Application of the eleventh revision of the International Classification of Diseases gaming disorder criteria to treatment-seeking patients: Comparison with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders Internet gaming disorder criteria.

BACKGROUND AND AIMS: The World Health Organization included gaming disorder (GD) in the eleventh revision of International Classification of Diseases in 2019. Due to the lack of diagnostic tools for GD, a definition has not been adequately applied. Therefore, this study aimed to apply an operationalized definition of GD to treatment-seekers. The relationship between the diagnoses of GD and Internet gaming disorder (IGD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders was also examined. Methods: Study participants comprised 241 treatment-seekers who had engaged in excessive gaming and experienced related problems. Psychiatrists applied the GD diagnostic criteria to the participants using a diagnostic form developed for this study. Information on gaming behavior and functional impairment was obtained through face-to-face interviews conducted by clinical psychologists. Results: In total, 78.4 and 83.0% of the participants fulfilled the GD and IGD diagnostic criteria, respectively. The sensitivity and specificity of GD diagnosis were both high when the IGD diagnosis was used as the gold standard. Participants with GD preferred online PC and console games, spent significantly more time gaming, and showed a higher level of functional impairment compared to those who did not fulfill the GD diagnostic criteria. Discussion and Conclusion: The definition of GD can be successfully applied to treatment-seekers with excessive gaming and related problems. A high concordance of GD and IGD diagnoses was found in those participants with relatively severe symptoms. The development and validation of a diagnostic tool for GD should be explored in future studies.

How to overcome taxonomical problems in the study of Internet use disorders and what to do with "smartphone addiction"?

AIMS: The present theoretical paper introduces the smartphone technology as a challenge for diagnostics in the study of Internet use disorders and reflects on the term "smartphone addiction." METHODS: Such a reflection is carried out against the background of a literature review and the inclusion of Gaming Disorder in ICD-11. RESULTS: We believe that it is necessary to divide research on Internet use disorder (IUD) into a mobile and non-mobile IUD branch. This is important because certain applications such as the messenger application WhatsApp have originally been developed for smartphones and enfold their power and attractiveness mainly on mobile devices. DISCUSSION AND CONCLUSIONS: Going beyond the argumentation for distinguishing between mobile and non-mobile IUD, it is of high relevance for scientists to better describe and understand what persons are actually (over-)using. This is stressed by a number of examples, explicitly targeting not only the diverse contents used in the online world, but also the exact behavior on each platform. Among others, it matters if a person is more of an active producer of content or passive consumer of social media.

Should Internet gaming disorder be considered a subtype of generalized problematic internet use? Findings from a study among medical college students.

PURPOSE: The current study aimed to explore whether Internet gaming disorder (IGD) should be considered a subtype of generalised problematic Internet use (PIU) by assessing the degree of overlap between them and comparing their correlates. The sociodemographic profile and presence of depressive symptoms were studied as correlates for IGD and generalised PIU. DESIGN AND METHODS: This was a self-report survey administered online among medical students (n = 306). FINDING: Less than half of the participants with IGD (45.45%; 5 out of 11) also met the criteria for generalised PIU. Only 6.67% (5 out of 75) of subjects with generalised PIU were also classified as having IGD. Male gender and time spent on digital gaming per day were associated with greater risk of IGD; whereas the time spent on Internet per day and more frequent use of the Internet for social networking rather than academic purposes were associated with greater risk of generalised PIU. The regression models built for IGD and generalised PIU were statistically significant (F = 64.10; P < .01 and F = 80.97; P < .01, respectively). The two models explained 66.1% and 57.4% of the variance in IGDS-SF and GPIUS2 scores, respectively. PRACTICE IMPLICATIONS: The IGD and generalised PIU appear to be conceptually distinct entities. The IGD should not be assumed as a subtype of generalised PIU. Thus, health care providers need to focus on IGD beyond and besides generalised PIU. There is a need to specifically enquire about IGD while screening for behavioural addictions involving use of Internet.

Identifying individuals in need of help for their uncontrolled gaming: A narrative review of concerns and comments regarding gaming disorder diagnostic criteria.

OBJECTIVE: In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) included the diagnostic criteria of Internet gaming disorder (IGD). Then, in 2019, the 11th Revision of the International Classification of Diseases (ICD-11) categorized gaming disorder (GD) as an addictive disorder. This review aimed to review the raised concerns, debate, and research of IGD or GD criteria and provide suggestions to resolve them. METHODS: A narrative review was conducted, and PubMed was searched for articles mentioning concerns and research on the DSM-5 criteria for IGD, ICD-11 criteria for GD, or criteria for other synonyms, such as problematic gaming or gaming addiction. A total of 107 articles were identified. RESULTS: Concerns were organized into three categories: conceptual framework, moral panic, and diagnostic validity. Most argumentations supported the proposition that GD and other substance use disorders have similar presentations. A clear definition of GD and adequate public education could prevent rather than exacerbate moral panic. Several researchers reported concerns regarding the nosology, diagnostic validity, and wording of each criterion. However, the threshold, five of the nine criteria with impaired function, demonstrated adequate validity in interview studies. CONCLUSION: The current findings support the addiction framework, functional impairment, and validity of the GD criteria. However, further prospective, experimental, and clinical studies validating these findings are warranted. Moreover, an integrative review or debate conference could contribute to the organization of the available results and concept development. Aggregating adequate scientific information could allay or resolve concerns related to the diagnosis of GD.

Classification of probable online social networking addiction: A latent profile analysis from a large-scale survey among Chinese adolescents.

BACKGROUND AND AIMS: Problematic online social networking use is prevalent among adolescents, but consensus about the instruments and their optimal cut-off points is lacking. This study derived an optimal cut-off point for the validated Online Social Networking Addiction (OSNA) scale to identify probable OSNA cases among Chinese adolescents. METHODS: A survey recruited 4,951 adolescent online social networking users. Latent profile analysis (LPA) and receiver operating characteristic curve (ROC) analyses were applied to the validated 8-item OSNA scale to determine its optimal cut-off point. RESULTS: The 3-class model was selected by multiple criteria, and validated in a randomly split-half subsample. Accordingly, participants were categorized into the low risk (36.4%), average risk (50.4%), and high risk (13.2%) groups. The highest risk group was regarded as "cases" and the rest as "non-cases", serving as the reference standard in ROC analysis, which identified an optimal cut-off point of 23 (sensitivity: 97.2%, specificity: 95.2%). The cut-off point was used to classify participants into positive (probable case: 17:0%) and negative groups according to their OSNA scores. The positive group (probable cases) reported significantly longer duration and higher intensity of online social networking use, and higher prevalence of Internet addiction than the negative group. CONCLUSIONS: The classification strategy and results are potentially useful for future research that measure problematic online social networking use and its impact on health among adolescents. The approach can facilitate research that requires cut-off points of screening tools but gold standards are unavailable.

Internet, gaming, and smartphone usage patterns of children and adolescents in Korea: A c-CURE clinical cohort study.

BACKGROUND AND AIM: Whereas many studies on Internet gaming disorder (IGD) have used self-report questionnaires, only a few have adopted clinical interviews and samples. The current study aimed at using data from face-to-face diagnostic interviews, based on the criteria for IGD in the DSM-5, to determine the Internet, gaming, and smartphone usage patterns of children and adolescents. METHODS: A latent class analysis was conducted using data collected through diagnostic interviews for Internet, gaming, and smartphone addiction with 190 participants (M = 13.14 years, SD = 2.46; 143 boys, 47 girls) who were part of a multicenter clinical cohort study. RESULTS: Participants were classified into four groups: pleasure-seeking (Class 1), internal-use (Class 2), problematic-use (Class 3), and pathological-use (Class 4). The pleasure-seeking group (8.11%) showed low tendencies in general and proper control. The internal-use group (17.63%) showed significant increases in "cognitive salience" and "craving," with strong internal desires. The problematic-use group (37.28%) had no "interference with role performance"; however, they displayed "difficulty regulating use" and "persistent use despite negative consequences," with a slight functional impairment. The pathological-use group (36.98%) scored the highest on all these items, revealing a severe functional impairment. Compared to the other groups, the pathological-use group had the highest depression and daily stress levels and displayed the lowest levels of happiness. CONCLUSIONS: This study provides basic data to elucidate Internet, gaming, and smartphone overuse patterns among children and adolescents, which could be used to develop differentiated intervention strategies for each group.

Examining the associations between smartphone use and mother-infant bonding and family functioning: A survey design.

Excessive smartphone use has been found to be associated with dysfunctional social and family relations. While most studies of this phenomenon have focused on adolescent and adult addiction, none has yet to focus on mothers with infants. This study examined the association of excessive smartphone use with mother-infant bonding, maternal mental health, and family functioning in Jordan. The predictive value of the study variables with respect to the level of smartphone use was evaluated. A descriptive correlational cross-sectional survey design was used. A sample of 114 mothers with infants was interviewed in person and completed a web-based questionnaire. Approximately 16% reported using smartphones 5 to 14 hours per day; 6.7% described themselves as smartphone addicts. The results suggest that excessive smartphone use may be linked to unhealthy family functioning. No associations were found between smartphone use and mother-infant bonding or maternal mental health. Raising awareness of this linkage and limiting smartphone use are recommended as precautionary measures. Although this study failed to find any association between smartphone use and mother-infant bonding, further studies using empirical methods might have better success.