Internet gaming disorder in children and adolescents: a systematic review

Impact of internet gaming disorder on mental well-being: prevalence and psychological distress among adolescents and young adults

INTRODUCTION

The rapid advancement of technology has led to the emergence of Internet Gaming Disorder (IGD), characterized by excessive engagement in online gaming and significant impairment in daily functioning. The addictive nature of gaming has raised concerns about its psychological impact, particularly among adolescents and young adults.

METHODOLOGY

This cross-sectional study involved 548 participants aged 15 years and older, recruited from various educational institutions. Participants were categorized into IGD and regular gamer groups who were engaged in online gaming without meeting the diagnostic criteria for IGD. Data collection included demographic information, gaming habits, and psychological assessment using the Depression, Anxiety, and Stress Scale (DASS-21).

RESULTS

Of the participants, 18.79% were identified with IGD. Significant associations were found between IGD and various factors, including gender (p = 0.049), gaming partner (p = 0.034), gaming device (p = 0.042), time spent gaming (p = 0.041), duration of gaming (p = 0.031), and sleep duration (p = 0.04). Psychological evaluations revealed a strong correlation between gaming addiction and psychological distress. Participants with IGD reported significantly higher levels of depression, anxiety, and stress, with a notable proportion falling into the "severe" and "extremely severe" categories as classified by the DASS-21.

CONCLUSION

The findings underscore the significant prevalence of IGD and its adverse psychological impacts. This study highlights the urgent need for targeted interventions and mental health support for individuals displaying symptoms of gaming addiction. Further research is warranted to explore the long-term effects of IGD and to develop effective strategies for mitigating its psychological consequences.

The role of attachment anxiety and intolerance of uncertainty in gaming during adolescence: A two-wave longitudinal study

Adolescents with attachment anxiety can compensate via gaming for their unmet needs of closeness, reassurance, and emotion regulation. However, individual factors linking attachment anxiety to compensation via gaming are still unclear. In this two-wave longitudinal study (Wave 1, W1 = baseline; Wave 2, W2 = 6 months later), we aimed to determine whether intolerance of uncertainty (IU) mediates the link between attachment anxiety and gaming behaviours (gaming compensation, gaming frequency, and problematic gaming). Online questionnaires were administered to Italian adolescent gamers (N = 570; Mage = 15.60; SDage = 1.56; 68.8 % males). First, via path analyses, we tested whether attachment anxiety towards mother and father (W1) and IU (W1) would predict gaming behaviours (W2). Second, we tested whether IU would mediate the link between attachment anxiety and gaming compensation specifically. Multigroup analysis was used to explore gender differences. We found that attachment anxiety towards the mother and father was positively associated with IU, whereas attachment anxiety towards only the mother predicted gaming compensation at W2 both directly and via IU. Moreover, IU positively predicted gaming compensation and problematic gaming at W2. Multigroup analysis further revealed that for females, attachment anxiety towards the mother positively predicted gaming compensation at W2. Findings revealed small/modest effect sizes. Overall, attachment anxiety and IU may boost individuals to compensate via gaming, increasing the risk of problematic gaming. These results hold implications for future prevention interventions, emphasizing the quality of the parent-child relationship and IU as potential targets to foster adaptive coping strategies in adolescence.

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.

Effectiveness of Non-Pharmacological Interventions on Gaming Disorder: A Systematic Review and Meta-Analysis

OBJECTIVE

Non-pharmacological interventions (NPIs) are effective in treating gaming disorder (GD). However, studies have not comprehensively evaluated the most effective NPIs. This systematic review and meta-analysis aimed to evaluate the effects of NPIs on the prevention and reduction of GD in the general population with GD.

METHODS

We searched five databases (MEDLINE, Embase, Cochrane CENTRAL, PsycINFO, and CINAHL) for English-language randomized controlled trials (RCTs) published till May 12, 2024, using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Two independent reviewers selected studies, extracted data, and assessed quality using the Cochrane Risk of Bias Tool (RoB2). Meta-analyses were conducted using a random-effect model, with effect sizes calculated using Hedges's g and heterogeneity assessed using I2 statistics.

RESULTS

A total of 18 RCTs involving 1,950 participants were included. The NPIs included psychotherapy, behavioral interventions, and other strategies. The pooled analysis showed a significant reduction in GD severity (Hedges's g=-0.82; 95% confidence interval, -1.23 to -0.52; I2=90.36%). Psychotherapy, particularly cognitive-behavioral therapy, showed the most substantial effect (10 studies, 1,036 participants; Hedges's g=-1.34). Behavioral interventions (4 studies, 456 participants) and prevention-focused interventions (6 studies, 1,164 participants) had smaller but positive effects. Subgroup analyses revealed greater effectiveness of treatment interventions in adults than in adolescents. Sensitivity analyses confirmed the robustness of these results despite high heterogeneity (I2=90.36%).

CONCLUSION

NPIs, particularly psychotherapy, are effective in reducing GD severity. However, more high-quality RCTs are needed robust, evidence-based treatment guidelines.

Novel rat model of gaming disorder: assessment of social reward and sex differences in behavior and c-Fos brain activity

RATIONALE

In 2018, the International Classification of Diseases (ICD-11) classified Gaming Disorder (GD) as a mental disorder. GD mainly occurs among adolescents, who, after developing addiction, show psychopathological traits, such as social anxiety, depression, social isolation, and attention deficit. However, the different studies conducted in humans so far show several limitations, such as the lack of demographic heterogeneity and equal representation of age, differences in the type of game and in the follow-up period. Furthermore, at present, no animal models specific to GD are available.

OBJECTIVES

To address the lack of an experimental model for GD, in the present work, we proposed a new GD rat model to investigate some peculiar tracts of the disorder.

METHODS

Two-month-old Wistar Kyoto rats, both males and females, were subject to a five-week training with a new innovative touch-screen platform. After five weeks of training, rats were assessed for: (a) their attachment to the play under several conditions, (b) their hyperactivity during gaming, and (c) the maintenance of these conditions after a period of game pause and reward interruption. After sacrifice, using immunohistochemistry techniques, the immunoreactivity of c-Fos (a marker of neuronal activity) was analyzed to study different neural areas.

RESULTS

After the training, the rats subjected to GD protocol developed GD-related traits (e.g., hyperactivity, loss control), and the behavioral phenotype was maintained consistently over time. These aspects were completely absent in the control groups. Lastly, the analysis of c-Fos immunoreactivity in prelimbic cortex (PrL), orbitofrontal cortex (OFC), nucleus Accumbens, amygdala and bed nucleus of stria terminalis (BNST) highlighted significant alterations in the GD groups compared to controls, suggesting modifications in neural activity related to the development of the GD phenotype.

CONCLUSIONS

The proposal of a new GD rat model could represent an innovative tool to investigate, in both sexes, the behavioral and neurobiological features of this disorder, the possible role of external factors in the predisposition and susceptibility and the development of new pharmacological therapies.

Recurrence of internet gaming disorder in Korean adolescents: a 24-month follow-up study

Many adolescents use internet games, and some of them experience psychological and social difficulties due to excessive gaming. Although there have been many studies on the onset and associated factors of internet gaming disorder (IGD) , research focusing specifically on its relapse is scarce. Considering that addictive disorders often have a chronic course with frequent relapse, this study prospectively observed adolescents from the general population to explore IGD recurrence rate and associated factors of recurrence. In this prospective cohort study, from 1587 middle school gaming users, 1452 (91.5%) were followed up at 12 months and 24 months. The results showed that the cumulative recurrence rate of IGD was 16.1%, which was higher than the initial incidence rate of 3.6%; the adjusted incidence rate ratio was 2.43 with 95% CI 1.21-4.87 (P = 0.012). In addition, starting internet gaming before entering primary school was associated with a higher risk of relapse (P = 0.004). Limiting internet gaming for children before they enter primary school may reduce the risk of relapse of IGD that they may encounter during their adolescent years.

The relationship between parental affective disorders and digital addiction in children and adolescents: A systematic review and meta-analysis

BACKGROUND AND AIMS

This study aims to comprehensively evaluate the correlation between parental affective disorders and four common digital addiction in children and adolescents.

METHODS

The research was conducted in MEDLINE, PsycINFO, Embase, CINAHL, and Web of Science. The meta-analysis included studies focusing on parental affective disorders and digital addiction to the Internet, smartphones, social media, and gaming among children and adolescents, using longitudinal, cohort, or cross-sectional study designs, and reporting correlation effect sizes or other data that could be converted to correlation r. Pooled Pearson's correlations were calculated using the random-effect model.

RESULTS

Nineteen studies were included (sample sizes ranged from 104 to 4,385), with ten on gaming addiction, four on smartphone addiction, three on Internet addiction, and two on social media addiction. The meta-analysis revealed a small but significant correlation (pooled r [95 %CI] = 0.15 [0.11-0.19]) between parental affective disorders and digital addiction in children and adolescents. This correlation was stronger in studies focusing on offspring's smartphone addiction (r [95 %CI] = 0.25 [0.17, 0.33]), and studies conducted in Asia (r [95 %CI] = 0.17 [0.12, 0.22]), and increased slightly from 0.09 to 0.10 to 0.15-0.16 by years in 2017 and 2024.

DISCUSSION AND CONCLUSIONS

Parental affective disorders were positively correlated with offspring's digital addiction, particularly on smartphone addiction and in Asian families. Improving parental mental health as a complementary strategy of clinical treatments might be more effective in reducing digital addiction in offspring. Further research is needed to explore the potential underlying mechanisms to gain a deeper understanding.

Prevalence of internet addiction among Chinese adolescents: A comprehensive meta-analysis of 164 epidemiological studies

BACKGROUND

Internet Addiction (IA) among Chinese adolescents is a growing concern that is associated with considerable psychological, social, and academic problems. Although numerous past studies on IA prevalence in China have been conducted, the findings have been mixed. This meta-analysis aimed to examine the pooled IA prevalence among adolescents in China and its associated factors.

METHODS

Both English (PubMed, Web of Science, PsycINFO) and Chinese (Wan Fang, CNKI) databases were systematically searched. Pooled prevalence and study heterogeneity were analyzed using the random effects model, while the factors contributing to prevalence variation were identified using subgroup and meta-regression analyses.

RESULTS

A total of 164 studies involving 737,384 adolescents were included in the meta-analysis. The overall pooled IA prevalence was 10.3 % (95 % CI: 9.1 %-11.7 %). In the subgroup analyses, differences in IA prevalence were significantly associated with the assessment tools (Q = 32.8, p < 0.001) and publication years (Q = 20.6, p < 0.001). In the meta-regression analyses, rural residence (β = 1.82, p = 0.030) and junior student level (β = 0.26, p = 0.002) were positively associated with the prevalence of IA, while only child status (β = -1.28, p = 0.033) was negatively associated with the prevalence of IA.

CONCLUSION

In this meta-analysis, IA among adolescents in China was common and associated with rural residence, junior student level, and only-child status. Given the detrimental impacts of IA, the development of effective prevention and treatment strategies for this population is critical.

A cross-lagged panel network model on internet gaming disorder and depressive symptoms concerning preferences for game genres

BACKGROUND

Internet gaming disorder (IGD) is a prevalent behavioral addiction that co-occurs with depression. Little is known about how IGD and depression intercorrelate longitudinally at a symptom level. This study aimed to explore the directional relationships between IGD and depressive symptoms and identify the key symptoms in their comorbidity using cross-lagged panel network (CLPN) modeling.

METHODS

A sample of 601 young gamers (mean age = 23.76) in Hong Kong completed the Internet Gaming Disorder Scale - Short Form and Patient Health Questionnaire-9 semi-annually at two-time points. Autoregressive and cross-lagged effects between depressive and IGD symptoms were analyzed via CLPN while controlling gamers' preferences across five game genres in R.

RESULTS

The comorbidity was mainly driven from depressive symptoms to IGD symptoms, with a few weaker associations from IGD to depressive symptoms. 'Anhedonia' (out-/bridge-expected influence = 2.88; 0.03) and 'Motor problems' (out-/bridge-expected influence = 1.24; 0.03) from depression were the central and bridge symptoms to trigger the development of IGD symptoms, whereas 'continue gaming despite harm' (in-expected influence = 1.29) was the most consequent symptom. 'Anhedonia' (r = 0.17) and 'suicidal risk' (r = 0.15) to 'continuation despite harm' were the strongest paths connecting depression and IGD. Gamers who preferred First-Person Shooter games and Massively Multiplayer Online Role-Playing games were more vulnerable to depressive and IGD symptoms.

CONCLUSIONS

Our findings provide empirical support for the comorbidity between IGD and depression and clarify their directional relationships at a symptom level. We identify antecedent bridge symptoms as targets for preventing escalation of co-occurring issues.

Effectiveness of Therapeutic Interventions in the Treatment of Internet Gaming Disorder: A Systematic Review

Internet Gaming Disorder (IGD) has been recognized by the World Health Organization (WHO) in the International Classification of Diseases (ICD-11) and as an emerging condition in the DSM-5. IGD is increasingly prevalent, with various negative effects on individuals' development and adaptation. To address this issue, different therapeutic interventions, like CBT, virtual reality, mindfulness, or family therapy, have been explored. This systematic review aimed to answer the following research question: What is the effectiveness of therapeutic interventions in reducing IGD symptoms in adolescents and young adults diagnosed with this disorder? Following PRISMA guidelines, 22 studies published between 2014 and 2025 were included. Results show that cognitive behavioral therapy (CBT) is the most effective intervention, significantly reducing IGD severity, anxiety, and depression. Combining CBT with physical exercise or mindfulness further enhanced outcomes. Other promising approaches include virtual reality (VR), transcranial direct current stimulation (tDCS), and family-based interventions. Additionally, treatments involving mindfulness and animal-assisted therapy showed potential in improving emotional regulation and interpersonal relationships. However, further research is needed to evaluate long-term efficacy and explore emerging therapies.

Sociotropy and video game playing: Massively multiplayer online role-playing games versus other games

INTRODUCTION

Internet Gaming Disorder (IGD) is associated with several psychiatric disorders. Previous research on IGD has predominantly focused on Massively Multiplayer Online Role-playing Games (MMORPGs), considered to be pro-social games as they foster interpersonal relationships necessary for in-game progress. Sociotropy is a personality trait characterized by a cognitive approach to dealing with interpersonal relationships. Individuals with high sociotropy have a strong desire for approval from others. Beck's cognitive theory of depression posits that high sociotropy can lead to depressive symptoms when faced with interpersonal stress. We used the I-PACE model to account for the consequences of distal factors such as sociotropy on the development and maintenance of IGD. The aim of this study was therefore to compare MMORPG players with players of other game genres in terms of sociotropy, social anxiety and depression. We hypothesized that sociotropy could serve as a predictor of IGD, particularly among MMORPG players.

METHODS

A total of 233 French videogame players recruited from specialized internet gaming forums participated in the study via questionnaires. Different scales were used to assess depression and social anxiety symptoms, IGD intensity, and sociotropy and autonomy.

RESULTS & DISCUSSION

MMORPG players reported higher psychological distress than players of other game genres. For all players, sociotropy, rather than autonomy, was found to be a predictor of social anxiety symptoms and IGD intensity. Sociotropy and depression explained IGD intensity only for MMORPG players and not for players of other game genres. The social dimension appears to be more prominent among MMORPG players and could be one of the main personality traits predicting this specific internet gaming disorder. The treatment implications for internet gaming disorder are discussed.

Altered resting-state network connectivity in internet gaming disorder

BACKGROUND

The growing popularity of internet gaming among adolescents and young adults has driven an increase in both casual and excessive gaming behavior. Nevertheless, it remains unclear how progressive increases in internet gaming engagement led to changes within and between brain networks. This study aims to investigate these connectivity alterations across varying levels of gaming involvement.

METHODS

In this cross-sectional study, 231 participants were recruited and classified into three groups according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for Internet Gaming Disorder (IGD): IGD group, highly engaged gaming(HEG) group, and lowly engaged gaming (LEG) group. Resting-state fMRI data from 217 participants (143 males, 74 females) were included in the final analysis. Independent component analysis was used to examine differences in intra- and inter-network functional connectivity (FC)across the three groups.

RESULTS

No significant differences were found in intra-network FC across the three groups. However, significant inter-network differences between the dorsal attention network(dAN)and the visual network (VN) among the three groups were observed. The HEG group exhibited significantly higher dAN-VN functional network connectivity (FNC) compared to the LEG group. Linear correlation analyses showed no significant correlation between the dAN-VN FNC values and IGD-20T scores.

CONCLUSION

Throughout the development of IGD, increasing levels of engagement are associated with a rise and subsequent decline in FNC of DAN-VN. This pattern may reflect top-down attentional regulation in the early stages of addiction, followed by attentional bias as addiction progresses.

Longitudinal Dynamic Relationships Between Videogame Use and Symptoms of Gaming Disorder and Depression Among Chinese Children and Adolescents

Although previous studies have shown a close relationship between gaming disorder and depressive symptoms, few have measured normal videogame use, symptoms of gaming disorder, and depressive symptoms concurrently. The longitudinal dynamics between these variables remain unclear. This study used two demographic cohorts to examine the longitudinal relationship between gaming and depressive symptoms: children (n = 1513, 46.9% girls, Mage ± SD = 9.63 ± 0.58 years) and adolescents (n = 1757, 48.5% girls, Mage ± SD = 12.55 ± 0.70 years). Random intercept cross-lagged panel models (RI-CLPMs) were employed to distinguish between within- and between-person levels of gaming and depressive symptoms. The RI-CLPM results showed a stable link between symptoms of gaming disorder and depression at the between-person level for both children and adolescents. At the within-person level, among children, depressive symptoms positively predicted subsequent gaming disorder symptoms, but gaming disorder symptoms were not a significant predictor of depressive symptoms at this level. Among adolescents, there was no significant cross-lagged effect between symptoms of gaming disorder and depression at the within-person level. Additionally, there was no significant cross-lagged effect between normal videogame use and depressive symptoms in either cohort. These results highlight the different effects of normal videogame use and gaming disorder symptoms associated with depressive symptoms. The different effects on children and adolescents underscore the importance of considering the different developmental stages in the study of gaming and mental health outcomes.

Association of self-reported dental caries with sex, lifestyle, and problematic Internet use among elementary school children in Japan

BACKGROUND

Dental caries is the most prevalent disease in elementary schoolchildren in Japan. Problematic Internet use (PIU) has increased among children; however, its association with caries has rarely been studied. We aimed to explore (1) sex differences in dental caries and (2) the association of dental caries with lifestyle and PIU among elementary school children in Japan.

METHODS

From 110 elementary schools in Toyama Prefecture, 13,413 children in the 4th-6th grades (mean age, 10.5 years) participated in the Toyama Safe Internet Use Project in 2018. We inquired about lifestyle, anthropometric data, family rules for screen time, PIU, and the number of self-reported treated caries. PIU was assessed using the Young's Diagnostic Questionnaire. We defined children having ≥ 3 caries as having multiple caries. Subsequently, a modified Poisson regression analysis was performed.

RESULTS

Overall, 12,146 children (90.7%) were analyzed. The prevalence of multiple caries was 25.7% (24.4% in boys and 27.0% in girls). In the regression analysis, the presence of multiple caries was significantly associated with being a girl(adjusted prevalence ratio (aPR) 1.13), being in higher grades (5th grade: aPR 1.13 and 6th grade: aPR 1.14), skipping breakfast (aPR 1.11), having late bedtime (10 to 11 p.m.: aPR 1.17 and ≥ 11 p.m.: aPR 1.23), tooth brushing (once a day: aPR 1.14 and not every day: aPR 1.41), having no family rules (aPR 1.20), and PIU (YDQ score 3-4: aPR 1.17). When stratified by sex, a dose-response relationship was observed between PIU and the presence of multiple caries in boys (YDQ score 3-4: aPR 1.19 and YDQ score ≥ 5: aPR 1.22).

CONCLUSION

Being a girl, having an undesirable lifestyle, and PIU were significantly associated with multiple self-reported caries. In addition to a having a healthy lifestyle, restricting PIU is recommended to prevent caries in children.

Blended digital health intervention for adolescents at high risk with digital media use disorders: protocol for a randomised controlled trial within the Res@t-Consortium

Background

Digital media use disorder (DMUD) is a prevalent problem among young people, which can result in adverse consequences and functional impairments across multiple domains of life due to a persistent inability to regulate one's use, which can lead to the development of psychological problems. In particular, children and adolescents who live in families that are part of the child and youth welfare system and receive support services are considered to be at high risk of developing mental disorders. It is less likely that these families will choose a therapeutic setting for the treatment of DMUD. The objective is to reduce DMUD-related symptoms and improve media use behaviour through the implementation of an app-based training programme.

Methods

The efficacy of Res@t digital, initially conceived as an adjunct to child and adolescent psychiatric treatment, is to be evaluated for n= 32 children and adolescents with a media use disorder or at risk of developing this disorder, and their families enrolled in child and youth welfare services. The efficacy of the app will be evaluated in a randomised controlled trial with a waitlist control group. The primary outcome is the reduction of DMUD symptoms over a 20-week period following the onset of app training. Secondary outcomes include EEG measurements and changes in standardised psychopathological variables.

Discussion

Should the Res@t app prove efficacious when compared to a waitlist control group, it would constitute an evidence-based intervention for the treatment of DMUD in children and adolescents. For high-risk families, the app could serve as a motivational tool to prompt action regarding potential DMUD and facilitates access to therapeutic facilities.

Clinical trial registration

https://drks.de, identifier DRKS00033379.

Alternations voxel-wise interhemispheric and intrahemipheric functional connectivity dynamics in internet gaming disorder

BACKGROUND

Currently, numerous studies have indicated that individuals with internet gaming disorder (IGDs) have aberrant functional connection patterns between multiple brain regions and networks. However, temporal variability in the intra- and interhemispheric dynamic functional connectivity in IGDs remains unknown.

METHODS

This study investigated resting-state functional magnetic resonance data from 55 IGDs and 50 demographically matched healthy controls (HCs). Functional connectivity density (FCD) combined with sliding window analysis is employed to calculate the temporal variability of global functional connectivity. The temporal variability of dynamic functional connectivity further quantified utilizing the standard deviations of global, intra-, and interhemispheric FCD. Finally, correlation analyses were performed between dynamic FCD varience (dFCD) in differential brain regions and clinical behaviors.

RESULT

IGDs showed decreased intra- and interhemispheric dFCD variance in the visual attention network (precuneus and calcarine) and also demonstrated hemispheric-level dFCD variance abnormalities in the posterior cingulate cortex (PCC) compared to HCs. Moreover, abnormal global dFCD variability of the calcarine and ipsilateral dFCD variability of the PCC were negatively correlated with the severity of IGDs in the IGD group.

CONCLUSION

Our results demonstrate abberant intra- and interhemispheric dynamic functional connectivity in the visual attention network, which emphasizes the neurobiological basis for impaired concentration in IGDs.

Exploring parent-child relationships in a Swedish child and adolescent psychiatry - cohort of adolescents with internet gaming disorder

BACKGROUND

While recent studies suggest a high prevalence of Internet gaming disorder (IGD) in child and adolescent psychiatry (CAP) clinics, little is known about the factors contributing to problematic gaming among these patients. Given the well-established role of parenting and parent-child relationships in the development of problem behaviors, this study aimed to explore parent-child relationships within a Swedish cohort of CAP patients with IGD.

METHODS

A total of 72 adolescents from CAP clinics in Skane, Sweden, diagnosed with IGD based on DSM-V criteria (73% boys), aged 13 to 18 years were included in the study. The adolescents completed the Game Addiction Scale for Adolescents (GASA) and reported on aspects of parent-child communication, such as parental control and adolescent disclosure and secrecy, and family climate. Adolescents were categorized as engaged, problem or addicted gamers based on core approach. Independent sample t-tests, Pearsons's correlations, and multivariate regression analyses were used to address the study goals.

RESULTS

Independent sample t-tests revealed that girls showed lower levels of parental knowledge than boys. Bivariate correlation analyses showed that IGD-symptoms were related to lower levels of child disclosure, while multivariate regression analyses revealed that higher IGD-symptoms were predicted by high levels of child secrecy and low child disclosure.

CONCLUSION

Parent-child relationships, in particular adolescent information management to parents, plays an important role for the level of IGD-symptoms in a clinical sample of adolescents. We suggest that therapeutic interventions for IGD should integrate family-focused strategies, such as parent training programs fostering open communication between parents and their children.

Video gaming is associated with maternal overprotective parenting style: A cross-sectional study in preschool children

BACKGROUND

Parents are responsible for rules and limits regarding screen use by preschool-aged children. In this study, we aimed to investigate the association between mothers' parenting styles and preschool children's video game playing.

METHODS

Two hundred and sixty-four mothers who had children aged 2-5 years were included in this cross-sectional study. The mothers filled out a structured questionnaire including general questions about demographic and video gaming characteristics and a parental attitude scale (PAS). PAS consisted of four subscales: "Authoritative," "Authoritarian," "Overprotective," and "Permissive." Subscale scores were categorized into the 1st, 2nd, and 3rd tertiles. Adjusted Odds ratios (AORs) with 95% confidence intervals (CIs) were calculated. To assess the impact of PAS's subscale score tertiles on video gaming, multivariate logistic regression analysis was conducted.

RESULTS

29.2% of children were playing video games. Video gaming was associated with older age, male sex, low paternal education, having an older sibling, and exceeding the recommended daily screen time (p < 0.05). Multivariate logistic regression analyses showed that mothers' high authoritarian [AOR: 2.47 (1.25-4.90)] and overprotective [AOR: 3.62 (1.69-7.79)] scores were associated with video gaming. When other parenting styles were included in the multivariate analysis, only the overprotective parenting style was associated with video gaming [AOR: 3.70 (1.68-8.16)].

CONCLUSIONS

The findings highlight a potential association between maternal overprotective parenting style and video gaming in preschool children.

The internet gaming disorder and its associated factors among college students at Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia: A cross-sectional study

Background

Internet gaming disorder (IGD) or video gaming has been considered by World Health Organization (WHO) and American Psychiatric Association (APA) as a disease. WHO defines IGD as a disease with a pattern of uncontrollable gaming behavior, characterized by increasing priority given to gaming over other activities to the point that gaming takes precedence over most interests and activities of daily living.

Objectives

This research aims to estimate the prevalence and examine the association of IGD scores with gender, age, sleeping hours, academic performance, and occurrence of arguing with others post-gaming among college students.

Methods

A cross-sectional study was conducted in October 2022 at (IMSIU), Riyadh, Saudi Arabia. A total of 1005 college students filled out an online self-administered questionnaire developed based on an extensive literature review and pilot study.

Results

More than two-thirds (76.1%) of students are active gamers. The majority (65.8%) reported no effects of gaming on daily activities. yet, one-third considered games as the most daily time-consuming activity. The majority are playing games to relieve stress. Interestingly, male and senior students had the highest IGD scores (P = 0.017, P = 0.072, respectively). Unfortunately, there were associations between high IGD scores and having fewer sleeping hours as well as low academic performance (P = 0.046, P = 0.047, respectively). Negative social effects include arguing after gaming was significantly linked with higher IGD scores (P < 0.001).

Conclusion

IGD was prevalent among college students. There was no impact of games on students' daily activities; however, gaming was the most time-consuming part of daily activity for the remaining students. Most college students were playing games to feel better. Higher IGD score was associated with male, senior students, less sleeping hours, poor academic performance, and post-gaming arguments with others.

Prevalence of internet gaming disorder among Chinese adolescents: A systematic review and meta-analysis

This study aimed to evaluate the prevalence of IGD among Chinese adolescents. Articles published up to April 11, 2024 were retrieved from PubMed, Wiley Online Library, Embase, Web of Science, Ebsco, CNKI, and WanFang. Random-effects models and univariate meta-regression analyses were used to calculate prevalence and heterogeneity estimates with the support of Stata17.0 software. The prevalence of IGD in Chinese adolescents was 10 % (95 %CI: 8 %-12 %). Univariate regression analyses revealed some significant moderators of IGD prevalence, including gender, sample size, and survey year. Spatiotemporal analysis showed the prevalence of IGD varied considerably across provinces in different survey years.

Scoping review of withdrawal's role in contemporary gaming disorder research: Conceptualizations and operationalizations

The global gaming community now exceeds 3 billion players, prompting increased attention from social and medical sciences regarding gaming-related disorders. Internet Gaming Disorder (IGD) was incorporated into DSM-5 in 2013, and Gaming Disorder (GD) found its place in ICD-11 in 2019. A contentious criterion in IGD, not present in GD, revolves around withdrawal symptoms. This paper offers a theoretical foundation on gaming withdrawal symptoms in gaming-related disorders and conducts a scoping review of withdrawal operationalization and conceptualization in 40 selected studies, following PRISMA-ScR guidelines. Most studies employed a correlation framework, relying on convenience samples and self-assessment questionnaires. A smaller portion focused on clinical samples and case studies. Withdrawal was predominantly conceptualized in terms of affective components, with less emphasis on behavioural, cognitive, physical, or neurological aspects. The prevailing terminology for gaming-related disorders was IGD, with only three studies referencing GD as defined in ICD-11. Notably, just six experimental studies included abstinence control. We advocate for an expansion of research on withdrawal symptoms, particularly through experimental studies that implement abstinence within experimental groups and offer alternative operationalizations beyond dominant self-assessment measures.

Computer and Internet Use Among Children and Adolescents in Greece: Levels of Addiction

OBJECTIVE

The digitalization of our daily living has changed dramatically the internet and digital media use among all ages. However, children and adolescents are particularly vulnerable to potential dangers and addiction risks. Our objective was to evaluate the computer and internet addiction levels in children and adolescents through their parents' reports.

METHODS

A cross-sectional study was conducted in the region of Megara (Attica, Greece) for two months (September-November 2022). In total, 205 parents (74 fathers, 131 mothers) of school-age children participated, completing the study questionnaire (demographic data and the Adolescent Computer Addiction Scale - parental version (20 items in a 1-5 Likert Scale).

RESULTS

 Based on the addiction scale score, only 2.45% (N=5) of the parents rated high scores indicating serious addictive behaviors regarding internet use. The majority were parents of boys (58%) and the mean age of children was 10.92±2.81years (five to 18 years). According to parental reports, the mean age of primary access to a computer or device with internet access was 7.18±2.29 years (two to 13 years). Regarding internet use, 58.5% of the children had access to the internet via smartphone, used the internet one to two hours/day (46.1%), and 62% of children had internet access in their bedroom. Children whose parents used the internet more than five hours/day displayed a greater addiction (F=3.06, df=3.187, p=0.03). A significant positive correlation was also found among children age (r=0.388, p<0.01), computer and internet availability in children's bedrooms, and internet addiction (t=4.43, df=189, p≤0.001 and t=3.88, df=189, p≤0.001, respectively). In summary, parents reported moderate or severe addiction in 7.2% of boys and 5.1% of girls. However, it should be noted that the exact cut-off points were difficult to determine due to a lack of objective criteria for diagnosing addiction severity.

CONCLUSIONS

The levels of addiction in our study according to the parents' reports were limited and only a small number of parents reported highly addictive behaviors. However, there is a direct correlation between increased parental internet use that can significantly increase children's addiction levels. Parents act as role models that may increase children's exposure to the internet and lead to addiction.

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.

Circadian Typology and Physical Activity in Young Adults with Gaming Disorder

Background and Objectives: Exploring daily lifestyle characteristics in individuals with gaming disorder (GD) might identify underlying causes and intervention points. However, integrative and subjective assessments are lacking in studies on this topic. This study aimed to assess circadian typology and physical activity in young adults with GD. Materials and Methods: We recruited 60 participants with GD and 120 age- and sex-matched controls. GD and delayed sleep phase syndrome (DSPS) were diagnosed through structured interviews. Physical activity and sleep patterns were measured using actigraphy. Self-reported measures were chronotype and insomnia by using composite scale of morningness (CSM) and the Pittsburg insomnia rating scale (PIRS). Results: We found that DSPS and eveningness chronotype was more prevalent in the GD group than in the control group. The GD group also contained more participants with insomnia with higher PIRS and a longer time to fall asleep compared with the control group. The GD group had lower physical activity levels for daily calorie expenditure, daily steps, and daily walking distance compared with the control group. No significant differences were observed in body weight and sleep duration between these groups. Conclusions: Individuals with GD, compared to HC, exhibit an eveningness chronotype, poorer sleep quality, lower physical activity, and higher obesity risk, suggesting that lifestyle adjustments like increased exercise and earlier sleep might help modify habitual behaviors and potentially further provide a way to treat GD.

School Climate and School Identification as Determinants of Internet Gaming Disorder Among Chinese Adolescent Internet Gamers: Cross-Sectional Mediation Study

Background

School climate and school identification are important features of the school environment and potential determinants of adolescent internet gaming disorder (IGD).

Objective

This novel study investigated their joint effects on IGD and related mediation mechanisms via the interpersonal factor of teacher-student relationship and the individual factors of academic stress and anxiety.

Methods

A large-scale cross-sectional study was conducted among adolescent internet gamers of junior, senior, and vocational middle schools in Taizhou City, China, from February to March 2022 (N=5778). Participants self-administered an anonymous, structured questionnaire in classrooms. Adjusted logistic regression and structural equation modeling (SEM) were used for data analysis.

Results

Among all participants, the prevalence of IGD was 8% (461/5778). The 4 school climate subscales (student-student relationship subscale: adjusted odds ratio [ORa] 0.88, 95% CI 0.85-0.91; student-staff relations subscale: ORa 0.87, 95% CI 0.84-0.90; academic emphasis subscale: ORa 0.88, 95% CI 0.85-0.91; shared values approach: ORa 0.88, 95% CI 0.85-0.90), the school identification subscale (ORa 0.85, 95% CI 0.83-0.88), and teacher-student relationship (ORa 0.80, 95% CI 0.76-0.84) were significant protective factors against IGD, while academic stress (ORa 1.18, 95% CI 1.14-1.23) and anxiety (ORa 1.16, 95% CI 1.14-1.18) were risk factors of IGD. The SEM showed that the negative associations between school climate and IGD and between school identification and IGD were mediated via (1) three 2-step paths, each involving a single mediator-teacher-student relationship, academic stress, and anxiety, respectively-and (2) two 3-step paths involving 2 mediators-teacher-student relationship and academic stress first, respectively, and then anxiety. The direct effect of school climate on IGD was statistically nonsignificant (ie, full mediation with effect size ranging from 4.2% to 20.4%), while that of school identification was statistically significant (ie, partial mediation with effect size ranging from 4.5% to 38.2%).

Conclusions

The relatively high prevalence of IGD among Chinese adolescents may be reduced through school-based interventions to improve school climate and school identification. Such improvements may reduce the levels of risk factors of IGD (poor teacher-student relationship, academic stress, and anxiety) and hence the risk of IGD. Future longitudinal and intervention studies are needed to confirm the findings.

How can digital citizen science approaches improve ethical smartphone use surveillance among youth: Traditional surveys versus ecological momentary assessments

Ubiquitous use of smartphones among youth poses significant challenges related to non-communicable diseases, including poor mental health. Although traditional survey measures can be used to assess smartphone use among youth, they are subject to recall bias. This study aims to compare self-reported smartphone use via retrospective modified traditional recall survey and prospective Ecological Momentary Assessments (EMAs) among youth. This study uses data from the Smart Platform, which engages with youth as citizen scientists. Youth (N = 77) aged 13-21 years in two urban jurisdictions in Canada (Regina and Saskatoon) engaged with our research team using a custom-built application via their own smartphones to report on a range of behaviours and outcomes on eight consecutive days. Youth reported smartphone use utilizing a traditional validated measure, which was modified to capture retrospective smartphone use on both weekdays and weekend days. In addition, daily EMAs were also time-triggered over a period of eight days to capture prospective smartphone use. Demographic, behavioural, and contextual factors were also collected. Data analyses included t-test and linear regression using Python statistical software. There was a significant difference between weekdays, weekends and overall smartphone use reported retrospectively and prospectively (p-value = <0.001), with youth reporting less smartphone use via EMAs. Overall retrospective smartphone use was significantly associated with not having a part-time job (β = 139.64, 95% confidence interval [CI] = 34.759, 244.519, p-value = 0.010) and having more than two friends who are physically active (β = -114.72, 95%[CI] = -208.872, -20.569, p-value = 0.018). However, prospective smartphone use reported via EMAs was not associated with any behavioural and contextual factors. The findings of this study have implications for appropriately understanding and monitoring smartphone use in the digital age among youth. EMAs can potentially minimize recall bias of smartphone use among youth, and other behaviours such as physical activity. More importantly, digital citizen science approaches that engage large populations of youth using their own smartphones can transform how we ethically monitor and mitigate the impact of excessive smartphone use.

Emotional regulation in Gaming Disorder: A systematic review

BACKGROUND AND OBJECTIVES

Problematic video game use is a source of concern. In addictions, difficulties with emotional regulation have become an important variable of interest. However, their study in relation to problematic video game use remains insufficient.

METHODS

A systematic review was conducted following PRISMA 2020 guidelines; 322 studies were screened, resulting in a final sample of k = 18 studies. The methodological quality of these studies was rated as moderate according to the McMaster Critical Review Form for Quantitative studies (CRF-Q).

RESULTS

There is evidence of relationship between different facets of emotional regulation and the presence of problematic video game use. Particularly, video games serve as escape strategy for suppressing emotional expression. There is no consensus regarding the nature of the relationship between emotional regulation, psychopathology, and problematic video game use, with various proposals suggesting moderation and mediation. There is also no consensus regarding the mediation of gender in the relationship between emotional dysregulation and problematic video game use. The level of certainty regarding the validity of the results was moderate.

DISCUSSION AND CONCLUSIONS

Emotional dysregulation plays a role in problematic video game use, especially through strategies as emotional suppression, and lack of abilities to understand and control emotions. It is important to consider emotional regulation as a potential target for research and intervention in clinical populations.

SCIENTIFIC SIGNIFICANCE

We review the largest sample of papers on problem gaming and emotion regulation to date. Our results highlight the importance of emotion regulation and, specially, emotional suppression, or negative escapism, on problematic video game use.

A Cross-sectional Study on Internet Gaming Disorder and Its Association with Personality Traits in Engineering Students

Background

In the field of psychiatry and mental health, Internet gaming disorder (IGD) is a relatively new concept. In the past few decades, as online gaming and internet usage became increasingly prevalent, this became a topic of concern and research. Therefore, this study aims to estimate the prevalence of IGD and its association with personality traits among students.

Methods and material

The present cross-sectional study was conducted at an Engineering college in Nunna, Andhra Pradesh. The planned duration of the study was 12 months, from March 2020 to March 2021. However, it was extended until August 2021 due to the COVID-19 pandemic lockdown, as colleges were closed indefinitely until further instructions. In the current study, a total of 170 students (first year to final year) from an engineering college, aged between 19 and 25 years, were included. Students who provided informed consent or expressed willingness to participate in the study through a self-structured questionnaire and those who had internet access or experience with online gaming in the past 12 months were included. The demographic profile, including age, sex, academic year, accommodation status, and departmental course was studied. Also, the device used for gaming was examined.

Results

The gender distribution in the given population indicates that approximately 65.88% are males and 34.12% are females, for a total of 170 individuals studied. In that 18 participants (10.58%) were found to have IGD. Among 18 participants with IGD, 14 were males and 4 were females. The gender prevalence for male and female participants was calculated separately and found to be 12.5% for males, and 6.9% for females which is almost a ratio of 2:1. The summary explores the relation between the Big Five personality traits and IGD. The current study subjects were categorized as low, medium, or high for each trait based on their IGD status (positive or negative). Significant correlations were determined between extraversion and IGD (p = .02), conscientiousness and IGD (p = .02), and neuroticism and IGD (p = .02).

Conclusion

The current study findings suggest that the overall prevalence of IGD among college students is 10.58% with a higher prevalence among males, IGD is positively connected with neuroticism and negatively correlated with extraversion and conscientiousness. This implies that certain characteristics, either alone or in combination, may raise the likelihood of individuals developing an IGD.

Family-Centered Treatment Program for Problematic Gaming and Excessive Screen Use in a Clinical Child and Youth Population (FAME): Protocol for a Feasibility Pilot Mixed Method Study

BACKGROUND

Screen time among children and adolescents has increased dramatically, raising concerns about its impact on development and mental health. While research highlights both potential benefits and risks, excessive use has been linked to issues like anxiety, depression, and gaming addiction. Despite growing concern, effective interventions are scarce. Recognizing the importance of family dynamics in child development, we propose a family-centered program to address problematic gaming and excessive screen use in a clinical population. By involving both children and parents, we aim to create a more comprehensive approach to prevention and treatment.

OBJECTIVE

This study aims to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical child and adolescent psychiatry (CAP) population. We will monitor the recruitment rate; track the retention and attendance rates of both parents and children; and assess whether each session's objectives are met, the content is delivered within the allotted time, and the necessary resources (eg, facilitators and materials) are available. Additionally, we will gather qualitative and quantitative feedback from participants through postprogram surveys and individual interviews with both children and parents.

METHODS

A total of 10 families with ongoing contact with CAP in Skåne, Sweden, will be recruited and offered participation in a family-centered group program targeting children aged 10-18 years with reported difficulties regarding screen gaming or screen use. The intervention to be tested is a newly developed, family-centered, psychoeducational, cognitive behavioral therapy-based intervention addressing both positive and negative aspects of screen use; setting boundaries; the connection between thoughts, feelings, and behaviors; conflict triggers; and sleep hygiene. The primary goal of the pilot study is to test the feasibility of the program, as well as recruitment and the analysis of participants' experiences with the program.

RESULTS

A total of 11 children and their parents were enrolled during first quarter of 2024. A 4-session pilot was delivered in first quarter of 2024, and the first results are expected in the third quarter of 2024.

CONCLUSIONS

The overarching goal of this pilot study is to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical CAP population. The insights gained from this study will guide our future research, which will focus on conducting a larger-scale evaluation of the intervention's impact on family screen time conflicts and inform future strategies for the implementation of family-centered interventions in child and youth clinics.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06098807; https://clinicaltrials.gov/study/NCT06098807.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/56387.

Relationship between awareness of digital game addiction, health literacy, and sociodemographic characteristics of mothers: A structural equation modeling analysis

AIM

Mothers' digital game addiction awareness and their health literacy levels are critical factors for addiction prevention strategies in children. Therefore, the present study is significant. This study examines the relationship between awareness of digital game addiction, health literacy, and the sociodemographic characteristics of mothers.

METHOD

This cross-sectional study was conducted with 457 mothers of children aged 5-11 years in Turkey. The data were collected using a personal information questionnaire, the Awareness of Digital Game Addiction Scale, and the Health Literacy Scale between May and September 2021.

RESULTS

This study revealed that mothers are highly aware of digital game addiction and have high health literacy. Furthermore, health literacy was determined to significantly and directly affect awareness of digital gaming addiction. Awareness of digital gaming addiction significantly and directly affects children owning their own technological devices and how much time mothers spend with their children.

CONCLUSION

The study's results confirmed that mothers' health literacy had a positive and statistically significant effect on awareness of digital gaming addiction. As the health literacy levels of mothers increased, the internal and external awareness of digital gaming addiction increased. It is recommended to design intervention programs that increase mothers' awareness of digital game addiction. These programs should be planned according to the health literacy levels of mothers.

Altered local intrinsic neural activity and molecular architecture in internet use disorders

BACKGROUND

Internet gaming disorder (IGD) is mainly characterized by its core dysfunction in higher-order brain cortices involved in inhibitory control, whose neurobiological basis remains unclear. Then, we will investigate local intrinsic neural activity (INA) alterations in IGD, ascertain whether these potential alterations are related to clinical characteristics, and further explore the underlying molecular architecture.

METHOD

In this study, we performed the fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo) derived from resting-state functional magnetic resonance imaging (rs-fMRI) to explore the impact of IGD on local INA. Correlation analysis revealed the relationship between ReHo and fALFF in terms of group differences and clinical characteristics. Moreover, correlations between fALFF, ReHo, and PET- and SPECT-driven maps were investigated to elucidate the specific molecular architecture alternations in IGD. Finally, receiver operating characteristic curve (ROC) analysis was used to show the potential abilities of fALFF and ReHo in distinguishing individuals with IGD (IGDs) from healthy controls (HCs).

RESULT

Compared with HCs, IGDs revealed increased ReHo and fALFF in the prefrontal cortex. Significantly decreased ReHo was observed in the temporal lobe, occipital lobe, and cerebellum. In addition, the ReHo values in the cerebellum_7b_R were positively correlated with internet addiction severity. ROC curve analysis showed that ReHo and fALFF-altered brain regions could effectively distinguish IGDs from HCs. More importantly, cross-modal correlations revealed local INA changes in brain regions associated with the monoamine neurotransmitter system and the less studied cholinergic/GABAergic system.

CONCLUSION

These results suggest that local functional impairments are shown in the audiovisual and inhibitory control circuits in IGDs. This may be associated with underlying neurotransmitter system alterations. Therefore, this study provides the possibility of GABAergic receptor agonists and cholinergic receptor inhibitors for the treatment of IGD.

Polymorphic variants of the dopamine receptor gene DRD2 (rs6277, rs1800497) in adolescents with problematic video game use

Problematic video games use, as a specific form of problematic Internet use, is widespread among adolescents and can have negative effects on their mental and somatic well-being. An increasing incidence of addictive video gaming, as well as the overuse of the Internet, among the young population makes the current study of susceptibility factors, including the genetic component, relevant. There has been a number of investigations related to the involvement of gene variants of the neurotransmitter system in the development of Internet addiction, with the results being different for various ethnic groups. The dopamine type 2 receptor gene (DRD2) is one of the candidate genes for susceptibility to video game addiction. The aim of the work was to study polymorphic variants of the dopamine receptor gene DRD2 (rs6277, rs1800497) in Russian adolescents with problematic use of computer video games. A sampling of 407 adolescents aged 14.1 ± 1.8 years was tested, of which 56 (13.8 %) were identified as having problems with the pathological use of video games use based on the GASA scale results. Boys in the sample proved to be addicted to video games more than girls (p = 0.041). As a result of comparing the allele frequency of DRD2 (rs6277), a tendency to a higher frequency of the minor allele T was revealed in the group of adolescents with problematic video game use compared with adolescents without problematic video game use (i. e. 0.563 and 0.466, respectively, p = 0.06). When using the dominant inheritance model, it was revealed that adolescents with problematic use of video games were statistically significantly more likely to carry the T (CT+TT) allele (p = 0.04, OR = 2.14, CI = 1.01-4.53). The T allele DRD2 (rs6277) is associated with low expression of the dopamine receptor D2 and leads to decreasing the density and affinity of extrastriatal dopamine type 2 receptors, which is associated with impaired social communication as well. We suggest that the presence of CT and TT genotypes of rs6277 DRD2 may be a potential risk factor for developing problematic video game use in adolescents.

The mediating role of social connectedness and negative cognitive emotion regulation in the association between problematic Internet use and depression among adolescents

Introduction

While the relationship between adolescent problematic Internet use (PIU) and depression has been extensively researched, few studies have investigated the role and mechanisms of social connectedness (SC) in this context. This study aimed to investigate the mediating effect of social connectedness (SC) and cognitive emotion regulation (CER) in the relationship between PIU and depression.

Methods

We conducted a cross-sectional study involving 9,407 adolescents aged 12-18 years in China from September 2022 to March 2023. We employed Young's 20-item Internet Addiction Test (IAT-20), the Social Connectedness Scale-Revised (SCS-R), the Cognitive Emotion Regulation Scale (CER), and the DSM-5 Level-2 Depression Scale to assess mental health outcomes. Logistic regression analysis was also performed to examine the independent association between the measured variables and depression. Mediation analysis was then conducted to evaluate the mediating roles of social connectedness and cognitive emotion regulation in the relationship between PIU and depression.

Results

We found that the prevalence of PIU was 21.8%. Offline SC (indirect effect: 0.112, 95% CI: 0.104-0.121) and negative CER (indirect effect: 00.140, 95% CI: 0.129-0.152) mainly played a parallel mediating role in the relationship between PIU and depression, along with online SC (on_SC) (indirect effect: 0.007, 95% CI: 0.005-0.010).

Discussion

These findings provide valuable insights into how PIU is associated with depression and highlight the importance of fostering real-life interpersonal interactions. However, the generalizability of this study's findings to other populations may be limited due to cultural factors.

Investigating the mechanisms of internet gaming disorder and developing intelligent monitoring models using artificial intelligence technologies: protocol of a prospective cohort

BACKGROUND

Internet gaming disorder (IGD), recognized by the World Health Organization (WHO), significantly impacts adolescent mental and physical health. With a global prevalence of 3.05%, rates are higher in Asia, especially among adolescents and males. The COVID-19 pandemic has exacerbated IGD due to increased gaming time from isolation and anxiety. Vulnerable groups include adolescents with poor academic performance, introverted personalities, and comorbid mental disorders. IGD mechanisms remain unclear, lacking prospective research. Based on Skinner's reinforcement theory, the purpose of this study is to explore the mechanisms of IGD from individual and environmental perspectives, incorporating age-related changes and game features, and to develop intelligent monitoring models for early intervention in high-risk adolescents.

METHODS

This prospective cohort study will investigate IGD mechanisms in middle and high school students in Shenzhen, China. Data will be collected via online surveys and Python-based web scraping, with a 3-year follow-up and assessments every 6 months. Unstructured data obtained through Python-based web scraping will be structured using natural language processing techniques. Collected data will include personal characteristics, gaming usage, academic experiences, and psycho-behavioral-social factors. Baseline data will train and test predictive models, while follow-up data will validate them. Data preprocessing, normalization, and analysis will be performed. Predictive models, including Cox proportional hazards and Weibull regression, will be evaluated through cross-validation, confusion matrix, receiver operating characteristic (ROC) curve, area under the curve (AUC), and root mean square error (RMSE).

DISCUSSION

The study aims to understand the interplay between individual and environmental factors in IGD, incorporating age-related changes and game features. Active monitoring and early intervention are critical for preventing IGD. Despite limitations in geographic scope and biological data collection, the study's innovative design and methodologies offer valuable contributions to public health, promoting effective interventions for high-risk individuals.

Resting-state brain networks alterations in adolescents with Internet Gaming Disorder associate with cognitive control impairments

Objective

Research indicates that cognitive control is compromised in individuals with internet gaming disorder (IGD). However, the neural mechanisms behind it are still unclear. This study aims to investigate alterations in resting-state brain networks in adolescents with IGD and the potential neurobiological mechanisms underlying cognitive dysfunction.

Materials and methods

A total of 44 adolescent IGD subjects (male/female: 38/6) and 50 healthy controls (male/female: 40/10) were enrolled. Participants underwent demographic assessments, Young's Internet Addiction Scale, Barratt Impulsiveness Scale 11 Chinese Revised Version, the Chinese Adolescents' Maladaptive Cognitions Scale, exploratory eye movement tests, and functional magnetic resonance imaging (fMRI). FMRI data were analyzed using the GIFT software for independent component analysis, focusing on functional connectivity within and between resting-state brain networks.

Results

In comparison to the control group, impulsivity in adolescent IGD subjects showed a positive correlation with the severity of IGD (r=0.6350, p < 0.001), linked to impairments in the Executive Control Network (ECN) and a decrease in functional connectivity between the Salience Network (SN) and ECN (r=0.4307, p=0.0021; r=-0.5147, p=0.0034). Decreased resting state activity of the dorsal attention network (DAN) was associated with attentional dysregulation of IGD in adolescents (r=0.4071, p=0.0017), and ECN increased functional connectivity with DAN. The degree of IGD was positively correlated with enhanced functional connectivity between the ECN and DAN (r=0.4283, p=0.0037).

Conclusions

This research demonstrates that changes in the ECN and DAN correlate with heightened impulsivity and attentional deficits in adolescents with IGD. The interaction between cognitive control disorders and resting-state brain networks in adolescent IGD is related.

Physiological Regularity and Synchrony in Individuals with Gaming Disorder

Individuals with gaming disorder (GD) show emotional dysregulation and autonomic dysfunction in daily life. Although studies have shown that the relaxation method of breathing exercise (BE) improves cardiopulmonary synchrony, the physiological regularity and synchrony of GD remain unclear. In this study, we investigated the regularities of pulse wave (PW), thoracic wall movement (TWM), and abdominal wall movement (AWM) using sample entropy (SE) and assessed the vascular-respiratory and TWM-AWM synchrony using cross-sample entropy (CSE). Twenty individuals with GD and 26 healthy control (HC) individuals participated in baseline, gaming, and recovery stages, both before and after BEs. The results showed that both groups had significantly higher SETWM, SEAWM, and CSETWM-AWM during gaming than baseline. Before BE, CSEPW-TWM and CSEPW-AWM during gaming were considerably higher in the GD group than in the HC group. Compared to before BE, both groups had decreased SETWM and CSETWM-AWM during gaming, particularly in the HC group. Online gaming may induce pulse wave and respiratory irregularities, as well as thoracic-abdominal wall movement asynchrony. Individuals with GD who engage in prolonged gaming periods may exhibit lower vascular-respiratory synchrony compared to the HC group. SETWM, SEAWM, CSETWM-AWM, CSEPW-TWM, and CSEPW-AWM may serve as biomarkers for assessing the risk of GD. BE may improve TWM regularity and vascular-respiratory synchrony during gaming, potentially alleviating addictive behavior.

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.

Neuropsychological Deficits in Disordered Screen Use Behaviours: A Systematic Review and Meta-analysis

Over the last few decades, excessive and disordered screen use has become more prevalent, prompting investigations into its associated consequences. The extent to which disordered screen use behaviours impact neuropsychological functioning has been reportedly mixed and at times inconsistent. This review sought to synthesise the literature and estimate the magnitude of overall cognitive impairment across a wide range of disordered screen use behaviours. We also sought to determine the cognitive domains most impacted, and whether the observed impairments were moderated by the classification of screen-related behaviours (i.e., Internet or gaming) or the format of cognitive test administration (i.e., paper-and-pencil or computerised). A systematic search of databases (Embase, PsycINFO, MEDLINE) identified 43 cross-sectional articles that assessed neuropsychological performance in disordered screen use populations, 34 of which were included in the meta-analysis. A random-effects meta-analysis revealed significant small/medium (g = .38) cognitive deficits for individuals with disordered screen use behaviours relative to controls. The most affected cognitive domain with a significant medium effect size (g = .50) was attention and focus followed by a significant reduction in executive functioning (g = .31). The classification of disordered screen use behaviours into Internet or gaming categories or the format of cognitive testing did not moderate these deficits. Additionally, excluding disordered social media use in an exploratory analysis had little effect on the observed outcomes. This study highlights a number of methodological considerations that may have contributed to disparate findings and shows that disordered screen use can significantly impact cognitive performance. Recommendations for future research are also discussed. Data for this study can be found at https://osf.io/upeha/ .

The Relationship between video game addiction and bladder/bowel dysfunction in children

INTRODUCTION

Video games have a strong influence on children and adolescents. Video game addiction has negative effects on children's health.

OBJECTIVE

To determine the relationship between video game addiction and bladder/bowel dysfunction in children.

MATERIALS AND METHODS

Three hundred sixty-three children and their mothers who met the inclusion criteria constituted the sample of this correlational study. The data were collected using a descriptive information form, the Video Game Addiction Scale for Children, and the Childhood Bladder and Bowel Dysfunction Questionnaire.

RESULTS

We found that 72.5% of the children were nine years old and 27.5% were ten years old; 50.4% were males and 49.6% were female. While 4.7% of the children who participated in the study were underweight, 19.6% were overweight, and 17.9% were obese. The mean Video Game Addiction Scale for Children score was 50.77 ± 16.17, whereas the mean Childhood Bladder and Bowel Dysfunction Questionnaire score was 29.98 ± 8.90. The ratio of children with a mean Video Game Addiction Scale for Children scores equal to or greater than 90 was 0.8% (n = 3). We found that 3.6% (n = 13) of the children had urinary/fecal incontinence while playing video games. There was a weak positive relationship between the dimensions of the Video Game Addiction Scale for Children scores, the Childhood Bladder and Bowel Dysfunction Questionnaire scores, and children's bladder and bowel function (r = 0.220; p ˂ 0.05).

CONCLUSIONS

There is a correlation between children's video game addiction level and their bladder and bowel dysfunction grade. Higher video game addiction levels correspond to higher bladder and bowel dysfunction.

Factorial structure of the Internet Gaming Disorder questionnaire in the Italian setting: a single-factored ailment or a multifaceted condition?

INTRODUCTION

Internet Gaming Disorder (IGD) according to DSM-5 is a behavioral addiction needing additional study. IGD in youth is correlated with anxiety, depression, attention problems, interpersonal problems, social phobia, behavior problems and low academic achievement. The aim of the present research is to contribute to the understanding of the disorder, by providing preliminary data on the factorial structure of the IGD Questionnaire in the Italian version.

PARTICIPANTS

612 Italian students (323 females), mean of age = 13.94 (SD = 2.44). Instruments: a survey comprising IGD Questionnaire, Internet Addiction Test (IAT), Children's Coping Strategies Checklist (CCSC-R1), Assessment of Interpersonal Relations (AIR), and Child Behavior Checklist (CBCL).

RESULTS

15.2% of participants showed a sub-clinical IGD and 2.1% met the full diagnostic criteria. Participants with IGD showed lower scores in interpersonal relationships, worse coping strategies and higher scores in externalization. The factorial structure of the IGD Questionnaire highlights 4 factors ("addiction", "gaming as coping", "impaired control" and "negative outcomes") that explain 52.14% of the variance. A single-factor solution was also tested and results seem to be coherent with the four-factor solution, explaining less variance.

CONCLUSIONS

IGD is a complex clinical condition that can be thought both as a single-factored and as a multi-faceted condition.

Going beyond video game consumption when considering Internet Gaming Disorder

BACKGROUND

Recognizing the crucial importance of understanding the impact of video games on health in today's gaming-dominated world, our study aimed to investigate the relationship between gaming time and Internet Gaming Disorder (IGD). Despite the widespread assumption that a connection exists between both, previous studies have revealed highly variable associations, highlighting significant weaknesses in establishing a robust link.

METHODS

To unravel this complex relationship, we recruited two independent samples of League of Legends players. We combined the collection of self-reported and actual gameplay data, together with assessments of mental health, personality traits, and cognitive abilities.

RESULTS

Surprisingly, none of the gaming variables demonstrated a robust and stable association with IGD, regardless of whether players spent less than or more than 30 hours per week gaming-a threshold suggested by the American Psychiatric Association as a potential indicator of disordered gaming. Notably, mental health factors, such as anxiety, depression and ADHD, emerged as the most influential predictors of IGD.

CONCLUSION

These findings, replicated across two independent samples, challenge the prevailing belief that limiting screen time alone effectively combats IGD. Instead, mental health factors play a crucial role in mitigating risks associated with gaming. Policies focusing solely on restricting screen time are insufficient in reducing the prevalence or symptoms of IGD. Rather, a comprehensive approach that considers mental health and key personality traits must be adopted to safeguard the well-being of individuals engaged in gaming.

Trajectories of Problem Behaviors and Information Technology Use Among Adolescents: A Latent Growth Model Using the Korean Children and Youth Panel Survey

We investigated the association between computer and mobile phone online activities and adolescents' problem behaviors (e.g., depressive symptoms, withdrawal, somatic complaints, attention deficit, and aggression) using data from the Korean Children and Youth Panel Survey and latent growth model analysis. The results demonstrated that text-related activities lowered withdrawal and attention deficit. Higher use of online communities or personal websites was associated with higher depressive symptoms, withdrawal, somatic symptoms, and aggression. Online gaming increased both attention deficit' initial value and its decrease rate. Taking photos decreased withdrawal. Watching videos increased depressive symptoms, withdrawal, and attention deficit. Listening to music lowered attention deficit' initial value and somatic symptoms' decrease rate. Accessing adult websites increased attention deficit and aggression. Educational information searches reduced attention deficit and aggression. Online transactions increased somatic symptoms. This study indicates that adolescents' problem behaviors may appear differently depending on the type of information technology use.

Cognitive-behavioral statuses in depression and internet gaming disorder of adolescents: A transdiagnostic approach

To investigate the comorbidity of adolescent depression and Internet gaming disorder (IGD) and their shared and unique cognitive-behavioral factors (i.e., self-esteem, dysfunctional attitudes, hopelessness, and coping), a large-scale school-based survey was conducted among 3147 Chinese secondary school students in Hong Kong. Probable depression and IGD were screened using the Centre for Epidemiological Studies-Depression Scale and DSM-5 IGD checklist, respectively. Multinomial logistic regression was performed to identify the associations between different condition statuses and cognitive-behavioral factors. Four groups were identified, including comorbidity group (having probable depression and IGD), IGD group (having probable IGD alone), depression group (probable depression alone), and healthy group (neither condition). Comorbidity group showed the worst cognitive-behavioral statuses, followed by depression group and then IGD group. Compared with healthy group, those with lower self-esteem and higher hopelessness and dysfunctional attitudes were more likely to be classified into depression group and comorbidity group, while maladaptive coping was positively associated with all three disorder groups. The results suggest that depression and IGD may share common cognitive-behavioral mechanisms (e.g., maladaptive coping) but also own their uniqueness regarding specific factors (e.g., hopelessness and self-esteem). A transdiagnostic intervention approach targeting the common factors may effectively address the comorbidity.

Longitudinal Relationships Between School Climate, Academic Achievement, and Gaming Disorder Symptoms Among Chinese Adolescents

Despite growing concerns regarding the development of gaming disorder symptoms among adolescents, the longitudinal relationship between school factors and gaming disorder symptoms remains far from being fully understood. This two-year longitudinal study examined the relationship between school climate perceptions, academic achievement, and gaming disorder symptoms among three distinct demographic cohorts: preadolescents (n = 1513; 46.9% girls, Mage = 10.64 years, SD = 0.56), early adolescents (n = 1771; 48.3% girls, Mage = 13.54 years, SD = 0.70), and late adolescents (n = 2385; 50.1% girls, Mage = 16.41 years, SD = 0.59). A four-wave study was conducted (six months apart) using random intercept cross-lagged panel models (RI-CLPMs) to separate the within-person (state level) from the between-person (trait level) effects. The results obtained from the RI-CLPMs indicated that fluctuations in school climate perceptions negatively predicted subsequent changes in gaming disorder symptoms among preadolescents at the within-person level, but not among early and late adolescents. Fluctuations relating to gaming disorder symptoms also negatively predicted subsequent changes regarding academic achievement in late adolescents, but not in preadolescents and early adolescents. The effect of school-related factors on gaming disorder symptoms varies across different developmental stages. While preadolescents may represent a particularly susceptible subgroup for gaming disorder in terms of being predicted by their school environment, late adolescents appear to be more vulnerable to predictors of gaming disorder symptoms. The current study also discusses the implications of school-wide programs aimed at improving school climate and preventing the development of gaming disorder symptoms during key developmental periods.

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.

Internet addiction among school adolescents in Jeddah-Saudi Arabia

BACKGROUND

Internet addiction is increasing among adolescents worldwide. There is a lack of research assessing internet addiction and factors contributing to it among adolescents in Jeddah city. The current study aimed to assess the rate of internet addiction among adolescents in Jeddah, Saudi Arabia, and the potential factors associated with it.

METHODS

A cross-sectional online survey, hosted by SurveyMonkey, was used to capture data on internet use from 462 adolescents aged 12-18 years between March and May 2022. Young's Internet Addiction Scale was used to assess the degree of internet addiction as perceived by adolescents. Multiple linear regression analysis was used to identify possible predictors of internet addiction among adolescents in Jeddah.

RESULTS

The mean age of the participants was 15.5 ± 1.9 years. The majority were females (75%) from public schools (63%), spent an average of six hours on the internet daily, owned smartphones (98%), accessed the internet via a smartphone (94%), and used the internet for socializing (82%). Internet addiction mean score was 39.20 ± 15.20 out of 100. More than two-thirds of the participants had mild to moderate levels of internet addiction (68%). Significant predictors contributing to internet addiction were using the internet for socialization and playing online games. The more hours spent on the internet daily, the more the internet addiction was (p ≤ 0.05).

CONCLUSIONS

The internet addiction rate is high among school adolescents in Jeddah. The majority of high school adolescents had mild to moderate levels of internet addiction. Interventional multidisciplinary programs are needed to mitigate the factors that influence internet addiction.

Disrupted inter-brain synchronization in the prefrontal cortex between adolescents and young adults with gaming disorders during the real-world cooperating video games

BACKGROUND

Gaming disorder (GD) and hazardous gaming (HG) have a high incidence among adolescents and young adults and have caused various negative consequences. Interpersonal interaction deficits are closely related to GD and HG, however, the underlying brain mechanisms are still unclear.

METHODS

The current study recruited 46 healthy subjects and 32 subjects with GD/HG. Gaming time and frequency, gaming disorder risks, life events, strengths, and difficulties were measured with scales. Subjects were randomly paired into 12 HC-HC dyads, 15 GD/HG-HC dyads, and 7 GD/HG-GD/HG dyads and in pairs completed a real-world cooperating video game - "Tied Together" with functional near-infrared spectroscopy hyperscanning recording in the prefrontal cortex. The inter-brain synchronization in each region of the PFC between dyads was calculated by wavelet to transform coherence to measure brain-to-brain synchronization.

RESULTS

We found subjects with GD/HG reported higher risks of gaming. The highest IBS in the left dorsolateral prefrontal cortex significantly decreased in the GD/HG-HC and GD/HG-GD/HG dyads compared with healthy controls. A decreasing highest IBS of the left dlPFC was related to a decreasing level of peer problems.

LIMITATIONS

We declare limitations of age gaps of samples, undistinguishing GD from HG, use of sub-samples, and the broad concept of interpersonal interaction.

CONCLUSIONS

The current study found a decreased highest IBS in the left dlPFC among adolescents and young adults with gaming diseases. It may provide new prevention and treatment insights into gaming disorders targeting disrupted interpersonal interaction.

The mediating effect of dispositional mindfulness on the association between UPPS-P impulsivity traits and gaming disorder among Asia-Pacific young adults

BACKGROUND

Little evidence is available to verify the mediating effect of dispositional mindfulness on the association between gaming disorder and various impulsivity traits. The present study aimed to investigate the mediating effect of dispositional mindfulness on the association between the five UPPS-P impulsivity traits and the risk of gaming disorder among young adults.

METHODS

It was an inter-regional cross-sectional study using online survey in Australia, Japan, The Philippines and China. Impulsivity measured by the UPPS-P Impulsive Behavior Scale-Short version; dispositional mindfulness measured by the Mindfulness Attention Awareness Scale; and the risk of gaming disorder measured by the Internet Gaming Disorder Scale were collected in the focal regions. Structural equation modeling was performed by SPSS AMOS version 26 to verify the study hypotheses. Bootstrapped 95% confidence interval was reported. Statistical significance was indicated by the p-value below 0.05.

RESULTS

Among the 1,134 returned questionnaires, about 40% of them aged 18-20 years and 21-23 years, respectively. 53.8% were male. 40.7% had been playing digital and video games for over 10 years. The prevalence of gaming disorder was 4.32%. The model fitness indices reflected that the constructed model had an acceptable model fit (χ2(118) = 558.994, p < 0.001; χ2/df = 4.737; CFI = 0.924; TLI = 0.890; GFI = 0.948; RMSEA = 0.058; SRMR = 0.0487). Dispositional mindfulness fully mediated the effect of positive urgency and negative urgency on the risk of gaming disorder. The effect of lack of premeditation on the risk of gaming disorder was partially mediated by dispositional mindfulness. However, dispositional mindfulness did not mediate the effect of sensation seeking on the risk of gaming disorder.

CONCLUSIONS

The varied associations between dispositional mindfulness and the five impulsivity traits hints that improving some impulsive traits may increase dispositional mindfulness and so lower the risk of gaming disorder. Despite further studies are needed to verify the present findings, it sheds light on the need to apply interventions on gamers based on their impulsivity profile. Interventions targeting at emotion regulation and self-control such as mindfulness-based interventions seem to be effective to help gamers with dominant features of urgency and lack of premeditation only. Other interventions shall be considered for gamers with high sensation seeking tendency to enhance the effectiveness of gaming disorder prevention.