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Authors: 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

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.)

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
Authors: Olatz Lopez-Fernandez, Daria J. Kuss, Lucia Romo, Yannick Morvan, Laurence Kern, Pierluigi Graziani, Amélie Rousseau, Hans-Jürgen Rumpf, Anja Bischof, Ann-Kathrin Gässler, Adriano Schimmenti, Alessia Passanisi, Niko Männikkö, Maria Kääriänen, Zsolt Demetrovics, Orsolya Király, Mariano Chóliz, Juan José Zacarés, Emilia Serra, Mark D. Griffiths, Halley M. Pontes, Bernadeta Lelonek-Kuleta, Joanna Chwaszcz, Daniele Zullino, Lucien Rochat, Sophia Achab and Joël Billieux

Background and aims

Despite many positive benefits, mobile phone use can be associated with harmful and detrimental behaviors. The aim of this study was twofold: to examine (a) cross-cultural patterns of perceived dependence on mobile phones in ten European countries, first, grouped in four different regions (North: Finland and UK; South: Spain and Italy; East: Hungary and Poland; West: France, Belgium, Germany, and Switzerland), and second by country, and (b) how socio-demographics, geographic differences, mobile phone usage patterns, and associated activities predicted this perceived dependence.

Methods

A sample of 2,775 young adults (aged 18–29 years) were recruited in different European Universities who participated in an online survey. Measures included socio-demographic variables, patterns of mobile phone use, and the dependence subscale of a short version of the Problematic Mobile Phone Use Questionnaire (PMPUQ; Billieux, Van der Linden, & Rochat, 2008).

Results

The young adults from the Northern and Southern regions reported the heaviest use of mobile phones, whereas perceived dependence was less prevalent in the Eastern region. However, the proportion of highly dependent mobile phone users was more elevated in Belgium, UK, and France. Regression analysis identified several risk factors for increased scores on the PMPUQ dependence subscale, namely using mobile phones daily, being female, engaging in social networking, playing video games, shopping and viewing TV shows through the Internet, chatting and messaging, and using mobile phones for downloading-related activities.

Discussion and conclusions

Self-reported dependence on mobile phone use is influenced by frequency and specific application usage.

Open access
Authors: John B. Saunders, Wei Hao, Jiang Long, Daniel L. King, Karl Mann, Mira Fauth-Bühler, Hans-Jürgen Rumpf, Henrietta Bowden-Jones, Afarin Rahimi-Movaghar, Thomas Chung, Elda Chan, Norharlina Bahar, Sophia Achab, Hae Kook Lee, Marc Potenza, Nancy Petry, Daniel Spritzer, Atul Ambekar, Jeffrey Derevensky, Mark D. Griffiths, Halley M. Pontes, Daria Kuss, Susumu Higuchi, Satoko Mihara, Sawitri Assangangkornchai, Manoj Sharma, Ahmad El Kashef, Patrick Ip, Michael Farrell, Emanuele Scafato, Natacha Carragher and Vladimir Poznyak

Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%–15% among young people in several Asian countries and of 1%–10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11.

Open access

Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective

Commentary on: A weak scientific basis for gaming disorder: Let us err on the side of caution (van Rooij et al., 2018)

Authors: Hans-Jürgen Rumpf, Sophia Achab, Joël Billieux, Henrietta Bowden-Jones, Natacha Carragher, Zsolt Demetrovics, Susumu Higuchi, Daniel L. King, Karl Mann, Marc Potenza, John B. Saunders, Max Abbott, Atul Ambekar, Osman Tolga Aricak, Sawitri Assanangkornchai, Norharlina Bahar, Guilherme Borges, Matthias Brand, Elda Mei-Lo Chan, Thomas Chung, Jeff Derevensky, Ahmad El Kashef, Michael Farrell, Naomi A. Fineberg, Claudia Gandin, Douglas A. Gentile, Mark D. Griffiths, Anna E. Goudriaan, Marie Grall-Bronnec, Wei Hao, David C. Hodgins, Patrick Ip, Orsolya Király, Hae Kook Lee, Daria Kuss, Jeroen S. Lemmens, Jiang Long, Olatz Lopez-Fernandez, Satoko Mihara, Nancy M. Petry, Halley M. Pontes, Afarin Rahimi-Movaghar, Florian Rehbein, Jürgen Rehm, Emanuele Scafato, Manoi Sharma, Daniel Spritzer, Dan J. Stein, Philip Tam, Aviv Weinstein, Hans-Ulrich Wittchen, Klaus Wölfling, Daniele Zullino and Vladimir Poznyak

The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate over the past year. Besides the broad support for the decision in the academic press, a recent publication by van Rooij et al. (2018) repeated the criticism raised against the inclusion of GD in ICD-11 by Aarseth et al. (2017). We argue that this group of researchers fails to recognize the clinical and public health considerations, which support the WHO perspective. It is important to recognize a range of biases that may influence this debate; in particular, the gaming industry may wish to diminish its responsibility by claiming that GD is not a public health problem, a position which maybe supported by arguments from scholars based in media psychology, computer games research, communication science, and related disciplines. However, just as with any other disease or disorder in the ICD-11, the decision whether or not to include GD is based on clinical evidence and public health needs. Therefore, we reiterate our conclusion that including GD reflects the essence of the ICD and will facilitate treatment and prevention for those who need it.

Open access