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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

Abstract

Background and aims

The literature has proposed two types of problematic smartphone/internet use: generalized problematic use and specific problematic use. However, longitudinal findings on the associations between the two types of problematic use and psychological distress are lacking among East-Asians. The present study examined temporal associations between both generalized and specific problematic use of the smartphone/internet, and psychological distress.

Methods

Hong Kong University students (N = 308; 100 males; mean age = 23.75 years; SD ± 5.15) were recruited with follow-ups at three, six, and nine months after baseline assessment. All participants completed the Smartphone Application-Based Addiction Scale (for generalized problematic smartphone/internet use), the Bergen Social Media Addiction Scale (for specific problematic smartphone/internet use), and the Hospital Anxiety and Depression Scale (for psychological distress) in each assessment. Latent growth modeling (LGM) was constructed to understand temporal associations between generalized/specific problematic use and psychological distress.

Results

The LGM suggested that the intercept of generalized problematic use was significantly associated with the intercept of psychological distress (standardized coefficient [β] = 0.32; P < 0.01). The growth of generalized problematic use was significantly associated with the growth of psychological distress (β = 0.51; P < 0.01). Moreover, the intercept of specific problematic use was significantly associated with the intercept of psychological distress (β = 0.28; P < 0.01) and the growth of psychological distress (β = 0.37; P < 0.01).

Conclusion

The initial level of problematic use of smartphone/internet increased the psychological distress among university students. Helping young adults address problematic use of the smartphone/internet may prevent psychological distress.

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
Journal of Behavioral Addictions
Authors:
Chung-Ying Lin
,
Maryam Ganji
,
Halley M. Pontes
,
Vida Imani
,
Anders Broström
,
Mark D. Griffiths
, and
Amir H. Pakpour

Background and aims

Given the growing epidemiological research interest concerning Internet addiction, brief instruments with a robust theoretical basis are warranted. The Internet Disorder Scale (IDS-15) is one such instrument that can be used to quickly assess the Internet addiction in an individual. However, only two language versions of the IDS-15 have been developed. This study translated the IDS-15 into Persian and examined its psychometric properties using comprehensive psychometric testing.

Methods

After ensuring the linguistic validity of the Persian IDS-15, 1,272 adolescents (mean age = 15.53 years; 728 males) completed the IDS-15, Depression Anxiety Stress Scale (DASS), Internet Gaming Disorder Scale – Short Form (IGDS9-SF), and the Bergen Social Media Addiction Scale (BSMAS). Confirmatory factor analysis (CFA), Rasch models, regression analysis, and latent profile analysis (LPA) were carried out to test the psychometric properties of the Persian IDS-15.

Results

Both CFA and Rasch supported the construct validity of the Persian IDS-15. Multigroup analysis in CFA and differential item functioning in Rasch indicated that male and female adolescents interpreted the IDS-15 items similarly. Regression analysis showed that the IDS-15 correlated with IGDS9-SF and BSMAS (ΔR 2 = .12 and .36, respectively) is stronger than the DASS (ΔR 2 = .03–.05). LPA based on IDS-15 suggests three subgroups for the sample. Significant differences in depression, anxiety, IGDS9-SF, and BSMAS were found among the three LPA subgroups.

Conclusion

The Persian IDS-15 has robust psychometric properties as evidenced by both classical test theory and Rasch analysis.

Open access
Journal of Behavioral Addictions
Authors:
Dominic Sagoe
,
Mark. D. Griffiths
,
Eilin Kristine Erevik
,
Turid Høyland
,
Tony Leino
,
Ida Alette Lande
,
Mie Engen Sigurdsson
, and
Ståle Pallesen

Abstract

Background and aims

The effect of internet-based psychological treatment for gambling problems has not been previously investigated by meta-analysis. The present study is therefore a quantitative synthesis of studies on the effects of internet-based treatment for gambling problems. Given that effects may vary according to the presence of therapist support and control conditions, it was presumed that subgroup analyses would elucidate such effects.

Methods

A systematic search with no time constraints was conducted in PsycINFO, MEDLINE, Web of Science, and the Cochrane Library. Two authors independently extracted data using a predefined form, including study quality assessment based on the Cochrane risk of bias tool. Effect sizes were calculated using random-effects models. Heterogeneity was indexed by Cochran’s Q and the I 2 statistics. Publication bias was investigated using trim and fill.

Results

Thirteen studies were included in the analysis. Random effects models at post-treatment showed significant effects for general gambling symptoms (g = 0.73; 95% CI = 0.43–1.03), gambling frequency (g = 0.29; 95% CI = 0.14–0.45), and amount of money lost gambling (g = 0.19; 95% CI = 0.11–0.27). The corresponding findings at follow-up were g = 1.20 (95% CI = 0.79–1.61), g = 0.36 (95% CI = 0.12–0.60), and g = 0.20 (95% CI = 0.12–0.29) respectively. Subgroup analyses showed that for general gambling symptoms, studies with therapist support yield larger effects than studies without, both post-treatment and at follow-up. Additionally, on general gambling symptoms and gambling frequency, there were lower effect sizes for studies with a control group compared to studies without a control group at follow-up. Studies with higher baseline severity of gambling problems were associated with larger effect sizes at both posttreatment and follow-up than studies with more lenient inclusion criteria concerning gambling problems.

Discussion and conclusions

Internet-based treatment has the potential to reach a large proportion of persons with gambling problems. Results of the meta-analysis suggest that such treatments hold promise as an effective approach. Future studies are encouraged to examine moderators of treatment outcomes, validate treatment effects cross-culturally, and investigate the effects of novel developments such as ecological momentary interventions.

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:
Jon Arcelus
,
Walter Pierre Bouman
,
Bethany Alice Jones
,
Christina Richards
,
Susana Jimenez-Murcia
, and
Mark D. Griffiths

Background

There is anecdotal clinical evidence that transgender people use the online world – such as forums and online video gaming – for the purpose of experiencing their gender identity in a safe, non-threatening, non-alienating, non-stigmatizing, and non-critical environment.

Aims

To describe gaming behavior, degree of problematic gaming behavior and associated factors with problematic gaming in a comparatively large group of transgender people accessing transgender health services.

Methods

Every individual referred to a national transgender health service in the United Kingdom during a 12-month period was invited to complete a series of questionnaires to measure gaming behavior, interpersonal functioning, severity of autistic features, and anxiety and depressive symptoms.

Results

A total of 245 people agreed to participate in the study with 154 (62.9%) describing themselves as current gamers. Gaming behavior in the transgender population attending transgender health services was prevalent, but less than 1% of them presented with clinical scores for Internet Gaming Disorder, with no differences according to gender. Problematic gaming behavior was associated with general interpersonal problems, depression, and young age.

Discussion and conclusions

Transgender people who engage in problematic gaming behavior are younger, and present with high interpersonal problems, and depression, which can affect a successful transition. In view of the high levels of gaming activity in this population games that are designed to address these psychological problems may be well received by transgender people.

Open access

Abstract

Background and aims

Due to the rapid spread of the novel coronavirus disease 2019 (COVID-19), policies based on the nature of “spatial distancing” have been implemented and have resulted in school suspensions and online learning among schoolchildren. In order to examine the impact of such policies on schoolchildren, the aims of the present study were to (i) assess changes in the level of engagement in three internet-related activities (smartphone use, social media use, and gaming) before and during the COVID-19 outbreak, including prolonged and problematic engagement in these activities; (ii) investigate the differences of psychological distress before and after COVID-19 outbreak; and (iii) to use structural equation modeling to investigate the mediating roles of problematic internet-related behaviors in the causal relationships of psychological distress and time spent on internet-related activities.

Methods

Self-report measures were used to assess internet-related activities and psychological distress. Time spent on internet-related activities, problematic use of internet-related activities, and psychological distress were collected from primary school students (N = 535; 265 boys; M age = 10.32 years [SD = 0.84]). The data were first collected before the COVID-19 outbreak (i.e., early November 2019) and then collected again during the school suspension due to COVID-19 outbreak (i.e., end of March 2020) for comparisons of changes.

Results

Schoolchildren spent significantly more time on the smartphone (increased 1.02 h daily; P < 0.001) and social media (increased 0.73 h daily; P < 0.001) but not gaming (increased 0.14 h daily; P = 0.07) during the school suspension compared to the baseline. Schoolchildren who increased by 15 or 30 min daily on internet-related activities showed an increased level of psychological distress. The association between problematic use of social media and psychological distress was stronger during the school suspension (β = 0.584) than at the baseline (β = 0.451; P < 0.001).

Conclusion

Increased problematic use of internet-related activities among schoolchildren was associated with greater psychological distress. Parents should therefore monitor internet-related activities and psychological distress of their children to support their mental health.

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:
Kun-Chia Chang
,
Yun-Husan Chang
,
Cheng-Fang Yen
,
Jung-Sheng Chen
,
Po-Jen Chen
,
Chung-Ying Lin
,
Mark D. Griffiths
,
Marc N. Potenza
, and
Amir H. Pakpour

Abstract

Background and aims

Individuals with schizophrenia may often experience poor sleep, self-stigma, impaired social functions, and problematic smartphone use. However, the temporal relationships between these factors have not been investigated. The present study used a longitudinal design to examine potential mediating roles of poor sleep and self-stigma in associations between problematic smartphone use and impaired social functions among individuals with schizophrenia.

Methods

From April 2019 to August 2021, 193 individuals with schizophrenia (mean [SD] age = 41.34 [9.01] years; 88 [45.6%] males) were recruited and asked to complete three psychometric scales: the Smartphone Application-Based Addiction Scale to assess problematic smartphone use; the Pittsburgh Sleep Quality Index to assess sleep quality; and the Self-Stigma Scale-Short Scale to assess self-stigma. Social functioning was evaluated by a psychiatrist using the Personal and Social Performance Scale. All measures were assessed five times (one baseline and four follow-ups) at three-month intervals between assessments.

Results

General estimating equations found that problematic smartphone use (coefficient = −0.096, SE = 0.021; P < 0.001), sleep quality (coefficient = −0.134, SE = 0.038; P < 0.001), and self-stigma (coefficient = −0.612, SE = 0.192; P = 0.001) were significant statistical predictors for social functioning. Moreover, sleep quality and self-stigma mediated associations between problematic smartphone use and social functioning.

Conclusion

Problematic smartphone use appears to impact social functioning longitudinally among individuals with schizophrenia via poor sleep and self-stigma concerns. Interventions aimed at reducing problematic smartphone use, improving sleep, and addressing self-stigma may help improve social functioning among individuals with schizophrenia.

Open access