Novel approaches for treating Internet Gaming Disorder: A review of technology-based interventions

Empowering Parents: The Impact of a Parenting Practice-Based Care Module on Preventing Internet Gaming Disorder in Elementary School Children

Background

The prevalence of Internet Gaming Disorder (IGD) among elementary school children has raised concerns about its potential negative impact on academic performance, social interactions, and overall mental well-being. In response, this research assessed the impact of the parenting Practice-Based Care Module (PPCM) as an effective preventive strategy to empower parents and promote balanced gaming behavior in their children.

Materials and Methods

A quasi-experimental study was conducted with 170 parents from Gresik Regency, Indonesia, in December 2022 using a non-randomized control group pretest-posttest design. The intervention group received psychoeducation and training on the PPCM, while the control group received training after data collection using a valid, reliable questionnaire.

Results

The results are showed that the PPCM significantly improved parents' ability to prevent IGD in their children. Eight parental factors significantly influenced endogenous variables, including parental responsiveness, mediation mechanism, parenting style, and parents' ability to prevent IGD, with R2 values in the "good" range (0.50 to 0.75), explaining 60.60% of the variation. The model's strong predictive relevance (Q2 values > 0) supported its effectiveness. Hypothesis testing revealed significant effects, such as parental responsiveness on the mediation mechanism (t-statistic: 3.92) and mediation mechanism on parenting psychoeducation (t-statistic: 2.60). Parenting style also positively impacted parents' ability to prevent IGD (t-statistic: 4.82). Notably, child factors had the most significant influence on parental responsiveness (path coefficient: 0.23).

Conclusions

This research underscores parents' pivotal role in addressing IGD in elementary school children. The PPCM significantly enhances IGD prevention through key parental factors. Collaboration is essential for fostering a healthy digital environment.

Investigating the Effectiveness of a Virtual-Reality-Based Mindfulness Intervention on Internet Gaming Disorder

Novel treatment approaches for Internet Gaming Disorder (IGD) include the use of mindfulness and technology-based interventions. Mindfulness has been shown as a protective factor against IGD, but the treatment dropout rates are high due to long sessions and treatment duration. Pathological gamers show approach bias towards technological gadgets, and the inclusion of Virtual Reality has been effective in IGD treatment. Due to the effectiveness of mindfulness and the attractiveness of VR, a combined intervention could decrease treatment time and willingness for treatment. Therefore, the aim of this study was to examine the effectiveness of a brief VR-based mindfulness intervention on IGD symptomatology. Nine participants meeting the IGD symptom criteria, ten recreational game users, and eight healthy controls without a gaming history participated in the study. The intervention consisted of four weekly 20-min-long Attentional Focus Mindfulness sessions. The results indicate a significant reduction in IGD symptoms and weekend gaming time in the treatment group. Despite the small sample size in the treatment group (n = 9) and lack of randomization, the findings constitute a valuable starting point. As a cost- and time-effective intervention, this approach could reduce dropout rates and increase treatment adherence, especially in younger gamers. Additional studies with a larger sample size, randomization, and a longitudinal approach are needed to further validate the found results.

Gaming Disorder: The role of a gamers flow profile

Digital games are widely popular and integral to contemporary entertainment. Nevertheless, a proportion of users present with disordered/excessive gaming behaviours, provisionally classified as Internet Gaming Disorder (IGD). Previous literature suggests examining the contribution of an individual's profile of immersive engagement with their gaming activity, known as online flow, for disordered gaming behaviours. Therefore, the main goals of this study were (1) to categorise gamers into distinct profiles based on their online flow experiences and (2) to investigate the differences in disordered gaming among these different flow profiles. A sample of 565 gamers (12-68 years, Mage = 29.3 years) was assessed twice over six months with the Online Flow Questionnaire (OFQ), the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), and the Gaming Disorder Test (GDT). Latent profile analysis (LPA) identified five distinct profiles encompassing 'High-Flow with High Loss of Control' (HF-HLOC; 14.0 %), 'Low Flow with Low Enjoyment' (LF-LE; 11.9 %), 'Average Flow with Low Enjoyment' (AF-LE; 17.5 %), 'Low Flow with High Enjoyment' (LF-HE; 20.2 %), and 'High Loss of Sense of Time with Low Loss of Control' groups (HLOT-LLOC; 36.5 %). As hypothesised, individuals across varying profiles evidenced differences in their concurrent and longitudinal disordered gaming behaviours. Overall, findings suggest that 'loss of sense of time' may be the most pivotal factor in differentiating flow states and profiles during gaming, advocating its consideration in disordered gaming assessment and treatment.

Impact of gaming disorder on first episode psychosis patients' evolution: Protocol for a multicentered prospective study

AIMS

The objective of this study is to underline the impact of Gaming Disorder on the clinical evolution of patients with First Episode Psychosis. The specific aims of the study are to determine the prevalence of gaming disorder among those patients and assess the consequences of gaming on their clinical trajectory.

METHODS

This is a prospective multicenter cohort study that will enrol 800 patients diagnosed with a first episode psychosis, with a follow-up period of up to 3 years. Using a systematic screening procedure for gaming disorder, the clinical staff will assess patients gaming habits at admission and every 6 months thereafter. Information from patients' medical records will also be extracted using the same timeframe.

RESULTS

The patients' characteristics at admission and during follow-up will be presented in the form of descriptive statistics and compared between different subgroups of patients using uni- and multivariate logistic regression models. Repeated measures ANCOVA will also be performed to analyse the impact of gaming disorders on patients' clinical path as assessed by the Positive and Negative Syndrome Scale and the Clinical Global Impression scale, considering covariates such as psychiatric diagnosis, pharmacological treatment, age, sex/gender, and duration of untreated psychosis.

CONCLUSION

These findings will guide the development of prevention, detection, and treatment strategies for the comorbidity between gaming disorder and first episode psychosis, ultimately improving the patients' recovery.

Disorder and rehabilitation: The paradox of digital games and vulnerabilities

BACKGROUND

The impact of digital gaming on human health, both mental and physical, can be both positive and negative. However, excessive gaming can lead to gaming disorders, which are a cause for concern. With the pandemic, online classes became more common, leading to an increase in gaming-related disorders and even suicides. While the combination of education and fun in online gaming can be beneficial, it can also be a risk for gaming disorders and suicide. This study aimed to explore this paradox and provide safety measures to prevent gaming disorders.

MATERIALS AND METHODS

A qualitative research methodology with exploratory and discourse analysis was used in the study. Several real-life incidents related to the research were gathered from newspaper research articles, media, and existing theses. The researchers used textual interpretation in secondary sources to identify the paradox of digital games and vulnerabilities.

RESULTS

This research article focuses on the various benefits and harmful effects of digital games on individuals' mental and physical health. The research findings were presented based on true events that occurred in and around India. The results of the current study specified that gaming disorders were pushing individuals toward mental disorders and suicide. It is crucial to implement preventive measures to address this issue.

CONCLUSION

According to the study, people who suffer from excessive gaming disorders may experience anxiety, depression, and even suicidal thoughts, which can have negative effects on society. To address this issue, it is helpful to monitor and control individuals' digital game usage and provide informative sessions on how to use digital games properly. While it may not be possible to completely ban the use of digital games, certain restrictions can be put in place. Educating individuals on both the benefits and drawbacks of digital gaming and the rapid technological advancements is essential. Through proper education, it is possible to reduce the number of suicides among gamers and individuals.

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

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

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

AIMS, DESIGN AND SETTING

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

PARTICIPANTS

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

MEASUREMENTS AND FINDINGS

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

CONCLUSIONS

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

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

Objectives

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

Methods

A narrative review was conducted.

Results

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

Conclusions

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

Digital Addiction Intervention for Children and Adolescents: A Scoping Review

Digital devices play a significant role in the learning and living of children and adolescents, whose overuse or addiction has become a global concern. This scoping review seeks to synthesize existing studies to investigate relevant interventions and their effects on digital addiction in children (ages 0-18). To understand the latest advances, we have identified 17 studies published in international peer-reviewed journals between 2018-2022. The findings revealed that, first, most interventions for digital addiction in children and adolescents were cognitive-behavioral therapies (CBT) or CBT-based interventions, which could improve anxiety, depression, and related symptoms of digital addiction. Second, rather than directly targeting addictive behaviors, some family-based interventions aim to strengthen family functions and relationships. Finally, digital-based interventions, such as website-based, application-based, and virtual reality interventions, are promising in adolescent digital addiction interventions. However, these studies shared the same limitations: small sample sizes, short intervention durations, no control group, and nonrandomized assignments. The small sample size problem is difficult to solve by offline intervention. Meanwhile, online digital-based intervention is still in its infancy, resulting in limited generalizability of the findings and the inability to popularize digital intervention. Accordingly, future intervention studies should integrate various assessments and interventions to form an integrated platform to provide interventions for addicted children and adolescents worldwide.

Impact of Virtual Reality Cognitive and Motor Exercises on Brain Health

Innovative technologies of the 21st century have an extremely significant impact on all activities of modern humans. Among them, virtual reality (VR) offers great opportunities for scientific research and public health. The results of research to date both demonstrate the beneficial effects of using virtual worlds, and indicate undesirable effects on bodily functions. This review presents interesting recent findings related to training/exercise in virtual environments and its impact on cognitive and motor functions. It also highlights the importance of VR as an effective tool for assessing and diagnosing these functions both in research and modern medical practice. The findings point to the enormous future potential of these rapidly developing innovative technologies. Of particular importance are applications of virtual reality in basic and clinical neuroscience.

Advances in problematic usage of the internet research - A narrative review by experts from the European network for problematic usage of the internet

Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders.

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.