Confusion in gaming disorder measurement

Despite gaming disorder now being diagnosable by the International Classification of Diseases (ICD-11) as a new mental disorder due to addictive behaviors, little is known about the concrete reasons for which people seek treatment for their videogame play. As the current literature is mainly based on children and adolescents, there is a strong need for better understanding adult treatment-seekers in particular. This preregistered study responds to the gap in research by qualitatively investigating the reasons for treatment-seeking with 110 participants who had sought help for their videogame play from a Finnish treatment program. We applied template analysis to the open-ended data, which consist of the participants’ personal accounts regarding their problems. Additionally, we report the game titles that the participants had problems with, as well as Internet Gaming Disorder Test (IGDT-10) scores, which were measured from 89 participants. The template analysis suggested five themes, which cover the main reasons for treatment-seeking: social reasons, existential reasons, practical reasons, self-perceived addiction, and wish for support. Many of these themes overlap with the ICD-11 description of gaming disorder, but several issues, such as loss of meaning and financial harms, are not part of the current diagnosis. The average IGDT-10 score among participants was 3.86 (SD = 2.55) and 37 (42%) individuals met the disorder cutoff (5.00). Numerous videogames with different designs were mentioned as sources of problems, of which 26 were mentioned more than once. The study indicates that adults seek treatment for many kinds of games and gaming-related problems, including but not limited to those, which are described part of the ICD-11 gaming disorder diagnoses. We recommend both researchers and practitioners to implement an expanded perspective on gaming behaviors, acknowledging that adults may seek treatment for diverse gaming-related problems, some of which not necessarily relevant to gaming disorder or mental disorders in general.

Background: An association between gaming disorder (GD) and the symptoms of common mental disorders is unraveled yet. In this preregistered study, we quantitatively synthesized reliability, convergent and discriminant validity of GD scales to examine association between GD and other constructs. Methods: Five representative GD instruments (GAS-7, AICA, IGDT-10, Lemmens IGD-9, and IGDS9-SF) were chosen based on recommendations by King et al. (2020) to conduct correlation meta-analyses and reliability generalization. A systematic literature search was conducted through Pubmed, Proquest, Embase, and Google Scholar to identify studies that reported information on either reliability or correlation with related variables. 2,124 studies were full-text assessed as of October 2020, and 184 were quantitatively synthesized. Conventional Hedges two-level meta-analytic method was utilized. Results: The result of reliability generalization reported a mean coefficient alpha of 0.86 (95% CI = 0.85 - 0.87) and a mean test-retest estimate of .86 (95% CI = 0.81 – 0.89). Estimated effect sizes of correlation between GD and the variables were as follows: .33 with depression (k = 45; number of effect sizes), .29 with anxiety (k = 37), .30 with aggression (k = 19), -.22 with quality of life (k = 18), .29 with loneliness (k = 18), .56 with internet addiction (k = 20), and .40 with game playtime (k = 53) respectively. The result of moderator analyses, funnel and forest plots, and publication bias analyses were also presented. Discussion and conclusions: All five GD instruments have good internal consistency and test-retest reliability. Relatively few studies reported the test-retest reliability. The result of correlation meta-analysis revealed that GD scores were only moderately associated with game playtime. Common psychological problems such as depression and anxiety were found to have a slightly smaller association with GD than the gaming behavior. GD scores were strongly correlated with internet addiction. Further studies should adopt a rigorous methodological procedure to unravel the bidirectional relationship between GD and other psychopathologies. Limitations: The current study did not include grey literature. The representativeness of the five tools included in the current study could be questioned. High heterogeneity is another limitation of the study.

Background: An association between gaming disorder (GD) and the symptoms of common mental disorders is unraveled yet. In this preregistered study, we quantitatively synthesized reliability, convergent and discriminant validity of GD scales to examine association between GD and other constructs. Methods: Five representative GD instruments (GAS-7, AICA, IGDT-10, Lemmens IGD-9, and IGDS9-SF) were chosen based on recommendations by King et al. (2020) to conduct correlation meta-analyses and reliability generalization. A systematic literature search was conducted through Pubmed, Proquest, Embase, and Google Scholar to identify studies that reported information on either reliability or correlation with related variables. 2,124 studies were full-text assessed as of October 2020, and 184 were quantitatively synthesized. Conventional Hedges two-level meta-analytic method was utilized. Results: The result of reliability generalization reported a mean coefficient alpha of 0.86 (95% CI = 0.85 - 0.87) and a mean test-retest estimate of .86 (95% CI = 0.81 – 0.89). Estimated effect sizes of correlation between GD and the variables were as follows: .33 with depression (k = 45; number of effect sizes), .29 with anxiety (k = 37), .30 with aggression (k = 19), -.22 with quality of life (k = 18), .29 with loneliness (k = 18), .56 with internet addiction (k = 20), and .40 with game playtime (k = 53) respectively. The result of moderator analyses, funnel and forest plots, and publication bias analyses were also presented. Discussion and conclusions: All five GD instruments have good internal consistency and test-retest reliability. Relatively few studies reported the test-retest reliability. The result of correlation meta-analysis revealed that GD scores were only moderately associated with game playtime. Common psychological problems such as depression and anxiety were found to have a slightly smaller association with GD than the gaming behavior. GD scores were strongly correlated with internet addiction. Further studies should adopt a rigorous methodological procedure to unravel the bidirectional relationship between GD and other psychopathologies. Limitations: The current study did not include grey literature. The representativeness of the five tools included in the current study could be questioned. High heterogeneity is another limitation of the study.

Playing computer and video games (so-called gaming) is of great popularity among children and adults. But for some people, gaming gets out of hand and can result in a Gaming Disorder (GD). Among others, high neuroticism and low conscientiousness are considered to play a role in the etiology of GD. Next to personality traits, environmental variables are debated such as the parental influence on children's gaming behavior. In detail, parental gaming behavior could have role model functions for children. Based on empirical observations and theoretical frameworks, it was hypothesized that higher tendencies to GD in children are associated with higher neuroticism, lower conscientiousness, and higher parental tendencies to GD. In an online survey N = 493 parents (n = 472 females; age: M = 36.30, SD = 5.46) rated their own and their children's (n = 233 girls, n = 260 boys; age: M = 6.03, SD = 2.30) tendencies to GD by the Gaming Disorder Test (GDT) and their children's personality by the Big Five Inventory (BFI). Neuroticism was significantly correlated with the GDT scores of boys (rho = 0.256, p = 0.001) and girls (rho = 0.300, p = 0.001), while a significant correlation with conscientiousness was only present for boys (rho = −0.196, p = 0.010). Parents' and children's general playing of computer and video games were interdependent [χ2(1) = 29.14, p < 0.001]; hence, if parents reported to be gamers, their children were more likely gamers as well. The GDT scores of parents and children were positively correlated (boys: rho = 0.36; p = 0.002; girls: rho = 0.33, p = 0.004). The results indicate that already in children the personality traits neuroticism and conscientiousness are associated with tendencies toward GD. Moreover, as gaming of parents and children was related to each other, it is conceivable that parents influence their children's gaming behavior via their own gaming behavior. Therefore, parents should be aware of their exemplary function for children and may overthink their own gaming behavior. But it has to be mentioned that the correlational nature of the present work allows no insights regarding causal relations.

BackgroundAddictive behavior of gambling, gaming and internet activity is partly a new research domain and has not been well investigated with regard to sexual minority populations. Although health disparities between sexual minorities and the general population are well documented, there is a lack of inclusion of sexual minorities in both research and clinic. Among lesbian, gay and bisexual populations certain features could be present that play a role for the development of addictive behaviors, such as social isolation and increased risk of other psychiatric problems. The aim of this study was to investigate problem gambling, problem gaming and problematic internet behavior in a European context and if it is affected by sexual orientation status.MethodsAn online web-survey was distributed among web-panels in England, Poland, Switzerland, Italy, Spain, Denmark, and Sweden in 2017–2018.Result10 983 complete answers were collected. 7.1% of the participants had a sexual minority status (n = 774). Regression models found that there was no difference in gambling, gaming and internet behavior among heterosexual and sexual minority men. Sexual minority women were associated with problematic gambling and gaming behavior, when also controlling for age and nationality. When also controlling for psychological distress, women defining as having another sexual minority status than lesbian and bisexual remained significant for having a problematic gaming behavior (AOR = 2.3).ConclusionAn awareness of female sexual minority perspectives is relevant in facilities treating behavioral addiction as well as in future research in behavioral addiction. More research is needed in problematic gambling and gaming behavior in different sexual minority populations with regard to psychiatric comorbidity and living conditions. An inclusion of sexual minority groups defining as other than gay and bisexual is needed in future research. No significant differences were found between heterosexual and sexual minority men in adjusted analysis in this study.

Background Video games have become a primary source of entertainment for adolescents worldwide due to the widespread integration of digital technology into daily life. Excessive gaming has emerged as a public health concern, as poor control over gaming behavior may lead to negative psychological and behavioral outcomes. This study aimed to assess gaming disorder among adolescents and examine its relationship with callous–unemotional (CU) traits and self-regulation. Adolescents were assessed using the Inventory of Callous–Unemotional Traits (ICU), the Self-Regulation Questionnaire (SRQ), and the Game Addiction Scale for Adolescents (GAD) to measure CU traits, self-regulation capacity, and video game addiction, respectively. Results Video game addiction scores indicated a moderate level of addictive tendencies (59.84 ± 21.17), with salience and relapse being the most prominent dimensions. Participants demonstrated generally adequate self-regulation (207.82 ± 25.11). CU traits were expressed at a moderate level overall (29.09 ± 8.66), with the unemotional dimension showing the highest scores. Significant negative correlations were found between gaming-related withdrawal and conflict with the self-regulation domain of formulating a plan. Total CU traits were positively correlated with all dimensions of video game addiction (r = 0.216 – 0.457, p &lt; 0.01). Conclusions Callous–unemotional traits are significantly associated with video game addiction among adolescents. Regarding self-regulation, only formulating a plan was negatively correlated with conflict and withdrawal dimension of gaming addiction. Regression analysis identified callousness as a significant positive predictor of video game addiction.

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

Background and aimsThe addiction to digital games is associated with substantial impairments in daily functioning and adolescents are particularly at risk. Screening instruments for the new ICD-11 diagnosis Gaming Disorder (GD) are rare and only include self-ratings thus far. Since adolescents' insight might be limited due to young age or symptom denial, external ratings are essential. We therefore aimed to develop and validate the Gaming Disorder Scale for Parents (GADIS-P) in a representative sample of parents and young gamers.MethodsGADIS-P was developed as an adaptation of a recently published self-rating scale. It was validated in 800 parents and their frequently gaming children between 10 and 17 years with standardized questionnaires in an online survey. Item structure was investigated by confirmatory factorial analysis. Gaming time, pathological gaming according to DSM-5, emotional dysregulation, and academic performance were used to derive criterion validity. Accordance with self-ratings was determined. ROC-Analyses were computed to determine cut-off values.ResultsA presumed two-factorial structure of GADIS-P could be confirmed describing cognitive-behavioral symptoms and negative consequences. The instrument showed good to excellent internal consistency (Cronbach's α = 0.89–0.92, McDonald's ω = 0.92–0.95) and criterion validity with moderate to strong correlations regarding gaming behavior (r/ϱ = 0.35–0.76), excellent discriminatory power, and moderate accordance with the adolescents' self-ratings (kappa = 0.47–0.58).Discussion and conclusionsAs the first successfully validated tool for the assessment of ICD-11 GD in adolescents by parental judgment, GADIS-P can make an important contribution to reliable GD screening in clinical and research settings.

Maladaptive daydreaming (MD) is a proposed syndrome characterized by extensive, immersive daydreaming. Case reports have suggested an association of MD with behavioral addictions such as excessive internet use, online gaming, and compulsive sexual behaviors. The aim of this study was to investigate maladaptive daydreaming and behavioral addiction symptoms among young adults. An online questionnaire was administered to 293 volunteer medical students. Participants were assessed by applying the 16-item Maladaptive Daydreaming Scale (MDS-16), Addictive Behavior Burden Form, and Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS). Participants were divided into two groups: probable MD (MDers) and non-MDers, according to MDS-16. Age and gender did not significantly differ between the MD and non-MD groups. MDers had more severe symptoms associated with gaming addiction (p = 0.03; U = 4941), problematic social media use (p = 0.01; U = 4680), food addiction (p = 0.01; U = 4965), sex/pornography addiction (p = 0.01; U = 4787), and compulsive buying (p = 0.03; U = 4874) than non-MDers. Among the behavioral addiction dimensions assessed in the study, only gaming addiction was a significant statistical predictor of MD. These findings highlight a significant association between MD and behavioral addictions, particularly gaming addiction, in young adults. Furthermore, the findings of this study suggest a unique relationship between gaming addiction and MD.

Background:In the extant literature, apart from few published case reports describing patients with severe form of gaming disorder (GD), there is a lack of studies describing the pattern and correlates of GD existing in the Indian settings. Thus, the present study aimed to explore the extent and pattern of gaming behavior in a sample of medical college students from India and explore its association with the sociodemographic, psychological (depressive symptoms), and Internet gaming characteristics.Materials and Methods:This Internet-based cross-sectional study was conducted as an online survey among 306 medical students by the Behavioral Addictions Clinic at a tertiary care teaching college in India. The severity of problematic gaming behavior and depressive symptoms was assessed using the Internet GD Scale-Short Form (IGDS9-SF) and Patient Health Questionnaire-9 (PHQ-9). A semi-structured questionnaire was used to collect information regarding sociodemographic and Internet gaming characteristics of the participants. Statistical analysis was done using SPSS software version 21.0, with two-tailed P < 0.05 taken as significant and P < 0.01 as highly significant results.Results:We identified 173 (55.6%) current gamers, with 11 (3.6%) Internet GD gamers based on the Diagnostic and Statistical Manual of Mental Disorders -5 criteria in the current study sample. A preference for multiplayer online gaming pattern (β =0.17, P = 0.005), spending greater amount of time in playing digital games (β = 0.53, P < 0.01), and higher PHQ-9 scores (β =0.25, P < 0.01**) representing greater depressive symptom severity were associated with statistically significantly greater scores on the IGDS9-SF, indicative of a higher risk for having GD.Conclusions:GD is a cause of concern among medical students in India. There is an urgent need to create awareness about it among students and concerned authorities. Further, there is a need to develop effective screening and treatment strategies suited for our population. The risk factors identified in the current study can be utilized to screen those at high risk of developing the same.

Background and aimsBehavioral addictions such as gambling and gaming disorder are significant public health issues that are of increasing importance to policy makers and health care providers. Problem gambling and gaming behaviors have been identified as being associated with externalizing and internalizing problems, with theoretical models suggesting that both conduct problems and depressive symptoms may be significant risk factors in the development of problem gambling and gaming. As such, the purpose of this systematic review is to provide an overview of research identifying the relationship between conduct problems, depressive symptoms and problem gambling and gaming among adolescents and young adults.MethodsSystematic literature searches in accordance with PRISMA guidelines found 71 eligible studies that met the inclusion criteria, 47 for problem gambling, 23 for problem gaming and one for both problem behaviors.ResultsBased on cross-sectional evidence, both problem gambling and gaming are consistently concurrently associated with conduct problems and depressive symptoms. Longitudinal evidence appears to be clearer for conduct problems as a risk factor for problem gambling, and depressive symptoms as a risk factor for problem gaming. However, both risk factors appear to increase the risk for these problem behaviors.Discussion and ConclusionsResults from the literature review suggest that problem gambling and gaming are associated with the presence of conduct problems and depressive symptoms, with the potential of sharing common etiological factors. Additional research is necessary to confirm these longitudinal relationships with an emphasis on investigating the interaction of both early conduct problems and depressive symptoms.

Background and objectiveExcessive online gaming is becoming a behavior pattern, and it has been recently classified as a medical illness and added to the International Classification of Diseases-11 (ICD-11), termed as "gaming disorder". This condition can be severe enough to result in significant impairment in psychological health. In light of this, we conducted this study to analyze the relationship between problematic online gaming and mental well-being among students of professional colleges in Rishikesh.MethodsA cross-sectional study was conducted among professional college students in Rishikesh on problematic online gaming behavior (POGB). The Problematic Online Gaming Questionnaire-Short Form (POGQ-SF) was used to assess POGB among the participants. The five-item World Health Organization Well-Being Index (WHO-5) and Patient Health Questionnaire-9 (PHQ-9) were used to assess mental well-being and depressive symptoms respectively.ResultsThe prevalence of POGB was 27.4% among our cohort, and its association with mental well-being as well as depressive symptoms was statistically significant. The study participants with poor mental well-being and mild or moderate to moderately severe depressive symptoms had higher odds of developing POGB.ConclusionPOGB has been recently identified as a behavioral addiction and it is often neglected. A significant proportion of the study participants exhibited problematic gaming behavior.

Digital games are widely popular and integral to contemporary entertainment. Nevertheless, a proportion of users present with disordered/excessive gaming behaviours, provisionally classified as Internet Gaming Disorder (IGD). Previous literature suggests examining the contribution of an individual’s profile of immersive engagement with their gaming activity, known as online flow, for disordered gaming behaviours. Therefore, the main goals of this study were (1) to categorise gamers into distinct profiles based on their online flow experiences and (2) to investigate the differences in disordered gaming among these different flow profiles. A sample of 565 gamers (12–68 years, Mage = 29.3 years) was assessed twice over six months with the Online Flow Questionnaire (OFQ), the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), and the Gaming Disorder Test (GDT). Latent profile analysis (LPA) identified five distinct profiles encompassing ’High-Flow with High Loss of Control’ (HF-HLOC; 14.0 %), ’Low Flow with Low Enjoyment’ (LF-LE; 11.9 %), ’Average Flow with Low Enjoyment’ (AF-LE; 17.5 %), ’Low Flow with High Enjoyment’ (LF-HE; 20.2 %), and ’High Loss of Sense of Time with Low Loss of Control’ groups (HLOT-LLOC; 36.5 %). As hypothesised, individuals across varying profiles evidenced differences in their concurrent and longitudinal disordered gaming behaviours. Overall, findings suggest that ’loss of sense of time’ may be the most pivotal factor in differentiating flow states and profiles during gaming, advocating its consideration in disordered gaming assessment and treatment.

Objective:To determine whether psychiatric and gaming pattern variables are associated with gaming disorder in a school-based sample.Methods:We analyzed data from the Brazilian High-Risk Cohort for Psychiatric Disorders, a community sample aged 10 to 18, using questionnaires on gaming use patterns. We applied the Gaming Addiction Scale to diagnose gaming disorder and the Development and Well-Being Behavior Assessment for other diagnoses.Results:Out of 407 subjects, 83 (20.4%) fulfilled the criteria for gaming disorder. More role-playing game players were diagnosed with gaming disorder that any other genre. Gaming disorder rates increased proportionally to the number of genres played. Playing online, being diagnosed with a mental disorder, and more hours of non-stop gaming were associated with higher rates of gaming disorder. When all variables (including age and gender) were considered in a logistic regression model, the number of genres played, the number of non-stop hours, the proportion of online games, and having a diagnosed mental disorder emerged as significant predictors of gaming disorder.Conclusion:Each variable seems to add further risk of gaming disorder among children and adolescents. Monitoring the length of gaming sessions, the number and type of genres played, time spent gaming online, and behavior changes may help parents or guardians identify unhealthy patterns of gaming behavior.

Online video gaming is a popular activity among people of all ages. For some, however, gaming can become problematic. While evidence exists for the effectiveness of cognitive behavioural therapy for gaming disorder (GD), a major challenge is that adolescents and young adults, particularly males, are often reluctant to seek help and engage long term with a mental health practitioner. This report presents a case involving brief parent‐delivered contingency management for a 19‐year‐old male with GD who refused to engage with treatment services following a significant decline in functioning and a high‐lethality suicide attempt. This approach led to a substantial reduction in gaming time, as well as related gains in self‐care and independence. This case highlights the value and feasibility of developing a therapeutic alliance with a parent to manage excessive gaming behaviours among treatment‐refusing individuals with GD. Practical challenges and associated lessons from managing this case are discussed. Practitioner points Brief parent‐delivered contingency management was implemented for a 19‐year‐old treatment‐refusing male with GD. This approach led to a substantial reduction in the young man's gaming time as well as related gains in areas of self‐care and independence at 6‐month follow‐up. This case highlights the value and feasibility of developing a therapeutic alliance with a parent to manage excessive gaming behaviours among treatment‐refusing individuals with GD.