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.

Heterogeneity of gaming disorder: A clinically-based typology for developing personalized interventions

Background

The eleventh revision of the International Classification of Diseases (ICD-11) defines the three key diagnostic criteria for gaming disorder (GD). These are loss of control over gaming, gaming as a priority over daily activities, and impaired functioning due to gaming. While this definition has implications for the prevention and treatment of GD, there is significant heterogeneity in the symptoms and etiology of GD among individuals, which results in different treatment needs. Cognitive control, emotional regulation, and reward sensitivity are three critical dimensions in the etiology model for GD. Aspects such as gender, comorbidity, motivation for gaming, stage or severity of GD, and risk factors all contribute to the heterogeneity of etiology among individuals with the disorder.

Method

On the basis of clinical symptoms and comorbidity characteristics among approximately 400 patients with gaming disorder, the present paper proposes a clinical typology of patients with GD based on the authors' clinical experience in treating individuals with GD.

Results

The findings indicated three common types of patients with GD: (i) impulsive male patients with attention deficit hyperactivity disorder (ADHD), (ii) dysphoria patients with dysfunctional coping skills, and (iii) isolated patients with social anxiety. The paper also discusses the presentation and treatment priority for these patients.

Conclusion

Personalized treatments for patients with GD should be developed to fit their individual needs. Future studies should examine the heterogeneity of GD and confirm these types, as well as obtain evidence-based information that can help in the development of personalized treatment. Treatment resources should be developed, and professionals should be trained to provide integrated individualized treatment.

The emerging evidence on the association between symptoms of ADHD and gaming disorder: A systematic review and meta-analysis

The co-existence of gaming disorder (GD) with other mental health problems has been widely reported. Despite the growing research interest in the comorbidity of GD with attention-deficit/hyperactivity disorder (ADHD), to date, no quantitative synthesis has been performed. The present study comprised a systematic literature search using Scopus, Science Direct, Web of Science, and PubMed databases. Three types of studies were included in the analyses: studies reporting (i) correlation coefficients between the symptoms of GD and ADHD, (ii) means, and standard deviations for comparison of GD severity between ADHD/non-ADHD individuals, and (iii) comparison of ADHD severity between GD/non-GD individuals. The results indicated a moderate relationship between GD and ADHD symptom severity when both subdomains of ADHD were combined (r = 0.296), and also when only inattention (r = 0.306) or hyperactivity (r = 0.266) symptoms were analyzed, which was also confirmed in a structural equation model meta-analysis. Studies showed a large average difference comparing the GD symptom severity of ADHD and non-ADHD individuals (g = 0.693), or ADHD symptom severity of GD and non-GD individuals (g = 0.854). In some cases, higher estimates of association were reported among studies that (i) had a higher proportion of males, (ii) assessed problematic internet use among predominantly videogame player samples rather than assessing only GD, and (iii) had been more recently published. The present review shows that this is an emerging field demonstrating significant results in cross-sectional correlational studies. However, future research should apply more rigorous methodologies to investigate the relationship further (e.g., longitudinal studies and studies using professional/clinical ratings and diagnosis). These results suggest that screening and treatment for ADHD among individuals with gaming disorder is necessary, and individuals with ADHD should be made aware of their higher susceptibility to gaming disorder.

Validation of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and Its Association with Functional Impairment in Brazilian Gamers

INTRODUCTION

Despite the growing recognition of gaming disorder as a mental disorder, there is still debate about how it should be best screened for. This is especially relevant in countries where prevalence studies that could support evidence-based policymaking are still to be conducted. This study aims to evaluate the psychometric properties of the Brazilian Portuguese version of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and to explore its association with functional impairment.

METHODS

An online convenience sample of 805 Brazilian adults who reported playing games completed the adapted version of IGDT-10 and World Health Organization Disability Assessment Schedule 2.0, as well as the Problematic Internet Use Questionnaire, the Center for Epidemiologic Studies-Depression Scale, the Rosenberg Self Esteem Scale and socio-demographic questions.

RESULTS

The Brazilian Portuguese version of IGDT-10 demonstrated a unidimensional structure in both confirmatory and exploratory factor analysis, with satisfactory internal consistency and adequate temporal stability. Participants who scored five or more on IGDT-10 presented higher levels of functional impairment compared to those who scored positive for four symptoms or less. The difference between the two groups was statistically significant and showed a moderate effect size. Network analysis showed a direct connection between IGDT-10 and functional impairment, and identified "negative consequences" as the most relevant item connecting these variables.

CONCLUSION

The IGDT-10 is a brief, easy-to-understand, valid, and reliable instrument, proving to be a suitable candidate for screening gaming disorder in future epidemiological studies.

The Potential Harm of Gambling Streams to Minors

Video games are designed to attract the attention of a potentially diverse audience. One of the most popular video game-related content distributor sites is Twitch, which provides daylong access to all kinds of gaming-related content through independent content creators. This platform, compared with YouTube (the world's popular video-based content distributor), has one important difference. Namely, it dominantly provides real-time video content sharing (ie, streaming). The total audience of gaming live streaming in 2021 was approximately 810 million gamers worldwide, expected to grow to 921 million in 2022. While most of the viewers are adults, 17% of male viewers and 11% of female viewers are minors, between 10 and 20 years of age.1 Risk assessment in this field is still missing, while some dangers are presumably related to the type of content shared. As gambling-related videos draw more and more viewers, the possible risk of age-inappropriate content access has appeared. Future research and policy making should consider exploring this area to protect young consumers.

Psychometric Properties of the Persian Version of the Gaming Motivation Scale

OBJECTIVE

Gaming motivations are a central aspect of playing video games, and their importance to understanding both healthy and problematic gaming behavior has been increasingly elucidated. In this study, we aimed to translate the 18-item Gaming Motivation Scale (GAMS-18) to Persian and validate it in a population of Persian speaking gamers, specifically for the assessment of online gaming.

METHODS

After translation from English to Persian, content validity of the questionnaire was assessed by a panel of experts and test-retest reliability was calculated in a sample of 70 students. Data from an online survey of 791 Iranian online gamers were used for the assessment of construct validity using confirmatory factor analysis.

RESULTS

The item content validity index and the scale content validity index for clarity and relevance ranged from 0.80 to 1.00. Internal consistency reliability of the GAMS-18 was 0.90 and the test-retest reliability was 0.89. The test-retest reliability of the GAMS-18 was 0.89, and the internal consistency was 0.90. The GAMS factors had acceptable correlation with other motivational scale such as Player Experience of Need Satisfaction. Incorporating the proposed additional error paths improved the model fit to an acceptable level.

CONCLUSION

The Persian version of the GAMS can assess digital gaming behavior based on the six self-determination theory motivation types, and measures different aspects of motivation that other instruments. It is also demonstrated to have good reliability and validity and could be used in research on the motivations of online gamers in Persian-speaking populations.

Gaming disorder: A summary of its characteristics and aetiology

The emergence, development, and maintenance of gaming disorder (GD) is the result of an interplay between gaming-related factors, individual factors, and environmental factors. None of these alone are sufficient to cause a disordered state, but it is the interactive co-occurrence of all these factors, which in some cases leads to GD. The goal of the present paper is to discuss in detail these three factors based on relevant and recent findings of the literature. Among gaming-related factors, we discuss online vs. offline videogames, the role of game genres, structural characteristics, game design elements, as well as some important monetization techniques. Among individual factors demographic risk factors, personality traits, motivational factors, comorbid psychopathology, genetic predisposition, and neurobiological processes are considered. Finally, among environmental factors we discuss family factors, early life experiences, the role of peers and school-related factors, as well as the broader context of culture including the popularity of esports.

Safer esports for players, spectators, and bettors: Issues, challenges, and policy recommendations

The present paper provides an overview of the possible risks, harms, and challenges that might arise with the development of the esports field and pose a threat to professional esports players, spectators, bettors and videogame players, including underage players. These include physical and mental health issues, gambling and gambling-like elements associated with videogames and esports, the challenges arising from pursuing a career in esports, the unique difficulties women face, and a need for supporting professional esports players. It briefly discusses possible responses and suggestions regarding how to address and mitigate these negative consequences. It emphasizes the need for cooperation and collaboration between various stakeholders: researchers, policymakers, regulators, the gaming industry, esports organizations, healthcare and treatment providers, educational institutes and the need for further evidence-based information.

The concept of recovery in gaming disorder: A scoping review

Background

Recovery from mental health and behavioral disorders is classically defined as a reduction in symptoms. More recent definitions see it as a process in which individuals improve their health, wellness and other life domains. The inclusion of gaming disorder (GD) in the 11th International Classification of Diseases in 2019 prompted growing interest in GD. However, relatively little is known about recovery from GD, and there is scant literature describing or assessing its course.

Objectives

This scoping review was designed to explore the state of the art on recovery from GD (e.g., terminology and measures used to assess recovery, main topics in studies about recovery from GD).

Methods

PubMed, Web of Science, and Scopus databases were searched and critically reviewed according to PRISMA guidelines. We included empirical studies in English covering individuals across all age groups who met the diagnostic criteria of GD/internet gaming disorder (IGD) according to valid scales that relate to recovery or any change, and were published before February 2022.

Results

A total of 47 out of 966 studies met the inclusion criteria. Recovery as a concept is not explicitly mentioned in GD studies. Rather, changes in subjects' disorders are described in terms of decreases/reductions in symptom severity, or improvement/increases. These changes are primarily measured by scales that evaluate symptom reduction and/or improvement in GD and other psychopathologies.

Conclusions

The concept of recovery is included in the GD field but is not clearly mentioned or used. Therapists and researchers should aim to promote and integrate the notion of recovery in GD.

Advances in problematic usage of the internet research - A narrative review by experts from the European network for problematic usage of the internet

Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders.

A comprehensive model to understand and assess the motivational background of video game use: The Gaming Motivation Inventory (GMI)

BACKGROUND AND AIMS

The popularity of video gaming has generated significant interest in research methods to examine motivations for gaming. Current measures of gaming motives are limited by lack of scope and/or their applicability to specific game genres only. We aimed to create a comprehensive motivation inventory applicable to any gaming genre and to evaluate its psychometric properties in a large sample of highly engaged video gamers.

METHODS

Stage 1 of this project involved a systematic review that generated the items for the Gaming Motivation Inventory (GMI). Stages 2-4 involved an evaluation of the psychometric properties of the GMI. A sample of 14,740 video gamers (89.3% male; mean age 24.1 years) were recruited via an online survey promoted by a popular gaming magazine.

RESULTS

In Stage 2, twenty-six gaming motives were identified, which clustered into six higher-order dimensions (Mastery, Immersion/Escapism, Competition, Stimulation, Social, Habit/Boredom). In Stage 3, construct validity of the six higher-order motives was assessed by associations with gaming-related, personality, and psychological variables. In Stage 4, the relationships between motives and depression symptoms and gaming disorder symptoms were explored. Although gaming motives had weak associations with gaming genres, they were moderately related to variables such as competitiveness, sociability, and positive and negative affect. Gaming disorder symptoms were directly predicted by depression symptoms and indirectly via Immersion/Escapism, Habit/Boredom, and Competition motives.

DISCUSSION AND CONCLUSIONS

These findings support the notion that motives are one of the primary causes of gaming behavior and play an important role in predicting its problematic nature. The GMI is a psychometrically valid tool that will be useful for gaining insights into factors underlying gaming behaviors.

Prevalence of Problematic Internet Use during the COVID-19 Pandemic

The present paper reviews recent studies on problematic Internet use (PIU) prevalence before and during the coronavirus disease 2019 (COVID-19) pandemic. Several pre-pandemic meta-analyses reported PIU prevalence estimates ranging from 6% to 9.7%. Experts in the field of online addictions speculated that PIU would increase during the pandemic because of increased time spent on the Internet. However, it is still unclear if increased time on the Internet resulted in higher PIU prevalence estimates during the pandemic. Prevalence estimates differed greatly across studies during the COVID-19 pandemic. Possible inconsistencies are outlined together with future directions for PIU prevalence studies.

The moderating role of mental health on the association between gaming time and gaming disorder symtoms

Introduction

Video games are among the most popular leisure time activities. While majority of gamers play in a healthy manner, a minority shows gaming disorder (GD) symptoms and experiences detrimenting effects in their lives. Even though gaming time is moderately associated with gaming disorder symtoms, research suggests that it is not a reliable predictor by itself.

Objectives

The aim of the present study is to explore whether depression symptoms, self-esteem, attention-deficit/hyperactivity disorder (ADHD) and escapism (when gaming is motivated by the avoidance of everyday problems) moderate the association between gaming time and GD symptoms and whether this is different for boys and girls.

Methods

Data was collected from a representative sample of 5^th grade students of public education institutions in Budapest. Sample selection was carried out by one-step sampling stratified for school type, district, and maintainer; the sampling unit was the class. Data from 2126 students were analyzed (49.3% male, mean age 10.7 years, SD=0.54).

Results

Depression symptoms moderated the association between gaming time and GD symtoms in both genders. For those with higher depression symptoms the aforementioned association was stronger. Furthermore, self-esteem had a moderator effect only among girls, while escapism motivation and ADHD only among boys. In these cases, the association between gaming time and GD symptoms was stronger among those with lower self-esteem, and higher ADHD and escapism scores.

Conclusions

Results suggest that gaming time is more strongly connected to GD symptoms in certain conditions, but its predictive value is limited even in those cases.

Disclosure

Funding statement: This study was supported by the Hungarian National Research, Development and Innovation Office (KKP126835). Orsolya Király was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences and by the ÚNKP-21-5

Psychometric Assessment of the Motives for Online Gaming Questionnaire Among Iranian Gamers

OBJECTIVE

Gaming motivations are crucial aspects of healthy and problematic video gaming behavior. The aim of this study was to assess the psychometric properties of the widely used Motives for Online Gaming Questionnaire (MOGQ).

METHODS

Test-retest reliability was evaluated in a sample of 66 university students. Data from 791 participants in an online survey of Iranian online gamers were examined to assess convergent validity and construct validity using confirmatory factor analysis. Internal consistency of MOGQ factors was assessed in both samples.

RESULTS

The item content validity index (I-CVI) and the scale content validity index (S-CVI) were between 0.8 and 1.0 for clarity and relevancy. The test-retest reliability of the 27-item questionnaire was 0.85 and internal consistency was 0.94. After incorporating additional error paths, model fit improved to an acceptable level. The MOGQ factors had acceptable correlations with relevant motivational scales such as Gaming Motivation Scale and Player Experience of Need Satisfaction. Recreation motives had the highest average score in the sample and social ones had the lowest, and males scored higher than females across all motivation domains except escape.

CONCLUSION

The MOGQ is a suitable instrument for the assessment of online gaming motivations in the Iranian population.

FOXN3 and GDNF Polymorphisms as Common Genetic Factors of Substance Use and Addictive Behaviors

Epidemiological and phenomenological studies suggest shared underpinnings between multiple addictive behaviors. The present genetic association study was conducted as part of the Psychological and Genetic Factors of Addictions study (n = 3003) and aimed to investigate genetic overlaps between different substance use, addictive, and other compulsive behaviors. Association analyses targeted 32 single-nucleotide polymorphisms, potentially addictive substances (alcohol, tobacco, cannabis, and other drugs), and potentially addictive or compulsive behaviors (internet use, gaming, social networking site use, gambling, exercise, hair-pulling, and eating). Analyses revealed 29 nominally significant associations, from which, nine survived an FDRbl correction. Four associations were observed between FOXN3 rs759364 and potentially addictive behaviors: rs759364 showed an association with the frequency of alcohol consumption and mean scores of scales assessing internet addiction, gaming disorder, and exercise addiction. Significant associations were found between GDNF rs1549250, rs2973033, CNR1 rs806380, DRD2/ANKK1 rs1800497 variants, and the “lifetime other drugs” variable. These suggested that genetic factors may contribute similarly to specific substance use and addictive behaviors. Specifically, FOXN3 rs759364 and GDNF rs1549250 and rs2973033 may constitute genetic risk factors for multiple addictive behaviors. Due to limitations (e.g., convenience sampling, lack of structured scales for substance use), further studies are needed. Functional correlates and mechanisms underlying these relationships should also be investigated.

Development and validation of the Reward Deficiency Syndrome Questionnaire (RDSQ-29)

BACKGROUND

The reward deficiency syndrome (RDS) integrates psychological, neurological, and genetic factors of addictive, impulsive, and compulsive behaviors. However, to date, no instrument has been validated to assess the RDS construct.

AIMS

The present study developed and tested a tool to assess RDS.

METHODS

Data were collected on two college and university samples. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed on Sample 1 (N = 1726), and confirmatory analysis was conducted on an independent sample (N = 253). Impulsivity and sensation-seeking were assessed.

RESULTS

Based on EFAs, a 29-item Reward Deficiency Syndrome Questionnaire (RDSQ-29) was developed, containing four subscales (lack of sexual satisfaction, activity, social concerns, and risk-seeking behavior). CFA indicated good fit (comparative fit index (CFI) = 0.941; Tucker-Lewis index (TLI) = 0.933; root mean square error of approximation (RMSEA) = 0.068). Construct validity analysis showed strong relationship between sensation-seeking and the RDS scale.

CONCLUSION

The RDSQ-29 is an adequate scale assessing psychological and behavioral aspects of RDS. The RDSQ-29 assesses psychological and behavioral characteristics that may contribute to addictions generally.

Polysubstance Use Is Positively Associated with Gaming Disorder Symptom Severity: A Latent Class Analytical Study

INTRODUCTION

The link between gaming disorder (GD) and substance use amongst adolescents is not clear. Some studies reported positive associations, whereas others suggested that alcohol and illicit drug use are not related to GD severity.

OBJECTIVES

The present study aimed to identify empirically based latent classes of alcohol and illicit drug use amongst adolescents and explore their associations with GD symptom severity and whether endorsement of specific criteria of GD is linked to the membership of latent classes of alcohol and illicit drug use.

METHODS

Data of the national sample of Hungarian adolescents from the Health Behaviour in School-aged Children survey (N = 2,768; females: 52.08%; mean age: 16.73 years) were analysed. Measures for frequency of alcohol and illicit drug use, gaming, GD symptom severity, and life satisfaction were included in the analyses.

RESULTS

Latent class analysis discriminated 4 subgroups of alcohol and illicit drug use: polysubstance users, high-risk alcohol users, moderate alcohol users, and infrequent substance users. Polysubstance users presented significantly higher levels of GD symptom severity and higher odds for endorsement of criteria of "giving up other activities" and "negative consequences."

CONCLUSIONS

Positive associations were shown between higher GD severity and the polysubstance using class. The roles of criteria of "giving up other activities" and "negative consequences" were highlighted in more severe substance use patterns. However, GD severity and criteria did not differ as a function of the level of alcohol use. These findings may imply common roots of GD and illicit drug use in adolescents.

Problematic use of the internet during the COVID-19 pandemic: Good practices and mental health recommendations

With the onset of the COVID-19 pandemic and the accelerated spread of the SARS-CoV-2 virus came jurisdictional limitations on mobility of citizens and distinct alterations in their daily routines. Confined to their homes, many people increased their overall internet use, with problematic use of the internet (PUI) becoming a potential reason for increased mental health concerns. Our narrative review summarizes information on the extent of PUI during the pandemic, by focusing on three types: online gaming, gambling and pornography viewing. We conclude by providing guidance for mental health professionals and those affected by PUI (with an outline of immediate research priorities and best therapeutic approaches), as well as for the general public (with an overview of safe and preventative practices).

Mental Health and Wellbeing in Lithuanian Medical Students and Resident Doctors During COVID-19 Pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has had a negative effect on mental health and subjective psychological wellbeing. One of the most affected population is medical students, reporting higher levels of depression, anxiety, sleep difficulties, and overall poorer wellbeing. However, the relationship between depression, anxiety, and sleep difficulties, and subjective psychological wellbeing has not been extensively researched in medical students in the context of COVID-19 pandemic. The aim of this study was to investigate the associations between depression, anxiety, and sleep quality, and subjective psychological wellbeing.

METHODS

In total, 524 medical students and resident doctors (78.6% female, mean age 24 ± 3 years old) participated in an online survey between December 2020 and February 2021. Participants completed the WHO-Five Wellbeing Index Questionnaire, the Pittsburgh Sleep Quality Index questionnaire, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder Assessment-7.

RESULTS

Multivariable logistic regression analysis showed that female participants' worse subjective psychological wellbeing was associated with sleep difficulties [odds ratio (OR) = 2.39, 95% CI = 1.37-4.18, p = 0.002], higher depression (OR = 6.13, 95% CI = 3.46-10.88, p < 0.001), and anxiety symptoms (OR = 2.95, 95% CI = 1.66-5.22, p < 0.001). In male participants, analysis revealed an association between worse subjective psychological wellbeing and higher depression scores (OR = 9.94, 95% CI = 3.29-30.03, p < 0.001).

CONCLUSION

Sex differences are an important factor to consider when evaluating subjective psychological wellbeing. Clinicians should be aware of significant contributors, such as sleep patterns anxiety, and depression, to subjective psychological wellbeing.

Compulsive Internet Use Scale: Psychometric Properties and Associations With Sleeping Patterns, Mental Health, and Well-Being in Lithuanian Medical Students During the Coronavirus Disease 2019 Pandemic

Background: The increase in problematic Internet use (PIU) among medical students and resident doctors during the coronavirus disease 2019 (COVID-19) pandemic may be leading to significant impairments in everyday functioning, including sleeping patterns, anxiety, depressive symptoms, and overall well-being. The Compulsive Internet Use Scale (CIUS) has been developed to assess the severity of PIU, however, it has not been elucidated whether this scale is also applicable to medical students and resident doctors. The first aim of this study was to explore the psychometric properties of the Lithuanian version of the CIUS. The second aim was to examine associations between subjectively reported mental health symptoms and PIU during the COVID-19 pandemic. Methods: A total of 524 medical students and resident doctors (78.60% women, mean age 24 [SD 3] years old) participated in an online survey between December 2020 and February 2021. Participants completed the CIUS, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder Assessment-7 (GAD-7), and the WHO-Five Well-Being Index questionnaire (WHO-5). Results: The confirmatory factor analysis (CFA) suggested brief versions (CIUS-5, CIUS-7, and CIUS-9) rather than the original (CIUS-14) version of the CIUS questionnaire as reliable and structurally stable instruments that can be used to measure compulsive Internet use severity in the sample of medical students and resident doctors. The most prevalent online behaviors were social media use (90.1%), online shopping (15.6%), and online gaming/gambling (11.3%). Students with higher CIUS scores reported significantly lower academic achievements during the 6 months (r = 0.12-0.13; p < 0.006), as well as more severe depressive and anxiety symptoms, worsened sleep quality, and lower sense of well-being (r = 0.21-0.41; p's < 0.001). Both, during workdays (d = 0.87) and weekend (d = 0.33), students spent more time online than resident doctors (p's < 0.001). Conclusion: The brief, 5-, 7-, and 9-item versions of the Lithuanian CIUS are reliable and valid self-report screening instruments for evaluating the severity of PIU symptoms among the medical student population. Symptoms of PIU during the COVID-19 period were associated with worsened self-reported mental health and everyday functioning.

Expert appraisal of criteria for assessing gaming disorder: an international Delphi study

BACKGROUND AND AIMS

Following the recognition of 'internet gaming disorder' (IGD) as a condition requiring further study by the DSM-5, 'gaming disorder' (GD) was officially included as a diagnostic entity by the World Health Organization (WHO) in the 11th revision of the International Classification of Diseases (ICD-11). However, the proposed diagnostic criteria for gaming disorder remain the subject of debate, and there has been no systematic attempt to integrate the views of different groups of experts. To achieve a more systematic agreement on this new disorder, this study employed the Delphi expert consensus method to obtain expert agreement on the diagnostic validity, clinical utility and prognostic value of the DSM-5 criteria and ICD-11 clinical guidelines for GD.

METHODS

A total of 29 international experts with clinical and/or research experience in GD completed three iterative rounds of a Delphi survey. Experts rated proposed criteria in progressive rounds until a pre-determined level of agreement was achieved.

RESULTS

For DSM-5 IGD criteria, there was an agreement both that a subset had high diagnostic validity, clinical utility and prognostic value and that some (e.g. tolerance, deception) had low diagnostic validity, clinical utility and prognostic value. Crucially, some DSM-5 criteria (e.g. escapism/mood regulation, tolerance) were regarded as incapable of distinguishing between problematic and non-problematic gaming. In contrast, ICD-11 diagnostic guidelines for GD (except for the criterion relating to diminished non-gaming interests) were judged as presenting high diagnostic validity, clinical utility and prognostic value.

CONCLUSIONS

This Delphi survey provides a foundation for identifying the most diagnostically valid and clinically useful criteria for GD. There was expert agreement that some DSM-5 criteria were not clinically relevant and may pathologize non-problematic patterns of gaming, whereas ICD-11 diagnostic guidelines are likely to diagnose GD adequately and avoid pathologizing.

Changes in pornography use and sexual behaviour during lockdown

COVID-19 pandemic and the related restrictions had a significant impact on the living and working conditions as well as the everyday behavior and mental health condition. Aim of the current analysis was to examine the impact of the input-deprived circumstances on the sexual life characteristics. An online survey carried out after a few weeks of the first nation-wide lockdown was enacted in Hungary. 1,755 persons participated in the first wave (50.4% males). Relationship and sexual life satisfaction, sexual intercourse and masturbation frequency were assessed with additional single-item questions about the subjective change (5-pont Likert scale; 1=“decreased significantly”; 5=“increased significantly) in these characetristics since the epidemiological restrictions had been introduced. Furthermore, several potential protective and risk factors were measured (depressive symptoms, perceived stress, loneliness, general well being, intolerance of uncertainty, sensation seeking, and COVID-19 related health anxiety). Linear regression models were calculated to assess which of the former variables predict the subjective changes of one’s sexual life. The analyses resulted in weak standardized coefficients. The subjective change in relationship satisfaction (mean 3.20, SD 0.94) and sexual satisfaction (mean 2.82, SD 0.73) were predicted positively by general well-being (β=.11–0.25, p<.01), and negatively by loneliness (β=-.14-0.19, p<0.01). Loneliness predicted negatively the subjective change in sexual intercourses (mean 2.75, SD 0.89) and masturbation frequency (mean 2.89, SD 0.84) (β=- .10–.12, p<.01), while sensation seeking had no effect (β=-.09, p<.01). The COVID-19 related health anxiety predicted negatively only the change in sexual life frequency (β=-.07, p<.05). The explained variances were rather small (1.7%-11.8%).

Who complies with coronavirus disease 2019 precautions and who does not?

PURPOSE OF REVIEW

Severe acute respiratory syndrome (SARS)-coronavirus disease 2019 (COVID-19) virus imposes a higher risk of complications and mortality among people with mental disorders. Until widely available vaccines, adherence to preventive behaviours remains the most crucial tool to prevent SARS/COVID-19 virus transmission. Our review focuses on the determinants of adherence behaviours.

RECENT FINDINGS

Adherence behaviours include the use of a face mask and protective gloves, personal hygienic behaviours (handwashing or using hand sanitiser), and keeping physical distance and avoiding social gatherings. In almost all studies, males and younger people show less adherence. Risk perception and health beliefs (especially perceived severity of COVID-19 related conditions) can explain the sex and age differences in adherence. Studies covering the impact of mental disorders on adherence are surprisingly missing, with the exception of smoking.

SUMMARY

Engaging men and young people in adopting preventive behaviours is crucial in protecting the whole community and specific vulnerable populations. There is a lack of studies investigating preventive behaviours among people living with mental disorders and addiction problems. Furthermore, descriptive and intervention studies are needed to understand and improve the adherence of this population to preventive behaviours.

The Moderating Role of Coping Mechanisms and Being an e-Sport Player Between Psychiatric Symptoms and Gaming Disorder: Online Survey

BACKGROUND

The emerging popularity of playing video games (gaming) as a hobby and as a professional sport raises awareness about both the benefits and possible downsides of the activity. Although a healthy and passionate hobby for most, a minority of gamers experience addiction-like symptoms and are considered to have gaming disorder (GD). GD has previously been found to be related to aversive conditions, such as depression or anxiety, as well as putatively maladaptive coping strategies.

OBJECTIVE

The aim of this study is twofold: to explore the moderating effect of different coping strategies and type of video game usage (professional [e-sport] or recreational) on the relationship between psychiatric symptoms and GD.

METHODS

A sample of 3476 gamers (n=3133, 90.13% males; mean age 23.20, SD 6.48 years) was recruited via the website and social networking site of the most popular gaming magazine in Hungary (GameStar).

RESULTS

The main effect of psychiatric symptoms was moderate to large in all models, whereas the moderation effects were significant (P<.001) for 4 out of 8 coping strategies (ie, self-blame/self-distraction, denial, emotional/social support, and active coping). However, the explained variance of the models only increased negligibly (from 0.3% to 0.5%) owing to the moderation effect. The direction of the moderations was as expected (ie, putatively maladaptive strategies were associated with more GD symptoms when the level of psychiatric symptoms was high, while putatively adaptive strategies were associated with less). Furthermore, no considerable moderation effect of the player type (recreational vs professional players) was found on the association between psychiatric symptoms and GD (β=.04; P=.02; 0.1% change in the explained variance).

CONCLUSIONS

Future studies should be designed to better understand coping-related mechanisms in the context of video gaming and GD.

Psychometric Properties of the Nine-Item Problematic Internet Use Questionnaire in a Brazilian General Population Sample

Objective: The goal of the study is to adapt and examine the psychometric properties of the Brazilian version of the nine-item Problematic Internet Use Questionnaire (PIUQ-SF-9). Methods: A convenience sample of Brazilian internet users aged between 18 and 89 years (72.7% female, mean age 38.7 years ± 13.5) was recruited online from September 2018 to July 2019 (test sample = 1,525; retest sample = 237). Participants responded to the adapted version of the PIUQ-SF-9, as well as the Center for Epidemiologic Studies-Depression Scale (CES-D-10) and sociodemographic questions. Results: A bifactor model with one general factor and three specific dimensions (obsession, neglect and control disorder) yielded the best fit indices [χ² = 67.66, df = 15, CFI = 0.99, TLI = 0.99, RMSEA = 0.048 (0.037-0.060), RMSEA p close = 0.587 and SRMR = 0.01]. McDonald's hierarchical omega coefficient was 0.76 for the general factor and varied between 0.16 and 0.33 for the specific dimensions. The intraclass correlation coefficient was 0.73 for the general factor and varied between 0.64 and 0.72 for the specific dimensions. The MIMIC model supported the scale's construct validity as the relationship of the predictors (age, time spent online, self-perception of problematic internet use, and depression symptoms) with the PIUQ-SF-9 factors was in line with the assumptions based on the literature. Conclusion: PIUQ-SF-9 seems to be a brief and culturally validated instrument with sound psychometric properties to be used in future studies on problematic internet use in the Brazilian population.

Identifying individuals in need of help for their uncontrolled gaming: A narrative review of concerns and comments regarding gaming disorder diagnostic criteria

OBJECTIVE

In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) included the diagnostic criteria of Internet gaming disorder (IGD). Then, in 2019, the 11th Revision of the International Classification of Diseases (ICD-11) categorized gaming disorder (GD) as an addictive disorder. This review aimed to review the raised concerns, debate, and research of IGD or GD criteria and provide suggestions to resolve them.

METHODS

A narrative review was conducted, and PubMed was searched for articles mentioning concerns and research on the DSM-5 criteria for IGD, ICD-11 criteria for GD, or criteria for other synonyms, such as problematic gaming or gaming addiction. A total of 107 articles were identified.

RESULTS

Concerns were organized into three categories: conceptual framework, moral panic, and diagnostic validity. Most argumentations supported the proposition that GD and other substance use disorders have similar presentations. A clear definition of GD and adequate public education could prevent rather than exacerbate moral panic. Several researchers reported concerns regarding the nosology, diagnostic validity, and wording of each criterion. However, the threshold, five of the nine criteria with impaired function, demonstrated adequate validity in interview studies.

CONCLUSION

The current findings support the addiction framework, functional impairment, and validity of the GD criteria. However, further prospective, experimental, and clinical studies validating these findings are warranted. Moreover, an integrative review or debate conference could contribute to the organization of the available results and concept development. Aggregating adequate scientific information could allay or resolve concerns related to the diagnosis of GD.

Career as a Professional Gamer: Gaming Motives as Predictors of Career Plans to Become a Professional Esport Player

Increasing numbers of young video gamers view esports (i.e., competitive video gaming) as a career opportunity, rather than just a recreational activity. Previous studies have explored the motivational differences between esport and recreational gamers and the motivational changes through career journey to become a professional esport player. The present study explored the predictors of career plans to become a professional esport player, with a specific focus on gaming motivations. Gaming time, gaming motivations, and esport-related playing experience were also examined among Hungarian gamers with competitive gaming experience (N = 190), such as years spent in esports, medium and frequency of participating in esport tournaments, the effort put into training before the tournaments, and the plans to become a professional esport player. Binary logistic regressions were carried out and results showed that the gaming motivations of competition, skill development, and social motivations predicted career planning as a professional esport player. Additionally, results showed that younger players were more likely to seek career opportunity as professional esport players than older players. Future studies should focus on novice esport players’ psychological exposure to the hypercompetitive scene of esports, such as high expectations or the risk of becoming problematic videogame users due to their motivational changes.

Co-occurrences of substance use and other potentially addictive behaviors: Epidemiological results from the Psychological and Genetic Factors of the Addictive Behaviors (PGA) Study

BACKGROUND AND AIMS

Changes in the nomenclature of addictions suggest a significant shift in the conceptualization of addictions, where non-substance related behaviors can also be classified as addictions. A large amount of data provides empirical evidence that there are overlaps of different types of addictive behaviors in etiology, phenomenology, and in the underlying psychological and biological mechanisms. Our aim was to investigate the co-occurrences of a wide range of substance use and behavioral addictions.

METHODS

The present epidemiological analysis was carried out as part of the Psychological and Genetic Factors of the Addictive Behaviors (PGA) Study, where data were collected from 3,003 adolescents and young adults (42.6% males; mean age 21 years). Addictions to psychoactive substances and behaviors were rigorously assessed.

RESULTS

Data is provided on lifetime occurrences of the assessed substance uses, their co-occurrences, the prevalence estimates of specific behavioral addictions, and co-occurrences of different substance use and potentially addictive behaviors. Associations were found between (i) smoking and problematic Internet use, exercising, eating disorders, and gambling (ii) alcohol consumption and problematic Internet use, problematic online gaming, gambling, and eating disorders, and (iii) cannabis use and problematic online gaming and gambling.

CONCLUSIONS

The results suggest a large overlap between the occurrence of these addictions and behaviors and underlies the importance of investigating the possible common psychological, genetic and neural pathways. These data further support concepts such as the Reward Deficiency Syndrome and the component model of addictions that propose a common phenomenological and etiological background of different addictive and related behaviors.

Psychometric Properties of the Nine-Item Problematic Internet Use Questionnaire (PIUQ-9) in a Lithuanian Sample of Students

Objectives: To date, there is no reliable instrument which could be used to assess problematic Internet use (PIU) in Lithuania. The nine-item Problematic Internet Use Questionnaire (PIUQ-9) previously validated in multiple countries, could be a potential tool for measuring PIU severity. The main objective of the present study was to explore the psychometric properties of the Lithuanian version of the questionnaire. Methods: A total of 272 students (17% men, mean age 27 ± 9 years) completed the PIUQ-9, the Patient Health Questionnaire (PHQ) and answered questions about the impairment of daily functioning caused by PIU in an online survey. Results: A confirmatory factor analysis indicated that a bi-factor model with one general factor "general problem" and two-specific factors "obsession" and "neglect + control disorder" fitted the data well. The presence of a strong global factor was supported by the common variance index in the bi-factor model indicating that the "general problem" factor explained 67.7% of common variance. The multiple indicators multiple causes (MIMIC) model showed that psychiatric symptoms (β = 0.25) had a moderate, while impairment due to PIU (β = 0.41) had a moderate-to-strong direct effect on the factor "general problem" supporting the construct validity of the scale. Conclusion: The Lithuanian version of the PIUQ-9 has appropriate psychometric properties to be used in measuring PIU severity in student samples.

Maladaptive player-game relationships in problematic gaming and gaming disorder: A systematic review

While certain player vulnerabilities are known to increase risk of gaming disorder (GD), the topic of maladaptive player × game relationships in GD has received limited attention. This review aimed to: (1) identify game types associated with GD symptomatology; and (2) evaluate individual differences (e.g., age, personality, depression) in the relationship between gaming and GD symptomatology. A systematic review of six databases identified 23 studies of the relations between game types and GD, including 13 studies employing multivariate analyses. Player vulnerabilities implicated in GD included impulsivity, risk-taking, psychopathological symptoms (e.g., depression, anxiety), and stronger gaming motivations (e.g., escapism, achievement). MMORPG involvement had the strongest positive association with GD. Problematic MMORPG players tend to have a socially anxious profile and may be attracted to the work-like roles and conventions of this genre. Problematic players of shooters tend to score higher on measures of sensation-seeking and impulsivity than other players. These findings suggest that GD may develop more readily and at more severe levels in complex, endless, socially driven games, irrespective of person-level characteristics. Some player vulnerabilities may selectively increase risk of GD for certain game types. Further research should investigate different player-game interactions to refine current models and interventions for GD.

The mediating effect of motivations between psychiatric distress and gaming disorder among esport gamers and recreational gamers

Research examining the relationship between gaming disorder, gaming motivations, and mental health is increasing, but the types of gaming use, such as recreational gaming and esports are not commonly distinguished. The present study compared recreational gamers and esport gamers (N = 4284) on a number of variables including game time, gaming motivations, severity of gaming disorder, and psychiatric symptoms. Additionally, the mediating effect of gaming motivations among esport and recreational gamers between psychiatric distress and problematic gaming was examined. Results showed that esport gamers spent significantly more time playing video games both on weekdays and weekend days than recreational gamers. Moreover, esport gamers had higher scores on social, competition, and skill development gaming motivations than recreational gamers. The mediation model demonstrated a significant positive direct and significant mediated effect via escapism (i.e., gaming excessively to avoid real life problems) between the higher levels of psychiatric distress and gaming disorder. However, esport and recreational gamers showed no significant differences in the model. The escapism motive appeared to be the common predictor of problematic gaming among both esport and recreational gamers. Future studies should focus on exploring escapism's mechanism in different subgroups of gamers in relation to problematic gaming to help the development of prevention, intervention, and treatment programs.

The Psychology of Esports: A Systematic Literature Review

Recently, the skill involved in playing and mastering video games has led to the professionalization of the activity in the form of 'esports' (electronic sports). The aim of the present paper was to review the main topics of psychological interest about esports and then to examine the similarities of esports to professional and problem gambling. As a result of a systematic literature search, eight studies were identified that had investigated three topics: (1) the process of becoming an esport player, (2) the characteristics of esport players such as mental skills and motivations, and (3) the motivations of esport spectators. These findings draw attention to the new research field of professional video game playing and provides some preliminary insight into the psychology of esports players. The paper also examines the similarities between esport players and professional gamblers (and more specifically poker players). It is suggested that future research should focus on esport players' psychological vulnerability because some studies have begun to investigate the difference between problematic and professional gambling and this might provide insights into whether the playing of esports could also be potentially problematic for some players.

Cross-Cultural Validation of the Compulsive Internet Use Scale in Four Forms and Eight Languages

The 14-item Compulsive Internet Use Scale (CIUS) is one of the most frequently internationally adapted psychometric instruments developed to assess generalized problematic Internet use. Multiple adaptations of this instrument have led to versions in different languages (e.g., Arabic and French), and different numbers of items (e.g., from 5 to 16 items instead of the original 14). However, to date, the CIUS has never been simultaneously compared and validated in several languages and different versions. Consequently, the present study tested the psychometric properties of four CIUS versions (i.e., CIUS-14, CIUS-9, CIUS-7, and CIUS-5) across eight languages (i.e., German, French, English, Finnish, Spanish, Italian, Polish, and Hungarian) to (a) examine their psychometric properties, and (b) test their measurement invariance. These analyses also identified the optimal versions of the CIUS. The data were collected via online surveys administered to 4,226 voluntary participants from 15 countries, aged at least 18 years, and recruited from academic environments. All brief versions of the CIUS in all eight languages were validated. Dimensional, configural, and metric invariance were established across all languages for the CIUS-5, CIUS-7, and CIUS-9, but the CIUS-5 and CIUS-7 were slightly more suitable because their model fitted the ordinal estimate better, while for cross-comparisons, the CIUS-9 was slightly better. The brief versions of the CIUS are therefore reliable and structurally stable instruments that can be used for cross-cultural research across adult populations.

Gender Moderates the Partial Mediation of Impulsivity in the Relationship Between Psychiatric Distress and Problematic Online Gaming: Online Survey

BACKGROUND

Research has shown that some individuals can develop problematic patterns of online gaming, leading to significant psychological and interpersonal problems. Psychiatric distress and impulsivity have been suggested to contribute to problematic online gaming (POG).

OBJECTIVE

This study aimed to investigate the potential mediating or moderating mechanisms of impulsivity and gender-related differences in possible associations between psychiatric distress and POG.

METHODS

A total of 596 matched female and male participants, ranging in age from 14 to 38 years (mean 21.4, SD 4.5), were chosen from a large cross-sectional, nationwide Hungarian online gaming sample. Participants completed online questionnaires about self-reported impulsivity, psychiatric distress, and POG.

RESULTS

Psychiatric distress directly predicted POG, and impulsivity partially mediated the relationship between psychiatric distress and POG. However, this mediation effect was found only for the impatience factor of impulsivity. Impulsivity did not moderate the relationship between psychiatric distress and POG. A moderating effect of gender was not found in the direct relationship between psychiatric distress and POG. However, a moderated mediation analysis revealed that impatience mediated the association between psychiatric distress and POG in males, whereas the indirect effect of impatience was not significant in females.

CONCLUSIONS

The results of this work highlight gender-related difference among online gamers in the mediation effect of impulsivity between psychiatric distress and POG and provide novel insights regarding clinical implications for preventing or treating POG.

The psychological and genetic factors of the addictive behaviors (PGA) study

OBJECTIVES

Most of the addiction studies focus on very specific aspects of addictions, often with contradictory results, and integrated studies are quite rare. Experimental studies comparing underlying mechanisms of addictions and analyzing data from an integrative psychological and genetic perspective are almost nonexistent. The aim of the present paper is to describe the research protocol of the Psychological and Genetic Factors of Addictive Behaviors (PGA) study, which applies an integrative approach to understanding the acquisition, development, and maintenance of addictive behaviors.

METHODS

A wide-spectrum national study was carried out. Data were collected from 3,003 adolescents. Addictions to both psychoactive substances and behaviors were thoroughly assessed via psychometrically robust scales, which also included assessment related to a wide range of related psychological dimensions. Additionally, a DNA sample was also collected from participants.

RESULTS

The paper presents the detailed methodology of the PGA study. Data collection procedures, instrumentation, and the analytical approach used to attain the research objectives are described.

CONCLUSIONS

Future plans, along with potential contributions of the PGA study, are also discussed. It is envisaged that the study will provide a unique opportunity to test possible mechanisms and causal pathways mediating the associations of genetic factors, psychological characteristics, and addictions.

The Role of Cognitive Emotion Regulation Strategies in Problem Gaming Among Adolescents: A Nationally Representative Survey Study

Explanatory theoretical models have proposed an association between problematic online gaming and abilities or strategies in alleviating distress or negative emotions in times of stress as proximal non-gaming-related personality factors. However, there is little research that has targeted how emotion regulation relates to problematic online gaming-especially during adolescence when gaming behavior is most prevalent. In emotion regulation research, there has been a particular emphasis on rumination because it is strongly associated with overall psychopathology. However, it is unknown whether this putatively maladaptive strategy relates to problematic online gaming and whether it is a gender-dependent association. Consequently, the present study examined how emotion regulation strategies, and particularly rumination, related to problem gaming and tested whether gender moderated this relationship in adolescents. In a national representative adolescent sample, 46.9% of the participants (N = 1,646) reported online gaming in the past 12 months and provided information on problematic gaming, and it was these data that were used for further analysis. Their data concerning problematic online gaming and emotion regulation strategies were analyzed, including rumination along with other putatively maladaptive (e.g., catastrophizing) and adaptive (e.g., positive reappraisal) strategies, while controlling for age, gender, and game genre preference. Results of linear regression analyses showed that all the putatively maladaptive emotion regulation strategies (including self-blame, other blame, catastrophizing, and rumination) were positively related to problematic online gaming. Positive reappraisal proved to be a protective factor; it was inversely related to problematic online gaming. In addition, the relationship between rumination and online gaming was moderated by gender (i.e., the relationship was stronger among boys). Based on the results, it is argued that emotion regulation is a useful framework to study problematic online gaming. The present study highlighted that the relative predictive value of rumination for problematic online gaming varied for boys and girls, suggesting that trait rumination might be a gender-specific vulnerability factor for problematic online gaming, but this requires further investigation and replication.

Psychometric Evaluation of the Nine-Item Problematic Internet Use Questionnaire (PIUQ-9) in Nine European Samples of Internet Users

Objectives: The nine-item Problematic Internet Use Questionnaire (PIUQ-9) is a brief self-report screening instrument for problematic internet use. The main objective of the present study was to explore the psychometric properties of the PIUQ-9 among nine different language-based samples of European internet users (Italian, German, French, Polish, Turkish, Hungarian, English, and Greek). Methods: The total sample comprised 5,593 internet users (38.1% men), aged between 18 and 87 years (M = 25.81; SD = 8.61). Via online recruitment, participants completed the PIUQ-9, the Brief Symptom Inventory (BSI) and items about time spent online. Results: Confirmatory factor analysis demonstrated that the bifactor model with one general factor (i.e., general problem) and two-specific factors (i.e., obsession and neglect + control disorder) yielded acceptable or good fit indices in all subsamples except for one. The common variance index in the bifactor model indicated that the general problem factor explained from 57.0 to 76.5% of common variance, which supports the presence of a strong global factor. According to the multiple indicators multiple causes (MIMIC) model, psychiatric symptoms had a moderate-to-strong direct effect on the general problem factor in all subsamples, ranging from β = 0.28 to β = 0.52 supporting the construct validity of the scale. Furthermore, in a majority of the subsamples, time spent online during the weekend had considerably higher effect sizes on the general problem factor than time spent online during weekdays. Conclusion: The present study highlights the appropriate psychometric properties of the PIUQ-9 across a number of European languages and cultures.

Ten-Item Internet Gaming Disorder Test (IGDT-10): Measurement invariance and cross-cultural validation across seven language-based samples

The Ten-Item Internet Gaming Disorder Test (IGDT-10) is a short screening instrument developed to assess Internet gaming disorder (IGD) as proposed in the Diagnostic and Statistical Manual of MentalDisorders, fifth edition (DSM-5), adopting a concise, clear, and consistent item-wording. According to initial studies conducted in 2014, the instrument showed promising psychometric characteristics. The present study tested the psychometric properties, including language and gender invariance, in a large international sample of online gamers. In this study, data were collected from 7,193 participants comprising Hungarian (n = 3,924), Iranian (n = 791), English-speaking (n = 754), French-speaking (n = 421), Norwegian (n = 195), Czech (n = 496), and Peruvian (n = 612) online gamers via gaming-related websites and gaming-related social-networking-site groups. A unidimensional factor structure provided a good fit to the data in all language-based samples. In addition, results indicated both language and gender invariance on the level of scalar invariance. Criterion and construct validity of the IGDT-10 was supported by its strong association with the Problematic Online Gaming Questionnaire and moderate association with weekly gaming time, psychopathological symptoms, and impulsivity. The proportions of each sample that met the cut-off score on the IGDT-10 varied between 1.61% and 4.48% in the individual samples, except for the Peruvian sample (13.44%). The IGDT-10 shows robust psychometric properties and appears suitable for conducting cross-cultural and gender comparisons across seven languages. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective

The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate over the past year. Besides the broad support for the decision in the academic press, a recent publication by van Rooij et al. (2018) repeated the criticism raised against the inclusion of GD in ICD-11 by Aarseth et al. (2017). We argue that this group of researchers fails to recognize the clinical and public health considerations, which support the WHO perspective. It is important to recognize a range of biases that may influence this debate; in particular, the gaming industry may wish to diminish its responsibility by claiming that GD is not a public health problem, a position which maybe supported by arguments from scholars based in media psychology, computer games research, communication science, and related disciplines. However, just as with any other disease or disorder in the ICD-11, the decision whether or not to include GD is based on clinical evidence and public health needs. Therefore, we reiterate our conclusion that including GD reflects the essence of the ICD and will facilitate treatment and prevention for those who need it.

Policy responses to problematic video game use: A systematic review of current measures and future possibilities

BACKGROUND AND AIMS

Empirical research into problematic video game playing suggests that overuse might cause functional and psychological impairments for a minority of gamers. Therefore, the need for regulation in the case of video games (whether governmental or self-imposed) has arisen but has only been implemented in a few countries around the world, and predominantly in Asia. This paper provides a systematic review of current and potential policies addressing problematic gaming.

METHODS

After conducting a systematic search in the areas of prevention, treatment, and policy measures relating to problematic Internet and video game use, papers were selected that targeted problematic gaming policies (N = 12; six in English and six in Korean). These papers served as the basis of this review.

RESULTS

Policies were classified into three major groups: (i) policy measures limiting availability of video games (e.g., shutdown policy, fatigue system, and parental controls), (ii) measures aiming to reduce risk and harm (e.g., warning messages), and (iii) measures taken to provide help services for gamers. Beyond the attempt to classify the current and potential policy measures, the authors also tried to evaluate their efficiency theoretically and (if data were available) empirically.

DISCUSSION AND CONCLUSIONS

Overall, it appears that although several steps have been taken to address problematic video game playing, most of these steps were not as effective as expected, or had not been evaluated empirically for efficacy. The reason for this may lie in the fact that the policies outlined only addressed or influenced specific aspects of the problem instead of using a more integrative approach.

Loving the love of boys: Motives for consuming yaoi media

In recent years, yaoi has been increasingly popular among youth interested in Japanese media such as anime and manga. Yaoi is defined as commercial and fan-created media that thematically focus on the romantic love between two men, often in a sexually explicit way. Despite the widespread popularity of this Japanese subgenre, there is a lack of empirical studies on the motives for consuming yaoi media that analyze the full range of motives using reliable research methods. The present study aimed to explore and operationalize the motives for yaoi media consumption based on previous qualitative research (Pagliassotti, 2008). Using an online survey, 724 yaoi consumers (58% male; M_age = 30.1 years, SD = 10.4) completed the Yaoi Consumption Motives Questionnaire (YCMQ). According to confirmatory factor analyses, the bi-factor model of nine motives yielded closer fit to the data than the theoretically proposed, first-order ten-factor model and a second-order nine-factor model. The nine-factor YCMQ demonstrated strong psychometric properties in terms of factor structure, internal consistency, and measurement invariance. These results indicate that the 31-item YCMQ is an appropriate instrument to assess individuals’ motives for consuming yaoi media.

Measurement Invariance of the Short Version of the Problematic Mobile Phone Use Questionnaire (PMPUQ-SV) across Eight Languages

The prevalence of mobile phone use across the world has increased greatly over the past two decades. Problematic Mobile Phone Use (PMPU) has been studied in relation to public health and comprises various behaviours, including dangerous, prohibited, and dependent use. These types of problematic mobile phone behaviours are typically assessed with the short version of the Problematic Mobile Phone Use Questionnaire (PMPUQ⁻SV). However, to date, no study has ever examined the degree to which the PMPU scale assesses the same construct across different languages. The aims of the present study were to (i) determine an optimal factor structure for the PMPUQ⁻SV among university populations using eight versions of the scale (i.e., French, German, Hungarian, English, Finnish, Italian, Polish, and Spanish); and (ii) simultaneously examine the measurement invariance (MI) of the PMPUQ⁻SV across all languages. The whole study sample comprised 3038 participants. Descriptive statistics, correlations, and Cronbach's alpha coefficients were extracted from the demographic and PMPUQ-SV items. Individual and multigroup confirmatory factor analyses alongside MI analyses were conducted. Results showed a similar pattern of PMPU across the translated scales. A three-factor model of the PMPUQ-SV fitted the data well and presented with good psychometric properties. Six languages were validated independently, and five were compared via measurement invariance for future cross-cultural comparisons. The present paper contributes to the assessment of problematic mobile phone use because it is the first study to provide a cross-cultural psychometric analysis of the PMPUQ-SV.

[Measuring psychosis-like symptoms and their relationship with caffeine consumption in healthy adult population]

INTRODUCTION

Our study is based on the concept that mental disorders - including psychotic symptoms - should be treated as dimensions/continuums rather than categories; an approach supported in the DSM-5 as well. Consequently, the measurement of certain symptoms of psychosis (e.g. hallucinations, persecutory ideation) may also be important in the normal population. We have performed the Hungarian adaptation of two questionnaires - the Persecutory Ideation Questionnaire and the Launay-Slade Hallucination Scale - in the current study and we also examined the relationship of the consumption of various caffeinated beverages, caffeine use disorder, the tendency to hallucinations and persecutory ideations.

METHOD

2259 adults (70.5% male, mean age = 34 years [standard deviation = 9.3]) participated in our cross-sectional online survey, completing the Persecutory Ideation Questionnaire, the Launay-Slade Hallucination Scale, the Caffeine Use Disorder Questionnaire and questions about caffeine consumption habits.

RESULTS

The Persecutory Ideation Questionnaire had a one-factor structure and its internal consistency was excellent. In the exploratory factor analysis of the Launay-Slade Hallucination Scale two factors emerged ("Vivid mental events" and "Clinical hallucinations"), but other factor solutions cannot be completely excluded. The moderate correlation between the two questionnaires indicates an appropriate divergent validity. There were no correlations between psychotic symptoms and caffeine, coffee, tea and cola consumption. A slightly increased level of persecutory ideation in the daily energy drink consumers was observed compared to non-daily consumers. The magnitude of caffeine use disorder symptoms had a moderate positive correlation with psychotic symptoms.

CONCLUSION

Both the Persecutory Ideation Questionnaire and the Launay-Slade Hallucination Scale are appropriate tools for measuring psychotic experiences in the healthy adult population. Further research may aim to test the questionnaires in a clinical population.

Why Do You Drink Caffeine? The Development of the Motives for Caffeine Consumption Questionnaire (MCCQ) and Its Relationship with Gender, Age and the Types of Caffeinated Beverages

Caffeine is the most popular psychoactive substance that is consumed worldwide. As motives influence behavior, investigation of the motivational background of caffeine consumption should help provide a better understanding of the popularity of caffeinated products. The present study aimed (i) to explore and operationalize the motives of caffeine consumption and (ii) to reveal possible differences in the motives regarding gender, age and the type of caffeinated products consumed. Motives for caffeine consumption were collected from regular caffeine consumers (N = 26) and were informed by a review of the relevant literature. Following this, a cross-sectional study was conducted on a convenience sample of Hungarian university students and working adults (N = 598). The participants completed the Motives for Caffeine Consumption Questionnaire and the Caffeine Consumption Questionnaire. Six motivational factors were identified: Alertness, Habit, Mood, Social, Taste and Symptom Management. Women had higher scores on Habit, Social, Taste and Symptom Management. Younger participants had higher scores on Alertness than the older group, and the older group had higher scores on Habit and Symptom Management. Five types of caffeine users were identified. Those who consumed (i) coffee, (ii) tea, (iii) energy drinks, (iv) coffee and tea and (v) mixed drinks. Several differences between the five groups were revealed across all motives except for Taste. The present study developed a robust psychometric instrument for assessing caffeine consumption motives. The factors varied in importance in relation to gender, age and caffeine consumption habits.

Intense video gaming is not essentially problematic

Video games are more popular than ever and the general public, including parents, educators, and the media, tends to consider intense video gaming fundamentally problematic. To test this hypothesis, participants were recruited via gaming-related websites resulting in a sample of N = 5,222 online video gamers (mean age: 22.2 years, SD = 6.4). Besides assessing gaming time, we administered the Ten-Item Internet Gaming Disorder Test, the Brief Symptom Inventory, and the Motives for Online Gaming Questionnaire. Two structural regression models were estimated with both gaming time and problematic gaming as outcome variables. Predictors were psychiatric symptoms in the first, and gaming motives in the second model. Both models yielded adequate fit indices. Psychiatric symptoms had a moderate positive effect on problematic use (β = .46, p < .001) whereas their effect on gaming time was practically zero (β = -.01, p = .84). In the second model, Escape was the most prominent motive and was moderately to-strongly associated (β = .58, p < .001) with problematic use. However, the association between Escape and gaming time was substantially weaker (β = .21, p < .001). The correlation between gaming time and problematic use was weak-to-moderate in both models (r = .26, p < .001 and r = .21, p < .001, respectively). Data suggest that gaming time is weakly associated with negative psychological factors such as psychiatric symptoms and Escape motive, which were found to be consistently related to problematic use. Therefore, the amount of gaming time alone appears to be an unreliable predictor of problematic use, which questions the aforementioned idea that intense gaming is essentially problematic. (PsycINFO Database Record

Inclusion of Gaming Disorder in ICD has more advantages than disadvantages

This paper is a response to a recent debate paper in which Aarseth et al. argue that the inclusion of a formal diagnosis and categories for problematic video gaming or Gaming Disorder (GD) in the World Health Organization's 11th Revision of the International Classification of Diseases (ICD-11) is premature and therefore the proposal should be removed. The present authors systematically address all the six main arguments presented by Aarseth et al. and argue that, even though some of the concerns presented in the debate paper are legitimate, the inclusion of GD in ICD-11 has more advantages than disadvantages. Furthermore, the present authors also argue that the two GD subtypes ("GD, predominantly online" and "GD, predominantly offline") are unnecessary and rather problematic; the main category for GD would be perfectly sufficient.