The present paper provides an overview of the possible risks, harms, and challenges that might arise with the development of the esports field and pose a threat to professional esports players, spectators, bettors and videogame players, including underage players. These include physical and mental health issues, gambling and gambling-like elements associated with videogames and esports, the challenges arising from pursuing a career in esports, the unique difficulties women face, and a need for supporting professional esports players. It briefly discusses possible responses and suggestions regarding how to address and mitigate these negative consequences. It emphasizes the need for cooperation and collaboration between various stakeholders: researchers, policymakers, regulators, the gaming industry, esports organizations, healthcare and treatment providers, educational institutes and the need for further evidence-based information.
Negative/positive urgency (NU/PU) refers to the proneness to act rashly under negative/positive emotions. These traits are proxies to generalized emotion dysregulation, and are well-established predictors of gambling-related problems. We aimed to replicate a previous work (Quintero et al., 2020) showing NU to be related to faulty extinction of conditioned stimuli in an emotional conditioning task, to extend these findings to PU, and to clarify the role of urgency in the development of gambling-related craving and problems.
81 gamblers performed an acquisition-extinction task in which neutral, disgusting, erotic and gambling-related images were used as unconditioned stimuli (US), and color patches as conditioned stimuli (CS). Trial-by-trial predictive responses were analyzed using generalized linear mixed-effects models (GLME).
PU was more strongly related than NU to craving and severity of gambling problems. PU did not influence acquisition in the associative task, whereas NU slightly slowed it. Extinction was hampered in individuals with high PU, and a follow-up analysis showed this effect to depend on relative preference for skill-based and casino games.
Discussion and conclusions
Results suggest that resistance to extinction of emotionally conditioned cues is a sign of malfunctioning emotion regulation in problematic gambling. In our work, the key effect was driven by PU (instead of NU), and gambling craving and symptoms were also more closely predicted by it. Future research should compare the involvement of PU and NU in emotion regulation and gambling problems, for gamblers with preference for different gambling modalities (e.g., pure chance vs skill games).
It has been argued that it is important to consider underlying mechanisms of mental health problems. Previous studies have shown that executive deficits, delay aversion, and emotion dysregulation are related to Internet Gaming Disorder (IGD) and Social Media Disorder (SMD). However, the present study is the first to investigate whether these neuropsychological deficits show additive effects or if they interact. The present study also investigated whether these deficits mediate the association between IGD/SMD and psychosocial outcomes.
The study involved 995 university students who completed a survey measuring IGD/SMD symptom severity, neuropsychological functions, and psychosocial outcomes. Both dimensional and categorical analyses were used to assess the associations between neuropsychological functions and IGD/SMD. Simple and multiple mediation analyses were conducted to examine if neuropsychological functioning mediates the association between IGD/SMD and psychosocial outcomes.
All neuropsychological functions were significantly associated with both IGD and SMD symptom severity. However, only inhibition and emotion regulation, as well as delay aversion for SMD, remained significant when controlling for the overlap between different functions. Associations were significantly stronger for men compared to women for IGD. In the categorical analyses, individuals with IGD/SMD were more likely to have neuropsychological deficits (odds ratios between 3.33 and 8.81). Finally, all neuropsychological functions, except inhibition, were significant mediators in the link between IGD/SMD and psychosocial outcomes.
Discussion and conclusions
These results shed light on the neuropsychological underpinnings of IGD/SMD, which can be used to identify more homogenous subgroups and provide more individualized treatment options.
Compulsive sexual behavior disorder (CSBD) has been included as an impulse control disorder in the International Classification of Diseases (ICD-11). However, the neurobiological mechanisms underlying CSBD remain largely unknown, and given previous indications of addiction-like mechanisms at play, the aim of the present study was to investigate if CSBD is associated with structural brain differences in regions involved in reward processing.
We analyzed structural MRI data of 22 male CSBD patients (mean = 38.7 years, SD = 11.7) and 20 matched healthy controls (HC; mean = 37.6 years, SD = 8.5). Main outcome measures were regional cortical thickness and surface area. We also tested for case-control differences in subcortical structures and the effects of demographic and clinical variables, such as CSBD symptom severity, on neuroimaging outcomes. Moreover, we explored case-control differences in regions outside our hypothesis including white matter.
CSBD patients had significantly lower cortical surface area in right posterior cingulate cortex than HC. We found negative correlations between right posterior cingulate area and CSBD symptoms scores. There were no group differences in subcortical volume.
Our findings suggest that CSBD is associated with structural brain differences, which contributes to a better understanding of CSBD and encourages further clarifications of the neurobiological mechanisms underlying the disorder.
About 1/3 of youth spend more than four hours/day engaged in screen media activity (SMA). This investigation utilized longitudinal brain imaging and mediation analyses to examine relationships among SMA, brain patterns, and internalizing problems.
Data from Adolescent Brain Cognitive Development (ABCD) participants with baseline and two-year follow-up structural imaging data that passed quality control (N = 5,166; 2,385 girls) were analyzed. Joint and Individual Variation Explained (JIVE) identified a brain co-development pattern among 221 brain features (i.e., differences in surface area, thickness, or cortical and subcortical gray-matter volume between baseline and two-year-follow-up data). Generalized linear mixed-effect models investigated associations between baseline SMA, structural co-development and internalizing and externalizing psychopathology at two-year follow-up.
SMA at baseline was related to internalizing psychopathology at year 2 () and a structural co-development pattern (), where the co-development pattern suggested that rates of change in gray-matter volumes of the brainstem, gray-matter volumes and/or cortical thickness measures of bilateral superior frontal, rostral middle frontal, inferior parietal, and inferior temporal regions were more similar than those in other regions. This component partially mediated the relationship between baseline SMA and future internalizing problems (indirect effect = 0.020, P-value = 0.043, proportion mediated: 2.24%).
Discussion and conclusions
Greater youth engagement in SMA at ages 9–10 years statistically predicted higher levels of internalizing two years later. This association was mediated by cortical-brainstem circuitry, albeit with relatively small effect sizes. The findings may help delineate processes contributing to internalizing behaviors and assist in identifying individuals at greater risk for such problems.
Recovery from mental health and behavioral disorders is classically defined as a reduction in symptoms. More recent definitions see it as a process in which individuals improve their health, wellness and other life domains. The inclusion of gaming disorder (GD) in the 11th International Classification of Diseases in 2019 prompted growing interest in GD. However, relatively little is known about recovery from GD, and there is scant literature describing or assessing its course.
This scoping review was designed to explore the state of the art on recovery from GD (e.g., terminology and measures used to assess recovery, main topics in studies about recovery from GD).
PubMed, Web of Science, and Scopus databases were searched and critically reviewed according to PRISMA guidelines. We included empirical studies in English covering individuals across all age groups who met the diagnostic criteria of GD/internet gaming disorder (IGD) according to valid scales that relate to recovery or any change, and were published before February 2022.
A total of 47 out of 966 studies met the inclusion criteria. Recovery as a concept is not explicitly mentioned in GD studies. Rather, changes in subjects' disorders are described in terms of decreases/reductions in symptom severity, or improvement/increases. These changes are primarily measured by scales that evaluate symptom reduction and/or improvement in GD and other psychopathologies.
The concept of recovery is included in the GD field but is not clearly mentioned or used. Therapists and researchers should aim to promote and integrate the notion of recovery in GD.
The World Health Organization's International Classification of Diseases (ICD-11) includes Compulsive Sexual Behavior Disorder (CSBD), a new diagnosis that is both controversial and groundbreaking, as it is the first diagnosis to codify a disorder related to excessive, compulsive, and out-of-control sexual behavior. The inclusion of this novel diagnosis demonstrates a clear need for valid assessments of this disorder that may be quickly administered in both clinical and research settings.
The present work details the development of the Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI) across seven samples, four languages, and five countries.
In the first study, data were collected in community samples drawn from Malaysia (N = 375), the U.S. (N = 877), Hungary (N = 7,279), and Germany (N = 449). In the second study, data were collected from nationally representative samples in the U.S. (N = 1,601), Poland (N = 1,036), and Hungary (N = 473).
Across both studies and all samples, results revealed strong psychometric qualities for the 7-item CSBD-DI, demonstrating evidence of validity via correlations with key behavioral indicators and longer measures of compulsive sexual behavior. Analyses from nationally representative samples revealed residual metric invariance across languages, scalar invariance across gender, strong evidence of validity, and utility in classifying individuals who self-identified as having problematic and excessive sexual behavior, as evidenced by ROC analyses revealing suitable cutoffs for a screening instrument.
Collectively, these findings demonstrate the cross-cultural utility of the CSBD-DI as a novel measure for CSBD and provide a brief, easily administrable instrument for screening for this novel disorder.
Little attention has been given to efficacious treatment and adherence to treatment of compulsive sexual behavior (CSB).
Randomized controlled trial investigated short-term psychodynamic group therapy followed by relapse prevention group (STPGP-RPGT) and pharmacological treatment (PT) for CSB men on sexual compulsivity and adherence.
135 men, 38 (SD = 9) years old on average, were randomly assigned to 1) STPGP-RPGT; 2) PT; 3) Both. Participants completed measures at baseline, 25th, and 34th week. 57 (42.2%) participants dropped out between baseline and 25th week, and 68 (50.4%) between baseline and 34th week. 94 (69.6%) did not adhere (80% pills taken or attended 75% therapy sessions).
A significant interaction effect was found between time and group (F (4, 128) = 2.62, P = 0.038, ES = 0.08), showing who received PT improved less in sexual compulsivity than those who received STPGP-RPGT (t = 2.41; P = 0.038; ES = 0.60) and PT + STPGP-RPGT (t = 3.15; P = 0.007, ES = 0.74). Adherent participants improved more in sexual compulsivity than non-adherent at the 25th week (t = 2.82; P = 0.006, ES = 0.65) and 34th week (t = 2.26; P = 0.027, ES = 0.55), but there was no interaction effect, F (2, 130) = 2.88; P = 0.06; ES = 0.04). The most reported behavior (masturbation) showed greater risk of non-adherence (72.6%).
Discussion and conclusions
Adherent participants improved better than non-adherent. Participants who received psychotherapy improved better than those who received PT. Methodological limitations preclude conclusions on efficacy.
Ingestion or administration of classic psychedelics is sometimes associated with improvements in well-being or mental health. Acute mystical-type experiences that psychedelics occasion have been suggested to be related to such improvements. Meanwhile, other features of the psychedelic experience, such as psychological insights and emotional breakthroughs, are also increasingly being studied. This review aimed to collect and assess the available evidence for mystical-type experiences under psychedelics associating with medium-to-long term improvements in well-being or mental health, on their own and as compared with other features of the acute experience.
I conducted a pre-registered, comprehensive review of existing empirical studies on the topic, based on a systematic search of the literature.
Forty-four eligible studies were found, with most reporting positive associations between mystical-type experiences and improvements in well-being or mental health. The current level of evidence appeared stronger among healthy people, in cross-sectional studies, and for links with positive changes in general well-being and life satisfaction, attitudes and behavior, and anxiety, than for depression or other aspects of well-being and mental health. A few studies suggested that psychological insights and emotional breakthroughs may be as or more closely associated with positive changes than mystical-type experiences.
Despite their significant limitations, the identified studies suggest that mystical-type experiences under psychedelics are associated with improvements in some areas of well-being. However, psychological insights and emotional breakthroughs might be at least as important and should also be measured in future studies.