Contribution of Game Genre and Structural Game Characteristics to the Risk of Problem Gaming and Gaming Disorder: a Systematic Review

Understanding the interplay between video game design features and dysregulated gaming patterns: A call to anchor future research directions in interactionist frameworks

•Research on video game design and dysregulated gaming needs further development.•Research directions must shift from linear causal approaches to interactionist ones.•Relevant research directions, with examples of suitable study designs, are proposed.

The Development and Validation of the Adolescent Problematic Gaming Scale (PGS-Adolescent)

This study aims to develop and validate the Adolescent Problematic Gaming Scale (PGS-Adolescent). Following established scientific protocols, we developed an initial version of the PGS-Adolescent scale and validated it using data from 448 valid survey responses collected from adolescents in China. The dataset was split into two parts: 225 responses were allocated for exploratory factor analysis (EFA), and 223 for confirmatory factor analysis (CFA). The EFA and CFA processes necessitated the removal of 10 items due to low factor loadings, low communalities, misalignment with intended factors, and inadequate item retention. Significantly, all the survey items measuring daily-life disturbance (DD) were excluded. The final 20-item PGS-Adolescent scale includes four constructs: interpersonal relationships (IRE), schooling disruption (SD), physical consequences (Phy-C), and psychological consequences (Psy-C). Researchers may consider directly applying the validated PGS-Adolescent scale or evaluating its applicability and validity in diverse populations and contexts.

Young and adult patients with gaming disorder: Psychiatric co-morbidities and progression of problematic gaming

Background

Previous research suggests age-dependent differences in the progression of addiction, and evidence is accumulating, showing that an early initiation of gaming increases the risk for addiction. With the recent introduction of gaming disorder (GD) as a psychiatric diagnosis, there is a need to extend the knowledge of the clinical characteristics of patients seeking treatment for GD of all age groups. Compared to adolescents and young adults, less is known about treatment-seeking adults. This study aimed to investigate whether there are clinically relevant age-dependent differences among patients seeking treatment for GD.

Method

Participants were recruited among patients seeking treatment and fulfilling diagnosis for GD at an outpatient clinic specialized in the treatment of GD. During the study period, 142 patients went through assessment for GD at the clinic, 37 did not fulfill the diagnosis for GD, and 36 declined participation, leaving a sample of 69 patients (age range = 15-56) for analysis. The sample (men, n = 66; women, n = 3) was divided in two age groups: adolescents and young adults (25 years or younger) and adults (26 years or older). Gaming-related data and information about psychiatric co-morbidity was collected through structured clinical interviews and questionnaires.

Results

The adolescents and young adults (AYAs) reported a more rapid progression into problematic gaming than the adult group. The younger group developed problematic gaming four years faster than the adults. We also observed comparable clinical profiles in both groups. Both age groups had similar levels of GD as well as symptoms of psychiatric co-morbidities including possible attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASD) and problematic gambling. We also noticed that half of our study population consisted of adults.

Conclusion

With the increasing prevalence of gaming in all age groups, it is unknown how the occurrence of GD will develop in different stages of life. We conclude that the adolescents and young adults had almost double as fast progression to problematic gaming than the adult group, highlighting the need for preventive strategies. The similarity in clinical profiles indicates that treatments with the same type of interventions could be offered to both age groups.

Big five personality traits, gaming motives, and regular and disordered gaming: A cross-national examination among college student gamers in seven countries

INTRODUCTION

Previous research has shown that personality traits and gaming motives are important predictors for explaining regular and disordered gaming. However, the mediating role of gaming motives in the relation between personality traits and video game outcomes (e.g., time spent gaming or disordered gaming) has been scarcely studied and limited cross-national studies have addressed this issue. The present study aimed to examine the direct and indirect effects of the Big Five personality traits on weekly gaming and disordered gaming via gaming motives across seven countries.

METHOD

3540 college student gamers (59.5% women) from the U.S., Canada, Spain, Argentina, Uruguay, South Africa and England completed the online survey. Structural equation modeling was conducted to test models. Multigroup models were employed to test model invariance across countries.

RESULTS

Significant, albeit weak, relations were found between personality traits and gaming outcomes, and were mediated mostly by coping motives in predicting disordered gaming, and by social interaction and recreation (to a lesser extent) motives in predicting weekly gaming. Some minor, yet significant, differences across countries appeared and are discussed in detail.

DISCUSSION

The present findings indicate that the differential interrelations between personality traits, gaming motives, and video gaming outcomes may be generalized in college students across countries.

Towards an automated approach for understanding problematic gaming

Introduction

Video games have become increasingly popular worldwide, attracting billions of gamers across diverse demographics. While studies have highlighted their potential benefits, concerns about problematic gaming behaviors have also emerged. Conditions such as Internet Gaming Disorder (IGD) have been recognized by major health organizations, necessitating accurate diagnostic tools. However, existing methods, primarily reliant on self-report questionnaires, face challenges in accuracy and consistency. This paper proposes a novel technological approach to provide gaming behavior indicators, aiming to offer precise insights into gamer behavior and emotion regulation.

Methods

To attain this objective, we investigate quantifiable gaming behavior metrics using automated, unobtrusive, and easily accessible methods. Our approach encompasses the analysis of behavioral telemetry data collected from online gaming platforms and incorporates automated extraction of gamer emotional states from face video recordings during gameplay. To illustrate the metrics and visualizations and demonstrate our method's application we collected data from two amateur and two professional gamers, all of whom played Counter-Strike2 on PC. Our approach offers objective insights into in-game gamer behavior, helping health professionals in the identification of patterns that may be difficult to discern through traditional assessment methods.

Results

Preliminary assessments of the proposed methodology demonstrate its potential usefulness in providing valuable insights about gaming behavior and emotion regulation. By leveraging automated data collection and visualization analysis techniques, our approach offers a more comprehensive understanding of gamer behavior, which could enhance diagnostic accuracy and inform interventions for individuals at risk of problematic gaming behaviors.

Conclusion

Our findings demonstrate the valuable insights obtainable from a tool that collects telemetry data, emotion regulation metrics, and gaming patterns. This tool, utilizing specific indicators, can support healthcare professionals in diagnosing IGD and tracking therapeutic progress, potentially addressing challenges linked to conventional IGD assessment methods. Furthermore, this initial data can provide therapists with detailed information on each player's problematic behaviors and gaming habits, enabling the development of personalized treatments tailored to individual needs. Future research endeavors will focus on refining the methodology and extending its application in clinical settings to facilitate more comprehensive diagnostic practices and tailored interventions for individuals at risk of problematic gaming behaviors.

Event-related prefrontal activations during online video game playing are modulated by game mechanics, physiological arousal and the amount of daily playing

There is a trend to study human brain functions in ecological contexts and in relation to human factors. In this study, functional near-infrared spectroscopy (fNIRS) was used to record real-time prefrontal activities in 42 male university student habitual video game players when they played a round of multiplayer online battle arena game, League of Legends. A content-based event coding approach was used to analyze regional activations in relation to event type, physiological arousal indexed by heart rate (HR) change, and individual characteristics of the player. Game events Slay and Slain were found to be associated with similar HR and prefrontal responses before the event onset, but differential responses after the event onset. Ventrolateral prefrontal cortex (VLPFC) activation preceding the Slay onset correlated positively with HR change, whereas activations in dorsolateral prefrontal cortex (DLPFC) and rostral frontal pole area (FPAr) preceding the Slain onset were predicted by self-reported hours of weekly playing (HoWP). Together, these results provide empirical evidence to support the notion that event-related regional prefrontal activations during online video game playing are shaped by game mechanics, in-game dynamics of physiological arousal and individual characteristics the players.

The tangled ways to classify games: A systematic review of how games are classified in psychological research

In the face of the rapid evolution of the gaming market and the puzzling overlap of genres, consistency in classification seems elusive. The purpose of the present review was to explore the classification of video game genres in the context of psychological research. The aim was to address the challenges associated with creating consistent and meaningful classifications of video game genres, considering the rapid evolution of the gaming market and recent tendency to create games that could be classified into multiple genres. We performed a search in four databases according to the PRISMA guidelines and reviewed 96 full-text papers (N = 49 909). Through our findings, we reveal how researchers strive to classify genres and the numerous complications that arise from this pursuit. In the face of these challenges, we propose alternative ways of classifying genres. Our first proposal is a new classification of video game genres based on our literature review. In our second proposal, we advocate a more detailed understanding by focusing on specific gaming mechanics, and thus we introduce the innovative concept of utilizing community-based tags, such as Steam tags, as an alternative to genres in psychological research.

Causal inference in ethnographic research: Refining explanations with abductive logic, strength of evidence assessments, and graphical models

In their classic accounts, anthropological ethnographers developed causal arguments for how specific sociocultural structures and processes shaped human thought, behavior, and experience in particular settings. Despite this history, many contemporary ethnographers avoid establishing in their work direct causal relationships between key variables in the way that, for example, quantitative research relying on experimental or longitudinal data might. As a result, ethnographers in anthropology and other fields have not advanced understandings of how to derive causal explanations from their data, which contrasts with a vibrant "causal revolution" unfolding in the broader social and behavioral sciences. Given this gap in understanding, we aim in the current article to clarify the potential ethnography has for illuminating causal processes related to the cultural influence on human knowledge and practice. We do so by drawing on our ongoing mixed methods ethnographic study of games, play, and avatar identities. In our ethnographic illustrations, we clarify points often left unsaid in both classic anthropological ethnographies and in more contemporary interdisciplinary theorizing on qualitative research methodologies. More specifically, we argue that for ethnographic studies to illuminate causal processes, it is helpful, first, to state the implicit strengths and logic of ethnography and, second, to connect ethnographic practice more fully to now well-developed interdisciplinary approaches to causal inference. In relation to the first point, we highlight the abductive inferential logic of ethnography. Regarding the second point, we connect the ethnographic logic of abduction to what Judea Pearl has called the ladder of causality, where moving from association to intervention to what he calls counterfactual reasoning produces stronger evidence for causal processes. Further, we show how graphical modeling approaches to causal explanation can help ethnographers clarify their thinking. Overall, we offer an alternative vision of ethnography, which contrasts, but nevertheless remains consistent with, currently more dominant interpretive approaches.

[Digital media use and mental health in adolescents-a narrative review]

The opportunities and hazards of digital media, especially with regard to children and adolescents, are currently the subject of frequent family, school, and social debates.Digital platforms can support the accomplishment of adolescent developmental tasks through gaming and social exchange as well as communication and contact promotion, learning, and health promotion, and are widely used for entertainment. In Germany, almost all adolescents own a smartphone. During the COVID-19 pandemic, an intensification of the use of digital games, social media, and streaming offers by adolescents was observed. Exposure to age-uncensored content such as the depiction of violence, extreme political views, and conspiracy theories, as well as personal attacks through cyberbullying, unfiltered initiation of contact including cybergrooming, dysfunctional role models, and addiction-promoting aspects are associated with mental health risks.Cyberbullying affects about 5% of children and adolescents in Germany. A bidirectional relationship with mental health could be shown. The gaming disorder is the first digital media use disorder (DMUD) that has been included in the ICD-11 and thus internationally recognized as a mental illness. Adolescents are affected disproportionately often and experience impairments in their mental development and levels of functioning.Services are available to promote adolescent media literacy, and their expansion, structured application, and evaluation are needed. Evidence-based prevention and treatment options for DMUD are currently largely lacking. Their development, review, and dissemination should be further supported.

Heart Rate Variability during Online Video Game Playing in Habitual Gamers: Effects of Internet Addiction Scale, Ranking Score and Gaming Performance

Previous studies have demonstrated that individuals with internet gaming disorder (IGD) display abnormal autonomic activities at rest and during gameplay. Here, we examined whether and how in-game autonomic activity is modulated by human characteristics and behavioral performance of the player. We measured heart rate variability (HRV) in 42 male university student habitual gamers (HGs) when they played a round of League of Legends game online. Short-term HRV indices measured in early, middle and late phases of the game were compared between the players at high risk of developing IGD and those at low risk, as assessed by the revised Chen Internet addiction scale (CIAS-R). Multiple linear regression (MLR) was used to identify significant predictors of HRV measured over the whole gameplay period (WG), among CIAS-R, ranking score, hours of weekly playing and selected in-game performance parameters. The high-risk players showed a significantly higher low-frequency power/high-frequency power ratio (LF/HF) relative to the low-risk players, regardless of game phase. MLR analysis revealed that LF/HF measured in WG was predicted by, and only by, CIAS-R. The HRV indicators of sympathetic activity were found to be predicted only by the number of slain in WG (NSlain), and the indicators of parasympathetic activity were predicted by both CIAS-R and NSlain. Collectively, the results demonstrated that risk of developing IGD is associated with dysregulated autonomic balance during gameplay, and in-game autonomic activities are modulated by complex interactions among personal attributes and in-game behavioral performance of the player, as well as situational factors embedded in game mechanics.

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

Introduction

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

Methods

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

Results

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

Conclusion

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

A systematic review and meta-analysis of risky decision-making in specific domains of problematic use of the internet: Evidence across different decision-making tasks

This systematic review summarizes empirical evidence on risky decision-making (objective risk and ambiguity) in specific domains of problematic use of the internet (PUI) focusing on online addictive behaviors. We conducted a pre-registered (PROSPERO: CRD42020188452) PubMed search for PUI domains: gaming, social-network use, online buying-shopping, online pornography use, and unspecified PUI. We used the Newcastle-Ottawa Scale for quality assessment. Relevant studies were identified only for gaming (n = 19), social-network use (n = 8), unspecified PUI (n = 7), and online gambling (n = 1). The meta-analyses included 25 studies (2498 participants) comparing PUI and control groups regarding decision-making performance under objective risk and ambiguity. Across PUI domains, individuals with PUI compared to control participants showed more disadvantageous decision-making in measures of objective risk (g = -0.42 [-0.69, -0.16], p = .002) but not ambiguity (g = -0.22 [-0.47, -0.04], p = .096). PUI domain and gender were significant moderators. In the risk domain, effects were particularly present in gaming disorder, especially in exclusively male samples. Overall, the paucity of empirical studies in the considered area necessitates further research to identify probable gender- and disorder-specific cognitive relationships.

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.

Parents Rate Problematic Video Streaming in Adolescents: Conceptualization and External Assessment of a New Clinical Phenomenon Based on the ICD-11 Criteria of Gaming Disorder

In recent years, video streaming (VS) increased substantially. Adolescents are at significant risk of presenting problematic VS patterns associated with a spectrum of mental-health difficulties. Because VS platforms rely on similar mechanisms as digital games, the ICD-11 criteria for Gaming Disorder (GD) have been successfully implemented to measure Streaming Disorder (StrD) in adolescents. For proper diagnoses, external rating scales are urgently required in addition to self-reports. The Streaming Disorder Scale for Parents (STREDIS-P) was created and validated in a representative sample of n = 891 adolescent-parent dyads. Mental health problems were assessed with standardized instruments. Confirmatory factor analysis was conducted to examine the underlying factor structure. Cutoff scores were determined using ROC analysis. Accordance between parental and adolescents' self-ratings was calculated. Consistent with the results of previous validation studies for screening instruments assessing similar phenomena based on ICD-11-GD criteria, two factors, cognitive-behavioral symptoms and negative consequences, were confirmed. STREDIS-P demonstrated good to excellent internal consistency, criterion validity, and discriminatory power. Accordance with adolescents' self-ratings was moderate. STREDIS-P is the first screening tool for assessing StrD in adolescents by parental ratings. It is highly relevant for conceptualizing a new phenomenon in clinical routine and academic research.

Public Health Approach to Problems Related to Excessive and Addictive Use of the Internet and Digital Media

Purpose of Review

Advances in digital technology and media have provided convenience and advantages in all areas of our daily lives. However, there is a risk of excessive and addictive use, which increases the risk of addiction as a disease and other related mental and physical problems. This article reviews the public health approach to problems related to excessive and addictive use of the Internet and digital media.

Recent Findings

The public health model views addiction as the result of interactions among individuals, digital media, and the environment; therefore, interventions should aim to reduce risk factors and increase protective factors in these three areas. This includes developing and providing evidence-based services according to each individual's problem type and severity. Regarding interventions for digital media and the environment, restricting accessibility and regulating content may be necessary. This calls for an integrative, comprehensive, and continuous intervention strategy, and to achieve such a framework, we need to establish an information system to monitor the magnitude and patterns of related problems.

Summary

This review suggests a surveillance system that provides a list of evidence-based policies from the public health perspective. Suggestions for an advanced international information, policy, and monitoring system are discussed.

Response to the Regulation of Video Games under the Youth Media Protection Act: A Public Health Perspective

The Swiss Youth and Media Act, which is about to enter into force, is an attempt to provide a legislative framework for video game use. Among other inclusions, the law intends to make providers more accountable by taking measures to protect minors from harm that can be caused by improper use of video games. However, it is a challenge to create a legal framework that can adequately regulate the evolving features of video games. Legislators must find a suitable regulatory approach which takes into account the fact that there is an increasing convergence between video games and gambling, particularly with the introduction of loot boxes. Moreover, there is a need for regulation, including the prohibition of misleading designs, the introduction of additional protection for minors, and the assurance of transparency of transactions. Appropriate policy legislation and consumer-protection measures are needed to protect people using these types of products, particularly children and adolescents. Further work should focus on assessing game characteristics to refine regulatory models to promote safe gaming. Based on experiences from the field of psychoactive substances as well as that of gambling, it is now a matter of developing a matrix of harm with elaborated categories: a tool that makes it possible to evaluate the potential harms of certain game design in an evidence-based manner.

Problem Gaming and Suicidality: A Systematic Literature Review

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This is the first review on the association between problem gaming and suicidality.

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12 studies were identified, all of which found a positive association.

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Future studies should investigate the causality and mechanisms in the relationship.

Background

No studies have so far synthesised the current evidence concerning a possible relationship between problem gaming and suicidality. We therefore conducted a systematic review of the literature. Our objective was to investigate the relationship between problem gaming and suicidality. The review was funded by the Norwegian Competence Center for Gambling and Gaming Research.

Methods

The review was pre-registered in PROSPERO International prospective register of systematic reviews (CRD42021279774). Searches were conducted in Web of Science, PsycINFO, EMBASE, PubMed and Google Scholar, September 2021. Studies that reported data on the relationship between problem gaming and suicidality, published between 2000 and 2021, and written in any European language were included. Studies investigating internet addiction/problematic internet use and not problem gaming, specifically, and studies investigating mental health in general or mental health outcomes other than suicidality, were excluded. Data from the included studies were extracted independently by two coders who also evaluated for risk of bias using the Newcastle-Ottawa Quality Assessment Scale. The results from each included study were presented in a table.

Results

A total of 12 cross-sectional studies, with in total 88,732 participants, were included in the review. In total 10 studies investigated the association between problem gaming and suicidal ideation. One of these also investigated the association between problem gaming and suicide attempts. Two studies combined suicidal ideation and suicide attempts into one variable and investigated the association between that variable and problem gaming. In total 11 of the 12 included studies found positive, crude associations between problem gaming and suicidal ideation/attempts. Five studies adjusted for possible confounding variables. Three of these still found significant associations between problem gaming and suicidal ideation, one found a positive but not statistically significant association, and the fifth found an inverse, non-significant association.

Discussion

The current findings indicate that there is an association between problem gaming and suicidal ideation, and likely between problem gaming and suicide attempts. The most important limitation of the included studies is the lack of longitudinal designs. Future studies should aim to investigate the causality and mechanisms in the relationships using more stringent designs.