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Background and aims: The ICD-11 chapter on mental, behavioral and neurodevelopmental disorders contains new controversial diagnoses including compulsive sexual behavior disorder (CSBD), intermittent explosive disorder (IED) and gaming disorder. Using a vignette-based methodology, this field study examined the ability of mental health professionals (MHPs) to apply the new ICD-11 diagnostic requirements for impulse control disorders, which include CSBD and IED, and disorders due to addictive behaviors, which include gaming disorder, compared to the previous ICD-10 guidelines. Methods: Across eleven comparisons, members of the WHO's Global Clinical Practice Network (N 5 1,090) evaluated standardized case descriptions that were designed to test key differences between the diagnostic guidelines of ICD-11 and ICD-10. Results: The ICD- 11 outperformed the ICD-10 in the accuracy of diagnosing impulse control disorders and behavioral addictions in most comparisons, while the ICD-10 was not superior in any. The superiority of the ICD-11 was particularly clear where new diagnoses had been added to the classification system or major revisions had been made. However, the ICD-11 outperformed the ICD-10 only in a minority of comparisons in which mental health professionals were asked to evaluate cases with non-pathological high involvement in rewarding behaviors. Discussion and Conclusions: Overall, the present study indicates that the ICD-11 diagnostic requirements represent an improvement over the ICD-10 guidelines. However, additional efforts, such as training programs for MHPs and possible refinements of diagnostic guidance, are needed to avoid over-diagnosis of people who are highly engaged in a repetitive and rewarding behavior but below the threshold for a disorder. [ABSTRACT FROM AUTHOR]

Background and aims: Internet Gaming Disorder (IGD) and depression have negative consequences on individuals' mental health, but their relationships are complex. This three-wave longitudinal study aimed to detect the metacognitive mechanisms underlying the association between IGD tendency and depression based on the self-regulatory executive function model. Methods: A total of 1,243 Chinese undergraduate student gamers (57% female, M 5 19.77, SD 5 1.29) were recruited at the baseline survey (Wave 1 [W1]), with 622 and 574 of them taking part in the two follow-up surveys (Wave 2 [W2] at 6 and Wave 3 [W3] at 12 months later), respectively. Results: The three-wave path model demonstrated, after controlling for the autoregressive effect of each variable, that depression consistently predicted IGD tendency but not vice versa, while negative but not positive metacognitions about online gaming (MOG) significantly predicted both depression and IGD tendency. Moreover, two statistically significant mediation paths: (i) negative MOG [W1]→depression [W2]→IGD tendency [W3]; and (ii) depression [W1] → negative MOG [W2] → IGD tendency [W3] were identified. Discussion and conclusions: These findings extend the understanding of the associations among depression, IGD tendency, and MOG, highlighting how negative MOG has a stronger prospective effect than positive MOG on depression and IGD tendency, and also reveal the mutual mediation effects of depression and negative MOG on IGD tendency. Integrated programmes with both emotional regulation training and Metacognitive Therapy are recommended for IGD treatment. [ABSTRACT FROM AUTHOR]

Background and aims: Game genres, availability on smartphones, in-game purchases, and playing duration, have been thought to influence Gaming Disorder (GD). However, little research has comprehensively examined their relationships with GD. Therefore, we examined the relationship between GD, in-game purchases, gaming duration via consoles and smartphones, and genres of smartphone games. Study 1 was based on self-reports, and Study 2 included objective data to clarify these associations. Methods: We conducted two independent online surveys that collected sociodemographic data, game use patterns, and psychopathological assessment data, including GD severity (Study 1: N 5 32,690; Study 2: N 5 3,163). General mental illness scores and objective gaming time were also collected in Study 2. Results: In Study 1, in-game purchases, several gaming genres, and subjective gaming duration were positively associated with probable GD. On the other hand, interactions between card games and loot box charges were negatively related to probable GD. In Study 2, objective gaming times of most game genres were not associated with GD. Although the correlation between subjective and objective gaming duration was moderate, their correlations with GD differed. Discussion and conclusion: These results suggest the complexity of relationships between GD and in-game purchases, genres, and gaming duration. Results of this study suggest the importance of proper assessment of GD reflecting actual functional impairment in social life. Future studies should improve and update evaluation of assessments for gaming. [ABSTRACT FROM AUTHOR]

Background: An imbalance between model-based and model-free decision-making systems is a common feature in addictive disorders. However, little is known about whether similar decision-making deficits appear in internet gaming disorder (IGD). This study compared neurocognitive features associated with model-based and model-free systems in IGD and alcohol use disorder (AUD). Method: Participants diagnosed with IGD (n 5 22) and AUD (n 5 22), and healthy controls (n 5 30) performed the two-stage task inside the functional magnetic resonance imaging (fMRI) scanner. We used computational modeling and hierarchical Bayesian analysis to provide a mechanistic account of their choice behavior. Then, we performed a model-based fMRI analysis and functional connectivity analysis to identify neural correlates of the decision-making processes in each group. Results: The computational modeling results showed similar levels of model-based behavior in the IGD and AUD groups. However, we observed distinct neural correlates of the model-based reward prediction error (RPE) between the two groups. The IGD group exhibited insula-specific activation associated with model-based RPE, while the AUD group showed prefrontal activation, particularly in the orbitofrontal cortex and superior frontal gyrus. Furthermore, individuals with IGD demonstrated hyper-connectivity between the insula and brain regions in the salience network in the context of model-based RPE. Discussion and Conclusions: The findings suggest potential differences in the neurobiological mechanisms underlying model-based behavior in IGD and AUD, albeit shared cognitive features observed in computational modeling analysis. As the first neuroimaging study to compare IGD and AUD in terms of the model-based system, this study provides novel insights into distinct decision-making processes in IGD. [ABSTRACT FROM AUTHOR]

Background: Although internet gaming disorder (IGD) has been listed in section III of the DSM-5 for approximately 10 years, the study of treatments for IGD remains in early stages. Nonetheless, a summary of findings to date and discussion of future research needs are warranted. Methods: The current study reviewed scientific treatment studies with control groups and randomized controlled trials. We summarized the strengths and weaknesses of different treatment strategies and identified gaps in the research literature that may inform the direction of future research efforts. Results: Sixteen studies were reviewed. Existing treatment studies may be categorized into cognitive behavioural therapy (CBT), pharmacotherapies, non-invasive brain stimulation (NIBS), and others. Conclusions: CBT is the most widely studied treatment strategy for IGD thus far. Future studies should consider IGD-specific CBT treatment strategies. Medication-based treatment should be implemented with caution. NIBS is promising, and future studies should explore the most efficacious parameters and targets. In addition, studies should consider sex differences in the treatment of IGD. [ABSTRACT FROM AUTHOR]

Background and Aims: Problematic Social Networking Site Use (PSNSU) is not a formally recognised addiction, but it is increasingly discussed as such in academic research and online. Taking a quantitative, exploratory approach, this study aims to (1) determine whether PSNSU is presented like clinically defined addictions by the affected community and (2) address how well measurements of PSNSU fit with the thematic content found within the associated discourse. Methods: Four corpora were created for this study: a corpus concerning PSNSU and three control corpora concerning established addictions, including Alcohol Use Disorder, Tobacco Use Disorder and Gaming Disorder. Keywords were identified, collocates and concordances were explored, and shared themes were compared. Results: Findings show broad thematic similarities between PSNSU and the three control addictions as well as prominent interdiscursive references, which indicate possible confirmation bias among speakers. Conclusions: Scales based upon the components model of addiction are suggested as the most appropriate measure of this emerging disorder. [ABSTRACT FROM AUTHOR]

Gaming disorder (GD) screening often involves self-report survey measures to detect the presence of symptoms. Studies have shown that gamers' responses vary greatly across survey items. Some symptoms, such as preoccupation and tolerance, are frequently reported by highly engaged but non-problematic gamers, and therefore these symptoms are thought to lack specificity and are suggested to be less important in classification decisions. We argue that the influence of response categories (e.g., dichotomous responses, such as 'yes' or 'no'; or frequency categories, such as 'rarely' and 'often') on item responses has been relatively underexplored despite potentially contributing significantly to the psychometric performance of items and scales. In short, the type of item response may be just as important to symptom reporting as the content of survey questions. We propose some practical alternatives to currently used item categories across GD tools. Research should examine the performance of different response categories, including whether certain response categories aid respondents' comprehension and insight, and better capture pathological behaviours and harms. [ABSTRACT FROM AUTHOR]

Background and aims: Resting-state brain activity may be associated with the ability to perform tasks; however, a multimodal approach involving resting-state functional magnetic resonance imaging (fMRI) and event-related potentials (ERPs) has not been widely used to investigate addictive disorders. Methods: We explored resting-state fMRI and auditory oddball ERP values from 26 with internet gaming disorder (IGD) patients and 27 age- and intelligence quotient-matched healthy controls (HCs). To assess the characteristics of resting-state fMRI, we calculated regional homogeneity (ReHo), amplitude of low-frequency fluctuation (ALFF), and fractional amplitude of low-frequency fluctuation (fALFF); we also calculated the P3 component of the ERPs. Results: Compared with HCs, the individuals with IGD exhibited significant decreases in ReHo and fALFF values in the left inferior occipital gyrus, increased ReHo and ALFF values in the right precuneus, increased ALFF in the left superior frontal gyrus, and lower P3 amplitudes in the midline centro-parietal area during the auditory ERP task. Furthermore, the regional activity of resting-state fMRI in the right inferior temporal gyrus and the occipital regions were positively correlated with the P3 amplitudes in IGD patients, whereas ReHo values of the left hippocampus and the right amygdala were negatively correlated with P3. Discussion and conclusions: Our results suggest that IGD patients have difficulty interacting effectively with cognitive function and sensory processing, although its interpretations need some cautions. The findings in this study will broaden the overall understanding of the neurobiological mechanisms that underlie IGD pathophysiology. [ABSTRACT FROM AUTHOR]

Background and aims: Gaming disorder [GD] risk has been associated with the way gamers bond with their visual representation (i.e., avatar) in the game-world. More specifically, a gamer's relationship with their avatar has been shown to provide reliable mental health information about the user in their offline life, such as their current and prospective GD risk, if appropriately decoded. Methods: To contribute to the paucity of knowledge in this area, 565 gamers (Mage = 29.3 years; SD = 10.6) were assessed twice, six months apart, using the User-Avatar-Bond Scale (UABS) and the Gaming Disorder Test. A series of tuned and untuned artificial intelligence [AI] classifiers analysed concurrently and prospectively their responses. Results: Findings showed that AI models learned to accurately and automatically identify GD risk cases, based on gamers' reported UABS score, age, and length of gaming involvement, both concurrently and longitudinally (i.e., six months later). Random forests outperformed all other AIs, while avatar immersion was shown to be the strongest training predictor. Conclusion: Study outcomes demonstrated that the user-avatar bond can be translated into accurate, concurrent and future GD risk predictions using trained AI classifiers. Assessment, prevention, and practice implications are discussed in the light of these findings. [ABSTRACT FROM AUTHOR]

Background: The eleventh revision of the International Classification of Diseases (ICD-11) defines the three key diagnostic criteria for gaming disorder (GD). These are loss of control over gaming, gaming as a priority over daily activities, and impaired functioning due to gaming. While this definition has implications for the prevention and treatment of GD, there is significant heterogeneity in the symptoms and etiology of GD among individuals, which results in different treatment needs. Cognitive control, emotional regulation, and reward sensitivity are three critical dimensions in the etiology model for GD. Aspects such as gender, comorbidity, motivation for gaming, stage or severity of GD, and risk factors all contribute to the heterogeneity of etiology among individuals with the disorder. Method: On the basis of clinical symptoms and comorbidity characteristics among approximately 400 patients with gaming disorder, the present paper proposes a clinical typology of patients with GD based on the authors' clinical experience in treating individuals with GD. Results: The findings indicated three common types of patients with GD: (i) impulsive male patients with attention deficit hyperactivity disorder (ADHD), (ii) dysphoria patients with dysfunctional coping skills, and (iii) isolated patients with social anxiety. The paper also discusses the presentation and treatment priority for these patients. Conclusion: Personalized treatments for patients with GD should be developed to fit their individual needs. Future studies should examine the heterogeneity of GD and confirm these types, as well as obtain evidence-based information that can help in the development of personalized treatment. Treatment resources should be developed, and professionals should be trained to provide integrated individualized treatment. [ABSTRACT FROM AUTHOR]

Objective: This study sought to investigate brain responses to positive and negative events in individuals with internet gaming disorder (IGD) during real gaming as a direct assessment of the neural features of IGD. This investigation reflects the neural deficits in individuals with IGD while playing games, providing direct and effective targets for prevention and treatment of IGD. Methods: Thirty subjects with IGD and fifty-two matched recreational game use (RGU) subjects were scanned while playing an online game. Abnormal brain activities during positive and negative events were detected using a general linear model. Functional connectivity (FC) and correlation analyses between neural features and addiction severity were conducted to provide additional support for the underlying neural features. Results: Compared to the RGU subjects, the IGD subjects exhibited decreased activation in the dorsolateral prefrontal cortex (DLPFC) during positive events and decreased activation in the middle frontal gyrus (MFG), precentral gyrus and postcentral gyrus during negative events. Decreased FC between the DLPFC and putamen during positive events and between the MFG and amygdala during negative events were observed among the IGD subjects. Neural features and addiction severity were significantly correlated. Conclusions: Individuals with IGD exhibited deficits in regulating game craving, maladaptive habitual gaming behaviors and negative emotions when experiencing positive and negative events during real game-playing compared to RGU gamers. These abnormalities in neural substrates during real gaming provide direct evidence for explaining why individuals with IGD uncontrollably and continuously engage in game playing, despite negative consequences. [ABSTRACT FROM AUTHOR]

Background and aims: Research on the development of gaming disorder assumes that the quality of reinforcement learning as well as the content of use expectancies are initially rewarding in the early stages of the addictive behavior and becomes steadily more compensatory in the later stages. This assumed transition could be reflected in gaming-related mental imagery as well as the decision to play videogames in daily life. Methods: We recruited 127 individuals who play videogames. Following a strict diagnostic procedure, individuals were either classified as showing casual or at-risk gaming patterns. The experience and expectancy of reward and relief were assessed in the laboratory, followed by a 14-day ambulatory assessment asking for gaming-related mental imagery intensity and playing frequency. Besides group differences, we tested a gratification and a compensation pathway in a structural equation model among groups separately. Results: Results indicate that mental imagery and playing frequency as well as reinforcement processes and use expectancies are heightened among individuals showing at-risk gaming patterns as compared to casual gaming patterns. Gaming-related mental imagery was only predicted by compensation among individuals showing casual gaming patterns, and we found no significant predictions for daily gaming frequency in any of the models. Discussion and conclusions: The results implicate that individuals with at-risk gaming patterns might hold stronger learned reinforcement contingencies. Daily usage seems unaffected by these contingencies, possibly indicative of habitualized behaviors. Additionally, the results provide some support for the consideration of imaginal desire thoughts as a specific coping mechanism in the context of gaming behaviors. [ABSTRACT FROM AUTHOR]

The Journal of Behavioral Addictions featured a debate on the topic of "behavioral addictions in ICD-11" in 2022. Three main debate papers were published and a total of eleven commentaries. One main topic of considerations in the three debate papers and in the majority of commentaries was compulsive sexual behavior disorder. The debate was balanced, collegial and conducted at a high scientific level. Although there are some disagreements regarding specific details, all authors consider more research on behavioral addictions as important. This scientific debate has been and continues to be enormously important to behavioral addiction research and clinical practice. [ABSTRACT FROM AUTHOR]

Background and aims: Impaired value-based decision-making is a feature of substance and behavioral addictions. Loss aversion is a core of value-based decision-making and its alteration plays an important role in addiction. However, few studies explored it in internet gaming disorder patients (IGD). Methods: In this study, IGD patients (PIGD) and healthy controls (Con-PIGD) performed the Iowa gambling task (IGT), under functional magnetic resonance imaging (fMRI). We investigated group differences in loss aversion, brain functional networks of node-centric functional connectivity (nFC) and the overlapping community features of edge-centric functional connectivity (eFC) in IGT. Results: PIGD performed worse with lower average net score in IGT. The computational model results showed that PIGD significantly reduced loss aversion. There was no group difference in nFC. However, there were significant group differences in the overlapping community features of eFC. Furthermore, in Con-PIGD, loss aversion was positively correlated with the edge community profile similarity of the edge between left IFG and right hippocampus at right caudate. This relationship was suppressed by response consistency in PIGD. In addition, reduced loss aversion was negatively correlated with the promoted bottom-to-up neuromodulation from the right hippocampus to the left IFG in PIGD. Discussion and conclusions: The reduced loss aversion in value-based decision making and their related edge-centric functional connectivity support that the IGD showed the same value-based decision-making deficit as the substance use and other behavioral addictive disorders. These findings may have important significance for understanding the definition and mechanism of IGD in the future. [ABSTRACT FROM AUTHOR]

Background and aims: The Pavlovian-to-instrumental transfer (PIT) effect is a phenomenon that Pavlovian conditioned cues that could influence one's instrumental behavior. In several substance and behavioral addictions, such as tobacco use disorder and gambling disorder, addiction-related cues could promote independently trained instrumental drug-seeking/drug-taking behaviors, indicating a specific PIT effect. However, it is unclear whether Internet gaming disorder (IGD) would show a similar change in PIT effects as other addictions. The study aimed to explore the specific PIT effects in IGD. Methods: We administrated a PIT task to individuals with IGD (n = 40) and matched health controls (HCs, n = 50), and compared the magnitude of specific PIT effects between the two groups. The severity of the IGD symptoms was assessed by the Chinese version 9-item Internet Gaming Disorder Scale (IGDS) and the Internet Addiction Test (IAT). Results: We found that: (1) related to the HCs group, the IGD group showed enhanced specific PITgame effects, where gaming-related cues lead to an increased choice rate of gaming-related responses; (2) in the IGD group, the magnitude of specific PITgame effects were positively correlated with IAT scores (rho = 0.39, p = 0.014). Discussion and conclusions: Individuals with IGD showed enhanced specific PIT effects related to HCs, which were associated with the severity of addictive symptoms. Our results highlighted the incentive salience of gaming-related cues in IGD. [ABSTRACT FROM AUTHOR]

Background and aims: The study aims to thoroughly understand the causal and precedent modifiable risk or protective factors for Internet Gaming Disorder (IGD), a newly defined and prevalent mental disorder. Methods: We performed a systematic review on quality-designed longitudinal studies based on five online databases: MEDLINE, PsycINFO, Embase, PubMed, and Web of Science. Studies were included in the meta-analysis if they addressed IGD, adopted longitudinal, prospective, or cohort study designs, presented modifiable factors of IGD, and reported the effect sizes for correlations. Pooled Pearson's correlations were calculated using the random effects model. Results: Thirty-nine studies with 37,042 subjects were included. We identified 34 modifiable factors, including 23 intrapersonal factors (e.g., gaming time, loneliness, etc.), 10 interpersonal factors (e.g., peer relationship, social support, etc.), and 1 environmental factor (i.e., school engagement). Age, the male ratio, study region, and study years were significant moderators. Discussion and conclusions: Intrapersonal factors were stronger predictors than interpersonal and environmental factors. It may imply that individual-based theories are more powerful to explain the development of IGD. Longitudinal research on the environmental factors of IGD was lacking; more studies are warranted. The identified modifiable factors would help to guide effective interventions for IGD reduction and prevention. [ABSTRACT FROM AUTHOR]

Background and aims: Gaming disorder (GD) is a mental health concern that has been heavily contested by experts. This scoping review synthesizes the literature to identify the structural features of video game design that can contribute to GD. Furthermore, a taxonomy of the structural features implicated with GD is proposed, revised from earlier work. Methods: Seven databases, in addition to Google Scholar, were searched. Peer-reviewed studies were included if they assessed a link between gaming structural characteristics and GD or a proxy. The final pool included 105 articles. Results: Avatar creation and customizability, multiplayer characteristics, and reward and punishment features were highly represented in the literature. There was no evidence for three categories in the original taxonomy: support network features, sexual content, and explicit language. Furthermore, structural feature sub-categories emerged that were absent from the previous taxonomy, such as general socialization features, type of virtual world, and in-game currency. Manipulation and control features and presentation features were less represented than social features, narrative and identity features, and reward and punishment features. The reviewers propose two broad classes of addictive gaming structural features: 'features enhancing in-game immersion and realism' and 'gambling-like features'. Discussion and conclusions: Numerous studies found a relationship between social, narrative and identity, and reward and punishment structural characteristics with GD. Two broad classes of gaming structural features were associated with addiction. The first, 'features enhancing in-game immersion and realism,' including social gameplay, avatar creation, storytelling, and graphics/sound. The second, 'gambling-like features,' included different mechanisms of rewards-and-punishment. [ABSTRACT FROM AUTHOR]

Background: Video gaming is a popular activity among young people. Time spent with gaming was found to be only moderately associated with gaming disorder. However, patterns of binge gaming (playing more than = h consecutively) were rarely considered in research on gaming. This study explores how binge gaming frequency is related with gaming disorder and mental health. Methods: The sample came from the Cohort study on substance use risk factors (C-SURF) and comprised 5,358 young men aged 28.26 years (SD = 1.27). ANCOVA was conducted to estimate the association between binge gaming frequency (gaming at least = h consecutively) and gaming disorder (measured with the Game Addiction Scale) as well as indicators of mental health. Results: A total of 33.3% of the sample engaged in binge gaming at least once in the previous year, and 6.1% at least weekly. Frequency of binge gaming was associated with gaming disorder score in a linear dose-response relationship (linear trend = 2.30 [2.14, 2.46]) even if adjusted for time spent gaming (linear trend = 1.24 [1.03, 1.45). More frequent binge gaming was associated with lower life satisfaction and sleep quality, and with more major depression and social anxiety disorder symptoms. Conclusions: Binge gaming patterns, especially daily or almost daily binge gaming, are important to consider with regard to gaming disorder and mental health. Asking about binge gaming may be a promising screening question for gaming related problems. Encouraging regular breaks from gaming may be a valuable prevention strategy to reduce negative outcomes of gaming. [ABSTRACT FROM AUTHOR]

Objective: According to ICD-11 gaming disorder is currently defined as a behavioral addiction. While our understanding of crucial aspects of this new condition including other subtypes of internet use disorders is growing, less is known about treatment strategies and their effectiveness. Particularly, dimensions of life satisfaction and their meaning for internet use disorders are poorly investigated. The aim of this study was addressing the role of life satisfaction dimensions in a randomized controlled trial. We examined life satisfaction as an additional treatment outcome and investigated in how far life satisfaction is predictive for symptom reduction and related to personality traits. Methods: A multicenter randomized controlled trial with three measure points (baseline, post-treatment, 6-month follow-up) was conducted based on N = 143 patients aged 17 and above meeting diagnostic criteria for internet use disorders. A cognitive-behavioral disorder specific intervention was applied in n = 72 and compared to a wait list control (n = 71). Endpoints included symptoms of internet use disorders, psychosocial functioning, and life satisfaction. Personality traits were assessed as moderating factors. Results: Life satisfaction (η² = 0.106) and health satisfaction (η² = 0.173) significantly increased in the intervention group with large effect sizes. Decreasing symptoms of internet use disorders at follow-up were predicted by life satisfaction at posttreatment (ß = -0.51) with extraversion (B = 1.606) and openness (B = 2.069) moderating this association. Conclusion: Life satisfaction yields additional value as a secondary treatment outcome in internet use disorders and can be therapeutically addressed in order to stabilize treatment effects in the long run. Our study indicates that existing treatment strategies might benefit from explicitly addressing and enhancing psychosocial resources in order to prevent relapses in patients. [ABSTRACT FROM AUTHOR]

Background and aims: Online gaming motives have proven to be useful in differentiating problematic engagement in online gaming. However, the mixture modeling approach for classifying problematic subtypes based on gaming motives remains limited. This study attempted to differentiate heterogeneous online gamers into more homogenous subtypes based on gaming motives using latent profile analysis (LPA). We also compared various psychological and gaming/leisure related variables across the derived profiles. Methods: A total of 674 Korean online game users (mean age = 21.81 years, male = 76%) completed self-report questionnaires, including the Korean version of the Motives for Online Gaming Questionnaire (K-MOGQ). After the LPA, the relationships between latent profile membership and auxiliary variables were explored. Results: Four latent profiles were identified, that were further classified into one problematic (highly motivated-dissatisfied gamer), one highly engaged (highly motivated-satisfied gamer), and two casual (moderately-motivated casual gamer and lowly-motivated casual gamer) gamer profiles. Inter-profile comparisons revealed that highly motivated-dissatisfied gamer had the most pathological profile, characterized by high Internet gaming disorder (IGD) tendency, neuroticism, and impulsivity, but the lowest recreation motive. While highly motivated-satisfied gamer also demonstrated a heightened IGD tendency, they showed positive patterns of psychological and gaming/leisure-related variables, which indicated they could be better considered as high engaged instead of problematic gamers. Discussion and conclusions: These results indicate that the recreation motive, in addition to fantasy or escape motives, is an important factor in differentiating maladaptive online gamers. Classifying online gamers based on gaming motives can contribute to a clearer conceptualization of heterogeneous gamers, paving the way for individualized assessment and treatment planning. [ABSTRACT FROM AUTHOR]

Background and aims: Limited research has investigated how individuals’ problem gaming affects significant others. The present study investigated the extent to which partners and parents were personally affected by their partner or child’s problematic gaming behavior and what steps, if any, were taken in relation to treatment and other help-seeking by the gamers and the respondents themselves. Methods: Two targeted samples (parents, n 5 104; partners, n 5 264) in Australia were recruited and administered an online survey. The survey assessed gaming-related harm across multiple domains, including financial, relationship, emotional wellbeing, physical health and work/study. Treatment and help-seeking questions referred to seeking psychological assistance, self-help, and community support. Non-parametric tests compared groups on harm measures based on GD status. Results: Parents and partners of individuals rated in the ‘problem gaming’ range reported significantly greater harms compared to those in the at-risk and non-problem categories. The most frequently endorsed harms were in the relationship domain, including neglected household responsibilities, withdrawal from social events, and relationship conflict. Some parents consult with friends and family (15%) to resolve their child’s gaming-related problems. Partners reported to seek outside support and assistance for themselves, including 30% who sought a psychologist. No partners reported having consulted a psychologist for their gaming partner. Discussion: Problem gaming affects significant others across multiple life areas, but few seek outside help or support, suggesting there may be significant unmet needs. Conclusions: Further research should examine factors that influence acceptance and engagement with problem gaming help options. Harm indicators may be useful for evaluating targeted interventions and other measures to reduce problem gaming. [ABSTRACT FROM AUTHOR]

Background and aims: It has been argued that it is important to consider underlying mechanisms of mental health problems. Previous studies have shown that executive deficits, delay aversion, and emotion dysregulation are related to Internet Gaming Disorder (IGD) and Social Media Disorder (SMD). However, the present study is the first to investigate whether these neuropsychological deficits show additive effects or if they interact. The present study also investigated whether these deficits mediate the association between IGD/SMD and psychosocial outcomes. Methods: The study involved 995 university students who completed a survey measuring IGD/SMD symptom severity, neuropsychological functions, and psychosocial outcomes. Both dimensional and categorical analyses were used to assess the associations between neuropsychological functions and IGD/SMD. Simple and multiple mediation analyses were conducted to examine if neuropsychological functioning mediates the association between IGD/SMD and psychosocial outcomes. Results: All neuropsychological functions were significantly associated with both IGD and SMD symptom severity. However, only inhibition and emotion regulation, as well as delay aversion for SMD, remained significant when controlling for the overlap between different functions. Associations were significantly stronger for men compared to women for IGD. In the categorical analyses, individuals with IGD/SMD were more likely to have neuropsychological deficits (odds ratios between 3.33 and 8.81). Finally, all neuropsychological functions, except inhibition, were significant mediators in the link between IGD/SMD and psychosocial outcomes. Discussion and conclusions: These results shed light on the neuropsychological underpinnings of IGD/SMD, which can be used to identify more homogenous subgroups and provide more individualized treatment options. [ABSTRACT FROM AUTHOR]

Background: Recovery from mental health and behavioral disorders is classically defined as a reduction in symptoms. More recent definitions see it as a process in which individuals improve their health, wellness and other life domains. The inclusion of gaming disorder (GD) in the 11th International Classification of Diseases in 2019 prompted growing interest in GD. However, relatively little is known about recovery from GD, and there is scant literature describing or assessing its course. Objectives: This scoping review was designed to explore the state of the art on recovery from GD (e.g., terminology and measures used to assess recovery, main topics in studies about recovery from GD). Methods: PubMed, Web of Science, and Scopus databases were searched and critically reviewed according to PRISMA guidelines. We included empirical studies in English covering individuals across all age groups who met the diagnostic criteria of GD/internet gaming disorder (IGD) according to valid scales that relate to recovery or any change, and were published before February 2022. Results: A total of 47 out of 966 studies met the inclusion criteria. Recovery as a concept is not explicitly mentioned in GD studies. Rather, changes in subjects’ disorders are described in terms of decreases/reductions in symptom severity, or improvement/increases. These changes are primarily measured by scales that evaluate symptom reduction and/or improvement in GD and other psychopathologies. Conclusions: The concept of recovery is included in the GD field but is not clearly mentioned or used. Therapists and researchers should aim to promote and integrate the notion of recovery in GD. [ABSTRACT FROM AUTHOR]

Background and aims: 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. Methods: 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. Results: 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. Discussion and conclusion: 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. [ABSTRACT FROM AUTHOR]

Background and aims: Internet use has become an important part of daily living. However, for a minority it may become problematic. Moreover, problematic use of the Internet/smartphone (PUIS) has been associated with low physical activity. The present study investigated the temporal associations between three types of PUIS (i.e., problematic smartphone use [PSPU], problematic social media use [PSMU] and problematic gaming [PG]) and physical activity among Taiwanese university students. Methods: A six-month longitudinal survey study comprising three time points for assessments was conducted. From the original 974 participants, a total of 452 completed all three waves of an online survey comprising the International Physical Activity Questionnaire Short Form (IPAQ-SF) assessing physical activity level, Smartphone Application-Based Addiction Scale (SABAS) assessing PSPU, Bergen Social Media Addiction Scale (BSMAS) assessing PSMU, and Internet Gaming Disorder Short Form (IGDS9-SF) assessing PG. Results: The linear mixed effects model found positive temporal associations of PSMU and PG with physical activity level (PSMU: B 5 85.88, SE 5 26.24; P 5 0.001; PG: B 5 36.81, SE 5 15.17; P 5 0.02). PSPU was not associated with physical activity level (B 5 40.54, SE 5 22.99; P 5 0.08). Additionally, the prevalence rates were 44.4% for at-risk/PSPU, 24.6% for at-risk/PSMU, and 12.3% for at-risk/PG. Discussion and Conclusions: PSMU and PG unexpectedly demonstrated correlations with higher physical activity level. The nature of these relationships warrants additional investigation into the underlying mechanisms in order to promote healthy lifestyles among university students. [ABSTRACT FROM AUTHOR]

Background: Accumulating evidence suggests brain structural and functional alterations in Internet Use Disorder (IUD). However, conclusions are strongly limited due to the retrospective case-control design of the studies, small samples, and the focus on general rather than symptom-specific approaches. Methods: We here employed a dimensional multi-methodical MRI-neuroimaging design in a final sample of n 5 203 subjects to examine associations between levels of IUD and its symptom-dimensions (loss of control/time management, craving/social problems) with brain structure, resting state and taskbased (pain empathy, affective go/no-go) brain function. Results: Although the present sample covered the entire range of IUD, including normal, problematic as well as pathological levels, general IUD symptom load was not associated with brain structural or functional alterations. However, the symptom-dimensions exhibited opposing associations with the intrinsic and structural organization of the brain, such that loss of control/time management exhibited negative associations with intrinsic striatal networks and hippocampal volume, while craving/social problems exhibited a positive association with intrinsic striatal networks and caudate volume. Conclusions: Our findings provided the first evidence for IUD symptom-domain specific associations with progressive alterations in the intrinsic structural and functional organization of the brain, particularly of striatal systems involved in reward, habitual and cognitive control processes. [ABSTRACT FROM AUTHOR]

Aim: This study evaluated the consistency between the International Classification of Diseases, 11th Edition (ICD-11) for gaming disorder (ICD-11-GD) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for internet gaming disorder (DSM-5-IGD). Moreover, the functional impairment of participants and their insight of their GD were evaluated. Methods: We recruited 60 participants with GD, 45 participants who engaged in hazardous gaming (HG), and 120 controls based on a diagnostic interview. Their operationalization of functional impairment and stage of change were evaluated by interviews and questionnaires, including the Brief Gaming Negative Consequence Scale (BGNCS). Results: We observed satisfactory consistency (kappa value 5 0.80) with a diagnostic accuracy of 91.5% between the ICD-11-GD and DSM-5-IGD criteria. Furthermore, 16 participants with IGD in DSM-5 were determined to have HG based on the ICD-11 criteria. Participants of GD group experienced impaired functioning in their health (96.7%), career (73.3%), social life (61.6%), academic performance (36.7%), and job performance (35%). Moreover, a proportion of them were in the pre-contemplation (25.0%), contemplation (61.7%), preparation (10%), and action stages (3.3%). Conclusion: There is a good consistency between ICD-11-GD and DSM-5-IGD criteria. The ICD-11 criteria have a high threshold for diagnosing GD. HG criteria could compensate for this high threshold and identify individuals with a gaming-related functional impairment who require help. Most of the participants with GD were in the early stage of change. Interventions to promote their insight are essential. The BGNCS can be used to examine the negative consequences of gaming and aid mental health professionals in assessing functional impairment. [ABSTRACT FROM AUTHOR]

Background and aims: Theories posit that the combination of external (e.g. cue exposure) and internal (e.g. attention biases) factors contributes to the development of game craving. Nevertheless, whether different components of attentional biases (namely, engagement bias and disengagement bias) play separate roles on game craving has not been fully elucidated. We aimed to examine the associations between two facets of attentional biases and game craving dynamics under a daily life setting. Methods: Participants (110 regular internet game players) accomplished the modified attentional assessment task in the laboratory, after which they entered a 10-day ecological momentary assessment (EMA) to collect data on their momentary game craving and occurrence of game-related events at five different time points per day. Results: We found that occurrence of game-related events was significantly associated with increased game craving. Moreover, attentional disengagement bias, instead of engagement bias, bore on the occasional level variations of game craving as moderating variables. Specifically, attentional disengagement bias, not engagement bias, was associated with a greater increase in game craving immediately after encountering a game-related event; however, neither attentional engagement bias nor disengagement bias was associated with the craving maintenance after a relatively long period. Discussion and conclusions: The present study highlights the specific attentional processes involved in game craving dynamics, which could be crucial for designing interventions for attentional bias modification (ABM) in Internet Gaming Disorder (IGD) populations. [ABSTRACT FROM AUTHOR]

Background and aims: Although the Ten-Item Internet Gaming Disorder Test (IGDT-10) has been translated into Japanese and widely used, the Japanese version has not previously been validated. We used the clinical diagnosis of IGD as a gold standard for validating the test. Methods: The Japanese version was validated using 244 gamers drawn from the general young population in Japan. Expert interviews using the Japanese version of the Structured Clinical Interview for Internet Gaming Disorder evaluated diagnoses of Internet gaming disorder (IGD). This resulted in a diagnosis of IGD for eight individuals, categorized as the gold standard group. The screening performance of the two Japanese versions with different scoring conditions was examined: the scoring method proposed by the original study (original version) and a less stringent scoring method where responses of either "often" or "sometimes" were regarded as affirmative (modified version). Results: The results of the sensitivity and specificity analyses, the Cronbach's alpha and the receiver operating characteristics analysis revealed a higher screening performance for the modified versus the original version. The optimum cutoff for the modified version was 5 or more - the sensitivity, specificity, and Youden's index were 87.5, 85.2, and 72.7%, respectively. The rate of probable IGD using the original and modified versions were 1.8% and 11.3%, respectively. Discussion and conclusion: A less stringent scoring method for the Japanese version of IGDT-10 showed a higher screening performance than the original scoring method. Future studies comprising different ethnic groups and gaming cultures should further examine the suggested scoring method. [ABSTRACT FROM AUTHOR]

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 5 1,541, 51.2% women, age: M 5 42.99, SD 5 14.38), we investigated the role of selfreported withdrawal symptoms and tolerance with respect to CSBD and PPU severity. Results: Both withdrawal and tolerance were significantly associated with the severities of CSBD (ß 5 0.34; P < 0.001 and ß 5 0.38; P < 0.001, respectively) and PPU (ß 5 0.24; P < 0.001 and ß 5 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. [ABSTRACT FROM AUTHOR]

Background and aims: Sex differences in internet gaming disorder (IGD) remain unknown. Investigating sex-specific neural features that underlie the core risk factor (i.e., risk-taking) of IGD would help in understanding sex-specific vulnerabilities to IGD and advance sex-specific treatments and prevention for IGD. Methods: 111 participants (28 IGD males, 27 IGD females, 26 recreational game user (RGU) males, 30 RGU females) completed a probability discounting task during fMRI scanning. Results: First, among RGUs, males showed a higher risk-taking tendency and greater neural activation associated with risk/ value evaluation for reward (the ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), left putamen) and smaller activation associated with cognitive control (the inferior frontal gyrus) than females during the contrast of risky-safe choices. Moreover, males showed a greater modulatory effect of risky choices on the connection from the vmPFC/ACC to the left putamen than females. Second, IGD males showed decreased activation in the vmPFC/ACC and left putamen compared to RGU males, whereas this decrease did not exist in IGD females. Discussion: Males show a higher risktaking tendency than females. Altered neural substrates associated with risky decision-making exist in IGD males but not in IGD females. Conclusions: The present findings fill the gap in information on the behavioral and neural substrates underlying IGD among females and demonstrate that a high risk-taking tendency is a risk factor and core symptom only in IGD males but not in IGD females. It is necessary to design and adopt distinct treatments and prevention strategies for IGD in males and females. [ABSTRACT FROM AUTHOR]

Background and aims: The popularity of video gaming has generated significant interest in research methods to examine motivations for gaming. Current measures of gaming motives are limited by lack of scope and/or their applicability to specific game genres only. We aimed to create a comprehensive motivation inventory applicable to any gaming genre and to evaluate its psychometric properties in a large sample of highly engaged video gamers. Methods: Stage 1 of this project involved a systematic review that generated the items for the Gaming Motivation Inventory (GMI). Stages 2-4 involved an evaluation of the psychometric properties of the GMI. A sample of 14,740 video gamers (89.3% male; mean age 24.1 years) were recruited via an online survey promoted by a popular gaming magazine. Results: In Stage 2, twenty-six gaming motives were identified, which clustered into six higher-order dimensions (Mastery, Immersion/Escapism, Competition, Stimulation, Social, Habit/Boredom). In Stage 3, construct validity of the six higher-order motives was assessed by associations with gaming-related, personality, and psychological variables. In Stage 4, the relationships between motives and depression symptoms and gaming disorder symptoms were explored. Although gaming motives had weak associations with gaming genres, they were moderately related to variables such as competitiveness, sociability, and positive and negative affect. Gaming disorder symptoms were directly predicted by depression symptoms and indirectly via Immersion/Escapism, Habit/Boredom, and Competition motives. Discussion and conclusions: These findings support the notion that motives are one of the primary causes of gaming behavior and play an important role in predicting its problematic nature. The GMI is a psychometrically valid tool that will be useful for gaining insights into factors underlying gaming behaviors. [ABSTRACT FROM AUTHOR]

Background: Adolescents and young adults (AYA) have an increased risk for Internet use disorders (IUD) compared to older individuals that may lead to functional impairments in daily life. To date, evidence-based brief interventions are lacking. This study aimed to test the efficacy of a low-threshold counseling approach based on Motivational Interviewing (MI) in a vocational school setting. Methods: Of 8.230 vocational students (age M520.56, SD54.68; 51.85% female) being proactively screened for IUD, 937 with positive screenings took part in telephone-based diagnostic interviews. IUD were assessed in line with the criteria of the Internet Gaming Disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Readiness to change, self-efficacy, and impairments in daily life were additionally assessed with standardized screening instruments. Participants fulfilling at least two IUD criteria were randomized to the intervention group (n5240, up to three MI-based counseling sessions via telephone) or the control group (n5257, information brochure on responsible Internet use). Follow-up interviews were conducted after five and ten months. The primary outcome was the reduction of IUD criteria. Secondary outcomes were improvements of readiness/ self-efficacy to change and the reduction of daily impairments. Data were analyzed with Intention-to-Treat (ITT) and complier average causal effect (CACE) analyses. Results: Overall, 153 (63.75%) individuals assigned to the intervention group participated at least in one counseling session (5compliers). Both groups reduced the number of IUD criteria over time. In ITT analyses, however, we did not find intervention effects for primary and secondary outcomes. Bayes statistics were inconclusive. Based on low participation rates in the intervention group, explorative CACE analyses were conducted to compare compliers in the intervention group to potential compliers in the control group. Again, we did not find intervention effects apart from improvements in self-efficacy after five months. Discussion: Telephonebased counseling seems not appropriate to address AYA at risk for IUD. Low participation rates in the intervention group caused underpowered analyses. Besides, dealing with the own Internet use during intensive assessments and receiving an information brochure led to behavioral changes also in the control group. Since the efficacy of brief interventions under the condition of higher participation rates cannot be fully ruled out, further research is required by taking the implications of this study into account. [ABSTRACT FROM AUTHOR]

Background and aims: Internet gaming disorder (IGD) in adolescents is a concerning issue. Positive parenting has been found to protect against adolescent IGD, but the underlying mechanisms await further investigation. As such, this study examined the longitudinal association between parental involvement (PI) -- a specific type of positive parenting understudied in the literature of adolescent gaming disorder -- and IGD. Moreover, this study also tested consideration of future consequences (CFC) as a mediator and peer victimization (PV) as a moderator. Methods: A two-wave longitudinal research spanning 6 months apart was conducted. Participants were Chinese adolescents (final N = 434; 222 females; Mage 5 14.44 years, SD = 1.56). They provided ratings on PI, PV, and IGD at Wave 1, and CFC-immediate, CFC-future, and IGD at Wave 2. Results: Descriptive statistics showed that the prevalence rate of IGD was 10.81% and 9.45% at Waves 1 and 2, respectively. Moreover, results of moderated mediation model found that after controlling for Wave 1 IGD and covariates, Wave 1 PI was associated with Wave 2 IGD via preventing adolescents who had higher levels of PV from developing a tendence of CFC-immediate and via promoting adolescents who had lower levels of PV to develop a tendence of CFC-future. Discussion and Conclusions: Altogether, these results suggest that facilitative ecological systems (e.g., positive parenting and good relationships with peers) and personal strengths (e.g., positive future orientation) jointly contribute to the mitigation of adolescent IGD. [ABSTRACT FROM AUTHOR]

Background and aims: Asian countries are deemed to be high prevalence areas for gaming disorder (GD). This meta-analysis is the first to synthesize the overall prevalence of GD in East Asia and investigate characteristics that influence prevalence estimates. Methods: Systematic and independent searches were conducted across PubMed, Web of Science, Embase, PsycINFO, and the Cochrane Library since their inception to January 27, 2021. The Agency for Healthcare Research and Quality scale was used for quality assessment. A random effect model was used to calculate the overall GD prevalence and 95% confidence intervals (CIs). Results: In total, 22 articles (26 studies) comprising 51,525 participants were included in this meta-analysis. The overall pooled prevalence of GD in East Asia was 12%, 95% CI (10%--15%); this figure was adjusted to 6%, 95% CI (3%-9%) for a representative sample. Higher prevalence was observed in males than in females (16% vs. 8%, respectively, P < 0.05). Subgroup and meta-regression analyses revealed that studies among gamers or those without random sampling reported significantly higher prevalence rates. There were no significant differences between countries/regions, sample size, quality score, proportion of males, and scale used. Discussion and conclusions: The prevalence of GD in East Asia is higher than that in other world regions. Future studies should extend such epidemiological research to other regions to calculate the accurate prevalence of GD to benefit the local identification, prevention, policy formulation, and treatment efforts. Considering its negative effects, effective preventive and treatment measures for GD in East Asia need greater attention. [ABSTRACT FROM AUTHOR]

Background and aims: The present systematic review and meta-analysis aimed to synthesize the available literature on the relationship between gaming motivations and gaming disorder symptoms. Specifically, to (1) explore what gaming motivation questionnaires and classifications are used in studies on gaming disorder symptoms and (2) investigate the relationship between motivational factors and symptoms of gaming disorder. Method: An electronic database search was conducted via EBSCO (MEDLINE and PsycINFO) and the Web of Science Core Collection. All studies using validated measurements on gaming disorder symptoms and gaming motivations and available correlation coefficients of the relationship between gaming disorder and gaming motivations were included. The meta-analyses were conducted using a random-effects model. Results: In total, 49 studies (k = 58 independent sub-samples), including 51,440 participants, out of which 46 studies (k = 55 sub-samples, n = 49,192 participants) provided data for the meta-analysis. The synthesis identified fourteen different gaming motivation instruments, seven unique motivation models, and 26 motivational factors. The meta-analysis showed statistically significant associations between gaming disorder symptoms and 23 out of 26 motivational factors, with the majority of the pooled mean effect sizes ranging from small to moderate. Moreover, large heterogeneity was observed, and the calculated prediction intervals indicated substantial variation in effects across populations and settings. Motivations related to emotional escape were robustly associated with gaming disorder symptoms. Discussion and conclusions: The present meta-analysis reinforces the importance of motivational factors in understanding problematic gaming behavior. The analysis showed significant heterogeneity in most outcomes, warranting further investigation. Registration detail: PROSPERO (CRD42020220050). [ABSTRACT FROM AUTHOR]

Background and aims: Behavioral addictions are a public health problem that causes harm to both individuals and society. Internet-based interventions offer potential benefits over face-to-face therapy for the treatment of behavioral addictions, including their accessibility, perceived anonymity, and low costs. We systematically reviewed the characteristics and effectiveness of these interventions. Methods: A systematic literature search was conducted in: PubMed, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials. A standardized methodological quality assessment was performed on all identified studies via the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. Results: Twenty-nine studies were assessed in this systematic review. Between them, considerable heterogeneity was noted in various study characteristics, including screening tools, inclusion criteria, and outcome measures. Attrition rates also ranged widely (9-89%), as did study quality, with three of the 29 studies rated strong, 12 moderate, and 14 weak methodologically. Twenty-two studies focused on gambling disorder, most revealing significant within-group effects for the assessed intervention on gambling-related symptoms and four of these studies identified significant between-group effects. Behavioral addictions studied in the remaining studies included gaming disorder, internet use disorder, hoarding disorder, and pornography use disorder, revealing generally-promising, albeit limited results. Conclusions: Internet-based interventions seem promising at reducing gambling problems, but too few studies have been published, to date, for conclusions to be drawn for other behavioral addictions. Internet-based interventions targeting other behavioral addictions -- like gaming disorder, internet use disorder, hoarding disorder, and pornography use disorder -- remain under-examined, warranting considerable additional research to assess their effectiveness. [ABSTRACT FROM AUTHOR]

Background: Gaming Disorder was included as an addictive disorder in the latest version of the International Classification of Diseases (ICD-11), published in 2022. The present study aimed to develop a screening tool for Gaming Disorder, the Gaming Disorder Identification Test (GADIT), based on the four ICD-11 diagnostic criteria: impaired control, increasing priority, continued gaming despite harm, and functional impairment., Method: We reviewed 297 questionnaire items from 48 existing gaming addiction scales and selected 68 items based on content validity. Two datasets were collected: 1) an online panel (N = 803) from Australia, United States, United Kingdom and Canada, split into a development set (N = 589) and a validation dataset (N = 214); and 2) a university sample (N = 408) from Australia. Item response theory and confirmatory factor analyses were conducted to select eight items to form the GADIT. Validity was established by regressing the GADIT against known correlates of Gaming Disorder., Results: Confirmatory factor analyses of the GADIT showed good model fit (RMSEA=<0.001-0.108; CFI = 0.98-1.00), and internal consistency was excellent (Cronbach's alphas = 0.77-0.92). GADIT scores were strongly associated with the Internet Gaming Disorder Test (IGDT-10), and significantly associated with gaming intensity, eye fatigue, hand pain, wrist pain, back or neck pain, and excessive in-game purchases, in both the validation and the university sample datasets., Conclusion: The GADIT has strong psychometric properties in two independent samples from four English-speaking countries collected through different channels, and shown validity against existing scales and variables that are associated with Gaming Disorder. A cut-off of 5 is tentatively recommended for screening for Gaming Disorder.

Background: While there are calls to restrict the time spent on gaming because it is seen as problematic and potentially leading to gaming disorder (GD), there is conflicting evidence about this issue. We explored the association between the average weekly time spent gaming and reported GD symptoms. Additionally, Latent Profile Analysis was employed to investigate how time spent gaming relates to variables representing psychological distress (PD), such as satisfaction with life, symptoms of depression, and perceived stress., Methods: Data were collected using surveys with a large sample of highly engaged gamers (N = 14,740; Mage = 24.14 years, SDage = 7.0, 89.3% males)., Results: We observed a positive, close to linear association between time spent gaming and GD symptoms. Groups at risk of GD played for about 42 h (SD = 19) on average, according to the American Psychiatric Association and World Health Organization frameworks. Furthermore, we identified four profiles representing varying levels of PD. Gamers reporting very high levels of PD (4.2% of the sample) played for 33 h per week on average. Remarkably, a substantial percentage of the sample (41.9%) showed no PD despite playing for 26 h per week., Conclusion: The association between gaming time and PD is complex as even prolonged time spent gaming can be unproblematic for many gamers.

Background: Observation of real-time neural characteristics during gameplay would provide distinct evidence for discriminating the currently controversial diagnosis of internet gaming disorder (IGD), and elucidate neural mechanisms that may be involved in addiction. We aimed to provide preliminary findings on possible neural features of IGD during real-time internet gaming using functional near-infrared spectroscopy (fNIRS). Methods: Prefrontal cortical activations accompanying positive and negative in-game events were investigated. Positive events: (1) participant’s champion slays or assists in slaying an opponent without being slain. (2) the opposing team’s nexus is destroyed. Negative events: (1) participant’s champion is slain without slaying or assisting in slaying any opponent. (2) the team’s nexus is destroyed. Collected data were compared between the IGD group and control group, each with 15 participants. Results: The IGD group scored significantly higher than the CTRL group on the craving scale. Following positive events, the IGD group displayed significantly stronger activation in the DLPFC. Following negative events, the IGD group displayed significantly weaker activation in the lateral OFC. Discussion and Conclusions: Individuals scoring high on the IGD scale may crave for more internet gaming after encountering desired events during the game. Such observations are supported by the correlation between the craving scale and DLPFC activation. The IGD group may also show diminished punishment sensitivity to negative in-game experiences rendering them to continue playing the game. The present study provides preliminary evidence that IGD may demonstrate neural characteristics observed in other addictive disorders and suggests the use of fNIRS in behavioral addiction studies. [ABSTRACT FROM AUTHOR]

Background: Despite the constant publication of new screening instruments for Internet use disorders (IUD), little is known about their content validity. This study aimed to identify potential mismatches between the items’ intention and young adults’ interpretation of these items when answering three screening instruments that are commonly used in research and clinical settings: The Compulsive Internet Use Scale (CIUS), the 10 Item-Internet Gaming Disorder Test (IGDT-10), and the Bergen Social Media Addiction Scale (BSMAS). Methods: In total, 30 vocational students (50% female, age = 21.3; SD = 2.1) took part in individual think-aloud interviews. All participants were asked to report their thoughts while completing the CIUS. In addition, participants who reported online games (OG) as their main Internet activity (n = 11) answered the IGDT-10. Participants who reported social networks (SN) as their main Internet activity (n = 18) answered the BSMAS. One participant used OG and SN equally and completed both screening instruments. All interviews were audio-recorded, transcribed, and content-analysed. Results: Overall, four potential sources for errors were identified: (1) High scorings were often not congruent with the underlying diagnostic criteria. In particular, such discrepancies were found in items aimed to assess dysfunctional emotional regulation strategies and cognitive involvement. (2) Some participants were uncertain which time frame or Internet activity should be considered in their answers. (3) Long and complex items led to the building of mean values or the choice of the middle answer category. (4) Some wordings were perceived to be outdated and difficult to understand. Discussion: These findings might help to provide recommendations on how to improve screening instruments for IUD. Most important, items should more clearly distinguish between Internet use as a “normal” leisure activity and Internet use that leads to functional impairments in daily life. [ABSTRACT FROM AUTHOR]

Background and aims: With the inclusion of gaming disorder in the ICD-11, diagnostic criteria were introduced for this relatively new disorder. These criteria may also be applied to other potential specific Internet-use disorders, which may be classified in ICD-11 as other disorders due to addictive behaviors, such as online buying-shopping disorder, online pornography-use disorder, social-networks-use disorder, and online gambling disorder. Due to the heterogeneity in existing instruments, we aimed to develop a consistent and economic measure of major types of (potential) specific Internet-use disorders based on ICD-11 criteria for gaming disorder. Methods: The new 11-item Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) measures five behavioral addictions with the same set of items by following the principles of WHO’s ASSIST. The ACSID-11 was administered to active Internet users (N = 985) together with an adaptation of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and screeners for mental health. We used Confirmatory Factor Analyses to analyze the factor structure of ACSID-11. Results: The assumed four-factorial structure was confirmed and was superior to the unidimensional solution. This applied to gaming disorder and to the other specific Internet-use disorders. ACSID-11 scores correlated with IGDT-10 as well as with the measures of psychological distress. Discussion and Conclusions: The ACSID-11 seems to be suitable for the consistent assessment of (potential) specific Internet-use disorders based on ICD-11 diagnostic criteria for gaming disorder. The ACSID-11 may be a useful and economic instrument for studying various behavioral addictions with the same items and improving comparability. [ABSTRACT FROM AUTHOR]

Aim: The study explores IGD withdrawal-related presentations, including autonomic reaction, affective symptoms, anhedonia, and gaming urge during abstinence from gaming. We prospectively evaluated these withdrawal-related symptoms (WRS) and gaming craving during abstinence from gaming. Methods: We examined 69 individuals with IGD and 69 regular gamers and evaluated their WRS (using an exploratory questionnaire), affective and behavioral WRS (using the Questionnaire on Gaming Urge-Brief Version gaming disorder questionnaire), and heart rate. All the participants attempted to abstain from gaming before our assessment. Subsequently, some participants’ WRS and gaming craving before they engaged in gaming were prospectively evaluated. Results: In the IGD group, 85.5% experienced gaming WRS, including affective, anhedonia, and gaming urge symptoms. They could relieve these symptoms through gaming. The IGD group experienced more severe gaming WRS, gaming craving, and a higher heart rate than the regular gamer group. Gaming urge was most associated WRS of IGD. Participants with IGD experienced more severe gaming cravings when their gaming abstinence before the assessment was shorter. WRS attenuated at night and the following morning when they maintained their gaming abstinence after assessment. Conclusion: Individuals with IGD experience withdrawal-related affective, anhedonia, and gaming urge symptoms and a higher heart rate during abstinence. The WRS attenuated in 1 day. Most participants agreed that these symptoms could be relieved through gaming. Further prospective evaluation by objective assessment in an adequate sample was required to understand gaming withdrawal symptoms comprehensively. [ABSTRACT FROM AUTHOR]

Background and aims: Internet video streaming (VS) has become a popular leisure activity among the majority of adolescents, especially under the COVID-19 pandemic. Research on binge watching patterns in adults suggests an addictive potential of VS. To date, no unified conceptualization on problematic VS and no standardized assessment tools for adolescents exist even though they might be especially vulnerable. Methods: STREDIS-A is based on the ICD-11 criteria of gaming disorder. It was validated in a representative sample of 959 dyads of 10- to 17-year old adolescents with frequent VS and a respective parent using standardized questionnaires on Internet addiction, depressive and anxiety symptoms, insomnia, loneliness, and academic performance in an online survey. Item structure was investigated by factorial analyses. Cutoffs were estimated and latent profile analysis was performed. Results: The two-factorial structure of STREDIS-A describes cognitive-behavioral symptoms and negative consequences of VS. Internal consistency and criterion validity were good to excellent. It could excellently discriminate between affected and non-affected adolescents. Discussion and conclusions: The present study makes a significant contribution to the conceptualization of a new phenomenon. It provides the very first tool to assess streaming disorder in adolescents for clinical and research settings. Clinical validation is highly warranted. [ABSTRACT FROM AUTHOR]

In this commentary paper, it is discussed if Compulsive Sexual Behavior Disorder (CSBD) is best categorized as an Impulse Control Disorder, an Obsessive-Compulsive Disorder or in light of the overlap of characteristics with both Gaming and Gambling Disorder as an addictive behavior. The overlapping features are: loss of control over the respective excessive behavior, giving increasing priority to the excessive behavior under investigation and upholding such a behavior despite negative consequences. Besides empirical evidence regarding underlying mechanisms, phenomenology also plays an important role to correctly classify CSBD. The phenomenological aspects of CSBD clearly speak in favor of classifying CSBD under the umbrella of addictive behaviors. [ABSTRACT FROM AUTHOR]

Gaming activities have conferred numerous benefits during the COVID-19 pandemic. However, some individuals may be at greater risk of problem gaming due to disruption to adaptive routines, increased anxiety and/or depression, and social isolation. This paper presents a summary of 2019–2021 service data from specialist addiction centers in Germany, Switzerland, Japan, and the United Kingdom. Treatment demand for gaming disorder has exceeded service capacity during the pandemic, with significant service access issues. These data highlight the need for adaptability of gaming disorder services and greater resources and funding to respond effectively in future public health crises. [ABSTRACT FROM AUTHOR]

When does repeated behaviour constitute behavioural addiction? There has been considerable debate about non-substance-related addictions and how to determine when impaired control over a behaviour is addiction. There are public health benefits to identifying new behavioural addictions if intervention can improve outcomes. However, criteria for establishing new behavioural addictions must guard against diagnostic inflation and the pathologizing of normal problems of living. Criteria should include clinical relevance (Criterion 1), alignment with addiction phenomenology (Criterion 2) and theory (Criterion 3), and taxonomic plausibility (Criterion 4). Against such criteria, evidence does not yet support classification of pornography-use and buying-shopping disorders as addictions. [ABSTRACT FROM AUTHOR]

Background: Recently, there has been significantly increased participation in online gaming and other addictive behaviors particularly in adolescents. Tendencies to avoid social interaction and become more involved in technology-based activities pose the danger of creating unhealthy addictions. Thus, the presence of relatively immature cognitive control and high risk-taking properties makes adolescence a period of major changes leading to an increased rate of emotional disorders and addiction. Aims: The critical roles of frontostriatal circuits in addiction have become the primary focus associated with reward in the striatum and cognitive control in the PFC. Internet gaming disorder (IGD) and nicotine addiction are currently becoming more and more serious. Methods: In the light of neuroimaging, the similarity between brain mechanisms causing substance use disorder (SUD) and IGD have been described in previous literature. Results: In particular, two distinct brain systems affect the way we act accounting for uncharacteristic neural function in addiction: the affective system comprises of the striatum driven by emotional, reward-related, and internal stimuli, and a cognitive system consisting of the prefrontal cortex (PFC) supporting the ventral affective system's actions via inhibitory control. Discussion and Conclusion: Therefore, as a novel concept, we focused on the implication of frontostriatal circuits in nicotine addiction and IGD by reviewing the main findings from our studies compared to those of others. We hope that all of these neuroimaging findings can lead to effective intervention and treatment for addiction especially during this critical period. [ABSTRACT FROM AUTHOR]

Background and aims: Internet gaming disorder (IGD) leads to serious impairments in cognitive functions, and lacks of effective treatments. Cue-induced craving is a hallmark feature of this disease and is associated with addictive memory elements. Memory retrieval-extinction manipulations could interfere with addictive memories and attenuate addictive syndromes, which might be a promising intervention for IGD. The aims of this study were to explore the effect of a memory retrieval-extinction manipulation on gaming cue-induced craving and reward processing in individuals with IGD. Methods: A total of 49 individuals (mean age: 20.52 ± 1.58) with IGD underwent a memory retrieval-extinction training (RET) with a 10-min interval (R-10min-E, n 5 24) or a RET with a 6-h interval (R-6h-E, n 5 25) for two consecutive days. We assessed cue-induced craving pre- and post-RET, and at the 1- and 3-month follow-ups. The neural activities during reward processing were also assessed pre- and post-RET. Results: Compared with the R-6h-E group, gaming cravings in individuals with IGD were significantly reduced after R-10min-E training at the 3-month follow-up (P < 0.05). Moreover, neural activities in the individuals with IGD were also altered after R-10min-E training, which was corroborated by enhanced reward processing, such as faster responses (P < 0.05) and stronger frontoparietal functional connectivity to monetary reward cues, while the R-6h-E training had no effects. Discussion and Conclusions: The two-day R-10min-E training reduced addicts' craving for Internet games, restored monetary reward processing in IGD individuals, and maintained long-term efficacy. [ABSTRACT FROM AUTHOR]

Background: Internet Use Disorders (IUD) cover a range of online-related behavioral addictions, which are acknowledged and strengthened by the inclusion of (online) gaming disorder in the ICD-11 by the World Health Organization. Internet-based telemedicine interventions offer the possibility to reach out for individuals with IUD where the disorder emerges, in order to enhance their motivation to change their Internet use behavior. Methods: In the course of the short-term telemedicine motivation-based intervention, adult participants took part in two webcam-based counselling sessions based on Motivational Interviewing techniques. Two weeks after the first webcam-based counselling session the second took place. Participants completed questionnaires regarding the motivation to change their Internet use behavior (iSOCRATES) and symptoms of IUD (s-IAT) at three times of measurement: t0 (pre-intervention), t1 (mid-intervention) and t2 (post-intervention). Results: 73 affected individuals (83.6% male, average age 35 years (SD = 12.49) took part in the whole intervention including the questionnaire-based post intervention survey (t2). Over the course of the telemedicine intervention, a significant increase in the motivation to change with regard to the own Internet use behavior as well as a significant reduction in the symptom severity of an IUD and duration of Internet use (reduction of 2 hrs/d) were shown. Conclusion: The telemedicine pilot study shows that online-based consultation can be effective and helpful for individuals with IUD. Therefore, such a telemedicine intervention may be a suitable extension to the already existing analogous care system. [ABSTRACT FROM AUTHOR]