Prevalence of Internet gaming disorder in German adolescents: diagnostic contribution of the nine DSM-5 criteria in a state-wide representative sample

Psychometric properties of the Turkish version of the gaming disorder scale for adolescents (GADIS-A)

PURPOSE

This methodological study established the Turkish validity and reliability of the Gaming Disorder Scale for Adolescents (GADIS-A).

METHODS

The study was conducted with 378 adolescents studying in primary and secondary education institutions in the central districts of a province in Turkey affiliated with the Provincial Directorate of National Education. Data were collected using an adolescent information form and GADIS-A. An ethics committee approved the study, and permission was obtained from the institution.

RESULTS

Confirmatory Factor Analysis (CFA) showed that the scale had factor loadings of 0.511 to 0.768, the Goodness of Fit indices of >0.87, and the RMSEA index of <0.10. The total scale had a Cronbach's alpha of 0.860.

CONCLUSION

The results show that GADIS-A is a valid and reliable measure for the Turkish sample.

IMPLICATIONS TO PRACTICE

GADIS-A, a highly valid and reliable scale, can be used as a measurement tool in national and international screening programs.

Serious educational games for children: A comprehensive framework

Introduction

Serious educational games are digital games designed to support teaching or learning objectives that have become popular among children. However, a set of principles is needed to develop a successful educational game. Therefore, this study aimed to provide a comprehensive and valid framework for designing children's serious educational games.

Methods

The conceptual framework is developed in two phases. First, a scoping review was conducted in PubMed, Ovid (APA PsycInfo), EMBASE, Scopus, Web of Science, ProQuest, and gray literature on August 1, 2022. Papers in English that reported the serious educational games' principles for children were included. Second, the extracted data from the previous step was reviewed and discussed by the research team to develop the initial framework. Then, it was distributed to 20 experts with relevant knowledge and experience in two rounds to validate and apply their comments within the framework.

Results

Of the 12916 papers identified, 15 were included in this study. In the proposed framework named CoDHP, the results were classified into four topics, including (a) content aspects, (b) design requirements, (c) highlighted attributes, and (d) children's preferences. Content aspects comprise four classes (goals and limits, child learning content, learning context, and a long-term program) with 16 principles. Design requirements contain 11 classes (stories and storylines, player characters, game mechanics, interactivity, game challenge, game rules, game help, entertaining games, user interface, accessibility, and setting) with 47 principles, of which 15 are highlighted. Regarding children's preferences for the game elements, various similarities and differences were extracted. For instance, both girls and boys prefer fun and popular games. Based on experts' comments, 21 supplementary principles were recommended to complete the content and design requirements.

Conclusion

Game designers or researchers can use the proposed framework as a formative guide to design successful serious games or evaluate children's digital games.

Comparing psychopathological symptoms, life satisfaction, and personality traits between the WHO and APA frameworks of gaming disorder symptoms: A psychometric investigation

INTRODUCTION

The inclusion of Internet Gaming Disorder (IGD) in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association and Gaming Disorder in the 11th revision of the International Classification of Diseases (ICD-11) by the World Health Organization requires consistent psychological measures for reliable estimates. The current study aimed to investigate the psychometric properties of the Gaming Disorder Test (GDT), the Ten-Item Internet Gaming Disorder Test (IGDT-10), and the Five-Item Gaming Disorder Test (GDT-5) and to compare the WHO and the APA frameworks of gaming disorder symptoms in terms of psychopathological symptoms, life satisfaction, and personality traits.

METHODS

A sample of 723 Swedish gamers was recruited (29.8% women, 68.3% men, 1.9% other, Mage  = 29.50 years, SD = 8.91).

RESULTS

The results indicated notable differences regarding the estimated possible risk groups between the two frameworks. However, the association between gaming disorder symptoms and personality traits, life satisfaction, and psychopathological symptoms appeared consistent across the two frameworks. The results showed excellent psychometric properties in support of the one-factor model of the GDT, IGDT-10, and GDT-5, including good reliability estimates (McDonald's omega) and evidence of construct validity. Additionally, the results demonstrated full gender and age measurement invariance of the GDT, IGDT-10, and GDT-5, indicating that gaming disorder symptoms are measured equally across the subgroups.

CONCLUSION

These findings demonstrate that the IGDT-10, GDT-5, and GDT are appropriate measures for assessing gaming disorder symptoms and facilitating future research in Sweden.

Exploring the Impact of Gaming Habits on Sleep Patterns Among Young Adults in Saudi Arabia: A Cross-Sectional Study

Background Video gaming is increasingly popular among young adults, potentially affecting health and daily routines, especially sleep patterns. In Al-Ahsa, Saudi Arabia, the impact of video gaming on sleep and health among young adults is not well understood. This study aims to explore this relationship, focusing on how video gaming habits influence sleep patterns and associated health outcomes. Methods This cross-sectional survey utilized an adapted online questionnaire to gather data on demographics, video gaming habits, sleep patterns, and body mass index from young adults in Al-Ahsa. Statistical analysis, including descriptive statistics, chi-square tests, and multivariable logistic regression, was applied to examine the associations between video gaming habits and sleep sufficiency. Results The study included 302 participants, including 165 (54.6%) females. A majority reported playing video games for less than one hour daily (36.1%), with 82.5% preferring online gaming. Notably, 54.3% of participants slept more than six hours nightly, yet challenges with sleep initiation were evident, as 48.0% went to bed past midnight. Multivariable logistic regression highlighted significant factors affecting sleep sufficiency: participants who played games after completing tasks had 80% lower odds of sleep insufficiency compared to those who played before tasks. Overweight participants were found to be 7.7 times more likely to experience sleep insufficiency compared to their underweight peers. Conclusion The study underscores a complex relationship between video gaming habits and sleep patterns among young adults in Al-Ahsa, with significant health implications. It suggests the necessity for interventions promoting balanced gaming habits and improved sleep hygiene to mitigate adverse health outcomes.

Measurement Invariance of the Lemmens Internet Gaming Disorder Scale-9 Across Age, Gender, and Respondents

Although Internet gaming disorder (IGD) has gained increased attention in scientific, clinical, and community contexts, there is still a lack of consensus regarding the best assessment tools (i.e., self-report or other reports) for assessing its symptoms. The present study aimed to investigate the reliability, validity, and measurement invariance of both versions (youth and parent) of The Lemmens Internet Gaming Disorder Scale-9. To achieve this goal, we recruited between June and October 2019 from five Romanian highschools a total of 697 adolescents (11-19 years old) and one of their parents (N = 391). The internal consistency was good in both versions of the instrument (α = 0.772 for the youth version and α = 0.781 for the parent version). Construct validity assessed through confirmatory factor analysis showed support for the one factor structure of the scales, while multigroup confirmatory factor analysis endorsed the invariance across age, gender, and respondents (i.e., parent vs. youth report). The current research identifies both IGD scales to be reliable and valid, arguing for their utility for assessing IGD symptomatology among adolescents. Implications for theory, assessment, and future directions are discussed.

Problematic video gaming is negatively associated with bone mineral density in adolescents

Adolescent bone health may be negatively impacted by problematic video gaming (PVG) due to factors such as prolonged screen time, poor sleep quality, and increased depression. Although sedentary behaviors have been linked to decreased bone mass, there is limited research on how PVG impacts bone health. We aimed to evaluate the association between PVG and bone mineral density (BMD) in adolescents by comparing the BMD z-scores of adolescents with and without PVG and by identifying PVG-related risk factors that may affect low BMD scores. This cross-sectional study took place between May 2019 and August 2021 with 110 adolescents who played video games for at least two hours per day. Data on screen time, game genre, tobacco, alcohol, caffeine consumption, and vigorous physical activity status were recorded. PVG was assessed using the Internet Gaming Disorder-Short Form (IGDS9-SF), with scores ≤ 16 comprising the control group and > 16 the PVG group. Sleep quality was assessed by Pittsburgh Sleep Quality Index, and depression was evaluated by Children's Depression Inventory. Dual-energy X-ray absorptiometry measurements of femoral neck and lumbar spine BMD were compared between the two groups. The mean age of the participants was 14.2 ± 1.8 years, and 86.4% were males. The PVG group exhibited lower femoral neck z-scores (p = 0.013) and a higher proportion of adolescents with low femoral neck BMD risk (27.8% vs 9.7%, p = 0.041). Lumber spine z-scores did not differ (p = 0.271). Despite poorer depressive symptoms and sleep quality in the PVG group, they were not associated with low BMD risk (OR 1.02, 95% CI 0.97-1.08, p = 0.398 and OR 1.00, 95% CI 0.87-1.18, p = 0.972, respectively). Among all PVG-related risk factors, video game time (aOR = 1.22, 95% CI = 1.06-1.41, p = 0.006) and vigorous physical activity amount (aOR = 2.86, 95% CI = 0.93-8.76, p = 0.080) showed the strongest associations with femoral neck z-scores.  Conclusion: The results of this study, showing a negative association between PVG and femoral neck BMD in adolescents, underscore the importance evaluating, monitoring, and supporting lower extremity bone health in adolescents with PVG. What is Known: • Adolescents with problematic video gaming are at risk for depression, impaired sleep; sedentary lifestyle; consumption of tobacco, alcohol, and drugs; and high caffeine intake. • These risk factors might lead to compromised bone health. What is New: • Problematic video gaming is associated with the low femoral neck bone mineral density risk in adolescents. • Extended video game time and reduced physical activity are found to be the primary risk factors.

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.

Cognitive Patterns and Problematic Use of Video Games in Adolescents: A Cluster Analysis

BACKGROUND

Video game playing (VGP) is an increasingly common leisure activity among children and adolescents, although in some cases, it is accompanied by problems due to misuse.

METHOD

A sample of 2884 children and adolescents aged between 12 and 20, representative of the Community of Madrid (Spain), were studied using a cluster analysis to explore the existence of cognitive patterns associated with engagement, attitudes, and concurrent cognitions. We also explored the relationship between these patterns and problematic VGP, using the 2173 gamers as a reference.

RESULTS

The concurrent cognitions were not qualitatively different between the problematic users and the others. High engagement and high activation of concurrent cognitions (intensity and frequency) showed the greatest relationship with problematic VGP.

CONCLUSIONS

The results suggest the existence of different groups of gamers and the relevance to include psycho-educational aspects in intervention programs, as well as the training of specific skills, especially those related with the control of activation. Limitations related to the sample size and potential supplementary analyses are acknowledged.

Video Game Playing and Internet Gaming Disorder: A Profile of Young Adolescents

In recent times, growing concern has arisen regarding the utilization of technology, video games, and the emergence of internet gaming disorder (IGD), particularly among young adolescents. This worry arises from the ambiguity in distinguishing between "normal" and "problematic" video game behavior, despite efforts to establish clear criteria for defining both. The goal of this study is to outline distinct profiles of adolescent video game players and identify variables associated with their gaming practices that correlate with problematic gaming. The study utilizes a substantial sample of adolescents drawn from a representative cross-section of educational institutions in the city of Madrid, ranging in age from 12 to 16 years. In total, 1516 participants (75%) acknowledged engaging in video game activities. The research delves into characterizing prevailing profiles of video game participants within this cohort and scrutinizes the profile that aligns with issues of IGD. In summary, approximately three-quarters of young adolescents participate in video gaming, with males constituting the majority. Typically, participants immerse themselves in action genre games for over three days per week, with males exhibiting a higher frequency than their female counterparts. Elevated gaming frequency correlates with heightened IGD scores, particularly among females. Young adolescents show a preference for game consoles (males) and mobile phones (females) and often play alone at home. Specific factors such as the device used, online mode, company, and gaming location impact the IGD scores. These profiles aim to assist families and educators in recognizing potential risk behaviors and IGD concerns; however, it is crucial to emphasize the necessity for case-specific screening and evaluation before deliberating on such behaviors.

Gaming passion contributes to the definition and identification of problematic gaming

Even if for most people playing video games is a healthy leisure activity, a minority of vulnerable users present an excessive use associated to negative consequences (e.g., psychosocial maladjustment, sleep interference) and functional impairment. The current study first aims to identify psychological factors that contribute to discriminate highly involved (but healthy) gamers from problematic gamers. For that purpose, we used a cluster analysis approach to identify different groups of gamers based on their profiles of passion towards gaming (using the Dualistic Model of Passion). Another objective of the present study is to explore, using supervised machine-learning, how gaming disorder symptoms, assessed within the substance use disorder framework (e.g., tolerance, withdrawal), might be linked to harmonious and/or an obsessive passion for gaming. Three distinct clusters of gamers were identified based on their passion profiles, including risky gamers, engaged gamers, and casual gamers. Supervised machine-learning algorithms identified that specific gaming disorder symptoms (salience, mood modification, tolerance, low level of conflict) were predominantly related to harmonious passion, whereas others (withdrawal, high level of conflict, relapse) were more directly related to obsessive passion. Our results support the relevance of person-centered approaches to the treatment of problematic gaming.

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.

Factor structure and psychometric properties of an Arabic version of the Internet Gaming Disorder Scale, short form (IGDS-SF9)

Background

In its most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychological Association recognized that internet gaming disorder is a psychological condition and provides nine criteria for its diagnosis, and the Internet Gaming Disorder Scale, short form (IGDS-SF9) was developed to assess individuals.

Aim

To develop and investigate the psychometric properties of an Arabic version of IGDS-SF9.

Method

A five-stage translation and verification process produced an Arabic version of IGDS-SF9, and a study was conducted using a sample of 410 respondents (45.6% females, mean age = 17.6, SD = 1.56) to assess its psychometric properties. Respondents completed the Arabic version, the Smartphone Addiction Scale, the Smartphone Application-Based Addiction Scale, the Hospital Anxiety and Depression Scale, as well as a demographic survey. Exploratory and confirmatory factor analyses, measurement invariance, item response theory, convergent, concurrent, criterion validity, and internal consistency reliability and test-retest reliability were employed to validate the scale.

Results

The exploratory factor analysis suggested the scale's unidimensional structure; the confirmatory factor analysis exhibited good model fit and factor loadings. Measurement invariance, and concurrent, convergent, and criterion validity were established, resulting in good internal consistency and test-retest reliability for the scale.

Conclusion

The Arabic version of IGDS-SF9 is a valid and reliable measure for research and diagnosis in Arabic-speaking countries.

Internet gaming disorder and psychological well-being among university students in Egypt

BACKGROUND

Internet gaming disorder (IGD) is a serious rising problem affecting people of all ages. Many researchers reported that students' addictive gaming behavior resulted in the loss of function and the development of psychological problems. In this study, we aimed mainly to measure the prevalence of internet gaming disorder among Mansoura University students and find its relationship with psychological well-being.

METHODS

A cross-sectional observational study was carried out during the academic year (2021-2022) at the University of Mansoura. Students from four different faculties were included. Participants ages ranged from 18 to 25 years old. An online Google Form questionnaire gathering the tools (questionnaire of demographic and clinical data, Internet Gaming Disorder Short Form scale, Ryff's scale of psychological well-being) was distributed among them.

RESULTS

In this study, 870 students were included. The age range was 18-25 years. They were divided into three groups: 315 normal gamers (36%), 500 risky gamers (58%), and 55 disordered gamers (6%), with no significant gender difference in each group (p-value = 0.138). A negative correlation was found between IGD and psychological well-being (r = -0.303).

CONCLUSIONS

The prevalence of IGD was 6% among Mansoura University students. Participants in the theoretical faculties who started playing internet gaming at a younger age and spent more than 2 h per week playing and more than 3 h per week thinking about playing internet games were more likely to develop IGD. Whenever IGD scores increased, psychological well-being scores were found to decrease (r = -0.303).

Assessment of Hazardous Gaming in children and its dissimilarities and overlaps with Internet Gaming Disorder

Background and aims

Children have been vastly overlooked in Internet Gaming Disorder (IGD) and Hazardous Gaming research so far. The diagnoses are listed in different ICD-11 chapters (addiction vs. problematic health condition) and are thus considered as distinct constructs. However, screening tools for children do not exist yet. We aimed to investigate the psychometric properties of an existing IGD screening tool modified to also assess Hazardous Gaming in children. Further, we aimed to compare the dissimilarity and overlap between (subclinical) IGD and Hazardous Gaming in children.

Methods

The study analyzed data from a mixed school and clinical sample. Data from N = 871 children aged between 8 and 12 years of age (M = 10.3, SD = 0.90) were analyzed. Data were collected via the Video Game Dependency Scale (CSAS) in its parent report version, which was adapted to assess Hazardous Gaming symptoms in addition to the IGD symptoms. Item analyses and reliability and factor analyses were conducted on the Hazardous Gaming version.

Results

The results show that the adapted CSAS version that assesses Hazardous Gaming symptoms in children mostly shows acceptable psychometric properties. Explorative Factor Analysis (EFA) shows a two-factor structure with one factor of higher order. Additionally, results show that 35.2% of all children meeting the threshold for Hazardous Gaming exclusively meet criteria for Hazardous Gaming but not for (subclinical) IGD. Vice versa, 91.3% of children with IGD also meet the criteria for Hazardous Gaming.

Discussion

Hazardous Gaming and (subclinical) IGD are distinct constructs with some overlaps and might have a temporal relation. We recommend adding four items to assess Hazardous Gaming using the CSAS and further evaluate the validity. The assessment of Hazardous Gaming in children is crucial because it might occur earlier than subclinical or full-syndrome IGD.

The impact of technology on promoting physical activities and mental health: a gender-based study

BACKGROUND

Physical inactivity is a significant public health concern globally, associated with an increased risk of chronic diseases and detrimental effects on both physical and mental health. Technologically based interventions have emerged as a potential solution to promote physical activity engagement and improve mental health outcomes. However, understanding the effectiveness of these interventions and the role of gender in their outcomes is essential for developing tailored strategies.

OBJECTIVE

This study aims to examine the effectiveness of technologically based interventions in promoting physical activity and improving mental health outcomes, with a specific focus on gender differences.

METHODOLOGY

This study employed a three-phase mixed methods research design. Phase one was an experimental phase where 300 participants were randomly assigned to intervention or control groups. The intervention group received a technologically based physical activity intervention, while the control group did not. Physical activity levels and mental health outcomes were assessed before and after the intervention. Phase two involved qualitative interviews with a subset of participants (n = 20) from the intervention group. These interviews explored motivations and barriers to physical activity, aiming to uncover personal factors influencing engagement. Thematic analysis was used to identify recurring themes. Phase three utilized a quantitative survey to compare motivations and barriers between males and females. The survey, administered to a larger sample, included participants from both intervention and control groups. It assessed various factors and allowed for a quantitative comparison of gender differences.

FINDINGS

findings indicated that the intervention improved the mental health and physical activities level of the intervention groups. Findings also there are 8 motivations for and barriers to using technology in physical activities. Male and females' scores on some of the motivations and barriers were statistically significant.

CONCLUSION

technology plays an important role in improving the mental health and physical activities of adults. Findings can be used by health care centers, digital psychologists, and physical trainers.

Procrastination Predicts Future Internet Use Disorders in Adolescents but Not Vice Versa: Results from a 12-Month Longitudinal Study

BACKGROUND

Use of Internet applications is often associated with postponing real-life obligations. Previous cross-sectional studies have reported a positive association between procrastination and Internet use disorders (IUDs). Further, procrastination is included in theoretical models explaining the development of IUDs. However, little is known about the temporal relationship; thus, longitudinal studies identifying the specific predictive direction are required.

METHODS

Using a cross-lagged panel design, a total of 240 students who were at high risk for IUDs, aged between 12 and 18 years (M = 15.17, SD = 1.66) were assessed at baseline (t1) and reassessed one year later (t2) with standardized measures for IUDs and procrastination.

RESULTS

Our results showed that IUD symptom severity at t2 was significantly predicted both by IUD symptom severity at t1 and procrastination at t1. However, procrastination at t2 was predicted only by procrastination at t1 but not by IUD symptom severity at t1.

CONCLUSIONS

We could not find a reciprocal relationship between procrastination and IUD symptom severity. Procrastination appears to be a causal risk factor for IUDs, but not a consequence. As a modifiable risk factor, procrastination is a promising starting point for preventive and therapeutic interventions for IUDs.

Impaired Control Over Gaming Scale (ICOGS): Development, confirmatory factor validation, and psychometric evaluation

Background and aims

The concept of impaired control is central to addictive disorders, including gaming disorder in the DSM-5 and ICD-11. Impaired control refers to the recurrent inability to resist impulses to engage in certain activities or behaviours and the failure to limit or stop this engagement. Although numerous screening tools for gaming disorder symptoms have been developed, these instruments have limited capacity for measuring the nature and extent of impaired control. To address this limitation, the present study reports on the creation of the Impaired Control Over Gaming Scale (ICOGS), an 8-item screening tool to assess gaming-related impaired control.

Methods

A total of 513 gamers, including 125 gamers (24.3%) who met the DSM-5 criteria for gaming disorder, were recruited from Prolific, an online crowd-sourcing platform.

Results

The ICOGS demonstrated promising psychometric properties. Exploratory and confirmatory factor analysis using two samples provided robust support for a 2-factor model and high internal consistency of the scale. ICOGS scores were significantly and positively associated with gaming disorder symptoms, gaming-related harms, gaming frequency, psychological distress, and neuroticism. Using receiver operating characteristic analysis, the ICOGS differentiated between non-problem gamers and those who met the criteria for GD.

Discussion and conclusions

Overall, the ICOGS appears to be a valid and reliable scale for use in studies of problem gaming, and may be useful for assessing outcomes of GD interventions that employ self-regulation and stopping techniques to reduce or eliminate problem gaming behavior.

Uncovering sample heterogeneity in gaming and social withdrawal behaviors in adolescent and young adult gamers in Hong Kong

OBJECTIVE

The current study aimed to examine the latent heterogeneity of gaming and social withdrawal behaviors in internet gamers and their associations with help-seeking behaviors.

METHOD

The present study recruited 3430 young people (1874 adolescents and 1556 young adults) in Hong Kong in 2019. The participants completed the Internet Gaming Disorder (IGD) Scale, Hikikomori Questionnaire, and measures on gaming characteristics, depression, help-seeking, and suicidality. Factor mixture analysis was used to classify the participants into latent classes based on their latent factors of IGD and hikikomori in separate age groups. Latent class regressions examined the associations between help-seeking and suicidality.

RESULTS

Both adolescents and young adults supported a 4-class, 2-factor model on gaming and social withdrawal behaviors. Over two-third of the sample were classified as healthy or low-risk gamers with low IGD factor means and low prevalence of hikikomori. Around one-fourth was moderate-risk gamers with elevated prevalence of hikikomori, higher IGD symptoms and psychological distress. A minority of the sample (3.8%-5.8%) belonged to high-risk gamers with the highest IGD symptoms and prevalence of hikikomori and heightened suicidal risks. Help-seeking in low-risk and moderate-risk gamers was positively associated with depressive symptoms and negatively associated with suicidal ideation. Perceived usefulness of help-seeking was significantly linked with lower likelihoods of suicidal ideation in the moderate-risk gamers and suicide attempt in the high-risk gamers.

CONCLUSIONS

The present findings explicate the latent heterogeneity of gaming and social withdrawal behaviors and associated factors on help-seeking and suicidality among internet gamers in Hong Kong.

Gamers' and non-gamers' perspectives on the development of problematic video game play

Gaming Disorder was recently included in the 11th Edition of the International Classification of Diseases and Internet Gaming Disorder may be introduced in the sixth edition of The Diagnostic and Statistical Manual. Much is not understood about how problems with video games develop. This qualitative study aimed to better understand the development of problematic gaming through focus groups. Eleven young adult "frequent gamers," twelve young adult "non-frequent or non-gamers," and five older adult "non-gamers" discussed vulnerabilities and risk factors of problematic gaming. Participants across all groups believed that problematic gaming developed when people used video games as a primary means of meeting basic psychological needs that were unsatisfied, thwarted, or blocked outside of video games. Frequent and non-frequent gamers, compared to older adult non-gamers, were more likely to view video games as a healthy way to meet basic psychological needs and less likely to stereotype gamers. Video games are equipped to meet basic psychological needs for autonomy, competence, and relatedness. That is, gamers often experience a sense of agency, skill, and connection to others when playing video games. However, problematic gaming may develop when people with unmet psychological needs rely exclusively on video games to meet them. Treatment and prevention approaches to problematic gaming can benefit from greater attention to helping at risk individuals meet needs for autonomy, competence, and relatedness outside of video games.

Validation of the Internet Gaming Disorder Symptoms Checklist Based on the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders in Chinese Adolescents

This study aims to develop and validate a checklist for IGD symptoms of Chinese adolescents based on the fifth edition of the diagnostic and statistical manual of mental disorders (DISCA). We recruited 2144 secondary school students who reported that they had played Internet games in the past 12 months in two large cities of China. The 9 item of DISCA were all significantly and positively correlated and the scale reliability was satisfactory. The unidimensional structure of the scale was confirmed by Confirmatory Factor Analysis (CFA), χ²/df = 246.18/27, CFI = .95, RMSEA = .06. Measurement invariance across gender and city groups was confirmed by Multiple-group CFA. Criterion validity was demonstrated by the significant positive associations between DISCA score and self-identified IGD, loss of control regarding time spent on Internet gaming, time spent on playing Internet games, depression, and suicidal ideation. DISCA is a brief, reliable, and validated assessment to measure adolescent IGD.

Role of Gaming Devices Associated With Internet Gaming Disorder in China: Cross-sectional Study

BACKGROUND

Chinese gamers use computer and mobile phone games widely. Consequently, concerns regarding the development of internet gaming disorder (IGD) in adolescents have been raised. However, only a few studies have focused on the influence of gaming devices on IGD.

OBJECTIVE

This study aims to compare sociodemographic information, gaming use characteristics, personality traits, and gaming motivations between computer game users (CGUs) and mobile phone game users (MGUs), as well as identifying IGD predictors.

METHODS

This was a cross-sectional study. A total of 3593 internet game players took part in an online survey, which included sociodemographic information, gaming patterns, gaming motivations, the Chinese version of the Video Game Dependency Scale, and the Chinese Big Five Personality Inventory brief version. The population was divided into 2 groups for comparison by mobile phone or computer use, and the IGD population was also compared within the 2 groups.

RESULTS

There were significant differences between the 2 gaming device groups in the time (t₂₉₉₄=7.75, P<.001) and money (t₂₉₉₄=5.11, P<.001) spent on gaming and in internet game addiction scores (t₂₉₉₄=3.68, P<.001). Individuals using different gaming devices had different game motivations and personality traits and preferred different genres of games. Results showed that IGD predictors were different for the 2 groups, for example, strategy (odds ratio [OR] 4.452, 95% CI 1.938-10.227; P<.001) and action shooter (OR 3.725, 95% CI 1.465-9.474; P=.01) games increased the risk for MGUs.

CONCLUSIONS

Gaming devices should be considered during early identification, such as long daily gaming time, much money spent on gaming, neuroticism, and conscientiousness. In addition, more research should be conducted on new gaming devices and IGD treatment.

Internet-Based Self-Assessment for Symptoms of Internet Use Disorder-Impact of Gender, Social Aspects, and Symptom Severity: German Cross-sectional Study

BACKGROUND

Internet use disorder (IUD) is a new type of behavioral addiction in the digital age. At the same time, internet applications and eHealth can also provide useful support in medical treatment.

OBJECTIVE

The purpose of this study is to examine if an internet-based eHealth service can reach individuals with IUD. In particular, it should be investigated whether both male and female individuals with more severe IUDs can be reached.

METHODS

Data were retrieved from the OMPRIS (online-based motivational intervention to reduce problematic internet use and promote treatment motivation in internet gaming disorder and internet use disorder) project (DRKS00019925), an internet-based motivational intervention to reduce problematic internet use and promote treatment motivation in internet gaming disorder and IUD. During the recruitment process (August 2020-March 2022), a total of 3007 individuals filled out the standardized scale for the assessment of internet and computer game addiction (AICA-S). The assessment was accessible via the project homepage. There was no preselection of participants at this stage of the study; however, the offer was addressed to people with hazardous internet use and IUDs. The web-based assessment was free and could be found via search engines, but attention was also drawn to the service via newspaper articles, radio reports, and podcasts.

RESULTS

Out of 3007 who participated in the web-based self-assessment, 1033 (34.4%) are female, 1740 (57.9%) are male, 67 (2.2%) are diverse individuals, and 167 (5.5%) did not disclose their gender. The IUD symptom severity score showed a wide range between the AICA-S extreme values of 0 and 27 points. On average, the total sample (mean 8.19, SD 5.47) was in the range of hazardous IUD behavior (AICA-S cutoff>7.0). Furthermore, 561 individuals (18.7% of the total sample; mean 17.42, SD 3.38) presented severe IUD (AICA-S cutoff>13.5). Focusing on female and male participants, 20.9% (363/1740) of the men and 14.9% (151/1033) of the women scored above 13.5 points, which can be considered pathological IUD behavior (χ²_2,2773=16.73, P<.001, effect size: Cramér V=0.078). Unemployment, being in vocational training or studying at a university, and being male were significantly associated with high IUD symptoms.

CONCLUSIONS

Using a large sample, the study showed that both mildly and severely IUD-affected individuals can be reached via the internet. An internet-based eHealth offer can thus be a good way to reach patients with IUD where they are addicted-on the internet. In addition, eHealth services increase the likelihood of reaching female patients, who hardly ever come to specialized outpatient clinics and hospitals. Since social problems, especially unemployment, have a strong association with disease severity, the integration of social counseling into treatment seems advisable in terms of a multidisciplinary approach.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS) DRKS00019925; https://drks.de/search/de/trial/DRKS00019925.

Internet addiction and suicidal behavior among vocational high school students in Hunan Province, China: A moderated mediation model

Background

Vocational education is an important part of high school education in China. However, there is little research on high school students' mental health. This study aimed to investigate the prevalence of suicidal behavior (SB) among this population and the mediating role of insomnia, depression, anxiety, and stress in the relationship between Internet addiction (IA) and SB using a structural equation model.

Methods

A cross-sectional questionnaire survey was conducted among several vocational high school students in Hunan Province, and 7,968 valid questionnaires were obtained. General demographic data and data from the Dual-Mode Self-Control Scale, Athens Insomnia Scale, Depression Anxiety Stress scale-21, and Revised Chen Internet Addiction Scale were collected. A structural equation model was used to explore the different pathways from IA to SB.

Results

Among the participants, 37.7, 15.7, and 21.8% reported suicidal ideation, plans, and attempts, respectively. The structural equation model confirmed that IA was indirectly related to SB and was mediated by insomnia and/or depression, anxiety, and stress.

Limitations

First, we only recruited students from vocational schools in Hunan Province, therefore, the sample may not represent the entire population of vocational students in China. Second, self-report scales were used in this study, and clinical diagnosis required professional interviews. Third, since this study had a cross-sectional design, the causal relationship between the variables could not be determined.

Conclusions

The prevalence of SB among vocational high school students in China was significantly high. The prevention of SB related to IA can be attributed to the improvement of insomnia and emotional problems.

Predictive power of the DSM-5 criteria for internet use disorder: A CHAID decision-tree analysis

Introduction

Although the majority of internet users enjoy the internet as a recreational activity, some individuals report problematic internet use behaviors causing negative psychosocial consequences. Therefore, it is important to have precise and valid diagnostic criteria to ensure suitable treatment for those affected and avoid over-pathologization.

Methods

The aim of the present study was to determine which of the nine DSM-5 criteria of internet gaming disorder (IGD) are crucial in distinguish pathological from non-pathological internet use based on the questionnaire-based response behavior of the participants by applying the Chi-squared automatic interaction detection (CHAID) decision tree analysis. Under consideration of the nine DSM-5 criteria for IGD and according to the short-form scale to assess Internet Gaming Disorder (IGDS-SF9) the DSM-5 criteria were formulated as questions and applied to the broader concept of Internet Use Disorder (IUD). The nine questions were answered on a 5-point Likert scale from "never" to "very often." In accordance with the IGDS-SF9 participants were assigned to IUD-5plus if at least 5 of the 9 criteria were answered with "very often." The study was conducted in Germany (N = 37,008; mean age: 32 years, SD = 13.18, 73.8% male).

Results

Although "loss of control," "continued overuse" and "mood regulation" were the most endorsed criteria, the analysis indicated that the criterion "jeopardizing" was found as the best predictor for IUD-5plus, followed by "loss of interest" and "continued overuse." Overall 64.9% of all participants who were in the IUD-5plus, could been identified by the fulfillment of the three criteria mentioned above.

Discussion

The results found support for adjustment of the DSM-5 criteria of IGD in accordance to ICD-11. If the predictive power of the three criteria can be replicated in future representative studies, such a decision tree can be used as guidance for diagnostics to capture the particularly relevant criteria.

Examination of game addiction studies conducted in Turkey: A systematic review study

The aim of this study is to examine the methodological orientations in game addiction studies in Turkey between 2019 and 2022 in a holistic way and to present suggestions for new literature studies. For this purpose, only articles written in Turkish language were reviewed on Google Scholar. Open-access quantitative studies between 2019 and 2022 were included in our study. As a result, 69 out of 257 studies were found to comply with the predetermined criteria. The number of participants in these 69 studies, with a total sample size of 26,415, varies between 60 and 987. Almost half of the studies sample group is children (n = 36). The majority of the studies examine the relationship between academic achievement, familial and social relationship problems, gaming behavior and game addiction in children and adolescents. It was found that gaming addiction was higher in male students compared to female students, especially between the ages of 14-15. Among children, male students play digital games more than girls, and they mostly prefer action-adventure, war, and racing games. Previous studies have concluded that the use of consoles and smartphones in adolescents and young adults has a high impact on digital game addiction. In the light of the findings, it is suggested that empirical studies on game addiction should be addressed with different aspects using new literature studies.

Lack of educational impact of video game addiction in children and adolescents diagnosed with ADHD: A cross-sectional study

Introduction

The use of video games has become widespread worldwide. Excessive use of video games is increasingly becoming a matter of concern, particularly in patients diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Currently, internet gaming disorder (IGD) is not included within the DSM-5-chapter Disorders related to substances and addictive disorders.

Methods

This is a post-hoc descriptive naturalistic study comparing children and adolescents diagnosed with ADHD with and without IGD. We used the 85% cut-off point of the test ADITEC-V for video game addiction to split our sample of ADHD patients into those with IGD (>=85%) and those without IGD (<85%).

Results

13 (25%) out of the 51 children and adolescents with ADHD included in our study had an IGD. Patients with IGD had a first contact with internet, smartphones, and videogames at a very early age (5.67 ± 3.31, 6.33 ± 4.60, and 7.50 ± 2.61, respectively). However, only age at first contact with the internet was statistically significantly different when comparing ADHD patients with and without IGD (8.68 ± 2.71 vs. 5.67 ± 3.31, t = 3.166, df = 47, p = 0.01). Different neurodevelopmental, clinical, and neuropsychological measures converging in impulsivity is a risk factor for IGD. Unexpectedly, we found no association between IGD and poor academic achievement.

Discussion

Future studies may include randomized controlled trials for treating IGD, the study of social adjustment as a protective factor against developing an IGD, and the role of serious and non-serious video games in the development of an IGD, among others. Additional research is clearly needed on IGD.

Resting-state heart rate variability, level of stress and resilience in internet gaming disorder and alcohol use disorder

Stress and resilience are involved in the pathophysiology of addictive disorders, and heart rate variability (HRV) is an index of an individual's global capability to regulate psychological responses. In this study, we aimed to identify transdiagnostic and disorder-specific markers in people with addictive disorders by analyzing resting-state HRV and associations with the levels of stress and resilience. We compared relevant data between patients with internet gaming disorder (IGD) and/or alcohol use disorder (AUD) and healthy controls (HCs). In all, 163 adults aged 18-35 years (53 with IGD, 49 with AUD, 61 HCs) participated. The levels of stress and resilience were measured using the Psychosocial Wellbeing Index and the Connor-Davidson Resilience Scale, respectively. The HRV was obtained from each participant during a 5 min resting-state. The IGD and AUD patients exhibited increased levels of stress and decreased resilience compared to the HCs. Patients with either addictive disorder exhibited a lower standard deviation of the normal-to-normal beat interval (SDNN) index [SDNNi] compared to HCs even after adjusting for clinical variables such as depression, anxiety, and impulsivity. In multiple comparison tests among the three groups, the AUD group had lower HRV than HCs, but no differences were observed among the groups after adjusting for the clinical variables. The HRV indices were correlated with the levels of stress, resilience, and disease severity. In conclusion, IGD and AUD patients exhibit lower HRV as indicated by the SDNNi compared to HCs, revealing their vulnerability to stress as well as a common transdiagnostic marker of addiction.

Psychological Effects of FIFA, PES, and Clash of Clans Games on Young Men at Risk of Developing Internet Gaming Disorder

BACKGROUND

The present study aimed to investigate the psychological effects of FIFA, PES, and Clash of Clans games on young men at risk of developing internet gaming disorder (IGD).

METHODS

The sample consisted of 150 young men, 50 of whom were in the FIFA and PES group, 50 in the Clash of Clans group, and 50 in the control group. Two groups of young men at risk of developing IGD were compared with a control group. The participants completed the General Health Questionnaire (GHQ), Quality of Relationships Inventory (QRI), Game Addiction Scale, and Behavior Rating Inventory of Executive Function (BRIEF).

FINDINGS

The results of the study showed that the scores of mental health problems, conflict with friends, and executive function problems in the Clash of Clans group were significantly higher than those of the FIFA, PES, and control groups. Concerning conflict with parents, the FIFA group had a higher score than the Clash of Clans and control groups. In addition, the results indicated that gaming addiction affects mental health by affecting executive functions.

CONCLUSION

The Clash of Clans game has more negative effects on psychological functions.

Prevalence of Internet Gaming Disorder among Saudi Arabian university students: relationship with psychological distress

Background and aim

Given the exponential growth of the gaming industry, Internet Gaming Disorder (IGD) merits further research. This study investigated the prevalence of IGD among Saudi Arabian university students and its relationship with the level of functioning, psychological distress, and potential for comorbid depression, as well as the effect of the COVID-19 lockdown on gaming behavior.

Materials and methods

306 participants were randomly selected from various Saudi Arabian universities and surveyed using the 20-item Internet Gaming Disorder Test (IGD-20 Test), the Patient Health Questionnaire (PHQ-9), and the 6-item Kessler Psychological Distress Scale (Kessler-6).

Results

The estimated prevalence of IGD was 10.1%, and significantly higher risk was observed among IGD and respective at risk groups with psychological distress. Moreover, 67.4% of the participants reported an increase in playtime during the COVID-19 lockdown. Based on the Kesseler-6, psychological distress was observed in 19.9% of the participants.

Conclusions

This study suggests that IGD is a growing mental health risk associated with a dysfunctional impact and psychological distress.

Occurrence of problematic Internet use and its correlates among Egyptian adolescent students in international schools in Cairo

Background

Internet addiction is a global phenomenon that has been a topic of great interest to researchers, clinicians, teachers, parents, and community groups. The study aims in determination of the rate of problematic Internet use among a sample of Egyptian adolescent students, relations of problematic Internet use with socio-demographic data, risk factors, and comorbid psychiatric disorders. A sample of 248 Egyptian adolescent school students aged 11 to 18 years old were assessed using the Young’s Internet Addiction Test (IAT), Internet Gaming Disorder (IGD) Scale, Social Media Disorder (SMD) Scale, Youth Self-Report (YSR), and The Mini International Neuropsychiatric Interview for children and adolescents (Mini KID).

Results

Among the study sample, 42.3% of the students suffered from mild Internet addiction, 35.1% suffered from moderate Internet addiction, and 3.6% suffered from severe addiction. 31.5% were risky gamers and 10.5% were disordered gamers; 34.3% had problematic social media disorder and the highest observed psychiatric disorders were major depressive episodes 9.3%, generalized anxiety disorder 7.7%, alcohol dependence 4.4%, attention-deficit hyperactivity disorder 4.4%, social phobia 4%, and a higher percentage of psychiatric disorders among severe Internet addiction 88.9% and among moderate addiction 70.6%, disordered gamers 92.3%, problematic social media users 60%, and a higher mean of hours spent online per day of 6.8 h per day.

Conclusions

Problematic Internet use has a negative impact on Egyptian adolescent students in international schools in study sample and adds to the existing literature regarding the magnitude of Internet addiction and its relationship with different psychiatric disorders.

Loot boxes use, video gaming, and gambling in adolescents: Results from a path analysis before and during COVID-19-pandemic-related lockdown in Italy

Loot Boxes (LBs), i.e., virtual items embedded within video games with numerous features reminiscent of gambling, are increasingly widespread among adolescents. LB use is associated with problem gambling in youth, but few studies have been conducted on the association between LB use and gambling behavior considering adolescents. Thus, the mechanisms underlying this relationship are not clear. As LB use is a significant and positive risk factor for video gaming severity, and video gaming is associated with problem gambling, we hypothesized that LB use would be related to gambling frequency and problem gambling through the intermediary role of video gaming frequency and problem video gaming. We tested our hypothesis before COVID-19-pandemic-related lockdown and during COVID-19-pandemic-related lockdown, in Italy. Study 1 was conducted with 1,078 high school students (39% boys, mean age = 16.46, SD = 1.28) before COVID-19-pandemic-related lockdown, and Study 2 was conducted with 1,204 high school students (57% boys, mean age = 15.62, SD = 0.64) during COVID-19-pandemic-related lockdown. A path analysis was carried out to analyze the significance of indirect effects from LB use to gambling behavior and problem gambling through video gaming and problem video gaming. In both the studies, results showed that LB use exerted significant and positive direct effects on video gaming frequency, problem video gaming, and gambling frequency. Moreover, LB use had indirect significant and positive effects on problem gambling through video gaming frequency, problem video gaming, and gambling frequency. Findings attest that LB use can be related to problem gambling through a greater involvement in videogames. Thus, a specific subtype of young gamblers can develop Gambling Disorder symptoms from the use of LBs and through an intense use of video games. Practical implications for prevention and treatment are discussed.

Evaluation of the Psychometric Properties of the Arab Compulsive Internet Use Scale (CIUS) by Item Response Theory Modeling (IRT)

INTRODUCTION

The psychometric properties of the Arab translation of the Compulsive Internet Use Scale (CIUS) have been previously studied by confirmatory factor analysis (CFA) with AMOS software using the asymptotically distribution-free (ADF) estimator. Unidimensionality has been achieved at the cost of correlating several item variance errors. However, several reviews of SEM software packages and estimation methods indicate that the option of robust standard errors is not present in the AMOS package and that ADF estimation may yield biased parameter estimates. We therefore explored a second analysis through item response theory (IRT) using the parametric graded response model (GRM) and the marginal maximum likelihood (MML) estimation method embedded in the LTM package of R software. Differential item functioning (DIF) or item bias across subpopulations was also explored within IRT framework as different samples were investigated. The objective of the current study is to (1) analyze the Arab CIUS scale with IRT, (2) investigate DIF in three samples, and (3) contribute to the ongoing debate on Internet-use-related addictive behaviors using the CIUS items as a proxy.

METHODS

We assessed three samples of people, one in Algeria and two in Lebanon, with a total of 1520 participants.

RESULTS

Almost three out of every five items were highly related to the latent construct. However, the unidimensionality hypothesis was not supported. Furthermore, besides being locally dependent, the scale may be weakened by DIF across geographic regions. Some of the CIUS items related to increasing priority, impaired control, continued use despite harm, and functional impairment as well as withdrawal and coping showed good discriminative capabilities. Those items were endorsed more frequently than other CIUS items in people with higher levels of addictive Internet use.

CONCLUSIONS

Contrary to earlier ADF estimation findings, unidimensionality of the CIUS scale was not supported by IRT parametric GRM in a large sample of Arab speaking participants. The results may be helpful for scale revision. By proxy, the study contributes to testing the validity of addiction criteria applied to Internet use related-addictive behaviors.

Relationship between time spent playing internet gaming apps and behavioral problems, sleep problems, alexithymia, and emotion dysregulations in children: a multicentre study

BACKGROUND

Internet gaming addiction (IGA) is a serious condition that can significantly impact personal and social functioning. Many studies of IGA have been conducted in adolescents and young adults, but there are limited data available in children. We investigated the time spent using internet gaming apps in children and its association with behavioral problems, sleep problems, alexithymia, and emotional regulation.

METHODS

The research populations (N = 564) were categorized based on the number of hours spent using online gaming applications. The Strengths and Difficulties Questionnaire, the Children's Sleep Habits Questionnaire Abbreviated, the Children's Alexithymia Measure (CAM), and the Clinical Evaluation of Emotional Regulation-9 were used to assess all participants.

RESULTS

Compared to other groups, children who used internet gaming applications for more than 6 h had a higher proportion of abnormal responses on the emotional symptoms and hyperactivity scales. Children who used internet gaming applications for more than 6 h had the poorest sleep quality (75%), while children who used internet gaming applications for 1-2 h had the best (36.7%). Participants who used internet gaming apps for 1-2 h had significantly lower mean total scores on the emotional regulation scale and total CAM, whereas those using internet gaming apps for more than 6 h had the highest mean scores in the CAM.

CONCLUSIONS

Excessive use of internet gaming apps during childhood may be associated with hyperactivity, peer problems, high socioeconomic level, alexithymia concerns, shorter daytime sleep duration, and a delayed morning wake-up.

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.

Associations of Adolescents’ Excessive Electronic Device Use, Emotional Symptoms, Sleep Difficulty, and Communication with Parents: Two-wave Comparison in the Czech Republic

Adolescents’ excessive electronic device use is associated with psychological problems. However, it is unknown which psychological symptom, including emotional symptoms and sleep difficulty, correlates with excessive electronic device use most strongly. Besides, according to the social displacement theory, parent–adolescent communication might mediate the relationship between excessive electronic device use and psychological symptoms. Using the Czech national survey Health Behaviour in School-aged Children (HBSC) data in the years 2006 (n = 4782) and 2014 (n = 5082), we used network analysis to explore the relationship between psychological symptoms and excessive electronic device use. In addition, we conducted a mediation analysis to examine the role of parent–adolescent communication. The results revealed that excessive electronic device use correlated most strongly with adolescents’ irritability or bad temper, and this conclusion was stable in 2006 and 2014. In 2014, parent–adolescent communication mediated the relationship between adolescents’ excessive electronic device use and their psychological symptoms. The findings suggest that as the internet industry grows, it is essential to improve parent–adolescent communication quality to prevent adolescents’ psychological problems caused by excessive electronic device use.

Prevalence of gaming disorder in East Asia: A comprehensive meta-analysis

BACKGROUND AND AIMS

Asian countries are deemed to be high prevalence areas for gaming disorder (GD). This meta-analysis is the first to synthesize the overall prevalence of GD in East Asia and investigate characteristics that influence prevalence estimates.

METHODS

Systematic and independent searches were conducted across PubMed, Web of Science, Embase, PsycINFO, and the Cochrane Library since their inception to January 27, 2021. The Agency for Healthcare Research and Quality scale was used for quality assessment. A random effect model was used to calculate the overall GD prevalence and 95% confidence intervals (CIs).

RESULTS

In total, 22 articles (26 studies) comprising 51,525 participants were included in this meta-analysis. The overall pooled prevalence of GD in East Asia was 12%, 95% CI (10%-15%); this figure was adjusted to 6%, 95% CI (3%-9%) for a representative sample. Higher prevalence was observed in males than in females (16% vs. 8%, respectively, P < 0.05). Subgroup and meta-regression analyses revealed that studies among gamers or those without random sampling reported significantly higher prevalence rates. There were no significant differences between countries/regions, sample size, quality score, proportion of males, and scale used.

DISCUSSION AND CONCLUSIONS

The prevalence of GD in East Asia is higher than that in other world regions. Future studies should extend such epidemiological research to other regions to calculate the accurate prevalence of GD to benefit the local identification, prevention, policy formulation, and treatment efforts. Considering its negative effects, effective preventive and treatment measures for GD in East Asia need greater attention.

Problematic gaming risk among European adolescents: a cross-national evaluation of individual and socio-economic factors

BACKGROUND AND AIMS

Previous research has identified numerous risk and protective factors of adolescent problematic gaming (PG) at the individual and social levels; however, the influence of socio-economic indicators on PG is less known. This study aimed to measure the contribution of individual and socio-economic factors involved in PG risk among adolescents from 30 European countries.

DESIGN

Multi-level logistic regression analysis of survey data from the 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional study using self-administered anonymous questionnaires.

SETTING

Thirty European countries.

PARTICIPANTS

A representative cohort of 15-16-year-old students (n = 88 998 students; males = 49.2%).

MEASUREMENTS

The primary outcome measure was adolescents' (low and high) risk of PG. Individual key predictors included self-report assessments of socio-demographic characteristics, time spent gaming and family variables (parental regulation and monitoring, family support). Main country-level predictors comprised Gini coefficient for economic inequalities and benefits for families and children (% gross domestic product), retrieved from international public data sets and national thematic reports. The data analysis plan involved multi-level logistic regression.

FINDINGS

Participants who reported stronger parental regulation [odds ratio (OR) = 0.81, 95% confidence interval (CI) = 0.79-0.83] and higher family support (OR = 0.93, 95% CI = 0.91-0.95) reported lower risk of PG. At the country-level, economic inequalities (OR = 1.05, 95% CI = 1.03-1.07) were positively associated with the risk of PG, while benefits for families and children (OR = 0.78, 95% CI = 0.70-0.89) were negatively correlated with the risk of PG.

CONCLUSIONS

Supportive family environments, lower country-level economic inequalities and higher government expenditures on benefits for families and children appear to be associated with a lower risk of problematic gaming among European adolescents.

Callous-unemotional traits and anxiety in adolescents: a latent profile analysis to identify different types of antisocial behavior in a high-risk community sample

OBJECTIVE

Callous-unemotional (CU) traits are associated with a more severe and chronic trajectory of antisocial behavior. The present study aimed to identify different classes of CU and anxiety and to compare these classes on overt and covert antisocial behavior and several clinical correlates.

METHOD

In a prospective high-risk cohort of adolescents (N = 679; mean age = 14.77, SD = 0.81), latent profile analysis was conducted using CU traits and anxiety symptoms as indicators, and multi-informant aggressive and rule breaking behavior as distal outcomes. Post-hoc analyses with binary logistic regression and a series of ANCOVA were performed on identified classes assessing violent aggression, property offending, and clinical correlates.

RESULTS

Three classes were found, a reference group (low CU, low anxiety; N = 500), a high CU-low anxiety group (N = 98), and an intermediate CU-high anxious group (N = 81). The high CU-low anxiety group scored highest on property offenses, while the intermediate CU-high anxious group scored highest on aggressive behavior. The intermediate CU-high anxious group scored highest on psychotic experiences, while the high CU group scored highest on internet gaming addiction problems and bullying victimization.

CONCLUSION

These findings provide further evidence for diverse variants of CU traits in a high-risk community sample. Future prospective studies should point out whether and to what extent adolescents with CU traits with and without anxiety develop criminal careers and psychiatric disorders in adulthood.

“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

Relation between internet gaming addiction and comorbid psychiatric disorders and emotion avoidance among adolescents: A cross-sectional study

INTRODUCTION

Internet Gaming Disorder has been a controversial subject. Even though internet addiction has been studied among adolescents, there is a lack of evidence regarding Internet Gaming Disorder. The purpose of this study was to assess the prevalence rate of Internet Gaming Disorder and the relationship between Internet Gaming Disorder, comorbid psychiatric disorders, and emotion avoidance among adolescents.

METHODS

Four hundred seven adolescents aged 11 to 18 years old were recruited. Participants were divided into two groups based on the internet gaming addiction scale-Adolescents with IGA (N = 40) and adolescents without IGA (N = 367). All participants were evaluated for demographic data, the Strengths and Difficulties Questionnaire (SDQ), socioeconomic scale, and the Emotional Avoidance Strategy Inventory for Adolescents (EASI-A).

RESULTS

The adolescent with IGA had a higher mean of the number of hours and devices using Internet gaming apps than an adolescent without IGA. Regarding SDQ, adolescents with IGA had a significantly higher mean value for all subscales of SDQ except the prosocial scale and all subscales of EASI-A compared with adolescents without IGA.

CONCLUSIONS

Adolescents with IGA had more hours and devices using Internet gaming apps; more comorbid psychiatric disorders and problems in emotional expression inform of using avoidance techniques than adolescents without IGA.

Emerging experience with selected new categories in the ICD-11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder

Among the important changes in the ICD-11 is the addition of 21 new mental disorders. New categories are typically proposed to: a) improve the usefulness of morbidity statistics; b) facilitate recognition of a clinically important but poorly classified mental disorder in order to provide appropriate management; and c) stimulate research into more effective treatments. Given the major implications for the field and for World Health Organization (WHO) member states, it is important to examine the impact of these new categories during the early phase of the ICD-11 implementation. This paper focuses on four disorders: complex post-traumatic stress disorder, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. These categories were selected because they have been the focus of considerable activity and/or controversy and because their inclusion in the ICD-11 represents a different decision than was made for the DSM-5. The lead authors invited experts on each of these disorders to provide insight into why it was considered important to add it to the ICD-11, implications for care of not having that diagnostic category, important controversies about adding the disorder, and a review of the evidence generated and other developments related to the category since the WHO signaled its intention to include it in the ICD-11. Each of the four diagnostic categories appears to describe a population with clinically important and distinctive features that had previously gone unrecognized as well as specific treatment needs that would otherwise likely go unmet. The introduction of these categories in the ICD-11 has been followed by a substantial expansion of research in each area, which has generally supported their validity and utility, and by a significant increase in the availability of appropriate services.

Problematic gaming and quality of life in online competitive videogame players: Identification of motivational profiles

BACKGROUND

Online competitive practice of video games has recently known a significant worldwide expansion. However, this practice can be associated to problematic use and deterioration of quality of life depending on multiple determinants, among which motivation is central. The purpose of this study was to identify motivational clusters and to compare them regarding quality of life, problematic use of video game, and personality traits.

METHODS

Participants (N = 256) in this cross-sectional study were recruited through specialized websites to complete self-reported questionnaires assessing motivation to play online (MOGQ), personality (BFI-Fr), quality of life (WHOQOL-BREF), and problematic gaming (IGD-Scale). A hierarchical clustering analysis and intergroup comparative analyses were conducted.

FINDINGS

Three motivational clusters were identified ("recreational", "competitive" and "escapers"). "Competitive" and "escapers" players reported higher IGD scores than the "recreational" players (p <.001). However, "escapers" players had lower psychological health scores (p <.001), were more neurotic (p <.001), and less extroverted (p <.001) than the others. Based on IGD scores, "competitive" and "escapers" players were considered as problematic albeit only "escapers" exhibited a functional impairment. Therefore, engaged and problematic players cannot be differentiated with IGD scores.

DISCUSSION

IGD scores were insufficient to differentiate between players at risk of evolution toward pathological states (i.e., "escapers" players) and those whose strong engagement is not detrimental to their quality of life (i.e., "competitive" players). Consequently, considering both psychological health and motivation is necessary to assess the problematic nature of competitive videogame practice. Better definitions and assessment tools are essential in order to avoid over-diagnosis of non-pathological gaming behavior.

Internet Gaming Disorder: Evidence for a Risk and Resilience Approach

Although previous research has noted a range of factors that predict developing Problematic Video Game Use (PVGU) and Internet Gaming Disorder (IGD), few studies have looked at risk and protective factors together, and there is scant empirical evidence examining whether risk for PVGU or IGD increases or decreases as risk or protective factors accumulate in the individual. The aim of the current study was to examine both issues using predictors from three demonstrated PVGU and IGD risk categories: executive dysfunction, unmet needs in everyday life, and unhelpful family environment. In a survey of N = 866 12–17-year-old school students, the risk/protective factors that most strongly predicted severity of IGD symptomology and meeting IGD diagnostic criteria were self-control and social exclusion. Other significant predictors included impulsivity, self-esteem, mastery, control of one’s external environment, and better parent-child attachment quality. Trend analyses revealed a linear increase in the risk of PVGU as risk and net-risk factors accumulated, and a decrease as protective and net-protective factors accumulated. Thus, a net accumulation of issues around impulse control and unmet needs in everyday life may predispose adolescents to PVGU or IGD. Results support a ‘risk and resilience’ approach to adolescent screen-based disorders and suggest potential benefits to a risk factor focus in treatment.

Exploring subtypes and correlates of internet gaming disorder severity among adolescents during COVID-19 in China: A latent class analysis

The WHO recently included Gaming Disorder as a psychiatric diagnosis. Whether there are distinct groups of adolescents who differ based on severity of gaming disorder and their relationships with other mental health and addictive behavior outcomes, including problematic smartphone use (PSU), remains unclear. The current study explored and identified subtypes of Internet Gaming Disorder (IGD) severity and estimated the association between these subtypes and other disorders. Participants completed online questionnaires assessing the severity of IGD, PSU, depression, and anxiety during COVID-19. We conducted a latent class analysis of IGD symptoms among 1,305 Chinese adolescents (mean age = 15.2; male = 58.5%) from 11 secondary schools in Macao (SAR), China. Multinomial logistic regression estimated correlates of latent class membership and PSU. A 4-class model adequately described the sample subgroups. Classes were labeled as normative gamers (30.9%), occasional gamers (42.4%), problematic gamers (22.7%), and addictive gamers (4.1%). Relative to normative gamers, PSU severity, depression, and being male were significantly higher among problematic gamers, addictive gamers, and occasional gamers. Only problematic gamers showed significant positive associations with anxiety severity compared to the other groups. The study revealed the differences in severity of gaming disorder and its association with psychopathology outcomes. Application in screening for IGD and comorbidity is discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03133-8.

Gaming disorder and the COVID-19 pandemic: Treatment demand and service delivery challenges

Gaming activities have conferred numerous benefits during the COVID-19 pandemic. However, some individuals may be at greater risk of problem gaming due to disruption to adaptive routines, increased anxiety and/or depression, and social isolation. This paper presents a summary of 2019-2021 service data from specialist addiction centers in Germany, Switzerland, Japan, and the United Kingdom. Treatment demand for gaming disorder has exceeded service capacity during the pandemic, with significant service access issues. These data highlight the need for adaptability of gaming disorder services and greater resources and funding to respond effectively in future public health crises.

Gambling, Gaming, and Internet Behavior in a Sexual Minority Perspective. A Cross-Sectional Study in Seven European Countries

Background

Addictive behavior of gambling, gaming and internet activity is partly a new research domain and has not been well investigated with regard to sexual minority populations. Although health disparities between sexual minorities and the general population are well documented, there is a lack of inclusion of sexual minorities in both research and clinic. Among lesbian, gay and bisexual populations certain features could be present that play a role for the development of addictive behaviors, such as social isolation and increased risk of other psychiatric problems. The aim of this study was to investigate problem gambling, problem gaming and problematic internet behavior in a European context and if it is affected by sexual orientation status.

Methods

An online web-survey was distributed among web-panels in England, Poland, Switzerland, Italy, Spain, Denmark, and Sweden in 2017-2018.

Result

10 983 complete answers were collected. 7.1% of the participants had a sexual minority status (n = 774). Regression models found that there was no difference in gambling, gaming and internet behavior among heterosexual and sexual minority men. Sexual minority women were associated with problematic gambling and gaming behavior, when also controlling for age and nationality. When also controlling for psychological distress, women defining as having another sexual minority status than lesbian and bisexual remained significant for having a problematic gaming behavior (AOR = 2.3).

Conclusion

An awareness of female sexual minority perspectives is relevant in facilities treating behavioral addiction as well as in future research in behavioral addiction. More research is needed in problematic gambling and gaming behavior in different sexual minority populations with regard to psychiatric comorbidity and living conditions. An inclusion of sexual minority groups defining as other than gay and bisexual is needed in future research. No significant differences were found between heterosexual and sexual minority men in adjusted analysis in this study.