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Journal of Behavioral Addictions
Authors: Daniel L. King, Paul H. Delfabbro, Joel Billieux, and Marc N. Potenza

Abstract

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.

Open access

Background and aims

Multiplayer Online Battle Arena (MOBA) games have become the most popular type of video games played worldwide, superseding the playing of Massively Multiplayer Online Role-Playing Games and First-Person Shooter games. However, empirical studies focusing on the use and abuse of MOBA games are still very limited, particularly regarding impulsivity, which is an indicator of addictive states but has not yet been explored in MOBA games. In this context, the objective of the present study is to explore the associations between impulsivity and symptoms of addictive use of MOBA games in a sample of highly involved League of Legends (LoL, currently the most popular MOBA game) gamers.

Methods

Thirty-six LoL gamers were recruited and completed both experimental (Single Key Impulsivity Paradigm) and self-reported impulsivity assessments (s-UPPS-P Impulsive Behavior Scale, Barratt Impulsiveness Scale), in addition to an assessment of problematic video game use (Problematic Online Gaming Questionnaire).

Results

Results showed links between impulsivity-related constructs and signs of excessive MOBA game involvement. Findings indicated that impaired ability to postpone rewards in an experimental laboratory task was strongly related to problematic patterns of MOBA game involvement. Although less consistent, several associations were also found between self-reported impulsivity traits and signs of excessive MOBA game involvement.

Conclusions

Despite these results are preliminary and based upon a small (self-selected) sample, the present study highlights potential psychological factors related to the addictive use of MOBA games.

Open access
Journal of Behavioral Addictions
Authors: Natale Canale, Tania Moretta, Luca Pancani, Giulia Buodo, Alessio Vieno, Mario Dalmaso, and Joël Billieux

Abstract

Background and aims

Problematic smartphone use (PSU) has been described as a growing public health issue. In the current study, we aimed to provide a unique and comprehensive test of the pathway model of PSU. This model posits three distinct developmental pathways leading to PSU: (1) the excessive reassurance pathway, (2) the impulsive pathway and (3) the extraversion pathway.

Methods

Undergraduate students (n = 795, 69.8% female, mean age = 23.80 years, sd = 3.02) completed online self-report measures of PSU (addictive use, antisocial use and dangerous use) and the psychological features (personality traits and psychopathological symptoms) underlying the three pathways.

Results

Bayesian analyses revealed that addictive use is mainly driven by the excessive reassurance pathway and the impulsive pathway, for which candidate etiopathological factors include heightened negative urgency, a hyperactive behavioural inhibition system and symptoms of social anxiety. Dangerous and antisocial use are mainly driven by the impulsive pathway and the extraversion pathway, for which candidate etiopathological factors include specific impulsivity components (lack of premeditation and sensation seeking) and primary psychopathy (inclination to lie, lack of remorse, callousness and manipulativeness).

Discussion and conclusions

The present study constitutes the first comprehensive test of the pathway model of PSU. We provide robust and original results regarding the psychological dimensions associated with each of the postulated pathways of PSU, which should be taken into account when considering regulation of smartphone use or tailoring prevention protocols to reduce problematic usage patterns.

Open access
Journal of Behavioral Addictions
Authors: Dr Gabriel Thorens, Sophia Achab, Joël Billieux, Yasser Khazaal, Riaz Khan, Edward Pivin, Vishal Gupta, and Daniel Zullino

Abstract

Aims

Controversies remain about the validity of the diagnosis of problematic Internet use. This might be due in part to the lack of longitudinal naturalistic studies that have followed a cohort of patients who self-identify as having Internet-related problems.

Methods

This retrospective study included 57 patients who consulted the Geneva Addiction Outpatient Clinic from January 1, 2007, to January 1, 2010. Patients underwent an initial clinical psychiatric evaluation that included collection of data on socio-demographics, method of referral, specific Internet usage, psychiatric diagnosis, and Internet Addiction Test (IAT) and Clinical Global Impression Scale (CGI) scores. Treatment consisted of individual psychotherapeutic sessions.

Results

Of these patients, 98% were male and 37% were 18 years or younger. Most patients were online gamers (46% playing massively multiplayer online role-playing games). The mean IAT score was 52.9 (range 20–90). Sixty-eight percent of patients had a co-morbid psychiatric diagnosis, with social phobia being the most prevalent (17.8%). Patients who remained in treatment (dropout rate 24%) showed an overall improvement of symptoms: 38.6% showed significant or average improvement on their CGI score, 26.3% showed minimal improvement, and 14% showed no change.

Conclusions

Our results support the hypothesis that there are specific types of Internet use, with online gaming mainly affecting young male patients. As Internet addiction is not yet an official diagnosis, better instruments are needed to screen patients and to avoid false-negative and false-positive diagnoses. Successful care should integrate the treatment of co-morbid symptoms and involve families and relatives in the therapeutic process.

Open access
Journal of Behavioral Addictions
Authors: Aline Wéry, Kim Vogelaere, Gaëlle Challet-Bouju, François-Xavier Poudat, Julie Caillon, Delphine Lever, Joël Billieux, and Marie Grall-Bronnec

Background and aims

Research on sexual addiction flourished during the last decade, promoted by the development of an increased number of online sexual activities. Despite the accumulation of studies, however, evidence collected in clinical samples of treatment-seeking people remains scarce. The aim of this study was to describe the characteristics (socio-demographics, sexual habits, and comorbidities) of self-identified “sexual addicts.”

Methods

The sample was composed of 72 patients who consulted an outpatient treatment center regarding their sexual behaviors. Data were collected through a combination of structured interviewing and self-report measures.

Results

Most patients were males (94.4%) aged 20–76 years (mean 40.3 ± 10.9). Endorsement of sexual addiction diagnosis varied from 56.9% to 95.8% depending on the criteria used. The sexual behaviors reported to have the highest degree of functional impairment were having multiple sexual partners (56%), having unprotected sexual intercourse (51.9%), and using cybersex (43.6%). Ninety percent of patients endorsed a comorbid psychiatric diagnosis, and 60.6% presented at least one paraphilia.

Conclusions

Results showed highly different profiles in terms of sexual preferences and behaviors, as well as comorbidities involved. These findings highlight the need to develop tailored psychotherapeutic interventions by taking into account the complexity and heterogeneity of the disorder.

Open access

Functional impairment matters in the screening and diagnosis of gaming disorder

Commentary on: Scholars’ open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal (Aarseth et al.)

Journal of Behavioral Addictions
Authors: Joël Billieux, Daniel L. King, Susumu Higuchi, Sophia Achab, Henrietta Bowden-Jones, Wei Hao, Jiang Long, Hae Kook Lee, Marc N. Potenza, John B. Saunders, and Vladimir Poznyak

This commentary responds to Aarseth et al.’s (in press) criticisms that the ICD-11 Gaming Disorder proposal would result in “moral panics around the harm of video gaming” and “the treatment of abundant false-positive cases.” The ICD-11 Gaming Disorder avoids potential “overpathologizing” with its explicit reference to functional impairment caused by gaming and therefore improves upon a number of flawed previous approaches to identifying cases with suspected gaming-related harms. We contend that moral panics are more likely to occur and be exacerbated by misinformation and lack of understanding, rather than proceed from having a clear diagnostic system.

Open access

Abstract

Background and aims

Buying-shopping disorder and its transferability to the online sector is controversial. This study investigates in-store and online shopping patterns by comparing data-based modeling to a diagnostic cut-off approach. Further aims were to test model equivalence for gender and identify socio-demographic risk factors.

Methods

In a representative survey, the Bergen Shopping Addiction Scale (BSAS) was applied, using both an online and in-store version. Latent class analyses were followed by multinomial logistic regression analyses to investigate socio-demographic variables. Measurement invariance across genders was tested with multi-group comparisons.

Results

With N = 1,012, 3-class solutions provided the best model fit for both in-store and online shopping. Most individuals (76, 86%) were grouped in non-addicted classes, followed by risky (21, 11%) and addicted classes (both 3%). Twenty-eight percent of individuals in the online addicted shopping class remained unidentified using the cut-off. For online shopping, only lower age and education differentiated classes significantly.

Discussion

Results indicate a close link between online and in-store shopping, albeit with distinguishing features. The cut-off yielded findings discrepant from class probabilities. That buying-shopping disorder mainly affects younger women of lower educational level must be questioned, given the limited associations identified.

Conclusions

It is important not only to consider different settings of pathological shopping, but also to focus on groups that may not have appeared at risk in previous investigations (e.g., men, older age). The BSAS cut-off warrants further research.

Open access

Abstract

Background and aims

Buying-shopping disorder and its transferability to the online sector is controversial. This study investigates in-store and online shopping patterns by comparing data-based modeling to a diagnostic cut-off approach. Further aims were to test model equivalence for gender and identify socio-demographic risk factors.

Methods

In a representative survey, the Bergen Shopping Addiction Scale (BSAS) was applied, using both an online and in-store version. Latent class analyses were followed by multinomial logistic regression analyses to investigate socio-demographic variables. Measurement invariance across genders was tested with multi-group comparisons.

Results

With N = 1,012, 3-class solutions provided the best model fit for both in-store and online shopping. Most individuals (76, 86%) were grouped in non-addicted classes, followed by risky (21, 11%) and addicted classes (both 3%). Twenty-eight percent of individuals in the online addicted shopping class remained unidentified using the cut-off. For online shopping, only lower age and education differentiated classes significantly.

Discussion

Results indicate a close link between online and in-store shopping, albeit with distinguishing features. The cut-off yielded findings discrepant from class probabilities. That buying-shopping disorder mainly affects younger women of lower educational level must be questioned, given the limited associations identified.

Conclusions

It is important not only to consider different settings of pathological shopping, but also to focus on groups that may not have appeared at risk in previous investigations (e.g., men, older age). The BSAS cut-off warrants further research.

Open access

“Diagnostic inflation” will not resolve taxonomical problems in the study of addictive online behaviours. •

Commentary on: How to overcome taxonomical problems in the study of Internet use disorders and what to do with “smartphone addiction”? (Montag et al., 2020)

Journal of Behavioral Addictions
Authors: Vladan Starcevic, Daniel L. King, Paul H. Delfabbro, Adriano Schimmenti, Jesús Castro-Calvo, Alessandro Giardina, and Joël Billieux

Abstract

This article suggests that the type of Internet-enabled device should not be prioritised when conceptualizing diagnostic categories of addictive online behaviours. The diagnostic distinction between “predominantly mobile” and “predominantly non-mobile” forms of Internet use disorders (IUD) is not empirically based, may not be clinically useful and may lead to “diagnostic inflation.” Problems with the concepts of smartphone use disorder and IUD on which the proposed distinction is largely based call for their re-examination. Future proposals for the taxonomy of addictive behaviours may not need to be based on online/offline and mobile/non-mobile dichotomies.

Open access
Journal of Behavioral Addictions
Authors: Valentin Flaudias, Sylvain Iceta, Oulmann Zerhouni, Rachel F Rodgers, JoËl Billieux, Pierre-Michel Llorca, Jordane Boudesseul, Ingrid de Chazeron, Lucia Romo, Pierre Maurage, Ludovic Samalin, Laurent BÈgue, Mickael Naassila, Georges Brousse, and Sébastien Guillaume

Abstract

Background and aims

Since mid-March 2020, over 3 billion people have been confined as a result of the COVID-19 pandemic. Problematic eating behaviors are likely to be impacted by the pandemic through multiple pathways. This study examined the relationships between stress related to lockdown measures and binge eating and dietary restriction in a population of French students during the first week of confinement.

Methods

A sample of undergraduate students (N = 5,738) completed an online questionnaire 7 days after lockdown measures were introduced. The survey comprised variables related to lockdown measures and the COVID-19-pandemic, mood, stress, body image, binge eating and dietary restriction during the past 7 days, as well as intent to binge eat and restrict in the following 15 days.

Results

Stress related to the lockdown was associated with greater likelihood of binge eating and dietary restriction over the past week and intentions to binge eat and restrict over the next 15 days. Greater exposure to COVID-19-related media was associated with increased eating restriction over the past week. Binge eating and restriction (past and intentions) were associated with established risk factors, including female gender, low impulse regulation, high body dissatisfaction, and having a concurrent probable eating disorder.

Discussion and conclusion

The higher the stress related to the first week of confinement, the higher the risk of problematic eating behaviors among students, particularly those characterized by eating-related concerns. Screening for risk factors and providing targeted interventions might help decrease problematic eating behaviors among those who are most vulnerable.

Open access