Internet Game Use-Elicited Symptom Screen Research Articles

Attention, Externalizing and Internalizing Problems Mediated Differently on Internet Gaming Disorder Among Children and Adolescents With a Family History of Addiction as an Adverse Childhood Experience.

This study aimed to examine the factors associated with internet gaming disorder (IGD) and the mediating role of pediatric symptoms (attention, externalizing problems and internalizing problems) in children and adolescents with a family history of addiction as an adverse childhood experience (ACE). A total of 2,586 children and adolescents (mean age = 14.04 ± 2.34; age range = 11-19 years; 50.5% boys) completed the Internet Game Use-Elicited Symptom Screen and the Pediatric Symptom Checklist-17. IBM SPSS Statistics 21 was used to calculate descriptive statistics and Pearson correlation coefficients and to conduct multiple regression analyses. Mediation analysis was performed using the Sobel test and the SPSS PROCESS macro. Serial multiple mediation analysis was performed using bootstrapping with 5,000 replications. The higher levels of Attention problems (β = -0.228, P < 0.001) and externalizing problems (β = -0.213, P < 0.001) were associated with IGD. Furthermore, the indirect effect of the independent variable on the dependent variable through the mediators was significant (Sobel's T: Z = -5.006, P < 0.001). These findings suggest that attention and externalizing problems mediate the effect of family history of addiction on IGD. This study demonstrated the associations among the family history of addiction, IGD, and pediatric symptoms (attention, externalizing problems, and internalizing problems) among Korean children and adolescents. Therefore, we need to pay attention to pediatric symptoms and develop systematic alternatives to improve mental health among Korean children and adolescents with a family history of addiction as ACEs.

Risk factors and outcomes of internet gaming disorder identified in Korean prospective adolescent cohort study.

Internet gaming disorder (IGD) is known to cause various psychological and physical complications. Through data collected from an adolescent prospective longitudinal cohort, we examined how IGD is related to lifestyle and physical symptoms, as well as the temporal relationship between them. This study was conducted as part of iCURE (Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence) in Korea between 2015 and 2019. Sleep and physical activity time, dry eye symptoms, musculoskeletal pain, and near-miss accidents were measured at baseline and followed-up after one year. IGD risk was evaluated using the Internet Game Use - Elicited Symptom Screen (IGUESS). The association between IGD risk and measured variables was analyzed, both at baseline and at follow-up after one year. At baseline, the IGD risk group had significantly less physical activity time and sleep time and had more dry eye symptoms, musculoskeletal pain, and near-miss accidents than the IGD non-risk group. Additionally, in the IGD risk group at baseline, dry eye symptoms, musculoskeletal pain, and near-miss accidents occurred significantly more after one year of follow-up. The results of this study show that IGD is a significant risk factor that increases the probability of physical disease and trauma in adolescents. Therefore, interventions aimed at reducing IGD risk and protecting the physical and mental health of adolescents are imperative.

Prospective Association Between Online Game Use and Risk of Internet Gaming Disorder in Korea: 12-Month Follow-up Results From the iCURE Study.

Children and adolescents' Internet game use has both functional and dysfunctional aspects. This study aimed to examine how changes in online gaming behaviors impact the risk of Internet gaming disorder (IGD). We observed 1318 adolescent online game users. Baseline and 12-month follow-up evaluations were performed, and it was defined whether the average online gaming time per day exceeded 1.5 hours and whether the number of gaming days per week exceeded 4 days. Gaming disorder was defined using the Internet Game Use-Elicited Symptom Screen. Multiple logistic regression was performed to examine the difference in the incidence rate ratio (IRR) of IGD risk according to changes in gaming time or frequency. Results indicated the IRR of IGD risk was 2.54 for the increased time spent group and 2.38 for the consistent higher time spent group against the consistent lower time spent group. The IRR was 3.76 for the increased frequency group and 2.92 for the consistent higher frequency group against the consistent lower frequency group. Therefore, managing Internet game use not to exceed 1.5 hours per day on average and 4 days per week would help prevent elevation of IGD risk.

Factors associated with severity, incidence or persistence of internet gaming disorder in children and adolescents: a 2-year longitudinal study.

This study examined factors associated with severity, incidence and/or persistence of internet gaming disorder (IGD) in children and adolescents. Prospective cohort study with 2-year follow-up study in South Korea. A total of 2319 3rd-, 4th- and 7th-graders enrolled into the internet user cohort for unbiased recognition of gaming disorder in early adolescence [intramural Continuing Umbrella of Research Experiences (iCURE)] and analyzed for the current study. Severity of the IGD features was assessed by the Internet Game Use-Elicited Symptom Screen (IGUESS), a self-reported questionnaire based on the DSM-5 IGD criteria. Participants with IGUESS scores ≥10 were considered to be at high risk for IGD (HIGD). Time spent playing on-line games, game types, depressive symptoms, trait anxiety, attention deficit hyperactivity disorder (ADHD) symptoms, social support, openness of communication with parents, attachment to parents and potential confounders were assessed by self-report. A total of 175 (7.5%) students were classified as HIGD cases upon initial assessment. The independent risk factors of incidence of HIGD included playing on-line games for ≥240minutes/day, playing multi-player games, depressive symptoms and ADHD symptoms [adjusted rate ratios (aRRs)=2.03, 1.63, 2.04, 2.53, respectively; all P<0.05]. Factors related to changing IGD severity scores were playing on-line games for 60-239minutes/day, playing single-player on-line games, higher attachment and social support [adjusted incidence rate ratio (aIRRs)=1.38, 1.22, 0.86, 0.87, respectively; all P<0.05]. Independent predictors of persistence of HIGD were playing on-line games for ≥240minutes/day and ADHD symptoms (aRRs=2.63, 2.14, respectively; all P<0.05). Among adolescents in South Korea, the existence of ADHD symptoms and spending more than 4hours per day playing on-line games were associated with the occurrence or persistence of high risk for internet gaming disorder.

Diagnostic Usefulness of an Ultra-Brief Screener to Identify Risk of Online Gaming Disorder for Children and Adolescents.

ObjectiveThis study examined the diagnostic validity of a three-item ultra-brief screening tool for online gaming disorder in line with the gaming disorder criteria in the International Classification of Diseases 11th Revision. MethodsThe Three-item Gaming disorder Test-Online-Centered (TIGTOC) was composed of three items using a four-point Likert scale selected from the Internet Game Use-Elicited Symptom Screen (IGUESS). Among a cohort of 2319 young-adolescent Internet users, the baseline data of 228 healthy controls and 45 Internet-gaming-disorder cases were analyzed. Receiver operation characteristic (ROC) analysis was performed using mental health specialists’ diagnoses as the gold standard. ResultsThe ROC curve analysis showed an area under the curve of 86%. Using a cut-off score of 4 from a full range of 0–9, the sensitivity, specificity, and Cronbach’s α were 72%, 90%, and 0.811, respectively. TIGTOC scores was positively associated with time spent on online gaming, depressive symptoms, attention-deficit/hyperactivity disorder symptoms, and addictive Internet use. ConclusionThe TIGTOC appears to be a brief, valid, and reliable screening tool for online gaming disorder within the community or in primary care settings.

Low self-control and aggression exert serial mediation between inattention/hyperactivity problems and severity of internet gaming disorder features longitudinally among adolescents.

ObjectivesWe examined serial mediating roles of low self-control and aggression in explaining relationships between levels of inattention and hyperactivity problems (IHPs) and severity of Internet gaming disorder (IGD) features when exposed to online games among adolescents without Attention deficit hyperactivity disorder (ADHD) stratified by gender using three-wave longitudinal study.MethodThe sample comprised a total of 1,732 family dyads from a study that was conducted among seventh graders without diagnoses of ADHD at baseline. Levels of IHPs were assessed by the parent reported Korean version of the ADHD rating scale at baseline (wave1). Severity of IGD features was assessed by the Internet Game Use-Elicited Symptom Screen (IGUESS) at wave3. Both levels of self-control (wave1) and aggression (wave2) were assessed by self-report. The mediating role of low self-control and aggression in the relationships between level of IHPs and severity of IGD were evaluated using serial mediation analysis separately for each gender.ResultsLevels of IHPs were related directly to severity of IGD features in both genders. The indirect effects via low self-control were also significant in both genders, however, the indirect effects via aggression was significant only in women. The serial mediation effect via low self-control and aggression between levels of IHPs and IGD features was significant in both genders (men, coefficient:0.009, 95%CI 0.005–0.019; women, coefficient:0.010, 95%CI:0.005–0.026).ConclusionWe revealed a possible mechanism underlying a serial mediation chain from low self-control to aggression explaining the effects of IHPs on severity of IGD features. However, this conclusion should be taken with a caution, because the effect sizes were very low.

A partial mediation effect of father-child attachment and self-esteem between parental marital conflict and subsequent features of internet gaming disorder in children: a 12-month follow-up study

BackgroundThis study evaluated whether parent-child attachment and self-esteem may mediate the relationship between parental marital conflict and increases in features of internet gaming disorder (IGD) in children at 1 year.MethodsThe baseline and one-year follow-up data for 268 pre-teens aged between 9 and 10 from the Internet User Cohort for Unbiased Recognition of Gaming Disorder in Early Adolescence (iCURE) study were collected. The students were children at low risk for IGD in the initial self-reported assessment, anyone living with both parents, current game user at baseline, and those who completed a 12-month follow-up assessment. The Internet Game Use-Elicited Symptom Screen (IGUESS) was used to identify increases in IGD features at 12 months. To examine a potential mediation effect, structural equation modeling was performed.ResultsThe direct effect was statistically significant, and parental marital conflict at baseline significantly predicted the increases in IGD features in children at the 12-month follow-up after adjusting for gender, sex, socioeconomic status, and baseline IGUESS score (ß = 0.206, P = 0.003). The indirect effect showed that attachment to fathers through self-esteem was a significant mediating effect (ß = 0.078, P = 0.045). Parental marital conflicts were associated with increases in IGD features in children through poor father-child attachment, and in turn, the lower levels of self-esteem in the children.ConclusionsParents, especially fathers, should make an effort to bond with their children to reduce the risk of their children’s developing the IGD features.

Reciprocal relationship between depression and Internet gaming disorder in children: A 12-month follow-up of the iCURE study using cross-lagged path analysis.

ObjectivesPrevious studies have reported an association between Internet gaming disorder (IGD) and depression, but the directionality of the relationship remains unclear. Therefore, we examined the reciprocal relationship between level of depressive symptoms and IGD among children in a longitudinal study.MethodsResearch panels for this study consisted of 366 elementary-school students in the iCURE study. All participants were current Internet users, so they could be considered an at-risk population for IGD. Self-reported severity of IGD features and level of depression were assessed by the Internet Game Use-Elicited Symptom Screen and Children’s Depression Inventory, respectively. Follow-up assessment was completed after 12 months. We fitted cross-lagged structural equation models to investigate the association between the two variables at two time points contemporaneously.ResultsThe cross-lagged analysis revealed that level of depression at baseline significantly predicted severity of IGD features at the 12-month follow-up (β = 0.15, p = .003). Severity of IGD features at baseline also significantly predicted level of depression at the 12-month follow-up (β = 0.11, p = .018), controlling for possible confounding factors.ConclusionsThe cross-lagged path analysis indicates a reciprocal relationship between severity of IGD features and level of depressive symptoms. Understanding the reciprocal relationship between depressive symptoms and severity of IGD features can assist in interventions to prevent both conditions. These findings provide theoretical support for prevention and remediation plans for IGD and depressive symptoms among children.

The association between aggression and risk of Internet gaming disorder in Korean adolescents: the mediation effect of father-adolescent communication style.

OBJECTIVESOpen and supportive communication between parents and children is known to reduce adolescents’ delinquent behavior. Recently, the risk of Internet gaming disorder (IGD) has been increasing in adolescents. The purpose of this study was to investigate the mediating effects of parent-child communication styles on the relationship between adolescent aggressiveness and risk of IGD.METHODSParticipants in this study were 402 first-year students from 4 middle schools in Seoul who enrolled in the Internet user Cohort for Unbiased Recognition of gaming disorder in Early adolescence (iCURE) and completed baseline assessment in 2016. The structural equation model was constructed based on an aggression questionnaire, the Internet game use-elicited symptom screen, a mother-child communication inventory, and a father-child communication inventory.RESULTSAdolescents’ aggressiveness was found to be related to their risk of IGD. The father-child communication style mediated the relationship between aggression and risk of IGD. However, the mother-child communication style had no mediating effect.CONCLUSIONSOur findings suggest that fathers should make an effort to improve open and positive communication skills with their children, because the father-child communication style plays an important role in the relationship between adolescent aggressiveness and risk of IGD.

The Internet Game Use-Elicited Symptom Screen proved to be a valid tool for adolescents aged 10-19 years.

This study tested the diagnostic validity of the nine-item Internet Game Use-Elicited Symptom Screen (IGUESS) tool, which was developed by the authors after the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, identified Internet gaming as a condition that needed further study. A self-report screening test comprising IGUESS and Young's Internet Addiction Test was administered to 121 adolescents (74% boys) with a median age of 14 (range 10-19) recruited from school and health settings in Korea. After the screening test, a clinician conducted one-to-one interviews with all of the subjects to set a gold standard for diagnosis. The sensitivity and specificity of IGUESS were 87.0 and 86.7%, respectively, for a cut-off score of 10 points, with an area under the curve value of 0.93. Its reliability, as determined by Cronbach's alpha, was 0.94, and the correlation coefficient between IGUESS and Young's Internet Addiction Test was r = 0.902. The findings suggest that a cut-off score of 10 is appropriate for administering the IGUESS in various community-based settings, including schools, to screen for potential subjects in need of further assessment for Internet gaming problems.

Study protocol of the internet user Cohort for Unbiased Recognition of gaming disorder in Early adolescence (iCURE), Korea, 2015–2019

IntroductionIn 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) proposed nine internet gaming disorder (IGD) diagnostic criteria as a condition warranting further empirical and clinical research....

Does adolescents’ depressive symptoms increase the possibility of addictive Internet gaming?: 1-year follow up study in Korea

IntroductionAdolescents’ Internet gaming disorders might influence on their social and psychological developmental tasks and physical health negatively. Depression is the commonly co-existed conditions with addictive Internet gaming, but not much research has been reported whether depressive symptoms would precede the addictive Internet gaming in this population.ObjectivesThis prospective observation study was performed to make clear whether adolescents’ depressive symptoms precede their addictive Internet gaming.AimsAdolescents’ 1-year incidence of the addictive Internet gaming was calculated, and test their depressive symptoms increase the incidence.MethodsIn Korea, whole students of the 1st grade in three middle schools were participated in this study. Baseline assessment of 508 students was performed via standardized self-reported questionnaire on May–June, 2015. Internet game use-elicited symptom screen (IGUESS) was used to addictive Internet gaming conditions. IGUESS is the 9-itemed DSM-5 diagnostic criteria-based instrument to screen high risk of Internet gaming disorders. Depressive symptoms was measured by Child Depression Inventory (CDI) group. One year after the baseline assessment, follow-up assessment was performed. Four hundred and forty-eight students have been participated in the 1-year check up without addictive Internet gaming at baseline.ResultsIn total, 4.7% of subjects had depressive symptoms at baseline, and incidence of addictive Internet gaming was 9.2%. After adjusted by sex, Internet game use per week, and self-control status, depressive symptoms of baseline increased the 1-year incidence of addictive Internet gaming significantly (OR = 3.5, P = 0.034).ConclusionsDepressive adolescents have higher possibility they could experience the addictive Internet gaming.Disclosure of interestThe authors have not supplied their declaration of competing interest.