The Mediating Role of Problematic Use of Loot Boxes Between Internet Gaming Disorder and Online Gambling Disorder: Cross-Sectional Analytical Study.

Background: The video game industry has introduced a new form of monetization through microtransactions. A controversial example has been the so-called "loot boxes" (LBs) as virtual objects, which are randomized and bought with legal money. In recent years, LBs have come to connect 2 distinct problem behaviors, namely internet gaming disorder (IGD) and online gambling disorder (OGD). Many association studies have been conducted on the 3 constructs, but few have delved into the relationship of problematic use of LBs (PU-LB) with IGD and OGD. Objective: This study aims to explore the mediating role of the PU-LB between IGD and OGD. Methods: This cross-sectional and analytical study used incidental sampling in 24 Spanish schools. The final sample consisted of 542 participants (male: n=523, 96.5%; age: range 11-30 y) who played video games, bought LBs, and had gambled online in the last 12 months. Participants then completed the Spanish versions of the Internet Gaming Disorder Scale-Short Form, Online Gambling Disorder Questionnaire, and PU-LB scale. Results: IGD scores were found to be significantly associated with both PU-LB (r=0.473, P<.001) and OGD (r=0.209, P<.001). Moreover, PU-LB was significantly associated with OGD (r=0.351, P<.001). The structural equation model results indicated that IGD had no significant direct effect on OGD (P=.903). However, the indirect effect of IGD on OGD through PU-LB was significant (P<.001). Therefore, PU-LB fully mediated the relationship between IGD and OGD. Furthermore, these results were found in the subsamples of both minors (<18 y) and young adults (≥18 y). Conclusions: It is suggested that there is a mediation effect of problematic LB use between internet gambling and online gambling problems in both minors and young adults. This has potential practical implications by providing more evidence on how LBs have become a hinge feature between 2 clinically relevant and independent issues. In this regard, adequate industry self-regulation is needed, and effective legislation for the protection of minors is necessary.

Online Gambling Disorder Questionnaire (OGD-Q): An item r'esponse theory examination.

Gambling disorder behaviours, such as one's preoccupation with gambling and/or mood modification due to gambling, have been proposed to differ in their diagnostic weight/importance, especially when informing diagnostic scales. Such potential differences are imperative to be considered to improve assessment accuracy. The latter is particularly important in the light of the rapidly increasing gambling opportunities offered online. To contribute to this area of knowledge, the current study assessed an online adult community sample (N = 968, Mage  = 29.5 years, SDage  = 9.36 years) regarding their responses on the Online Gambling Disorder Questionnaire (OGD-Q). Item response theory (IRT) procedures examined the psychometric properties of the instrument, at both the item and the scale level. Results indicated that the OGD-Q demonstrated good capacity to reliably assess problem gambling and differentiate between individuals at similar levels of the trait, particularly between 1 and 3 SDs above the mean. The findings also showed OGD-Q components/items possess varying discrimination capacities, whilst they also differ in reliability across respondents with different levels of disordered gambling behaviours. Thus, it is supported that consideration is required regarding the differential weighting of one's item responses in the assessment procedure, taking concurrently into account their severity of disordered gambling behaviours.

Assessment of Criteria for Specific Internet-use Disorders (ACSID-11): Introduction of a new screening instrument capturing ICD-11 criteria for gaming disorder and other potential Internet-use disorders.

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.

Parental Acceptance/Rejection Perceptions and Attachment Styles of Men With Online Gambling Disorder.

Online gambling disorder has recently emerged as a significant public health issue. Family dynamics play an important role in the development of online gambling disorder. In this research, the aimed to compare the parental acceptance/rejection and attachment styles of individuals with online gambling disorder with a healthy control group. Also, the relationship between parental acceptance/rejection and attachment styles was examined in individuals with online gambling disorder. The study group consisted of 53 male patients with online gambling disorder and 57 healthy controls. The individuals with online gambling disorder perceived more rejection from mothers but especially from fathers than the individuals in the control group. Paternal hostility/aggression and indifference/neglect are determinants of online gambling behavior. The individuals with online gambling disorder had lower levels of secure attachment and higher levels of dismissive and fearful attachment than the individuals in the control group. Both secure attachment style and dismissive attachment style are thought to be determinants of gambling behavior. Mother-father rejection and insecure attachment are important in terms of creating risk for online gambling. Assessment of the effects of maternal and especially paternal rejection in online gambling disorder will be beneficial within the scope of preventive mental health.

Managing Problematic Usage of the Internet and Related Disorders in an Era of Diagnostic Transition: An Updated Review.

INTRODUCTION: Problematic Usage of the Internet (PUI) refers to a broad and likely heterogeneous group of Internet-related conditions associated with behavioural disturbances and functional impairment. METHODS: Within PUI several conditions have been reported, including Gaming Disorder, Shopping Addiction, Cyberchondria, Gambling Disorder, Cyberpornography Addiction and Cyberbullying. While increasing reports in the field try to define the epidemiologic and clinical boundaries of these conditions, the rapid and continuous evolution of Internet related behaviours as well as their problematic/pathological expressions are often difficult to diagnose, assess, approach with treatment interventions and follow-up. RESULTS: In addition, some of the PUI-related conditions show characteristics of addiction to the Internet as a preferential tool to engage in specific behaviours, while some others exclusively manifest on the Internet, making it necessary to find distinct assessment and treatment pathways. CONCLUSION: The inclusion of Internet Gaming Disorder in Section III by the DSM-5 and the recognition of Gaming Disorder by the ICD-11 opened the way for a systematic clinical investigation of this and other PUI-related conditions, particularly in terms of preventive and therapeutic strategies. The present article is aimed at offering an updated clinical overview on the main expressions of PUI, focussing on the latest acquisitions in this evolving field.

Design and Measurement Properties of the Online Gambling Disorder Questionnaire (OGD-Q) in Spanish Adolescents.

Gambling disorder is of great clinical and social relevance since it seriously affects people who suffer from it. More recently, the Internet has exacerbated the problem with online casinos, poker, and sports betting. However, there is little evidence of this problem, and we know of no diagnostic questionnaire. The main objectives of this study were to develop the Online Gambling Disorder Questionnaire (OGD-Q) for adolescents, evaluate its main psychometric properties, and establish diagnostic criteria to differentiate pathological from non-pathological online gamblers. We conducted a study in 16 schools across seven regions of Spain, sampling 2691 adolescents, 883 of whom had reported some online gambling experience. Of those, 602 were boys (68.2%) and 281 were girls (31.8%) Sampling was non-probabilistic and incidental. Mean age and standard deviation were 14.25 ± 1.55 (11-19 years). Confirmatory factor analysis yielded a one-dimensional model with a good fit. The reliability indicators were satisfactory (>0.94). The scores on the OGD-Q were related to other constructs, such as Internet gaming disorder, problematic Internet use, and nomophobia. Participants classified as having problems or being at risk of online gambling disorder presented significantly more stress, anxiety, and depression. Participants categorized as having online gambling disorder comprised 0.89% (n = 24) of the total sample and 2.71% of those who have gambled at some time. We discuss these findings and their practical implications in this article and propose future lines of research.