Editorial: Internet Gaming Disorder: A Pathway Towards Assessment Consensus

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.

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

Background and aims

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

Materials and methods

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

Results

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

Discussion

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

Conclusion

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

The Online Flow Questionnaire: An Item Response Theory Examination

Online flow refers to the rate of an individual's absorbance in an Internet activity in which they are engaged. It has been implicated with both the effectiveness of cyberhealth and online education applications, as well as excessive Internet use. One way of assessing it is the Online Flow Questionnaire (OFQ). Consequently, this study investigated the optimum measurement of online flow, as well as OFQ cutoff points, using Item Response Theory (IRT). A large sample of high school students from Greece (N = 1579, M_age = 16.12, SD_age = 0.85; 50.5 percent females) completed the OFQ and the data were analyzed using IRT procedures. The analysis indicated that items in the OFQ possess differing levels of discrimination and difficulty, although all items were generally within acceptable ranges. An OFQ cutoff score of 5 represented an extremely high level of online flow experiences. The findings suggest that the OFQ generally functions as an acceptable marker of overall online flow. However, the current format of the OFQ appears to inhibit its ability to detect variability at the extreme low and high ends of the latent trait in the population assessed. Future revisions (potentially employing computerized adaptive tests) of the OFQ response format may enhance its utility.

Cross-Addiction Risk Profile Associations with COVID-19 Anxiety: a Preliminary Exploratory Study

"Cross-addiction" involves a person substituting one form of addictive behaviour for another. Indeed, cross-additive presentations have been frequently described (e.g. from drugs to alcohol, gambling to sex), and risk profiles have been assumed. Nevertheless, there has been a dearth of evidence considering the occurrence of cross-addiction risk profiles in the community. This research is imperative for informing effective prevention/intervention policies, especially under anxiety-provoking conditions, such as the current coronavirus pandemic. To address this need, a cross-sectional exploratory research design was utilized, with quantitative survey data obtained from 968 respondents (18-64; M age  = 29.5 years, SD = 9.36), who completed an online survey regarding a range of addictive behaviours (i.e. abuse of alcohol, drug, smoking, online gaming, shopping, internet, exercise, online gambling, sex, and social media) and their anxiety about the coronavirus. Latent class/profiling analyses were implemented to (a) explore profiles of cross-addiction risk, (b) describe the characteristics and the proportions of these profiles, and (c) identify their differential associations with the pandemic precipitated anxiety. Findings revealed two distinct profiles/types, the "cross-addiction low risk" (57.4%) and the "cross-addiction high risk" (42.6%). Those in the latter scored consistently higher across all behaviours assessed, were more likely to suffer from concurrent addictive problems, and reported significantly higher levels of pandemic-related anxiety. Implications for prevention, assessment, and treatment and future research are discussed.

Massively Multiplayer Online Games and Well-Being: A Systematic Literature Review

Background: Massively multiplayer online games (MMOs) evolve online, whilst engaging large numbers of participants who play concurrently. Their online socialization component is a primary reason for their high popularity. Interestingly, the adverse effects of MMOs have attracted significant attention compared to their potential benefits.

Methods: To address this deficit, employing PRISMA guidelines, this systematic review aimed to summarize empirical evidence regarding a range of interpersonal and intrapersonal MMO well-being outcomes for those older than 13.

Results: Three databases identified 18 relevant English language studies, 13 quantitative, 4 qualitative and 1 mixed method published between January 2012 and August 2020. A narrative synthesis methodology was employed, whilst validated tools appraised risk of bias and study quality.

Conclusions: A significant positive relationship between playing MMOs and social well-being was concluded, irrespective of one's age and/or their casual or immersed gaming patterns. This finding should be considered in the light of the limited: (a) game platforms investigated; (b) well-being constructs identified; and (c) research quality (i.e., modest). Nonetheless, conclusions are of relevance for game developers and health professionals, who should be cognizant of the significant MMOs-well-being association(s). Future research should focus on broadening the well-being constructs investigated, whilst enhancing the applied methodologies.

Internet Gaming Disorder profiles and their associations with social engagement behaviours

Internet Gaming Disorder (IGD), describes the abuse of Internet games with detrimental impact to the real-life social engagement of some gamers. Indeed, evidence suggests that gamers differ on the severity and way in which they express IGD symptoms, as well as their social engagement behaviours. The present study aimed to: a) profile gamers regarding their experience of IGD symptoms and; b) examine how different IGD profiles varied on social engagement behaviours.

METHODS

A sample consisting of 1032 gamers (18-72 years, Mage = 24) was assessed with the Internet Gaming Disorder Scale 9 Items Short Form (IGDS9-SF) and social engagement questions regarding their participation in employment, education, romantic relationships and living status.

RESULTS

Latent class analyses (LCA) resulted in 4 distinct IGD classes. These entailed 'IGD aversive' (11.5%), 'Normative' (47.9%), 'Moderate IGD risk' (31.2%) and 'High IGD risk' (9.4%) gamers. The high IGD risk profile linked with higher unemployment, lower level of education and tended to live with divorced parents, friends and/or had transient accommodation.

CONCLUSION

Findings suggest that there are different IGD profiles driven by symptom severity, whilst gamers higher on IGD risk present with lower social engagement signs. Thus, social engagement and participation should be particularly targeted by IGD immunization and treatment protocols.

Internet gaming disorder behaviours: a preliminary exploration of individualism and collectivism profiles

BACKGROUND

Internet Gaming Disorder (IGD) behaviours involve excessive use of Internet games to the extent that one's everyday life is compromised. It has been suggested that IGD symptoms are dependent on whether one is more individualistic or collectivistic. However, the range of potential individualism-collectivismeffects on IGD presentations remains largely unknown. The current study aims to further understanding of the role of individualistic and collectivistic tendencies in IGD, allowing us to develop more gamer centredIGD prevention and intervention strategies.

METHODS

One thousand and thirty-twocommunity participants withinternet gaming experience were measured online for IGD symptom's severity using the Internet Gaming Disorder Scale - Short Form (IGDS9-SF) andindividualism-collectivism behavioursvia the Individualism & Collectivism Scale (ICS). Latent Class Analysis (LCA) and T-Tests were performed in relation to their responses.

RESULTS

Upon inspection of the LCA output, two profiles of internet gamers were identified. These includedthe Collectivism Aversivegamers (CA; 11%) and the Collectivism Neutral gamers (CN; 89%). The CA gamers displayed significantly higher IGD behaviours overall, and, were higher inpreoccupation, withdrawal symptoms, tolerance, relapse, deception, escapism/mood modification, and functional impairment compared to CN gamers. There were no differences between CA and CN gamers in loss of interest and conflicts with others.

CONCLUSIONS

The findings suggest that one's individualism-collectivism orientation can influence the presentation of IGD. Specifically, those who are less collectivistic or are less influenced by social groups willdisplay greater IGD symptoms and present a profile that requires a different intervention from gamers who are more collectivistic. Researchers and clinicians should emphasize the value of belonging in a collective and experiencing equality with others in relation to mental health and gaming patterns.

Symptoms of Internet Gaming Disorder, Inattention, and Impulsivity: a Cross-Sectional Study Conducted in the United Arab Emirates

The addictive use of internet video games is now recognized as a valid diagnostic construct by both the World Health Organization and the American Psychiatric Association. A burgeoning body of preliminary evidence points to a relationship between attention deficit and hyperactivity disorder (ADHD) symptoms as being a risk factor for behaviors indicative of internet gaming disorder (IGD), however, studies have rarely examined ADHD's two diagnostic constructs, inattention and impulsivity, separately. Moreover, IGD research is non-existent in Middle Eastern contexts. Therefore, this study examined, separately, the association of IGD with inattention and impulsivity in a sample of gamers from the United Arab Emirates. A cross-sectional survey was completed by 214 participants aged 18-33 years (m_age = 20.64, SD = 4.34) who completed measures of IGD and ADHD, and self-reported daily duration of gameplay as well as a number of demographic characteristics. The pair of hierarchical linear regressions indicated that both the examined constructs, increased symptoms of inattention and impulsivity, were separately associated with elevated risk for engagement in IGD behaviors. However, these associations were not moderated by gender. These results confirm that symptoms of ADHD are indeed associated with IGD and is the first to confirm the presence of this relationship in a Middle Eastern sample.

Measurement, Profiles, Prevalence, and Psychological Risk Factors of Problematic Gaming Among the Turkish Community: A Large-scale National Study

The present study investigated the prevalence, the potential different profiles, and the associated psychological factors of disordered gaming using data from a large-scale epidemiological study (TURBAHAR [Turkey’s Addiction and Mental Health Risk Profile Map Project]) carried out in Turkey in 2018 with 24,494 participants aged 18–81 years. Participants completed a comprehensive survey comprising a demographic questionnaire, Gaming Addiction Risk Questionnaire, Brief Symptom Inventory, Personal Well-Being Index Adult Form, Positive and Negative Affect Schedule, Toronto Alexithymia Scale, and Experiences in Close Relationships-Revised Scale. Latent class analysis showed the existence of eight different game profiles, which differed in relation to the intensity and specific features of the behavior. Results showed that 1.6% of the participants were problematic gamers. Being male, being younger, lower education level, being single, using alcohol and cigarettes, psychiatric distress, positive and negative affect, and anxious adult attachment were positively associated with problematic gaming.

Depression and Disordered Gaming: Does Culture Matter?

The dearth of evidence related to cultural and gender variations of established associations between Internet Gaming Disorder (IGD) and other psychopathologies has been highlighted. Accordingly, the present study examined the association between depression and disordered gaming behaviors, while considering cultural perspectives of vertical individualism (independence and hierarchy) and gender as potentially variating factors. To achieve this, an ethnically diverse online sample of internet gamers from multicultural societies (N = 1032; Australia = 738; 71.5%; USA = 222; 21.5%; other multicultural countries = 72; 13.3%; Mage = 24 years; males = 503 [48.7%], females = 529 [51.3%]) completed the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF); the Depression, Anxiety and Stress Scale (DASS-21) and the Individualism and Collectivism Scale (ICS). Regression, moderation and moderated moderation analyses were conducted. Results demonstrated that gamers presenting concurrently with symptoms of depression and vertically individualistic inclinations reported higher levels of disordered gaming behaviors, with no significant gender differences. The findings obtained imply that practitioners globally, and especially in multicultural societies (e.g., Australia, USA), should consider cultural differences when developing prevention and intervention strategies for disordered gaming.

Psychopathological Symptoms and Gaming Motives in Disordered Gaming-A Psychometric Comparison between the WHO and APA Diagnostic Frameworks

BACKGROUND

'Gaming Disorder' (GD) has received increased medical attention and official recognition from both the American Psychiatric Association (APA) and the World Health Organization (WHO). Although these two medical organizations have independently developed promising clinical diagnostic frameworks to assess disordered gaming, little is known about how these frameworks compare at different psychometric levels in terms of producing consistent outcomes in the assessment of GD.

METHODS

A sample of 1429 German gamers (Meanage = 29.74 years; SD = 12.37 years) completed an online survey including measures on different psychopathological symptoms (depression, loneliness and attention problems), gaming motives and disordered gaming according to the WHO and APA frameworks.

RESULTS

The findings suggest the existence of minor discrepancies in the estimation of prevalence rates of GD according among the two frameworks. Nevertheless, both diagnostic frameworks are fairly consistent in the psychometric prediction of GD in relation to gaming motives and psychopathological symptoms. The findings underscore the role of key gaming motives as risk factors and protective factors across both diagnostic frameworks. Finally, the study provides support for the WHO diagnostic framework for GD and its measurement with the German Gaming Disorder Test (GDT). The findings and their implications are further discussed in terms of clinical relevance.