidal ideation, with subgroup and sensitivity analyses performed.

RESULTS

The prevalence of baseline suicidal ideation was 21.4 %, including 17.5 % mild, 2.5 % moderate, and 1.3 % severe. The one-year incidence and persistence rates of suicidal ideation were 13.8 % and 50.1 %, respectively. Among 19,254 adolescents with mild or moderate suicidal ideation, 1656 reported worsening over the year. Compared to non-gamers, gamers with IGD had a higher risk of incident (adjusted odds ratio [AOR], 1.95; 95 % CI, 1.57-2.42), persistent (AOR, 1.56; 95 % CI, 1.34-1.82), and worsening suicidal ideation (AOR, 1.75; 95 % CI, 1.37-2.23) (all p < 0.001).

CONCLUSIONS

IGD contributes to the development, persistence, and worsening of suicidal ideation among Chinese adolescents. Targeted interventions addressing IGD may reduce suicidal ideation in this population.

LIMITATIONS

Self-reported data potentially introduced bias.

Prevalence and predisposing factors of digital game addiction and cyberbullying in adolescents: A cross-sectional study

OBJECTIVES

This research was conducted to measure the prevalence of digital game addiction and cyberbullying and their predisposing factors among adolescents.

STUDY DESIGN

A cross-sectional design.

METHODS

The sample consisted of 1002 adolescents (the mean age was 15.77 (SD = 1.08), and 95.1 % boys) from a vocational high school. Data were collected through a questionnaire, the Digital Game Addiction Scale, and the Revised Cyberbullying Inventory-II. Associations were analyzed with multiple logistic regression analyses.

RESULTS

The prevalence of digital game addiction was 41.5 %. The risk of digital game addiction was higher among adolescents who were cyberbullies (2.3 times), those who played games for 4 h or more (5.1 times), and those who played action/adventure (1.4 Times) and sci-fi games (1.5 times). The risk of cyberbullying was higher in adolescents who were addicted to digital games (2.3 times) or used the Internet for 5 h or more (2.2 times). Meeting on the Internet (2 times) and being a 9th-grader (2 times) compared to 10th and 11th-graders increased the risk of being a cyberbully.

CONCLUSIONS

The study concluded that about half of the adolescents were addicted to digital games, and the majority of them were cyberbullies. Common predisposing factor for digital game addiction and cyberbullying was found to be time spent on the Internet.

Internet gaming disorder and suicidal behaviors mediated by sleep disturbance: a large-scale school-based study in 135,174 Chinese middle school students

Emerging research suggests a positive association between Internet gaming disorder (IGD) and suicidal behaviors. However, existing studies predominantly focus on suicidal ideation rather than suicide attempts and often do not adequately control for potential psychological confounders. The mechanism linking IGD to suicidality remains unclear. This study aims to assess the independent association between IGD and suicidal behaviors and to examine the mediating role of sleep disturbance among Chinese adolescents. We recruited 135,174 middle school students from Zigong City using cluster sampling. Data on demographics, suicidal ideation, and suicidal attempts were collected. IGD was assessed using the Internet Gaming Disorder Scale-Short Form. Mental distress, including depression, anxiety, hyperactivity/inattention, conduct problems, sleep problems, and psychotic experiences, was evaluated using standardized questionnaires. Multiple logistic regression models and mediation analysis were conducted. The prevalence rates of IGD, suicidal behaviors, suicidal ideation, and suicide attempts were 1.6%, 16.7%, 11.9%, and 9.8%, respectively. Adolescents with IGD showed a significantly higher risk for suicidality: nearly 60% reported suicidal behaviors, 50% reported suicidal ideation, and 40% reported suicide attempts. Both IGD and gaming usage were independently linked to suicidal behaviors. Sleep disturbance partially mediated the relationship between IGD and suicidal behaviors, accounting for 47.0% of the total effect. Our studies call for timely and regular assessments for suicidality and sleep disturbance in IGD. Targeted interventions addressing sleep disturbance might reduce suicidal risk among adolescents with IGD.

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.

The association between digital addiction and interpersonal relationships: A systematic review and meta-analysis

Digital addiction (DA) has been identified as an emerging public health problem worldwide. However, the extent and direction of the association between DA and interpersonal relationships (IRs) are unknown. Does DA have adverse effects on IRs, and how credible is the evidence for this association in published analyses of real-world data? Using the PRISMA method, we conducted a meta-analysis to quantitatively synthesize the results of the relevant studies and obtain reliable effect size estimates and performed an analysis of moderating factors. A systematic literature search identified 98 studies involving 134,593 participants and 99 effect sizes. A significant negative association was observed between DA and IRs. Importantly, our meta-analysis revealed that the DA subtype has no significant moderating effect on IRs, suggesting that combining numerous categories of DA rather than focusing on specific forms of DA may be appropriate for understanding the relationship between DA and IRs. Relative to the IR subtype, the association between DA and offline relationships is significant and negative, whereas the association between DA and online relationships is significant and positive. The strength of the relationship is also influenced by the participants' sex ratio, educational level, and measurement tools. These results may help resolve the disagreement over the magnitude and direction of the association between DA and IRs and have potential implications for the treatment of DA.

Parent-adolescent conflict and problematic internet use among Chinese adolescents: the mediating role of depression and the moderating role of school climate

BACKGROUND

Problematic Internet use (PIU) may lead adolescents to physical, emotional, social, or functional impairment due to the risky, excessive, or impulsive internet use manner. How do the experiences of adolescents influence them using the internet in a problematic manner? The answer to this question is the key to preventing and intervening PIU of adolescents. To address this question, we focus on the interactions among family (parent-adolescent conflict), school (school climate), and individual factors (PIU, depression), exploring the influence factors of PIU.

METHODS

A moderated mediation model was constructed to explore the relationship between variables. Using a two-wave longitudinal design with a six-month interval between timepoints, this study collected data from 801 Chinese adolescents (411 boys, Mage = 14.68) by questionnaires. Path analysis was employed to test the model and participants' age, sex and baseline were controlled.

RESULTS

Parent-adolescent conflict at Time 1 (T1) was positively related to PIU at Time 2 (T2) in adolescents. Depression at T2 mediated the relationship between parent-adolescent conflict at T1 and PIU at T2. School climate at T2 significantly moderated the mediation effect of depression on the relationship between parent-adolescent conflict at T1 and PIU at T2. Specifically, positive school climate could significantly weaken the negative effect of depression on PIU for adolescents with low level of depression.

CONCLUSIONS

The present study reveals that parent-adolescent conflict leads to PIU in adolescents through depression whilst the school climate moderates the impacts of depression on PIU. This adds further evidence regarding the significance of systematically and consistently incorporating family and school in the alleviating of problem behaviors displayed by teens.

When the Relationship Is at Stake: Parents' Perception of the Relationship with a Child with Problematic Gaming and Their Perceived Need for Support

Intrapersonal parental factors play a significant role in the development of problematic gaming in children. However, few studies have explored parental perspectives on their relationship with a child engaged in problematic gaming, as well as the need for support parents perceive in relation to the child's gaming. We conducted semi-structured interviews with 12 parents (83.3% women) of 11 children (81.8% boys, Mage = 15 ± 2) to examine how parents of children with problematic gaming behavior perceive the parent-child relationship and their need for additional support. We analyzed qualitative accounts using thematic analysis to identify themes and subthemes while drawing on the theoretical frameworks of Aaron Antonovsky's theory of sense of coherence (SOC) and Jürgen Habermas' theory of logic. Participants described difficulties regarding all three components of SOC (meaningfulness, comprehensibility, and manageability) in relation to their child's gaming, with the most significant challenge being manageability. Parents primarily sought assistance from institutions and organizations, such as mental health services, to enhance manageability. The findings emphasize parents' need for relational and practical support tailored to their unique context, as well as their wish to be more involved in the treatment of their children.

Does parents' perceived style of setting limits to gaming matter? The interplay between profiles of parental mediation and BIS/BAS sensitivity in problematic gaming and online gambling

INTRODUCTION

Parents try to prevent possible negative outcomes associated with gaming by setting rules on their adolescent's gaming behavior (i.e., restrictive mediation). Parents can use either more autonomy-supportive or more controlling styles to communicate those rules. Using a person-centered approach, this study aims to, first, identify profiles of parents' perceived degree of restrictive mediation in gaming and styles of communicating these rules (i.e., autonomy-supportive and controlling); second, to examine how adolescents in different profiles differ in terms of maladaptive gaming outcomes (i.e., problematic gaming, simulated, and online gambling); third, to investigate the moderating role of gaming frequency and adolescents' personality (i.e., behavioral inhibition system [BIS] sensitivity and behavioral activation system [BAS] sensitivity) in the associations between the parental profiles and the outcomes.

METHODS

The study used quantitative, cross-sectional survey data from Belgian adolescents (N = 1651, mean age = 14.00 years, 51.2% boys), collected between November 2021 and February 2022 in schools.

RESULTS

Cluster analysis yielded four profiles of perceived restrictive mediation: an exclusively controlling one, an autonomy-supportive one, one where parents used a perceived mix of both communication styles, and one where there was an overall perceived lack of restrictive mediation. Adolescents in the controlling profile displayed the most maladaptive outcomes. Some of the associations between the parental profiles and the outcomes were stronger for more frequent gamers and for adolescents scoring higher on both BIS and BAS sensitivity.

CONCLUSION

Associations between the parental profiles and gaming outcomes were theoretically meaningful, yet small in terms of effect size.

"I have no control over how much time I play" the metacognitions about online gaming scale: Evidence from a cross-cultural validation among Israeli adolescents

In the current study we evaluated the psychometric properties of the Metacognitions about Online Gaming Scale (MOGS), including its factor structure, reliability, and predictive validity among Israeli adolescents in a six-month prospective study. We also examined the usefulness of the MOGS as a mediator of the effect of attachment patterns on Internet Gaming Disorder (IGD), the preference for online social interactions, and the motives for online gaming. The study population included 1,056 Israeli adolescents (610 males and 446 females, M = 15.77, standard deviation (SD) = 1.43) with an age range of 13-18 years. The participants completed the translated Hebrew version of the MOGS and measures on attachment style, IGD, preference for online social interactions, emotion regulation, and motives for online gaming. The analyses indicated that the factorial structure of the Hebrew MOGS comprised the expected two factors at T1 and T2 (a six-month follow-up). We also found that positive and negative metacognitions significantly mediated the effect of attachment styles on IGD, the preference for online social interactions, and the motives for online gaming. The findings provide evidence that the Hebrew MOGS among Israeli adolescents appears psychometrically appropriate for use by researchers and practitioners dealing with the prevention and treatment of IGD.

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.

Problematic Use of Video Games, Social Media, and Alcohol: Associations with Mother-Child Relationship

INTRODUCTION

According to current concepts of developmental tasks, both the use of digital media and the consumption of psychotropic substances are age-typical challenges for adolescents. The majority overcomes these developmental tasks, but a substantial proportion of youth develops problematic usage patterns (e.g., of video games) or problematic consumption behavior (e.g., of alcohol). Empirical findings show the importance of family aspects for these problematic behavior patterns. Currently, it is not clear which specific areas of parent-child relationship are associated in each case and whether there are differences between substance-related and substance-unrelated problematic behavioral patterns.

METHODS

We surveyed 480 adolescents (45.2% females, mean age = 16.84 years) with standardized instruments regarding the mother-child relationship as well as problematic gaming, problematic social media use, and problematic alcohol use. We conducted correlation and multiple linear regression analyses (separately for problematic gaming, problematic social media use, and problematic alcohol use) as well as a multivariate multiple regression analysis.

RESULTS

In the regression analyses, more conflicts with the mother were related to all three behavioral patterns. However, lower cohesion was only statistically significantly associated with problematic alcohol use, but not with problematic gaming and problematic social media use, whereas lower autonomy and more frequent punishment of the child were statistically significantly related to problematic gaming and problematic social media use, but not to problematic alcohol use.

DISCUSSION/CONCLUSION

The findings indicate partially different relational dynamics for substance-related and substance-unrelated problem behaviors (interestingly, for cohesion and autonomy, the 95% confidence intervals of the standardized regression coefficients were not overlapping). The results of the present study could be used in family-based prevention approaches or in treatments in the clinical setting.

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.

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 association between parent-child relationship and problematic internet use among English- and Chinese-language studies: A meta-analysis

As past studies of the association between parent-child relationship and problematic internet use show mixed results and are influenced by many factors, this meta-analysis of 75 primary Chinese and English language studies from 1990 to 2021 with 110,601 participants (aged 6−25 years) explored (a) the overall association between parent-child relationship and problematic internet use, and (b) whether the association is affected by their types, country, measures, objects of the parent-child relationship, gender, age, year and publication types. We used funnel plots, Classic fail-safe N and Egger's test to test for publication bias and for moderation with the homogeneity tests. The results showed a negative association between quality of parent-child relationship and problematic internet use (r = −0.18, 95% CI = [−0.20, −0.15]). The moderation analysis found that compared with internet addiction tendency, the association between social media addiction and parent-child relationship was stronger. Moreover, the association between the parent-child relationship and problematic internet use of emerging adults (18–25 years old) was stronger than that of adolescents (12−18 years old). Furthermore, the negative association between parent-child relationship and problematic internet use was weaker (a) in Italy than those in Turkey and China, (b) when using CPS (Closeness to Parents Scale), IPPA (Inventory of Parent and Peer Attachment), or PARQ (Parent-Child Relationship Questionnaire) measuring parent-child relationship than using PCCS (Parent-Child Communication Scale), (c) when using IAT measuring problematic internet use rather than using IGDS or APIUS. Hence, these results indicate a negative association between parent-child relationships and problematic internet use, and the association is moderated by types of problematic internet use, age, country, scales of both parent-child relationship and problematic internet use.

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.

“Game (not) Over”: A Systematic Review of Video Game Disorder in Adolescents

This study aims to characterize video game use disorder in adolescents, identifying the particularities of those who present it, its effects at the brain level, related factors, and existing measurement instruments. A systematic review of the scientific publications available in Scopus was carried out, between the period 2014-2018 on video game use disorder in adolescents. Adolescents with this disorder are characterized by being mostly men, spending more time daily and weekly playing than adolescents without this disorder, showing diverse symptoms in the behavioral, affective, and cognitive areas. At brain level, it is referred that in this disorder there is an increase and decrease in the activation of specific areas of the brain. Likewise, the presence of some psychological disorder and impulsivity are considered factors that increase the risk of suffering from it. However, there are protective factors as school commitment and parental supervision, among others. How to cite: Rojas-Jara, C., Polanco-Carrasco, R., Navarro-Castillo, R., Faúndez-Castillo, F., & Chamorro-Gallardo, M. (2022). “Game (not) Over”: A Systematic Review of Video Game Disorder in Adolescents. Revista Colombiana de Psicología, 31(2), 45-64. https://doi.org/10.15446/rcp.v31n2.90741

Internet Gaming Disorder: Evidence for a Risk and Resilience Approach

Although previous research has noted a range of factors that predict developing Problematic Video Game Use (PVGU) and Internet Gaming Disorder (IGD), few studies have looked at risk and protective factors together, and there is scant empirical evidence examining whether risk for PVGU or IGD increases or decreases as risk or protective factors accumulate in the individual. The aim of the current study was to examine both issues using predictors from three demonstrated PVGU and IGD risk categories: executive dysfunction, unmet needs in everyday life, and unhelpful family environment. In a survey of N = 866 12–17-year-old school students, the risk/protective factors that most strongly predicted severity of IGD symptomology and meeting IGD diagnostic criteria were self-control and social exclusion. Other significant predictors included impulsivity, self-esteem, mastery, control of one’s external environment, and better parent-child attachment quality. Trend analyses revealed a linear increase in the risk of PVGU as risk and net-risk factors accumulated, and a decrease as protective and net-protective factors accumulated. Thus, a net accumulation of issues around impulse control and unmet needs in everyday life may predispose adolescents to PVGU or IGD. Results support a ‘risk and resilience’ approach to adolescent screen-based disorders and suggest potential benefits to a risk factor focus in treatment.

Research on the Mechanism of Parent-Child Attachment to College Student Adversarial Growth

This study explores the impact of parent–child attachment mechanisms on adversarial growth among Chinese students. After Chinese college students start independent life away from their parents, they face adversity on their own. However, their original family always influences students’ methods for dealing with adversity and how they grow and mature. A survey of 364 college students found that parental trust and communication have positive impacts on adversarial growth through the improvement of self-identity, while parental alienation reduces self-identity and contributes negative effects on the adversarial growth of college students. Internal control personality has a negative moderating effect between parental trust, parental communication, and adversarial growth and a positive moderating effect between parental alienation and adversarial growth. Low internal control personality therefore has a positive influence on parental trust and communication on adversarial growth and decreases the negative influence of parental alienation. A substitution effect between internal control personality and parental attachment was also found. Different child personality requires different type of parent–child attachment relationship to maximize their ability to handle future adversity.

Adolescent Internet gaming addiction and personality characteristics by game genre

With the emergence of a new concept called 'Internet Gaming Disorder' in DSM-5 and ICD-11, related research is underway around the globe. However, not enough literature on Internet gaming addiction has considered the diversity in game genres. Internet gaming addiction may take on a different form according to the particular characteristics of a game being played. To better understand adolescent Internet gaming addiction, this study sought to identify the differences in Internet gaming addiction and personality characteristics based on the game genre played. A total of 3,217 elementary and middle school students across Korea participated in the survey that included the Maladaptive Game Use Scale and the Adolescent Personality Questionnaire. ANOVA analysis revealed that Internet gaming addiction and personality characteristics varied according to the game genre played. In particular, post-hoc tests showed that Real-Time Strategy (RTS) and First-Person Shooter (FPS) game users have higher levels of tolerance, withdrawal, and neglect of everyday life compared to other genres such as Role-Playing Game (RPG), Racing, and Arcade/Shooting. Also, Internet gamers users of particular genres showed significantly lower self-esteem (Arcade/Shooting), conscientiousness (Racing), empathy (RPG), and sense of community (Racing and RTS) scores than comparison group. The implications of the study results were discussed with a special emphasis on Internet gaming addiction interventions.

The association of mobile touch screen device use with parent-child attachment: a systematic review

Mobile touch screen devices (smartphones and tablet computers) have become an integral part of many parents' and children's lives, with this interaction linked to physical, mental and social outcomes. Despite the known importance of parent-child attachment, evidence on the association between device use and attachment was yet to be reviewed. Following protocol pre-registration, databases were searched, papers screened, and methodological quality assessed. Three papers met the inclusion criteria, and reported some negative associations between duration of parent/child smartphone use and attachment outcomes. A narrative synthesis on two groups of related papers found child time using any screen technology (including television viewing), and child 'problematic' internet, mobile phone, gaming and social media use, was negatively associated with attachment outcomes. Currently there is limited direct evidence on any association between time parents or children spend using these devices and parent-child attachment to support time guidelines for families and professionals working with families. Practitioner summary: Many parents and children regularly spend time using smartphones and tablet computers. This systematic review found limited evidence evaluating associations between child/adolescent or parent time using devices and parent-child attachment. Until quality evidence exists, practitioners should be alert to potential impacts of device use on family relationships and child outcomes.

[Parental factors in internet and computer game addiction in adolescence: An overview]

Parental factors in internet and computer game addiction in adolescence: An overview Abstract. Objective: Internet-related disorders (IRD) in adolescents and young adults are closely linked to family factors. However, few research and review articles include the family. To this end, N = 87 scientific papers were integrated into the literature review. Method: The present work gives an overview of parental factors that can be involved in the development, maintenance, and reduction of symptoms. Results: The literature provides clear connections between the parent-child relationship and IRD in adolescents and young adults. The quality of parent-child communication appears to be a promising approach for influencing IRD symptoms. There are indications that, at least for some families, encouraging the time spent together could be helpful. Regarding educational aspects, a distinction should be made between different areas. Parental knowledge and control of internet use seem to be protective factors. The effect of rules and restrictions, however, is unclear. Conclusions: To change IRD symptoms, it makes sense to improve the parent-child relationship. However, the ways to achieve that have hardly been explored. Recommendations regarding parenting strategies (e. g., rules and restrictions) should be formulated very carefully, as the effects are still unclear. The integration of parents in prevention and intervention efforts is advocated by many researchers, but there only individual studies have considered parents in the context of interventions.

Factors associated with severity, incidence or persistence of internet gaming disorder in children and adolescents: a 2-year longitudinal study

AIM

This study examined factors associated with severity, incidence and/or persistence of internet gaming disorder (IGD) in children and adolescents.

DESIGN, SETTING, PARTICIPANTS

Prospective cohort study with 2-year follow-up study in South Korea. A total of 2319 3rd-, 4th- and 7th-graders enrolled into the internet user cohort for unbiased recognition of gaming disorder in early adolescence [intramural Continuing Umbrella of Research Experiences (iCURE)] and analyzed for the current study.

MEASUREMENTS

Severity of the IGD features was assessed by the Internet Game Use-Elicited Symptom Screen (IGUESS), a self-reported questionnaire based on the DSM-5 IGD criteria. Participants with IGUESS scores ≥ 10 were considered to be at high risk for IGD (HIGD). Time spent playing on-line games, game types, depressive symptoms, trait anxiety, attention deficit hyperactivity disorder (ADHD) symptoms, social support, openness of communication with parents, attachment to parents and potential confounders were assessed by self-report.

FINDINGS

A total of 175 (7.5%) students were classified as HIGD cases upon initial assessment. The independent risk factors of incidence of HIGD included playing on-line games for ≥ 240 minutes/day, playing multi-player games, depressive symptoms and ADHD symptoms [adjusted rate ratios (aRRs) = 2.03, 1.63, 2.04, 2.53, respectively; all P < 0.05]. Factors related to changing IGD severity scores were playing on-line games for 60-239 minutes/day, playing single-player on-line games, higher attachment and social support [adjusted incidence rate ratio (aIRRs) = 1.38, 1.22, 0.86, 0.87, respectively; all P < 0.05]. Independent predictors of persistence of HIGD were playing on-line games for ≥ 240 minutes/day and ADHD symptoms (aRRs = 2.63, 2.14, respectively; all P < 0.05).

CONCLUSIONS

Among adolescents in South Korea, the existence of ADHD symptoms and spending more than 4 hours per day playing on-line games were associated with the occurrence or persistence of high risk for internet gaming disorder.

Factors related to Internet and game addiction among adolescents: A scoping review

Background

Understanding factors influencing Internet and game addiction in children and adolescents is very important to prevent negative consequences; however, the existing factors in the literature remain inconclusive.

Objective

This study aims to systematically map the existing literature of factors related to Internet and game addiction in adolescents.

Methods

A scoping review was completed using three databases - Science Direct, PROQUEST Dissertations and Theses, and Google Scholar, which covered the years between 2009 to July 2020. Quality appraisal and data extraction were presented. A content analysis was used to synthesize the results.

Results

Ultimately, 62 studies met inclusion criteria. There were 82 associated factors identified and grouped into 11 categories, including (1) socio-demographic characteristics, (2) parental and family factors, (3) device ownership, Internet access and location, social media, and the game itself, (4) personality/traits, psychopathology factors, self-efficacy, (5) education and school factors, (6) perceived enjoyment, (7) perceived benefits, (8) health-compromising behaviors, (9) peers/friends relationships and supports, (10) life dissatisfaction and stress, and (11) cybersafety.

Conclusion

Internet and game addiction among adolescents are multifactorial. Nurses should consider the factors identified in this study to provide strategies to prevent and reduce addiction in adolescents.

Social and Behavioral Health Factors Associated with Violent and Mature Gaming in Early Adolescence

We examined how risk level of video games, measured by maturity and violence level, was associated with behavioral health, social impacts, and online social interactions. School-based surveys in two different cohorts assessed self-reported gaming behaviors, health, and social media use. For Study 1, our 700 participants were 52% female and 48% White (mean age 12.7). Middle school students who played the high-risk games reported higher depressive symptoms and problematic internet behaviors, less sleep, more time spent playing games, and higher frequency of checking social media than non-gaming students. Those who played high-risk games were less likely to play alone and to play with strangers than those who played minimal-risk games. For Study 2, our 772 participants were 50% female and 57% White (mean age 12.6). Similar to Study 1, we found that those who played the high-risk games spent significantly more time playing games, were more interactive with other players, and had poorer sleep outcomes than non-high-risk gamers. Additionally, playing high-risk games had significantly different social impacts of gaming compared to less-risky gaming, including spending more money on games, spending less time on homework and with family or skipping meals due to gaming. Mature and violent content of video games and amount of online social interaction associated with gaming play a strong role in behavioral health and social impacts within families. These results can inform guidelines to intervene when problematic behaviors emerge.

Exploring mentalization, trust, communication quality, and alienation in adolescents

INTRODUCTION

A growing body of evidence has demonstrated the importance of mentalization for adolescents' psychosocial functioning; however, further research is needed to understand links between mentalization and other socio-cognitive factors. The aim of this quantitative, cross-sectional study was to investigate the relationship between a teen's capacity to mentalize and three attachment-related factors: parent-teen trust, parent-teen communication, and parent-teen alienation.

METHODS

In an online survey, 82 (mainly) Australian adolescents (57 female; 23 male; 2 non-binary; mean age 17.09 years) completed: i) The Children's Eyes Test, which measured mentalization; and ii) The Inventory of Parent and Peer Attachment-45, which measured trust, communication quality, and alienation.

RESULTS

In teens' relationships with both mothers and fathers, trust and communication quality were significantly positively correlated (p = .001) when controlling for age and gender. Both were significantly negatively correlated with alienation (p = .001) with control variables included. Capacity to mentalize did not correlate with trust, communication quality, or alienation in relationships with either mothers or fathers (p ≤ .05).

CONCLUSIONS

Possible reasons are proposed for why no relationship was found between mentalization and trust, communication quality, or alienation. Implications for future research are discussed.

Early-Life Interpersonal and Affective Risk Factors for Pathological Gaming

Internet gaming is among the most popular entertainment options, worldwide; however, a considerable proportion of gamers show symptoms of pathological gaming. Internet gaming disorder (IGD) has been proposed to describe a behavioral addiction, which shares many similarities, both physical and psychological, with substance use disorder. Environmental factors, such as interpersonal and relationship dynamics during childhood and adolescence, have been suggested to modulate the onset and trajectories of IGD. However, studies exploring the contributions of dysfunctional family environments to the development of IGD remain limited. This minireview aims to offer an overview of the current knowledge regarding the impacts of early-life interpersonal and relationship dynamics on the development of IGD and to provide a snapshot of the current state of the literature in this field. Specifically, it underlines the modulatory role of early-life relational factors such as a) family function, b) parent-child relationships, c) childhood maltreatment, and d) bullying and cyberbullying on the development of IGD. Consistent with this evidence, therapeutic interventions that aim to "restructure" the emotional ties and familiar dynamics that are known to be associated with dysfunctional behaviors and feelings, and likely promote pathological gaming, are recognized as the most successful clinical therapeutic approaches for IGD.

Parent-adolescent attachment and peer attachment associated with Internet Gaming Disorder: A longitudinal study of first-year undergraduate students

BACKGROUND AND AIMS

Given that Internet Gaming Disorder (IGD) has tentatively been included in DSM-5 as a psychiatric disorder, it is important that the effect of parental and peer attachment in the development of IGD is further explored.

METHODS

Utilizing a longitudinal design, this study investigated the bidirectional association between perceived parent–adolescent attachment, peer attachment, and IGD among 1,054 first-year undergraduate students (58.8% female). The students provided demographic information (e.g., age, gender) and were assessed using the nine-item Internet Gaming Disorder Scale and the Inventory of Parent and Peer Attachment. Assessments occurred three times, six months apart (October 2017; April 2018; October 2018).

RESULTS

Cross-lagged panel models suggested that IGD weakly predicted subsequent mother attachment but significantly negatively predicted father attachment. However, father and mother attachment did not predict subsequent IGD. Moreover, peer attachment had a bidirectional association with IGD. Furthermore, the model also demonstrated stable cross-sectional negative correlations between attachment and IGD across all three assessments.

DISCUSSION AND CONCLUSIONS

The findings of the present study did not show a bidirectional association between parental attachment and IGD, but they did show a negative bidirectional association between peer attachment and IGD. The results suggested previous cross-sectional associations between IGD and attachment, with larger links among males than females at the first measurement point. We found that peer attachment negatively predicted subsequent IGD, which indicates that peer attachment plays an important role in preventing addictive gaming behaviors for university students.

Parent-child relationship and smartphone use disorder among Chinese adolescents: The mediating role of quality of life and the moderating role of educational level

The present study explored the effect of parent-child relationship on Smartphone Use Disorder (SUD) and the mediating role of quality of life (QOL). In addition, we explored the role of educational level from the developmental psychology perspective. Our results indicate that: (1) parent-child relationship could negatively predict SUD among adolescents; (2) QOL played a partial mediator role in the relationship between parent-child relationship and SUD; (3) As educational level increased from elementary school to middle school to high school, the effect of parent-child relationship on QOL weakened. This study showed that adolescents with good parent-child relationship had a higher QOL thus exhibiting a lower extent of SUD. Moreover, the link between parent-child relationship and SUD weakened as the educational level increased.

Prevalence and Interpersonal Correlates of Internet Gaming Disorders among Chinese Adolescents

This study investigated the prevalence and interpersonal correlates of Internet gaming disorders (IGD) among Chinese adolescents. A cross-sectional survey was conducted in two cities (Shanghai and Xi’an) in China. A total of 2666 (Mean_age = 12.77 ± 0.75) year-one students from eight middle schools completed a self-reported questionnaire. It tested their levels of IGD, parental psychological control, negative interpersonal events (physical/verbal abuse by parents, verbal abuse by teachers, peer/online bullying), social support from parents/peers, and positive relationships with parents/peers. Results showed that 346 participants (13.0%) were classified as having IGD. Gender, city, single-parent family, family socio-economic status, and mother’s education level were significantly associated with the risk of IGD. Logistic regression analyses with and without controlling for the significant background variables showed that the studied interpersonal variables were significantly associated with IGD, respectively. Forward stepwise logistic regression showed that the significant correlates of IGD included parental psychological control, physical/verbal abuse by parents, verbal abuse by teachers, and peer/online bullying. Results highlight the importance of addressing interpersonal risk factors to reduce adolescent IGD. Limitations and implications of this study are discussed.

Bio-psychosocial factors of children and adolescents with internet gaming disorder: a systematic review

Previous large-scale studies suggest that internet gaming disorder (IGD) among children and adolescents has become an important public concern. Minors are known to be particularly susceptible to problematic internet gaming use owing to age-related underdevelopment of cognitive control. It has been shown that precursors of addictions appear during adolescence; therefore, prevention efforts must be established targeting minors who have their first experience with addictive substances and behaviors during pubescence. Since the DSM-5 classification of IGD in 2013, studies on IGD have drastically increased in number. Thus, we performed an updated review of studies of IGD in children and adolescents to assess the clinical implications of IGD. The search included all publication years, using PubMed, MEDLINE, and PsycINFO. Across studies, the presence of IGD had a negative effect on sleep and schoolwork in minors. Additionally, family factors, including the quality of parent-child relationships, were important social factors in minors with IGD. Brain imaging studies indicate that impaired cognitive control in minors with IGD is associated with abnormal function in the prefrontal cortex and striatum. Persistent pathological online game use from childhood may aggravate abnormal brain function; therefore, preventive care and early intervention are increasingly important. Although extant research supports the effectiveness of cognitive behavioral therapy for minors with IGD, effective psychological intervention for minors with IGD is an urgent issue that requires further research. This review, which presents updated findings of IGD in minors, is expected to contribute to the development of future research and be useful in clinical practice in the field of child and adolescent psychiatry.

Treatment efficacy of a specialized psychotherapy program for Internet Gaming Disorder

BACKGROUND AND AIMS

Internet Gaming Disorder (IGD) has become health concern around the world, and specialized health services for the treatment of IGD are emerging. Despite the increase in such services, few studies have examined the efficacy of psychological treatments for IGD. The primary aim of this study was to assess the efficacy of a specialized psychotherapy program for adolescents with IGD [i.e., the "Programa Individualizado Psicoterapéutico para la Adicción a las Tecnologías de la Información y la Comunicación" (PIPATIC) program].

METHODS

The sample comprised 31 adolescents (aged 12-18 years) from two public mental health centers who were assigned to either the (a) PIPATIC intervention experimental group or (b) standard cognitive-behavioral therapy (CBT) control group. The interventions were assessed at pre-, middle-, and post-treatment phases, as well as a 3-month assessment was carried out after completing the interventions.

RESULTS

No significant differences between either group in the pre-treatment phase were found. Relating to the different interventions examined, significant differences were found at pre-test and post-test on the following variables: comorbid disorders, intrapersonal and interpersonal abilities, family relationships, and therapists' measures. Both groups experienced a significant reduction of IGD symptoms, although the PIPATIC group experienced higher significant improvements in the remainder of the variables examined.

DISCUSSION AND CONCLUSIONS

The findings suggest that PIPATIC program is effective in the treatment of IGD and its comorbid disorders/symptoms, alongside the improvement of intra- and interpersonal abilities and family relationships. However, it should also be noted that standard CBT was also effective in the treatment of IGD. Changing the focus of treatment and applying an integrative focus (including the addiction, the comorbid symptoms, intra- and interpersonal abilities, and family psychotherapy) appear to be more effective in facilitating adolescent behavior change than CBT focusing only on the IGD itself.

Internet gaming disorder in adolescence: Psychological characteristics of a clinical sample

BACKGROUND AND AIMS

Internet gaming disorder (IGD) has become a topic of increasing research interest since its inclusion in Section 3 of the DSM-5. Given the lack of clinical studies concerning IGD, exploring the characteristics of clinical samples with IGD will help to delineate the gaming disorder construct and inform future treatment studies.

METHODS

Data collection consisted of clinical interviews comprising 31 male adolescents diagnosed with IGD. Alongside the clinical interviews, the participants were administered a battery of psychometric tests assessing the following: IGD, personality traits, comorbid symptomatology, emotional intelligence (EI), and family environment characteristics.

RESULTS

The results showed that the adolescents with IGD and their relatives reported a high number of hours per week and high presence of stressful life events in the majority of the sample. High scores on scales assessing depression, anxiety, and somatic disorders were found. However, the findings indicate the presence of several other comorbid disorders meaning that some of the adolescent sample with IGD had different clinical profiles. Several personality traits were found to be highly associated with IGD including introversion, inhibition, submissiveness, self-devaluation, interpersonal sensibility, obsessive-compulsive tendencies, phobic anxiety, and hostility, as well as paranoid and borderline personality traits. Other negative characteristics found in the present sample included a high level of social problems, low EI, and dysfunctional family relationships.

DISCUSSION AND CONCLUSIONS

The findings suggest a more global pattern of key psychological characteristics associated with Internet gaming disorder in adolescence. This may help in understanding the complexity of this proposed disorder and it may also help in designing more specialized interventions for adolescents with IGD. The findings have important implications for clinical practice and interventions.

The Treatment of Internet Gaming Disorder: a Brief Overview of the PIPATIC Program

Over the last decade, there has been an increase in children and adolescents accessing psychology services regarding problematic use of online videogames. Consequently, providing effective treatment is essential. The present paper describes the design process of a manualized PIPATIC (Programa Individualizado Psicoterapéutico para la Adicción a las Tecnologías de la información y la comunicación) intervention program for 12- to 18-year-old adolescents with Internet Gaming Disorder. The design and application of the PIPATIC program integrates several areas of intervention structured into six modules: psychoeducational, treatment as usual, intrapersonal, interpersonal, family intervention, and development of a new lifestyle. The program’s goals are to reduce the addiction symptoms related to online videogames and to improve the well-being of adolescents. Preliminary findings suggest positive and encouraging effects.