Problematic video gaming is negatively associated with bone mineral density in adolescents.

Adolescent bone health may be negatively impacted by problematic video gaming (PVG) due to factors such as prolonged screen time, poor sleep quality, and increased depression. Although sedentary behaviors have been linked to decreased bone mass, there is limited research on how PVG impacts bone health. We aimed to evaluate the association between PVG and bone mineral density (BMD) in adolescents by comparing the BMD z-scores of adolescents with and without PVG and by identifying PVG-related risk factors that may affect low BMD scores. This cross-sectional study took place between May 2019 and August 2021 with 110 adolescents who played video games for at least two hours per day. Data on screen time, game genre, tobacco, alcohol, caffeine consumption, and vigorous physical activity status were recorded. PVG was assessed using the Internet Gaming Disorder-Short Form (IGDS9-SF), with scores ≤ 16 comprising the control group and > 16 the PVG group. Sleep quality was assessed by Pittsburgh Sleep Quality Index, and depression was evaluated by Children's Depression Inventory. Dual-energy X-ray absorptiometry measurements of femoral neck and lumbar spine BMD were compared between the two groups. The mean age of the participants was 14.2 ± 1.8 years, and 86.4% were males. The PVG group exhibited lower femoral neck z-scores (p = 0.013) and a higher proportion of adolescents with low femoral neck BMD risk (27.8% vs 9.7%, p = 0.041). Lumber spine z-scores did not differ (p = 0.271). Despite poorer depressive symptoms and sleep quality in the PVG group, they were not associated with low BMD risk (OR 1.02, 95% CI 0.97-1.08, p = 0.398 and OR 1.00, 95% CI 0.87-1.18, p = 0.972, respectively). Among all PVG-related risk factors, video game time (aOR = 1.22, 95% CI = 1.06-1.41, p = 0.006) and vigorous physical activity amount (aOR = 2.86, 95% CI = 0.93-8.76, p = 0.080) showed the strongest associations with femoral neck z-scores.  Conclusion: The results of this study, showing a negative association between PVG and femoral neck BMD in adolescents, underscore the importance evaluating, monitoring, and supporting lower extremity bone health in adolescents with PVG. What is Known: • Adolescents with problematic video gaming are at risk for depression, impaired sleep; sedentary lifestyle; consumption of tobacco, alcohol, and drugs; and high caffeine intake. • These risk factors might lead to compromised bone health. What is New: • Problematic video gaming is associated with the low femoral neck bone mineral density risk in adolescents. • Extended video game time and reduced physical activity are found to be the primary risk factors.

The interplay between mental health and dosage for gaming disorder risk: a brief report.

The relationship between gaming time and gaming disorder can be moderated by other variables. This study aimed to test the moderating role of mental health. Participants (N = 461) were recruited online. Gaming time was a statistically significant predictor of gaming disorder risk, with an explained variance of 3.3%. The goodness of fit of the model that took into account both moderators (anxiety and depression) improved to 13.9%. The interaction between gaming time and both moderators was significant. The results showed that depression and anxiety acted as moderators of the dosage effect, possibly by amplifying the gratification of playing games and thus contributing to the development of gaming disorder. It may be important in practise, as it seems to place the mental health at the right place, namely among risk factors that can contribute to gaming disorder in combination with a key trigger, which is gaming.

Impact of movie and video game elements on tic manifestation in children.

BACKGROUND AND PURPOSE: Children in developed countries spend a significant portion of their waking hours engaging with audiovisual content and video games. The impact of media consumption on children's health and well-being has been widely studied, including its effects on tic disorders. Previous studies have shown that tic frequency can both increase and decrease during activities like gaming and television watching, resulting in mixed findings. METHODS: To better understand the impact of audiovisual media on tics, we conducted a fine-grained tic manifestation analysis. We focused on the effects of the impact of a movie scene with suspensful elements and a video game designed to heighten anticipation, thought to stimulate phasic and striatal dopamine release. We closely monitored tic frequency throuhghout these experiences based on moment-to-moment tic annotation. The study included 20 participants (19 males aged 7-16) diagnosed with tic disorders (Yale Global Tic Severity Scale≥8), and we tested the replicability of our findings with an independent group of 36 children (15 females, aged 7-15) with tic disorders. RESULTS: During film viewing, we observed significant synchronization in the temporal tic patterns of various individuals despite diversity in their tic profiles. Furthermore, employing a video game developed for our study, we found that tic frequency increases during anticipation of a pending reward. This finding was replicated in a second experiment with an independent cohort. CONCLUSIONS: Our results indicate that tic frequency is affected by media elements in the short-term, and call for further investigation of the long-term impacts of exposure to such tic triggers.

Adverse childhood experiences predict internet gaming disorder in university students: the mediating role of resilience.

BACKGROUND: To investigate the relationship between adverse childhood experiences and internet gaming disorder (IGD) and the mediating role of resilience in the relationship between these two factors. METHODS: The adverse childhood experience scale, resilience scale and IGD Scale were administered to 9349 university students. Correlations and mediating effects were calculated among these scores. RESULTS: After controlling for sex and age, significant correlations among adverse childhood experiences, resilience and IGD were observed; resilience was a partial mediator variable in the relationship between adverse childhood experiences and IGD. CONCLUSIONS: The more adverse childhood experiences an individual has, the less their mental toughness and the greater their tendency to become addicted to internet games. Adverse childhood experiences can effectively predict IGD, and the risk of becoming addicted to the internet can be decreased by increasing one's mental toughness.

The Relationship Between Lockdowns and Video Game Playtime: Multilevel Time-Series Analysis Using Massive-Scale Data Telemetry.

BACKGROUND: COVID-19 led governments worldwide to enact a variety of containment and closure policies. Substantial attention has been directed toward the idea that these public health measures may have unanticipated negative side effects. One proposed effect relates to video games. There is a nascent evidence base suggesting that individuals played video games for longer and in a more disordered manner during lockdowns and school closures specifically. These increases are commonly framed as a potential health concern in relation to disordered gaming. However, the evidence base regarding changes in gaming during the COVID-19 pandemic is based on self-report and, thus, is susceptible to bias. Therefore, it is unclear what the true consequences of lockdowns were for gaming behavior worldwide. OBJECTIVE: The primary objective of this study was to estimate whether any specific lockdown policy led to meaningful increases in the amount of time individuals spent playing video games. METHODS: Rather than relying on self-report, we used >251 billion hours of raw gameplay telemetry data from 184 separate countries to assess the behavioral correlates of COVID-19-related policy decisions. A multilevel model estimated the impact of varying enforcement levels of 8 containment and closure policies on the amount of time that individual users spent in-game. Similar models estimated the impact of policy on overall playtime and the number of users within a country. RESULTS: No lockdown policy can explain substantial variance in playtime per gamer. School closures were uniquely associated with meaningful increases in total playtime within a country (r2=0.048). However, this was associated with increases in the number of unique individuals playing games (r2=0.057) rather than increases in playtime per gamer (r2<0.001). CONCLUSIONS: Previous work using self-report data has suggested that important increases in heavy gaming may occur during pandemics because of containment and closure ("lockdown") procedures. This study contrasts with the previous evidence base and finds no evidence of such a relationship. It suggests that significant further work is needed before increases in disordered or heavy gaming are considered when planning public health policies for pandemic preparedness.

Video game playing and oral health in school-age children: A cross-sectional study in Turkey.

AIM: The aim of this study is to evaluate the relationship of video game playing with oral/dental health and harmful oral habits in school-age children. METHODS: The daily video gamer (n = 77) and occasional video gamer (n = 77) children between 6 and 12 years old were included in the study. A questionnaire inquiring socio-demographic characteristics, video gaming and abnormal oral habits of the children was filled by parents. The children were examined intraorally and decayed-missing-filled tooth, the International Caries Detection and the Assessment-II System scores, dental plaque and gingival indices were recorded. RESULTS: Of the children; 42.9% daily video gamers played video games for between 1 and 2 h and 57.1% played for ≥2 h while all of the occasional video gamers spent for between 1 and 2 h on video game per day. The daily video gamer and occasional video gamer children were not different in terms of socio-demographic characteristics, frequency of having daily tooth brushing habit, using children's toothpaste and having regular dental checkup (P > 0.05). No statistically significant difference was present between the groups in terms of frequencies of abnormal oral habits and having at least one abnormal oral habit (P > 0.05). Severe gingivitis and advanced caries lesions were more common in daily video gamer group (14.2% vs. 3.9%, P = 0.025 and 90.9% vs. 70.9%, P = 0.026, respectively). Daily video gaming time was weakly correlated with plaque index (r = 0.26, n = 77, P = 0.024). Daily video gaming for ≥2 h increased the risk for severe gingivitis (odds (95% confidence interval) = 4.53 (1.07-19.23), P = 0.041) while daily video gaming for between 1 and 2 h decreased the risk for having abnormal oral habit (odds (95% confidence interval) = 0.39 (0.16-0.93), P = 0.034). CONCLUSION: In school age, daily video gaming may worsen oral and dental health compared with occasional video gaming. Particularly, an excessive video gaming time seems to be associated with poor oral health in school children.

Fatal Cardiac Arrhythmias During Electronic Gaming in Patients With Genetically Mediated Heart Diseases.

BACKGROUND: Recently, electronic gaming has been reported as a precipitant of life-threatening cardiac arrhythmias in susceptible individuals. However, the prevalence of cardiac events in genetic heart diseases (GHDs) in the setting of electronic gaming has not been established. OBJECTIVES: In this study, we sought to define the prevalence of cardiac events occurring in the setting of electronic gaming in GHDs. METHODS: Retrospective review of all patients evaluated and treated at Mayo Clinic's genetic heart rhythm clinic from July 2000 to November 2022 was performed to identify patients with a history of playing electronic games at the time of their cardiac event. Cardiac event was used to define events occurring before diagnosis, and breakthrough cardiac event (BCE) was used for events occurring after diagnosis. RESULTS: Of the 3,370 patients with a GHD (mean age at first evaluation 27 ± 19 years, 55% female), 1,079 (32%) had a cardiac event before diagnosis, with 5 patients (0.5%) having an electronic gaming-associated event (3 catecholaminergic polymorphic ventricular tachycardia, 1 long QT syndrome, and 1 premature ventricular contraction-triggered ventricular fibrillation). After diagnosis and treatment, 431 patients (13%) experienced ≥1 BCE during follow-up, of which 1 electronic gaming-associated BCE (0.2%) occurred in a patient with catecholamine-sensitive right outflow tract ventricular tachycardia. CONCLUSIONS: Although anecdotal cases of electronic gaming-associated life-threatening arrhythmias have been reported, in this largest single-center study to date, we show that these are extremely rare occurrences. While electronic gaming can have adverse health consequences, the threat of electronic gaming-triggered sudden death should not be used to try to curb time spent gaming.

Cue-reactivity to distal cues in individuals at risk for gaming disorder.

BACKGROUND: Gaming disorder (GD) is a disorder due to addictive behaviors (ICD-11). Cue-reactivity and craving are relevant mechanisms in the development and maintenance of addictive behaviors. When confronted with cues showing in-game content (proximal cues) individuals with higher symptom severity show increased cue-reactivity. Based on conditioning and addiction theories on incentive sensitization, cue-reactivity responses may generalize to more distal cues, e.g. when individuals at risk of developing a GD are confronted with a starting page of an online game. In cue-reactivity paradigms so far, only proximal gaming cues have been used. METHODS: We investigated the effect of distal gaming cues compared to gaming-unrelated control cues on cue-reactivity and craving in 88 individuals with non-problematic use of online games (nPGU) and 69 individuals at risk for GD (rGD). The distal cues showed the use of an electronic device (e.g., desktop PC or smartphone) whose screen showed starting pages of either games (target cues), shopping- or pornography sites (control cues) from a first-person perspective. FINDINGS: We found significantly higher urge and arousal ratings as well as longer viewing times for gaming-related compared to gaming-unrelated control cues in rGD compared to nPGU. Valence ratings did not differ between groups. INTERPRETATION: The results demonstrate that already distal gaming-specific cues lead to cue-reactivity and craving in rGD. This finding indicates that based on conditioning processes, cue-reactivity and craving develop during the course of GD and generalize to cues that are only moderately related to the specific gaming activity.

High-Risk Gaming Is Associated with Frequent Substance Use: An Exploratory Survey among Young Adults.

INTRODUCTION: Internet gaming disorder (IGD) is an emerging condition within the field of behavioural addictions. IGD has been demonstrated to be highly comorbid with many other mental health disorders. Among these, substance use has been associated with IGD, and there are underlying similarities between behavioural addictions and substance use disorders. The main aims of the present study were (i) to investigate the association between high-risk gaming and substance use among young adults drawn from the general Italian population; and (ii) to explore the psychopathological correlates of high-risk gaming. METHODS: Lifetime substance use, type of substances consumed, and frequency of use were investigated through an online survey in a sample of 913 adults aged 18-40 years. High-risk gaming was assessed using the ten-item Internet Gaming Disorder Test (IGDT-10). Psychopathology was assessed using the Revised 90-item Symptom Checklist (SCL-90-R). RESULTS: High-risk gaming prevalence rate was 4.4%. High-risk gamers scored higher on all dimensions of psychopathology, confirming the association between high-risk gaming and psychiatric distress. Regarding substance use, high-risk gamers were more commonly polysubstance users and more commonly made use of psychodysleptic substances. High-risk gamers were more commonly frequent substance users, and 32.5% of high-risk gamers used or had used psychoactive substances often or everyday throughout their lives. DISCUSSION AND CONCLUSION: The findings are in line with the concept of a common neurobiological vulnerability for both gaming and substance use. There is the need for more research to examine the phenomenology of gaming and its interplay with substance use to help develop effective interventions and prevention strategies.

The Potential Harm of Gambling Streams to Minors.

Video games are designed to attract the attention of a potentially diverse audience. One of the most popular video game-related content distributor sites is Twitch, which provides daylong access to all kinds of gaming-related content through independent content creators. This platform, compared with YouTube (the world's popular video-based content distributor), has one important difference. Namely, it dominantly provides real-time video content sharing (ie, streaming). The total audience of gaming live streaming in 2021 was approximately 810 million gamers worldwide, expected to grow to 921 million in 2022. While most of the viewers are adults, 17% of male viewers and 11% of female viewers are minors, between 10 and 20 years of age.1 Risk assessment in this field is still missing, while some dangers are presumably related to the type of content shared. As gambling-related videos draw more and more viewers, the possible risk of age-inappropriate content access has appeared. Future research and policy making should consider exploring this area to protect young consumers.

Skin Gambling Contributes to Gambling Problems and Harm After Controlling for Other Forms of Traditional Gambling.

Esports betting and skin gambling involve betting on the outcomes of video game competitions and/or using virtual currencies for betting. The present study evaluated a conceptual model linking video game involvement, video-game related gambling, traditional gambling, and gambling problems and harm. Data were collected via a cross-sectional online survey with 737 participants aged 18 + who engaged in esports cash betting (n = 576), esports skin betting (n = 184), or skin gambling on games of chance (n = 330). The findings highlighted the distinctly different relationships esports cash betting versus skin gambling had with traditional gambling involvement and harmful gambling. Gambling with skins on games of chance was predictive of gambling problems and gambling harm after controlling for participation in traditional gambling (OR = 1.32 and 1.17 respectively). Whereas betting on esports with cash was associated with betting on a variety of other forms of gambling, and there was no unique contribution to problems and harm over and above participation on these other forms (e.g., EGMs, sports betting). Skin gambling is directly implicated in gambling problems and harm, whereas cash betting on esports is only indicative of interest in many forms of potentially harmful gambling. Greater research attention to skin gambling is warranted, and particularly with respect to its role as a virtual currency more easily accessible for gambling.

Behavioral Addictive Disorders in Children and Adolescents.

Behavioral addictive disorders (BADs) are syndromes similar to substance use disorders (SUDs) but with a focus on behaviors rather than on use of psychoactive substances. These non-substance-related disorders occur when typical, rewarding behaviors, such as gambling, playing video games, and using social media, are done in excess, affecting daily functioning and/or inducing severe psychological distress. BADs are chronic and relapsing, and characterized by a failure to resist an impulse, drive, or temptation to perform an act despite adverse consequences. They are common among youth and linked to poor mental health outcomes and negative social consequences. Given the high prevalence of BADs and their potential serious outcomes, the burden on the youth population's mental health can be consequential.1.

El consumo de loot boxes como una nueva forma de azar en los videojuegos / Loot boxes use as a new form of gambling within video games

Las loot boxes son cajas dentro de los videojuegos que los usuarios pagan por abrir y obtener, al azar, un objeto cuyo valor inicialmente desconocen. Tanto la población adolescente como la adulta tiene fácil acceso a ellas, y se han relacionado con el juego de azar. El objetivo de este estudio fue examinar el consumo de loot boxes y explorar si se asociaba con culpabilidad, pérdida de control y malestar. Para ello, 475 participantes (266 adolescentes y 209 adultos) respondieron a un cuestionario ex profeso de elaboración propia. Los resultados mostraron que son los adolescentes los que más dinero invierten en cajas botín. Este gasto se ve aumentado cuando se anuncia nuevo contenido en las plataformas multimedia online (entre ellas, Twitch, YouTube). Además, no obtener los ítems que desean, lo cual es frecuente por su aleatoriedad, predice mayores niveles de culpabilidad y malestar, mientras que su obtención predice la posterior pérdida de control. Así, el 45,5% de los participantes refirieron culpabilidad tras la compra, el 50% malestar y el 17% pérdida de control. En síntesis, las loot boxes están cada vez más presentes en los entornos virtuales de los adolescentes y adultos, y dadas las consecuencias psicológicas y emocionales que parecen tener, es necesario seguir abordando esta problemática en futuras investigaciones en aras de prevenir y apoyar a la población vulnerable. (AU)

Loot boxes are items within video games which players pay to open and, ultimately, to randomly obtain an object whose value is initially unknown. Being easily accessible for both teenagers and adults, loot boxes have been associated with gambling. The purpose of this study was to explore the use of loot boxes and to analyze whether it is associated with guilt, loss of control, and emotional distress. To this end, 475 participants (266 adolescents and 209 adults) were surveyed on their habits regarding loot boxes and gaming. The results showed that teenagers invest more money in loot boxes than adults. This expenditure increases when a new item is announced on online platforms (Twitch, YouTube). Additionally, not obtaining the coveted items, which is common due to loot box randomness, predicts greater levels of guilt and emotional distress, while obtaining them predicts subsequent loss of control. Thus, 45.5% reported guilt over purchasing, 50% distress and 17% loss of control. Summarizing, loot boxes are increasingly present in video games, and owing to their psycho-emotional outcomes, it is necessary for future research to address this matter in order to develop prevention strategies and to provide support to vulnerable populations. (AU)

Tratamientos psicológicos para la adicción a videojuegos en adolescentes y adultos jóvenes: una revisión sistemática / Psychological Treatments for Video Game Adicction in Adolescents and Young Adults: a Systematic Review

La adicción a los videojuegos constituye un problema relevante, pues se encuentra vinculado a numerosas alteraciones psicosociales. El objetivo de este trabajo fue conocer los tratamientos psicológicos para la adicción mencionada y determinar su eficacia. Se realizó una búsqueda bibliográfica en 7 bases de datos. Se obtuvo 2.355 artículos, de los que 21 cumplieron los criterios de inclusión. Se examinaron las características de los participantes, el diseño de los estudios, el riesgo de sesgo y la calidad de los estudios, el método de diagnóstico, el tipo de intervención y los efectos de las intervenciones. La Terapia Cognitivo Conductual (TCC) ha sido ampliamente estudiada, encontrándose disminuciones significativas en las variables contempladas (reducción de la sintomatología y/o tiempo de juego) en la mayoría de los estudios analizados. Sin embargo, la falta de rigurosidad en los diseños empleados y los sesgos asociados, impide ubicarla en la categoría de tratamientos bien establecidos según las normas APA. No obstante, existen indicios experimentales prometedores de que estas intervenciones pueden alcanzar los niveles de eficacia postulados. Esto mismo ocurre con los tratamientos catalogados como otros enfoques de tratamiento, a pesar de que estos todavía se encuentran en una fase experimental. Por esta razón, es necesario que investigaciones futuras superen las limitaciones metodológicas propias de los estudios realizados hasta el momento. (AU)

Video game addiction is a relevant problem, as it is linked to numerous psychosocial disorders. The objective of this work was to know the psychological treatments for the aforementioned addiction and to determine their effectiveness. A bibliographic search was carried out in 7 databases. 2,355 articles were obtained, of which 21 met the inclusion criteria. Participant characteristics, study design, risk of bias and quality of studies, method of diagnosis, type of intervention, and effects of interventions were examined. Cognitive-Behavioral Therapy (CBT) has been widely studied, finding significant decreases in the variables contemplated (reduction of symptoms and/or playing time) in most of the studies analyzed. However, the lack of rigor in the designs used and the associated biases make it impossible to place it in the category of well-established treatments according to the APA standards. However, there is promising experimental evidence that these interventions can achieve the postulated levels of efficacy. The same is true for treatments listed as other treatment approaches, even though these are still in an experimental phase. For this reason, future research needs to overcome the methodological limitations of the studies carried out to date. (AU)

Tecnotest: Desarrollo de una herramienta de screening de adicciones tecnológicas y juego / Tecnotest: A screening tool for technological addictions and gambling disorder

Una de las demandas sociales y científicas más acuciantes, que se plasma en las actuales líneas prioritarias del Plan Nacional sobre Drogas (PNSD) es el desarrollo de herramientas de screening para la detección temprana de adicciones, singularmente adicciones sin sustancia, debido al impacto que estas están teniendo en el desarrollo de adicciones desde hace unos años, especialmente en adolescentes y jóvenes. Objetivo. El objetivo principal de esta investigación fue el desarrollo de una herramienta de screening de adicciones tecnológicas (videojuegos, móvil y redes sociales) y al juego para vincular la detección temprana con la intervención y la prevención en el campo de las adicciones conductuales. Método. Participantes. Participaron en el estudio 1.813 estudiantes de entre 11 y 19 años de 13 comunidades autónomas. Instrumentos. Se desarrolló una encuesta con cuatro pruebas validadas sobre adicciones tecnológicas y al juego. Procedimiento. Para la construcción de la herramienta de screening se seleccionaron los tres elementos que obtuvieron mayor Valor Predictivo Positivo (VPP) de cada una de las cuatro pruebas validadas para diferenciar entre quienes utilizaban las tecnologías y/o jugaban de un modo social y no tenían ningún problema de aquellos que ya tenían un problema adictivo. Resultados. Se obtuvo una herramienta de uso de las tecnologías y juego que consta de 24 ítems (12 ítems de cribado de las cuatro tecnologías y 12 de uso de las mismas) con sus principales propiedades psicométricas (fiabilidad, estructura factorial). Discusión. La escala tiene unas adecuadas propiedades psicométricas y es congruente teóricamente. Se presenta la herramienta definitiva de screening, la cual queda a disposición de las/os psicólogas/os para la detección temprana de personas que puedan padecer alguna de estas adicciones, en cuyo caso podrían ser derivados a los recursos sanitarios especializados. (AU)

One of the most pressing social and scientific issues, as reflected in the current priority lines of the National Drugs Plan (PNSD), is the development of screening tools for the early detection of addictions, particularly behavioral addictions, due to the impact that these problems are having on the growth of addictions in recent years, especially in adolescents and young people. Goal. The main goal of this research was to develop a screening tool for technological addictions (video games, mobile and social networks) and gambling for early detection in people suffering this kind of behavioral addiction. Procedure. With technologies, in the absence of agreed clinical criteria, those participants who perceived themselves as having problems and, in addition, had received treatment for it, were selected. Regarding gambling, the diagnostic criteria of the DSM-5 were used. The three items that scored the highest Positive Predictive Values (PPV) in each of the four validated tests were selected. These indicators serve to distinguish those who use the technologies and/or gamble in a functional way and do not have any problems from those who already have an addictive problem with video games, mobile, social networks or gambling. Results. This paper shows the finished screening tool with its main psychometric properties, which can be used by professionals working with adolescents in order to detect people who could have some addictive problem, in which case the psychologist can refer them to a specialized healthcare resource. (AU)

Rasgos de personalidad y psicopatología en adolescentes con adicción a videojuegos / Personality traits and psychopathology in adolescents with videogame addiction

El trastorno por uso de videojuegos se incluyó recientemente en la 11ªedición de la Clasificación Internacional de Enfermedades. Se realizó un estudio transversal en cinco institutos, con una muestra final de 119 alumnos. El 6,4% (n = 23) de los sujetos tenía trastorno por uso de videojuegos. Los adolescentes con trastorno por uso de videojuegos mostraron bajos niveles de consciencia (F = 7,82; p = ,001) y amabilidad (F = 3,31; p = ,041); y puntuaron más alto en inadaptación escolar (SMC; F = 9,230; p < ,001)que los sanos. Obtuvimos dos funciones discriminantes que clasificaban correctamente al 60,5% (Z1 = 0,406 × Sexo + 0,560 × Conciencia - 0,677× SMC; Z2 = 0,915 × Sexo + 0,191 × Conciencia + 0,326 × SMC). Los sujetos con adicción se diferenciaban de los sanos en presentar inadaptación escolar y baja conciencia, mientras que ambos grupos con adicción se diferenciaban en que los alumnos con adicción a videojuegos eran en mayor proporción varones. La probabilidad de trastorno por uso de videojuegos aumentaba si el sujeto era varón (OR [CI 95%] = 4,82 (1,17-19,81); p =,029) con inadaptación escolar (OR [IC 95%] = 1,08 (1-1,17); p = ,047);mientras que el trastorno por uso de sustancias aumentaba si el sujeto presentaba neuroticismo (OR [IC 95%] =1,07 [1-1,14]; p < ,040), desajuste clínico (OR [IC 95%] = 1,10 [1,01-1,20]; p = ,020), inadaptación escolar(OR [IC 95%] = 1,06 [1-1,13]; p = ,048), bajo ajuste personal (OR [IC95%] = 0,94 [0,88-0,99]; p = ,047) y síntomas emocionales (OR [IC 95%]= 0,86 [0,78-0,96]; p = ,006). (AU)

Gaming disorder (GD) was recently included in the 11th edition of theInternational Classification of Diseases. A cross-sectional study was conducted in five secondary schools, with a final sample of 119 students. A diagnosis of GD was made in 6.4% (n = 23) of this sample. Compared with healthy subjects, adolescents with GD showed low levels of conscientiousness(F = 7.82; p = .001) and agreeableness (F = 3.31; p = .041) and scored higherin school maladjustment (SMC; F = 9.23; p < .001). Two discriminating functions were obtained that allowed us to predict patient group allocation with a success rate of 60.5% (Z1 = 0.406 × Sex + 0.560 × Conscientiousness− 0.677 × SMC; Z2 = 0.915 × Sex + 0.191 × Conscientiousness + 0.326 ×SMC). Subjects with addiction differed from healthy subjects in presenting school maladjustment and low consciousness, while both groups of subjectswith addiction differed in that video game addiction was proportionally higher in boys. The probability of GD was higher if subjects were male (OR[95% CI]) = 4.82 [1.17-19.81]; p = .029) and had school maladjustment(OR [95% CI] = 1.08 [1-1.17]; p = .047); while that of substance use disorder was higher if the subjects had neuroticism (OR [95% CI] = 1.07[1-1.14]; p < .040), clinical maladjustment (OR [95% CI] = 1.10 [1.01-1.20]; p = .020), school maladjustment (OR [95% CI] = 1.06 [1-1.13]; p =.048), low personal adjustment (OR [95% CI] = 0.94 [0.88-0.99]; p = .047)and emotional symptoms (OR [95% CI] = 0.86 [0.78-0.96]; p = .006). (AU)

Sintomas auditivos e vocais: uma análise da autopercepção de jogadores de jogos digitais / Auditory and vocal symptoms: an analysis of the self-perception of digital game players

RESUMO Objetivo identificar os fatores associados a zumbido, percepção auditiva e risco de distúrbio vocal entre jogadores de jogos digitais. Métodos estudo transversal realizado com jogadores de jogos digitais por meio de questionários eletrônicos para coletar dados relacionados à saúde auditiva e vocal. Foram analisados três desfechos principais: zumbido, percepção auditiva (sensação da diminuição da audição) e risco de distúrbio de voz, mensurado pela Escala de Sintomas Vocais. As variáveis independentes referiram-se às características sociodemográficas, perfil dos jogadores e sinais e sintomas. Aplicaram-se os testes Qui-quadrado de Pearson e Exato de Fisher. Resultados a amostra foi composta por 59 jogadores, sendo a maioria do gênero masculino (79,7%), com idade entre 18 e 24 anos (69,5%). Com relação aos desfechos, 27,6% dos participantes apresentaram zumbido, 57,6%, risco de distúrbio vocal e 13,6% referiram sensação de diminuição da audição. Observou-se associação entre zumbido e cefaleia (p=0,024), zumbido e uso de smartphone (0,012), sensação de diminuição da audição e presença de ansiedade (p=0,049). O risco de distúrbio de voz associou-se ao maior tempo de horas jogadas por semana (p=0,020). Conclusão a autopercepção de zumbido esteve associada à cefaleia e ao uso de smartphone. Houve, ainda, associação entre ansiedade e sensação de diminuição da audição, além de risco de distúrbio de voz e maior tempo de horas jogadas por semana.

ABSTRACT Purpose to identify factors associated with tinnitus, auditory perception and risk of voice disorders among digital game players. Methods cross-sectional study carried out with digital game players through electronic procedures to collect data related to hearing and vocal health. Three main outcomes were analyzed: tinnitus; auditory perception (sensation of diminished hearing) and risk of voice disorders, measured by the Vocal Symptoms Scale (VSS). The independent variables were related to sociodemographic characteristics, player profile and signs and symptoms. Pearson's chi-square test and Fisher's exact test were applied. Results the sample consisted of 59 players. Most were male (79.7%) and ages between 18 and 24 years (69.5%). Regarding the terms, 27.6% had tinnitus, 57.6% were at risk of vocal disorder and 13.6% reported hearing loss. There was an association between tinnitus and headache (p=0.024), tinnitus and smartphone use (0.012), hearing loss and anxiety (p= 0.049). A risk of voice disorder(s ) was associated with more hours played per week (p=0.020). Conclusion self-perceived tinnitus was associated with headache and smartphone use; there was also an association between anxiety and the feeling of hearing impairment, in addition to the risk of voice disorders and more hours played per week.

Sudden gamer death: non-violent death cases linked to playing video games.

BACKGROUND AND AIMS: Internet gaming disorder (IGD) is an emerging problem. Rarely, media reports about people, who have died during playing video games, but thus far no systematic, scientific study is available about the topic. We investigated such cases, looking for common characteristics, connection between gaming and death, and the possible reasons leading to death. METHODS: Cases were collected through internet search with general keywords, with ones specific to identified cases, and by working along cross references. RESULTS: 24 cases were found: one from 1982, the others between 2002 and 2021. Twenty-three of the victims were male, age ranged from 11 to 40 years. More than half of the cases originated from Southeast Asia, and 12 deaths happened in internet cafes. Gamers played action-rich multiplayer games. In 18 cases the gaming session before death was extremely long (around a day or even several days) with minimal rest. The cause of death was pulmonary embolism in 5 cases, cerebral hemorrhage in 2 cases, most of the rest was presumably due to fatal cardiac arrhythmia. DISCUSSION: Long sedentary position and dehydration may precipitate thromboembolism, acute blood pressure elevation during gaming may promote cerebral hemorrhage, and several factors (including acute and chronic sleep deprivation, exhaustion, stress) can lead to acute autonomic dysfunction and fatal arrhythmia. CONCLUSION: Incidence of non-violent death cases linked to playing video games is presumably very low. It mostly occurs in young males and it is often characterized by extremely long gaming time.