Regulation of gaming is largely based on the perception of gaming-related harm. This perception varies from one country to another and does not necessarily correspond to the real gaming-related harm. It is argued that there is a crucial need to define and assess domains of this harm in order to introduce policies that regulate gaming. Such policies would ideally be targeted at individuals at risk for problematic gaming and would be based more on educational efforts than on restrictive measures. The role of gaming industry in the regulation of gaming would depend on the more precise estimates of gaming-related harm.
Authors:Maèva Flayelle, Pierre Maurage, and Joël Billieux
Background and aims
Binge-watching (i.e., seeing multiple episodes of the same TV series in a row) now constitutes a widespread phenomenon. However, little is known about the psychological factors underlying this behavior, as reflected by the paucity of available studies, most merely focusing on its potential harmfulness by applying the classic criteria used for other addictive disorders without exploring the uniqueness of binge-watching. This study thus aimed to take the opposite approach as a first step toward a genuine understanding of binge-watching behaviors through a qualitative analysis of the phenomenological characteristics of TV series watching.
A focus group of regular TV series viewers (N = 7) was established to explore a wide range of aspects related to TV series watching (e.g., motives, viewing practices, and related behaviors).
A content analysis identified binge-watching features across three dimensions: TV series watching motivations, TV series watching engagement, and structural characteristics of TV shows. Most participants acknowledged that TV series watching can become addictive, but they all agreed having trouble recognizing themselves as truly being an “addict.” Although obvious connections could be established with substance addiction criteria and symptoms, such parallelism appeared to be insufficient, as several distinctive facets emerged (e.g., positive view, transient overinvolvement, context dependency, and low everyday life impact).
Discussion and conclusion
The research should go beyond the classic biomedical and psychological models of addictive behaviors to account for binge-watching in order to explore its specificities and generate the first steps toward an adequate theoretical rationale for these emerging problematic behaviors.
Authors:Niko Männikkö, Joël Billieux, and Maria Kääriäinen
Background and Aims
The aim of this study was to identify problematic gaming behavior among Finnish adolescents and young adults, and evaluate its connection to a variety of psychological, social, and physical health symptoms.
This cross-sectional study was conducted with a random sample of 293 respondents aged from 13 to 24 years. Participants completed an online survey. Problematic gaming behavior was measured with the Game Addiction Scale (GAS). Self-reports covered health measures such as psychological health (psychopathological symptoms, satisfaction with life), social health (preferences for social interaction), and physical health (general health, Body Mass Index [BMI], body discomfort, physical activity).
Problematic gaming behavior was found to relate to psychological and health problems, namely fatigue, sleep interference, depression and anxiety symptoms. Multiple linear regression indicated that the amount of weekly gaming, depression and a preference for online social interaction predicted increased problematic gaming symptoms.
This research emphasized that problematic gaming behavior had a strong negative correlation to a variety of subjective health outcomes.
Authors:Daniel L. King, Joel Billieux, Natacha Carragher, and Paul H. Delfabbro
Critics of gaming disorder (GD; i.e., Internet gaming disorder in the DSM-5; Gaming disorder in the ICD-11) have expressed concerns about the potential risks of misclassification (e.g., false positives). An important consideration of relevance to this discussion is the extent to which commonly used screening instruments contain appropriate, sensible, and relevant items. The aim of this review was to evaluate the face validity of items within current tools for GD.
A systematic review of databases identified 29 instruments. An item bank (n = 417 items) was independently evaluated by three professional raters (i.e., a senior academic in clinical psychology, a senior psychometrician, and an academic/clinical psychologist) according to guidelines for defining and measuring addiction and gaming disorder.
Evaluation of the item bank identified issues related to: scope (i.e., “scope creep” or items of questionable relevance); language (i.e., confusing language, unusual wording or syntax); and overpathologizing (i.e., pathologizing typical and/or beneficial aspects or consequences of gaming). A total of 71 items across 23 tools had at least one face validity issue.
Most items (83%) demonstrated satisfactory face validity and were consistent with either the DSM-5 or ICD-11 GD classification. However, many tests contain at least one item that may pathologize normal gaming behaviors. Such items refer to basic changes in mood when gaming, a desire to play or continue playing games, and experiencing immersion when gaming. This analysis highlights the challenges of screening for problematic behaviors that are thought to arise within the context of normal recreational activities.
Authors:Joël Billieux, Adriano Schimmenti, Yasser Khazaal, Pierre Maurage, and Alexandre Heeren
Behavioral addiction research has been particularly flourishing over the last two decades. However, recent publications have suggested that nearly all daily life activities might lead to a genuine addiction.
Methods and aim
In this article, we discuss how the use of atheoretical and confirmatory research approaches may result in the identification of an unlimited list of “new” behavioral addictions.
Both methodological and theoretical shortcomings of these studies were discussed.
We suggested that studies overpathologizing daily life activities are likely to prompt a dismissive appraisal of behavioral addiction research. Consequently, we proposed several roadmaps for future research in the field, centrally highlighting the need for longer tenable behavioral addiction research that shifts from a mere criteria-based approach toward an approach focusing on the psychological processes involved.
Authors:Maèva Flayelle, Pierre Maurage, Laurent Karila, Claus Vögele, and Joël Billieux
Background and aims
Binge-watching (i.e., watching multiple episodes of a TV series in one session) has recently become standard practice among TV series viewers; this expansion generates concerns regarding the potential negative outcomes associated with this habit. However, the investigation of its psychological correlates remains fragmentary, with few initial studies a priori conceptualizing this behavior as a new addictive disorder. This study explored these psychological correlates using cluster analysis of binge-watching behavior based on three key psychological factors: motivations, impulsivity, and emotional reactivity.
An online survey was completed by 4,039 TV series viewers. Data were analyzed using hierarchical and non-hierarchical cluster analyses, the validity of the clusters being finally determined through mutual comparisons with a selection of external correlates.
Four clusters were identified: recreational TV series viewers (presenting low involvement in binge-watching), regulated binge-watchers (moderately involved), avid binge-watchers (presenting elevated but non-problematic involvement), and unregulated binge-watchers (presenting potentially problematic involvement associated with negative outcomes).
Discussion and conclusions
This study underlines the heterogeneous and multidetermined nature of binge-watching. Our findings suggest that high engagement in binge-watching is distinct from problematic binge-watching, thus reinforcing the notion that conceptualizing binge-watching as an addictive disorder is of low relevance and might actually lead to the overpathologization of this highly popular leisure activity.
Authors:Maria Di Blasi, Alessandro Giardina, Cecilia Giordano, Gianluca Lo Coco, Crispino Tosto, Joel Billieux, and Adriano Schimmenti
A positive relationship between problematic gaming and escapism motivation to play video games has been well established, suggesting that problematic gaming may result from attempts to deal with negative emotions. However, to date, no study has examined how emotion dysregulation affects both escapism motives and problematic gaming patterns.
Difficulties in emotion regulation, escapism, and problematic involvement with video games were assessed in a sample of 390 World of Warcraft players. A structural equation modeling framework was used to test the hypothesis that escapism mediates the relationship between emotion dysregulation and problematic gaming.
Statistical analyses showed that difficulties in emotion regulation predicted both escapism motives and problematic gaming, and that escapism partially mediated this relationship.
Our findings support the view that problematic players are likely to escape in online games as a maladaptive coping strategy for dealing with adverse emotional experiences.
Authors:Jesús Castro-Calvo, Rafael Ballester-Arnal, Joel Billieux, Beatriz Gil-Juliá, and María Dolores Gil-Llario
Background and aims
Sexual addiction is a pathological behavior characterized by a combination of excessive sexual desire and impaired ability to control it. Its incidence ranges between 1.2% and 32.2%, although this number may vary depending on the screening tool used. This wide variability is largely due to the use of non-validated instruments (e.g., structural validity relying on exploratory analyses, instruments translated without an additional validation process, or instruments validated in another format). To deal with these limitations, this study tested the psychometric properties of the Spanish paper-and-pencil and online versions of the Sexual Addiction Screening Test (SAST).
A total of 2,528 participants (1,163 males) completed the Spanish version of the SAST, along with other instruments assessing sexual compulsivity (1,585 = paper-and-pencil, 943 = online).
The exploratory factor analysis yielded a four-factor structure explaining 57.39% of the variance for the SAST paper-and-pencil version. This factor structure was then verified for the online version through the use of confirmatory factor analysis [χ2(264) = 441.59; χ2/df = 1.66; RMSEA = 0.02; CFI = 0.94; IFI = 0.94]. This methodology was also used to support measurement invariance (configural, metric, and scalar invariance) according to gender. The reliability of the total score ranged from .82 to .85. Similarly, correlations with related scales were positive and significant (r between .22 and .71). Temporal stability 1 year after the first application was 0.65 (paper-and-pencil format) and 0.60 (online version).
These results, together with the absence of questionnaires translated into Spanish to assess this construct, justify the use of the SAST in the evaluation of sexual addiction in Spanish-speaking countries.
Authors:Jory Deleuze, Filip Nuyens, Lucien Rochat, Stéphane Rothen, Pierre Maurage, and Joël Billieux
Background and aims
The DSM-5 includes criteria for diagnosing Internet gaming disorder (IGD) that are adapted from substance abuse and widely used in research and clinical contexts, although evidence supporting their validity remains scarce. This study compared online gamers who do or do not endorse IGD criteria regarding self-control-related abilities (impulsivity, inhibitory control, and decision-making), considered the hallmarks of addictive behaviors.
A double approach was adopted to distinguish pathological from recreational gamers: The first is the classic DSM-5 approach (≥5 criteria required to endorse the IGD diagnosis), and the second consists in using latent class analysis (LCA) for IGD criteria to distinguish gamers’ subgroups. We computed comparisons separately for each approach. Ninety-seven volunteer gamers from the community were recruited. Self-reported questionnaires were used to measure demographic- and game-related characteristics, problematic online gaming (with the Problematic Online Gaming Questionnaire), impulsivity (with the UPPS-P Impulsive Behavior Scale), and depression (with the Beck Depression Inventory-II). Experimental tasks were used to measure inhibitory control (Hybrid-Stop Task) and decision-making abilities (Game of Dice Task).
Thirty-two participants met IGD criteria (33% of the sample), whereas LCA identified two groups of gamers [pathological (35%) and recreational]. Comparisons that used both approaches (DSM-5 and LCA) failed to identify significant differences regarding all constructs except for variables related to actual or problematic gaming behaviors.
The validity of IGD criteria is questioned, mostly with respect to their relevance in distinguishing high engagement from pathological involvement in video games.
Authors:Jesús Castro-Calvo, Rafael Ballester-Arnal, Marc N. Potenza, Daniel L. King, and Joël Billieux
In April 2018, the servers of the popular video game “Fortnite” crashed for 24 hr. During this period, Pornhub (a popular pornographic website) analyzed trends in pornography access, finding that: (a) the percentage of gamers accessing Pornhub increased by 10% and (b) the searches of pornographic videos using the key term “Fortnite” increased by 60%. In this letter, we discuss these observations in the context of ongoing debate regarding the validity of “withdrawal” when applied to problematic involvement in video gaming and the potential use of pornography as a “compensation behavior” during the periods of “forced abstinence” from gaming.