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The association between problematic online gaming and perceived stress:
The moderating effect of psychological resilience
NATALE CANALE
1
*, CLAUDIA MARINO
1
, MARK D. GRIFFITHS
2
, LUCA SCACCHI
3
, MARIA GRAZIA MONACI
3
and
ALESSIO VIENO
1
1
Department of Developmental and Social Psychology, University of Padova, Padova, Italy
2
International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
3
Dipartimento di Scienze Umane e Sociali, Università della Valle d’Aosta, Aosta, Italy
(Received: July 24, 2018; revised manuscript received: December 5, 2018; accepted: December 9, 2018)
Background and aims: Vulnerability to stress appears to be a potential predisposing factor for developing specific
internet-use disorders, such as Internet Gaming Disorder (IGD). Studies investigating the protective effect of
psychological resilience against the impact of perceived stress on IGD and weekly gameplay have yet to be reported
in the existing literature. The aim of this study was to examine the potential moderating relationships between
perceived stress and online gaming (more specifically operationalized as IGD and weekly gameplay) with
psychological resilience. Methods: An online survey was administered to 605 participants (males =82%,
M
age
=24.01 years, SD
age
=6.11). A multivariate multiple regression model was applied to test for the possible
contribution of perceived stress and psychological resilience to weekly gameplay and IGD. Results: Perceived stress
was associated with higher scores of IGD, whereas psychological resilience was related to lower scores of IGD. In
addition, the combination of having higher perceived stress and lower level of psychological resilience was associated
with a particularly high hours of gameplay per week. Discussion and conclusions: These findings further support the
importance of personal traits (perceived stress and psychological resilience) in online gaming (IGD severity and
weekly gameplay), and also emphasize the unique moderating relationship between perceived stress and weekly
gameplay with lack of resilience. Enhancing psychological resilience to decrease the likelihood of online gamers who
experience higher level of stress from spending more hours per week gaming is recommended.
Keywords: gaming, Internet Gaming Disorder, IGD, problematic gaming, resilience, stress
INTRODUCTION
There is growing evidence sustaining that Internet Gaming
Disorder (IGD) constitutes a public health concern, and can
have negative consequences (e.g., Rumpf et al., 2018).
Despite the ongoing debate about the definition and concep-
tualization of IGD (e.g., Griffiths et al., 2016;King et al.,
2018), recent research demonstrates that problematic gaming
is characterized by an extensive engagement in gaming
activities in terms of time spent gaming (e.g., displacing other
important activities), addictive-like symptoms, and significant
impairments in daily life (Marino & Spada, 2017;Pontes &
Griffiths, 2015). It has been advocated that compared to the
huge numbers of gamers worldwide, only a small proportion
is affected by IGD (e.g., Snodgrass et al., 2017). However, the
World Health Organization (WHO) recently asserted that the
increasing time people spend gaming should be monitored
and evaluated as it may constitute a risk factor for developing
IGD (WHO, 2018). Based on this assertion, this study
included measures of both weekly gameplay (hours) and
IGD as outcome variables to simultaneously investigate the
role of perceived stress and psychological resilience in
explaining both aspects of problematic gaming.
According to a recent model on the development
and maintenance of specific internet-use disorders
(i.e., Interaction of Person-Affect-Cognition-Execution
model; Brand, Young, Laier, Wölfling, & Potenza,
2016), vulnerability to stress is a potential predisposing
factor for developing specific internet-use disorders. The
model highlights that perceived stress resulting from
abnormal mood, personal conflicts, or life events may
potentially influence how people use the internet
(e.g., coping with problems in various psychosocial
domains). Perceived stress is defined as the level to which
someone tends to perceive stressful situations as uncon-
trollable, unpredictable, and severe (Cohen, Kamarck, &
Mermelstein, 1983). Recent studies have shown per-
ceived stress is positively associated with internet addic-
tion and/or IGD (Che et al., 2017;Rosenkranz, Müller,
Dreier, Beutel, & Wölfling, 2017). Highly stressed online
gamers may use gaming as a potential vehicle to relieve
* Corresponding author: Natale Canale, PhD; Department of
Developmental and Social Psychology, University of Padova, Via
Venezia, Padova 15-35121, Italy; Phone: +39 049 827 6524; Fax:
+39 049 827 6547; E-mail: natale.canale@unipd.it
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License,
which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and
source are credited, a link to the CC License is provided, and changes –if any –are indicated.
© 2019 The Author(s)
BRIEF REPORT Journal of Behavioral Addictions
DOI: 10.1556/2006.8.2019.01
their preexisting life stress, which might amplify their
stress experience (Snodgrass et al., 2014).
According to the General Theory of Addictions (Jacobs,
1986), potential factors that have been found to interact in
the relationship between stress and addictive behaviors are
personality variables. For example, personality traits mod-
erated the effect of stress on addictive behaviors or decision-
making under ambiguity (Canale, Rubaltelli, Vieno,
Pittarello, & Billieux, 2017). Among the personality vari-
ables, a relevant one is psychological resilience, defined as
the ability to adapt to adverse situations in a positive manner
(Lussier, Derevensky, Gupta, Bergevin, & Ellenbogen,
2007). Psychological resilience can be considered a resource
that helps individuals in coping with adversity, facilitates
adequate adjustment, and aids development (Hu, Zhang, &
Wang, 2015) because it provides them with the required
ability to respond effectively under stressful circumstances
(Dyrbye et al., 2010). Consequently, low levels of psycho-
logical resilience can be a disadvantage. In fact, tendencies
toward lack of psychological resilience when confronted
with daily stress have been considered problematic in the
context of addicted use of specific internet applications. For
instance, Hou et al. (2017) found the association between
perceived stress and problematic social networking site
(SNS) use was statistically significant for college students
who reported a lack of psychological resilience (and not for
those with a higher level of psychological resilience).
This highlights that psychological resilience may prevent
the development of problematic behaviors (e.g., Green,
Beckham, Youseef, & Elbogen, 2014) because individuals
who report higher levels of psychological resilience are
less affected by adverse risks and stress (Roy, Carli, &
Sarchiapone, 2011;Stoddard, Zimmerman, & Bauermeister,
2012). Although the potential (modest) protective effects of
psychological resilience on SNS/IGD have been reported
among Chinese adults/college students (Hou et al., 2017;
Wu, Chen, Tong, Yu, & Lau, 2018), studies investigating
the protective effect of psychological resilience against the
impact of perceived stress on IGD and weekly gameplay
have yet to be reported. To date, only one study has tested
the moderating effect of psychological resilience in the
relationships between psychological distress (depression/
anxiety) and IGD, and no significant buffering effect was
found in general Chinese adult populations (Wu et al.,
2018). However, an important limitation was that they
operationalized psychological distress as a combined mea-
sure of depression and anxiety, two of the three subscales of
the Depression Anxiety Stress Scales (DASS-21; Lovibond
& Lovibond,1995) while specifically excluding stress
(i.e., the third subscale of DASS-21). This omission is
important, because their measure of psychological distress
did not consider individual vulnerability to stress. However,
the degree to which an individual tends to perceive stressful
events as uncontrollable, unpredictable, and severe is likely
to be a potential predisposing factor for developing IGD
(Brand et al., 2016). Consequently, the present study
addresses this gap in the literature.
The purposes of this study were to: (a) further confirm the
relationship between perceived stress, psychological resil-
ience, and IGD (alongside weekly number of gameplay
hours); and (b) test the potential interaction effects of
perceived stress with psychological resilience on weekly
gameplay and IGD in a general adult sample. It was
hypothesized that: (a) perceived stress would be positively
related to weekly gameplay and IGD; (b) psychological
resilience would be negatively associated with weekly
gameplay and IGD; and (c) low psychological resilience
would moderate (i.e., strengthen) the association between
perceived stress and weekly gameplay and IGD, by showing
that the association between perceived stress and weekly
gameplay/IGD would be statistically significant for indivi-
duals with lower levels of psychological resilience, whereas
there would be no significant association for those with a
higher level of psychological resilience.
METHODS
Procedure and participants
This study utilized a cross-sectional online survey from June 1
to October 15, 2017. Participants were recruited through
online advertisements on research-related websites and Face-
book groups. Inclusion criteria were: (a) being at least 18 years
old, (b) being able to complete the questionnaire in Italian, and
(c) reporting online gaming of at least half an hour per week.
A total of 699 respondents began the survey, and 87%
completed it without any financial incentives. The final sample
size was 605 participants (males =82%; M
age
=24.01 years,
SD
age
=6.11, age range =18–61 years). With regard to game
genre, 27.5% of the participants reported playing massively
multiplayer online games. The average of total number of
years of gaming experience was approximately 9 years rang-
ing from 1 to 20 years in the present sample. Other data, not
related with this study, will be presented elsewhere.
Measures
Trait perceived stress. Trait perceived stress was assessed
using the Perceived Stress Scale (PSS), which assesses the
degree to which life events are appraised as stressful (Cohen
et al., 1983; Italian translation: Fossati, 2010). The PSS
comprises 10 items rated on a 5-point Likert scale, ranging
from 0 (never)to4(very frequently). Higher scores reflect
higher levels of perceived stress in response to stressful
situations. The internal consistency of the PSS in this study
was 0.83 [95% CI =0.81–0.85].
Psychological resilience. Psychological resilience
was assessed using the 10-item Resilience Scale (RS-10;
Wagnild & Young, 1993; Italian version: Peveri, 2010),
which assesses the ability to successfully cope with change
or misfortune. Responses are rated on a 7-point scale
(ranging from disagree to agree). Higher scores represent
higher psychological resilience. The internal consistency of
the RS-10 in this study was 0.84 [95% CI =0.82–0.86].
Weekly gameplay. Weekly gameplay reflected partici-
pants’weekly time spent playing on computers, consoles,
and/or other gaming platforms (e.g., handheld devices). For
this measure, a single item was used: How many hours (if
any) do you usually spend on online videogames in a week?
Internet Gaming Disorder (IGD). The severity of IGD
and its detrimental effects over a 12-month period was
Journal of Behavioral Addictions
Canale et al.
assessed using the Italian version of the nine-item (short
form) of the Internet Gaming Disorder Scale (IGDS9-SF;
Monacis, Palo, Griffiths, & Sinatra, 2016; original English
version by Pontes & Griffiths, 2015) based on the nine IGD
DSM-5 items (American Psychiatric Association [APA],
2013). Responses are rated on a 5-point scale (never to very
often). On the basis of α=.84 in this study [95% CI =0.82–
0.86], responses were averaged to obtain a synthetic mea-
sure, where higher scores represented a higher IGD severity
(i.e., minimum 1 and maximum 5).
Sociodemographics. The survey also included questions
concerning sociodemographics characteristics of the parti-
cipants including gender, age, game genre, and gaming
experience.
Statistical analysis
To test for the possible contribution of perceived stress and
psychological resilience to weekly gameplay and IGD simul-
taneously, multivariate multiple regression was applied
(e.g., for modeling multiple simultaneous dependent variables
with a single set of independent variables), using the package
lavaan (Rosseel, 2012) of the open-source software R
(R Development Core Team, 2013). The covariance matrix
of the observed variables was analyzed using a maximum
likelihood method estimator. The variables considered for
moderation analyses were mean-centered to reduce possible
collinearity with interaction terms. To probe the moderating
effect, the recommendations of Cohen, Cohen, West, and
Aiken (2003) were followed for the interpretation of the
moderation between the dependent variable and the modera-
tor variable. More specifically, the association between the
independent variable and the dependent variable was plotted
when the levels of the moderator variable were 1 SD below
and above the mean value of the moderator variable. Tests of
the simple slopes were also performed by testing the statistical
significance of each of the two slopes (Aiken, West, & Reno,
1991). According to previous studies that have demonstrated
that gender and age (e.g., Hawi, Samaha, & Griffiths, 2018;
Kuss & Griffiths, 2012;Lemmens, Valkenburg, & Gentile,
2015) are associated with IGD and weekly gameplay, gender
and age were included as control variables in the multivariate
multiple regression model. To evaluate the goodness of fitof
the multivariate regression model, the R
2
of each dependent
variable and the total variance explained by the model were
considered [total coefficient of determination (TCD); Canale
et al., 2016;Jöreskog & Sörbom, 1996;Marino, Mazzieri,
Caselli, Vieno, & Spada, 2018].
Ethics
The ethical committee of the University of Padova provided
approval for the study. All participants were informed about
the study aims and gave their informed consent prior to the
online survey, which took approximately 25 min to com-
plete. This study did not involve human and/or animal
experimentation and conformed to all guidelines according
to the Declaration of Helsinki.
RESULTS
Table 1summarizes the means, standard deviations (SDs),
and bivariate correlations among the study variables. The
average amount of weekly gameplay was 22.13 hr
(SD =16.87 hr per week, minimum =0.5 hr and maximum =
112 hr, skewness =1.65, kurtosis =3.90). Almost one
third of the sample (27.2%) reported playing games for
more than 30 hr per week. The average severity of IGD was
small 1.90 (SD =0.72, range =1–5, skewness =1.18,
kurtosis =1.18). The severity of IGD was correlated mod-
erately with playing time per week (r=.32, p<.001). No
multicollinearity issues were detected for the multiple re-
gression analyses model. All predictors had tolerance values
of at least 0.65 and variance inflation factor (VIF) values
below 1.51. Tolerance values over 0.02 and a value under
2.5 for VIF are considered reliable cut-off points for the
absence of multicollinearity (Craney & Surles, 2002). In
addition, Cook’s distance was used to assess the influence of
individual observations on the multivariate multiple regres-
sion model for weekly gameplay scores and IGD scores.
Cook’s distance was less than 1 (Cook & Weisberg, 1982),
so none of the participants fulfilled the criteria for outliers as
assessed by Cook’s distance.
The results from the multivariate multiple regression
analyses (Table 2) showed that higher levels of perceived
stress were associated with higher IGD scores (β=0.32,
p<.001), whereas higher psychological resilience scores
were associated with lower IGD scores (β=−0.17,
p<.001). With regard to the control variables, age
(β=−0.08, p=.04) and gender (β=−0.13, p=.001) were
negatively associated with IGD scores. The results for the
weekly gameplay showed that perceived stress and psycho-
logical resilience were not associated with gameplay during
the week. The two-way interaction between perceived stress
and psychological resilience was significantly related to
weekly gameplay (β=−0.10, p=.020). To probe the
Table 1. Mean (M), standard deviations (SDs), and correlation between variables
12 3456M(%) SD
1. Gender (males) –82.00
2. Age .04 –24.00 6.11
3. Psychological resilience −.07 .09* –5.11 1.01
4. Perceived stress .20*** −.15*** −.544*** –2.00 0.70
5. Weekly gameplay −.10* −.13** −.15*** .13** –22.13 16.87
6. IGD score −.05 −.15*** −.35*** .39*** .32*** –1.90 0.72
Note. IGD: Internet Gaming Disorder.
*p<.05. **p<.01. ***p<.001.
Journal of Behavioral Addictions
Stress, resilience, and problematic online gaming
interaction-effect, a simple slope test was conducted (Aiken
et al., 1991), which showed weekly gameplay as a function
of perceived stress and psychological resilience (Figure 1).
The positive association between perceived stress and
weekly gameplay was statistically significant among parti-
cipants with lower levels of psychological resilience (simple
slope =3.41, SE =1.35, tvalue =2.55, p=.011), whereas
it was non-significant for those with higher levels of psy-
chological resilience (simple slope =−0.13, SE =1.43,
tvalue =−0.09, p=.926). This means that low psycho-
logical resilience strengthened the association between
perceived stress and weekly gameplay. Finally, gender
(β=−0.10, p=.009) and age (β=−0.11, p=.006) had a
significant negative association with weekly gameplay.
The regression model accounted for 20% of the variance
of IGD with less variance for weekly hours (i.e., 6%;
Table 2). Finally, the total amount variance explained by
the multivariate regression model (TCD =0.22) indicated a
good fit to the observed data. In terms of effect size,
TCD =0.22 corresponded to a correlation of r=.47 (which
is a medium effect size according to the traditional criteria of
Cohen, 1988).
DISCUSSION
This study offers new insight into the psychosocial mechan-
isms by which perceived stress might influence online
gaming. Perceived stress was positively related to IGD.
The finding that participants who had high levels of
perceived stress were more susceptible to IGD severity
compared to participants with low levels of perceived
stress supports previous findings (e.g., Che et al., 2017;
Rosenkranz et al., 2017), suggesting that individual vulner-
ability to stress is strongly associated with IGD severity.
Online gaming may help individuals to satisfy their need for
psychological escape when confronted with challenging
and/or stressful situations (Young & de Abreu, 2010).
Other possible explanations are that perceived stress
may influence: (a) cognitive processes by seeking out
immediate reward despite long-term negative consequences;
(b) motivation-seeking for reducing stress and/or to experi-
ence pleasure (e.g., Brand et al., 2016); and (c) risky
decision-making, which is related to IGD (e.g., Ko et al.,
2017). Highly stressed online gamers may use online gam-
ing as a way to relieve their perceived life stress (Snodgrass
et al., 2014) or may react with withdrawal symptoms when
exposed to gaming-related cues (Brand et al., 2016).
This study also found that psychological resilience was
negatively associated with IGD. This finding is consistent
with a previous Chinese study where psychological resil-
ience was weakly correlated with IGD (Wu et al., 2018). A
possible explanation is that resilient individuals might pos-
sess some positive characteristics (e.g., high tolerance for
negative feelings, a responsible nature, and/or a robust
capacity for self-reflection; Vanderpol, 2002), which enable
such individuals to be more proactive in challenging situa-
tions and being less likely to develop negative behaviors
(e.g., problematic gaming; Hou et al., 2017). Moreover,
psychological resilience was not negatively associated with
weekly gameplay. Previous studies found that some motives
(e.g., escapism and coping) are more strongly associated
with problematic online gambling than the amount of
gaming (e.g., Király, T´oth, Urbán, Demetrovics, & Maraz,
2017;Kircaburun, Jonason, & Griffiths, 2018). Consequent-
ly, psychological resilience may help gamers cope with and
Table 2. Unstandardized beta (B), the standard error for the unstandardized beta (SE B), the standardized beta (β), and zvalues for weekly
gameplay and Internet Gaming Disorder score
Weekly gameplay IGD score
BSEBβzvalue p B SE B βzvalue p
Gender (2 =female) −4.61 1.76 −0.10 −2.62 .009 −0.24 0.004 −0.13 −3.47 .001
Age −0.30 0.10 −0.11 −2.77 .006 −0.01 0.004 −0.08 −2.06 .040
Psychological resilience (PR) −1.22 0.80 −0.08 −1.62 n.s. −0.12 0.030 −0.17 −3.96 <.001
Perceived stress (PS) 1.65 1.15 0.07 1.43 n.s. 0.32 0.040 0.32 7.21 <.001
PR ×PS −1.77 0.76 −0.10 −2.33 .020 0.02 0.030 0.03 0.81 n.s.
R
2
0.06 0.20
Note. IGD: Internet Gaming Disorder; SE: standard error.
Figure 1. Interaction between perceived stress (xaxis) and low
(−1SD) and high (+1 SD) levels of psychological resilience on
weekly gameplay (yaxis)
Journal of Behavioral Addictions
Canale et al.
combat gaming-related symptoms but does not have a
coping mechanism role in weekly time spent gaming online.
This is the first study to demonstrate that psychological
resilience moderates the relationships between perceived
stress and weekly gameplay. More specifically, the results
indicated that the relationship between perceived stress and
weekly gameplay was positive for students who reported a
lack of psychological resilience. It is possible that indivi-
duals with a greater vulnerability to stress in combination
with a lack of psychological resilience may be more inclined
to use dysfunctional and/or impulsive coping strategies,
which make them more likely to react with an urge for
mood regulation (e.g., going online for stress-relieving
capabilities) when confronted with a stressful situation
(Brand et al., 2016). Thus, consistent with Garmezy, Mas-
ten, and Tellegen’s(1984) protective factor model, specific
(positive) personal attributes reduce the negative influence
of stress on adaptive behaviors. Moreover, the hypothesized
moderating effect of psychological resilience on the associ-
ation between perceived stress and IGD was not found in
this study. It is possible that the protective effect of psy-
chological resilience being less affected by stress or adverse
risks helps individuals in being less distracted by an exciting
activity such as online gaming (less gameplay), rather that
preventing the development of addictive gaming and/or
compulsive behavioral patterns.
Consistent with findings reported in previous studies
(e.g., Ko, Yen, Chen, Chen, & Yen, 2005;Lee, Ko, &
Chou, 2015), gender and age differences were found. More
specifically, males and young adults appeared to report more
adverse consequences and be more engaged in gaming
activities.
This study has some limitations that also need to be
considered. First, the data were cross-sectional. Consequent-
ly, longitudinal studies are needed to clarify issues relating
to causality of the variables examined here. Second, the
study comprised a self-selected sample of Italian gamers
utilizing self-report methods to collect data. Future research
is therefore needed using more nationally representative
data and using other methodologies (e.g., comparing objec-
tive tracking data online with subjective self-report data;
Auer & Griffiths, 2017). Third, the variance explained in the
weekly gameplay was only 6% and some effects found in
this study were modest. It is possible that the effect of
perceived stress and psychological resilience is more salient
in emerging adulthood (around age 20 years), a develop-
mental period characterized by important tasks as searching
for and accomplishing work and romantic relationship goals
(Roisman, Masten, Coatsworth, & Tellegen, 2004), and by
emerging adult-related lifestyle norms that may facilitate
addiction problems (Sussman & Arnett, 2014). Considering
that experimental studies addressing the reactivity to stress
on a subjective and neurobiological level in behavioral
addictions are scarce (Canale et al., 2017;Kaess et al.,
2017), future studies could test the buffering effect of
psychological resilience between stress vulnerability and
IGD. Fourth, weekly gaming scores had skewness/kurtosis
values >1.5. All these limitations suggest that the results of
this study should be interpreted cautiously, and hence
further replication studies are warranted. Finally, partici-
pants were asked to estimate the weekly time spent playing
online video games. Although this measure is consistent
with previous works (e.g., King & Delfabbro, 2016;Pontes,
& Griffiths, 2015), future studies should also assess the time
spent gaming on both weekdays and weekends in order to
quantify gaming time more accurately.
Despite these limitations, this is the first study to
demonstrate the moderating effect of psychological resil-
ience on the relationship between perceived stress and
weekly gameplay. At the practice level, among individuals
who lacked resilience, participants with higher levels of
perceived stress spent more hours engaged in weekly
online gaming (43.5 hr) compared to low stress partici-
pants (39 hr). This difference of extra hours could be
crucial, considering that disordered gamers typically de-
vote at least 30 hr per week gaming (APA, 2013). There-
fore, one avenue for online gaming-related prevention is to
contemplate that enhancing psychological resilience may
help in decreasing the amount of time spent on weekly
online gaming for individuals who face high levels of
stress in the life. The finding that psychological resilience
is a potential protective factor against IGD might suggest
that problematic online gamers could benefitfromresil-
ience programs that facilitate social–emotional compe-
tence and help develop positive coping skills.
Funding sources: No external funding source has been
received for this study.
Authors’contribution: NC, CM, and AV are responsible for
the study concept and design. NC performed the analysis.
CM and AV supervised the statistical analysis and NC wrote
the first draft of the manuscript. All authors critically
reviewed, revised and approved the final version of the
manuscript as submitted and agree to be accountable for all
aspects of the work.
Conflict of interest: The authors declare no conflict of
interest.
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Journal of Behavioral Addictions
Stress, resilience, and problematic online gaming