No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Craving for internet games? Withdrawal symptoms from an 84-h abstinence from Massively Multiplayer Online Gaming.
Abstract
This qualitative study examined the psychological consequences of an 84-hour Internet gaming abstinence period for young adults with and without Internet gaming disorder. Using a repeated-measures online survey methodology, participants were asked to abstain and then describe their craving for Internet games, including any coping strategies used to manage craving, and to reflect on the positive and negative aspects of gaming abstinence. A total of 155 written responses were gathered from 24 participants (Mage=24.6 years, SD=5.8), including 9 who met the criteria for Internet gaming disorder, recruited from online gaming communities. Participants completed a series of seven online surveys containing open ended questions before, during, and after abstaining from Massively Multiplayer Online games. The results revealed several key themes, including: (1) internal and external cues that elicit craving for Internet games; (2) beliefs and assumptions about Internet gaming experiences; (3) negative affect related to abstinence; (4) coping strategies for managing craving; (5) beneficial outcomes in behavioral and cognitive domains, including adjustments to gaming-specific activities; and (6) negative outcomes such as unwanted emotional and cognitive states, and social isolation. Participants' reactions to gaming abstinence could be broadly characterized as boredom and a drive for mental stimulation, which seemed somewhat inconsistent with the DSM-5 criterion of withdrawal. These data provide new insights to guide clinical conceptualization and interventions for problematic patterns of Internet gaming behavior.
... Researchers have commonly defined withdrawal by referencing the official definition of the DSM-V (APA, 2013). Withdrawal and its associated symptoms are described as feelings of irritability, anxiety, or sadness that emerge after cessation of gaming (Karhulahti et al., 2023;Ryu et al., 2019;King et al., 2018;Yen et al., 2022;King et al., 2016;Ko et al., 2020). Some researchers have provided additional descriptions. ...
... Yen et al. (2022) added that withdrawal symptoms encompass unpleasant feeling states and may involve physical effects after gaming cessation (Griffiths et al., 2010). and King et al. (2016) defined withdrawal as a dysphoric state resulting from withdrawal from an addictive behaviour or substance, potentially leading to irritability and aggressive behaviour (Grant et al., 2010;Müller et al., 2015). ...
... The most frequently utilized scales for withdrawal symptoms were the Depression, Anxiety, Stress Scale (DASS-21) (Lovibond & Lovibond, 1995) and the Positive and Negative Affect Schedule (PANAS) (Watson et al., 1988). For craving, open-ended questions proposed by the study authors were most commonly employed (Evans et al., 2018;King et al., 2016;King et al., 2017;Lee et al., 2017). Additionally, the 10-item Gaming Urge Questionnaire, modified from a smoking urge questionnaire (Cox et al., 2001), was also utilized. ...
INTRODUCTION: This systematic review aims to synthesize and summarize the available evidence on the definitions of craving and withdrawal, the nature and presence of withdrawal symptoms, the duration of abstinence, the prevalence and nature of craving. RESULTS: A total of 29 studies met the inclusion criteria. Inconsistencies were revealed in definitions of craving and abstinence, as well as in the specific withdrawal symptoms that might be present among players. Furthermore, there is a predominance of exploration of affective symptoms compared to cognitive and physical symptoms. Mini meta-analyses indicate a significant difference in depression, anxiety, and craving between players with Internet Gaming Disorder (IGD) and regular players. Most studies typically used short-term abstinence, during which participants refrain from specific behaviours for periods ranging from a few days. A majority of studies did not provide information on the occurrence of craving. CONCLUSIONS: Emphasizing craving reduction may alleviate gaming-related withdrawal severity. Longitudinal and qualitative research is essential for understanding craving and withdrawal phenomenology. Bridging the empirical-clinical gap in gaming disorder requires interdisciplinary studies. Investigating prevalent withdrawal symptoms aids in comprehensive research and refined treatments. Prioritizing craving assessment before, during, and after abstinence is crucial.
... This could potentially hinder the understanding of the structure and characteristics of the disorder (Cornil et al., 2018). In fact, one of the few qualitative studies examining craving in behavioral addictions, conducted by King et al. (2016) and focusing on video games, found that during an 84-hour period, withdrawal symptoms manifested as boredom and a desire for mental engagement. These results do not align with the components model of addiction, which suggests that symptoms such as "extreme moodiness and irritability", along with other physiological symptoms (e.g., nausea, sweats), should be reported. ...
... Furthermore, it is important to highlight that the withdrawal phenomenon observed shares more similarities with internet gaming disorder than with withdrawal experiences associated with substance abuse or gambling disorder (Blaszczynski et al., 2008;Griffiths, 2005;Fernandez et al., 2020). Essentially, individuals engaged in both video games and SNs commonly report feelings of boredom (King et al., 2016). When access to specific SNs is restricted, they tend to engage in compensatory activities (Castro-Calvo et al., 2018;King et al., 2016). ...
... Essentially, individuals engaged in both video games and SNs commonly report feelings of boredom (King et al., 2016). When access to specific SNs is restricted, they tend to engage in compensatory activities (Castro-Calvo et al., 2018;King et al., 2016). Additionally, participants report feeling increased pressure to use SNs (Fernandez et al., 2020). ...
Social networks (SNs) are immensely popular, especially among teenagers, yet our understanding of problematic SNs remains limited. Understanding motivations and patterns of use is crucial given the current prevalence of problematic SNs use. Perarles et al. (2020) distinguish two behavioral control modes: Model-Free Control, where actions are characterized by actions driven by immediate gratification without reflective consideration for long-term consequences, and Model-Based Control, enabling planned and goal-directed actions. Both control modes can lead to problematic social network use. This study aims to delve into problematic SNs use and the underlying motives behind adolescents' participation in SNs, drawing upon the theoretical proposal by Perales et al. (2020). We conducted four focus groups with adolescents aged 13-17 (50 % female; M age = 14.5, SD = 1.75), comprising two public school and two Catholic private school groups. Thematic analysis using Atlas.ti software revealed three themes. The first uncovers characteristics of problematic SNs use, including withdrawal, increased usage time, impaired control, behavioral salience and attentional capture and cognitive hijacking. The second spotlights motives, emphasizing emotional regulation, finding out what is going on, and social interaction. The third theme explores consequences such as compromised academic performance and physical harm. In conclusion, addressing both motives and problematic behaviors present a more effective approach to confronting SNs use challenges and fostering healthier online experiences for adolescents.
... There are some reports of the addiction before the early 2000s, but with the turn of the century came games that required individuals to spend more time playing the game in order to beat it (Argles et al., 2015). Gaming companies also began developing games that had no end, and players could continue to add to their own individual worlds without ever meeting an end (King et al., 2016). ...
... Kaye and Pennington (2016) theorized that this is due to toxic masculinity and the need for certain individuals to feel powerful over others, as well as how online communities centered around women are more supportive than men. King et al. (2016) focused on gaming addiction and how online gamers attempt to handle it. King et al. (2016) found that most players can identify ___ 25 when they have an addiction to gaming, as they state it starts to affect other areas of their lives. ...
... King et al. (2016) focused on gaming addiction and how online gamers attempt to handle it. King et al. (2016) found that most players can identify ___ 25 when they have an addiction to gaming, as they state it starts to affect other areas of their lives. Kowert et al. (2015) explored the consequences that online gaming can have on an individual's mental health and discovered both positive and negative effects. ...
Online gaming can have multiple effects on an individual’s life and this topic has been a frequent
topic of discussion in academia. Since the late 1990s, blame began being placed towards gaming
violence for driving criminal activity, especially mass murder. The media has been a major cause of
this discussion and, as a result, many research studies have been conducted in order to explain why
some individuals have become violent or anti-social after gaming. Despite the wealth of information
available, there have been conflicting results regarding the influence of gaming on people and few
researchers are in agreement regarding the influence on the mental health of players.
The role of the present study is to increase the literature regarding the personal perspectives and
experiences of individuals that engage in gaming. It considered the frequency of gaming per week,
the number of years of gaming, and different ways it affects their life and relationships with others.
Other information considered is feelings experienced while engaging in game play. The whole of
this information will lead to an examination of the feelings of the gamer about how gaming has
impacted their personal and social development. The present study is beneficial because it can
drive future studies in assessing whether or not gaming is beneficial as a positive outlet for
individuals.
*****************************************
Online gaming har mange forskjellige effekter på en persons liv, og tematikken har vært et hyppig
diskusjonstema i akademia. Siden slutten av 1990-tallet har online gaming fått skylden for å
promotere kriminell aktivitet og spesielt massemord. Mediene har vært en viktig årsak til denne
debatten, og som et resultat har mange forskningsstudier blitt gjennomført for å forklare hvorfor
noen individer har blitt voldelige, eller antisosiale grunnet online gaming. Til tross for en enorm
mengde tilgjengelig informasjon, har det vært motstridende forskningsresultater om hvordan online
gaming påvirker mennesker, og få forskere er enige om hvordan online gaming har innflytelse på
menneskers helse.
Målet med studiet er å gi økt innsikt om personlige perspektiver og enkeltpersoners erfaringer fra
online gaming. Det er undersøkt hvordan frekvensen av spill per uke, antall år med spill, og hvordan
det påvirker spillernes liv og relasjoner med andre. Det er også studert hvordan online gaming
påvirker spillernes personlige utvikling. Resultatet av studiet gir innsikt i hvordan online gaming har
påvirket spillernes personlige og sosiale utvikling. Studiet er nyttig da det kan motivere til fremtidig
forskning om hvorvidt online gaming gir spillerne positive effekter i spillernes liv.
... Internet Gaming Disorder Scale-Short Form 9 (IGDS-SF-9) [86] 8 [14,30,47,49,58,71,77,78] 9-item self-report ...
... In a study investigating the craving and withdrawal symptoms of adults meeting the diagnostic criteria for GD, Kaptsis and colleagues [47] reported that although these individuals experienced negative affect and psychological distress when abstaining from gaming, these symptoms largely declined within the first 24 h of abstinence. Elaborating on this study, King and colleagues [49] conducted a qualitative longitudinal follow-up 7 and 28 days following the cessation of gaming and identified various factors that maintained GD among these participants. These factors included internal and external cues, beliefs and assumptions regarding gaming, abstinence-related negative affect, and poor coping strategies. ...
... Moreover, results indicate that commonly reported psychological risk factors for GD among youth include emotional dysregulation [35,41,57,79], attention problems [43,70,77], and negative self-esteem [35,55,77], with some evidence for under-stimulation/boredom [35], aggression [52], autistic traits [27], anhedonia [43], and depression [30,36]. Moreover, commonly reported social risk factors include a negative parent-child relationship [34,57], poor social competencies [41,55,57], and loneliness [49,50,62]. The above-noted psychological risk factors are consistent with the internal factors considered in Paulus and colleagues' [13] integrated model and the predisposing variables of the I-PACE model [25,26]. ...
---- Full text view-only version of paper: https://rdcu.be/b8QXP ----
Purpose of review: Gaming disorder is a mental disorder characterized by impaired control over gaming behaviors resulting in the escalation of gaming despite significant negative consequences and functional impairments. This scoping review aims to synthesize empirical evidence for the development of gaming disorder based solely on extant findings from longitudinal studies. Recent findings: Although research efforts investigating gaming disorder are expanding, there is a need to conceptualize this disorder from a developmental framework in order to identify trajectories of this disorder across the lifespan while accounting for both risk factors and consequences of GD. Summary: The scoping review identified 57 research papers identifying antecedents (n = 33), consequences (n = 24), and variables having reciprocal relationships with GD (n = 9). The temporal stability of GD differed based on age and study duration, ranging from 20 to 84%. Commonly reported risk factors for GD include emotion dysregulation and negative self-esteem, with depressive symptoms, inattentive symptoms, and social isolation being reciprocally associated with GD. Consequences of GD include increases in anxiety and poor parental relationships and decreases in life satisfaction and academic performance. Overall, various psychosocial factors interact to influence the development of GD across the lifespan, while certain consequences may maintain GD symptomatology.
... Four of the seven gaming studies used a similar 84-h self-restraint protocol (Evans, King, & Delfabbro, 2018;King, Kaptsis, Delfabbro, & Gradisar, 2017), the findings of which have important implications for understanding the nature and trajectory of gaming withdrawal, and short-term abstinence as a potential clinical intervention. It should be noted that three of these studies (i.e., Kaptsis et al., 2016;King et al., 2016;King et al., 2017) used the same sample. In one sample , the nature of qualitatively reported withdrawal symptoms (i.e., craving, boredom, and drive for mental stimulation) were inconsistent with DSM-5 conceptualizations of withdrawal (i.e., sadness, irritability, anxiety). ...
... The finding that withdrawal symptoms declined in the control group as well is somewhat counterintuitive, and was attributed to either self-monitoring playing a role, or defensive responding (Evans et al., 2018). Importantly, positive abstinence effects were reported across both samples, including an increase in attitudinal shifts towards gaming, positive behavioral changes to gaming post-abstinence and free time for other activities (Evans et al., 2018;King et al., 2016), along with a decrease in maladaptive gaming cognitions and IGD symptoms (King et al., 2017). Notably, two of these gaming studies (Evans et al., 2018;King et al., 2017) were the only studies in the present review to directly investigate the possibility of using short-term abstinence as an intervention for a problematic behavior (i.e., gaming). ...
... Or, negative emotional reactions might be expected to result from not being able to engage in a valued healthy activity (e.g., exercise; Szabo, 1995). It could also be that an over-reliance on a single behavior (e.g., gaming or social media use) to achieve a specific mood-modifying function (e.g., entertainment) could naturally result in boredom during abstinence (e.g., King et al., 2016;Stieger & Lewetz, 2018). In short, the presence of withdrawal-like symptoms during abstinence may indicate that there is some level of dependency on the behavior, but this does not automatically mean that the dependency is pathological or indicative of an underlying addiction. ...
Observing short-term abstinence effects across potential behavioral addictions is vital for informing understanding about how addiction-related symptoms (withdrawal, craving and relapse) might manifest across these behaviors. Short-term abstinence may also have potential as a clinical intervention for behavioral addictions. This review aimed to synthesize existing research evidence on short-term abstinence effects across potential behavioral addictions in light of (1) manifestations of withdrawal, craving and relapse, and (2) benefits or counterproductive consequences of abstinence. We reviewed 47 prospective studies examining effects of short-term abstinence across six potential behavioral addictions (exercise, gambling, gaming, mobile phone use, pornography use, social media use). Findings of the review showed that there is a paucity of prospective studies investigating abstinence effects in relation to potential behavioral addictions, except for exercise. Across all behaviors, exercise demonstrated the clearest pattern of withdrawal-related symptoms mainly related to mood disturbances. While withdrawal and craving were investigated to a fair extent across the studies, the study of relapse using abstinence protocols is underutilized within behavioral addiction research. Short-term abstinence shows promise as an intervention for some problematic behaviors, especially gaming, pornography use, mobile phone use, and social media use. However, potential counterproductive consequences of abstinence (e.g., rebound effects and compensatory behaviors) were not adequately assessed by the studies, which limits current evaluation of the utility of abstinence as an intervention.
... In all cases, craving is understood as intense desire but, as discussed in Muela et al. (2022), intense desire could merely reflect the anticipation of some strong reward, whereas a more restricted definition of craving requires that urge to be overwhelming, to be perceived as intrusive, and to jeopardize control attempts. Actually, the scarce research available (e.g., D. L. King et al., 2016) suggests that craving for video games could show some non-trivial differences with craving in bona fide addictive disorders. ...
... extremely strong effect of craving (measured with only 3, nonoverlapping items) on IGD symptoms' endorsement. This finding seems to imply that craving is the main driver of problematic video gaming, and supports the recent proposal that craving is a central feature for the development and recognition of IGD (Antons et al., 2020;Brand et al., 2019;D. L. King et al., 2016;Saunders et al., 2017). Nevertheless, although craving appears to be a central process in the etiology of IGD, more research is needed to clarify whether craving remains an identical construct across different behavioral domains. This is because, despite evidence of parallelisms between different addictive behaviors, there are also diffe ...
The role of negative and positive urgency in the relationship between craving and symptoms of problematic video game use. Abstract Craving and emotion-driven impulsivity dimensions (positive and negative urgency) have been suggested as factors involved in the progression of different potentially problematic behaviors. However, their role in severity of video gaming-related problems remains unclear. This study aims to assess the differential capacity of negative and positive urgency to predict craving and the number of internet gaming disorder (IGD) symptoms endorsed (as a proxy to severity of video gaming problems) in majoritarily non-pathological video-gamers. Convenience sampling was used to recruit 232 Spanish and 222 Ecuadorian frequent video game players. Mixed-effects generalized linear (GMLE) and mediation modeling were used to test moderation and mediation hypotheses regarding the association between urgency, craving, and endorsement of IGD symptoms. Results show that (1) craving largely overlaps with endorsement of IGD symptoms; (2) craving for video games is linked to positive urgency, but not to negative urgency, which reinforces the idea that craving, at least in mostly non-pathological gamers, is a positively valenced expectancy state; (3) positive urgency exerts an indirect effect (mediated by craving) on the number of symptoms endorsed; (4) negative urgency exerts a direct effect on the number of symptoms endorsed; and (5) urgency traits do not interact with craving to predict the number of symptoms. These findings are consistent with the proposal that craving is an emotional state, and that dysregulation of positive affect (as measured by positive urgency) influences its emergence and control. In addition, they support the idea that craving is a central feature in the emergence of IGD symptoms.
... Those unpleasant feelings are commonly related to rising feelings of anxiety, moodiness, sadness, and irritability following abstinence . In a qualitative study, King et al. (2016) studied which withdrawal effects normally feel the disordered gamers in abstinence. The results showed that the GD symptoms as assessed under the APA framework were not the ones clearest reported by the participants, being boredom and a drive for mental stimulation two of the most withdrawal reported symptoms. ...
... At the itemlevel of each scale, the items related to 'withdrawal' (IGDS9-SF) and 'experience of significant problems in life' (GDT) were the ones that better discriminated between high and low levels of GD symptoms. As explained previously (pages 105-106) in the study conducted by King et al (2016), 'withdrawal symptoms' (as referred to in the IGDS9-SF) ...
In recent decades, video games have become a popular form of entertainment; so much so, that elite video gamers can be paid in a professional capacity. As such, the scientific community has shown interest in studying the short- and long-term consequences of playing video games, finding both positive (e.g., increasing time reaction) and negative effects.
One of the most studied negative effects of video gaming is Gaming Disorder (GD) or disordered gaming. The American Psychiatric Association (APA) defined GD in the 5th version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; APA, 2013), with the World Health Organization’s 11th revision of the International Classification of Disease (ICD-11;WHO, 2019) following soon after. Each official body classifies GD as “a persistent and current use of the internet to engage in games, often with other players, leading to clinically significant impairment or distress” (APA, 2013; WHO, 2019).
Within the mental health field it is necessary to have reliable and valid tools to detect the presence or absence of disordered behaviour and also to observe said behaviours progress. For this reason, the main objective of the present dissertation is to adapt and validate two globally used scales, in order to obtain information about the psychometric characteristics of each scale and increase the knowledge about these tools in different cultural contexts.
The tools under examination are the Internet Gaming Disorder Scale Short-Form (IGDS9-SF; Pontes & Griffiths, 2015) and the Gaming Disorder Test (GDT; Pontes et al., 2021). Each scale was originally created and validated in English, and also adapted in several other languages. However, to date there has been limited adaption and validation of the IGDS9-SF in the Spanish language, and no adaptation or validation of the GDT in the Spanish language. Thus, the main aim of the present thesis is to address this crucial gap in the field.
Four studies will be presented to achieve this objective. The first two studies will aim to adapt each of the scales into Spanish, and then evaluate the reliability and validity
2
using Classical Test Theory (CTT) and Item Response Theory (IRT). In addition, the measurement invariance in terms of gender will also be explored.
The third study will analyse the properties of each scale using the Mokken scale Analysis (MSA) to observe which items are more difficult and which items more discriminative, taking into account the different diagnostic and evaluation processes. Finally, the fourth study will investigate the measurement invariance of both scales, in order to observe if there are any differences in terms of professional and non-professional gamers.
The results of the four studies suggests that both the IGDS9-SF and the GDT are valid and reliable measures when assessing GD in the European Spanish population. In addition, it is also possible to know which items are more informative, more difficult and more discriminative. There was also a result regarding the non-differences in the evaluation of the GD across professionals and non-professionals.
In conclusion, the present doctoral dissertation highlights the effectiveness of the IGDS9-SF and the GDT measures to assess GD in European Spanish population and provides guidelines to consider during the diagnostic and prognostic process.
... Some substance use disorder (SUD) symptoms such as loss of control, gaming to escape negative moods, involvement despite negative consequences, and giving up activities are common in IGD and GD Wichstrøm et al., 2019). Other SUD symptoms, like craving, tolerance, and withdrawal have also been observed, but they do not reliably differentiate normal and dysfunctional video game play (King et al., 2016(King et al., , 2017Petry et al., 2015). For these and other reasons discussed below, the status of problematic gaming (PG; which we use throughout this paper to refer to GD and IGD) as an addictive disorder is controversial. ...
... In fact, despite over a decade of research on PG, IGD remains in Section III (conditions for further study) of the recently released technical revision to the DSM-5 (American Psychiatric Association, 2022). Some symptoms of addictive disorders, like loss of control and giving up activities, are reliable indicators of PG; other symptoms such as tolerance, craving, and withdrawal are not (King et al., 2016(King et al., , 2017Petry et al., 2015). Researchers have speculated that PG may not be a unique mental health disorder because it exhibits poor diagnostic stability and high rates of spontaneous remission and is rarely observed in the absence of depression, social anxiety, or other psychological problems (Society for Media Psychology and Technology and Special Interest Group in the Media, the Arts and Cyberpsychology, 2018). ...
Gaming Disorder was recently included in the 11th Edition of the International Classification of Diseases and Internet Gaming Disorder may be introduced in the sixth edition of The Diagnostic and Statistical Manual. Much is not understood about how problems with video games develop. This qualitative study aimed to better understand the development of problematic gaming through focus groups. Eleven young adult “frequent gamers,” twelve young adult “non-frequent or non-gamers,” and five older adult “non-gamers” discussed vulnerabilities and risk factors of problematic gaming. Participants across all groups believed that problematic gaming developed when people used video games as a primary means of meeting basic psychological needs that were unsatisfied, thwarted, or blocked outside of video games. Frequent and non-frequent gamers, compared to older adult non-gamers, were more likely to view video games as a healthy way to meet basic psychological needs and less likely to stereotype gamers. Video games are equipped to meet basic psychological needs for autonomy, competence, and relatedness. That is, gamers often experience a sense of agency, skill, and connection to others when playing video games. However, problematic gaming may develop when people with unmet psychological needs rely exclusively on video games to meet them. Treatment and prevention approaches to problematic gaming can benefit from greater attention to helping at risk individuals meet needs for autonomy, competence, and relatedness outside of video games.
... with some studies announcing another 16.2% at a high risk of developing IGD. [42,64] The prevalence of IGD from the study by Zahra et al was 10.0%. According to Zahra, IGD was signi cantly higher in male participants (t = 2.94, p = 0.004) and individuals with prolonged gaming duration (p < 0.001). ...
... According to Zahra, IGD was signi cantly higher in male participants (t = 2.94, p = 0.004) and individuals with prolonged gaming duration (p < 0.001). [42] Tang et al concluded from their study the existence of signi cant odds of depression among students addicted to online gaming (OR = 1.398, 95% CI = 1.008-1.932, p = .045). ...
Introduction: Online gaming addiction has alarmingly emerged as a behavioral problem that is associated with serious implications ranging from psychosomatic issues to suicidal and homicidal tendencies. Psychological distress is among the list of its adverse effects, which is entirely treatable. Reasons and psychological distress due to online gaming addiction can be tackled if considered from a public health aspect.
Materials and Methods: An analytical cross-sectional approach was employed using a proportionate randomized sampling technique to recruit 317 participants from 6 sister institutes affiliated with Khyber Medical University (KMU), Peshawar over a period of 6 months from May 2021 to November 2021. Information pertaining to the objectives was collected using two pre-tested validated questionnaires; the Compulsive Internet Gaming Use Scale (CIUS) and Internet Gaming Disorder Test (IGDT – 10). Analysis of the data was made with SPSS version 26.0 and presented as tables, graphs, and figures.
Results: This study found psychological distress from internet gaming disorder (IGD) in 7.6% of the study pool with a mean age of 21.08 ± 1.17 years with 68.1% males and 31.9% females. Among the study participants, 17.0% were married, 79.8% were financially dependent, 9.1% showed a history of substance abuse, and 63.4% kept outdoor hobbies. The mean duration of gaming among those screened positive with IGD was 54.58 ± 14.01 hours per week, the mean CIUS score was 28.42 ± 3.78, mean IGDT score was 2.18 ± 1.09. 18.0% of participants had online gaming addiction while 42.11% showed psychological distress from online gaming addiction. A strongly positive correlation was established between psychological distress and online gaming addiction (r = 0.955, p < 0.001).
Conclusions: This study concluded a strong positive association between psychological distress in undergraduate health sciences students and their online gaming addiction. Owing to these findings, relevant changes to the existing policy on the online gaming industry in Pakistan is recommended.
... Consistent with conceptualizations discussed previously, for the current study, we defined withdrawal with regards to sexual activity as a set of adverse cognitive, emotional and/or physiological changes that occur as a direct result of abstaining from or limiting engagement in a previously habitual form of sexual behavior, occurring as a result of psycho-and physiological dependence on this activity. Tolerance with regards to sexual activity is defined as decreasing sensitivity to sexual behavior and stimuli over time, resulting in a need to engage in more stimulating/ intensive forms of the behavior or increasing the frequency of the behavior, to achieve the same level of stimulation (for related definitions, see, e.g., Bőthe et al., 2018;Kaptsis et al., 2016;King et al., 2016King et al., , 2017). In the current study, we sought to collect information on specific characteristics of withdrawal and tolerance facets, including their frequency and strength in individuals with and without CSBD and PPU. ...
... Sexual behavior withdrawal symptoms were assessed by our own, newly created inventory of possible withdrawal symptoms, based on measures previously used to assess withdrawal syndrome in other behavioral addictions, and the literature review. To create the questionnaire, we also aggregated withdrawal symptom types reported in previous studies for behavioral addictions (Blaszczynski et al., 2008;Griffiths & Smeaton, 2002;Kaptsis et al., 2016;King et al., 2016;Lee et al., 2020;Rosenthal & Lesieur, 1992), included withdrawal symptoms reported by individuals with self-reported sex addiction (Wines, 1997) and removed duplicates or highly related items. The resulting questionnaire (α 5 0.94) is a broad measure consisting of 21 possible withdrawal symptom types and includes assessment of a possible withdrawal syndrome in the cognitive, emotional, and physical domains (sample items corresponding to specific withdrawal symptoms include "More frequent sexual thoughts which are difficult to stop", "Irritability" or "Frequent mood changes"). ...
Background
The addiction model of compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU) predicts the presence of withdrawal symptoms and increased tolerance for sexual stimuli in the disorder phenotype. However, clear empirical evidence supporting this claim has largely been lacking.
Methods
In the preregistered, nationally representative survey ( n = 1,541, 51.2% women, age: M = 42.99, SD = 14.38), we investigated the role of self-reported withdrawal symptoms and tolerance with respect to CSBD and PPU severity.
Results
Both withdrawal and tolerance were significantly associated with the severities of CSBD ( β = 0.34; P < 0.001 and β = 0.38; P < 0.001, respectively) and PPU ( β = 0.24; P < 0.001 and β = 0.27; P < 0.001, respectively). Of the 21 withdrawal symptom types investigated, the most often reported symptoms were frequent sexual thoughts that were difficult to stop (for participants with CSBD: 65.2% and with PPU: 43.3%), increased overall arousal (37.9%; 29.2%), difficult to control level of sexual desire (57.6%; 31.0%), irritability (37.9%; 25.4%), frequent mood changes (33.3%; 22.6%), and sleep problems (36.4%; 24.5%).
Conclusions
Changes related to mood and general arousal noted in the current study were similar to the cluster of symptoms in a withdrawal syndrome proposed for gambling disorder and internet gaming disorder in DSM-5. The study provides preliminary evidence on an understudied topic, and present findings can have significant implications for understanding the etiology and classification of CSBD and PPU. Simultaneously, drawing conclusions about clinical importance, diagnostic utility and detailed characteristics of withdrawal symptoms and tolerance as a part of CSBD and PPU, as well as other behavioral addictions, requires further research efforts.
... Albeit being inspired by the traditional "pen and paper" role-playing games, levelling, which is a fundamental mechanism in computer games, has been found to be impactful on the interaction design of a computer game [22]. Differences in levels may be sufficient to reduce the cohesion of the guild and can become a substantial "churn rate" factor between the members. ...
... According to [31], the described psychological state of an addict is called "dependency". King et al. [22], in their study, provided an example of how aggressive and frustrated an addict could be when asked to avoid playing computer games. They reported that players who were unable to play computer games might suffer from extreme emotions including irritability, nervousness, or depression. ...
The advancement of technology has enabled powerful microprocessors to render high-quality graphics for computer gaming. Despite being intended for leisure purposes, several components of the games alongside the gamer’s environmental factors have resulted in digital addiction (DA) towards computer games such as massively multiplayer online games (MMOG). Excessive gaming among adolescents has various negative impacts on an individual. However, only a few researchers have addressed the impact of DA on physical health. Thus, the primary objective of this research is to study the impact of DA on physical health among Malaysian adolescents. This study focuses on Malaysian adolescents of ages 12–18 years old who are addicted to computer games, specifically the MMOG. The methodology used for the study involves focus group discussions (FGD) and extensive literature study. The FGD sessions have involved both medical experts and game experts. The outcome of FGD discussion is recorded and justified with the existing relevant literature from high-impact journals, theses, conferences, books, and reports. This paper provides evidence of five physical health impacts of DA associated with adolescents. The factors of DA, the addiction components existing in MMOG computer games, and the DA health risk assessment are presented in the results section. Based on the study, it is concluded that DA among Malaysian adolescents can cause various impacts on physical health such as obesity, back pain, and neck pain, orthopaedic/joint muscle, eyesight problem, hearing problem, as well as physical inactivity.
... Existing empirical evidence has thus far highlighted the commonality between the neural mechanisms underlying substance use disorder and IGD (e.g., Fauth-Bühler & Mann, 2017), PSU (e.g., Horvath et al., 2020) and PSNSU (e.g., Aydın, Obu ca, et al., 2020;Lee et al., 2021). In keeping with these results, craving symptoms have been reported among IGD subjects (e.g., King et al., 2016), social media users (e.g., Stieger & Lewetz, 2018) and smartphone users (e.g., Wilcockson et al., 2019) under abstinence conditions. Withdrawal effects across technological addictions have also been highlighted through various experimental studies (see, for a review, Fernandez et al., 2020). ...
... Furthermore, no research has examined metacognitions about craving in the present field, although levels of craving appear to increase following smartphone and social media abstinence (e.g., Stieger & Lewetz, 2018;Wilcockson et al., 2019) and adults with IGD report boredom and the need for stimulation as consequences of an 84-h Internet gaming abstinence (King et al., 2016). As previous research on smoking cessation has shown that people who tend to have a negative appraisal of their craving-related thoughts present a greater risk of relapse after cessation (Nosen & Woody, 2014), it might be useful for future research to focus its attention on metacognitions about craving for Internet, social media, online games and smartphone use. ...
Background
The use of new technologies is growing, and some authors have suggested that frequent use might hide a non‐chemical addiction (i.e., technological addiction). Over the last five years several studies investigating the role of metacognitions in technological addictions have been published. We aim to provide the first systematic review focused on this topic, by updating the initial evidence highlighted by a previous systematic review on metacognitions across addictive behaviors (Hamonniere & Varescon, 2018).
Methods
Electronic literature databases (Pubmed, PsychINFO, SCOPUS, and Web of Science) were searched to identify studies that examined the relationship between metacognitions and four different technological addictions (Internet Gaming Disorder, IGD; problematic Internet use, PIU; problematic smartphone use, PSU; and problematic social networking sites use, PSNSU).
Results
We found 13 empirical studies published between 2018 and 2021. Positive low‐to‐moderate cross‐sectional associations between the four technological addictions and both generic and specific metacognitions were found, in accordance with the metacognitive model of addictive behaviors. Positive beliefs about worry, negative beliefs about thoughts concerning uncontrollability and danger, beliefs about the need to control thoughts, and a lack of cognitive confidence were associated with IGD, PIU, PSU, and PSNSU.
Conclusions
The absence of longitudinal studies prevent us from providing definitive answers about the role of metacognitions in technological addictions. Despite this limitation, interventions that target metacognitions could be beneficial for people presenting with technological addictions.
... More specifically, AI can aid to transform big data into useful information and required knowledge required for companies to develop correct marketing and decision-making for sales strategies [5][6][7]. Therefore, the companies expect AI can help in customization, user personalization, addiction [13], time distortion [14], menticide [15,16], and cheating behaviors in online gaming communities [17,18]. Nevertheless, antecedent research has rarely taken the positive effects of the online game into consideration [19]; therefore, this study will adopt the perspective of online game players' consumer engagement behavior. ...
... Sustainability 2020, 12, x FOR PEER REVIEW 3 of 20 [10][11][12], whereas another research path focused on the negative effects of online game, such as game addiction [13], time distortion [14], menticide [15,16], and cheating behaviors in online gaming communities [17,18]. Nevertheless, antecedent research has rarely taken the positive effects of the online game into consideration [19]; therefore, this study will adopt the perspective of online game players' consumer engagement behavior. ...
With the development and proliferation of online games, understanding how to seize these players has become an essential issue for academic scholars and practitioners. Based on virtual experience in online gaming communities and consumer engagement perspectives, this research developed and verified a multi-dimensional framework for assessing how to retain and encourage players continuous dedication and engagement behaviors. The proposed framework illustrates the interrelationships among six constructs in online gaming communities: social presence, telepresence, cognitive social identity, affective social identity, psychological engagement, and behavioral engagement. Data collected from 338 players who have experience in engagement behaviors in online gaming communities. The collected data were examined against the research framework using structural equation modeling (SEM). The research findings offer sufficient evidence that behavioral engagement is influenced by psychological engagement, which consecutively, are determined by cognitive social identity, affective social identity, social presence, and telepresence. More importantly, the mediating analysis indicated that psychological engagement is a crucial mediator, meaning that consumer engagement is a sequential process, and behavioral engagement cannot independently exist without psychological engagement. Taken together, the research results of this study have several critical theoretical and practical implications for future academic researchers and practitioners to have better understanding of consumer engagement. By doing so, the game companies can have sustainable competitive advantage and support sustainable development.
... L'apparition des symptômes de sevrage pendant 84 heures a é té é valué e dans une é tude, les patients ont rapporté principalement l'apparition de l'ennui et un besoin de stimulation mentale. Les autres symptômes de sevrage dé crits dans le DSM-5 n'é taient pas retrouvé s de façon é vidente, ce qui semblait incompatible avec ce critè re [42]. Une revue de la litté rature conclut que les donné es disponibles sur le sevrage des jeux vidé o sont peu dé veloppé es, il se pourrait que les problè mes lié s au jeu puissent survenir sans symptô mes de sevrage associé s [35]. ...
... Concernant la pré occupation, un inté rêt plus centré sur le contenu cognitif pourrait le rendre plus utile [43]. Le critè re de sevrage semble peu pertinent concernant l'IGD [35,42,92]. La tolé rance et sa dé finition sont é galement remises en question [52]. ...
Résumé
Objectifs
L’objectif de ce travail était d’examiner la proposition d’internet gaming disorder (addiction aux jeux vidéo) du DSM-5, de rendre compte de la controverse immédiate survenue à la suite et d’examiner l’apport du diagnostic de gaming disorder de la CIM-11.
Méthode
Une analyse descriptive a été élaborée à partir des documents princeps du DSM-5 et des critiques faites pour inventorier les points faisant débat. Une analyse critique a été réalisée afin de répondre à ces points. Enfin, nous avons examiné l’apport du diagnostic de gaming disorder de la CIM-11.
Résultats
L’analyse critique propose des réponses aux points de débat soulevés concernant la définition, la pertinence clinique des critères diagnostiques, la prévalence, l’évolution et les comorbidités de l’addiction aux jeux vidéo du DSM-5. L’apport du gaming disorder de la CIM-11 a pu être examiné et les controverses entourant ce diagnostic ont été rapportées.
Discussion
Des réponses cohérentes ont été obtenues concernant la définition de l’internet gaming disorder. La prévalence, ses comorbidités et leur évolution restent débattues. Des différences de validité des critères diagnostiques sont retrouvées. Le craving semble être un critère potentiel. Il reste à définir si l’approche du gaming disorder reflètera mieux le trouble de l’usage des jeux vidéo.
Conclusions
L’addiction aux jeux vidéo est de plus en plus reconnue. Les récentes recherches ont permis une avancée dans la compréhension de cette pathologie mentale. Des études complémentaires sont nécessaires pour répondre aux incohérences restantes.
... The present study's approach was to monitor habitual players of games abstaining from games for a predetermined amount of time to examine the psychosocial consequences. While there are some preliminary studies of adult gamers abstaining from games (Kaptsis, King, Delfabbro, & Gradisar, 2016a;King, Kaptsis, Delfabbro, & Gradisar, 2016) and some neuroimaging studies have examined cue-related craving following gaming exposure (Dong, Wang, Du, & Potenza, 2017), there have been very few studies of gaming abstinence in adolescents who habitually play games. The DSM-5 refers to gaming withdrawal occurring "when gaming is taken away" (APA, 2013, p.795), which may be much more relevant to adolescents' experiences given the sudden removal or a forced inability to access games is likely to be carried out by parents or carers. ...
... Adolescent gamers' withdrawal symptoms, referring to the desire or craving to play games (van Rooij, Van Looy, & Billieux, 2016), were stronger in the context of their standard routine of gaming. With respect to the abstainers, this was consistent with some research that has shown that gamers report higher craving scores in the context of playing (Kaptsis et al., 2016), and immediately following presentation of gaming stimuli (Dong et al., 2017), than during gaming abstinence. The observation of reduced withdrawal for the control group was less intuitive. ...
Adolescents who engage in habitual digital gaming activities may be at risk of gaming disorder. Regular periods of gaming abstinence may reduce gaming urges and control gaming at healthy levels. This study examined the impact of 84-hour gaming abstinence on withdrawal, affect, and psychological distress in adolescent habitual gamers. A two (Group: abstainers; control) x six (Time: baseline; day 1, day 2, day 3; post-test; 7-day follow-up) repeated measures design was employed. A sample of 37 adolescent participants were recruited by referral from parents with concerns about their gaming behavior. Participants completed questionnaires and answered open-ended reflective questions about gaming. Overall, the principal hypotheses received limited support. Both groups reported a significant reduction in withdrawal symptoms post-baseline, which was maintained at follow up. Abstainers felt bored without a daily gaming routine, but reportedly developed new gaming attitudes and engaged in family activities and outdoor physical activities. Daily self-monitoring may have reduced gaming withdrawal, and self-monitoring combined with brief abstinence may have fostered healthier gaming attitudes. However, the reduction in withdrawal among non-abstainers suggests that the relationship between urges to play games and actual time spent playing may not be straightforward.
... The constant stimulation from gaming can hijack the brain's reward system, leading to heightened stress, frustration, and irritability when gaming is unavailable (Kuss 2013). This "gaming withdrawal syndrome" shares similarities with substance use disorders, including tolerance, withdrawal, and cravings (King et al., 2016). These emotional disturbances can significantly contribute to the development and exacerbation of mental health issues, such as depression and anxiety. ...
The rise of digital gaming has transformed entertainment, and social interaction. However, excessive gaming behaviors have raised concerns about Internet Gaming Disorder (IGD), a condition characterized by loss of control over gaming, prioritization of gaming over daily activities, and resulted negative consequences. The current study is aimed to estimate the prevalence of IGD among under graduate students and to determine the association of IGD with substance abuse and common psychosocial behavior. In this cross-sectional study with a sample size of 68 undergraduate students currently studying in a college were chosen through a random sampling and the participants are from various streams of under graduate courses. The IGD was determine through IGDS9-SF and psychological problems like depression, anxiety, and stress were measured using the DASS-12 scale. The prevalence of IGD was found to be 28% among the total population. 49% of the male respondents exhibit the prevalence of IGD. In this study a significant association between substance abuse and IGD score was reported. The substance abuse includes alcohol consumption (p= 0.00098) and smoking (p= 0.00003) shows positive relation with IGD scores. A statistically significant association between IGD score and DASS score found at 0.05 level (p-value is <0.00001). Males are more addicted IGD than female students. Males are more addicted to internet gaming disorders. Excessive use of gaming application leads to mental disorders, variation in psychosocial behaviors of students. This study will help to identify the effects of internet gaming disorder on the health status of the students.
... Several qualitative and quantitative studies have indicated that social isolation plays a key role in the emergence of IGD, especially as seen during the COVID-19 pandemic [18,19]. Social isolation is an objective measure reflecting an individual's absence or limitation of social contact or interactions with friends, family, neighbors, and colleagues [20]. ...
Background
Internet gaming disorder among university students has become a great concern for university counsellors worldwide since the COVID-19 pandemic. The factors influencing the development of internet gaming disorder in students during the COVID-19 pandemic could be different from those before the pandemic.
Objective
This study aims to explore the associations among social isolation, self-control, and internet gaming disorder in Chinese university students and to examine whether self-control mediates the positive effects of social isolation on internet gaming disorder.
Methods
A cross-sectional survey was employed to collect data from university students in Shandong province of China from April to September 2022. The Isolation subscale of the Self-Compassion Scale, Self-Control Scale, and Internet Gaming Disorder Scale were used to assess the social isolation, self-control, and internet gaming disorder among university students, respectively. Models 4 and 5 of PROCESS software were used to analyze the mediating role of self-control and the moderating role of gender on the association between social isolation and internet gaming disorder.
Results
A total of 479 students were recruited from 6 universities located in 3 different regions of Shandong, China. Students had low levels of internet gaming disorder and moderate levels of social isolation and self-control, with mean scores of 8.94 (SD 9.06), 12.04 (SD 3.53), and 57.15 (SD 8.44), respectively. Social isolation was positively correlated with internet gaming disorder (r=0.217; P<.001), and self-control was negatively correlated with social isolation (r=–0.355; P<.001) and internet gaming disorder (r=–0.260; P<.001). Self-control played a mediating role in the association between social isolation and internet gaming disorder (β=–.185, 95% CI –.295 to –.087). The effects of social isolation on internet gaming disorder among female students were lower than those among male students.
Conclusions
Self-control was a mediator in the association between social isolation and internet gaming disorder. Moreover, gender played a moderating role in the association between social isolation and internet gaming disorder. This study highlights the need to alleviate the development of internet gaming disorder among students during a pandemic, especially that of male students. Effective interventions that lessen social isolation and promote self-control should be developed.
... In 2013, the Diagnostic and Statistical Manual of Mental Disorders (5 th ed.; DSM-5) introduced Internet Gaming Disorder (IGD) as a concept requiring further investigation [10]. The proposed criteria for IGD have prompted extensive discourse among researchers, highlighting various concerns, including the absence of standardized measurement instruments and the necessity for criteria enhancement [6,[11][12][13][14]. ...
Purpose
This study aims to adapt and verify the psychometric properties of the Craving for Internet Gaming Scale (CIGS) in a Polish sample. Craving, although observed as significantly associated with Internet Gaming Disorder, is not currently included in its diagnostic criteria. This research addresses the need for scales to measure craving in this particular context.
Methods
The research involved a sample of 575 participants. Psychometric analysis, including confirmatory factor analysis, was conducted to assess the CIGS’ reliability and validity. Additional scales, such as the Game Transfer Phenomena Scale, Motives for Online Gaming Questionnaire, and the Depression Anxiety Stress Scales, were used for concurrent validity analysis.
Results
The study results demonstrate the excellent psychometric properties of the Polish adaptation of the CIGS. It showed high reliability in terms of internal consistency and provided evidence for construct validity. Furthermore, it exhibited a positive correlation with various scales associated with problematic video game use and gaming addiction, while also showing a moderate negative correlation with self-control.
Conclusions
Our findings suggest that the CIGS retains its psychometric properties in different cultures, making it a valuable instrument for comprehending craving within the context of Internet gaming disorder. Future research should focus on the adaptation of the CIGS to various cultural settings and the exploration of potential intergroup differences.
... En el primer caso, existe evidencia convincente de que los cravings experimentados por los jugadores son tan o más intensos que en los trastornos por uso de sustancias (Limbrick-Oldfield et al., 2017;De Castro, Fong, Rosenthal y Tavares, 2007). Sin embargo, en el caso de las supuestas adicciones tecnológicas y, más concretamente, en el caso del trastorno por uso de videojuegos, el deseo experimentado durante periodos forzosos de abstinencia no parece ser ni cualitativa ni cuantitativamente comparable al de los trastornos adictivos mejor establecidos (King, Delfabbro y Gradisar, 2016). ...
La reciente inclusión del trastorno por juego de azar (TJA) en el Manual Diagnóstico y Estadístico de Trastornos Mentales (American Psychiatric Association, 2013) ha supuesto un hito conceptual importante en la definición de los trastornos adictivos, porque por primera vez éste reconoce que un trastorno adictivo no requiere el consumo de una sustancia química externa. En un primer momento, se tomó en consideración la posibilidad de que dicha nueva categoría de adicciones comportamentales incluyese también el uso excesivo de videojuegos en Internet, aunque finalmente esa propuesta se rechazó. Más recientemente, por el contrario, la Organización Mundial de la Salud sí ha incluido el trastorno por uso de (vídeo) juegos en su Clasificación Internacional de Enfermedades (World Health Organization, 2018).
Al margen del DSM y la CIE, sin embargo, existen incontables propuestas de supuestas adicciones comportamentales. Algunas de ellas se refieren conductas que se realizan a través de dispositivos digitales, como el uso excesivo de redes sociales (He, Turel & Bechara, 2017; Andreassen, 2015; Griffiths, 2013) y de pornografía online (Duffy, Dawson & Das Nair, 2016; Love, Laier, Brand, Hatch & Hajela, 2015), el consumo de vídeos o series en forma de atracón (binge watching) (Flayelle, Maurage, Karila, Vögele & Billieux, 2019; Flayelle, Maurage & Billieux, 2017), u otras posibles conductas problemáticas vía móvil u ordenador sin especificar (Bisen & Deshpande, 2018; De-Sola Gutierrez, Rodríguez de Fonseca & Rubio, 2016; Kuss, Griffiths, Karila & Billieux, 2014). Otras se refieren a conductas que ocurren siempre o en su mayor parte fuera de Internet (Muller et al., 2019; Dumitru, Dumitru & Maher, 2018; Carter et al., 2016).
Tales propuestas se basan en las similitudes que la realización excesiva de esas actividades parece tener con el juego de azar o con el consumo abusivo de sustancias. Sin embargo, como argumentaremos aquí, tales similitudes pueden ser superficiales, y la consideración de esos patrones comportamentales problemáticos como trastornos adictivos puede estar suponiendo un obstáculo para avanzar en su comprensión, su tratamiento y su prevención (Panova & Carbonell, 2018; Fletcher & Kenny, 2018; Carbonell & Panova, 2017; Griffiths, Pontes & Kuss, 2016; King & Delfabbro, 2014).
... Syahputra et al. (2022) showed that narcissistic and social media-addicted students typically accessed the internet for more than six hours daily. Both males and females who spend 3-5 hours on the internet differ from those who spend 6-8 or more (King et al., 2016;Syahputra & Erwinda, 2020). ...
The aim of this study was to analyze trend in obtaining career information in the digital era within the context of post-COVID-19 career anxiety. This was a comparative descriptive study and the data were obtained through random sampling. The sample consisted of 267 students randomly selected from various universities in East Aceh. Furthermore, career anxiety scale was used as the main measurement tool, which has high reliability with Cronbach's alpha of 0.85 and item reliability in Rasch 0.98. Descriptive analysis and ANOVA test were used to analyze the data. The results showed significant differences in level of post-COVID-19 career anxiety based on gender and addiction level. However, in the context of career information, there were no statistically significant differences. Another interesting result was that career information from friends remained trend in the digital era, and this trend persisted till present. Therefore, the results of this study can be used as a basis for the development of programs to overcome career anxiety.
... In this perspective, unlike pornography and shopping addiction that might exist regardless of digital technologies, technology use is a necessary component of problematic behavior (Casale et al., 2021) in Internet Gaming Disorder (IGD), problematic smartphone use (PSU) and problematic social networking sites use (PSNSU). Various studies have shown that IGD, PSU and PSNSU share some core dimensions with substance addictions and gambling disorder, including some commonality between the neural mechanisms (e.g., Fauth-Bühler & Mann, 2017;Horvath et al., 2020;Lee, Namkoong, Lee, & Jung, 2021), craving symptoms under abstinence conditions (e.g., King, Kaptsis, Delfabbro, & Gradisar, 2016;Stieger & Lewetz, 2018;Wilcockson, Osborne, & Ellis, 2019) and withdrawal effects (see, for a review, Fernandez, Kuss, & Griffiths, 2020). Yet, consensus on the conceptualization of PSU and PSNSU as primary mental health conditions has still not been reached (Panova & Carbonell, 2018), and a recent debate on the risk of the so-called "diagnostic inflation" has highlighted the importance of having a clinically useful definition of problematic behaviors in online contexts (Musetti et al., 2022;Starcevic et al., 2021). ...
Public stigma on substance and gambling disorders have been well documented. Negative effects of stigma include shame, embarrassment, fear being judged and the determent of help-seeking behaviors among stigmatized individuals. Less is known about the public perception toward Internet gaming disorder (IGD) and other widespread problematic behaviors that share some characteristics with established behavioral addictions, such as Problematic smartphone use (PSU) and Problematic social networking sites use (PSNSU). The purpose of this study is to compare the public perception of problematic Internet gamers, problematic smartphone users and problematic social networking sites users using an experimental within-group vignette study design. A sample of 280 adults (F = 72.1%; Mage = 32.84, SD = 13.85) was recruited and completed the study online. The gender of the target vignette was randomized and participants were presented with a vignette describing an individual with IGD, PSU, and PSNSU. A repeated-measures ANOVA followed by post hoc tests using Bonferroni’s correction was used. IGD was seen as more serious, more noticeable, and less understandable than both PSU and PSNU. Moreover, participants’ emotional reaction (e.g., anger and sadness) and desired social distance were significantly stronger toward IGD. However, vanity attributions were higher for individuals with PSNSU, which were also more blamed compared to both IGD and PSU. PSU was seen as more controllable than both IGD and PSNSU. The results, taken together, suggest that IGD is perceived as more inherently problematic, but PSNSU also seem to deserve scientific attention as individuals showing symptoms of PSNSU are blamed more than problematic Internet gamers. Our findings provide initial information that can be used when developing interventions to impact stigma toward technological addictions.
... For example, intense craving generated by pop-ups about limited special offers for a specific product on e-commerce sites could lead to compulsive buying. Unfortunately, results from attempts to determine whether or not craving is central to the development of chronic problems in behavioural domains other than gambling are inconclusive, as these studies mostly rely on self-report methods in which craving-related items use generic terminology such as 'urge' or 'desire' (for example, 'sometimes, I feel an irrepressible urge to play') 196 that could refer to different underlying constructs in different behavioural domains 197,198 . ...
Gaming disorder was officially recognized as a disorder of addictive behaviour in the International Classification of Diseases 11th revision in 2019. Since then, other types of potentially problematic online behaviour have been discussed as possible candidates for inclusion in the psychiatric nosography of addictive disorders. Understanding these problematic online behaviours requires further study of the specific psychological mechanisms involved in their formation and maintenance. An important but underdeveloped line of research has examined the ways in which technology design features might influence users’ capacity to exert control over how they engage with and use websites and applications, thereby amplifying uncontrolled, and perhaps addictive, use. In this Review, we critically examine the available research on the relationships between technology design features and the loss of control and harms experienced by those who engage in online video gaming, online gambling, cybersexual activities, online shopping, social networking and on-demand TV streaming. We then propose a theory-driven general taxonomy of the design features of online applications that might promote uncontrolled and problematic online behaviours.
... Finally, it is worth acknowledging that negative psychological effects of abstinence may not necessarily be interpreted within an addiction framework as withdrawal symptoms. For example, heightened negative affect during abstinence could instead reflect normal, non-pathological reactions to sexual deprivation (Castro-Calvo et al., 2022) or a disruption of routine particularly if abstinence is involuntary or not intrinsically motivated (King et al., 2016;Szabo, 1995). Alternatively, anxiety-related effects during abstinence could be interpreted within an obsessive-compulsive framework as a consequence of being prevented from engaging in the compulsive behavior to relieve anxiety-evoking obsessive thoughts (Coleman, 1990). ...
Little is known about whether withdrawal-like symptoms manifest when regular pornography users attempt to abstain from pornography. The present study used a randomized controlled design to examine whether (1) negative abstinence effects that may be potentially reflective of withdrawal-related symptoms manifest when a non-clinical sample of regular pornography users attempt to abstain from pornography for a 7-day period and (2) these negative abstinence effects would only manifest (or manifest more strongly) for those with higher levels of problematic pornography use (PPU). A total of 176 undergraduate students (64.2% female) who were regular pornography users (defined as having used pornography ≥ three times a week in the past 4 weeks) were randomly assigned to an abstinence group (instructed to attempt abstinence from pornography for 7 days, n = 86) or a control group (free to watch pornography as usual, n = 90). Participants completed measures of craving, positive and negative affect, and withdrawal symptoms at baseline and each night of the 7-day period. Contrary to the confirmatory hypotheses, there were no significant main effects of group (abstinence vs. control) or group × PPU interaction effects on any of the outcome measures, controlling for baseline scores. These findings indicate that no evidence of withdrawal-related symptoms was found for abstaining participants, and this was not dependent on level of PPU. However, exploratory analyses showed a significant three-way interaction (group × PPU × past 4-week frequency of pornography use [FPU]) on craving, where an abstinence effect on craving was found at high levels of PPU only once past 4-week FPU reached the threshold of daily use. While these exploratory findings should be interpreted with caution, they suggest that abstinence effects could potentially manifest when there is a combination of high PPU and high FPU-a hypothesis that warrants investigation in future prospective abstinence studies.
... Notably, purchasers reference both external variables-such as events and promotions, and exciting sounds and animations-and intrinsic drivers, centring around fulfilling desires or satisfying needs, such as the desire to be competitive, or to experience excitement. This is consistent with the literature on motives for both gaming and gambling, which are influenced by external drivers such as advertisements and promotions [16,17] and the structural characteristics of the game [18,19], in addition to being behaviours people pursue in order to satisfy psychological needs for competence, relatedness, or autonomy (which are often framed within concepts of self-determination theory, [20][21][22]). ...
Qualitative studies have identified a diverse array of motivations for purchasing items within video games through chance-based mechanisms (i.e., “loot boxes”). Given that some individuals—particularly those at risk of disordered gaming and/or gambling—are prone to over-involvement with loot box purchasing, it is important to have a reliable, valid means of measuring the role of different motivations in driving purchasing behaviour. Building on prior qualitative research, this paper reports the development and validation of the “RAFFLE” scale, to measure the Reasons and Facilitators for Loot box Engagement. A 23-item, seven-factor scale was developed through cognitive interviews (n = 25) followed by two surveys of UK-based gamers who purchase loot boxes; analysed via exploratory (n = 503) and confirmatory (n = 1495) factor analysis, respectively. Subscales encompassed “enhancement’; “progression’; “social pressure’; “distraction/compulsion’; “altruism’; “fear of missing out’; and “resale”. The scale showed good criterion and construct validity (correlating well with measures of loot box engagement; the risky loot box index (r = 0.63) and monthly self-reported spend (r = 0.38)), and good internal validity (Cronbach’s alpha = 0.84). Parallels with, and divergence from, motivations for related activities of gaming and gambling, and alignment with broader theoretical models of motivation, are discussed.
... It highlights the need to develop a diverse range of early intervention and support options. Studies also indicate gamers engage with a broad range of self-managed cognitive and behavioural strategies to limit their gaming [62] and are able to adhere to personal change goals [63]. The current study highlights the need to consider a stepped care service system that is inclusive of low-severity (e.g., brief interventions such as personalised normative feedback) and low-intensity service options (e.g., self-directed treatments) as well as options that are more intensive (e.g., in-person and group treatment). ...
Background
Problem gaming is reported by approximately 1–3% of the population and is associated with decreased health and wellbeing. Research on optimal health responses to problem gaming remains limited. This study aimed to identify and describe the key components of a person-centred approach to interventions for problem gaming for individuals who voluntary seek assistance.
Methods
Online interviews were conducted with 20 adults (90% male; Mage = 23y) currently seeking help for problem gaming. The interview protocol was guided by a health care access framework which investigated participants’ experiences and needs related to accessing professional support. Transcripts were analysed in NVivo using qualitative content analysis to systematically classify participant data into the themes informed by this framework.
Results
Participants had mixed views on how the negative consequences of problem gaming could be best addressed. Some indicated problems could be addressed through self-help resources whereas others suggested in-person treatment with a health professional who had expertise in gaming. Participants described the essential components of an effective health service for problem gaming as including: valid and reliable screening tools; practitioners with specialist knowledge of gaming; and access to a multimodal system of intervention, including self-help, internet and in-person options that allow gamers to easily transition between types and intensity of support.
Conclusion
A comprehensive health care approach for interventions for problem gaming is in its infancy, with numerous service access and delivery issues still to be resolved. This study highlights the importance of involving individuals with gaming-related problems in developing solutions that are fit for purpose and address the spectrum of individual preferences and needs. These findings recommend a stepped healthcare system that adheres to evidence-based practice tailored to each individual and the implementation of standard assessment and routine outcome monitoring.
... Park et al. reported signi cant reductions in time spent gaming and improvements to severity of gaming symptoms and general wellbeing. Other studies also indicate gamers engage with a broad range of self-managed cognitive and behavioural strategies to limit their gaming (62) and are able to adhere to personal change goals (63). ...
Background Problematic gaming, including its most serious form known as gaming disorder (GD) in the ICD-11, affects approximately 1-3% of the population and can have significant negative impacts on health and wellbeing. Research to determine the optimal health system responses to GD remains limited. This study aimed to identify and describe the key components of a patient-centred approach to prevention, early intervention, and treatment of GD.
Methods Online interviews were conducted with 20 adults (90% male; Mage=23y) currently seeking help for GD. The interview protocol was guided by a health care access framework which investigated participants’ experiences and needs related to accessing professional support. Transcripts were analysed in NVivo using qualitative content analysis to systematically classify participant data into the themes informed by this framework.
Results Although the characteristics and resultant harms of GD were broadly recognised, participants indicated that these issues may not always be viewed by healthcare providers as a serious problem that requires intervention or that could be addressed through treatment. This highlights a significant barrier to access at the beginning of the patient journey when patients may perceive that they have a legitimate need for care and seek a relevant, tailored, and safe service to meet this need. Participants described the essential components of an effective health service for GD as including: valid and reliable screening tools for GD; practitioners with specialist knowledge of GD that includes, or is strongly informed by, lived experience of peers; and access to a multimodal system of intervention, including self-help, internet and face-to-face options that allow gamers to transition between types and intensity of support.
Conclusion A comprehensive health care approach for gaming disorder is currently in its infancy and there are numerous service access and delivery issues still to be resolved. This study highlights the importance of involving individuals with GD in developing solutions that are fit for purpose and address the spectrum of intervention needs. These findings recommend a stepped GD healthcare system that adheres to evidence-based practice tailored to each individual and the implementation of standard assessment and routine outcome monitoring.
... Thus, understanding what happens to people undergoing "detox" and finding ways to increase their sense of agency are important future research directions that can build on the findings presented in this study. This study's findings may also inform research on abstinence from other technologies, such as video games (Evans, King, & Delfabbro, 2018;King, Herd, & Delfabbro, 2018;King, Kaptsis, Delfabbro, & Gradisar, 2016), by pointing to a need to consider reflective outcomes, such as changes in perceived agency, after abstinence attempts and to the role of cognitive reflection tendencies in the development of such reflections. ...
Many social media users have lost some agency over the use of these sites. Restoring this sense of agency is important as it can help users live responsibly with the technology, and can serve as a target for therapists treating people with difficulty to control their social media use. Nevertheless, knowledge about ways to increase people's sense of agency has been limited. In this study I propose that invoking reflections about agency but allowing normal use will likely produce realization about loss of agency, and result in undesirable reduced sense of agency. In contrast, I suggest that if invoking reflections on agency is followed by a brief abstinence attempt, people will process insights on their actual ability to exert control over social media use, which will result in an increase in perceived agency. I further argue that this information processing will only accrue in people high in cognitive reflection tendencies. A 2 (time: pre vs. post) by 2 (condition: abstinence vs. control) by 2 (cognitive reflection group: low vs. high) experiment with 610 Facebook users showed an increase in agency only among high cognitive reflection participants who experienced abstinence; all other groups showed decline in perceived agency. Implications are discussed.
... When developing their plans, participants reported a wide range of barriers that were focused specially on mechanisms that support extended gaming (e.g., multi-player social co-operation and competition) and implementation planning (e.g., loss of motivation, shifting priorities). In a sample of 24 abstaining gamers, King et al. (2016) also reported internal and external cues such as boredom and loss of financial or competitive advantage were barriers to maintaining change. However, these results differ because the current sample was predominantly initiating behaviour change reductions, therefore barriers were relevant to implementation rather than barriers to maintaining abstinence. ...
Gaming Disorder is a recognised mental health condition with a very narrow range of treatment options. This pre-post study recruited 50 adult gamers from New Zealand to test the feasibility of a brief internet-delivered intervention. The intervention components were derived from Implementation Intention principles whereby the gap between intention and behaviour was targeted. The intervention delivery was in accordance with Self-Determination Theory to facilitate autonomy (personalised goals and action plans), competence (facilitated coping plans, self-monitoring, and relapse prevention) and relatedness (access to a goal coach providing written feedback and support to implement plans). Follow-up evaluation at 3-months indicated the intervention was feasible as it demonstrated rapid recruitment, program engagement (86% used the program), and high satisfaction (easy to understand and convenient). Plans most frequently focused on behavioural substitution and lifestyle change, and the most frequent barrier to change was time management followed by social pressure. Completers (n = 35) reported a significant increase in well-being and reduction in severity, intensity, and time spent gaming, which reduced from an average of 29 to 11 hours per week. Delivery of a brief internet-delivered intervention shows promise and could be used to treat people experiencing problems who are unable or unwilling to access face-to-face treatment.
... This includes a wider range of treatment content beyond CBT and low and high intensity service options. A recent study indicated that gamers may engage with a broad range of self-managed cognitive and behavioural strategies to limit their gaming (50) and adhere to personal change goals (51). There are currently few options for self-directed treatment or additional support for what people attempted to recover without intervention. ...
Background
Problematic gaming, including its most serious form known as gaming disorder (GD) in the ICD-11, affects approximately 1–3% of the population and can have significant negative impacts on health and wellbeing. Research to determine the optimal health system responses to GD remains limited. This study aimed to identify and describe the key components of a patient-centred approach to prevention, early intervention, and treatment of GD.
Methods
Online interviews were conducted with 20 adults (90% male; Mage=23y) currently seeking help for GD-related issues. The interview protocol was guided by a health care access framework which investigated participants’ experiences and needs related to accessing professional support. Transcripts were analysed in Nvivo using qualitative content analysis to systematically classify participant data into the themes informed by this framework.
Results
Although the characteristics and resultant harms of GD were broadly recognised, participants indicated that these issues may not always be viewed by healthcare providers as a serious problem that requires intervention or that could be addressed through treatment. This highlights a significant barrier to access at the beginning of the patient journey when patients may perceive that they have a legitimate need for care and seek a relevant, tailored, and safe service to meet this need. Participants described the essential components of an effective health service for GD as including: valid and reliable screening tools for GD; practitioners with specialist knowledge of GD that includes, or is strongly informed by, lived experience of peers; and access to a multimodal system of intervention, including web-based and face-to-face options that allow gamers to transition between types and intensity of support.
Conclusion
A comprehensive health care approach for gaming disorder is currently in its infancy and there are numerous service access and delivery issues still to be resolved. This study highlights the importance of involving individuals with GD in developing solutions that are fit for purpose and address the spectrum of intervention needs. These findings recommend a stepped GD healthcare system that adheres to evidence-based practice tailored to each individual and the implementation of standard assessment and routine outcome monitoring.
... Therefore, boredom may be a contributing influence on PGs' continued engagement in problem gaming, similar to how it could contribute to high relapse rates among substance abusers. A study on gaming abstinence among young adults conducted online found that boredom and a need for mental stimulation was experienced by gamers who did not play for 84 h (King, Kaptsis, Delfabbro, & Gradisar, 2016). Furthermore, studies have found that restricting gameplay alone, without introducing other forms of meaningful activity will have minimal positive effects on PGs. ...
Currently, a full appreciation of how problem gaming impacts the daily lives of gamers is lacking. This study aims to gain a more holistic understanding of the activities in the daily lives of problem gamers; particularly, what is important to them, what motivates gaming, and what supports/constraints engagement in other life activities. Semi-structured interviews and week-long activity logs were used to collect data from the 16 problem gamers in five countries. Qualitative data were analyzed thematically. Two main themes emerged. First, gaming was found to be a meaningful and purposeful activity. Participants in this study understood what activities offered them a sense of meaning and personal growth. Video gaming offered both positive and negative experiences in gamers’ lives. The negative experiences mainly resulted from using video games as a coping strategy for other life stressors. Second, individual, interpersonal, and environmental influences acted simultaneously to push and pull on the amount of gaming. The push and pull influences on the amount of gaming can occur in real-life or virtually. Assistance for problem gamers could include minimizing/removing the pull forces and obtaining adequate push forces to enable their desired participation in daily activities.
... Moreover, evaluating the prevalence of media addiction (e.g., Poli & Agrimi, 2012) was the focus of 7.84% of the studies. Additional research purposes included evaluating and discussing symptoms of media addiction (5.7%; e.g., King, Kaptsis, Delfabbro, & Gradisar, 2016); reviewing previous studies on a specific domain of media addiction research (4.62%; e.g., Byun et al., 2009); designing and evaluating treatments, preventive programs, and policies (3.96%; e.g., Du, Jiang, & Vance, 2010); discussing media addiction at the conceptual level (3.39%; e.g., Starcevic, 2013); testing a theoretical model (3.39%; e.g., Haagsma, Caplan, Peters, & Pieterse, 2013); and criticizing other studies on media addiction (.83%; e.g., Griffiths, 2012). ...
In this review study, a descriptive analysis was conducted of the media addiction research published from 1991 to 2016. The search of all academic output published in 13 major scientific and academic databases in 256 journals within the 26-year period yielded 1,099 Social Sciences Citation Index/Science Citation Index (SSCI/SCI) articles that were relevant to this study. The review was focused on the trends, developmental periods, study domains, themes, research methods, measurement instruments, and research purposes in the field of media addiction. The results show that most previous media addiction research in the study period were conducted from the perspectives of compulsivity and impairment. As a psychiatric disorder and a complex biopsychosocial phenomenon, the findings suggest that future media addiction research should go beyond the predominant perspectives in the prevalence, causes, and consequences of media addiction (59.7%) and extend into the effectiveness of prevention and treatment (only 3.96%) provided in both clinical and nonclinical settings. The review also shows that of the 974 studies using quantitative or mixed methods to examine media addiction, over 30% used Young’s Internet Addiction Test and Diagnostic Questionnaire as the two frequently used measurement scales, which means that they were adopted by at least 20 studies in the study period. Furthermore, over 77% of the media addiction studies employed survey and experiment methods. The implications of these findings for future media addiction research and the limitations of the study are discussed.
... Kaptsis et al. also identified 25 different wording to measure withdrawal summarized as an affective reaction when it is not possible to play. Another qualitative study of King, Kaptsis, Delfabbro, and Gradisar (2016) received 155 answers of gamers who were asked to abstain from playing for 84 hours and then to describe their craving and coping strategies. The authors identified "boredom" and the "search for mental stimulation", both being unrelated to the withdrawal IGD criterion (i.e., anxiety, sadness, irritability). ...
Video games have become the most popular leisure activity around the world, sometimes mobilizing millions of players on a daily basis. However, accumulating evidence suggests that excessive use of video games is associated to a wide range of negative consequences. In 2013, the American Psychiatric Association included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorder criteria to define Internet Gaming Disorder. This proposal was incorporated into Section 3 on emerging measures and models, calling for future studies on these criteria.The originality of this thesis was to be among the first to empirically test the DSM-5 criteria based on various psychological factors recognized as playing a role in the addictive disorders and in the excessive use of video games. The crucial distinction between high but non-problematic engagement in video games and “addiction” was also addressed. Since this thesis was printed, the study presented in Chapter 3 has been modified and printed. Please take this into account via the following reference:Deleuze, J., Long, J., Liu, T.-Q., Maurage, P., & Billieux, J. (2018). Passion or addiction? Correlates of healthy versus problematic use of videogames in a sample of French-speaking regular players. Addictive Behaviors, 82, 114–121. https://doi.org/10.1016/j.addbeh.2018.02.031 Note that no proofreading by an English speaker has been done on the entire manuscript.
... These perceived outcome expectancies of video game playing result in and reinforce maladaptive cognitions in relation to video game playing, and motivate players to continually engage in excessive and problematic gaming behaviors (33). Findings from a qualitative study suggested that maladaptive gaming-related cognitions might lead to preoccupation with the next gaming session and intensify urges for video game playing (35). Our findings suggest that maladaptive gaming-related cognitions may be an important factor in IGD to be targeted by psychosocial interventions. ...
Background:
Internet gaming disorder (IGD) is characterized by signs and symptoms similar to substance use and gambling disorders, and associated with psychosocial impairments. Research suggests that maladaptive gaming-related cognitions and coping may be implicated in IGD; therefore, interventions for IGD need to target these underlying mechanisms. Mindfulness-based treatment is effective in changing maladaptive cognitive processes and increasing adaptive coping among people with addictions.
Aims:
This study used data from an RCT of Mindfulness-Oriented Recovery Enhancement (MORE) for IGD to further examine changes in maladaptive gaming-related cognitions and positive reappraisal as mediators of the effects of MORE on IGD signs/symptoms.
Methods:
Participants (N = 30, Age M = 25.0, SD = 5.4) were randomized to 8-weekly sessions of MORE or a support group (SG) control condition. IGD severity, levels of craving for video game playing, maladaptive gaming-related cognitions, and positive reappraisal were measured at pre-and posttreatment, and 3-month follow-up.
Results:
Multivariate path analyses revealed that effects of MORE in reducing IGD and craving were statistically mediated by changes in maladaptive gaming-related cognitions. Though changes in positive reappraisal did not significantly mediate effects of MORE on IGD or craving, MORE enhanced positive reappraisal to a significantly greater extent than the SG at posttreatment.
Discussion:
Findings suggest that effects of mindfulness treatment in reducing maladaptive gaming-related cognitions might lead to reductions in IGD severity and cravings for video game playing. This cognitive mechanism should be evaluated in a future, full-scale RCT.
Background: Internet gaming disorder (IGD) is a prevalent behavioral addiction that co-occurs with depression. Little is known about how IGD and depression intercorrelate longitudinally at a symptom level. This study aimed to explore the directional relationships between IGD and depressive symptoms and identify the key symptoms in their comorbidity using cross-lagged panel network (CLPN) modeling.
Methods: A sample of 601 young gamers (mean age = 23.76) in Hong Kong completed the Internet Gaming Disorder Scale – Short Form and Patient Health Questionnaire-9 semi-annually at two-time points. Autoregressive and cross-lagged effects between depressive and IGD symptoms were analyzed via CLPN while controlling gamers' preferences across five game genres in R.
Results: The comorbidity was mainly driven from depressive symptoms to IGD symptoms, with a few weaker associations from IGD to depressive symptoms. ‘Anhedonia’ (out-/bridge-expected influence = 2.88; 0.03) and ‘Motor problems’ (out-/bridge-expected influence = 1.24; 0.03) from depression were the central and bridge symptoms to trigger the development of IGD symptoms, whereas ‘continue gaming despite harm’ (in-expected influence = 1.29) was the most consequent symptom. ‘Anhedonia’ (r = 0.17) and ‘suicidal risk’ (r = 0.15) to ‘continuation despite harm’ were the strongest paths connecting depression and IGD. Gamers who preferred First-Person Shooter games and Massively Multiplayer Online Role-Playing games were more vulnerable to depressive and IGD symptoms.
Conclusions: Our findings provide empirical support for the comorbidity between IGD and depression and clarify their directional relationships at a symptom level. We identify antecedent bridge symptoms as targets for preventing escalation of co-occurring issues.
This chapter explores the convergence of various digital technologies and their potential impacts on problematic online behaviors. Incorporation of gaming elements into many online activities (e.g., gambling, on-demand video streaming, social media, and pornography) has created concerns about problematic use, particularly among youth). We review the current state of knowledge, which suggests that problematic engagement in different activities represents distinct conditions. Nonetheless, despite their apparent distinctiveness, online addictive activities have shared risk factors, including personality factors, comorbid psychopathological symptoms, cognitive processes, and neurobiology. A common approach to prevention is therefore sensible, even if treatment of problematic cases should follow individualized approaches. Approaches actively involving parents are encouraged. We call for expanded research on the impact of specific design features of online activities on problematic behavior and risk, particularly relating to gamified activities. Longitudinal research is needed to better understand the use and impacts of online activities across developmental stages. Given the limited understanding of long-term impacts and the dynamic nature of related technologies, greater evidence is needed to inform policy and regulation relating to exposure of children and adolescents to content and activities that might in some cases promote problematic behaviors.
Introduction
The Internet, with its unlimited information, revolutionary communication capabilities, and innovative potential to expand knowledge, is ubiquitous throughout the world, but it also has significant implications for users’ mental health. Given the not yet clearly defined and distinguishable nosographic categories of online addiction and the resulting difficulties in describing the impact on users’ mental health, the present cross-sectional study aimed to gain new insights into the relationship between Internet addiction (especially social networking site [SNS] addiction), psychological distress, and physical discomfort, as well as gender differences in impact among users.
Method
A sample of 583 Italian speakers (50.8% males; 48.7% females) with a mean age of 30.96 (SD = 12.12) completed an online survey in July 2021. A set of psychometric self-report instruments was administered to assess the study variables. Mediation analyses were performed for both the whole sample and across genders.
Results
The study found that men exhibited higher levels of Internet addiction and craving than women, but no differences were found for SNS addiction. Furthermore, indicators of psychological distress (i.e., anxiety, depression, stress, loneliness, insomnia, and self-esteem) mediated the association between SNS addiction and body uneasiness, with slight differences across genders.
Conclusion
This paper contributes to the existing literature on online addictive behaviors by also highlighting gender differences. The findings underscore the need for educational experiences that can prevent problematic use of the Internet and SNSs.
Objective:
There has been growing evidence of comorbidity between problematic internet game use and internalizing and externalizing problems in young people. However, little is known about the directionality and gender differences in these longitudinal relations at the symptoms level in the framework of network theory among youth. This study estimated the longitudinal relations between the symptoms of problematic internet game use, internalizing and externalizing problems, and the gender differences of these relations in Chinese youth using cross-lagged panel network modeling (CLPN).
Methods:
A sample of 1269 Chinese youth (M age = 10.35 years) participated in this study semi-annually at two time points. CLPN analysis was used to calculate the network model of problematic internet game use and internalizing and externalizing problems to explore bridge symptoms and find transmission pathways between problematic internet game use and internalizing and externalizing problems.
Results:
The CLPN revealed significant gender differences. For boys, depressed mood, which leads to relationships turning sour in order to play online games, bridges the relations between internalizing symptoms and problematic internet game use. For girls, irritability is the central predictive symptom, causing a range of problems related to problematic internet game use, which can, in turn, lead to fights or feelings of worthlessness. However, the effect sizes for the pathways between problematic internet game use and internalizing/externalizing problems were relatively weak, and the comorbidity between their relations should not be over-interpreted.
Conclusions:
The current findings provide new evidence for understanding the directional relationship between the central characteristics of problematic internet game use and internalizing and externalizing problems in boys and girls. Gender-specific interventions targeting the central symptoms of internalizing and externalizing problems and problematic internet game use can help mitigate the vicious cycle of comorbidity among adolescents.
A portion of the US population is choosing online games as a form of recreation and, consequently, is developing unhealthy preoccupations. The most notable form of Internet addiction for the past 20 years has been Massive Multi-user Online Role-Playing Game (MMORPG) with adults between 20 and 40 years old identified as high risk of developing problematic online gaming behaviors. Problematic online gaming behaviors and the resultant functional impairment of daily living that adults experience from playing MMORPGs was the problem addressed in this study, while the purpose was to provide further insight into those behaviors that adults experience from playing MMORPGs. This study used descriptive, pre-transcendental, psychological phenomenological methods and associated five-step phenomenological psychological data analysis and was predicated on the integration of the Online Gameplay Motivations Theory and the Cognitive-Behavioral Model of Pathological Internet Use. Seven adult participants who have played numerous MMORPGs over a period of no less than 5 years and as recently as 2 months were recruited. Interviews provided raw data, the analysis produced 26 themes and subthemes, which answered four research questions. The results indicated that adult MMORPG players who experience problematic online gaming behaviors experience both benefits (e.g., access to virtual-relationships, increased attention and focus, increased technology competency) and detriments (e.g., maladaptive cognitions, behavioral symptoms) from this online gameplay.
Experimental models identify the transition from choice to compulsivity as the main mechanism underlying addiction. In behavioral addictions research, however, the adjective compulsive is used to describe virtually any kind of excessive or dysregulated behavior, which hinders the connection between experimental and clinical models.
In this systematic review, we adopted a preliminary definition of compulsive behavior based on previous theoretical work. Subsequently, a systematic review following PRISMA guidelines was conducted (a) to identify the validated instruments, currently used in behavioral addictions research, that include items that are sensitive (intendedly or not) to compulsivity, and (b) to categorize those items into differentiable operationalizations of compulsivity.
Six operationalizations of compulsivity emerged from item content analysis: 1. Automatic or habitual behavior occurring in absence of conscious instrumental goals; 2. Behavior insensitive to negative consequences despite conscious awareness of them; 3. Overwhelming urge or desire that impels the individual to initiate the activity and jeopardizes control attempts; 4. Bingeing, or inability to stop or interrupt the activity once initiated, resulting in an episode substantially longer or more intense than intended; 5. Attentional capture and cognitive hijacking; and 6. Inflexible rules, stereotyped behaviors, and rituals related to task completion or execution.
Subsequently, a list of 15 representative items per operationalization was elaborated for independent assessment and identification of delimitation problems. A high degree of agreement was reached in assessing them as instantiating compulsivity, as well as in their assignment to the corresponding categories. However, many of them were also considered overinclusive, i.e., uncapable of distinguishing compulsivity from value-based momentary choice.
To increase their discriminative value, items in future compulsivity scales should be refined to explicitly mention disconnection between behavior and declarative goals. Further research on factorial structure of a pool of items derived from these operational definitions is warranted. Such a factorial structure could be used as an intermediate link between specific behavioral items and explanatory psychobiological, learning, and cognitive mechanisms.
Internet gaming disorder (IGD) has been classified by the DSM-5 as a condition for further study, and many studies have shown that the occurrence and maintenance of IGD and the automatic detection bias to gaming cues of individuals with IGD may be significantly related. However, whether abstinence, a common intervention method in behavioral addiction, can adjust the automatic detection bias in individuals with IGD and its underlying neural mechanisms is unclear. In this study, we investigated the effects of 7 days of abstinence from gaming on automatic detection bias, negative affect and craving in individuals with IGD with event-related potential technology. A total of 50 IGD subjects were recruited in this study and randomly divided into abstinence and control groups. Visual mismatch negativity (vMMN) was induced using a standard-deviant reversed oddball paradigm, and differences in automatic detection bias, negative affect, and craving between the two groups were recorded and compared at baseline, day 3, and day 7. The results showed that compared with baseline, vMMN, negative affect and craving were significantly enhanced on day 3 and significantly diminished on day 7 in the abstinence group but not in the control group, and the changes in vMMN were significantly correlated with changes in negative affect and craving in both groups. This study demonstrates that abstinence can restore automatic detection bias in individuals with IGD and that abstinence has to last for 7 days to have a significant effect, while recovery may be related to the negative affect and craving.
As the vast majority of online videogames imply the immersion into an alternative reality where a virtual body is also involved, the current cross-sectional study aims to investigate the contribution of low body awareness (i.e. low attention to sensory cues indicating bodily state) and body dissociation (i.e. low emotional connection with one’s own body) in predicting Internet gaming disorder (IGD) symptoms, after controlling for internalizing (i.e., depression, anxiety, and stress) and externalizing symptoms (i.e., aggression). A total of 370 online-game players (73% men; mean age 29.63 ± 7.64 years) recruited in online player communities took part in the study and were given a survey that included gaming characteristics, the Depression, Anxiety and Stress Scale -21, the Aggression Questionnaire, the Body Disconnection Scale, and the Internet Gaming Disorder Scale- Short Form. A hierarchical regression analysis showed that low body awareness and high body dissociation predicted IGD scores after controlling for all the other factors. Moreover, we found an interaction effect between physical aggression and body dissociation in predicting IGD scores. On the one hand, these results provide support to previous studies that stressed the potential association between dissociative detachment (in terms of bodily disconnections) and problematic videogaming; on the other hand, the current study provides first evidence of the opportunity to focus on the integration of bodily experiences in clinical practice with people suffering from problematic gaming.
As the use of digital technology has increased, abuse and addiction to technology have been identified among a minority of users. In the mid-1990s, the concept of internet addiction was first used. Today, almost every digital technology use has been claimed to have a minority of disordered users. One key aspect of addictive substance behaviors is craving. Craving is also an important component of behavioral addictions including digital technology disorders such as Internet Gaming Disorder. The aim of the present study was to develop the Turkish version of the Craving for Internet Gaming Scale (CIGS) via an adaptation of the Penn Alcohol Craving Scale (PACS). The present study comprised 368 adolescents from four different samples. The measures used included the Craving for Internet Gaming Scale, Digital Game Addiction Scale, and Brief Self-Control Scale. The structural validity of CIGS was investigated with Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and criterion validity. The reliability of CIGS was evaluated using Cronbach α internal consistency reliability coefficient and corrected item total correlation coefficients. As a result of EFA, it was found that the five-item CIGS had a single-factor structure. The unidimensional CIGS obtained as a result of EFA was tested with CFA. As a result of CFA, the unidimensional structure of CIGS was confirmed in two different samples. Criterion validity of CIGS was assessed via digital gaming addiction, self-discipline, impulsiveness, daily internet gaming duration, and internet gaming history. As a result of criterion analysis, CIGS was associated with these variables in the expected direction. Finally, according to reliability analysis, the CIGS was found to be a reliable scale. When validity and reliability analysis of the CIGS are considered as a whole, it is concluded that the CIGS is a valid and reliable scale that assesses craving for internet gaming.
Background
Videogame addiction has been suggested as a tentative disorder in 2013 by the American Psychiatric Association (APA) and was recently officially recognized as a mental health disorder by the World Health Organization (WHO). Although a few studies have identified attention deficit and hyperactivity disorder (ADHD) as a key risk factor for Internet Gaming Disorder (IGD), the interplay between ADHD and IGD symptoms with gender differences across cultures remains to be further examined.
Objective
This study examined the moderating effects of gender in the association between ADHD and IGD across two nations.
Method
A cross-sectional online survey was developed to recruit 164 Australian (Mage = 23.01, SD = 3.35, Minage = 18, Maxage = 31, Males n = 121, 73.80%) and 457 U.S.-North American (Mage = 25.25 years, SD = 2.76, Minage = 18 years, Maxage = 29 years, Males = 265, 57.98%) Massively Multiplayer Online (MMO) players aged between 18 and 29 years.
Results
The hierarchical linear regression, moderation and moderated moderation analyses revealed that participants presenting greater inattention and hyperactivity symptoms exhibited higher levels of IGD-related behaviors in the two samples. Moreover, these associations differed across genders between the two countries. Specifically, more hyperactive-impulsive, as well as inattentive males in the USA presented higher levels of disordered gaming.
Conclusion
The results highlight the need for more cross-cultural and symptom-focused research in the broader IGD field.
In April 2018, the servers of the popular video game “Fortnite” crashed for 24 hr. During this period, Pornhub (a popular pornographic website) analyzed trends in pornography access, finding that: (a) the percentage of gamers accessing Pornhub increased by 10% and (b) the searches of pornographic videos using the key term “Fortnite” increased by 60%. In this letter, we discuss these observations in the context of ongoing debate regarding the validity of “withdrawal” when applied to problematic involvement in video gaming and the potential use of pornography as a “compensation behavior” during the periods of “forced abstinence” from gaming.
Internet gaming disorder (IGD) has been viewed by scholars as (a) a pathology that co-occurs with psychological problems (comorbidity hypothesis), (b) maladaptive coping with abundant interpersonal problems (interpersonal impairment hypothesis), and (c) deficient self-regulation with the underlying motive to restore psychosocial well-being (dilution effect hypothesis). We examined the associations between IGD symptoms and four major criteria (psychological problems, interpersonal problems, psychological well-being, and interpersonal well-being), and compared the magnitude of these associations across countries. To test these hypotheses, we performed mixed-effects meta-analysis on 84 independent samples comprising 58,834 participants from 20 countries. The findings showed moderately strong positive associations between IGD symptoms and psychological problems across the countries, providing some support for the universality of the comorbidity hypothesis. The interpersonal impairment hypothesis was more tenable to countries lower (vs. higher) in power distance, which exhibited a stronger (vs. weaker) positive correlation between IGD symptoms and interpersonal problems. The dilution effect hypothesis was more tenable to countries either higher (vs. lower) in national life satisfaction or lower (vs. higher) in cultural masculinity, each of which displayed a weaker (vs. stronger) inverse correlation between IGD symptoms and interpersonal well-being.
Internet gaming disorder (IGD) is a proposed condition that refers to persistent gaming leading to clinically significant impairment. However, there have been few attempts to study the different types and degrees of harm caused by IGD. This commentary describes some of the negative intrapersonal and interpersonal effects of an extreme time investment in gaming activities in the context of IGD. Future research should examine the way in which IGD harms may occur at different levels and degrees. This may enhance the screening of individuals whose behavior is suspected to meet the definition of the proposed IGD criteria.
Aim
Internet gaming disorder (IGD) is a serious disorder leading to and maintaining pertinent personal and social impairment. IGD has to be considered in view of heterogeneous and incomplete concepts. We therefore reviewed the scientific literature on IGD to provide an overview focusing on definitions, symptoms, prevalence, and aetiology.
Method
We systematically reviewed the databases ERIC, PsyARTICLES, PsycINFO, PSYNDEX, and PubMed for the period January 1991 to August 2016, and additionally identified secondary references.
Results
The proposed definition in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition provides a good starting point for diagnosing IGD but entails some disadvantages. Developing IGD requires several interacting internal factors such as deficient self, mood and reward regulation, problems of decision‐making, and external factors such as deficient family background and social skills. In addition, specific game‐related factors may promote IGD. Summarizing aetiological knowledge, we suggest an integrated model of IGD elucidating the interplay of internal and external factors.
Interpretation
So far, the concept of IGD and the pathways leading to it are not entirely clear. In particular, long‐term follow‐up studies are missing. IGD should be understood as an endangering disorder with a complex psychosocial background.
What this paper adds
• In representative samples of children and adolescents, on average, 2% are affected by Internet gaming disorder (IGD).
• The mean prevalences (overall, clinical samples included) reach 5.5%.
• Definitions are heterogeneous and the relationship with substance‐related addictions is inconsistent.
• Many aetiological factors are related to the development and maintenance of IGD.
• This review presents an integrated model of IGD, delineating the interplay of these factors.
Internet gaming disorder (IGD) is currently positioned in the appendix of the DSM-5 as a condition requiring further study. The aim of this review was to examine the state of current knowledge of gaming withdrawal symptomatology, given the importance of withdrawal in positioning the disorder as a behavioral addiction. A total of 34 studies, including 10 qualitative studies, 17 research reports on psychometric instruments, and 7 treatment studies, were evaluated. The results indicated that the available evidence on Internet gaming withdrawal is very underdeveloped. Internet gaming withdrawal is most consistently referred to as ‘irritability’ and ‘restlessness’ following cessation of the activity. There exists a concerning paucity of qualitative studies that provide detailed clinical descriptions of symptoms arising from cessation of Internet gaming. This has arguably compromised efforts to quantify withdrawal symptoms in empirical studies of gaming populations. Treatment studies have not reported on the natural course of withdrawal and/or withdrawal symptom trajectory following intervention. It is concluded that many more qualitative clinical studies are needed, and should be prioritised, to develop our understanding of gaming withdrawal. This should improve clinical descriptions of problematic Internet gaming and in turn improve the quantification of IGD withdrawal and thus treatments for harmful Internet gaming.
Individuals receiving treatment for alcohol use disorders (AUDs) often experience urges to drink, and reductions in drinking urges during cognitive-behavioral therapy (CBT) predict better treatment outcomes. However, little previous work has examined patterns of daily drinking urges during treatment. This study examined patterns of change in daily drinking urges among participants in two randomized clinical trials of males (N = 80 with 4,401 daily recordings) and females ( N = 101 with 8,011 daily recordings) receiving individual- or couples-based CBT. Drinking urges were common during treatment, occurring on 45.1% of days for men and 44.8% for women. Drinking urges and alcohol use for both genders decreased substantially during the course of treatment. Both genders had increases in drinking urges as more time elapsed since attending a treatment session. For men, this increase was most pronounced at the beginning of treatment, but for women it was most pronounced near the end of treatment. Alcohol use and drinking urges were both more likely to occur on weekends. The results suggest that these times may lead to higher risk for drinking, and clients may benefit from high-risk planning that is focused on these times.
Several studies have suggested that addictive disorders including substance abuse and pathologic gambling might be associated with dysfunction on working memory and prefrontal activity. We hypothesized that excessive online game playing is associated with deficits in prefrontal cortex function and that recovery from excessive online game playing might improve prefrontal cortical activation in response to working memory stimulation.
Thirteen adolescents with excessive online game playing (AEOP) and ten healthy adolescents (HC) agreed to participate in this study. The severity of online game play and playing time were evaluated for a baseline measurement and again following four weeks of treatment. Brain activation in response to working memory tasks (simple and complex calculations) at baseline and subsequent measurements was assessed using BOLD functional magnetic resonance imaging (fMRI).
Compared to the HC subjects, the AEOP participants exhibited significantly greater activity in the right middle occipital gyrus, left cerebellum posterior lobe, left premotor cortex and left middle temporal gyrus in response to working memory tasks during baseline measurements. After four weeks of treatment, the AEOP subjects showed increased activity within the right dorsolateral prefrontal cortex and left occipital fusiform gyrus. After four weeks of treatment, changes in the severity of online game playing were negatively correlated with changes in the mean β value of the right dorsolateral prefrontal cortex in response to complex stimulation.
We suggest that the effects of online game addiction on working memory may be similar to those observed in patients with substance dependence.
Background
Behavioral addiction research has been particularly flourishing over the last two decades. However, recent publications have suggested that nearly all daily life activities might lead to a genuine addiction.
Methods and aim
In this article, we discuss how the use of atheoretical and confirmatory research approaches may result in the identification of an unlimited list of “new” behavioral addictions.
Results
Both methodological and theoretical shortcomings of these studies were discussed.
Conclusions
We suggested that studies overpathologizing daily life activities are likely to prompt a dismissive appraisal of behavioral addiction research. Consequently, we proposed several roadmaps for future research in the field, centrally highlighting the need for longer tenable behavioral addiction research that shifts from a mere criteria-based approach toward an approach focusing on the psychological processes involved.
Drawing from phenomenological interviews with 24 adult videogamers, we explore videogame consumption as a source of individualised, episodic progress. We first consider the relationship between play, progress, technology and the market. We then document adults' accounts of progress through the acquisition of new consoles and software, in the accumulation of in-game resources, and in creative achievements within videogames. Alongside an understanding of technological improvements as representing both technological and personal progress, we see how individuals may also turn to videogames in search of quick and easy episodes of achievement; here, progress is not some grand plan, but a series of small events helpfully structured by the latest game releases. Thus, in a society which aspires to a life where things 'get better' and time is usefully spent, adults who fail to actualise progress elsewhere may use videogames and related hardware to perform the idea of achievement as individualised episodes of play. In integrating the accepted cultural idea of progress, perceptions of adult play as 'frivolous' can be overcome and such practices may be normalised as a legitimate adult activity. However, play emerges from its frivolousness as legitimate only in compensating for working practices that remain alienated through technology-driven productivity, and through the latest technological commodities. The enjoyable nature of games as a leisure pursuit can become overshadowed by an obligation to achieve at the same time as distancing players from areas of their lives where progress is not experienced.
The inclusion of assessment criteria for internet gaming disorder in the DSM-5 appendix means that research in this area is likely to increase. However, a standardized assessment instrument is contingent on identifying criteria that adequately captures the phenomenon. I argue in this article that issues with the proposed criteria are consistently overlooked. First, there has been a tendency to adhere to DSM-4 criteria for substance use disorders or pathological gambling when defining the assessment criteria, rather than aiming to capture the unique determinants of internet gaming disorder. Furthermore, a diagnostic instrument for gaming in particular needs to account for cultural and social divides that are a non-issue when assessing substance use. Finally, some of the proposed criteria make little sense within the context of gaming and seem to be included as residuals from existing disorders. In this article, I discuss critically each proposed criterion. I conclude that deception is socially or culturally subjective and depends on people close to the player, rather than the player himself. Symptoms like preoccupation, withdrawal, tolerance and a loss of interest in other activities may all be preceded by legitimate explanations for excessive use following widespread popularity of online gaming, which makes them unreliable in an assessment instrument. Finally, I argue that tolerance does not make sense within a gaming context and is a residual criterion from substance use disorders. A reappraisal of these criteria would benefit the development of a standardized assessment instrument for internet gaming disorder.
Internet gaming disorder (IGD) has received nomenclatural recognition as a potential mental health disorder, despite evident variability in its core psychopathology and psychometric assessment. Although cognitive-behavioural therapy (CBT) is considered an efficacious treatment for IGD, the underlying cognitions of the disorder are not well understood. This review aimed to synthesise research evidence on Internet gaming cognition toward identification of cognitive factors underlying IGD. A systematic review of 29 quantitative studies on Internet gaming cognition and 7 treatment studies employing cognitive therapy for IGD was conducted. Four cognitive factors underlying IGD were identified. Factors included (a) beliefs about game reward value and tangibility, (b) maladaptive and inflexible rules about gaming behaviour, (c) over-reliance on gaming to meet self-esteem needs, and (d) gaming as a method of gaining social acceptance. It is proposed that IGD-related cognition may be more complex than "preoccupation" (i.e., criterion A of IGD). IGD cognition may involve the persistent overvaluation of video gaming rewards, activities, and identities, combined with a need to adhere to maladaptive rules governing use and completion of video games. Greater understanding of the proposed cognitive factors may advance clinical research agendas on identification of individuals with IGD, as well as the expansion and improvement of cognitive therapies for the disorder.
be included as a separate mental disorder until the defining features of IGD have been identified, reliability and validity of specific IGD criteria have been obtained cross-culturally, prevalence rates have been determined in representative epidemiologi -cal samples across the world, and etiology and associated biological features have been evaluated
Adolescents increasingly use electronic media as a night-time activity, amid concerns about the potential negative impact on sleep and daytime functioning. The present study examined electronic media use and pathological media use in relation to sleep activity in a normative sample of Australian adolescents. A total of 1,287 high school students aged 12–18 years (50 % female) were recruited from seven secondary schools in South Australia. Adolescents completed a questionnaire assessing electronic media use, pathological media use, and sleep factors. Adolescents reported non-optimal sleep duration on weekday (71 %) and weekend nights (53 %). One in five adolescents reported nightly bedtime delay as a consequence of electronic media use. Adolescent pathological media users reported significantly more sleep problems than their non-pathological peers. These data contribute to current knowledge of how electronic media use may negatively affect adolescent sleep patterns, particularly in regard to sleep displacement and sleep-onset latency effects. Further research is needed in light of the increasing accessibility and uptake of portable electronic media devices, as well as the growing use of media as a sleeping aid, among young people.
Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology. In this paper, we argue that it offers an accessible and theoretically flexible approach to analysing qualitative data. We outline what thematic analysis is, locating it in relation to other qualitative analytic methods that search for themes or patterns, and in relation to different epistemological and ontological positions. We then provide clear guidelines to those wanting to start thematic analysis, or conduct it in a more deliberate and rigorous way, and consider potential pitfalls in conducting thematic analysis. Finally, we outline the disadvantages and advantages of thematic analysis. We conclude by advocating thematic analysis as a useful and flexible method for qualitative research in and beyond psychology.
Four studies apply self-determination theory (SDT; Ryan & Deci, 2000) in investigating motivation for computer game play,
and the effects of game play on well-being. Studies 1–3 examine individuals playing 1, 2 and 4 games, respectively and show
that perceived in-game autonomy and competence are associated with game enjoyment, preferences, and changes in well-being
pre- to post-play. Competence and autonomy perceptions are also related to the intuitive nature of game controls, and the
sense of presence or immersion in participants’ game play experiences. Study 4 surveys an on-line community with experience
in multi-player games. Results show that SDT’s theorized needs for autonomy, competence, and relatedness independently predict
enjoyment and future game play. The SDT model is also compared with Yee’s (2005) motivation taxonomy of game play motivations.
Results are discussed in terms of the relatively unexplored landscape of human motivation within virtual worlds.
Excessive video game playing behaviour may be influenced by a variety of factors including the structural characteristics
of video games. Structural characteristics refer to those features inherent within the video game itself that may facilitate
initiation, development and maintenance of video game playing over time. Numerous structural characteristics that influence
gambling frequency and expenditure have been identified in the gambling literature, and some researchers have drawn comparisons
between the rewarding elements in video gaming and those in slot machine gambling. However, there have been few rigorous attempts
to classify and organise the psycho-structural elements of video games in a similar way to gambling. In order to aid current
psychological understanding of problem video game playing and guide further research questions in this area, a new taxonomy
of video game features is proposed, which includes: (a) social features, (b) manipulation and control features, (c) narrative
and identity features, (d) reward and punishment features, and (e) presentation features. Each category is supported with
relevant theory and research, where available, and the implications of these features for excessive video game playing are
discussed.
Innovative and impressive technological advances coupled with economies of scale have led to the mass availability of personal computers, mobile (cell) phones with integrated web-access, personal organizer and camera, and dedicated games and GPS devices. The common usage and reliance on electronic applications is evident by statistical data indicating that 56% of households own a personal computer and 50% access Internet facilities (US Census Bureau, 2005). In one survey of 4,000 users (Stanford University, 2005), 90% reported using the Internet for email communication followed by 77% for general information, 62% for product information, 36% for entertainment and games, 27% for stock shares, 24% for seeking positions of employment, and 12% for banking purposes. Internet is now consolidated as a necessary and standard business and communication tool with wireless technology improving mobility and enhancing easy access to the Internet. The potential for misuse and inappropriate and excessive use of certain computer applications has led to the expression of concerns related to the psychological and behavioural impact of the Internet on individuals. We find reference in media reports referring to complaints from commercial enterprises of email and Internet use leading to inefficiencies and reduced productivity, termination of employment or prosecutions resulting from the access to illegal/inappropriate websites, parental complaints related to children and adolescents becoming socially withdrawn and secluded through excessive time spent on computers, and educators and health professional concerned about the impact of computer usage on education and the physical health and obesity levels. Within this context emerges the claim from mental health professionals that a proportion of individuals develop a Fbehavioural_ addiction to computers (Shotton, 1991; Griffiths, 1996) and Internet use (Young, 1996). The concept of humanmachine Ftechnological_ addiction, it is argued, is a natural extension of behavioural or non-chemical group of addictions containing the core elements defining addiction
This study assessed how problem video game playing (PVP) varies with game type, or "genre," among adult video gamers. Participants (n=3,380) were adults (18+) who reported playing video games for 1 hour or more during the past week and completed a nationally representative online survey. The survey asked about characteristics of video game use, including titles played in the past year and patterns of (problematic) use. Participants self-reported the extent to which characteristics of PVP (e.g., playing longer than intended) described their game play. Five percent of our sample reported moderate to extreme problems. PVP was concentrated among persons who reported playing first-person shooter, action adventure, role-playing, and gambling games most during the past year. The identification of a subset of game types most associated with problem use suggests new directions for research into the specific design elements and reward mechanics of "addictive" video games and those populations at greatest risk of PVP with the ultimate goal of better understanding, preventing, and treating this contemporary mental health problem.
Online gaming has become increasingly popular in recent years. Currently, the most common business model of on- line gaming is based on monthly subscription fees that game players pay to obtain credits, which allow them to start or continue a journey in the game's virtual world. There- fore, from the perspective of game operators, predicting how many players will join a game and how long they will stay in the game is important since these two factors dominate their revenue. This paper represents a pilot study of the predictability of online gamers' subscription time. Specifically, we study the gameplay hours of online gamers and investigate whether strong patterns are embedded in their game hours. Our ulti- mate goal is to provide a prediction model of online gamers, which takes a player's game hours as the input and predicts whether the player will leave in the near future. Our study is based on real-life traces collected from World of Warcraft, a famous MMORPG (Massively Multiplayer Online Role- Playing Game). The traces contain the gameplay histories of 34, 524 players during a two-year period. We believe that our study would be useful for building a prediction model of players' future game hours and unsubscription decisions; i.e., decisions not to renew subscriptions.
Tobacco withdrawal is a key factor in smoking relapse, but important questions about the withdrawal phenomenon remain.
This research was intended to provide information about two core components of withdrawal (negative affect and craving): (1) how various withdrawal symptom profile dimensions (e.g., mean level, volatility, extreme values) differ between negative affect and craving; and (2) how these dimensions relate to cessation outcome.
Adult smokers (N = 1,504) in a double-blind randomized placebo-controlled smoking cessation trial provided real-time withdrawal symptom data four times per day for 4 weeks (2 weeks pre-quit and 2 weeks post-quit) via palmtop computers. Cessation outcome was biochemically confirmed 8-week point-prevalence abstinence.
Examination of craving and negative affect dimensions following a cessation attempt revealed that craving symptoms differed from negative affect symptoms, with higher means, greater variability, and a greater incidence of extreme peaks. Regression analyses revealed that abstinence was associated with lower mean levels of both craving and negative affect and fewer incidences of extreme craving peaks. In a multivariate model, the increase in mean craving and negative affect scores each uniquely predicted relapse.
Real-time reports revealed different patterns of abstinence-related negative affect and craving and that dimensions of both predict cessation outcome, suggesting that negative affect and craving dimensions each has motivational significance. This underscores the complexity of withdrawal as a determinant of relapse and the need to measure its distinct components and dimensions.
Several behaviors, besides psychoactive substance ingestion, produce short-term reward that may engender persistent behavior, despite knowledge of adverse consequences, i.e., diminished control over the behavior. These disorders have historically been conceptualized in several ways. One view posits these disorders as lying along an impulsive-compulsive spectrum, with some classified as impulse control disorders. An alternate, but not mutually exclusive, conceptualization considers the disorders as non-substance or "behavioral" addictions.
Inform the discussion on the relationship between psychoactive substance and behavioral addictions.
We review data illustrating similarities and differences between impulse control disorders or behavioral addictions and substance addictions. This topic is particularly relevant to the optimal classification of these disorders in the forthcoming fifth edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-V).
Growing evidence suggests that behavioral addictions resemble substance addictions in many domains, including natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment, supporting the DSM-V Task Force proposed new category of Addiction and Related Disorders encompassing both substance use disorders and non-substance addictions. Current data suggest that this combined category may be appropriate for pathological gambling and a few other better studied behavioral addictions, e.g., Internet addiction. There is currently insufficient data to justify any classification of other proposed behavioral addictions.
Proper categorization of behavioral addictions or impulse control disorders has substantial implications for the development of improved prevention and treatment strategies.
Young boys who did not own video games were promised a video-game system and child-appropriate games in exchange for participating in an "ongoing study of child development." After baseline assessment of boys' academic achievement and parent- and teacher-reported behavior, boys were randomly assigned to receive the video-game system immediately or to receive the video-game system after follow-up assessment, 4 months later. Boys who received the system immediately spent more time playing video games and less time engaged in after-school academic activities than comparison children. Boys who received the system immediately also had lower reading and writing scores and greater teacher-reported academic problems at follow-up than comparison children. Amount of video-game play mediated the relationship between video-game ownership and academic outcomes. Results provide experimental evidence that video games may displace after-school activities that have educational value and may interfere with the development of reading and writing skills in some children.
In a prospective study of 167 patients with head and neck cancer, we assessed the causes and mechanisms of pain, as well as the efficacy and side effects of analgesic treatment, along World Health Organization (WHO) guidelines. The majority of patients had pain caused by cancer (83%) and/or treatment (28%), 4% had pain due to debility, and 7% had pain unrelated to cancer. Palliative antineoplastic treatment was performed in 32% of patients. Systemic analgesics were administered on 97% of a total of 8,106 treatment days, and coanalgesics or adjuvant drugs on 100%. The treatment proved to be very successful, as severe pain was experienced only during 5% of the observation period. In the absence of serious side effects, the most frequent symptoms observed were insomnia, dysphagia, anorexia, constipation, and nausea. The use of analgesic and adjuvant drugs along WHO guidelines to treat pain in head and neck cancer is highly effective and relatively safe.
Problems related to intemperate Internet use are examined within the conceptual framework of addiction. It is argued that empirical support for the construct validity of computer addiction has yet to emerge, that defining the construct as a unique psychiatric disorder is therefore premature, and that, in most cases, excessive computer use may be symptomatic of other, more primary disorders. Greater caution and rigor are urged in investigating and treating problems related to intemperate computer use.
Fifty pathological gamblers and 42 alcohol dependent subjects were compared regarding craving, emotional states and social functioning. Subjects self-rated their cravings using the Weiss Craving Scale (WCS) and the Pennsylvania Craving Scale (PCS). Subjects answered a semi-structured interview, the Positive and Negative Affect Scale Extended Form (PANAS-X), and the Social Adjustment Scale (SAS-SR). Gamblers had higher scores on craving measures. Regression models showed that craving for gambling and alcohol have a significant correlation with emotional states. Craving for gambling was inversely correlated with positive affect and craving for alcohol was directly correlated with negative affect. Gambling craving was more dependent upon external factors and related to an unpleasant dearousing state, while alcohol craving was associated with an unpleasant arousing state. These findings point to the key role of emotional deregulation on gambling and alcohol cravings following early abstinence.
Internet gaming disorder (IGD) is a new disorder currently positioned in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Few clinical studies report that psychological and pharmacological interventions can significantly reduce the severity of IGD symptomatology. The aim of this review was to assess current knowledge of the short- and long-term benefits of IGD interventions. This review presents a systematic evaluation of definitions of diagnosis and treatment outcomes employed in IGD treatment studies, including an assessment of goodness of fit with the DSM-5 classification.
A computer database search of Academic Search Premier, PubMed, PsychINFO, ScienceDirect, Web of Science, and Google Scholar was conducted to identify all available research evidence on Internet gaming disorder treatment (N = 8 studies). Diagnostic and treatment outcome parameters were systematically evaluated.
Several weaknesses of IGD treatment literature were identified. Only 2 treatment studies have employed an equivalent method of diagnosis for IGD. Studies have not assessed formative change in diagnostic status at posttreatment or follow-up. Duration of follow-up has been inadequate to assess relapse and remission. Posttreatment assessment has been predominantly limited to IGD symptomatology, comorbidity, and frequency of gaming behavior.
Currently, there is insufficient evidence to warrant suggestion that trialled IGD interventions confer a long-term therapeutic benefit. Several improvements to study design and reporting are proposed to guide future studies of IGD.
For the first time, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduces non-substance addictions as psychiatric diagnoses. The aims of this paper are to (i) present the main controversies surrounding the decision to include internet gaming disorder, but not internet addiction more globally, as a non-substance addiction in the research appendix of the DSM-5, and (ii) discuss the meaning behind the DSM-5 criteria for internet gaming disorder. The paper also proposes a common method for assessing internet gaming disorder. Although the need for common diagnostic criteria is not debated, the existence of multiple instruments reflect the divergence of opinions in the field regarding how best to diagnose this condition.
We convened international experts from European, North and South American, Asian and Australasian countries to discuss and achieve consensus about assessing internet gaming disorder as defined within DSM-5.
We describe the intended meaning behind each of the nine DSM-5 criteria for internet gaming disorder and present a single item that best reflects each criterion, translated into the 10 main languages of countries in which research on this condition has been conducted.
Using results from this cross-cultural collaboration, we outline important research directions for understanding and assessing internet gaming disorder. As this field moves forward, it is critical that researchers and clinicians around the world begin to apply a common methodology; this report is the first to achieve an international consensus related to the assessment of internet gaming disorder.
Online gaming addiction is a relatively under-researched area and there have been few studies examining online gamers in treatment. This paper reports the findings from a qualitative interview study of nine players undergoing treatment for their addictive playing of Massively Multiplayer Online Role Playing Games (MMORPGs). A face-to-face interview study with nine online gaming addicts was carried out using Grounded Theory. The six most reported phenomena by the participants were: (i) entertainment search, (ii) virtual friendship, (iii) escapism and/or dissociation, (iv) game context, (v) control versus no control, and (vi) conflict. The findings suggest that players’ initial gaming motivation is because of three factors: (i) entertainment, (ii) escapism, and/or (iii) virtual friendship. MMORPG addiction appears once the playing time significantly increases, coupled with a loss of control and a narrow behavior focus. These factors lead to problems and result in psychological dependence and serious life conflicts. The consequences of MMORPG addiction are similar to the consequences of more established substance addictions including salience, mood modification, loss of control, craving, and serious adverse effects. Additionally, in some cases, tolerance and relapse may also be present.
There is now a growing movement that views a number of behaviours as potentially addictive including many that do not involve the ingestion of a drug (such as gambling, sex, exercise, videogame playing and Internet use). This paper argues that all addictions consist of a number of distinct common components (salience, mood modification, tolerance, withdrawal, conflict and relapse). The paper argues that addictions are a part of a biopsychosocial process and evidence is growing that excessive behaviours of all types do seem to have many commonalities. It is argued that an eclectic approach to the studying of addictive behaviour appears to be the most pragmatic way forward in the field. Such commonalities may have implications not only for treatment of such behaviours but also for how the general public perceive such behaviours.
This paper argues that the recent concerns about video game “addiction” have been based less on scientific facts and more
upon media hysteria. By examining the literature, it will be demonstrated that the current criteria used for identifying this
concept are both inappropriate and misleading. Furthermore, by presenting four case studies as examples it will be demonstrated
how such claims of video game addiction can be inaccurately applied. It is concluded that the most likely reasons that people
play video games excessively are due to either ineffective time management skills, or as a symptomatic response to other underlying
problems that they are escaping from, rather than any inherent addictive properties of the actual games.
Research into online gaming addiction is a relatively new area of psychological study. Furthermore, there are studies that
have claimed that online gaming addiction may be addictive because of self-report accounts of very excessive use of up to
80h a week. This study uses data from two case studies to highlight the role of context in distinguishing excessive gaming
from addictive gaming. Both of the gamers in this study claimed to be playing for up to 14h a day yet and although they were
behaviorally identical in terms of their game playing, they were very different in terms of psychological motivation and the
meaning and experience of gaming within their lives. It is argued that one of the players appears to be genuinely addicted
to online gaming but that the other player is not based on context and consequences. The two cases outlined highlight the
importance of context in the life of a gamer and demonstrates that excessive gaming does not necessarily mean that a person
is addicted. It is argued that online gaming addiction should be characterized by the extent to which excessive gaming impacts
negatively on other areas of the gamers’ lives rather than the amount of time spent playing. It is also concluded that an
activity cannot be described as an addiction if there are few (or no) negative consequences in the player’s life even if the
gamer is playing 14h a day.
Over the last few years there has been an increasing interest in Massively Multiplayer Online Role-Playing Games (MMORPGs). These represent the latest Internet-only computer gaming experience consisting of a multi-player universe with an advanced and detailed world. One of the most popular (and largest) of these is Everquest. The data for this study were taken from a range of online gaming forums where individuals shared their experiences of playing EverQuest. Data were analyzed using interpretative phenomenological analysis (IPA), a method for analyzing qualitative data and meaning making activities. The study presents an IPA account of online gamers who perceive themselves to play excessively. The aim of the study was to examine how individuals perceived and made sense of EverQuest in the context of their lives. It is clear that the accounts presented by players and ex-players appear to be ‘addicted’ to EverQuest in the same way that other people become addicted to alcohol or gambling. Most of the individuals in this study appear to display (or allude to) the core components of addiction such as salience, mood modification, tolerance, conflict, withdrawal symptoms, cravings, and relapse.
Preliminary research studies suggest that some people who use computer, video
games, and the Internet heavily develop dysfunctional symptoms, often referred to in the
popular press as an “addiction.” Although several studies have measured various facets of
this issue, there has been no common framework within which to view these studies. This
paper aims to provide a conceptual framework of “impulse control disorders” and describe
what is known currently based on a review of the international literature, and highlight what
remains to be studied. We suggest the term “Pathological Technology Use” (PTU) rather
than “internet addiction”, since there is robust construct validity (via convergent validity and
comorbidity) for pathological computer, video game and Internet use, regardless of how
individual researchers defined or measured it. Questions concerning diagnostic criteria are
raised, and a common set of diagnostic criteria is proposed.
To examine the association of person-specific trajectories of withdrawal symptoms of urge-to-smoke, negative affect, physical symptoms and hunger during the first 7 days after smoking cessation with abstinence at end of treatment (EOT) and at 6 months.
Hierarchical linear modeling (HLM) was used to model person-specific trajectory parameters (level, slope, curvature and volatility) for withdrawal symptoms.
University-based smoking cessation trials.
Treatment-seeking smokers in clinical trials of transdermal nicotine versus nicotine spray (n = 514) and bupropion versus placebo (n = 421).
Self-reported withdrawal symptoms for 7 days after the planned quit date, and 7-day point prevalence and continuous abstinence at EOT and 6 months.
In regressions that included trajectory parameters for one group of withdrawal symptoms, both urge-to-smoke and negative affect were predictive of abstinence while physical symptoms and hunger were generally not predictive. In stepwise regressions that included the complete set of trajectory parameters across withdrawal symptoms (for urge-to-smoke, negative affect, physical symptoms and hunger), with a single exception only the trajectory parameters for urge-to-smoke were predictive. Area under the receiver operator characteristic curve was 0.594 for covariates alone, and 0.670 for covariates plus urge-to-smoke trajectory parameters.
Among a number of different withdrawal symptoms (urge-to-smoke, negative affect, physical symptoms and hunger) urge-to-smoke trajectory parameters (level, slope and volatility) over the first 7 days of smoking cessation show the strongest prediction of both short- and long-term relapse. Other withdrawal symptoms increase the predictive ability by negligible amounts.
The objective of this study was to develop diagnostic criteria for internet addiction disorder (IAD) and to evaluate the validity of our proposed diagnostic criteria for discriminating non-dependent from dependent internet use in the general population.
This study was conducted in three stages: the developmental stage (110 subjects in the survey group; 408 subjects in the training group), where items of the proposed diagnostic criteria were developed and tested; the validation stage (n = 405), where the proposed criteria were evaluated for criterion-related validity; and the clinical stage (n = 150), where the criteria and the global clinical impression of IAD were evaluated by more than one psychiatrist to determine inter-rater reliability.
The proposed internet addiction diagnostic criteria consisted of symptom criterion (seven clinical symptoms of IAD), clinically significant impairment criterion (functional and psychosocial impairments), course criterion (duration of addiction lasting at least 3 months, with at least 6 hours of non-essential internet usage per day) and exclusion criterion (exclusion of dependency attributed to psychotic disorders). A diagnostic score of 2 + 1, where the first two symptoms (preoccupation and withdrawal symptoms) and at least one of the five other symptoms (tolerance, lack of control, continued excessive use despite knowledge of negative effects/affects, loss of interests excluding internet, and use of the internet to escape or relieve a dysphoric mood) was established. Inter-rater reliability was 98%.
Our findings suggest that the proposed diagnostic criteria may be useful for the standardization of diagnostic criteria for IAD.
To examine whether withdrawal after abstinence and cue-elicited craving were associated with polymorphisms within two genes involved in regulating the endocannabinoid system, cannabinoid receptor 1 (CNR1) and fatty acid amide hydrolase (FAAH). Two single nucleotide polymorphisms (SNPs) in the CNR1 (rs2023239) and FAAH (rs324420) genes, associated previously with substance abuse and functional changes in cannabinoid regulation, were examined in a sample of daily marijuana smokers.
Participants were 105 students at the University of Colorado, Boulder between the ages of 18 and 25 years who reported smoking marijuana daily.
Participants were assessed once at baseline and again after 5 days of abstinence, during which they were exposed to a cue-elicited craving paradigm. Outcome measures were withdrawal and craving collected using self-reported questionnaires. In addition, urine samples were collected at baseline and on day 5 for the purposes of 11-nor-9-carboxy-Delta9-tetrahydrocannabinol (THC-COOH) metabolite analysis.
Between the two sessions, THC-COOH metabolite levels decreased significantly, while measures of withdrawal and craving increased significantly. The CNR1 SNP displayed a significant abstinence x genotype interaction on withdrawal, as well as a main effect on overall levels of craving, while the FAAH SNP displayed a significant abstinence x genotype interaction on craving.
These genetic findings may have both etiological and treatment implications. However, longitudinal studies will be needed to clarify whether these genetic variations influence the trajectory of marijuana use/dependence. The identification of underlying genetic differences in phenotypes such as craving and withdrawal may aid genetically targeted approaches to the treatment of cannabis dependence.
This paper reports on the experience gained using World Health Organization Guidelines for cancer pain relief over a 10-year period in an anaesthesiology-based pain service associated with a palliative care programme. The course of treatment of 2118 patients was assessed prospectively over a period of 140,478 treatment days. Non-opioid analgesics (WHO step I) were used on 11%, weak opioids (WHO step II) on 31% and strong opioids (WHO step III) on 49% of treatment days. Administration was via the enteral route on 82% and parenterally on 9% of treatment days. On the remaining days, either spinally applied opioids (2%) or other treatments (6%) were utilised. Fifty-six percent of the patients were treated with morphine. Morphine dose escalation was observed in about one-half of the patients being cared for until death, whereas the other half had stable or decreasing doses over the course of treatment. Co-analgesics were administered on 37% of days, most often antidepressants (15%), anticonvulsants (13%) and corticosteroids (13%). Adjuvants to treat symptoms other than pain were prescribed on 79% of days, most commonly laxatives (42%), histamine-2-receptor antagonists (39%) and antiemetics (35%). In addition, palliative antineoplastic treatment was performed in 42%, nerve blocks in 8%, physiotherapy in 5%, psychotherapy in 3% and TENS in 3% of patients. A highly significant pain reduction was achieved within the 1st week of treatment (P < 0.001). Over the whole treatment period, good pain relief was reported in 76%, satisfactory efficacy in 12% and inadequate efficacy in 12% of patients. In the final days of life, 84% rated their pain as moderate or less, while 10% were unable to give a rating. Analgesics remained constantly effective in all 3 steps of the WHO ladder. Other clinical symptoms were likewise significantly reduced at 1 week after initial assessment, with the exception of neuropsychiatric symptoms. During the course of treatment, the latter were the major symptoms on 23% of days, followed by nausea (23%), constipation (23%) and anorexia (20%). Our results emphasise once again the marked efficacy and low rate of complications associated with oral and parenteral analgesic therapy as the mainstay of pain treatment in the palliative care of patients with advanced cancer. Wide dissemination of WHO guidelines among doctors and healthcare workers is thus necessary to effect a clear improvement in the treatment of the many patients suffering from cancer pain in the clinical and home setting.
Craving is a central phenomenon in addiction. Temperament factors are also important for pathologic gambling and other addictions. The aim of this study was to compare craving between pathologic gamblers (PG) and alcohol-dependent subjects (ADS), correlating craving with personality.
Forty-nine PG and 101 ADS willing to start treatment were recruited. A trained psychiatrist diagnosed them according to DSM-IV criteria. To be included in this study, subjects had to be abstinent for at least five days and no longer than 21 days. Alcoholics should have no significant physical withdrawal symptoms by the time of craving assessment. Subjects with current comorbidity with other addictions were excluded, except nicotine. ADS rated craving for alcohol and PG rated craving for gambling on the same questions, respectively. Both answered a semistructured interview, the Temperament and Character Inventory and the Beck Scales for anxiety and depression.
Pathologic gamblers scored higher than ADS on craving measures (p<0.001) and novelty seeking (p=0.01). ADS scored higher in harm avoidance (p=0.01). Alcohol craving correlated positively with anxiety and novelty seeking and negatively with length of abstinence and persistence. Gambling craving correlated positively with depression and negatively with length of abstinence and reward dependence
Pathologic gamblers experienced stronger cravings than did ADS. This may be a disturbing experience for PG and a potential cause for relapse. The higher scores on novelty seeking concur with previous studies that associate PG and impulsivity. ADS higher scores on harm avoidance suggest anxiety vulnerability. The positive relation between alcohol craving, anxiety, and harm avoidance suggests that ADS rely on alcohol to deal with a proclivity to negative emotions. The positive relation of gambling craving to depression and negative relation to reward dependence suggests that individuals who have a lesser susceptibility to experience positive emotions are the ones who most miss gambling when abstaining.
An empirical model of player motivations in online games provides the foundation to understand and assess how players differ from one another and how motivations of play relate to age, gender, usage patterns, and in-game behaviors. In the current study, a factor analytic approach was used to create an empirical model of player motivations. The analysis revealed 10 motivation subcomponents that grouped into three overarching components (achievement, social, and immersion). Relationships between motivations and demographic variables (age, gender, and usage patterns) are also presented.
There is burgeoning interest in the study of video games. Existing work is limited by the use of correlational designs and is thus unable to make causal inferences or remove self-selection biases from observed results. The recent development of online, socially integrated video games (massively multiplayer online role-playing games [MMORPGs]) has created a new experience for gamers. This randomized, longitudinal study examined the effects of being assigned to play different video game types on game usage, health, well-being, sleep, socializing, and academics. One hundred 18- to 20-year-old participants (73% male; 68% Caucasian) were randomly assigned to play arcade, console, solo computer, or MMORPG games for 1 month. The MMORPG group differed significantly from other groups after 1 month, reporting more hours spent playing, worse health, worse sleep quality, and greater interference in "real-life" socializing and academic work. In contrast, this group also reported greater enjoyment in playing, greater interest in continuing to play, and greater acquisition of new friendships. MMORPGs represent a different gaming experience with different consequences than other types of video games and appear to pose both unique risks and benefits from their use.
Rules of play: Game design fundamentals
- K Salen
- E Zimmerman
Salen, K., & Zimmerman, E. (2004). Rules of play: Game design fundamentals. MIT
press.
Toward a consensus definition of pathological video-gaming: a systematic review of psychometric assessment tools
- D L King
- M C Haagsma
- P H Delfabbro
- M Gradisar
- M D Griffiths
King, D. L., Haagsma, M. C., Delfabbro, P. H., Gradisar, M., & Griffiths, M. D. (2013).
Toward a consensus definition of pathological video-gaming: a systematic review of psychometric assessment tools. Clinical Psychology Review, 33, 331e342.
Molesworth, M., & Watkins, R. D. (2014). Adult videogame consumption as individualised, episodic progress. Journal of Consumer Culture. http://dx.doi.org/
10.1177/1469540514528195.