Internet Gaming Research Articles

Hikikomori and Internet Gaming Disorder: a Case Report

Aim: Social withdrawal is frequently considered a result of or a symptom of several mental health issues that can significantly alter a person’s way of life. Excessive internet use is also a mediating factor for increasing social withdrawal. To our knowledge, a classic case of Hikikomori had never been reported from India. We report a case who sought help to manage social withdrawal and online activities at a tertiary specialty centre of India. Case report: Student Mr. A, aged 18, residing with his parents, working as professionals, and younger brother, reported with complaints of ambivalence to take action and to plan his future activities, along with low self-confidence and feelings of sadness, hesitancy to establish contact with his friends, poor social life and difficulty in controlling his online gaming for the last 3 years. Mr. A met the criteria for internet gaming disorder on the Internet gaming questionnaire. Cognitive behavioural therapy was initiated to address his cognitions about gaming/online activities, decreased socialization, lower levels of behavioural activation, and enhancement of interpersonal interactions with family members. Since he could not regularly come for psychotherapy sessions, significant treatment progress could not be achieved. Conclusions: The case implicates more focused individual & family interventions to improve resocialization to mitigate the risk of Hikikomori and IGD.

Correlates of Borderline Personality Disorder Traits and Internet Gaming Disorder in College Students.

Borderline personality disorder (BPD) frequently co-occurs with addictive behaviors. One such behavior that is increasing, especially among college students, is pathological gaming. However, to the best of our knowledge, no prior research has been conducted on BPD in relation to internet gaming disorder (IGD), despite the two sharing correlates such as negative emotionality and impulsivity. We therefore explored the relationship between BPD traits and IGD. We sampled a large (N = 407) sample of college students using two non-overlapping measures of BPD traits. We additionally examined the unique relationship of BPD traits with specific motivations for internet game playing and the perceived positive and negative impacts of internet games. On a bivariate level, BPD traits were associated with IGD, motivations to play internet games, especially for reasons of escapism or coping, and self-reported negative impact of gaming on participants' lives. However, the associations with IGD for escapism/coping motivations did not remain after controlling for demographics, and internalizing and externalizing psychopathology. Instead, only depression uniquely predicted IGD and various motives for internet gaming. The results highlight the robust predictive power of negative effect on IGD, and it is suggested that future studies may benefit from continuing to focus on this relationship.

Impact of internet addiction and gaming disorder on body weight in children and adolescents: A systematic review.

Internet use and gaming have increased in daily life. Internet addiction has not been recognised in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition or 11th Revision of International Classification of Diseases despite gaming addiction having been listed since 2013. Previous studies have shown an association between internet use and weight gain or disordered eating patterns in the general population, however none have addressed this association in a paediatric population. The aim of this study is to investigate the relationship between internet addiction or gaming addiction and weight in children and adolescents under 18 years of age. A systematic search of electronic databases was conducted, and articles were screened for relevance. The Joanna Briggs Institute (JBI) 3critical appraisal tool was used to assess quality of studies. Due to heterogeneity of the studies, a meta-analysis could not be performed, thus a narrative summary was performed with the results summarised and tabulated. Of 8114 initial articles identified, we included 14 studies. The review produced inconsistent results, with three of the 14 studies demonstrating no statistically significant relationship between internet and/or gaming addiction and obesity. The remaining 11 studies showed a statistically significant positive association. One study demonstrated that those who are underweight as well as overweight and obese were more likely to have problematic internet use. Four articles demonstrated increased rates of poor nutritional habits, poor eating patterns and weight control behaviour in children and adolescents with internet addiction or gaming disorder. Another study showed no statistically significant association between internet addiction and disordered eating or eating disorder. Most of the available studies revealed increased rates of obesity in children and adolescents with internet addiction or gaming disorder, with poor patterns of eating. Clearer definitions and consistent use of terminology are required to enable more robust research in this field.

A case-control study for psychiatric comorbidityand associative factors of gamingdisorder and hazardous gaming basedonICD-11 criteria: Cognitive control, emotion regulation, and reinforcement sensitivity.

The authors of the present study wanted to know whether the previously reported psychiatric comorbidities of internet gaming disorder (IGD) based on DSM-5 criteria were also more prevalent among gaming disorder (GD) or hazardous gaming (HG) based on ICD-11 criteria. Therefore, the present case-control study evaluated the psychiatric comorbidities and associative factors of GD and HG based on ICD-11 criteria. A sample of 60 individuals with GD, 45 with HG, and 120 controls were assessed with an ICD-11 criteria-based diagnostic interview along with attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), depressive disorder, and social anxiety disorder(SAD). Participants also completed Conners' Continuous Performance Test (CCPT), Dickman's Impulsivity Inventory, the Emotion Regulation Questionnaire, and the Behavior Inhibition System and Behavior Approach System Scales. GD was associated with ADHD, depressive disorder, and GAD. ADHD was the most associative comorbidity of HG. Depressive disorder was associated with GD relative to HG. Moreover, individuals with lower reappraisal, higher aversion sensitivity, and impulsivity were more likely to be diagnosed with GD. Those with higher fun-seeking were more likely to be diagnosed with HG. In the present study, ADHD was the psychiatric comorbidity most significantly associated with GD, followed by depressive disorder and GAD, as previously reported for IGD. ADHD was also associated with HG. Depressive disorder was more associated with GD compared to HG. Intervention for HG and GD should be tailored by the consideration of the clients' psychiatric comorbidity as well as their reappraisal skills, impulsivity, aversion sensitivity, and fun-seeking.

Differences in impulsivity between adolescents with ADHD and those with comorbidity of ADHD and IGD

BackgroundNumerous studies have demonstrated that patients with attention deficit hyperactivity disorder (ADHD) have high impulsivity. However, few studies have been published on the differences in impulsivity between patients presenting with comorbidity of ADHD and Internet gaming disorder (IGD) and ADHD alone. AimThe present study designed an experiment to address this significant question, to explore the differences in impulsivity between individuals with ADHD and those with comorbid ADHD and IGD, specifically focusing on various dimensions of impulsivity. MethodsA total of 81 adolescents with ADHD alone and 59 patients with comorbidity of ADHD and IGD were included in this study, and all of them were assessed using the Stop-signal Task (SST), Delay Discount Task (DDT), and Balloon Analogue Risk Task (BART). ResultsPatients with comorbid ADHD and IGD had higher impulsivity than those with only ADHD, and it was expressed in different dimensions. Additionally, response inhibition, delayed discount rate, risky decision-making behavior, inattention, and hyperactivity were identified as risk factors for comorbid ADHD and IGD. ConclusionThese findings can help distinguish whether ADHD is comorbid with IGD in clinical settings. They will also be helpful in the implementation of more precise treatments.

The Impact of Cyberbullying Victimization on Internet Gaming Addiction Among College Students: The Mediating Roles of Basic Psychological Need Satisfaction and Frustration, and the Moderating Role of Parental Autonomy Support.

Research on the relationship between cyberbullying victimization and Internet gaming addiction in China is limited, while the mechanisms underlying this association remain unclear. Based on the Self-Determination Theory, this study establishes a moderated mediation model to test the mediating roles of basic psychological need satisfaction and frustration between cyberbullying victimization and Internet gaming addiction, as well as the moderating role of parental autonomy support in this mediating effect. 2819 college students were surveyed using self-reported questionnaires about cyberbullying victimization, basic psychological need satisfaction and frustration, parental autonomy support, and Internet gaming addiction. SPSS 24.0 was utilized to analyze the correlations between variables, and Amos 24.0 was employed to test the structural equation model of this study. Cyberbullying victimization was found to significantly predict Internet gaming addiction positively. Basic psychological need satisfaction and frustration played partial mediating roles between cyberbullying victimization and Internet gaming addiction respectively. Parental autonomy support further moderated the first half of the mediated model pathway. Specifically, the impact of cyberbullying victimization on basic psychological need satisfaction and frustration are more obvious among college students with high level of parental autonomy support. The findings advance our understanding of how cyberbullying victimization affects Internet gaming addiction.Within the college environment, reducing cyberbullying victimization could prevent Internet gaming addiction. Furthermore, enhancing basic psychological need satisfaction, reducing basic psychological need frustration, and reinforcing parental autonomy support among college students who have experienced cyberbullying would be effective to prevent Internet gaming addiction.

Cross-Cultural Differences in the Pathways to Internet Gaming Disorder.

No research to date has examined cross-cultural differences in the pathways to internet gaming disorder (IGD). The current study aimed to address this limitation by examining the relationships between nationality (Singaporeans vs. Australians), culture orientation, gaming motivations, and IGD. Participants were 101 Singaporeans (55.4% males) and 98 Australians (52.0% males). They completed the Culture Orientation Scale, the Motives for Online Gaming Questionnaire, and the Internet Gaming Disorder Scale-Short-Form. A series of mediational analyses showed that Singaporeans tend to be more collectivistic (both horizontally and vertically). In turn, this culture orientation motivates them to play games for social reasons, increasing the risk for IGD. In contrast, Australians tend to be more individualistic (vertically only). In turn, this culture orientation motivates them to play games for competitive reasons, increasing the risk for IGD. Limitations include the use of samples from two countries only, precluding a generalization of the results. Future research directions include examining the role of game genres as a mediator in the nationality-IGD relationship.

Mindfulness Meditation Changed Interregional Connectivity in Subcortical and Default Mode Networks in Internet Gaming Disorder

Mindfulness Meditation Changed Interregional Connectivity in Subcortical and Default Mode Networks in Internet Gaming Disorder

Influence of unhealthy diet and sedentary behavior on the oral health-related quality of life of 12-year-old Brazilian adolescents.

This study analyzed the factors associated with the oral health-related quality of life (OHRQOL) of 12-year-old adolescents and their relationship with unhealthy eating and sedentary behavior. Data were collected from 615 adolescents from the five largest cities in Mato Grosso do Sul, Brazil. The theoretical framework of the social determinants of oral health guided all analyses and the measurement instrument was OIDP (impact of oral health on daily performance). Multilevel logistic and negative binomial regressions were performed to test the association of OHRQOL with unhealthy eating, sedentary behavior, sociodemographic characteristics and health behaviours. Considering the sample weights, 43% of the adolescents reported some impact on OHRQOL. In the adjusted models, higher consumption of unhealthy foods (moderate and high) was associated with a prevalence of impact on OHRQOL [OR = 3.59 (95%CI 1.99; 6.46)] and higher OHRQOL severity [RR = 2.05 (95%CI 1.43; 2.94)] compared to their counterparts. Sedentary behaviour was associated with the prevalence of impact on OHRQOL [OR = 1.52 (95%CI 1.22; 1.89)] and greater severity [RR = 1.21 (95%CI 1.07; 1.37)] compared to their counterparts. Unhealthy food consumption and sedentary behavior were associated with OHRQOL. Intersectoral health public policies for healthy eating and for reducing sedentary behavior on the internet and electronic games can help in the quality of life of adolescents.

The Association Between Causality Orientation and Internet Gaming Disorder, and the Role of Sensation Seeking, Anxiety, and Depression.

Self-determination theory (SDT) deems that people have three causality orientations: autonomy orientation, control orientation, and impersonal orientation. Previous studies suggested that lower autonomy orientation or higher control and impersonal orientations may be associated with more addictive behaviors. Our study aimed to investigate if these associations exist in Internet gaming disorder (IGD), and if sensation seeking, anxiety, and depression could influence the associations between causality orientations and IGD symptoms. A total of 1,400 college students completed the Internet Gaming Disorder Scale, General Causality Orientation Scale, Brief Sensation Seeking Scale, Generalized Anxiety Disorder Scale, and Patient Health Questionnaire. Correlation, multiple linear regressions, structural equation model (SEM) analyses, and moderation analyses were conducted to explore the associations. The control and impersonal orientations were positively associated with IGD symptoms, while the autonomy orientation was negatively associated with them. Moreover, SEM analyses showed that the autonomy-IGD relationship was totally mediated by anxiety and depression, the impersonal-IGD relationship was partially mediated by anxiety, and the control-IGD relationship was partially mediated by depression. Finally, the effects of causality orientations on IGD were moderated by sensation seeking. Overall, autonomy orientation is linked to fewer gaming problems, whereas control and impersonal orientations are associated with more gaming problems. Moreover, the relationships between causality orientations and IGD symptoms are mediated by anxiety and depression and moderated by sensation seeking. Our findings inform theory on the motivations of gaming behaviors and may shed light on the prevention and intervention of IGD from the perspective of SDT.

Acting with awareness is positively correlated with dorsal anterior cingulate cortex glutamate concentration but both are impaired in Internet gaming disorder

Internet gaming disorder (IGD) is increasingly recognized as a public concern for its adverse impacts on cognition and mental health. In IGD, the transition from goal-directed actions to habitual and eventually compulsive behaviors is accompanied by altered neural response within the dorsal anterior cingulate cortex (dACC), a critical region involved in conscious actions. However, the neurochemical profile of the dACC in IGD and its relationship with behavioral awareness remain poorly understood. In this study, 1H-magnetic resonance spectroscopy was employed to quantify dACC glutamate concentration and examine its association with the capacity for ‘acting with awareness’ among 21 participants with IGD and 19 recreational game users. Results indicated that dACC glutamate levels and behavioral awareness were significantly lower in the IGD group compared to recreational game users. Moreover, a significant positive correlation between awareness and dACC glutamate concentration emerged in the recreational game users’ group, a relationship attenuated in those with IGD. In an independent cohort of 107 participants, the positive association between awareness and dACC glutamate concentration was replicated. These findings suggest that reduced dACC glutamate in IGD may underlie diminished awareness of maladaptive habitual behaviors. Enhancing dACC neural excitability through neuromodulation or mindfulness training could represent a potential intervention to restore behavioral awareness.

Neurobiological correlates of reactive aggression in young adults with internet gaming disorder

BackgroundPrevious research has found a significant positive correlation between internet gaming disorder (IGD) and reactive aggression (RA), with excessive use of online games increasing aggression in subjects. However, the neural mechanisms underlying increased RA in IGD are unclear. This study explores the neurobiological underpinnings of reactive aggression in young adults with IGD. MethodThis case-control study included 84 young adults, comprised of 23 subjects with IGD, 24 at-risk participants, and 37 healthy controls. Employing T1-weighted magnetic resonance imaging (MRI), voxel-based morphometry (VBM) analysis was conducted to evaluate the gray matter volume (GMV) changes among groups, and the partial correlations between GMV alterations and RA score were investigated. Finally, mediation analyses were conducted to examine whether GMV alterations could modulate the relationship between IGD degree and RA score. ResultsCompared with controls, the IGD group showed significantly increased GMV in the middle frontal gyrus (MFG), parahippocampal gyrus and significantly decreased GMV in the right median cingulate and paracingulate gyri (DCG), while the at-risk group showed significantly increased GMV in the left MFG. In addition, the RA score showed a significant negative correlation (r=-0.301, p=0.006) with the mean GMV of the right DCG. Furthermore, the mean GMV of the right DCG significantly mediated the correlation between degrees of IGD and RA score, and the effect size for this mediation effect was 22.8 %. ConclusionOur findings provide potential early risk biomarkers for IGD and enhance our understanding of the neurobiological mechanisms linking RA to IGD, thus facilitating several potential avenues for therapeutic intervention.

Treatment of Cognitive Behavior Therapy for the Locus of Control with Internet Gaming Addiction Problem

AbstractResearch has identified Internet gaming addiction as a new and often unrecognized clinical disorder that impacts users' ability to control Internet gaming use, which can lead to relational, work, and social problems. The locus of control is a factor in controlling the use of Internet games. Researchers have suggested using cognitive behavior therapy (CBT) as the treatment of choice for Internet addiction. This paper presents the findings of a study that utilized an A‐B‐A single‐case research design to explore the impact of CBT on enhancing internal locus of control and reducing Internet gaming addiction. The participants in this study were three high school students (N = 3) who exhibited a high level of Internet gaming addiction and a predominantly external locus of control. CBT intervention was provided in six sessions. Treatment focused on modified cognitive distortion and developing positive behavior using the down arrow technique, acting as if, shaping, problem‐solving, and behavior reinforcement. Participants completed the Game Addiction Scale for Adolescents and the Locus of Control Scale for Game Addiction. Data were obtained at three distinct phases: before, during, and after the CBT intervention. Results show that CBT reduced Internet gaming addiction and enhanced internal locus of control both during and after the intervention, indicating its potential as an effective treatment for students with gaming addiction issues.

Network analysis of the relationship between internet gaming motives, internet gaming disorder, and leisure satisfaction

Despite an emphasis on its adverse consequences, Internet gaming has diverse motivational backgrounds and fulfills various human needs. This study used network analysis to identify the core motives underlying Internet gaming and the links between motives, Internet gaming disorder (IGD), and leisure satisfaction. University students (1720) participated in an online cross-sectional survey with the following results: (1) The overall network of Internet gaming motives showed that coping motives exhibited the highest centrality, suggesting their crucial network role; escape motives were most significantly linked to coping motives. The IGD group (n = 217) exhibited higher global network strength than the non-IGD group (n = 1503), with significant differences in specific edge and centrality indices (e.g., escape motives were more central in the IGD group, while recreational motives were more central in non-IGD.) (2) The network combining motives, IGD, and leisure satisfaction showed that the edge between escape motives and mood-modification symptoms built a significant link, while that between recreational motives and relaxation satisfaction was the most significant. Coping motives were positively associated with relaxation satisfaction, whereas social motives were negatively associated. These results highlight gaming motives' distinct IGD roles and imply the need to adopt personalized approaches to prevention/treatment strategies.

Diurnal Profiles of the Endocrine Stress Response in Internet Gaming Disorder

Background: Differences in subjective stress perception and acute response of the hypothalamic-pituitary-adrenal axis have been reported in internet gaming disorder (IGD). The present study aimed to further investigate alterations in diurnal profiles of the endocrine stress response system in IGD compared to healthy controls (HCs). Methods: The diurnal course of endocrine markers (salivary cortisol and α-amylase) was investigated in a clinical sample of n = 29 adolescents with IGD compared to n = 26 HC. Further, the effect of unrestricted gaming versus restricted gaming was examined within the IGD group. Results: No significant differences in salivary cortisol and α-amylase were observed comparing adolescents with IGD and HC. In addition, in the IGD group, there were no significant differences in salivary cortisol and α-amylase between conditions of unrestricted gaming versus restricted gaming. Compared to the HC group, the IGD group showed a significantly higher body mass index. Conclusions: Our results indicate no alteration in diurnal profiles of the endocrine stress response in IGD.

Unveiling the essence of trash-talking: A phenomenological study of teenagers’ behavior in online games

ABSTRACT This study focuses on teens’ trash-talking behavior while playing internet games. Phenomenology is the method used, and it seeks to reduce individual perceptions of phenomena into descriptions of universal essences or essences. This research aims to discover and examine the trash-talking behavior that has become common among teenagers while playing online games (OG). The findings of this study suggest that markers of trash-talking conduct include insults to intelligence, swearing at prohibited items, and calling animal and dirt names. The symbol of trash-talking conduct represents a release of emotions such as anger and disappointment, sarcasm or criticism, admiration for a good game, and an outpouring of joy. This study’s findings indicate a process of symbolic contact amongst the five informants while playing the Mobile Legends game. On the mental side, three categories are distinguished: being conscious of the situation and conditions in trash-talking conduct, feeling strange if you don’t have trash-talking behavior, and being accustomed to trash-talking behavior. Trash-talking conduct can be classified into two types: showing team closeness and cohesion and disrupting the opposing team’s concentration. Trash-talking conduct is classified as either helping to break down the mood in a freshly established group or producing conflict in the actual world due to feelings of offense.

Cognitive Mechanisms Between Psychosocial Resources and the Behavioral Intention of Professional Help-Seeking for Internet Gaming Disorder Among Chinese Adolescent Gamers: Cross-Sectional Mediation Study.

Internet gaming disorder (IGD) is a global public health concern for adolescents due to its potential severe negative consequences. Professional help-seeking is important for early screening, diagnosis, and treatment of IGD. However, research on the factors associated with professional help-seeking for IGD as well as relevant mediation mechanisms among adolescents is limited. Based on the stress coping theory, the conservation of resource theory, and behavioral change theories, this study investigated the prevalence and factors influencing the behavioral intention of professional help-seeking for internet gaming disorder (BI-PHSIGD). The research also explored the underlying mechanisms, including psychosocial resources like resilience and social support, perceived resource loss due to reduced gaming time, and self-efficacy, in professional help-seeking among adolescent internet gamers. A cross-sectional survey was conducted among secondary school students who were internet gamers in 2 Chinese cities from October 2019 to January 2020. Data from the full sample (N=1526) and a subsample of 256 IGD cases (according to the 9-item DSM-5 [Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition] IGD Checklist) were analyzed. Multivariate logistic regression analysis was conducted to examine the factors of BI-PHSIGD, while structural equation modeling was performed to test the proposed mediation mechanisms. The prevalence of BI-PHSIGD was 54.3% (829/1526) in the full sample and 40.6% (104/256) in the IGD subsample (vs 708/1239, 57.1% among non-IGD cases). In the full sample, psychosocial resources of resilience (adjusted odds ratio [aOR] 1.03, 95% CI 1.02-1.05) and social support (aOR 1.03, 95% CI 1.02-1.04) as well as self-efficacy in professional help-seeking (aOR 1.64, 95% CI 1.49-1.81) were positively associated with BI-PHSIGD, while perceived resource loss due to reduced gaming time was negatively associated with BI-PHSIGD (aOR 0.97, 95% CI 0.96-0.98); the positive association between psychosocial resources and BI-PHSIGD was fully mediated via 2 single-mediator indirect paths (via self-efficacy in professional help-seeking alone: effect size=53.4%; indirect effect/total effect=0.10/0.19 and via perceived resource loss due to reduced gaming time alone: effect size=17.8%; indirect effect/total effect=0.03/0.19) and one 2-mediator serial indirect path (first via perceived resource loss due to reduced gaming time then via self-efficacy in professional help-seeking: effect size=4.7%; indirect effect/total effect=0.009/0.19). In the IGD subgroup, a full mediation via self-efficacy in professional help-seeking alone but not the other 2 indirect paths was statistically significant. Many adolescent internet gamers, especially those with IGD, were unwilling to seek professional help; as a result, early treatment is often difficult to achieve. To increase BI-PHSIGD, enhancing psychosocial resources such as resilience and social support, perceived resource loss due to reduced gaming time, and self-efficacy in professional help-seeking may be effective. Future longitudinal and intervention studies are needed to confirm and extend the findings.

The Role of Videogame Micro-Transactions in the Relationship Between Motivations, Problem Gaming, and Problem Gambling.

Emerging research has highlighted potential associations between micro-transaction use and problematic videogame and gambling behaviour. An increasingly prominent theory highlights that self-determined motivations and basic psychological needs may play crucial roles in the development of problematic videogame and gambling behaviour. However, literature discussing the role thatmicro-transaction use has in this relationship is scarce. The present study examined the role of micro-transactions in the relationship between self-determined motivations for gaming and gambling and problematic behaviour (internet gaming disorder and problem gambling severity). A sample of 370 participants (74.1% male, Mage = 28.24years, SD = 7.88) answered questions related to their gaming and gambling motivations, basic psychological needs, micro-transaction use (i.e., type of micro-transaction, expenditure, and frequency of use), internet gaming disorder, and problem gambling. The present study used structural equation modelling methods to test relationships between these variables. The results indicated positive associations between extrinsic gaming and gambling motivations and frequency of micro-transaction use. Frequency of micro-transaction use (i) partially mediated the relationship between extrinsic gambling motivations and problem gambling severity, and (ii) fully mediated the relationship between externally regulated gaming motivations and problem gambling severity. Expenditure on micro-transactions and basic psychological needs were not found to be significant variables in the present study. Potential explanations for the findings, including a lack of self-esteem and a need to boost ego, social pressure, and rapid reward processes, are discussed. The implications and applications of the research are also discussed, focusing on limit setting and policy development focusing on frequency of micro-transaction use.

School Climate and School Identification as Determinants of Internet Gaming Disorder Among Chinese Adolescent Internet Gamers: Cross-Sectional Mediation Study

Abstract Background School climate and school identification are important features of the school environment and potential determinants of adolescent internet gaming disorder (IGD). Objective This novel study investigated their joint effects on IGD and related mediation mechanisms via the interpersonal factor of teacher-student relationship and the individual factors of academic stress and anxiety. Methods A large-scale cross-sectional study was conducted among adolescent internet gamers of junior, senior, and vocational middle schools in Taizhou City, China, from February to March 2022 (N=5778). Participants self-administered an anonymous, structured questionnaire in classrooms. Adjusted logistic regression and structural equation modeling (SEM) were used for data analysis. Results Among all participants, the prevalence of IGD was 8% (461/5778). The 4 school climate subscales (student-student relationship subscale: adjusted odds ratio [ORa] 0.88, 95% CI 0.85-0.91; student-staff relations subscale: ORa 0.87, 95% CI 0.84-0.90; academic emphasis subscale: ORa 0.88, 95% CI 0.85-0.91; shared values approach: ORa 0.88, 95% CI 0.85-0.90), the school identification subscale (ORa 0.85, 95% CI 0.83-0.88), and teacher-student relationship (ORa 0.80, 95% CI 0.76-0.84) were significant protective factors against IGD, while academic stress (ORa 1.18, 95% CI 1.14-1.23) and anxiety (ORa 1.16, 95% CI 1.14-1.18) were risk factors of IGD. The SEM showed that the negative associations between school climate and IGD and between school identification and IGD were mediated via (1) three 2-step paths, each involving a single mediator—teacher-student relationship, academic stress, and anxiety, respectively—and (2) two 3-step paths involving 2 mediators—teacher-student relationship and academic stress first, respectively, and then anxiety. The direct effect of school climate on IGD was statistically nonsignificant (ie, full mediation with effect size ranging from 4.2% to 20.4%), while that of school identification was statistically significant (ie, partial mediation with effect size ranging from 4.5% to 38.2%). Conclusions The relatively high prevalence of IGD among Chinese adolescents may be reduced through school-based interventions to improve school climate and school identification. Such improvements may reduce the levels of risk factors of IGD (poor teacher-student relationship, academic stress, and anxiety) and hence the risk of IGD. Future longitudinal and intervention studies are needed to confirm the findings.

Internet Gaming Disorder and Problem Gambling Severity do not Predict Money and Time Spent on Games with Loot Boxes

Internet Gaming Disorder and Problem Gambling Severity do not Predict Money and Time Spent on Games with Loot Boxes