Background:
Gaming disorder was included in the latest revision of the International Classification of Diseases (11th ed.). Worldwide, prevalence estimates of gaming disorder are considerably ...heterogeneous and often appear to be exceedingly high. However, few studies have examined the methodological, cultural and/or demographic factors that might explain this phenomenon. This review employed meta-analytic techniques to compute the worldwide-pooled prevalence of gaming disorder and evaluate the potential contributing factors for varied prevalence estimates.
Method:
Prevalence estimates were extracted from 53 studies conducted between 2009 and 2019, which included 226,247 participants across 17 different countries. Study findings were meta-analyzed using a random-effects model. Subgroup and moderator analyses examined potential sources of heterogeneity, including assessment tool and cut-off, participant age and gender, sample size and type, study region, and year of data collection.
Results:
The worldwide prevalence of gaming disorder was 3.05% (confidence interval: 2.38, 3.91); this figure was adjusted to 1.96% 0.19, 17.12 when considering only studies that met more stringent sampling criteria (e.g. stratified random sampling). However, these estimates were associated with significant variability. The choice of screening tool accounted for 77% of the variance, with the Lemmens Internet gaming disorder-9, Gaming Addiction Identification Test and Problematic Videogame Playing scales associated with the highest estimates. Adolescent samples, lower cut-off scores and smaller sample size were significant predictors of higher prevalence. Gaming disorder rates were approximately 2.5:1 in favor of males compared to females.
Conclusion:
The worldwide prevalence of gaming disorder appears to be comparable to obsessive-compulsive disorder and some substance-related addictions, but lower than compulsive buying and higher than problem gambling. Gaming disorder prevalence rates appear to be inflated by methodological characteristics, particularly measurement and sampling issues.
Stay-at-home mandates and quarantines related to the coronavirus (COVID-19) pandemic have led to greatly increased participation in online gaming. Initiatives such as #PlayApartTogether that promote ...gaming for socializing and stress reduction may achieve positive outcomes. Although gaming can be a healthy coping strategy for the majority, it can also pose risks to some vulnerable individuals. Protracted periods of social isolation and technology-based activity pose the danger of solidifying unhealthy lifestyle patterns, leading to difficulties to readaptation when the COVID-19 crisis has passed. Balanced and effective approaches to gaming during the COVID-19 pandemic are needed to support physical and psychological wellbeing.
This important new book critically examines the complex policy and practice issues surrounding child protection, including the impact of theoretical orientations, contemporary debates, policy ...initiatives and research findings, and maintains an emphasis on the ethics and values underpinning child welfare interventions.
The book introduces policies that are central to understanding the position and needs of children and young people, and how policy and practice have been influenced by developments including the children’s rights agenda. It also explores the most significant issues in child welfare. These include: the experience of maltreatment by children, the systems of child protection to safeguard them, the methods and challenges of risk assessment, and the wide range of policy and therapeutic interventions to respond to children’s needs. The book also examines family support to promote children’s wellbeing before considering provision for children and young people who are looked after in out-of-home care. There is also a final section that focuses on best practice in communicating and working with children and young people, drawing on participatory, rights-oriented and resilience-based approaches, and supporting foster and adoptive carers and biological parents.
Contributing in a substantive and clear manner to a growing international conversation about the present function and future directions for child welfare in contemporary societies, this textbook will be of interest to undergraduate and postgraduate social work students and those from allied disciplines, and professionals who are engaged in child welfare services.
Pathological video-gaming, or its proposed DSM-V classification of “Internet Use Disorder”, is of increasing interest to scholars and practitioners in allied health disciplines. This systematic ...review was designed to evaluate the standards in pathological video-gaming instrumentation, according to Cicchetti (1994) and Groth-Marnat's (2009) criteria and guidelines for sound psychometric assessment. A total of 63 quantitative studies, including eighteen instruments and representing 58,415 participants, were evaluated. Results indicated that reviewed instrumentation may be broadly characterized as inconsistent. Strengths of available measures include: (i) short length and ease of scoring, (ii) excellent internal consistency and convergent validity, and (iii) potentially adequate data for development of standardized norms for adolescent populations. However, key limitations included: (a) inconsistent coverage of core addiction indicators, (b) varying cut-off scores to indicate clinical status, (c) a lack of a temporal dimension, (d) untested or inconsistent dimensionality, and (e) inadequate data on predictive validity and inter-rater reliability. An emerging consensus suggests that pathological video-gaming is commonly defined by (1) withdrawal, (2) loss of control, and (3) conflict. It is concluded that a unified approach to assessment of pathological video-gaming is needed. A synthesis of extant research efforts by meta-analysis may be difficult in the context of several divergent approaches to assessment.
► We review the psychometric properties of eighteen instruments for pathological video-gaming. ► Available measures may be broadly characterized as inconsistent. ► Research consensus suggests three key symptoms of pathological video-gaming. ► Instruments are limited by differing theoretical orientations, and some psychometric inadequacies. ► Areas of improvement for future research on the proposed DSM-V disorder are outlined.
Internet gaming disorder (IGD) has received nomenclatural recognition as a potential mental health disorder, despite evident variability in its core psychopathology and psychometric assessment. ...Although cognitive-behavioural therapy (CBT) is considered an efficacious treatment for IGD, the underlying cognitions of the disorder are not well understood. This review aimed to synthesise research evidence on Internet gaming cognition toward identification of cognitive factors underlying IGD. A systematic review of 29 quantitative studies on Internet gaming cognition and 7 treatment studies employing cognitive therapy for IGD was conducted. Four cognitive factors underlying IGD were identified. Factors included (a) beliefs about game reward value and tangibility, (b) maladaptive and inflexible rules about gaming behaviour, (c) over-reliance on gaming to meet self-esteem needs, and (d) gaming as a method of gaining social acceptance. It is proposed that IGD-related cognition may be more complex than “preoccupation” (i.e., criterion A of IGD). IGD cognition may involve the persistent overvaluation of video gaming rewards, activities, and identities, combined with a need to adhere to maladaptive rules governing use and completion of video games. Greater understanding of the proposed cognitive factors may advance clinical research agendas on identification of individuals with IGD, as well as the expansion and improvement of cognitive therapies for the disorder.
•We review 36 studies on Internet gaming disorder cognition.•IGD treatment studies employing CT tend to lack cognition-based measures.•Four types of cognition may underlie Internet gaming disorder.•Implications for criterion A of DSM-5 Internet gaming disorder are discussed.•We outline areas for future research on Internet gaming disorder.
Objective
Although there is sufficient research and clinical evidence to support the inclusion of gaming disorder in the latest revision of the International Classification of Diseases, relatively ...little is known about the effectiveness of first‐line psychological treatment for gaming disorder or internet gaming disorder (IGD) as it is listed in the Diagnostic and Statistical Manual. This systematic review employed meta‐analytic techniques to determine the effectiveness of cognitive–behavioural therapy (CBT) for IGD on four key outcomes: IGD symptoms, anxiety, depression, and time spent gaming.
Method
A database search identified 12 independent CBT studies. Effect size estimates (Hedges' g) with associated confidence intervals, prediction intervals, and p values for each pre–post treatment outcome, were calculated. Study reporting quality was evaluated in accordance with the Consolidated Standards of Reporting Trials guidelines. Subgroup and moderator analyses were undertaken to investigate potential sources of heterogeneity.
Results
CBT demonstrated high efficacy in reducing IGD symptoms (g = 0.92; 0.50, 1.34) and depression (g = 0.80, 0.21, 1.38), and showed moderate efficacy in reducing anxiety (g = 0.55, 0.17, 0.93) at post‐test. There was insufficient power to determine whether CBT was capable of reducing time spent gaming. Treatment gains at follow‐up were nonsignificant across the four treatment outcomes.
Conclusions
The pooled findings suggest that CBT for IGD is an effective short‐term intervention for reducing IGD and depressive symptoms. However, the effectiveness of CBT for reducing actual time spent gaming was unclear. Given the limitations of this evidence base, there is a need for more rigorous studies to determine the potential long‐term benefits of CBT for IGD.
Public Health Significance Statement
Given the rise in treatment demand for internet gaming disorder (IGD) and problematic gaming, it is necessary to determine which treatments are most effective for whom and under which conditions. This review shows that cognitive‐behavioural therapy for IGD, which is often considered the first‐line therapy, can improve IGD symptoms and comorbid depression. However, treatment gains tend to be short‐term and their effect in reducing time spent gaming is unclear. Programs that target problematic gaming may be improved by additional support beyond the standard program of therapy sessions. More funding and resources are needed to support the development of a more rigorous evidence base on IGD and its treatment.
Internet gaming disorder (IGD) is currently positioned in the appendix of the DSM-5 as a condition requiring further study. The aim of this review was to examine the state of current knowledge of ...gaming withdrawal symptomatology, given the importance of withdrawal in positioning the disorder as a behavioral addiction. A total of 34 studies, including 10 qualitative studies, 17 research reports on psychometric instruments, and 7 treatment studies, were evaluated. The results indicated that the available evidence on Internet gaming withdrawal is very underdeveloped. Internet gaming withdrawal is most consistently referred to as ‘irritability’ and ‘restlessness’ following cessation of the activity. There exists a concerning paucity of qualitative studies that provide detailed clinical descriptions of symptoms arising from cessation of internet gaming. This has arguably compromised efforts to quantify withdrawal symptoms in empirical studies of gaming populations. Treatment studies have not reported on the natural course of withdrawal and/or withdrawal symptom trajectory following intervention. It is concluded that many more qualitative clinical studies are needed, and should be prioritised, to develop our understanding of gaming withdrawal. This should improve clinical descriptions of problematic internet gaming and in turn improve the quantification of IGD withdrawal and thus treatments for harmful internet gaming.
•We review the literature on Internet gaming withdrawal and craving.•Clinical qualitative studies of gaming withdrawal offer limited description.•We identify 25 different scale items that measure withdrawal as an affective state.•Internet gaming problems may arise without associated withdrawal symptoms.•Research on the salient stimuli of Internet gaming may advance knowledge.
While certain player vulnerabilities are known to increase risk of gaming disorder (GD), the topic of maladaptive player × game relationships in GD has received limited attention. This review aimed ...to: (1) identify game types associated with GD symptomatology; and (2) evaluate individual differences (e.g., age, personality, depression) in the relationship between gaming and GD symptomatology. A systematic review of six databases identified 23 studies of the relations between game types and GD, including 13 studies employing multivariate analyses. Player vulnerabilities implicated in GD included impulsivity, risk-taking, psychopathological symptoms (e.g., depression, anxiety), and stronger gaming motivations (e.g., escapism, achievement). MMORPG involvement had the strongest positive association with GD. Problematic MMORPG players tend to have a socially anxious profile and may be attracted to the work-like roles and conventions of this genre. Problematic players of shooters tend to score higher on measures of sensation-seeking and impulsivity than other players. These findings suggest that GD may develop more readily and at more severe levels in complex, endless, socially driven games, irrespective of person-level characteristics. Some player vulnerabilities may selectively increase risk of GD for certain game types. Further research should investigate different player-game interactions to refine current models and interventions for GD.
•Gaming disorder involves maladaptive player-game relationships.•We reviewed 23 empirical studies of player-game interactions related to GD.•MMORPG play had the strongest positive association with GD as compared to other games.•Higher impulsivity, risk-taking, comorbidity, and game motivations predicted GD.•Some player vulnerabilities may selectively increase risk of GD for certain games.
This systematic review synthesized current knowledge about the prevalence of adverse childhood experiences (ACEs) among young people known to have offended and examined evidence of associations ...between ACEs, trauma symptoms, and offending behavior. A systematic search of English-language, peer-reviewed studies published from the year 2000 onwards was conducted. A final pool of 124 studies that reported quantitative data were included in the review. The Cambridge Quality Checklist for the assessment of studies on offending was used to assess methodological quality of included studies. Pooled data indicated that almost 87% of justice-involved young people across 13 countries experienced at least one traumatic event. The odds of experiencing at least one ACE were over 12 times greater for justice-involved young people compared with nonjustice-involved young people. Prevalence of individual ACEs ranged from 12.2% for childhood sexual abuse to 80.4% for parental separation among justice-involved young people. Those who reported both a higher number and multiple types of ACEs were more likely to be diagnosed with post-traumatic stress symptoms. However, when considering only high-quality studies, there was minimal evidence to suggest that a higher incidence of ACEs predicted trauma symptoms or that trauma symptoms mediated the association between ACEs and offending behavior. Further research is needed to elucidate factors that differentiate young people exposed to ACEs who go on to offend from those who do not. This research is essential to understanding whether ACEs and trauma are drivers of offending behavior and for informing prevention and intervention strategies.
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