Biopsychosocial factors of gaming disorder: a systematic review employing screening tools with well-defined psychometric properties.

Background and aims: Considering the growing number of gamers worldwide and increasing public concerns regarding the negative consequences of problematic gaming, the aim of the present systematic review was to provide a comprehensive overview of gaming disorder (GD) by identifying empirical studies that investigate biological, psychological, and social factors of GD using screening tools with well-defined psychometric properties. Materials and methods: A systematic literature search was conducted through PsycINFO, PubMed, RISS, and KISS, and papers published up to January 2022 were included. Studies were screened based on the GD diagnostic tool usage, and only five scales with well-established psychometric properties were included. A total of 93 studies were included in the synthesis, and the results were classified into three groups based on biological, psychological, and social factors. Results: Biological factors (n = 8) included reward, self-concept, brain structure, and functional connectivity. Psychological factors (n = 67) included psychiatric symptoms, psychological health, emotion regulation, personality traits, and other dimensions. Social factors (n = 29) included family, social interaction, culture, school, and social support. Discussion: When the excess amount of assessment tools with varying psychometric properties were controlled for, mixed results were observed with regards to impulsivity, social relations, and family-related factors, and some domains suffered from a lack of study results to confirm any relevant patterns. Conclusion: More longitudinal and neurobiological studies, consensus on a diagnostic tool with well-defined psychometric properties, and an in-depth understanding of gaming-related factors should be established to settle the debate regarding psychometric weaknesses of the current diagnostic system and for GD to gain greater legitimacy in the field of behavioral addiction.

Psychological treatments for excessive gaming: a systematic review and meta-analysis.

Despite widespread public interest in problematic gaming interventions, questions regarding the empirical status of treatment efficacy persist. We conducted pairwise and network meta-analyses based on 17 psychological intervention studies on excessive gaming (n = 745 participants). The pairwise meta-analysis showed that psychological interventions reduce excessive gaming more than the inactive control (standardized mean difference [SMD] = 1.70, 95% confidence interval [CI] 1.27 to 2.12) and active control (SMD = 0.88, 95% CI 0.21 to 1.56). The network meta-analysis showed that a combined treatment of Cognitive Behavioral Therapy (CBT) and Mindfulness was the most effective intervention in reducing excessive gaming, followed by a combined CBT and Family intervention, Mindfulness, and then CBT as a standalone treatment. Due to the limited number of included studies and resulting identified methodological concerns, the current results should be interpreted as preliminary to help support future research focused on excessive gaming interventions. Recommendations for improving the methodological rigor are also discussed.

Prevalence of gaming disorder: A meta-analysis.

BACKGROUND: Gaming disorder (GD) has been listed in the International Classification of Diseases 11th Revision. Studies on GD prevalence have been highly heterogeneous, and there are significant gaps in prevalence estimates. Few studies have examined what methodological and demographic factors could explain this phenomenon. Therefore, this meta-analytic study quantifies globally reported GD prevalence rates and explores their various moderating variables. METHODS: Prevalence estimates were extracted from 61 studies conducted before December 3, 2020, which included 227,665 participants across 29 countries. Subgroup and moderator analyses were used to investigate the potential causes of heterogeneity, including region, sample size, year of data collection, age group, study design, sampling method, survey format, sample type, risk of bias, terminology, assessment tool, and male proportion. RESULTS: The overall pooled prevalence of GD was 3.3% (95% confidence interval: 2.6-4.0) (8.5% in males and 3.5% in females). By selecting only 28 representative sample studies, the prevalence estimate was reduced to 2.4% (95% CI 1.7-3.2), and the adjusted prevalence estimate using the trim-and-fill method was 1.4% (95% CI 0.9-1.9). High heterogeneity in GD prevalence rates was influenced by various moderators, such as participant variables (e.g., region, sample size, and age) and study methodology (e.g., study design, sampling method, sample type, terminology, and instrument). The moderator analyses revealed that the sample size, mean age, and study quality were negatively associated with GD prevalence. CONCLUSIONS: This study confirms that GD prevalence studies were highly heterogeneous based on participant demographics and research methodologies. Various confounding variables, such as sampling methods, sample types, assessment tools, age, region, and cultural factors have significantly influenced the GD prevalence rates. Prevalence estimates are likely to vary depending on study quality. Further epidemiological studies should be conducted using rigorous methodological standards to more accurately estimate GD prevalence.

Reliability, and Convergent and Discriminant Validity of Gaming Disorder Scales: A Meta-Analysis.

Background: An association between gaming disorder (GD) and the symptoms of common mental disorders is unraveled yet. In this preregistered study, we quantitatively synthesized reliability, convergent and discriminant validity of GD scales to examine association between GD and other constructs. Methods: Five representative GD instruments (GAS-7, AICA, IGDT-10, Lemmens IGD-9, and IGDS9-SF) were chosen based on recommendations by the previous systematic review study to conduct correlation meta-analyses and reliability generalization. A systematic literature search was conducted through Pubmed, Proquest, Embase, and Google Scholar to identify studies that reported information on either reliability or correlation with related variables. 2,124 studies were full-text assessed as of October 2020, and 184 were quantitatively synthesized. Conventional Hedges two-level meta-analytic method was utilized. Results: The result of reliability generalization reported a mean coefficient alpha of 0.86 (95% CI = 0.85-0.87) and a mean test-retest estimate of 0.86 (95% CI = 0.81-0.89). Estimated effect sizes of correlation between GD and the variables were as follows: 0.33 with depression (k = 45; number of effect sizes), 0.29 with anxiety (k = 37), 0.30 with aggression (k = 19), -0.22 with quality of life (k = 18), 0.29 with loneliness (k = 18), 0.56 with internet addiction (k = 20), and 0.40 with game playtime (k = 53), respectively. The result of moderator analyses, funnel and forest plots, and publication bias analyses were also presented. Discussion and Conclusion: All five GD instruments have good internal consistency and test-retest reliability. Relatively few studies reported the test-retest reliability. The result of correlation meta-analysis revealed that GD scores were only moderately associated with game playtime. Common psychological problems such as depression and anxiety were found to have a slightly smaller association with GD than the gaming behavior. GD scores were strongly correlated with internet addiction. Further studies should adopt a rigorous methodological procedure to unravel the bidirectional relationship between GD and other psychopathologies. Limitations: The current study did not include gray literature. The representativeness of the five tools included in the current study could be questioned. High heterogeneity is another limitation of the study. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42020219781].

Association of Extensive Video Gaming and Cognitive Function Changes in Brain-Imaging Studies of Pro Gamers and Individuals With Gaming Disorder: Systematic Literature Review.

BACKGROUND: The World Health Organization announced the inclusion of gaming disorder (GD) in the International Classification of Diseases, 11th Revision, despite some concerns. However, video gaming has been associated with the enhancement of cognitive function. Moreover, despite comparable extensive video gaming, pro gamers have not shown any of the negative symptoms that individuals with GD have reported. It is important to understand the association between extensive video gaming and alterations in brain regions more objectively. OBJECTIVE: This study aimed to systematically explore the association between extensive video gaming and changes in cognitive function by focusing on pro gamers and individuals with GD. METHODS: Studies about pro gamers and individuals with GD were searched for in the PubMed and Web of Science databases using relevant search terms, for example, "pro-gamers" and "(Internet) gaming disorder." While studies for pro gamers were searched for without date restrictions, only studies published since 2013 about individuals with GD were included in search results. Article selection was conducted by following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS: By following the PRISMA guidelines, 1903 records with unique titles were identified. Through the screening process of titles and abstracts, 86 full-text articles were accessed to determine their eligibility. A total of 18 studies were included in this systematic review. Among the included 18 studies, six studies included pro gamers as participants, one study included both pro gamers and individuals with GD, and 11 studies included individuals with GD. Pro gamers showed structural and functional alterations in brain regions (eg, the left cingulate cortex, the insula subregions, and the prefrontal regions). Cognitive function (eg, attention and sensorimotor function) and cognitive control improved in pro gamers. Individuals with GD showed structural and functional alterations in brain regions (eg, the striatum, the orbitofrontal cortex, and the amygdala) that were associated with impaired cognitive control and higher levels of craving video game playing. They also showed increased cortical thickness in the middle temporal cortex, which indicated the acquisition of better skills. Moreover, it was suggested that various factors (eg, gaming expertise, duration or severity of GD, and level of self-control) seemed to modulate the association of extensive video game playing with changes in cognitive function. CONCLUSIONS: Although a limited number of studies were identified that included pro gamers and/or individuals who reported showing symptoms of GD for more than 1 year, this review contributed to the objective understanding of the association between extensive video game playing and changes in cognitive function. Conducting studies with a longitudinal design or with various comparison groups in the future would be helpful in deepening the understanding of this association.

Commercial video games and cognitive functions: video game genres and modulating factors of cognitive enhancement.

BACKGROUND: Unlike the emphasis on negative results of video games such as the impulsive engagement in video games, cognitive training studies in individuals with cognitive deficits showed that characteristics of video game elements were helpful to train cognitive functions. Thus, this study aimed to have a more balanced view toward the video game playing by reviewing genres of commercial video games and the association of video games with cognitive functions and modulating factors. Literatures were searched with search terms (e.g. genres of video games, cognitive training) on database and Google scholar. RESULTS: video games, of which purpose is players' entertainment, were found to be positively associated with cognitive functions (e.g. attention, problem solving skills) despite some discrepancy between studies. However, the enhancement of cognitive functions through video gaming was limited to the task or performance requiring the same cognitive functions. Moreover, as several factors (e.g. age, gender) were identified to modulate cognitive enhancement, the individual difference in the association between video game playing and cognitive function was found. CONCLUSION: Commercial video games are suggested to have the potential for cognitive function enhancement. As understanding the association between video gaming and cognitive function in a more balanced view is essential to evaluate the potential outcomes of commercial video games that more people reported to engage, this review contributes to provide more objective evidence for commercial video gaming.