Autism, Problematic Internet Use and Gaming Disorder: A Systematic Review

Internet addiction and Internet gaming disorders are increasingly prevalent. Whilst there has been much focus on the use of conventional psychological approaches in the treatment of individuals with these addictive disorders, there has also been ongoing research exploring the potential of cognitive bias modification amongst individuals with Internet and gaming addiction. Some studies have documented the presence of cognitive biases and the effectiveness of bias modification for Internet addiction and gaming disorders. However, there have not been any reviews that have synthesized the findings related to cognitive biases for Internet addiction and Internet gaming disorders. It is important for us to undertake a scoping review as an attempt to map out the literature for cognitive biases in Internet addiction and gaming disorders. A scoping review was undertaken, and articles were identified using a search through the following databases: PubMed, MEDLINE, and PsycINFO. Six articles were identified. There were differences in the methods of ascertaining whether an individual has an underlying Internet or gaming addiction, as several different instruments have been used. With regards to the characteristics of the cognitive bias assessment task utilized, the most common task used was that of the Stroop task. Of the six identified studies, five have provided evidence documenting the presence of cognitive biases in these disorders. Only one study has examined cognitive bias modification and provided support for its effectiveness. Whilst several studies have provided preliminary findings documenting the presence of cognitive biases in these disorders, there remains a need for further research evaluating the effectiveness of bias modification, as well as the standardization of the diagnostic tools and the task paradigms used in the assessment.

Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young’s Diagnostic Questionnaire and the Compulsive Internet Use Scale) and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students’ experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a) use Internet longer than intended, b) preoccupation with the Internet, c) withdrawal symptoms when unable to access the Internet, d) unsuccessful attempts to stop or reduce Internet use, e) craving, f) loss of interest in hobbies or activities other than the Internet, g) excessive Internet use despite the knowledge of related problems, g) use of the Internet to escape or relieve a negative mood, and h) lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed.

ObjectiveNon-suicidal self-injury (NSSI) constitutes an important public health concern. Here, we systematically reviewed and synthesized existing literature to provide an up-to-date overview of associations between NSSI, problem gambling, problem gaming, and problematic internet use (PIU).MethodsWe searched four databases through April 2025: Web of Science, Scopus, PubMed, and PsycINFO. The Joanna Briggs Institute's tool was used to assess the quality of studies. Empirical studies utilizing quantitative or qualitative methods or case studies that presented evidence on the relationships between NSSI and frequent or problematic gambling, internet use, and gaming were included.ResultsForty studies published between 2009 and 2025 were reviewed. Four investigated the relationship between NSSI and problem gambling, seven focused on problem gaming, and twenty-nine examined PIU. Cross-sectional designs and surveys were common. Findings suggest that at-risk or problem gambling was associated with NSSI in adolescents, college students, and adults. An association between PIU and NSSI appeared moderated by social support, with impulsivity representing a shared factor. Similarly, internet gaming disorder and its severity were linked to NSSI, with anxiety acting both as a mediator and moderator. Limitations entailed self-reported measures, limited generalizability, poor ability to establish causal relationships due to cross-sectional designs, and frequent use of single unvalidated questions to assess NSSI.ConclusionThe review provides a comprehensive overview and suggests complex relationships between NSSI and problem gambling, problem gaming, and PIU. Clinicians and future studies should focus on co-occurring disorders and identify risk factors, predictors, and moderators that influence these relationships.

Internet gaming disorder (IGD) and problematic internet use (PIU) are becoming increasingly detrimental to modern society, with serious consequences for daily functioning. IGD and PIU may be exacerbated by lifestyle changes imposed by the coronavirus 2019 (COVID-19) pandemic. This study investigated changes in IGD and PIU during the pandemic and risk factors for them. This study is a part of a larger online study of problematic smartphone use in Japan, originally planned in 2019, and expanded in August 2020 to include the impact of COVID-19. 51,246 adults completed an online survey during the pandemic (August 2020), in Japan. Of these, 3,938 had also completed the survey before the onset of the pandemic (December 2019) and were used as the study population to determine how the pandemic has influenced IGD and PIU. IGD was assessed using the Internet Gaming Disorder Scale (IGDS). PIU was measured using the Compulsive Internet Use Scale (CIUS). The prevalence of probable IGD during COVID-19 was 4.1% overall [95%CI, 3.9%–4.2%] (N = 51,246), and 8.6% among younger people (age < 30), 1–2.5% higher than reported before the pandemic. Probable PIU was 7.8% overall [95%CI, 7.6%–8.1%], and 17.0% [95%CI, 15.9%–18.2%] among younger people, 3.2–3.7% higher than reported before the pandemic. Comparisons before and during the pandemic, revealed that probable IGD prevalence has increased 1.6 times, and probable PIU prevalence by 1.5 times (IGD: χ2= 619.9, p < .001, PIU: χ2= 594.2, p < .001). Youth (age < 30) and COVID-19 infection were strongly associated with IGD exacerbation (odds ratio, 2.10 [95%CI, 1.18 to 3.75] and 5.67 [95%CI, 1.33 to 24.16]). Internet gaming disorder and problematic internet use appear to be aggravated by the pandemic. In particular, younger persons and people infected with COVID-19 are at higher risk for Internet Gaming Disorder. Prevention and treatment of these problems are needed.

Background/aimIt is known that various temperament and character dimensions, and parenting styles could be associated with problematic internet and smartphone use. This study aimed to examine the association between temperament, character, and parenting styles and problematic smartphone and internet use in nonclinical female teenagers.Materials and methods244 nonclinical female adolescent were included the study. Young’s Internet Addiction Test Short Form, Smartphone Addiction Scale, Junior Temperament and Character Inventory and Parenting Style Scale were used for collecting data.ResultsProblematic smartphone use was significantly negatively correlated with cooperativeness character type, strictness/supervision, and acceptance/involvement subscales of the parenting style scale. A significant correlation was found between problematic internet use and acceptance/involvement, strictness/supervision subscales of Parenting Style Scale. In ANOVA analysis, it was found that the authoritative parenting style was associated with less problematic use, and the neglectful, authoritarian, and indulgent parenting styles were associated with increased problematic use. A negative correlation was found between the cooperativeness character style and problematic smartphone use.ConclusionAccording to our results, parenting style is more important for problematic internet and smartphone use among female adolescents than temperament and character.

Problematic Internet use is recognized as a significant public health concern among adolescents. Previous research has shown that adolescents with problematic Internet use tend to experience higher levels of anxiety and depression compared to non-problematic Internet users. Nevertheless, when it comes to differences in specific symptoms, the evidence is less clear-cut. This study conducted Gaussian graphical model and Bayesian network analysis to compare the network structures of anxiety symptoms and depression symptoms among adolescents with problematic and non-problematic Internet use. A total of 1,139 Chinese adolescents (540 problematic Internet users, M age = 15.96; 599 non-problematic Internet users, M age = 16.03) were included in the study. The results showed that compared to adolescents with non-problematic Internet use, most anxiety symptoms (e.g., inability to stop or control worries) emerged as upstream nodes with significant downstream effects on a series of emotional symptoms of anxiety and depression among adolescents with problematic Internet use. “Fear of something terrible happening,” “irritability,” “feeling fearful” and “feeling effortful” were symptomatic targets for intervening problematic Internet use and improving mental health. These findings offer novel data-driven insights on the core symptoms and directional relationships of anxiety-depression comorbidity network among Chinese adolescents with different Internet use states.

Serum cartilage oligomeric matrix protein (sCOMP) is elevated in patients with knee osteoarthritis: a systematic review and meta-analysis

Adolescents with autism spectrum disorder (ASD) often have various psychiatric comorbidities, particularly depression. In recent years, gaming disorder (GD) and Internet addiction (IA) have been identified as common comorbidities of ASD. We administered three self-administered screening instruments to adolescents with ASD to assess the severity of depression, GD, and IA. The participants were 10-18-year-olds with ASD. They were asked to complete three questionnaires to assess depressive symptoms, GD, and IA: the Patient Health Questionnaire for Adolescents (PHQ-A), Ten-Item Internet Gaming Disorder Test (IGDT-10), and Internet Addiction Test (IAT). The total IGDT-10 score was calculated in two different ways: the original scoring version (IGDT-10-OV) and the modified version (IGDT-10-MV). Of the 74 respondents, 24.3% had moderate or severe depressive symptoms, 8.1% were identified as having possible GD according to the IGDT-10-OV, 39.2% were identified as having possible GD according to the IGDT-10-MV, and 27.0% were positive for IA according to the IAT. Two-group comparisons revealed that depressive symptoms were more strongly associated with IA than with GD. IA was associated with more depressive symptoms than GD. Since adolescents with ASD have difficulties with social communication, they are prone to isolation and feelings of loneliness. Longer screen times due to social isolation may be a risk factor for the development of GD/IA. Adolescents with ASD often exhibit a preference for visual processing but may struggle with verbal communication. Thus, they may find online spaces more comfortable for them to alleviate their feelings of loneliness.

BackgroundIn recent years, the relationship between childhood trauma and problematic Internet use has been widely studied by scholars, but the research conclusions on the relationship between them are not consistent. Some studies report that childhood trauma and problematic Internet use are significantly correlated. However, others believe that there is a weak correlation between them. So the relationship between them needs to be studied further. The aim of this study is to explore the relationship between childhood trauma and problematic Internet use, and the effects of some moderating variables on both for students in Mainland China.MethodsThis study followed the requirements of Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statement for literature screening. We searched the related studies on childhood trauma and problematic Internet use in Mainland China from January 2009 to November 2022 from CNKI, Wanfang Data, Chongqing VIP Information Co., Ltd. (VIP), Baidu scholar, ProQuest dissertations, SAGE Online Journals, Elsevier SDOL, Taylor & Francis, Springer, Web of Science, Google Scholar, EBSCO, Medline, Scopus Database, PubMed Central, Embase, The Cochrane Library, PsycINFO, CMA 3.0 was used to analyse the overall effect and test the moderating effect.ResultsAmong the papers included in the meta-analysis in this study, 31 papers reflected the relationship between childhood trauma and problematic Internet use, involving 52,503 subjects, and the sample size ranged from 388 to 16,130. This relationship between childhood trauma and problematic Internet use can be considered as a moderate correlation (r = 0.281, 95%CI[0.221, 0.338], p < 0.001). The results showed that the relationship between childhood trauma and problematic Internet use was affected by different problematic Internet use measures. Meanwhile, meta-regression demonstrated that the relationship between childhood trauma and problematic Internet use was moderated by survey’s year. Specifically, the correlation coefficient between childhood trauma and problematic Internet use also increases with increasing year. However, the relationship between childhood trauma and problematic Internet use was not affected by the region, grade, childhood trauma measures, publication source.ConclusionChildhood trauma is closely related to problematic Internet use. In order to reduce problematic Internet use, corresponding prevention and intervention measures should be taken.

In the past decade, research has accumulated suggesting that excessive Internet use can lead to the development of a behavioral addiction. Internet addiction has been considered as a serious threat to mental health and the excessive use of the Internet has been linked to a variety of negative psychosocial consequences. The aim of this review is to identify all empirical studies to date that used neuroimaging techniques to shed light upon the emerging mental health problem of Internet and gaming addiction from a neuroscientific perspective. Neuroimaging studies offer an advantage over traditional survey and behavioral research because with this method, it is possible to distinguish particular brain areas that are involved in the development and maintenance of addiction. A systematic literature search was conducted, identifying 18 studies. These studies provide compelling evidence for the similarities between different types of addictions, notably substance-related addictions and Internet and gaming addiction, on a variety of levels. On the molecular level, Internet addiction is characterized by an overall reward deficiency that entails decreased dopaminergic activity. On the level of neural circuitry, Internet and gaming addiction led to neuroadaptation and structural changes that occur as a consequence of prolonged increased activity in brain areas associated with addiction. On a behavioral level, Internet and gaming addicts appear to be constricted with regards to their cognitive functioning in various domains. The paper shows that understanding the neuronal correlates associated with the development of Internet and gaming addiction will promote future research and will pave the way for the development of addiction treatment approaches.

This study used a sample of Korean adolescents to evaluate: (a) associations between problematic internet use and depression, bipolar disorder symptoms and suicidal ideation; and (b) whether mood disorders mediate the relationship between problematic internet use and suicidal ideation. A total of 795 middle and high school students were recruited (538 girls; mean age, 13.87 ± 1.51 years). The Internet Addiction Proneness Scale for Youth-Short Form (KS-scale) was used to evaluate the presence and severity of problematic internet use. The frequencies of depression, suicidal ideation and probable bipolar disorder were compared between adolescents with and without internet addiction. The associations between the severity of problematic internet use and the severity of depressive symptoms, bipolar symptoms and suicidal ideation were also analyzed. Seventy-five adolescents (9.4%) met the criteria for problematic internet use. The presence of problematic internet use was significantly associated with suicidal ideation (OR = 5.82, 95% CI = 3.30-10.26, p < 0.001) as well as depression (OR = 5.00, 95% CI = 2.88-8.66, p < 0.001). There was a marginally significant association between problematic internet use and probable bipolar disorder (OR = 3.05, 95% CI = 0.96-9.69, p = 0.059). In the path model, problematic internet use significantly predicted depressive symptoms (β = 0.296, 95% CI = 0.214-0.367, p = 0.005), which predicted suicidal ideation (β = 0.699, 95% CI = 0.631-0.751, p = 0.009). Problematic internet use also predicted suicidal ideation directly (β = 0.115, 95% CI = 0.052-0.193, p = 0.006). Conversely, depressive symptoms (β = 0.119, 95% CI = -0.005-0.219, p = 0.040) and suicidal ideation (β = 0.215, 95% CI = 0.089-0.346, p = 0.005) predicted problematic internet use. There is a complex transactional relationship between problematic internet use, depressive symptoms, bipolar symptoms and suicidal ideation, so these conditions must be assessed together during the evaluation of adolescents. Prospective studies are warranted to elucidate the causal relationships between problematic internet use, mood symptoms and suicidal ideation.

While studies indicate that high self-control may serve as a safeguard against problematic internet use, there's evidence suggesting that problematic internet use can, in turn, diminish self-control. This study aimed to elucidate the longitudinal interplay between internet self-control and problematic internet use in adolescents, employing cross-lagged panel modeling. Furthermore, drawing from a positive psychology perspective, we examined the potential role of 'meaning in life' as a protective mediator within this longitudinal relationship. We then constructed a mediation model to explore protective factors against problematic internet use. Through a questionnaire, we tracked 659 adolescents (331 males and 328 females; mean age=13.61) in a longitudinal design across two time points, spaced at five-month intervals, to assess their internet self-control, problematic internet use, and meaning in life. Results of the cross-lagged panel models showed that: Internet self-control had a significant negative impact on problematic internet use after five months (β = -0.094, p < 0.01). Conversely, problematic internet use had a significant negative impact on internet self-control after five months (β = -0.099, p < 0.05). Results from the longitudinal mediation model showed that: Meaning in life mediated the effect of internet self-control on problematic internet use after five months (βinternet self-control(T1)-meaning in life(T2) = 0.142, p < 0.01; βmeaning in life(T1)-problematic internet use (T2) = -0.075, p < 0.05). Our study uncovers a reciprocal predictive relationship between internet self-control and problematic internet use, while highlighting the mediating role of meaning in life within this relationship. These findings suggest that fostering internet self-control and cultivating a sense of meaning in life among adolescents can serve as effective prevention and intervention strategies for addressing the issue of problematic internet use.

INTERNET ADDICTION OR PSYCHOPATHOLOGY IN DISGUISE? RESULTS FROM A SURVEY OF COLLEGE-AGED INTERNET USERS

Investigating the relationship between behavioural addictions and mental health is essential due to their impact on well-being and the significant barriers they create to achieving lasting recovery. The aim of the study was to examine the prevalence of food addiction, problematic internet use, and internet gaming disorder among 866 high school students (grades 9-12) in Turkey, Bingöl and their associated with impulsivity, emotional regulation, depression, anxiety, and stress. The sample was selected using a convenience sampling approach. Data were collected via online questionnaires using validated scales and analysed with SPSS package programme. The prevalence of food addiction was 6.9%, problematic internet use 14.3%, and internet gaming disorder 0.9%. Problematic internet use relatively high prevalence likely reflects adolescents' increased exposure to digital devices. Mental health factors were found to be significantly related to behavioural addictions: depression, anxiety, and stress predicted food addiction; depression and stress predicted problematic internet use, and anxiety was linked to internet gaming disorder. This study contributes to the literature by examining multiple behavioural addictions and their common risk factors simultaneously and provides a comprehensive perspective. It is also one of the rare studies examining food addiction with other behavioural addictions. More research is needed to develop better intervention programmes and policies in the issue.

Internet Gaming Disorder, Internet Addiction, Problematic Internet Use and Compulsive Internet Use cause distress and significant impairment in important areas of a person’s functioning, in particular among young people. The literature has indicated that males show higher levels of problematic internet use than females. People can use the internet to avoid or alleviate negative affects; in fact, problematic internet use is associated with alexithymia and dissociation. Few studies have focused on the different stages of adolescence, gender differences, and the relationships between the aforementioned variables. This research aims to fill this gap. Five hundred and ninety-four adolescents aged between 13 and 19 filled in the Compulsive Internet Use Scale, the Toronto Alexithymia Scale, the Adolescents Dissociative Experiences Scale, and other ad hoc measures. Surprisingly, females reported higher compulsive internet use compared with males. Moreover, they referred more difficulties/symptoms and greater levels of alexithymia than males. No differences across the stages of adolescence were found. Different strengths in the relationships between variables were found according to gender. Moderated mediation analyses indicated that dissociation is an important mediator in the relation between alexithymia and Compulsive Internet Use only among females. This study shed new light on gender differences around problematic internet use and some related risk factors, in order to identify and develop prevention and treatment programs to face this topical and relevant issue.