Why is Internet gaming disorder more prevalent among Chinese male than female adolescents? The role of cognitive mediators.

<bold>Background: </bold>Adolescent males were consistently reported to have a higher prevalence of Internet gaming disorder (IGD) than females. The mechanisms underlying the sex difference were potentially important for designing sex-specific interventions but were under-researched. Maladaptive cognitions were potential mediators between sex and adolescent IGD, as they were positively associated with both sex and adolescent IGD.<bold>Methods: </bold>A total of 3,075 students participated in a cross-sectional survey that was conducted in Guangzhou and Chengdu, China. IGD was measured by using the DSM-5 checklist and maladaptive cognitions were measured by the validated Chinese version of Revised Internet Gaming Cognition Scale (C-RIGCS). Structural equation modeling was used to test the mediation hypotheses.<bold>Results: </bold>Adolescent males showed a significantly higher prevalence of IGD than females (19.2% versus 7.8%, p < .05). Significant positive associations were found between sex and both maladaptive cognitions and IGD. The sex difference in IGD prevalence was partially mediated by the overall scale of C-RIGCS and its three subscales (i.e., perceived overvaluation of rewards of Internet gaming, perceived urges for playing Internet games, and perceived unwillingness to stop playing without completion of gaming tasks), with large mediation effect sizes ranging from 35.0% to 60.0% (Sobel test, p < ,01).<bold>Conclusions: </bold>The higher levels of maladaptive cognitions among adolescent males explained a relatively large part of the substantially higher prevalence of IGD among adolescent males than females. Interventions targeting adolescent males may consider modifying such cognitions to reduce their IGD. [ABSTRACT FROM AUTHOR]