An investigation into Video Game Addiction in Pre-Adolescents and Adolescents: A Cross-Sectional Study

Validation of the Farsi version of the video-game addiction scale for children: its associations with social media addiction, internet addiction and executive functions

Addiction to video games can negatively affect cognitive and social functioning. We aim to validate the Video Game Addiction Scale for Children (VASC) among Iranian children aged 8-13 in this study. This study confirmed the four-factor structure (self-control, reward, problems, involvement) and demonstrated strong internal consistency reliability (Cronbach's alpha = 0.89) that has significant practical implications. The VASC showed significant correlation with the Bergen Social Media Addiction Scale (BSMAS) and the Internet Addiction Test (IAT), indicating its convergent validity. The VASC was negatively correlated with executive function, as measured by the Behavior Rating Inventory of Executive Function (BRIEF).The study provided a reliable and practical tool for future clinical and research investigations of gaming addiction tendencies in Iranian culture.

Down the Digital Rabbit Hole: Objectification Increases Problematic Gaming

Objectification, being perceived and treated merely as an object with a denial of one's humanness, has been linked to numerous adverse outcomes in daily life. Despite this, its influence on online behaviors, particularly problematic gaming, remains underexplored. The current research (total N = 1,000) extends the literature on objectification by investigating the effect of objectification on problematic gaming. Study 1, with a correlational design (N = 300), established a significant association between objectification and problematic gaming. Subsequent experimental studies (Studies 2 and 3) demonstrated that objectification directly contributes to increased problematic gaming intentions. Study 2, with a measurement-of-mediation design (N = 300), also identified escapism as a mediating factor, suggesting that objectification intensifies the motive to escape from reality, thereby increasing problematic gaming intentions. Furthermore, Study 3, with a moderation design (N = 400), revealed that perceived meaning in life could mitigate the negative impact of objectification on problematic gaming intentions. Collectively, these findings advance our understanding of the detrimental effects of objectification, highlighting its role in problematic gaming and identifying the potential intervention.

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.

Parental Phubbing Behavior and Adolescents' Online Gaming Time: The Mediating Role of Electronic Health Literacy

OBJECTIVE

The purpose of this study is to explore the relationship between parents' phubbing behavior and children's online gaming time. More importantly, we investigated the mediating role of electronic health literacy in this association.

METHODS

A total of 1200 questionnaires were sent out and 1130 effective questionnaires were returned, an effective recovery of 94.17%. As some students did not answer part of the EHL survey, eventually only 867 students were included in this study based on the selected independent variables and the degree of questionnaire completion. Both tools used for measuring parental phubbing and electronic health literacy passed confirmatory factor analyses. To analyze the mediating effect of electronic health literacy on parental phubbing behavior and online gaming time, 5000 datapoints were sampled using the Bootstrapping method.

RESULTS

The results indicated that parents' phubbing was positively related to their children's online gaming time, which was mediated by electronic health literacy, parental phubbing is positively and significantly correlated with electronic health literacy, and electronic health literacy is negatively and significantly correlated with online gaming time among adolescents.

CONCLUSIONS

Electronic health literacy partially mediates the relationship between parental phubbing behavior and adolescent online gaming time, and Chinese students' electronic health literacy is a two-dimensional structure consisting of health information acquisition and application. This study is the first empirical study to explore the relationship between parental phubbing behavior and the amount of time adolescents spend playing games online.

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.

Assessing Autistic Traits, Hikikomori Tendencies, Pathological Videogaming, and Eating Disorders in University Students: Are Pathological Videogaming and Eating Disorders Gender-Specific Manifestations of the Autism Spectrum?

In the previous literature, specific attention has been paid to investigate autism spectrum symptoms and traits in university students. In this framework, we aimed to evaluate the presence and correlates of autistic traits, hikikomori tendencies, altered eating behaviors, and pathological videogaming in a sample of Italian university students enrolled in bachelor's degree courses. A total of 1192 students were recruited via an online survey and assessed with the Hikikomori Questionnaire-25, the Adult Autism Subthreshold Spectrum Questionnaire, the Eating Attitude test-26, and the Assessment of Internet and Computer Game Addiction. Our results highlighted significant differences in the prevalence of autistic traits, social withdrawal tendencies, altered eating habits, and pathological videogame use in university students based on gender, age, parents' level of instruction, and field of study. A significant effect of the presence of autistic traits and gender on the scores obtained with the other questionnaires was reported. Our results not only support the role of autistic traits as a vulnerability factor for the development of a set of psychopathological conditions but also suggest that gender could modulate this vulnerability, supporting the hypothesis of gender-specific phenotypes in the autism spectrum.

European Portuguese Version of the Game Addiction Scale-7: Factor Structure and Psychometric Properties

INTRODUCTION

Game addiction (GA) can be described as a compulsive and excessive usage of computers or video games that causes emotional and or social problems. The current study tested the factor structure and psychometric properties of the European Portuguese Game Addiction Scale (GAS-7-PT) short version.

METHODS

The sample encompassed 375 participants, 233 women (62.1%) and 142 men (37.9%), with a mean age of 21.71 (standard deviation = 5.82) years old. Participants completed a set of self-report measures online: the GAS-7-PT, the Scale of Involvement in Video Games and the Patient Health Questionnaire-4.

RESULTS

Confirmatory factor analyses confirmed a biological sex invariant single-factor structure with a very good fit to the data. The GAS-7-PT showed good reliability and test-retest reliability. Correlations with related and unrelated measures suggested convergent validity, and partial correlation results pointed to incremental validity. Men showed significantly higher scores than women.

CONCLUSION

The GAS-7-PT is a self-report instrument with suitable psychometric properties for clinical and research contexts. The availability of a European Portuguese version confirms the GAS-7 robust consistency and allows further cross-cultural clinical research.

Evaluation of Problematic Video Game Use in Adolescents with ADHD and without ADHD: New Evidence and Recommendations

Video game addiction among adolescents, particularly those with ADHD, is a significant concern. To gather more insights into video game usage patterns in this population, we investigated levels of potentially problematic use, passion, motivations, and emotional/behavioral symptoms in adolescents with and without ADHD. Our cross-sectional, multicenter study involved 2513 subjects (Age M = 15.07; SD = 2.82) from 24 schools in Galicia (Spain), including 158 (6.3%) diagnosed with ADHD. We employed an ad hoc questionnaire covering sociodemographic data and ADHD diagnosis, the Questionnaire of Experiences Associated with Video Games (CERV), the scale of passion for video games, reasons for playing video games Questionaire (VMQ), and emotional/behavioral problems assessment (SDQ). Results indicated heightened vulnerability in adolescents with ADHD, manifesting in longer usage durations and higher problematic use scores. Interestingly, ADHD medication did not affect internet gaming disorder development. Motivations for gaming differed between groups, with the ADHD cohort showing distinctions in cognitive development, coping, and violent reward. Additionally, the ADHD group exhibited greater emotional/behavioral symptoms, hyperactivity, and reduced prosocial behavior.

Eating Behavior, Sleep Disorders and Digital Game Addiction in Children and Determination of Associated Factors by CHAID Analysis

Background

Healthy nutrition and good quality sleep are one of the most important factors for growth and development in a child. Digital game addiction may cause some problematic behaviors and affect children's nutrition and sleep. We aimed to investigate the relationship between digital game addiction, eating behavior, and sleep disorders in children.

Methods

The study was conducted with 252 mothers with children between the ages of 4-7 years, selected by convenient sampling methods. The Digital Game Addiction Scale, Children's Eating Behavior Questionnaire and The Sleep Disturbance Scale for Children (SDSC) were used to collect data. The correlation coefficient and the decision tree CHAID algorithm were used in the data analysis.

Results

Digital game addiction negatively affects children's eating behavior and sleep patterns. It was found that there was a mostly positive but weakly significant relationship between digital game addiction and children's eating behaviors (P<.01; P<.05) and a highly significant relationship was found between the sleep disorder scale sleep hyperhidrosis sub-dimension (P<.05). While digital game addiction is affected by gender, the mother's education level, and eating behavior are affected by the mother's age, the parent's education level, and the child's gender (P<.05). The child's age is the variable that affects the children's sleep disorder (P<.05).

Conclusion

Intervention programs for children and families can be created for the causes of digital game addiction, its effects on child development and the correct use of the digital world.

Does parents' perceived style of setting limits to gaming matter? The interplay between profiles of parental mediation and BIS/BAS sensitivity in problematic gaming and online gambling

INTRODUCTION

Parents try to prevent possible negative outcomes associated with gaming by setting rules on their adolescent's gaming behavior (i.e., restrictive mediation). Parents can use either more autonomy-supportive or more controlling styles to communicate those rules. Using a person-centered approach, this study aims to, first, identify profiles of parents' perceived degree of restrictive mediation in gaming and styles of communicating these rules (i.e., autonomy-supportive and controlling); second, to examine how adolescents in different profiles differ in terms of maladaptive gaming outcomes (i.e., problematic gaming, simulated, and online gambling); third, to investigate the moderating role of gaming frequency and adolescents' personality (i.e., behavioral inhibition system [BIS] sensitivity and behavioral activation system [BAS] sensitivity) in the associations between the parental profiles and the outcomes.

METHODS

The study used quantitative, cross-sectional survey data from Belgian adolescents (N = 1651, mean age = 14.00 years, 51.2% boys), collected between November 2021 and February 2022 in schools.

RESULTS

Cluster analysis yielded four profiles of perceived restrictive mediation: an exclusively controlling one, an autonomy-supportive one, one where parents used a perceived mix of both communication styles, and one where there was an overall perceived lack of restrictive mediation. Adolescents in the controlling profile displayed the most maladaptive outcomes. Some of the associations between the parental profiles and the outcomes were stronger for more frequent gamers and for adolescents scoring higher on both BIS and BAS sensitivity.

CONCLUSION

Associations between the parental profiles and gaming outcomes were theoretically meaningful, yet small in terms of effect size.

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

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

The effects of online game addiction on reduced academic achievement motivation among Chinese college students: the mediating role of learning engagement

Introduction

The present study aimed to examine the effects of online game addiction on reduced academic achievement motivation, and the mediating role of learning engagement among Chinese college students to investigate the relationships between the three variables.

Methods

The study used convenience sampling to recruit Chinese university students to participate voluntarily. A total of 443 valid questionnaires were collected through the Questionnaire Star application. The average age of the participants was 18.77 years old, with 157 males and 286 females. Statistical analysis was conducted using SPSS and AMOS.

Results

(1) Chinese college students' online game addiction negatively affected their behavioral, emotional, and cognitive engagement (the three dimensions of learning engagement); (2) behavioral, emotional, and cognitive engagement negatively affected their reduced academic achievement motivation; (3) learning engagement mediated the relationship between online game addiction and reduced academic achievement motivation.

Predictors of Problematic Video Gaming in Elementary School Boys with ADHD

The aim of the study was to expand the current knowledge base on problematic video gaming and ADHD with four questions: (1) Are there differences in the length of video gaming between boys with ADHD and typically developing boys? (2) Are there differences in problematic video gaming between boys with ADHD and typically developing boys? (3) What are the predictors of problematic video gaming? (4) Does problematic video gaming affect academic performance while controlling for the effect of inattention and hyperactivity/impulsivity symptoms? Symptoms of inattention, hyperactivity/impulsivity scale (SNAP IV), the Problematic Video Game Scale, and the Video Game Patterns Questionnaire were administered to 127 parents of elementary school boys in Croatia, 57 of whom were parents of boys with a clinical ADHD diagnosis and 70 of whom were parents of typically developing boys. The results show that there are no differences in length of play and problematic video gaming between ADHD and typically developing boys. A hierarchical regression analysis showed that age, inattention symptoms, and length of play are predictors of problematic video gaming. Inattention symptoms and age are significant predictors of academic achievement whereas it seems that hyperactivity and impulsivity symptoms are not predictors of problematic video gaming and academic achievement in boys.

Relationship between Medical Students' Perceived Stress and Gaming Behavior at King Saud University

Gaming addiction has gradually developed among medical students and has been a contentious topic for nearly a decade. This study is aimed at estimating the prevalence of gaming addiction among medical students at King Saud University and examining the relationship between perceived stress levels and gaming addiction. We conducted a cross-sectional study among 370 students from 2019 to 2020 using a self-reporting questionnaire consisting of two validated test scales: the Gaming Disorder Test and the Perceived Stress Scale. The questionnaire was sent to all students through an email. Descriptive analyses and t-test statistical tests were used in this study. The prevalence rate of gaming addiction was found to be 4.6%, while the prevalence of perceived stress was confirmed at 95.9%. Students with excellent GPAs and high family income were associated (p < 0.001). Younger groups, females, and students with high family incomes showed higher levels of perceived stress than others. According to Pearson's correlation, gaming addiction was not significantly correlated with stress among medical students (p > 0.05). According to chi-square test also, no significant association was found between gaming disorder and perceived stress (χ ² = 4.412; p = 0.353). In conclusion, gaming addiction among medical students has scored low prevalence, indicating gaming is not a factor contributing to stress among this group. The high level of perceived stress among medical students should draw attention to the provision of regular psychological care.

“Game (not) Over”: A Systematic Review of Video Game Disorder in Adolescents

This study aims to characterize video game use disorder in adolescents, identifying the particularities of those who present it, its effects at the brain level, related factors, and existing measurement instruments. A systematic review of the scientific publications available in Scopus was carried out, between the period 2014-2018 on video game use disorder in adolescents. Adolescents with this disorder are characterized by being mostly men, spending more time daily and weekly playing than adolescents without this disorder, showing diverse symptoms in the behavioral, affective, and cognitive areas. At brain level, it is referred that in this disorder there is an increase and decrease in the activation of specific areas of the brain. Likewise, the presence of some psychological disorder and impulsivity are considered factors that increase the risk of suffering from it. However, there are protective factors as school commitment and parental supervision, among others. How to cite: Rojas-Jara, C., Polanco-Carrasco, R., Navarro-Castillo, R., Faúndez-Castillo, F., & Chamorro-Gallardo, M. (2022). “Game (not) Over”: A Systematic Review of Video Game Disorder in Adolescents. Revista Colombiana de Psicología, 31(2), 45-64. https://doi.org/10.15446/rcp.v31n2.90741

Internet gaming disorder in an adolescent during the COVID-19 pandemic: a case report

The internet has become an indispensable tool in people´s daily lives during the COVID-19 pandemic. Internet and video game use are experiencing rapid growth in the youth and adult populations as a major source of entertainment. However, excessive gaming may cause addiction and negatively impact mental health, entailing low psychosocial well-being, poor social skills, and decreased academic achievement. We report the case of a 16-year-old student with a "typical" pattern of internet gaming disorder (IGD) developed during the pandemic, which improved after weeks of treatment with pharmacotherapy and psychosocial interventions. This case highlights that it is essential for the mental health professionals to know the psychopathology of IGD and multimodal approaches to treat it.

Individual and Interpersonal Factors Associated with the Incidence, Persistence, and Remission of Internet Gaming Disorders Symptoms in an Adolescents Sample

Video game playing behavior has serious consequences for adolescents on a personal, family, social, and academic level. This research aimed to examine risk and protective factors involving incidence, persistence, and remission of gaming disorders symptoms (IGDs) in Spanish adolescents after nine months of follow-up. Data were drawn from self-administered questionnaires completed on two occasions: at the beginning (T1) and end of the academic year (T2). A total of 950 adolescents aged from 11 to 20 years (M = 14, SD = 1.52, 48.5% female) completed the questionnaire at T1, while 550 adolescents aged from 11 to 18 years (M = 13.43, SD = 1.23, 48.9% female) took part in the follow-up study (T2). The incidence, persistence, and remission rates were 6%, 2.7%, and 4.2%, respectively. Significant relationships with IGDs were found between the male gender and studying at a private school in T1 and T2. The findings show that the time spent playing video games during T1 was positively associated with IGDs in T1 and T2. The incidence of IGDs was associated with emotional problems and low family affection. The persistence of IGDs was linked to higher motor impulsivity, agreeableness, and lower family resolve. Remission was related to a decrease in anxiety and hostility as well as an increase in the emotional stability of adolescents. These findings imply that emotional well-being and family adjustment could be relevant for the effective management of gaming behaviors.

What game we are playing: the psychosocial context of problem gambling, problem gaming and poor well-being among Italian high school students

Gambling and gaming are not infrequent among adolescents and preventing low-risk youth from becoming at-risk appears to be a priority of public health strategies. Greater scrutiny of the risk and protective factors in the relationships and community of young people appears crucial in steering prevention initiatives adequately. This study aimed to explore the role of the qualities of relational networks (i.e. family functioning, perceived social and class support), family and peer approval and view of the social environment in predicting problem gambling, problem gaming and overall well-being among adolescents. High-school students aged 14-18 years (N: 595; female: 68,7%) completed a survey including the target variables. A multivariate multiple regression analysis was performed to examine the role of socio-demographic characteristics and psychosocial predictors on gaming, gambling, and well-being. Multivariate multiple regressions identify a common core underpinning problem gambling, gaming and poor well-being but also the distinct roles of psychosocial variables: being male, with low parental monitoring, and an anomic view of the social environment all predict problem gambling and gaming, which were also found to be associated. Low social support predicts problem gambling but not problem gaming; poor family functioning predicts problem gaming but not problem gambling. All the target psychosocial variables, except approval of gambling, predict poor well-being. On the whole the findings suggest the need to look more closely at the way adolescents, their system of activity and their culture participate in constructing the meaning of gambling and gaming activities and their impact on adolescents' well-being, so that future studies and strategies can more effectively examine the relational dynamics in which problem gambling and gaming develop.

Validity and Psychometric Properties of the Internet Gaming Disorder Scale in Three Large Independent Samples of Children and Adolescents

Background: Problematic gaming has become a major health issue in children and adolescents resulting in the need for targeted valid and reliable screening instruments. This study aimed to explore the psychometric properties and criterion validity of the widely used 9-item Internet Gaming Disorder Scale (IGDS) in young gamers. Methods: Three independent samples were drawn from socio-demographically representative cross-sectional telephone surveys collected in the years 2016 (N = 762), 2017 (N = 777), and 2018 (N = 784) and analyzed separately. Results: The IGDS revealed psychometric properties suitable for screening in large samples. Cronbach’s alpha was 0.563, 0.724, and 0.778. The unidimensionality assumption was challenged. At-risk and pathological gamers compared to normal gamers reported longer digital media use and more emotional symptoms and hyperactivity/inattention with clinical relevance to medium effect sizes. The comparison of at-risk and pathological gamers indicated a partial distinction between the two problematic gaming groups. Conclusions: The IGDS could be shown to be an overall suitable and valid tool to identify pathological gamers in childhood and adolescence according to the DSM-5 criteria on a population level. However, the polythetic structure limits comparability with the recent ICD-11 criteria. At-risk gamers appeared as a heterogeneous group warranting more research.

The Influence of Online Game Behaviors on the Emotional State and Executive Function of College Students in China

Background and Objective: Since the classification of gaming disorder (GD) by the World Health Organization (WHO) as "mental disorder caused by addictive behaviors," there has been controversy regarding whether online game behaviors can lead to mental disorder. This study aims to clarify the correlation between the online game behaviors of college students and anxiety, depression, and executive function of college students in China, from a questionnaire-based investigation. Methods: Based on the whole class random sampling method, a questionnaire survey was conducted among college students in Northern Anhui, China from March 7 to March 27, 2020. The questionnaires included the Internet Game Addiction (IGA) Scale, Behavior Rating Inventory of Executive Function (Adult Version, BRIEF-A), Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire Scale (PHQ-9). Results: A total of 850 participants completed the survey, including 353 males (41.53%) and 497 females (58.47%). The primary age group was 18-27 years (91.53%), and the educational background was a bachelor's degree (94.7%). The study found that the online behavior of 17.76% of college students was online game behavior. This study did not identify any students who met the criteria for IGA, and 3% met the criteria for indulgent behavior. A dual role of online games was identified; moderate online game activities can improve the emotional state and executive function of college students, while excessive online game behaviors that may not reach the degree of addiction can also harm emotional state and executive function. Conclusions: This study suggests that although IGA has been regarded as a mental disease, online game behavior should be treated differently. Online game activities should not be entirely denied, but mental disorders caused by excessive gaming activities deserve attention. In particular, the emotional state and executive function of students with excessive online game behaviors should be monitored and intervened in advance to avoid game behaviors turning into indulgent behaviors or addiction. As a cognitive control process, executive function may play a key role in regulating IGA and emotional state.

Differential Effects of Anxiety on Internet Gaming Disorder: A Large-Scale Cross-Sectional Survey

BACKGROUND

Internet gaming disorder (IGD) has become a serious public health problem in East Asia, and studies have reported IGD to be significantly associated with anxiety, but no causal relationship between the two has yet been demonstrated. Children are at high risk of developing IGD, however, previous studies have principally focused on the condition in adults and adolescents and reported non-clinical samples. A large-scale survey is needed to research and evaluate IGD and anxiety in children and adolescents to understand the current situation of IGD in children and explore the impact of IGD on anxiety.

METHODS

A cross-sectional study using an online questionnaire was conducted between March 1 and July 31, 2021. A total of 10,479 school children and adolescents in the western provinces of China were selected by convenience sampling. A questionnaire was used to collect data anonymously. The questionnaire covered IGD and the Revised Children's Manifest Anxiety Scale (RCMAS). Welch's ANOVA Test and Games-Howell test were used to test for differences in anxiety levels between IGD groups. Poisson regression analysis was used to further investigate the key predictors of IGD.

RESULTS

3.2% of participants (n = 334) (95% CI: 2.9-3.2%) were classified as at high risk of presenting with IGD, 71.1% (n = 7,454) (95% CI: 70.3-72.0%) were classified as low-risk players, and 25.7% (n = 2,691) (95% CI: 24.9-26.5%) were classified as non-gaming. The average RCMAS score was (7.18 ± 7.534). The high-risk group had a higher total score RCMAS, as well as scoring higher in its three dimensions. Regression analysis using gender, age, and total RCMAS score as independent variables, and risk of IGD as a dependent variable showed that the odds ratio (OR) for gender was 2.864 (95% CI: 2.267-3.618), and the OR for total RCMAS score was 1.101 (95% CI: 1.087-1.114). The OR for age was not statistically significant.

CONCLUSION

Anxiety was a predictor of IGD, with statistically significant group differences in total anxiety, as well as the dimensions of physiological anxiety, social correlation, and sensitivity. The timely assessment of anxiety in children and adolescents, training social skills, and facilitating effective integration into society could be effective ways of reducing the incidence and impact of IGD.

Development and validation of gaming disorder and hazardous gaming scale (GDHGS) based on the WHO framework (ICD-11 criteria) of disordered gaming

This study aimed to develop and validate a brief psychometric scale for gaming disorder and hazardous gaming based on the WHO framework as defined in the ICD-11. The study was carried out among college students using face to face interview. A panel of mental health experts examined the face validity of the new Gaming Disorder and Hazardous Gaming Scale (GDHGS). An Exploratory Factor Analysis (EFA) using the principle component analysis (PCA) method with direct oblimin rotation on the five items of GDHGS was used for assessment of construct validity. The results of Kaiser Meyer Olkin (KMO) measure used for sampling adequacy and Bartlett's test (BT) of sphericity used to show the appropriateness of using factor analysis, confirmed the appropriateness of EFA for the present study sample. The factor analysis extracted single component with an eigenvalue of greater than one, which was further supported by the examination of scree plot. To examine the criterion related validity of the GDHGS, correlation between GDHGS and IGDS-SF scores was assessed. Spearman correlational analysis showed strong positive correlation of GDGHS score with IGDS-SF score (rs = 0.878, p < 0.01). Further, the sum of first four item score of GDHGS among participants diagnosed with GD (median: 15.00; IQR: 15.00-15.75) was significantly greater than those without GD (median: 4.00; IQR: 3.00-6.50) according to the diagnostic interview based on the ICD-11 criteria (U = 0.000, p < 0.001). The internal consistency of GDHGS as measured by the Cronbach's alpha was 0.914. Further, the GDHGS did not have its reliability increased by removal of any of the five items included in the scale. Also, the threshold for significant floor and ceiling effect was not reached. In conclusion, GDHGS is a valid measurement scale for disorders involving gaming behaviour based on the ICD- 11 construct.

Mathematical models in nursing research

This paper discusses the use of advanced mathematical tools in nursing research, such as mathematical models used in medicine for description and prediction of experimental tumor growth. They are rarely used in nursing research, but fortunately in the last decade, their use is increased, mainly due to artificial intelligence and Big Data, with great benefits for further nursing development. Therefore, a strong interaction between nurses and mathematicians is needed to improve nursing research, and consequently, the nurses' performance in daily work.