Going beyond video game consumption when considering Internet Gaming Disorder.

BACKGROUND: Recognizing the crucial importance of understanding the impact of video games on health in today's gaming-dominated world, our study aimed to investigate the relationship between gaming time and Internet Gaming Disorder (IGD). Despite the widespread assumption that a connection exists between both, previous studies have revealed highly variable associations, highlighting significant weaknesses in establishing a robust link. METHODS: To unravel this complex relationship, we recruited two independent samples of League of Legends players. We combined the collection of self-reported and actual gameplay data, together with assessments of mental health, personality traits, and cognitive abilities. RESULTS: Surprisingly, none of the gaming variables demonstrated a robust and stable association with IGD, regardless of whether players spent less than or more than 30 hours per week gaming-a threshold suggested by the American Psychiatric Association as a potential indicator of disordered gaming. Notably, mental health factors, such as anxiety, depression and ADHD, emerged as the most influential predictors of IGD. CONCLUSION: These findings, replicated across two independent samples, challenge the prevailing belief that limiting screen time alone effectively combats IGD. Instead, mental health factors play a crucial role in mitigating risks associated with gaming. Policies focusing solely on restricting screen time are insufficient in reducing the prevalence or symptoms of IGD. Rather, a comprehensive approach that considers mental health and key personality traits must be adopted to safeguard the well-being of individuals engaged in gaming.

[Screens and adolescence: what issues for the Z generation?] / Écrans et adolescence : quels enjeux pour la Génération Z ?

Digital media and screens are ubiquitous in the daily lives of adolescents. The screen-addicted portrait of young people has gained public attention, and health professionals are often consulted about the impact of screen use on teenagers' physical and mental health. Scientific evidence suggests that screen use is associated with risks and benefits that need to be weighed up in a nuanced way. This paper takes a critical look at the issue of screen time and at the models for understanding a problematic screen use. These considerations underline the importance of adopting a contextual understanding of screen use in adolescence.

Les médias numériques sont omniprésents dans la vie quotidienne des adolescent-es. La figure de l'adolescent-e « addict-e ¼ aux écrans est devenue un sujet de préoccupation dans l'opinion publique et il est fréquent que les professionnel-les de la santé soient sollicité-es pour répondre aux interrogations sur l'impact de l'utilisation des écrans sur la santé mentale et physique des jeunes. Les données scientifiques indiquent que l'usage des écrans est associé à des risques et des bénéfices qu'il s'agit d'évaluer de manière nuancée. Dans cet article, nous discutons en particulier et de façon critique du temps d'écran et des modèles de compréhension de l'usage problématique de celui-ci. Ces réflexions nous amènent à souligner l'importance d'adopter une compréhension contextualisée de cet usage à l'adolescence.

Unraveling the developmental dynamic of visual exploration of social interactions in autism.

Atypical deployment of social gaze is present early on in toddlers with autism spectrum disorders (ASDs). Yet, studies characterizing the developmental dynamic behind it are scarce. Here, we used a data-driven method to delineate the developmental change in visual exploration of social interaction over childhood years in autism. Longitudinal eye-tracking data were acquired as children with ASD and their typically developing (TD) peers freely explored a short cartoon movie. We found divergent moment-to-moment gaze patterns in children with ASD compared to their TD peers. This divergence was particularly evident in sequences that displayed social interactions between characters and even more so in children with lower developmental and functional levels. The basic visual properties of the animated scene did not account for the enhanced divergence. Over childhood years, these differences dramatically increased to become more idiosyncratic. These findings suggest that social attention should be targeted early in clinical treatments.

Evaluating the effect of action-like video game play and of casual video game play on anxiety in adolescents with elevated anxiety: protocol for a multi-center, parallel group, assessor-blind, randomized controlled trial.

BACKGROUND: Adolescence is a critical period for the onset and maintenance of anxiety disorders, which raises the importance of intervening early; one possibility of doing so is via digital interventions. Within that research field, at least two important research paths have been explored in the past years. On the one hand, the anxiolytic effect of casual video games has been tested as such gaming activity may distract away from anxious thoughts through the induction of flow and redirection of attention toward the game and thus away of anxious thoughts. On the other hand, the bidirectional link between weak attentional control and higher anxiety has led to the design of interventions aiming at improving attentional control such as working memory training studies. Taking stock that another genre of gaming, action video games, improves attentional control, game-based interventions that combines cognitive training and action-like game features would seem relevant. This three-arm randomized controlled trial aims to evaluate the feasibility and the efficacy of two video game interventions to document how each may potentially alleviate adolescent anxiety-related symptoms when deployed fully on-line. METHODS: The study aims to recruit 150 individuals, 12 to 14 years of age, with high levels of anxiety as reported by the parents' online form of the Screen for Child Anxiety Related Disorders questionnaire. This trial contrasts a child-friendly, "action-like" video game designed to improve attentional control abilities in a progressive and stepwise manner (Eco-Rescue), a casual puzzle video game selected to act as a positive distraction tool (Bejeweled) and finally a control group with no assigned training intervention to control for possible test-retest effects (No-training). Participants will be assigned randomly to one of the three study arms. They will be assessed for main (anxiety) and secondary outcomes (attentional control, affective working memory) at three time points, before training (T1), one week after the 6-week training (T2) and four months after completing the training (T3). DISCUSSION: The results will provide evidence for the feasibility and the efficacy of two online video game interventions at improving mental health and emotional well-being in adolescents with high levels of anxiety. This project will contribute unique knowledge to the field, as few studies have examined the effects of video game play in the context of digital mental health interventions for adolescents. TRIAL REGISTRATION: The trial is registered on ClinicalTrials.gov (NCT05923944, June 20, 2023).

In search of better practice in executive functions assessment: Methodological issues and potential solutions.

The multicomponent nature of executive functions (EF) has long been recognized, pushing for a better understanding of both the commonalities and the diversity between EF components. Despite the advances made, the operationalization of performance in EF tasks remains rather heterogeneous, and the structure of EF as modeled by confirmatory factor analyses (CFA) is still a topic of debate (Karr et al., 2018). The present work demonstrates these two issues are related, showing how different operationalizations in task-based performance indicators impact the resulting models of EF structure with CFA. Using bootstrapped data from 294 children (8-12 years old) and nine EF tasks (tapping inhibition, working memory, and cognitive flexibility), we first show improved model convergence and acceptance when operationalizing EF through single tasks' scores (e.g., incongruent trials, Flanker task) relative to difference scores (e.g., incongruent minus congruent trials, Flanker task). Furthermore, we show that response times exhibit poor model convergence and acceptance compared not only to accuracy but also drift rate. The latter, a well-known indicator in drift-diffusion models, is found to present the best trade-off between convergence and acceptance to model EF with CFA. Finally, we examine how various operationalizations of performance in EF tasks impact CFA model comparison in the assessment of EF structure and discuss the theoretical foundations for these results. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A novel task and methods to evaluate inter-individual variation in audio-visual associative learning.

Learning audio-visual associations is foundational to a number of real-world skills, such as reading acquisition or social communication. Characterizing individual differences in such learning has therefore been of interest to researchers in the field. Here, we present a novel audio-visual associative learning task designed to efficiently capture inter-individual differences in learning, with the added feature of using non-linguistic stimuli, so as to unconfound language and reading proficiency of the learner from their more domain-general learning capability. By fitting trial-by-trial performance in our novel learning task using simple-to-use statistical tools, we demonstrate the expected inter-individual variability in learning rate as well as high precision in its estimation. We further demonstrate that such measured learning rate is linked to working memory performance in Italian-speaking (N = 58) and French-speaking (N = 51) adults. Finally, we investigate the extent to which learning rate in our task, which measures cross-modal audio-visual associations while mitigating familiarity confounds, predicts reading ability across participants with different linguistic backgrounds. The present work thus introduces a novel non-linguistic audio-visual associative learning task that can be used across languages. In doing so, it brings a new tool to researchers in the various domains that rely on multi-sensory integration from reading to social cognition or socio-emotional learning.

Not screens but their context of use impact cognitive development: a commentary on Yang et al. (2023).

There have been extensive debates about the impact of the digital transformation on human development. A recent study by Yang and colleagues highlights the importance of considering context of use, beyond amount of use. In their study, children from parents who reported having TV-on during family meals when they were 2 years old showed poorer cognitive development at age 3.5 as compared to those with TV-off during family meals. This highlights the importance of considering the context of use when studying effect of screen use. While Yang et al. discuss the distracting effects of TV-on sensory processing, we propose an alternative - and not mutually exclusive - interpretation based on TV induced deprivation of family interactions. On a more practical note, this should encourage to preserve screen-free time, especially during structured time such as family meals, in order to maintain family interactions known to be critical to development.

Aerobic fitness and academic achievement: Disentangling the indirect role of executive functions and intelligence.

Research in children points to aerobic fitness as a source of individual differences in academic achievement. By examining the indirect effects of executive functions (EF) and intelligence on the relationship between aerobic fitness and academic achievement, the present study provides novel insight about the cognitive mechanisms underlying this relationship. 218 children (8-10 years) completed the following assessments: (i) a VO2max test to assess aerobic fitness; (ii) four tasks tapping components of EF (i.e., inhibition and cognitive flexibility); (iii) sub-tests of the Kaufman Brief Intelligence Test to assess fluid and crystallized intelligence; and (iv) sub-tests of arithmetic, spelling, and reading achievement (WRAT 3rd edition). Structural equation modeling (SEM) was conducted to examine the indirect role of EF and intelligence on the relationship between aerobic fitness and sub-domains of academic achievement. Covariate analyses included age, pubertal timing, and socio-economic status. Preliminary analysis via linear regression showed a direct effect of aerobic fitness on arithmetic achievement, whereas no effect was observed on spelling and reading achievement. Importantly, multiple mediation SEM revealed the direct effect of aerobic fitness on arithmetic achievement disappeared after accounting for the indirect effects of EF, whereas intelligence did not contribute significantly on this complex mediation process. Moreover, among EF components, cognitive flexibility, was the main driver of the relationship between aerobic fitness and arithmetic achievement. Unpacking which components of EF and intelligence affect the link between aerobic fitness and academic achievement, holds the promise of better understanding the heterogeneity still present in the literature.

A video-game-based method to induce states of high and low flow.

Flow has been defined as a state of full immersion that may emerge when the skills of a person match the challenge of an activity. It is a special case of being on task, as during flow, keeping focused on the task feels effortless. Most experimental investigations of the neural or physiological correlates of flow contrast conditions with different levels of challenge. Yet comparing different levels of challenge that are too distant may trigger states where the participant is off task, such as boredom or frustration. Thus, it remains unclear whether previously observed differences ascribed to flow may rather reflect differences in how much participants were on task-trying their best-across the contrasted conditions. To remedy this, we introduce a method to manipulate flow by contrasting two video game play conditions at personalized levels of difficulty calibrated such that participants similarly tried their best in both conditions. Across three experiments (> 90 participants), higher flow was robustly reported in our high-flow than in our low-flow condition (mean effect size d = 1.31). Cardiac, respiratory, and skin conductance measures confirmed the known difference between a period of rest and the two on-task conditions of high and low flow, but failed to distinguish between these latter two. In light of the conflicting findings regarding the physiological correlates of flow, we discuss the importance of ensuring a low-flow baseline condition that maintains participants on task, and propose that the present method provides a methodological advance toward that goal.

Play in video games.

Video game play is remarkably ubiquitous in today's society given its recent emergence only in the late 1950s. While this fast evolution could exemplify the power of play, video games exploit but also extend other types of play. Here, we review a classification of the ecosystem of video games useful in the emerging field of the cognitive neuroscience of video games. We then discuss how video games may leverage different play types, considering first locomotor-rotational, object, and social play before highlighting the importance of role, rule, and pretend play in video games. With an eye toward comparative studies of the neural bases of play across species, we discuss whether video games may fulfil the five criteria from Burghardt (2005) to identify play. Finally, in line with play's possible preparatory role for adulthood, we review the positive impact on cognition and future learning of action-like video games. Highlighting that not all video games have this impact, we note more granular hypotheses about the biological functions of play are to be encouraged.

Unravelling the link between media multitasking and attention across three samples.

A negative link between media multitasking and sustained attention has been proposed; yet, whether such a link exists remains hotly debated as previous studies found mixed effects. The present study seeks to evaluate the size of this effect taking into account possible variations due to how media multitasking is measured, how sustained attention is assessed, and the origin of the samples. Using an established and a novel, shortened measure for media multitasking, 924 participants were recruited through three different platforms (MTurk, Prolific and university students). In addition to questionnaire- and task-based assessments for sustained attention, impulsivity and sensation seeking were also assessed to further qualify behavioral problems associated with media multitasking. The findings establish a negative link between media multitasking and sustained attention of a medium effect size, whether questionnaires (r =.20) or a task-based measure (r =.21) are used. Importantly, the findings support the notion that previous differences across studies can be at least partly attributed to the choice of media multitasking measure as well as differences across samples.

Computer vision-based algorithm to sUppoRt coRrect electrode placemeNT (CURRENT) for home-based electric non-invasive brain stimulation.

OBJECTIVE: Home-based non-invasive brain stimulation (NIBS) has been suggested as an adjunct treatment strategy for neuro-psychiatric disorders. There are currently no available solutions to direct and monitor correct placement of the stimulation electrodes. To address this issue, we propose an easy-to-use digital tool to support patients for self-application. METHODS: We recruited 36 healthy participants and compared their cap placement performance with the one of a NIBS-expert investigator. We tested participants' placement accuracy with instructions before (Pre) and after the investigator's placement (Post), as well as participants using the support tool (CURRENT). User experience (UX) and confidence were further evaluated. RESULTS: Permutation tests demonstrated a smaller deviation within the CURRENT compared with Pre cap placement (p = 0.02). Subjective evaluation of ease of use and usefulness of the tool were vastly positive (8.04 out of 10). CURRENT decreased the variability of performance, ensured placement within the suggested maximum of deviation (10 mm) and supported confidence of correct placement. CONCLUSIONS: This study supports the usability of this novel technology for correct electrode placement during self-application in home-based settings. SIGNIFICANCE: CURRENT provides an exciting opportunity to promote home-based, self-applied NIBS as a safe, high-frequency treatment strategy that can be well integrated in patients' daily lives.

Multiple timescales of learning indicated by changes in evidence-accumulation processes during perceptual decision-making.

Evidence accumulation models have enabled strong advances in our understanding of decision-making, yet their application to examining learning has not been common. Using data from participants completing a dynamic random dot-motion direction discrimination task across four days, we characterized alterations in two components of perceptual decision-making (Drift Diffusion Model drift rate and response boundary). Continuous-time learning models were applied to characterize trajectories of performance change, with different models allowing for varying dynamics. The best-fitting model included drift rate changing as a continuous, exponential function of cumulative trial number. In contrast, response boundary changed within each daily session, but in an independent manner across daily sessions. Our results highlight two different processes underlying the pattern of behavior observed across the entire learning trajectory, one involving a continuous tuning of perceptual sensitivity, and another more variable process describing participants' threshold of when enough evidence is present to act.

Stereoptic serious games as a visual rehabilitation tool for individuals with a residual amblyopia (AMBER trial): a protocol for a crossover randomized controlled trial.

BACKGROUND: Amblyopia is the most common developmental vision disorder in children. The initial treatment consists of refractive correction. When insufficient, occlusion therapy may further improve visual acuity. However, the challenges and compliance issues associated with occlusion therapy may result in treatment failure and residual amblyopia. Virtual reality (VR) games developed to improve visual function have shown positive preliminary results. The aim of this study is to determine the efficacy of these games to improve vision, attention, and motor skills in patients with residual amblyopia and identify brain-related changes. We hypothesize that a VR-based training with the suggested ingredients (3D cues and rich feedback), combined with increasing the difficulty level and the use of various games in a home-based environment is crucial for treatment efficacy of vision recovery, and may be particularly effective in children. METHODS: The AMBER study is a randomized, cross-over, controlled trial designed to assess the effect of binocular stimulation (VR-based stereoptic serious games) in individuals with residual amblyopia (n = 30, 6-35 years of age), compared to refractive correction on vision, selective attention and motor control skills. Additionally, they will be compared to a control group of age-matched healthy individuals (n = 30) to account for the unique benefit of VR-based serious games. All participants will play serious games 30 min per day, 5 days per week, for 8 weeks. The games are delivered with the Vivid Vision Home software. The amblyopic cohort will receive both treatments in a randomized order according to the type of amblyopia, while the control group will only receive the VR-based stereoscopic serious games. The primary outcome is visual acuity in the amblyopic eye. Secondary outcomes include stereoacuity, functional vision, cortical visual responses, selective attention, and motor control. The outcomes will be measured before and after each treatment with 8-week follow-up. DISCUSSION: The VR-based games used in this study have been conceived to deliver binocular visual stimulation tailored to the individual visual needs of the patient, which will potentially result in improved basic and functional vision skills as well as visual attention and motor control skills. TRIAL REGISTRATION: This protocol is registered on ClinicalTrials.gov (identifier: NCT05114252) and in the Swiss National Clinical Trials Portal (identifier: SNCTP000005024).

The eRDS v6 Stereotest and the Vivid Vision Stereo Test: Two New Tests of Stereoscopic Vision.

Purpose: To describe two new stereoacuity tests: the eRDS v6 stereotest, a global dynamic random dot stereogram (dRDS) test, and the Vivid Vision Stereo Test version 2 (VV), a local or "contour" stereotest for virtual reality (VR) headsets; and to evaluate the tests' reliability, validity compared to a dRDS standard, and learning effects. Methods: Sixty-four subjects passed a battery of stereotests, including perceiving depth from RDS. Validity was evaluated relative to a tablet-based dRDS reference test, ASTEROID. Reliability and learning effects were assessed over six sessions. Results: eRDS v6 was effective at measuring small thresholds (<10 arcsec) and had a moderate correlation (0.48) with ASTEROID. Across the six sessions, test-retest reliability was good, varying from 0.84 to 0.91, but learning occurred across the first three sessions. VV did not measure stereoacuities below 15 arcsec. It had a weak correlation with ASTEROID (0.27), and test-retest reliability was poor to moderate, varying from 0.35 to 0.74; however, no learning occurred between sessions. Conclusions: eRDS v6 is precise and reliable but shows learning effects. If repeated three times at baseline, this test is well suited as an outcome measure for testing interventions. VV is less precise, but it is easy and rapid and shows no learning. It may be useful for testing interventions in patients who have no global stereopsis. Translational Relevance: eRDS v6 is well suited as an outcome measure to evaluate treatments that improve adult stereodepth perception. VV can be considered for screening patient with compromised stereovision.

Evidence of target enhancement and distractor suppression in early visual areas.

Although the mechanisms of target enhancement and distractor suppression have been investigated along the visual processing hierarchy, there remains some unknown as to the role of perceptual load on the competition between different task-related information as attention deployment is manipulated. We present an fMRI spatial cueing paradigm, in which 32 participants had to attend to either a left or a right hemifield location and to indicate the orientation of the target Gabor that was presented simultaneously to a noise patch distractor. Critically, the target could appear at either the cued, valid location or at the uncued, invalid location; in the latter, the noise patch distractor appeared at the cued location. Perceptual load was manipulated by the presence or absence of high-contrast Gabor patches close to the fixation cross, which acted as lateral masks. Behavioural results indicated that participants performed more efficiently in validly cued trials compared to invalidly cued trials and under low compared to high load. Enhancement effects for targets and suppression effects for noise patches were greater in early visual areas at high load, that is in the presence of lateral masks. These results are in line with the hypothesis that attention results in both target enhancement and distractor suppression, and that these effects are most marked under high perceptual load. Theoretical implications of these results for different models of attention are discussed.

Attentional modulation as a mechanism for enhanced facial emotion discrimination: The case of action video game players.

Action video game players (AVGPs) outperform nonvideo game players (NVGPs) on a wide variety of attentional tasks, mediating benefits to perceptual and cognitive decision processes. A key issue in the literature is the extent to which such benefits transfer beyond cognition. Using steady-state visual evoked potentials (SSVEP) as a neural measure of attentional resource allocation, we investigated whether the attentional benefit of AVGPs generalizes to the processing of rapidly presented facial emotions. AVGPs (n = 36) and NVGPs (n = 32) performed a novel, attention-demanding emotion discrimination task, requiring the identification of a target emotion in one of two laterally presented streams of emotional faces. The emotional faces flickered at either 2.0 Hz or 2.5 Hz. AVGPs outperformed NVGPs at detecting the target emotions regardless of the type of emotion. Correspondingly, attentional modulation of the SSVEP at parieto-occipital recording sites was larger in AVGPs compared with NVGPs. This difference appeared to be driven by a larger response to attended information, as opposed to a reduced response to irrelevant distractor information. Exploratory analyses confirmed that this novel paradigm elicited the expected pattern of event-related potentials associated with target detection and error processing. These components did not, however, differ between groups. Overall, the results indicate enhanced discrimination of facial emotions in AVGPs arising from enhanced attentional processing of emotional information. This presents evidence for the attentional advantage of AVGPs to extend beyond perceptual and cognitive processes.

Examining the synergistic effects of a cognitive control video game and a home-based, self-administered non-invasive brain stimulation on alleviating depression: the DiSCoVeR trial protocol.

Enhanced behavioral interventions are gaining increasing interest as innovative treatment strategies for major depressive disorder (MDD). In this study protocol, we propose to examine the synergistic effects of a self-administered home-treatment, encompassing transcranial direct current stimulation (tDCS) along with a video game based training of attentional control. The study is designed as a two-arm, double-blind, randomized and placebo-controlled multi-center trial (ClinicalTrials.gov: NCT04953208). At three study sites (Israel, Latvia, and Germany), 114 patients with a primary diagnosis of MDD undergo 6 weeks of intervention (30 × 30 min sessions). Patients assigned to the intervention group receive active tDCS (anode F3 and cathode F4; 2 mA intensity) and an action-like video game, while those assigned to the control group receive sham tDCS along with a control video game. An electrode-positioning algorithm is used to standardize tDCS electrode positioning. Participants perform their designated treatment at the clinical center (sessions 1-5) and continue treatment at home under remote supervision (sessions 6-30). The endpoints are feasibility (primary) and safety, treatment efficacy (secondary, i.e., change of Montgomery-Åsberg Depression Rating Scale (MADRS) scores at week six from baseline, clinical response and remission, measures of social, occupational, and psychological functioning, quality of life, and cognitive control (tertiary). Demonstrating the feasibility, safety, and efficacy of this novel combined intervention could expand the range of available treatments for MDD to neuromodulation enhanced interventions providing cost-effective, easily accessible, and low-risk treatment options.ClinicalTrials.gov: NCT04953208.