Neuroticism and introversion mediates the relationship between probable ADHD and symptoms of Internet gaming disorder: results of an online survey

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

Background and aims

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

Materials and methods

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

Results

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

Discussion

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

Conclusion

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

Sluggish cognitive tempo (Cognitive Disengagement Syndrome) symptoms are more associated with a higher risk of internet addiction and internet gaming disorder than ADHD symptoms: A study with medical students and resident doctors

BACKGROUND & AIMS

The purpose of this study was to examine the relationships between Attention Deficit Hyperactivity Disorder (ADHD), Sluggish Cognitive Tempo (SCT), demographic factors, and Internet Addiction (IA) and internet gaming disorder (IGD) among medical students and resident doctors.

METHODS

The study included 274 medical students and resident doctors. (Ages:18-35, 70.4% female). Fisher exact test, Contingency Table analyses, Mann Whithey-U Test and structural equation model-path analysis were used for analysis. The Sociodemographic Information Form, ASRS Scale, Barkley SCT Scale, Young Internet Addiction Test-Short Form and The Digital Game Addiction Scale were utilized to collect data.

RESULTS

In the sample, 48 participants (17.51%, 22 female, 26 male) were classified as having a high-risk internet gaming disorder (IGD+), while 53 participants (19.3%, 37 female, 16 male) were classified as having a high-risk internet addiction (IA+). SCT Scale Daydreaming and Sluggishness scores, as well as ASRS Scale Inattention and Hyperactivity/Impulsivity ratings, were all substantially higher in high-risk groups (for all, p < 0.05). Instead of age, there was no difference between high and low-risk groups, but men had a significantly greater rate of high risk- IGD (%32.1 vs. 11.4; p = 0.001). Path analysis revealed that while older age has a substantial negative effect (β = -0.37, p = 0.001) on increased risk of IA, Inattention (β = 0.19, p = 0.028), Daydreaming (β = 0.62, p0.001), and Sluggishness ( β = 1.12, p0.001) had significant positive effects. On the other hand, results revealed that male gender (β = 5.08, p0.001), IA scores (β = 0.21, p0.001), and only Sluggishness ( = 0.52, p = 0.002), but not Inattention, Hyperactivity/impulsivity, or Daydreaming, have positive effects on greater risk of internet gaming disorder (IGD).

CONCLUSION & IMPLICATIONS

Our study is the first to show that SCT symptoms increase the risk of Internet addiction and Internet Gaming Disorder even when ADHD symptoms are controlled. To date, many research have highlighted the necessity of ADHD treatment when evaluating IA and IGD. However, SCT symptoms have a greater impact on people who are predisposed to these behavioral addictions, and despite high comorbidity rates, various treatment approaches for ADHD and SCT are effective. SCT should be kept in mind when assessing treatment-resistant individuals with IA and IGD.

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.

The relationship between neuroticism and mobile phone use among college students in love: The masking effect of self-emotional assessment

The relationship between neuroticism and mobile phone use is a hot research topic in the academic community. The purpose of this study was to investigate the roles of self-emotional assessment and love status in the mechanism through which college students’ neuroticism influences mobile phone use.We construct a moderated mediation model, and taking 869 Chinese college students as the research object and testing the mediating role of self-emotional assessment and the moderating role of love status. The results show that: (1) neuroticism was significantly positively related to mobile phone use and significantly negatively related to self-emotional assessment; self-emotional assessment was significantly positively related to mobile phone use; (2) self-emotional assessment had a masking effect on the relationship between neuroticism and mobile phone use; (3) love status not only moderated the relationship between self-emotional assessment and mobile phone use but also moderated the process through which self-emotional assessment masked the effect of neuroticism on mobile phone use. Our research expands the literature on the mechanisms underlying the effects of neuroticism on mobile phone use, enriches the understanding of the pertinent boundary conditions, and provides a better explanatory basis for the mobile phone use of college students.

Dissociative Experiences Associated With Internet Gaming Disorder After Controlling For Childhood Trauma And ADHD Diagnosis

The aim of this study was to investigate the relationships among childhood trauma, dissociative experiences, and internet gaming disorder (IGD) in young adults diagnosed with attention deficit hyperactivity disorder (ADHD) and age- and gender-matched controls. Forty participants diagnosed with ADHD at a university hospital psychiatric outpatient clinic and 40 healthy controls completed a test battery that included a sociodemographic form as well as the Adult ADHD Severity Rating Scale (ASRS), Childhood Trauma Questionnaire (CTQ), Dissociative Experiences Scale (DES), Somatoform Dissociation Questionnaire (SDQ), and Internet Gaming Disorder Scale - Short Form (IGDS9-SF). The CTQ (t = -4.61, p < .01), DES (t = -4.71, p < .01), SDQ (t = -2.40, p < .01), and IGDS9-SF (t = -4.89, p < .01) scores were significantly higher in the ADHD group than in the control group. A hierarchical regression analysis that explained 50% of unique variance in internet gaming disorder (IGD) indicated that being male (β = 0.41, t = 4.61, p < .001) and having an ADHD diagnosis (β = 0.48, t = 5.49, p < .001) are robust predictors. Additionally, the DES score, which indicates the severity of psychoform dissociation (β = 0.34, t = 2.43, p = .017), was found to be significantly associated with IGD after controlling for ADHD diagnosis and childhood trauma. While excessive gaming may increase dissociative symptoms, the mental state of dissociative experiences may be a predisposing factor for IGD; however, further studies are needed to investigate these claims.

Relationship Between Gaming Disorder, Self-Compensation Motivation, Game Flow, Time Spent Gaming, and Fear of Missing Out Among a Sample of Chinese University Students: A Network Analysis

Background and Aims: In previous correlational research, the relationship between gaming disorder (GD), compensation motivation, game flow, time spent gaming, and fear of missing out (FoMO) has been examined. However, network analysis has rarely been applied to explore the relationship between GD, self-compensation motivation, game flow, time spent gaming, and FoMO. Therefore, the present study used network analysis to examine the relationship between the aforementioned variables among a sample of gamers. Methods: The present study comprised gamers (N = 1,635) recruited from three Chinese universities, who completed an online survey including the Gaming Disorder Test, Self-Compensation Motivation Questionnaire, Game Flow Questionnaire, and Trait-State Fear of Missing Out Scale, as well as four items related to time spent gaming. Results: Self-compensation motivation, game flow, time spent gaming, and FoMO were all significantly and positively associated with GD. In the domain-level and facet-level networks, weekday gaming hours and weekend gaming hours had the strongest edge intensity. The domain-level, facet-level, and item-level networks analysis also showed that GD was connected with self-compensation motivation, game flow, time spent gaming, and FoMO. The network structure demonstrated a significant difference between males and females (2.33 vs. 2.81, p = 0.001) using the domain-level network comparison test (NCT). Conclusions: The results suggest that GD is closely associated with self-compensation motivation, game flow, time spent gaming, and FoMO. FoMO and gaming motivation (i.e., self-compensation and game flow) may increase time spent gaming and facilitate GD. Therefore, interventions that decrease game immersion and time spent gaming are likely to decrease GD.

Impact of attention-deficit/hyperactivity disorder comorbidity on longitudinal course in Internet gaming disorder: a 3-year clinical cohort study

BACKGROUND

Although attention-deficit/hyperactivity disorder (ADHD) symptoms were identified as a key risk factor for Internet gaming disorder (IGD), the effect of ADHD comorbidity on longitudinal course of IGD in the clinical population remains to be further examined. This study aimed to investigate whether ADHD comorbidity in IGD patients affects the recovery, recurrence rates, and trajectories of IGD symptoms, and examine the relationship between the changes in IGD and ADHD symptoms.

METHODS

The study included 128 IGD patients without any psychiatric comorbidities (pure-IGD group) and 127 IGD patients with comorbid ADHD (ADHD-IGD group) aged 11 to 42 years. IGD and ADHD were diagnosed according to DSM-5 criteria at enrollment. Participants were offered 8-week treatment with additional care provided as needed and followed up over a 3-year period. IGD diagnosis was reassessed annually and used as a dichotomous outcome. The severity of IGD and ADHD symptoms was measured using the Young Internet Addiction Scale and the Korean ADHD rating scale, respectively, at baseline and each annual follow-up.

RESULTS

The recovery rates of IGD by Year 3 were 60% and 93% in ADHD-IGD and in pure-IGD groups, respectively. The ADHD-IGD group showed lower rates of recovery, higher odds of recurrence within 1 year, and higher severity of IGD symptoms over time than the pure-IGD group. Family environment was also associated with the trajectories of IGD symptoms. The changes in ADHD symptoms were significantly associated with the changes in IGD symptoms.

CONCLUSIONS

This study found that ADHD comorbidity in IGD patients was associated with poor clinical course of IGD and that the changes in ADHD symptoms were associated with the changes in IGD symptoms over time. Our findings suggest that evaluation and treatment of ADHD symptoms and family environment in IGD patients may be important in improving the prognosis of IGD.

A systematic review on the intersection of attention-deficit hyperactivity disorder and gaming disorder

INTRODUCTION

Studies of Gaming Disorder (GD) consistently identify co-morbidity with various psychiatric disorders including major depression, obsessive compulsive disorder and anxiety disorders. One of the strongest associations has been with Attention Deficit Hyperactivity Disorder (ADHD). We present a systematic review of this association by pooling and integrating available evidence.

METHODS

PubMed, EMBASE, PsychInfo and CINHAHL were searched for articles that reported a quantitative association between GD and ADHD and its dimensions, using equivalent search terms. Quality appraisal was done using criteria adapted from the Critical Appraisal Skills Package (CASP) checklists.

RESULTS

1028 articles were identified, of which 29 studies were included for systematic review (n = 56650 participants). Most of these studies were observational in nature, and were of moderate quality, with deficits particularly in the domains of generalisability and confounding. Community surveys (n = 18) of purposive samples constituted the majority, with fewer clinic-based samples (n = 11). While ADHD symptoms were consistently associated with GD, More frequent associations were displayed with inattention associations with GD than other ADHD subscales. There were no conclusive findings regarding the type of game on severity of either condition, or on completion of treatment.

CONCLUSIONS

The findings suggest an association between ADHD and GD, although the direction of the relationship is unclear. This has implications for clinical practice, policy and research. We recommend that ADHD is screened for when evaluating IGD as part of routine practice."

Inattention and Disordered Gaming: Does Culture Matter?

Problematic gaming has emerged as a contemporary concern, leading to the introduction of the diagnostic term 'Internet Gaming Disorder' (IGD; American Psychiatric Association). The present study aims to empirically assess the association between inattention and IGD, in the light of variable levels of vertical-individualism that reflects cultural inclinations towards independence, competitiveness, and hierarchy. The participants (N = 1032) comprised a normative cohort of Massively Multiplayer Online (MMO) gamers (Mage = 24 years; 48.7% male). IGD was measured with the nine-item short-form IGD Scale (IGD9-SF), inattention with the Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale, and vertical individualism with the Individualism-Collectivism Questionnaire. Complex hierarchical and moderated regressions were employed. Findings demonstrated an association between IGD and inattention, and additionally showed that this association was exacerbated by a more vertically-individualistic cultural orientation without significant gender differences. The need of differentially addressing IGD risk among inattentive gamers of diverse cultural orientation is highlighted.

Relationships of Internet addiction and Internet gaming disorder symptom severities with probable attention deficit/hyperactivity disorder, aggression and negative affect among university students

The aim of the present study was to evaluate relationships of Internet addiction (IA) and Internet gaming disorder (IGD) symptom severities with probable attention deficit/hyperactivity disorder (ADHD) and aggression among university students, while controlling the effects of anxiety and depressive symptoms. The study was conducted with online survey among 1509 volunteered university students in Ankara who regularly use the Internet, among whom we conducted analyses related with IA. Among these students, 987 of them, who play video games, were included in the analyses related with IGD. Correlation analyses revealed that the severities of the scale scores were mildly correlated with each other both among students who regularly use the Internet and students who play video games. Probable ADHD was associated with the severity of IA symptoms, together with depression and aggression, particularly physical aggression and hostility, in ANCOVA analyses. Similarly probable ADHD was also associated with the severity of IGD symptoms, together with depression and aggression, particularly physical aggression, anger and hostility, in ANCOVA analyses. These findings suggest that the presence of probable ADHD is related with both severity of IA and IGD symptoms, together with aggression and depression.