(Internet) Gaming Disorder in DSM-5 and ICD-11: A Case of the Glass Half Empty or Half Full: (Internet) Le trouble du jeu dans le DSM-5 et la CIM-11: Un cas de verre à moitié vide et à moitié plein

Validation of the ACSID-11 for consistent screening of specific Internet-use disorders based on ICD-11 criteria for gaming disorder: A multitrait-multimethod approach

INTRODUCTION

With the inclusion of gaming disorder in the ICD-11, diagnostic criteria were introduced for this relatively new disorder. These criteria may be applied to other potential specific Internet-use disorders. The 11-item Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) was developed for consistent screening of gaming disorder, online buying-shopping disorder, online pornography-use disorder, social networks-use disorder, and online gambling disorder. This study tested the construct validity of the ACSID-11, including convergent and divergent measures.

METHODS

The ACSID-11 measures five behavioral addictions with the same set of items by following the principles of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ACSID-11 was administered to a convenience sample of active Internet users (N = 1597) together with validated and established measures of each specific Internet-use disorder along with screeners for mental health. Included are the Ten-Item Internet Gaming Disorder Test (IGDT-10), the Bergen Shopping Addiction Scale (BSAS), the Problematic Pornography Consumption Scale (PPCS), the Bergen Social Media Addiction Scale (BSMAS) and the Berlin Inventory of Gambling behavior - Screening (BIG-S). The ACSID-11 was compared convergently and divergently through a multitrait-multimethod approach along with contingency tables with the other Internet-use disorder screeners.

RESULTS

The multitrait-multimethod results shows that each behavior assessed with the ACSID-11 has moderate to strong correlations (r's from 0.462 to 0.609) with the scores of the corresponding established measures and, furthermore, positive correlations (r's from 0.122 to 0.434) with measures of psychological distress and further shows that the ACSID-11 can be used for a comprehensive assessment of different behaviors. The contingency tables reveal large divergences between the ACSID-11 and other screening instruments concerning the classification of problematic specific Internet use based on the given cut-off values.

CONCLUSION

The current work provides additional validation for the ACSID-11. Accordingly, this tool can be considered as reliable and valid for the simultaneous assessment of different Internet-use disorders: gaming disorder, online buying-shopping disorder, online pornography use disorder, social networks use disorder, and online gambling disorder. With a subsequent clinical validation of the scale and the proposed cut-off score, the ACSID-11 will be a thoroughly validated useful screening tool for clinical practice.

Screened realities: a Grounded Theory exploration of gaming disorder dynamics among Iranian male adolescents

Introduction

The increasing prevalence of gaming Disorder (GD) among adolescents has become a global concern. Despite the rising number of studies investigating GD, the cultural and socio-economic factors influencing GD with a qualitative approach are scarce. This study aims to explore the underlying factors, processes, and consequences of GD among Iranian male adolescents and contextual factors related to GD within Iran's unique socio-cultural and psychological tapestry.

Methods

The study used a qualitative design based on the Grounded Theory Method (GTM). The researchers conducted semi-structured interviews with 13 male adolescents aged 15-18 who Dignasoed according to DSM-5 and ICD-11 criteria. The interviews were transcribed and analyzed using the GTM approach, which involves open, axial, and selective coding.

Results

The study revealed nine main themes and a core category: (1) interaction seeking, (2) encounter and familiarize with games, (3) games attraction, (4) Socialization, (5) game careerism, (6) dexterity, (7) lack and compensation, (8) physical harm, territorial-cultural barrier, (9) second life, and ''life crafting'' as the core category.

Discussion

The study's findings provide valuable insights into the cultural and socio-economic factors influencing GD among Iranian male adolescents. For example, Iran's economic conditions make adolescents choose gaming as their job and try to earn money in this way, which makes them more dependent on gaming. On the other hand, communities related to games play an essential role in the identity development of adolescents with GD.

The relationship between internet gaming disorder and psychotic experiences: cyberbullying and insomnia severity as mediators

BACKGROUND

The nature of the relationship between Internet Gaming Disorder (IGD) and psychosis is unclear so far. There is evidence that greater time spent in playing video games may expose players to both insomnia and a toxic online environment with widespread cyberbullying. These two possible consequences of IGD may, in turn, be associated with greater psychotic experiences (PE). Based on this theoretical framework, the present study proposed to contribute the body of the knowledge in this area, by testing the possible indirect effects of insomnia severity, cyber-victimization and cyberbullying in the cross-sectional association between IGD and PE in a sample of Tunisian university students.

METHOD

We conducted a cross-sectional study over 4 months (February-May 2022). The Arabic versions of the Brief Symptom Inventory, the Internet Gaming disorder-20 Test, the Insomnia Severity Index, and the Revised Cyber Bullying Inventory-II were administered to a total of 851 students (mean age = 21.26 ± 1.68 years, 53.7% females).

RESULTS

We found that 25% of students were at risk of IGD, and 1.8% had an IGD. The results of the mediation analysis showed that insomnia severity fully mediated the association between IGD and paranoid ideation. Higher IGD was significantly associated with more insomnia severity, which was, in turn, significantly associated with more paranoid ideation. Cyberbullying partly mediated the association between IGD and psychoticism. Higher IGD scores were significantly associated with more cyberbullying, which was, in turn, significantly associated with more psychoticism. Finally, greater IGD was significantly and directly associated with higher psychoticism.

CONCLUSION

Our findings suggest that insomnia and cyberbullying may be regarded as potential targets for youth mental health promotion, as well as community-focused prevention and early intervention in psychosis. More particular attention should be devoted to the huge potential for engaging in cyberbullying among online gamers. Sleep deprivation should be prevented, assessed and treated in heavy gamers.

Validation of the Thai Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) among young adults

BACKGROUND

The Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) is a consistent and comprehensive instrument to assess symptoms of specific internet-use disorders including those related to gaming, shopping, pornography use disorder, social networks use and gambling considering criteria in the eleventh revision of the International Classification of Diseases (ICD-11). However, to date, there is little evidence supporting instruments assessing major types of specific internet use disorders in Thailand. The aim of this present study was to assess the psychometric properties of the ACSID-11 among Thai young adults.

METHODS

A total of 612 participants were recruited. A confirmatory factor analysis (CFA) examined construct validity of the ACSID-11. Cronbach's α and McDonald's ω were used to assess reliability of the ACSID-11. Pearson correlations examined relationships between ACSID-11 domains and Internet Gaming Disorder Scale-Short Form (IGDS9-SF) scores.

RESULTS

The CFA supported validity of the Thai version of the ACSID-11 and a four-factor structure. Specific domains of the Thai ACSID-11, particularly gaming, were positively and significantly correlated with IGDS9-SF scores.

CONCLUSIONS

Data indicate that the Thai version of the ACSID-11 is a valid and reliable instrument to assess major types of specific internet use disorders. Additional studies are needed to further examine the validity and reliability of the Thai ACSID-11.

Prevalence of problematic Internet use and problematic gaming in Spanish adolescents

Epidemiological studies on problematic Internet use and problematic gaming conducted so far have mainly been carried out with unrepresentative and self-selected convenience samples, resulting in unreliable prevalence rates. This study estimates the prevalence of problematic Internet use and problematic gaming in a large sample of Spanish adolescents (N = 41,507) and identifies risk and protective factors for these risky behaviours. Data were collected online using the Adolescent Problem Internet Use Scale and the Adolescent Gaming Addiction Scale. Using a cut-off approach with measurement instruments inspired by the DSM-5 framework, we found a prevalence of 33% for problematic Internet use and 3.1% for problematic gaming. With a more conservative approach inspired by the ICD-11 framework, prevalence rates decreased to 2.98% for problematic Internet use and 1.8% for problematic gaming. Female gender, higher parents' education, elevated Internet connection time, reporting being online after midnight and using the mobile phone in class predicted problematic Internet use; whereas male gender, "living situation" where families do not have a traditional structure or stable environment, elevated Internet connection time and reporting using the mobile phone in class predicted problematic gaming. A cut-off approach involving scales that recycle substance use criteria (as in the DSM-5) over-pathologize Internet use and gaming behaviours. In contrast, the ICD-11 approach seems to provide more realistic and reliable prevalence rates.

Rate of Overlap between ICD-11 Gaming Disorder and DSM-5 Internet Gaming Disorder along with Turkish Reliability of the Gaming Disorder Scale for Adolescents (GADIS-A)

<b><i>Introduction:</i></b> The main aims of the current study were (i) to explore the overlap between Internet gaming disorder (IGD) and gaming disorder (GD) diagnoses, (ii) to identify clinical characteristics in clinical settings, and (iii) to measure psychometric properties of the Gaming Disorder Scale for Adolescents (GADIS-A). <b><i>Methods:</i></b> 222 adolescents who were followed up within a tertiary-care mental health hospital, were included (IGD/GD group [<i>n</i> = 111], clinical comparison group [<i>n</i> = 90], healthy controls [<i>n</i> = 21]). The tools used were the GADIS-A, Internet Gaming Disorder Scale – Short-Form, The Difficulties in Emotion Regulation Scale (DERS-36), Children’s Global Assessment Scale, and a semistructured interview for DSM-5 diagnoses. <b><i>Results:</i></b> The overlap rate of IGD and GD is 73%. Comorbid ADHD diagnoses were more commonly found in the IGD group compared to the clinical comparison group. Patients who met GD and IGD diagnoses revealed higher scores in DERS-36. Turkish GADIS-A Item-total score correlation coefficients were between 0.627 and 0.860. In the sample, there was a high level of correlation between the number of DSM-5 and ICD-11 diagnostic criteria met and GADIS-A scale scores. The Cronbach’s alphas if item deleted ranged between 0.942 and 0.954. In addition, treatment refusal was more frequent in the IGD group than in the clinical comparison group. <b><i>Conclusion:</i></b> The GADIS-A had good to excellent psychometric properties in Turkish adolescents. Despite having a stricter diagnostic criterion, GD overlapped with IGD in a clinical population.

Gaming among female adolescents: profiling and psychopathological characteristics in the Indian context

Objectives

Gaming is a predominant leisure time activity among adolescents, and the literature suggests that unrestrained gaming behavior might lead to gaming disorder. ICD-11 and DSM-5 have recognized gaming disorder as a psychiatric condition and grouped it under the behavioral addiction category. Research on gaming behavior and addiction is largely based on data from the male population, and problematic gaming has largely been understood from the male perspective. In this study, we are attempting to bridge the existing lacuna in the literature by exploring gaming behavior, gaming disorder, and its related psychopathological characteristics among female adolescents in India.

Methods

The study was conducted on a sample of 707 female adolescent participants who were contacted through schools and academic institutes in a city in Southern India. The study adopted a cross-sectional survey design, and data were administered using the mixed modality of online and offline data collection. The participants filled out the following set of questionnaires: socio-demographic sheet, Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), Strength and Difficulties Questionnaire (SDQ), Rosenberg self-esteem scale, and Brief sensation-seeking scale (BSSS-8). The data gathered from the participants were then statistically analyzed using SPSS software version 26.

Results

The descriptive statistics revealed that 0.8% of the sample (i.e., five participants out of 707) obtained scores meeting gaming addiction criteria. Correlation analysis demonstrated a significant relationship between all the psychological variables with total IGD scale scores (p < 0.05). Total SDQ, total BSSS-8, and domain scores of SDQ, such as emotional symptoms, conduct, hyperactivity, and peer problems, were positively correlated, whereas total Rosenberg scores and domain scores of prosocial behaviors of SDQ were negatively correlated. The Mann-Whitney U-test was employed to compare "with gaming disorder" and "without gaming disorder" categories of female participants. Comparing these two groups revealed significant differences in emotional symptoms, conduct, hyperactivity/inattention, peer problem, and self-esteem scale scores. Furthermore, quantile regression was computed, showing that conduct, peer problem, and self-esteem displayed trend-level prediction for gaming disorder.

Conclusion

Female adolescents prone to gaming addiction can be identified through psychopathological characteristics of conduct, peer problem, and low self-esteem. This understanding can be useful in developing a theoretical model focusing on early screening and preventive strategies for at-risk female adolescents.

Alcohol and Substance Use Disorders Diagnostic Criteria Changes and Innovations in ICD-11: An Overview

Background

The new revision of the ICD came into effect on January 1st, 2022, and significant changes have been introduced in the section related to substance use disorders.

Method

In the present work we describe the new ICD-11 section "Disorders due to Substance Use and Addictive Behaviors" and outline the innovations in classification and diagnosis introduced, with a view to addressing the most important issues in terms of new opportunities for identifying and caring for people in need of treatment.

Results

The main innovations introduced in the ICD-11 chapter of interest are the expanded classes of psychoactive substances, the introduction of single episodes of substance use, the introduction of harmful patterns of substance use and severity qualifiers for substance intoxication. Furthermore, the new category "Disorders due to addictive behaviors" has been added, including "Gambling disorder" and the new diagnostic category "Gaming disorder".

Conclusions

ICD-11 calls for renewed public health response and policies fostering the multi-professional and multidisciplinary management of alcohol and substance abuse treatment, giving to these forms of addiction new chances also towards the reaching of the UN 2030 Agenda Sustainable Development Goals.

The prevalence and possible risk factors of internet gaming disorder among adolescents and young adults: Systematic reviews and meta-analyses

BACKGROUND

As a spreading addictive behaviour in recent years, internet gaming disorder (IGD) has been studied a lot and the overall research results indicate that IGD has a high prevalence among adolescents and young adults (AYAs). To update the status quo of prevalence, it is necessary to conduct comprehensive analyses.

METHODS

On the premise of following the PRISMA statement, the study conducted two systematic reviews and meta-analyses to assess the global prevalence of IGD among AYAs and identify its possible risk factors. To achieve the goals, PubMed and CNKI databases were used to select the concerned studies published up to May 31, 2021. Heterogeneity was assessed using a funnel plot, Begg's test, Egger's test, and trim-and-fil method, followed by sensitivity analysis, subgroup analysis, and meta-regression analysis.

RESULTS

For the meta-analysis of prevalence, 407,620 participants from 155 reports in 33 countries were included. The pooled prevalence of IGD among AYAs was 9.9% (95% CI: 8.6%-11.3%, P = 0.000, I² = 94.4%), including 8.8% (95% CI: 7.5%-10.0%) among adolescents and 10.4% (95% CI: 8.8%-11.9%) among young adults. The following 12 factors are the possible risk factors of IGD among AYAs, which are stress, long average game time, family dysfunction, poor academic performance, being bullied, bullying, interpersonal problems, hyperactivity/inattention, anxiety, depression, emotional distress and low self-esteem.

CONCLUSIONS

This study confirms the prevalence and possible risk factors for IGD among AYAs. It's valuable in understanding the threat of IGD and finding intervention strategies for IGD among AYAs.

Prevalence and Factors Associated with Gaming Disorder in Latin America and the Caribbean: A Systematic Review

We aimed to determine the prevalence and factors associated with gaming disorder (GD) in the population of Latin America and the Caribbean (LAC). A systematic review was performed (PROSPERO protocol registration: CRD42021230565). We included studies that identified participants with GD and/or factors associated with this condition, reported the prevalence of GD, or contained data that assisted in its estimation, were published after 2013 (the year of inclusion of GD in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders) and were carried out in a population residing in an LAC country. Evaluation of the quality of the studies was carried out using the Joanna Briggs Institute Critical appraisal checklist tool. A qualitative synthesis of the data was performed. Of the total of 1567 records identified, 25 passed the full-text review phase, and 6 met the selection criteria. These studies were published between 2018 and 2021 and had a cross-sectional design (three in Brazil, one in Ecuador, Mexico, and the other was multi-country, including a LAC country [Peru]). The prevalence of GD ranged from 1.1% to 38.2%. The three studies in Brazil had the highest figures of GD prevalence (20.4-38.2%). Four studies evaluated factors associated with GD. Characteristics regarding the game (type), pattern of use (hours played), as well as gender (higher in men), tobacco and alcohol consumption, poor interpersonal relationships, and the presence of mental disorders were found to be associated with GD in LAC. Evidence on the prevalence and factors associated with GD in LAC is limited. Studies on GD in LAC evaluate different population subgroups, describing a wide prevalence of this condition (present in up to 38 out of 100 evaluated). Characteristics such as the type and hours of use of the games, sociodemographic data, lifestyles, interpersonal relationships, and the presence of mental disorders increase the probability of presenting GD.

Current Status of Internet Gaming Disorder (IGD) in Japan: New Lifestyle-Related Disease in Children and Adolescents

The World Health Organization recognizes internet gaming disorder (IGD) as a disorder that causes problems in daily life as a result of excessive interest in online games. The causes of IGD have become more apparent in recent years. Because of prolonged exposure to games, the mechanisms controlling the reward system, such as the prefrontal cortex, limbic system, and amygdala of the cerebrum, do not function properly in IGD. This mechanism is similar to that of various behavioral addictions, such as gambling addiction. IGD is particularly risky in children and adolescents because it easily causes brain dysfunction, especially in the developing brain. IGD should be regarded as a new lifestyle-related disease in younger individuals, and lifestyle modifications, including counseling and family therapy, are critical for its management.

The gaming problem: A latent class analysis of DSM-5 criteria for Internet Gaming Disorder in a non-clinical sample

Background: In this study we aimed to test whether suggested DSM-5 criteria for Internet Gaming Disorder (IGD) share a similar latent structure to formally recognised addiction. Methods: We used latent class analysis on a dichotomous measure of IGD. The data was collected from a convenient general population sample (500) and a targeted gaming forum sample (236). Results: We found a four or six-class model to be most appropriate, ranging from ‘casual/non-gamer’ to ‘potentially disordered’ with increasing symptom severity. The majority of ‘potentially disordered’ gamers (5+ criteria) were found to be 18-30 years old, and no ‘potentially disordered’ gamers were over 42. Conclusions: The results suggest that gaming may share a similar latent structure to established addictions, with adolescents and young adults being more at risk. Studies replicating these results would be beneficial, with further emphasis on a critical evaluation of the criteria and symptom cut-off point.