A data-driven approach for examining the demand for relaxation games on Steam during the COVID-19 pandemic.

The COVID-19 pandemic has been a major source of stress for a majority of people that might have negative long-term effects on mental health and well-being. In recent years, video games and their potential positive effects on stress relief have been researched and "relaxation" has been an important keyword in marketing a certain kind of video game. In a quasi-experimental design, this study investigated the increase of average daily player peak (ADPPs) for the COVID period compared to the pre-COVID period and if this increase was significantly larger for relaxing games in contrast to non-relaxing games. Results showed a medium-sized increase of ADPPs over all types of games but no difference between relaxing games and non-relaxing games. These results are discussed in regards to their potential of presenting gaps between the current theoretical models of the influence of video games on mental health and actual observed player behaviour.

Videogames That Encourage Healthy Behavior Did Not Alter Fasting Insulin or Other Diabetes Risks in Children: Randomized Clinical Trial.

Background: Previous research indicates games for health have substantial promise in promoting change in children's diet and physical activity (PA) behavior for obesity and diabetes prevention, but the research has generally not been rigorous. The study reported here was an efficacy trial of two role-playing videogames played in sequence, "Escape from Diab" (hereinafter called Diab) and "Nanoswarm: Invasion from Inner Space" (hereinafter called Nano), on diabetes and obesity risk factors: fasting insulin and body mass index (BMI), and risk-related behaviors: diet, PA, and sedentary behavior (SB). Design: A two-group (treatment vs. wait list control) randomized clinical trial was used with baseline, immediate postintervention (∼3 months postbaseline), and 2 months postassessments. Intervention: Diab and Nano were desktop or laptop role-playing videogames with nine sessions (each episode/session lasting ∼60 minutes). Two storylines attempted to immerse players and used ethnically diverse characters to model desired behaviors. Tailored goal setting, problem solving, and motivational statements were used. Methods: A sample of 200 overweight or obese children (ages 10-12 years from 85th to 99th BMI percentile [%ile]) was recruited, primarily using a volunteer list. Fasting insulin was the primary dependent variable. BMI, fruit, vegetable and sweetened beverage intakes, PA, and SBs were secondary outcomes. Generalized linear mixed models were used to test for the treatment effects. Results: No significant differences were detected in any of the tested outcome variables. Conclusions: The lack of differences may indicate that games cannot change dietary behaviors and thereby not change-related clinical outcomes. Alternatively, there seem to have been changes in (1) the types of videogames children expect and like to play since a pilot study was conducted, (2) productization challenges, and/or (3) problems in staff management of the trial. All may have contributed to the lack of effect.

The interplay among stress, frustration tolerance, mindfulness, and social support in Internet gaming disorder symptoms among Chinese working adults.

INTRODUCTION: Internet gaming disorder (IGD) is a growing mental health threat across age groups, but existing literature regarding IGD mainly focuses on student populations. Empirical investigation of the risk and protective factors in adult populations is warranted. This study aimed to fill the research gap by examining whether stress and 3 positive psychology factors (ie, frustration tolerance, mindfulness, and social support) are associated with IGD symptoms in working adults. It was also the first attempt to test the buffering effects of these positive psychology factors on the relationship between stress and IGD vulnerability. METHOD: This cross-sectional study was conducted in Shenzhen, China. We recruited 327 full-time working Chinese adults (mean age = 31.93 years), who had online gaming experience and voluntarily completed an anonymous questionnaire with DSM-5 criteria to measure their IGD symptoms. RESULTS: Internet gaming disorder symptoms were positively correlated with stress and negatively correlated with the 3 positive psychology factors, among which mindfulness emerged as the most salient protective factor. Moreover, mindfulness, but not frustration tolerance and social support, was found to significantly alleviate the relationship between stress and IGD. DISCUSSION: Our findings provide supportive evidence for the protective and moderating roles of positive psychology variables against IGD among Chinese working adults. Workplace-based prevention programs may take the identified factors into account to help promote individuals' personal resources to mitigate development of IGD.

The Role of Habits in Massive Multiplayer Online Role-Playing Game Usage: Predicting Excessive and Problematic Gaming Through Players' Sensitivity to Situational Cues.

We examined the effect of habitual regulation of massive multiplayer online role-playing game (MMORPG) playing on the problematic (addictive) usage and excessiveness of gaming (time that user spent playing weekly, per session, and in relation to his other leisure activities). We developed the approach to assess the strength of habitual regulation that was based on sensitivity to situational cues. We defined cues as real-life or in-game conditions (e.g., work to be done, activities with friends or family, need to relax, new game expansion) that usually promote gaming (proplay cues) or prevent it (contraplay cues). Using a sample of 377 MMORPG players, we analyzed relationships between variables through partial least squares path modeling. We found that proplay cues sensitivity significantly positively affected the excessiveness of gaming (playing time) as well as the occurrence of problematic usage symptoms. Conversely, contraplay cues sensitivity functioned as a protective factor from these conditions; significant negative effects were found for playing time and problematic usage. Playing time was confirmed to be a mediating variable, affected by cues sensitivity and at the same time affecting problematic usage symptoms. We obtained moderately strong coefficients of determination for both endogenous variables (R(2) = 0.28 for playing time; R(2) = 0.31 for problematic usage) suggesting that the proposed variables possess good explanatory power. Based on our results, we argue that the strength of habitual regulation within MMORPG usage has both positive and negative effects on excessive and problematic usage, which is a new and important finding within the area of Internet gaming addiction.

Gaming Preferences, Motivations, and Experiences of Pharmacy Students in Asia.

OBJECTIVE: Serious games are becoming popular in various healthcare domains. However, they should be designed to cater toward learners' perspectives, needs, and specifications in order to be used to their full potential in education. This study investigated the gaming experiences, motivations, and preferences of pharmacy students. MATERIALS AND METHODS: An anonymous self-administered survey obtained participant demographics, gaming experiences (enjoyment level of different game genres, years of experience, gaming frequency and duration, and motivations), and gaming preferences (on in-game rewards, settings, storylines, perspectives, and styles). Descriptive statistics, t tests, analysis of variance, chi-squared tests, and Fisher's exact tests were used for analysis. RESULTS: The response rate was 69.1 percent (465/673 undergraduates). Role-playing games (RPGs) (4.12 ± 1.07) and massively multiplayer online RPGs (MMORPGs) (3.81 ± 1.26) had the highest enjoyment ratings. Males enjoyed imagination games (e.g., RPGs, MMORPGs) more than females, whereas females enjoyed simulation games more. Top motivating factors for respondents were progressing to the next level (3.63 ± 1.19), excitement (3.33 ± 1.33), and a feeling of efficacy when playing (3.02 ± 1.16). Unlocking mechanisms (25.2 percent) and experience points (17.6 percent) were the most popular in-game reward systems. Most respondents preferred a fantasy/medieval/mythic setting (59.8 percent) and an adventurer storyline (41.3 percent), with similar proportions preferring competitive (35.3 percent), cooperative (33.3 percent), and collaborative (30.8 percent) game styles. CONCLUSIONS: Different groups of pharmacy students differ in their gaming experiences, motivating factors, and preferences. There is no "one size fits all" game that is suitable for all pharmacy education. Such differences should be considered when developing a pharmacy game in order to cater to the diverse student population.

Tobacco imagery in video games: ratings and gamer recall.

OBJECTIVE: To assess whether tobacco content found in video games was appropriately labelled for tobacco-related content by the Entertainment and Software Ratings Board (ESRB). METHODS: Sixty-five gamer participants (self-identified age range 13-50) were interviewed in-person (n=25) or online (n=40) and asked (A) to list favourite games and (B) to name games that they could recall containing tobacco content. The ESRB database was searched for all games mentioned to ascertain whether they had been assigned tobacco-related content descriptors. Games were independently assessed for tobacco content by examining user-created game wiki sites and watching YouTube videos of gameplay. Games with tobacco-related ESRB content descriptors and/or with tobacco imagery verified by researchers were considered to contain tobacco content. Games identified by participants as including tobacco but lacking verifiable tobacco content were treated as not containing tobacco content. RESULTS: Participants recalled playing 140 unique games, of which 118 were listed in the ESRB database. Participants explicitly recalled tobacco content in 31% (37/118) of the games, of which 94% (35/37) included independently verified tobacco content. Only 8% (9/118) of the games had received ESRB tobacco-related content descriptors, but researchers verified that 42% (50/118) contained such content; 42% (49/118) of games were rated 'M' for mature (content deemed appropriate for ages 17+). Of these, 76% (37/49) contained verified tobacco content; however, only 4% (2/49) received ESRB tobacco-related content descriptors. CONCLUSIONS: Gamers are exposed to tobacco imagery in many video games. The ESRB is not a reliable source for determining whether video games contain tobacco imagery.

Gaming and Religion: The Impact of Spirituality and Denomination.

A previous investigation from Korea indicated that religion might modulate gaming behavior (Kim and Kim in J Korean Acad Nurs 40:378-388, 2010). Our present study aimed to investigate whether a belief in God, practicing religious behavior and religious denomination affected gaming behavior. Data were derived from a Western cohort of young men (Cohort Study on Substance Use Risk Factors, n = 5990). The results showed that a stronger belief in God was associated with lower gaming frequency and smaller game addiction scale scores. In addition, practicing religiosity was related to less frequent online and offline gaming. Finally, Christians gamed less frequently and had lower game addiction scale scores than subjects without religious denomination. In the future, these results could prove useful in developing preventive and therapeutic strategies for the Internet gaming disorder.

Role-Playing and Real-Time Strategy Games Associated with Greater Probability of Internet Gaming Disorder.

Research indicates that a small subset of those who routinely play video games show signs of pathological habits, with side effects ranging from mild (e.g., being late) to quite severe (e.g., losing a job). However, it is still not clear whether individual types, or genres, of games are most strongly associated with Internet gaming disorder (IGD). A sample of 4,744 University of Wisconsin-Madison undergraduates (Mage=18.9 years; SD=1.9 years; 60.5% female) completed questionnaires on general video game playing habits and on symptoms of IGD. Consistent with previous reports: 5.9-10.8% (depending on classification criteria) of individuals who played video games show signs of pathological play. Furthermore, real-time strategy and role-playing video games were more strongly associated with pathological play, compared with action and other games (e.g., phone games). The current investigation adds support to the idea that not all video games are equal. Instead, certain genres of video games, specifically real-time strategy and role-playing/fantasy games, are disproportionately associated with IGD symptoms.

Neurobiological correlates of physical self-concept and self-identification with avatars in addicted players of Massively Multiplayer Online Role-Playing Games (MMORPGs).

AIMS: MMORPG addiction has been associated with self-concept impairments and increased identification with the own avatar. Yet, the underlying neurobiological mechanisms of self-identification with avatars, especially reflected in the left angular gyrus (AG), have only been assessed in regular gamers. Therefore, the study aims to examine neurobiological processes in addicted MMORPG players while evaluating their own and their personal avatar's body image (physical self-concept). METHODS: Sixteen addicted and seventeen non-addicted gamers underwent functional Magnetic Resonance Imaging (fMRI) while viewing images of themselves, their own avatar and unfamiliar persons. The Body Image Questionnaire (FKB-20) and Visual Analog Scales (VAS) assessing the degree of attractiveness, sympathy and gender identity of the self, of the avatar as well as of the unfamiliar persons were applied. RESULTS: Addicts showed a significantly extended negative body image and lower gender identity levels as well as decreased bilateral brain activations in the AG and the middle occipital gyrus during self-perception. They further exhibited higher activations in the left AG during avatar-perception. Regression analyses in the overall group and in addicted gamers indicated a significant positive correlation between gender identity and brain activation in the left AG during self-perception. CONCLUSIONS: Our results confirm addicted MMORPG players to have physical self-concept deficits which may be related to hypoactivations in the AG. The findings further indicate addicted gamers to have a tendency to identify themselves easier with their own avatar than with their real self. Lower gender identity levels might be associated with physical self-concept deficits in MMORPG addiction.

Video game use in boys with autism spectrum disorder, ADHD, or typical development.

OBJECTIVES: The study objectives were to examine video game use in boys with autism spectrum disorder (ASD) compared with those with ADHD or typical development (TD) and to examine how specific symptoms and game features relate to problematic video game use across groups. METHODS: Participants included parents of boys (aged 8-18) with ASD (n = 56), ADHD (n = 44), or TD (n = 41). Questionnaires assessed daily hours of video game use, in-room video game access, video game genres, problematic video game use, ASD symptoms, and ADHD symptoms. RESULTS: Boys with ASD spent more time than did boys with TD playing video games (2.1 vs 1.2 h/d). Both the ASD and ADHD groups had greater in-room video game access and greater problematic video game use than the TD group. Multivariate models showed that inattentive symptoms predicted problematic game use for both the ASD and ADHD groups; and preferences for role-playing games predicted problematic game use in the ASD group only. CONCLUSIONS: Boys with ASD spend much more time playing video games than do boys with TD, and boys with ASD and ADHD are at greater risk for problematic video game use than are boys with TD. Inattentive symptoms, in particular, were strongly associated with problematic video game use for both groups, and role-playing game preferences may be an additional risk factor for problematic video game use among children with ASD. These findings suggest a need for longitudinal research to better understand predictors and outcomes of video game use in children with ASD and ADHD.

Validity of the Microsoft Kinect for providing lateral trunk lean feedback during gait retraining.

Gait retraining programs are prescribed to assist in the rehabilitation process of many clinical conditions. Using lateral trunk lean modification as the model, the aim of this study was to assess the concurrent validity of kinematic data recorded using a marker-based 3D motion analysis (3DMA) system and a low-cost alternative, the Microsoft Kinect™ (Kinect), during a gait retraining session. Twenty healthy adults were trained to modify their gait to obtain a lateral trunk lean angle of 10°. Real-time biofeedback of the lateral trunk lean angle was provided on a computer screen in front of the subject using data extracted from the Kinect skeletal tracking algorithm. Marker coordinate data were concurrently recorded using the 3DMA system, and the similarity and equivalency of the trunk lean angle data from each system were compared. The lateral trunk lean angle data obtained from the Kinect system without any form of calibration resulted in errors of a high (>2°) magnitude (mean error=3.2±2.2°). Performing global and individualized calibration significantly (P<0.001) improved this error to 1.7±1.5° and 0.8±0.8° respectively. With the addition of a simple calibration the anatomical position coordinates of the Kinect can be used to create a real-time biofeedback system for gait retraining. Given that this system is low-cost, portable and does not require any sensors to be attached to the body, it could provide numerous advantages when compared to laboratory-based gait retraining systems.

Time perspective as a predictor of massive multiplayer online role-playing game playing.

This article focuses on the relationship between the time perspective (TP) personality trait and massive multiplayer online role-playing game (MMORPG) playing. We investigate the question of frequency of playing. The TP was measured with Zimbardo's TP Inventory (ZTPI), which includes five factors-past negative, past positive, present hedonistic, present fatalistic, and future. The study used data from 154 MMORPG players. We demonstrated that TP partially explained differences within a group of players with respect to the frequency of playing. Significant positive correlations were found between present factors and the amount of time spent playing MMORPGs, and significant negative correlation was found between the future factor and the time spent playing MMORPGs. Our study also revealed the influence of future-present balance on playing time. Players who scored lower in future-present balance variables (their present score was relatively high compared with their future score) reported higher values in playing time. In contrast to referential studies on TP and drug abuse and gambling, present fatalistic TP was demonstrated to be a stronger predictor of extensive playing than present hedonistic TP, which opened the question of motivation for playing. The advantage of our study compared with other personality-based studies lies in the fact that TP is a stable but malleable personality trait with a direct link to playing behavior. Therefore, TP is a promising conceptual resource for excessive playing therapy.