Systematic literature review online gaming addiction among children and young adults: A framework and research agenda

Exploring the relationship among hikikomori tendencies, autistic traits, computer game use and eating disorder symptoms

OBJECTIVE

The hikikomori phenomenon has recently gained growing global interest, and evidences of its association with other psychopathological dimensions are slowly but steadily emerging. We aimed to evaluate the presence and correlates of hikikomori tendencies in an Italian University population, focusing on its relationships with autism spectrum, pathological computer gaming, and eating disorders. In particular, to our knowledge, no study has yet systematically evaluated the latter association, using psychometric instruments tailored to assess eating disorder symptoms.

METHODS

2574 students were recruited via an online survey. All participants were assessed with the Hikikomori Questionnaire-25 (HQ-25), the Adult Autism Subthreshold Spectrum Questionnaire (AdAS Spectrum), the Eating Attitude test-26 (EAT-26), and the Assessment of Internet and Computer Game Addiction (AICA-S).

RESULTS

The results outlined how hikikomori risk was significantly correlated to autistic dimensions, altered eating behaviors, and videogame addiction. The closest relationship was detected with the autism spectrum. Interestingly, pathological computer gaming, most autistic dimensions, and EAT-26 oral control emerged as significant predictors of a greater risk for hikikomori, while the proneness to inflexibility and adherence to routine emerged as negative predictors.

CONCLUSIONS

Our findings support the association among hikikomori, autism spectrum, pathological computer game use, and eating disorder symptoms.

The symptom network of internet gaming addiction, depression, and anxiety among children and adolescents

Internet gaming addiction (IGA), depression, and anxiety are significant issues among children and adolescents, with substantial social implications. Understanding the specific characteristics of this relationship is crucial for developing effective prevention and intervention strategies. The present study employed network analysis to explore the symptom network of IGA, depression, and anxiety among 1,548 Chinese children and adolescents. The results showed that the core symptoms of IGA among children and adolescents were "tolerance", "withdrawal", and "conflict". There was no significant gender difference in the structure, global strength, and core symptoms of IGA. Although there were no significant differences in the structure of the symptom network of IGA among children and adolescents of different ages, there were significant differences in global strength and some core symptoms ("conflict"). The core symptoms of the comorbidity of IGA, depression, and anxiety in children and adolescents included "feeling downhearted and blue", "breathing difficulty", "difficult to work up the initiative to do things", and "withdrawal". The comorbidity network did not show significant gender and age differences in network structure, but there were significant gender differences in global strength. Furthermore, there were significant gender and age differences in some core symptoms. The social impact of these findings is profound, highlighting the need for targeted interventions in schools and communities to address IGA and its comorbidities. Our results also suggest that interventions should be tailored to consider gender and age differences to maximize effectiveness.

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.

Exploring the association between online gaming addiction and academic performance among the school-going adolescents in Bangladesh: A cross-sectional study

Background and Aims

The pervasive nature of online gaming, notably accentuated during the COVID-19 pandemic, has spurred concerns regarding gaming addiction among children. This study explores the intricate ramifications of online gaming addiction on the academic performance and social dynamics of children in Bangladesh. Our primary objective is to gauge the extent of online gaming addiction and unravel its profound effects on academic performance.

Methods

Conducting a nationwide survey from January 1, 2023, to June 30, 2023, we analyzed 502 responses from participants aged 6-17 years. The survey encompassed sociodemographic details, gaming addiction assessment, and academic performance following a simple random sampling method. We analyzed participant demographics utilizing descriptive statistics, chi-square tests, and logistic regression.

Results

Key findings revealed a majority within the 13-17 age bracket (75.50%), predominantly male (58.57%), and enrolled in secondary education (83.27%). A robust inverse relationship showed that nonaddicted students towards online gaming had higher academic performance. Therefore, it is important to implement targeted strategies to address online gaming addiction among Bangladeshi children.

Conclusion

Recommending early intervention, academic initiatives, and holistic therapy, we advocate for collaboration among educational institutions, mental health professionals, parents, and policymakers. All of these initiatives are essential to navigate the evolving challenges presented by gaming addiction. Furthermore, our call for ongoing research seeks to deepen our understanding of enduring consequences on academic and social dimensions, fostering a digitally supportive environment conducive to the holistic well-being of children.

Video Game Addiction in Young People (8-18 Years Old) after the COVID-19 Pandemic: The Grey Area of Addiction and the Phenomenon of "Gaming Non-Pathological Abuse (GNPA)"

INTRODUCTION

In the literature, video game addiction in youths is correlated with dysfunctional symptoms of anxiety, emotional disorders, and mood disorders, and the pandemic period of 2020-2022 has favored the aggravation of this behavioral addiction. Therefore, we identified the need to analyze this phenomenon with an emphasis on the risks and correlates related to deviance and maladjustment from a prospective perspective, seeking to understand the impact of the individual variables examined.

AIM

To demonstrate whether the condition of "gaming non-pathological abuse" (GNPA) promotes psychopathological features of clinical interest, in the absence of a diagnosis of "gaming disorder" (GD).

MATERIALS AND METHODS

A search performed on PubMed and administration of an ad hoc sociological questionnaire were used to investigate individual variables of criminological interest in a representative population sample (531 males/females, 8-18 years old, M: 14.4, SD: 2.5).

RESULTS

Statistical analysis showed that after the pandemic period, digital video game addiction was reinforced, feeding psychopathological traits consistent with anxiety, emotional disorders, and mood disorders. Variables correlated with impulsive, aggressive, and violent behavior related to age, gender, socio-environmental and economic background, and the severity of digital video game addiction.

CONCLUSIONS

In the youth population (8-18 years), "gaming non-pathological abuse" (GNPA) is related to aggressive, impulsive and violent behaviors that foster phenomena of social maladjustment and deviance, especially in individuals living in disadvantaged or otherwise complex socio-economic and family contexts. Looking forward, the study of structural and functional personality profiles is essential in order to anticipate and reduce the future risk of psychopathological and criminal behavior.

Gender Differences in the Longitudinal Linkages between Fear of COVID-19 and Internet Game Addiction: A Moderated Multiple Mediation Model

BACKGROUND

The COVID-19 outbreak has profoundly affected the psychological well-being of university students globally. Previous studies have found a positive longitudinal link between fear of COVID-19 (FoC-19) and internet addiction. However, there is a notable gap in the literature regarding COVID-19-specific predictors and underlying mechanisms of internet gaming addiction (IGA).

METHODS

Integrating the compensatory internet use theory and social role theory as frameworks, a three-wave longitudinal approach was used in this study to test the hypothesized model. Data spanning a duration of one year were gathered from undergraduate students in China. From 2021 to 2022, we conducted online self-report surveys in the midst of the COVID-19 pandemic to obtain participants' levels of FoC-19, loneliness, depressive symptoms, and IGA.

RESULTS

FoC-19 showed a longitudinal positive relationship with IGA. The longitudinal link between FoC-19 and IGA was mediated by loneliness and depression. Gender moderated the direct effect of FoC-19 on IGA, with this effect being significant only among male students and not among their female counterparts.

CONCLUSION

These findings advance our comprehension of the mechanisms and gender differences underlying the link between FoC-19 and IGA, and provide a novel perspective for interventions to reduce IGA.

Confounding analysis with gaming aspects in predicting psychological distress of esports players

This research aimed to explore the interplay between the central and peripheral aspects of gaming and their correlation with internet gaming disorder (IGD) in predicting indicators of psychological distress. The study proposed that the core and peripheral characteristics of gaming serve as confounding variables affecting the direct relationship between IGD and psychological distress. Employing a longitudinal design spanning two distinct timeframes, the research involved 100 esports players from Malaysia, all of whom had participated in at least one official tournament. The outcomes revealed that both the core and peripheral attributes of gaming significantly predicted stress, anxiety, and depression. However, IGD exhibited a significant predictive association only with stress. Notably, the study also detected the confounding effects of core and peripheral characteristics in the direct link between IGD and stress. These results imply that core and peripheral gaming traits should be interpreted as individual differences that amplify susceptibility to IGD and its associated psychological distress indicators. Moreover, the findings suggested that IGD might not be a prominent concern for esports players, potentially due to their training in performance management as athletes. The paper explores further implications stemming from these findings.

The Closed Loop Between Parental Upbringing and Online Game Addiction: A Narrative Study of Rural Children's Growth in China

Purpose

With the rapid development of information, digital networks, and artificial intelligence technologies, the new generation of children growing up with electronic products faces the dilemma of addiction to online games. There is a significant correlation between the addiction of rural children to online games and the lack of proper parental upbringing.

Patients and Methods

Based on purposive sampling, the research selected 41 sixth-grade rural children, 20 parents, and 14 teachers from three cities in Zhejiang Province, China. Three rounds of semi-structured, in-depth interviews were conducted.

Results

The research portrayed that the parental upbringing styles of rural children addicted to online games could be categorized into four types: conflict and chaos type, indulgent and permissive type, disciplinary neglect type, and coercive and brutal type. All four parenting styles were related to emotional involvement and value guidance.

Discussion

Both the parenting styles of rural parents and the children's addiction to online games were difficult to self-update and change, and they mutually "affirmed" and even reinforced each other. Insufficient cultural capital was found in rural families, resulting in a closed loop between parental upbringing and online game addiction. Introducing professional expertise, increasing cultural capital, and promoting improvement in rural parenting styles are crucial.

Longitudinal associations between loneliness and online game addiction among undergraduates: A moderated mediation model

Online gaming addiction (OGA) has become a noteworthy public concern, especially among university students, thereby requiring in-depth scrutiny. Although previous cross-sectional studies have established a positive link between loneliness and OGA, there is a lack of longitudinal evidence within this field. Moreover, the underlying mechanisms that elucidate the connection between loneliness and OGA are still poorly understood, underscoring a crucial research gap that requires further investigation. Our study utilized a longitudinal approach and developed a moderated mediation model. From September 2021 to September 2022, during the COVID-19 pandemic, data were collected from a sample of Chinese undergraduate students, with 367 participants at T1, 352 at T2, and 340 at T3. Participants completed online self-report surveys, providing valuable data on their levels of loneliness at T1, fear of missing out (FoMO) at T2, sensation seeking at T2, and OGA at T3. Our findings found that loneliness was positively linked to OGA. Further analysis demonstrated that FoMO partially mediated the link between loneliness and OGA. Meanwhile, sensation seeking moderated the pathway from FoMO to later OGA. Specifically, the effect of FoMO on OGA was significant for college students with high sensation seeking. This study offers longitudinal evidence linking loneliness and OGA, which has implications for the development of interventions to reduce OGA.

The Effects of Equine-Assisted Learning on Adolescents with Internet Gaming Disorder

During the COVID-19 pandemic, internet gaming became more popular as a way to cope with stress, but excessive gaming can lead to mental health issues like internet gaming disorder (IGD). IGD has serious consequences, especially among children and young adults, and the gaming industry's profits continue to grow. This study aims to understand the mental and behavioral health of adolescents with IGD participating in an equine-assisted learning (EAL) program and assess the changes in their addiction tendencies and emotional and behavioral problems. The results showed that the participants' tendency towards internet gaming addiction and emotional and behavioral problems decreased immediately after the EAL program, but they rose again a month later. This suggests the importance of ongoing program involvement. As COVID-19 restrictions ease worldwide, this study highlights the increasing risk of IGD. It suggests that EAL could be a valuable approach to treating behavioral addictions, including gaming addiction. While prior research has shown the effectiveness of EAL in treating substance addiction, more research is needed to explore its potential in treating various types of addictions, such as gambling or gaming addictions.

More grateful, less addicted! Understanding how gratitude affects online gaming addiction among Chinese college students: a three-wave multiple mediation model

BACKGROUND

Online game addiction has become a prominent public concern, particularly among emerging adults, warranting in-depth investigation. Despite prior cross-sectional research indicating a negative correlation between gratitude and online gaming addiction, a dearth of longitudinal research exists in this area. Furthermore, the underlying mechanisms that explain the link between gratitude and online gaming addiction remain poorly understood, highlighting a critical research gap in the field.

METHODS

To bridge this gap, our study adopted a three-wave longitudinal design and constructed a multiple mediation model. Over the course of one year, data was collected from a sample of Chinese undergraduates, with 319 students participating at Time 1, 305 at Time 2, and 292 at Time 3. Participants were administered online self-report surveys, enabling the acquisition of valuable data regarding their levels of gratitude, online game addiction, self-control, and loneliness.

RESULTS

The findings revealed a negative correlation between gratitude measured at Time 1 and online game addiction assessed at Time 3. Further analysis demonstrated that both self-control and loneliness played multiple mediating roles at Time 2 in the link between gratitude and online game addiction.

CONCLUSION

These research findings shed light on the underlying mechanisms between gratitude and online game addiction, which provide implications for developing interventions (e.g., interventions based on gratitude) for reducing young adults' online game addiction.

The Relationship of Internet Gaming Addiction and Suicidal Ideation among Adolescents: The Mediating Role of Negative Emotion and the Moderating Role of Hope

Recently, internet gaming addiction and suicide have been global public health issues among adolescents. This study used convenience sampling and surveyed 1906 Chinese adolescents to investigate the relationship between internet gaming addiction and suicidal ideation and the role of negative emotion and hope in the relationship between the two. The results showed that the detection rate of internet gaming addiction among adolescents was 17.16% and the detection rate of suicidal ideation was 16.37%. Moreover, there was a significant positive correlation between internet gaming addiction and suicidal ideation. Negative emotion partially mediated the relationship between internet gaming addiction and suicidal ideation. In addition, hope moderated the relationship between negative emotion and suicidal ideation. The effect of negative emotion on suicidal ideation decreased as hope increased. These findings suggest that the role of emotion and hope in coping with adolescent internet gaming addiction and suicidal ideation should be emphasized.

Online Gaming Addiction and Basic Psychological Needs Among Adolescents: The Mediating Roles of Meaning in Life and Responsibility

Individuals whose basic needs are naturally satisfied are much less dependent on their environment and more autonomous. Basic psychological needs (i.e., the general motivators of human actions) are significant predictors of online gaming addiction. Moreover, it has been posited that meaning and responsibility in life are at the center of life from an existential point of view. Therefore, a hypothetical model was tested to examine the relationships between basic psychological needs (autonomy, competence, relatedness), online gaming addiction, responsibility, and meaning in life. Data were collected from a sample of 546 participants. Mediation analysis was conducted, and the results indicated that basic psychological needs, online gaming addiction, responsibility, and meaning in life had significant negative and positive relationships. The findings indicated that responsibility and meaning in life had a serial mediating effect in the relationship between basic psychological needs and online gaming addiction. The findings also showed that the inverse relationship between online gaming addiction and basic psychological needs was at least partially explained by meaning in life and responsibility. The results of the present study are of great importance and suggest that interventions to satisfy the basic psychological needs of adolescents may help prevent online gaming addiction.

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.

A cross-sectional study on gaming intensity and social vulnerability in adolescents that have a chronic condition

Background

Adolescents growing up with a chronic condition might experience more social vulnerabilities compared to their healthy peers as an indirect result of their conditions. This can lead to a relatedness need frustration for these adolescents. Consequently, they might spend more time playing video games compared to their peers. Research shows that both social vulnerability and gaming intensity are predictors for problematic gaming. Therefore, we investigated if social vulnerability and gaming intensity are more pronounced in adolescents that have a chronic condition compared to the general population; and if these levels reflect the levels of a clinical group being treated for Internet Gaming Disorder (IGD).

Methods

Data on peer problems and gaming intensity were compared from three separate samples: a national representative sample of adolescents, a clinical sample of adolescents that are undergoing treatment for IGD, and a sample of adolescents diagnosed with a chronic condition.

Results

No differences were found on either peer problems or gaming intensity between the group of adolescents that have chronic conditions and the national representative group. The group with chronic conditions scored significantly lower on gaming intensity than the clinical group. No significant differences were found between these groups on peer problems. We repeated the analyses for boys only. Similar results were found for the group with chronic conditions compared to the national representative group. The group with chronic conditions now scored significantly lower on both peer problems and gaming intensity than the clinical group.

Conclusion

Adolescents growing up with a chronic condition appear similar in their gaming intensity and peer problems compared to their healthy peers.

Worsened Anxiety and Loneliness Influenced Gaming and Gambling during the COVID-19 Pandemic

Aim: To study the prevalence and patterns of problematic gaming and gambling during the COVID-19 pandemic and the association with psychiatric traits and major types of anxiety categories. Method: 1067 young adults participated in both wave 3 (2018) and wave 4 (2021) of the SALVe Cohort. Associations with psychiatric symptoms and anxiety were examined using logistic regression and Chi-square tests. Results: Problematic gaming decreased by 1.3 percentage points to 23.2% since the start of the pandemic, while problematic gambling increased by 0.9 percentage points to 6.5% in w4. Average time spent playing video games/day decreased from 2.2 h (w3) to 1.7 h (w4), while increases in gaming activity were associated with worsened feelings of loneliness (p = 0.002), depression (p < 0.001), and anxiety (p < 0.01) during the pandemic. Predictors for problematic gaming at w4 were previous problematic gaming and social anxiety (p = < 0.001 and 0.01, respectively). Moreover, previous problem gambling also predicted problem gambling at w4 p < 0.001. All anxiety categories were associated with both problematic gaming and gambling when adjusted for age and sex. However, after adjusting for depression and insomnia, social anxiety was associated with problematic gaming (p < 0.001), while panic was associated with problem gambling (p < 0.001). Conclusion: Overall, problematic gaming has decreased since the start of the pandemic, while problem gambling has increased. Worsened feelings of loneliness, depression, and anxiety during the pandemic are associated with increased gaming. Moreover, the association between problematic gaming and gambling and anxiety is independent of depression and sleep problems.

Online gaming addiction in youth: Some comments on Rosendo-Rios et al. (2022)

A recent systematic review examining online gaming addiction among children and young adults was published in Addictive Behaviors (i.e., Rosendo-Rios, Trott & Shukla, 2022). However, dozens of papers were missing from the review. One of the reasons why so many studies were not in the review is likely to be because of the search terms used. None of the search terms included the words 'adolescent', 'adolescence', 'emerging adults', 'excessive gaming', 'gaming disorder', 'video game addiction' or 'problematic gaming'. Moreover, studies were also included in the review if the mean age of the total sample was 25 years or below. This meant that some studies in the review included some participants who were not children, adolescents or emerging adults. It also meant that many studies were not included that had mean ages below the age of 26 years because they were not picked up by the search strategy. Given the high number of studies that were not included in the review, readers should view this systematic review as 'suggestive' of research in the area of problematic gaming in youth rather than 'definitive'.

Need Frustration, Gaming Motives, and Internet Gaming Disorder in Mobile Multiplayer Online Battle Arena (MOBA) Games: Through the Lens of Self-Determination Theory

Playing mobile MOBA games has become a popular leisure activity among Malaysian youth. However, MOBA games are highly addictive and have negative impacts on adult development. Inadequate local studies investigated the risk factors of excessive MOBA gameplay. The present study examined the (1) predictive role of need frustration on Internet gaming disorder (IGD) and (2) mediating effect of gaming motives. A total of 398 mobile MOBA gamers aged 18 to 29 participated in this cross-sectional online survey study. The findings showed that need frustration positively predicted IGD. Social, escape, competition, coping, and skill motives were significant mediators for the association between need frustration and IGD. However, fantasy and recreation motives were not significant mediators. MOBA players who were frustrated while fulfilling their basic needs may succumb to uncontrollable gaming behavior. Therefore, future prevention and intervention programs should cultivate positive mental strength for youth while meeting their basic needs.

Internet addiction in young adults: The role of impulsivity and codependency

Excessive Internet use has demonstrated comorbidity with other psychological symptoms and psychiatric disorders, as well as impairments in the management of daily life, relationships and emotional stability. Recent findings in the literature have consistently supported the relationship between impulsivity and Internet addiction. The present study hypothesized that, in addition to impulsivity, a further predictor of Internet addiction might be relational co-dependency, which is also associated in the literature with addiction phenomena, but mainly substance addiction. This paper investigates the role and predictive weight of impulsivity and codependency on Internet addiction on a sample of young adult university students (n = 481) by using a hierarchical regression analysis. The participants were administered the UADI-2, the BIS-11 and the SFCDS. In terms of percentage distribution, 38 % of the participants were in the dependency range, while 37.7 % demonstrated Internet abuse behavior. The results confirmed the role of impulsiveness (β = 0.312) and added to the literature by showing the significant role of relational codependency (β = 0.275), gender (β = 0.174) and age (β = 0.196). Thus, male participants were more dependent, more impulsive and more co-dependent, with increasing age in the given range (18-30). The present study shed light to the presence of this issue among young adults and that, as a preventive and restraining measure, there is a need not only for targeted awareness-raising programmes but also for interventions to promote greater emotional control and a more balanced management of personal relationships.