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Journal of Behavioral Addictions
Authors:
Belle Gavriel-Fried
,
Meytal Serry
,
Dana Katz
,
Dorottya Hidvégi
,
Zsolt Demetrovics
, and
Orsolya Király

Abstract

Background

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.

Objectives

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).

Methods

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.

Results

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.

Conclusions

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.

Open access
Journal of Behavioral Addictions
Authors:
Orsolya Király
,
Joël Billieux
,
Daniel L. King
,
Róbert Urbán
,
Patrik Koncz
,
Eszter Polgár
, and
Zsolt Demetrovics

Abstract

Background and aims

The popularity of video gaming has generated significant interest in research methods to examine motivations for gaming. Current measures of gaming motives are limited by lack of scope and/or their applicability to specific game genres only. We aimed to create a comprehensive motivation inventory applicable to any gaming genre and to evaluate its psychometric properties in a large sample of highly engaged video gamers.

Methods

Stage 1 of this project involved a systematic review that generated the items for the Gaming Motivation Inventory (GMI). Stages 2–4 involved an evaluation of the psychometric properties of the GMI. A sample of 14,740 video gamers (89.3% male; mean age 24.1 years) were recruited via an online survey promoted by a popular gaming magazine.

Results

In Stage 2, twenty-six gaming motives were identified, which clustered into six higher-order dimensions (Mastery, Immersion/Escapism, Competition, Stimulation, Social, Habit/Boredom). In Stage 3, construct validity of the six higher-order motives was assessed by associations with gaming-related, personality, and psychological variables. In Stage 4, the relationships between motives and depression symptoms and gaming disorder symptoms were explored. Although gaming motives had weak associations with gaming genres, they were moderately related to variables such as competitiveness, sociability, and positive and negative affect. Gaming disorder symptoms were directly predicted by depression symptoms and indirectly via Immersion/Escapism, Habit/Boredom, and Competition motives.

Discussion and conclusions

These findings support the notion that motives are one of the primary causes of gaming behavior and play an important role in predicting its problematic nature. The GMI is a psychometrically valid tool that will be useful for gaining insights into factors underlying gaming behaviors.

Open access
Journal of Behavioral Addictions
Authors:
Chih-Hung Ko
,
Orsolya Király
,
Zsolt Demetrovics
,
Mark D. Griffiths
,
Takahiro A. Kato
,
Masaru Tateno
, and
Ju-Yu Yen

Abstract

Background

The eleventh revision of the International Classification of Diseases (ICD-11) defines the three key diagnostic criteria for gaming disorder (GD). These are loss of control over gaming, gaming as a priority over daily activities, and impaired functioning due to gaming. While this definition has implications for the prevention and treatment of GD, there is significant heterogeneity in the symptoms and etiology of GD among individuals, which results in different treatment needs. Cognitive control, emotional regulation, and reward sensitivity are three critical dimensions in the etiology model for GD. Aspects such as gender, comorbidity, motivation for gaming, stage or severity of GD, and risk factors all contribute to the heterogeneity of etiology among individuals with the disorder.

Method

On the basis of clinical symptoms and comorbidity characteristics among approximately 400 patients with gaming disorder, the present paper proposes a clinical typology of patients with GD based on the authors' clinical experience in treating individuals with GD.

Results

The findings indicated three common types of patients with GD: (i) impulsive male patients with attention deficit hyperactivity disorder (ADHD), (ii) dysphoria patients with dysfunctional coping skills, and (iii) isolated patients with social anxiety. The paper also discusses the presentation and treatment priority for these patients.

Conclusion

Personalized treatments for patients with GD should be developed to fit their individual needs. Future studies should examine the heterogeneity of GD and confirm these types, as well as obtain evidence-based information that can help in the development of personalized treatment. Treatment resources should be developed, and professionals should be trained to provide integrated individualized treatment.

Open access
Journal of Behavioral Addictions
Authors:
Orsolya Király
,
Mark D. Griffiths
,
Daniel L. King
,
Hae-Kook Lee
,
Seung-Yup Lee
,
Fanni Bányai
,
Ágnes Zsila
,
Zsofia K. Takacs
, and
Zsolt Demetrovics

Background and aims

Empirical research into problematic video game playing suggests that overuse might cause functional and psychological impairments for a minority of gamers. Therefore, the need for regulation in the case of video games (whether governmental or self-imposed) has arisen but has only been implemented in a few countries around the world, and predominantly in Asia. This paper provides a systematic review of current and potential policies addressing problematic gaming.

Methods

After conducting a systematic search in the areas of prevention, treatment, and policy measures relating to problematic Internet and video game use, papers were selected that targeted problematic gaming policies (N = 12; six in English and six in Korean). These papers served as the basis of this review.

Results

Policies were classified into three major groups: (i) policy measures limiting availability of video games (e.g., shutdown policy, fatigue system, and parental controls), (ii) measures aiming to reduce risk and harm (e.g., warning messages), and (iii) measures taken to provide help services for gamers. Beyond the attempt to classify the current and potential policy measures, the authors also tried to evaluate their efficiency theoretically and (if data were available) empirically.

Discussion and conclusions

Overall, it appears that although several steps have been taken to address problematic video game playing, most of these steps were not as effective as expected, or had not been evaluated empirically for efficacy. The reason for this may lie in the fact that the policies outlined only addressed or influenced specific aspects of the problem instead of using a more integrative approach.

Open access
Orvosi Hetilap
Authors:
Bence András Lázár
,
Ildikó Katalin Pribék
,
Csenge Kovács
,
Ildikó Demeter
,
János Kálmán
,
János Szemelyácz
,
Gábor Kelemen
,
Zoltán Janka
,
Zsolt Demetrovics
, and
Bálint Andó

Absztrakt:

Bevezetés és célkitűzés: Alkoholbetegek egészségügyi ellátása során az alkoholfogyasztás csökkentésével vagy annak elhagyásával alkohol okozta megvonási szindróma alakulhat ki. Jelenleg hazánkban nem áll rendelkezésre olyan standardizált mérőeszköz, amellyel az alkoholmegvonás tünetei mérhetők lennének. A nemzetközi szakirodalom, illetve irányelvek a megvonás tüneteinek monitorozására elsődlegesen a Clinical Institute Withdrawal Assessment of Alcohol, Revised mérőeszközt ajánlják, melynek hazai bevezetése hiánypótlónak tekinthető. A jelen vizsgálat célja a Clinical Institute Withdrawal Assessment of Alcohol, Revised hazai változata (Alkohol Megvonási Skála) pszichometriai mutatóinak feltárása, illetve a mérőeszköz alkalmazásának bemutatása. Módszer: A vizsgálat a Szegedi Tudományegyetem Pszichiátriai Klinikájára alkohol okozta megvonási szindróma iránydiagnózissal osztályra felvett páciensek (n = 30) körében történt, utánkövetéses elrendezésben. Kétnaponta, hat alkalommal került felvételre az Alkohol Megvonási Skála, illetve mellette a Klinikai Globális Összbenyomás – Súlyosság Skála. A felvételek során kapott átlagok összehasonlítása ismételt méréses varianciaanalízissel történt. Belső konzisztenciai mutatók (Cronbach-alfa, tétel-totál korreláció), konvergens és divergens validitási mutatók (Alkohol Megvonási Skála, illetve a Klinikai Globális Összbenyomás – Súlyosság Skála közötti Pearson korrelációs elemzés alapján) kerültek kiszámításra. Eredmények: Szignifikáns csökkenés volt megfigyelhető a 6 adatfelvételi időpontban az Alkohol Megvonási Skála (F = 202,46, p<0,001), illetve a Klinikai Globális Összbenyomás – Súlyosság Skála (F = 503,04, p<0,001) pontszámainak esetében. A Cronbach-alfa-értékek az első 3 mérési napon 0,7 felett voltak. Az egy időben felvett Alkohol Megvonási Skála és a Klinikai Globális Összbenyomás – Súlyosság Skála minden esetben 0,45 feletti korrelációt mutatott. Következtetés: Az Alkohol Megvonási Skála megbízható és érvényes mérőeszköz a megvonási tünetek részletes szimptomatológiai vizsgálatára. Így lehetővé teszi a hazai betegellátási gyakorlatban az alkoholmegvonás tüneteinek felismerését és súlyosságának meghatározását. Orv Hetil. 2019; 160(30): 1184–1192.

Open access
Journal of Behavioral Addictions
Authors:
Beáta Bőthe
,
Marc N. Potenza
,
Mark D. Griffiths
,
Shane W. Kraus
,
Verena Klein
,
Johannes Fuss
, and
Zsolt Demetrovics

Abstract

Background

Compulsive Sexual Behavior Disorder (CSBD) is included in the eleventh edition of The International Classification of Diseases (ICD-11) as an impulse-control disorder.

Aims

The aim of the present work was to develop a scale (Compulsive Sexual Behavior Disorder Scale–CSBD-19) that can reliably and validly assess CSBD based on ICD-11 diagnostic guidelines.

Method

Four independent samples of 9,325 individuals completed self-reported measures from three countries (the United States, Hungary, and Germany). The psychometric properties of the CSBD-19 were examined in terms of factor structure, reliability, measurement invariance, and theoretically relevant correlates. A potential threshold was determined to identify individuals with an elevated risk of CSBD.

Results

The five-factor model of the CSBD-19 (i.e., control, salience, relapse, dissatisfaction, and negative consequences) had an excellent fit to the data and demonstrated appropriate associations with the correlates. Measurement invariance suggested that the CSBD-19 functions similarly across languages. Men had higher means than women. A score of 50 points was found as an optimal threshold to identify individuals at high-risk of CSBD.

Conclusions

The CSBD-19 is a short, valid, and reliable measure of potential CSBD based on ICD-11 diagnostic guidelines. Its use in large-scale, cross-cultural studies may promote the identification and understanding of individuals with a high risk of CSBD.

Open access
Journal of Behavioral Addictions
Authors:
Máté Kapitány-Fövény
,
Róbert Urbán
,
Gábor Varga
,
Marc N. Potenza
,
Mark D. Griffiths
,
Anna Szekely
,
Borbála Paksi
,
Bernadette Kun
,
Judit Farkas
,
Gyöngyi Kökönyei
, and
Zsolt Demetrovics

Abstract

Background and aims

Due to its important role in both healthy groups and those with physical, mental and behavioral disorders, impulsivity is a widely researched construct. Among various self-report questionnaires of impulsivity, the Barratt Impulsiveness Scale is arguably the most frequently used measure. Despite its international use, inconsistencies in the suggested factor structure of its latest version, the BIS-11, have been observed repeatedly in different samples. The goal of the present study was therefore to test the factor structure of the BIS-11 in several samples.

Methods

Exploratory and confirmatory factor analyses were conducted on two representative samples of Hungarian adults (N = 2,457; N = 2,040) and a college sample (N = 765).

Results

Analyses did not confirm the original model of the measure in any of the samples. Based on explorative factor analyses, an alternative three-factor model (cognitive impulsivity; behavioral impulsivity; and impatience/restlessness) of the Barratt Impulsiveness Scale is suggested. The pattern of the associations between the three factors and aggression, exercise, smoking, alcohol use, and psychological distress supports the construct validity of this new model.

Discussion

The new measurement model of impulsivity was confirmed in two independent samples. However, it requires further cross-cultural validation to clarify the content of self-reported impulsivity in both clinical and nonclinical samples.

Open access
Journal of Behavioral Addictions
Authors:
Eszter Kotyuk
,
Anna Magi
,
Andrea Eisinger
,
Orsolya Király
,
Andrea Vereczkei
,
Csaba Barta
,
Mark D. Griffiths
,
Anna Székely
,
Gyöngyi Kökönyei
,
Judit Farkas
,
Bernadette Kun
,
Rajendra D. Badgaiyan
,
Róbert Urbán
,
Kenneth Blum
, and
Zsolt Demetrovics

Abstract

Background and aims

Changes in the nomenclature of addictions suggest a significant shift in the conceptualization of addictions, where non-substance related behaviors can also be classified as addictions. A large amount of data provides empirical evidence that there are overlaps of different types of addictive behaviors in etiology, phenomenology, and in the underlying psychological and biological mechanisms. Our aim was to investigate the co-occurrences of a wide range of substance use and behavioral addictions.

Methods

The present epidemiological analysis was carried out as part of the Psychological and Genetic Factors of the Addictive Behaviors (PGA) Study, where data were collected from 3,003 adolescents and young adults (42.6% males; mean age 21 years). Addictions to psychoactive substances and behaviors were rigorously assessed.

Results

Data is provided on lifetime occurrences of the assessed substance uses, their co-occurrences, the prevalence estimates of specific behavioral addictions, and co-occurrences of different substance use and potentially addictive behaviors. Associations were found between (i) smoking and problematic Internet use, exercising, eating disorders, and gambling (ii) alcohol consumption and problematic Internet use, problematic online gaming, gambling, and eating disorders, and (iii) cannabis use and problematic online gaming and gambling.

Conclusions

The results suggest a large overlap between the occurrence of these addictions and behaviors and underlies the importance of investigating the possible common psychological, genetic and neural pathways. These data further support concepts such as the Reward Deficiency Syndrome and the component model of addictions that propose a common phenomenological and etiological background of different addictive and related behaviors.

Open access
Journal of Behavioral Addictions
Authors:
Andrea Czakó
,
Orsolya Király
,
Patrik Koncz
,
Shu M. Yu
,
Harshdeep S. Mangat
,
Judith A Glynn
,
Pedro Romero
,
Mark D Griffiths
,
Hans-Jürgen Rumpf
, and
Zsolt Demetrovics

Abstract

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.

Open access
Journal of Behavioral Addictions
Authors:
Joshua B. Grubbs
,
Rory C. Reid
,
Beáta Bőthe
,
Zsolt Demetrovics
,
Eli Coleman
,
Neil Gleason
,
Michael H. Miner
,
Johannes Fuss
,
Verena Klein
,
Karol Lewczuk
,
Mateusz Gola
,
David P. Fernandez
,
Elaine F. Fernandez
,
Stefanie Carnes
,
Michal Lew-Starowicz
,
Drew Kingston
, and
Shane W. Kraus

Abstract

Background and aims

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.

Design

The present work details the development of the Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI) across seven samples, four languages, and five countries.

Setting

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).

Findings

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.

Conclusion

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.

Open access