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Li Lin School of Graduate Studies and Department of Psychology, Lingnan University, Hong Kong, China

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Ruyi Ding Department of Psychology, Sun Yat-Sen University, China

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Shiguang Ni Tsinghua Shenzhen International Graduate School, Tsinghua University, China

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Abstract

Background and Aims

Emerging research has identified parents' psychological distress as a potential risk factor that increases adolescents' vulnerability to problematic gaming. This study attempted to address “why” from a relational perspective. We hypothesized that parents' psychological distress may link to adolescents' problematic gaming through the mediation of parent-child relationship quality, while the mediating effects of parent-child relationship quality may vary depending on adolescents' emotion regulation.

Methods

We collected data from 4,835 parent-child dyads in China (parental age = 41.45 ± 4.53 years; adolescent age = 13.50 ± 1.00 years). Structural Equation Modeling (SEM) was utilized to analyze the relationships among the variables under study.

Results

Parent-reported parental depression/anxiety was related to worse adolescent-reported parent-child relationship, which in turn related to more severe adolescent-reported problematic gaming. Moreover, the mediating effects of parent-child relationship quality were weaker when adolescents used more expressive suppression (but not cognitive reappraisal).

Discussion and Conclusions

The findings of this study highlight the need to consider both parent-child relationships and adolescents' active role in their own emotion regulation in order to understand parental influence on adolescent problematic gaming.

Abstract

Background and Aims

Emerging research has identified parents' psychological distress as a potential risk factor that increases adolescents' vulnerability to problematic gaming. This study attempted to address “why” from a relational perspective. We hypothesized that parents' psychological distress may link to adolescents' problematic gaming through the mediation of parent-child relationship quality, while the mediating effects of parent-child relationship quality may vary depending on adolescents' emotion regulation.

Methods

We collected data from 4,835 parent-child dyads in China (parental age = 41.45 ± 4.53 years; adolescent age = 13.50 ± 1.00 years). Structural Equation Modeling (SEM) was utilized to analyze the relationships among the variables under study.

Results

Parent-reported parental depression/anxiety was related to worse adolescent-reported parent-child relationship, which in turn related to more severe adolescent-reported problematic gaming. Moreover, the mediating effects of parent-child relationship quality were weaker when adolescents used more expressive suppression (but not cognitive reappraisal).

Discussion and Conclusions

The findings of this study highlight the need to consider both parent-child relationships and adolescents' active role in their own emotion regulation in order to understand parental influence on adolescent problematic gaming.

Introduction

Despite the multiple merits of playing video games, problematic or addictive use among adolescents has been a matter of growing global concern due to its associations with psychosocial, academic, mental, and physical problems (e.g., Brunborg et al., 2013; see review, King, Delfabbro, Billieux, & Potenza, 2020). The eleventh revision of the International Classification of Diseases (ICD-11; World Health Organization, 2019) has recognized gaming disorder as a formal diagnosis, while the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) also considers it as a condition worthy further clinical research and experience (American Psychiatric Association [APA], 2013). Despite an ongoing debate over the core diagnostic features of gaming disorder, Castro-Calvo et al.’s (2021) study using the Delphi approach suggests that essential features of gaming disorder include loss of control over gaming, gaming despite harm, conflict due to gaming, and remarkable functional impairment.

Adolescents are considered vulnerable to problematic gaming. Previous review studies have pointed out a higher prevalence of problematic gaming among youth compared with other age groups (Stevens, Dorstyn, Delfabbro, & King, 2021), with a prevalence rate of 8.8% and 10.4% among adolescents and young adults, respectively (Gao, Wang, & Dong, 2022). Adolescents are experiencing multiple stressors, while having not yet developed the ability to control their excessive use of digital and video games (King et al., 2020). The risk factors or stressors that might increase adolescents' vulnerability to problematic use include but not are limited to intrapersonal problems (e.g., loneliness, poor academic performance), interpersonal challenges (e.g., lack of social support, poor peer relationship), and adverse family environment (e.g., family dysfunction, lower school engagement) (for meta-analysis review, see Gao et al., 2022; Zhuang et al., 2023). Emerging research has pinpointed another risk – parents' mental health problems. For instance, several studies found that the severity of problematic gaming among adolescents was concurrently and positively associated with parental depression (Lam & Cheng, 2022; Mun & Lee, 2021; Wartberg et al., 2017) and parental anxiety (Wartberg et al., 2017). Also, Jeong et al. (2021) demonstrated that compared with adolescents without emotional problems and depressed parents, those with either or both difficulties were more likely to be classified as addicted gamers one year later. However, the findings were not entirely consistent. Rikkers, Lawrence, Hafekost, and Zubrick (2016) did not find a difference in the prevalence of problematic gaming between adolescents whose parents had medical history of mental problems and those with diagnosis-free parents. Similarly, Wartberg et al. (2017) did not find cross-lagged effects of parental depression and anxiety on adolescents' problematic gaming over a one-year period.

There are two possible explanations that may reconcile the inconsistent results. First, parents' psychological distress may be a distal factor that affects adolescents' problematic gaming through a proximal factor (i.e., indirect effect), and thus the direct effect might be invisible. Additionally, not all adolescents are equally susceptible to the influences of parental psychological distress and thus there is a boundary condition for the effects of parental psychological distress.

This study attempted to address the above-mentioned possibilities from a relational perspective based on the Emotional Security Theory (Cummings & Davies, 1999). Specifically, we proposed that parents' psychological distress may become a risk factor of adolescent problematic gaming because it possibly impairs parent-child relationship. Moreover, systems theories (Bronfenbrenner, 1979; Lerner et al., 2021) contend that adolescents are not passively subjected to parental influence; instead, they play an important role in regulating such environmental influences. Thus, we also considered adolescents' active role in face of parental psychological distress. Past studies (for a review, see Marchica, Mills, Derevensky, & Montreuil, 2019) have suggested that emotion regulation may help reduce problematic gaming. It is thus likely that the mediating effect of parent-child relationship quality may depend on adolescents' use of emotion regulation strategies. We explained this “regulated relational hypothesis” in the following paragraph.

The mediating role of parent-child relationship quality

Emotional Security Theory (EST; Cummings & Davies, 1999), initially derived from attachment theory (Bowlby, 1988), contends that children's emotional security derives from multiple family relationships (including parent-child relationship quality) and plays an important role in their developmental adjustment (Cummings & Warmuth, 2019). Adolescents who perceive their family relationships to be unstable, unresponsive, insecure, or filled with conflicts are more likely to engage in maladaptive behavior (Cummings, Schermerhorn, Keller, & Davies, 2008), while excessive gaming can be one of them.

Parents with distress symptoms may threaten children's emotional security and make children more likely to develop negative representations of family relationships (Cummings et al., 2008). The impaired cognitive functioning, diminished ability to regulate affect, and deficits in relationship management of parents may make them disengage from positive parenting, thwarting supportive parent-child interaction (Albers, Müller, Mehring, & Romer, 2020; Papp, Cummings, & Goeke-Morey, 2005). Symptomatic parents likely make negative and critical appraisals of their children, display negative affect, and use maladaptive parenting styles, which possibly disrupts parent-child relationship quality (Goodman & Gotlib, 1999; Wilson & Durbin, 2010). Supporting this notion, previous studies have found that depressed parents tended to be more intrusive (Mun & Lee, 2023) or neglectful in their discipline (Mun & Lee, 2021) and hostile toward their children (Sellers et al., 2014; for meta-analysis review, see Wilson & Durbin, 2010), while anxious parents tended to be more overprotective and controlling (Borelli, Margolin, & Rasmussen, 2015) but less warm and autonomy-supportive (Moore, Whaley, & Sigman, 2004; Van Der Bruggen, Stams, & Bögels, 2008).

Gaming may serve as a coping strategy in the context of impaired relationships, although such a coping strategy might be maladaptive, and excessive gaming might result in fewer chances to develop healthy approaches to coping with stressors in the long run (Kuss & Griffiths, 2012). Researchers have pointed out that engaging in video games helps adolescents escape from reality in response to familial difficulties and distress (see Nielsen, Favez, & Rigter, 2020; Schneider, King, & Delfabbro, 2017). The model of compensatory Internet use (Kardefelt-Winther, 2014) also contends that unfavorable life experiences or circumstances can motivate adolescents to turn to the online world as a means of alleviating negative emotions or seeking social support. However, such escape or compensatory use possibly makes them more prone to developing dysfunctional patterns of video game use. Indeed, a systematic literature review (Nielsen et al., 2020) has found negative and significant associations between parent-child attachment (including parent-child relationship quality) and children's problematic gaming in 10 out of 14 studies, notwithstanding a small effect size. Altogether, it is plausible that parents' psychological distress may heighten the risk of problematic gaming among adolescents through the mediation of disrupted parent-child relationship.

The moderating role of adolescents' use of emotion regulation strategies

Systems theories in developmental science (e.g., Ecological Systems Theory; Bronfenbrenner, 1979; Relational Developmental Systems Model; Lerner et al., 2021) have acknowledged that human development results from an interaction between individual and environmental factors (including parental factors). These theories contend that adolescents may modulate the parental influence on their development. Parents' psychological distress presumably creates an insecure emotional environment (Cummings et al., 2008), while adolescents could use different emotion regulation strategies in response to this adversity.

Emotion regulation refers to the ability to manage and change individuals' emotional responses to meet ongoing demands of experience in order to achieve their goals (Matsumoto, Yoo, & Nakagawa, 2008). According to the process model of emotion regulation (Gross & John, 2003), cognitive reappraisal and expressive suppression are two commonly used emotion regulation strategies that represent antecedent-focused regulation and response-focused regulation, respectively. Reappraisal refers to reconsidering, reframing, and re-interpreting an emotional situation, which alters its emotional impact; suppression indicates inhibiting or not displaying a facial, verbal, or bodily expression of emotion (McRae, 2016). Although there is no universally adaptive strategy, studies have indicated that reappraisal (relative to suppression) generally brings about more desirable and healthy outcomes, such as better mental health and social functioning (see reviews, Hu et al., 2014; McRae, 2016). In contrast, using suppression might not effectively reduce negative emotions, and may even relate to a variety of psychological and health costs, since it consumes great cognitive resources and thwarts the authentic self (Gross & Cassidy, 2019). A meta-analysis has shown that suppression positively relates to anxiety and depressive symptoms among adolescents (Schäfer, Naumann, Holmes, Tuschen-Caffier, & Samson, 2017). Additionally, studies have demonstrated that reappraisal (but not suppression) can protect adolescents with adverse life experiences or life stressors from developing psychological and behavioral problems (for a review, see Daniel, Abdel-Baki, & Hall, 2020).

Accordingly, using more reappraisal (relative to suppression) may protect adolescents with symptomatic parents from developing an addiction to gaming through impaired parent-child relationship quality. For instance, when their parents demonstrate dysregulated emotions and behavior in their interactions, adolescents who are able to make sense of this situation may avoid provoking more conflicts with their symptomatic parents and thus protect their relationships. However, it is uncertain whether habitually suppressing their own emotions may backfire for Chinese adolescents with symptomatic parents, as the efficacy of suppression depends on cultural context (Matsumoto, Yoo, & Fontaine, 2008). Compared with cultures endorsing independence (e.g., Western White cultures), suppression has been documented to be more adaptive in cultures valuing interdependence (e.g., Eastern Asian cultures), wherein emotional control and restraint are emphasized and encouraged for the sake of social harmony (Butler, Lee, & Gross, 2007; Wei, Su, Carrera, Lin, & Yi, 2013). Therefore, we derived our hypotheses according to the process model of emotional regulation (Gross & John, 2003), but remained open to the possibility that suppression would play a culture-specific role. Specifically, we expected that when adolescents use more cognitive reappraisal (or possibly less expressive suppression), they would be more likely to minimize the harm of parental psychological distress on their parent-child relationship, and also less likely to develop problematic gaming associated with the impaired parent-child relationship.

Aims and hypotheses

To elucidate the association between parental psychological distress and adolescent problematic gaming, this study tested the “regulated relational hypothesis” (see Fig. 1) by using a large sample of Chinese parent-adolescent dyads. Specifically, we expected that parents' psychological distress indicated by depression and anxiety would positively relate to adolescents' problematic gaming (Hypotheses 1a and 1b) via the mediator of parent-child relationship quality (Hypotheses 2a and 2b). We also expected that adolescents' use of cognitive reappraisal and expressive suppression would moderate the effect of parental psychological distress on problematic gaming. We tested whether the effect of parental psychological distress on parent-child relationship quality (Hypotheses 3a and 3b) and the mediating effects (Hypotheses 4a and 4b) of parent-child relationship quality would be weaker when adolescents adopted more cognitive reappraisal or less expressive suppression.

Fig. 1.
Fig. 1.

Illustration of hypothesized relationships among key variables

Note: A indicates adolescent-report, P indicates parent-report; + indicates positive sign of coefficient, − indicates negative sign of coefficient.

Citation: Journal of Behavioral Addictions 12, 4; 10.1556/2006.2023.00060

Methods

Participants and procedure

This study was conducted in 2019 before the Chinese government introduced an online gaming curfew for youngsters to curb online gaming addiction (Huaxia, 2021).1 The electronic invitation was distributed to parents via 36 secondary schools in Shenzhen, an economically developed city in China. One parent and one adolescent child were invited to respond to an online survey. A total of 4,902 families with junior secondary school students participated in this study. We used a bogus item (i.e., I was born on February 30) to detect untrustworthy responses. Participants who provided a “yes” response to this item were removed from the data analyses, which resulted in 4,835 families with valid responses. The average age of parents (69.8% mothers) was 41.45 years old (SD = 4.53) and that of adolescents (45.5% females) was 13.5 years old (SD = 1.00) (for more information about data collection and participant characteristics, see Table S1 in supplementary materials).

Measures

Parents reported their distress symptoms as well as demographic information, and adolescents reported the severity of problematic gaming, parent-child relationship quality, academic performance, and basic personal information. We used Chinese-translated versions of the scales, which have been reliably used in other Chinese samples (e.g., Ding et al., 2022; Dong et al., 2022; Liu et al., 2020; Yang, Zhu, Chen, Song, & Wang, 2016; Yin et al., 2022). The internal consistencies of these scales were all good (see Table 1). Table S2 (in Supplementary Materials) shows the sample items. We took a mean score of the measure to represent the level of each variable.

Table 1.

Means, standard deviations, and reliabilities of key variables

VariableMeanSDRangeSkewnessKurtosisCronbach's α
Parental depression1.45.531–4.11−.29.93
Parental anxiety2.03.581–41.793.98.76
Parent-child relationship3.64.781–5−.14−.44.85
Adolescent problematic gaming1.93.891–5.79.10.93
Emotion regulation
Reappraisal4.961.201–7−.25.14.94
Suppression4.301.311–7.08.01.84

Parental psychological distress

Parents' psychological distress was indexed by depression and anxiety. First, depression was assessed by the depression module of the Patient Health Questionnaire-9 (PHO-9; Kroenke, Spitzer, & Williams, 2001). Parents rated the frequency of nine symptoms in the past two weeks on a 4-point scale (1 = not at all, 4 = nearly every day). Second, anxiety was assessed using a six-item version of the state scale of Spielberger State–Trait Anxiety Inventory (STAI; Marteau & Bekker, 1992; Spielberger, 1983). Parents rated the frequency of six symptoms in the past two weeks on a 4-point scale (1 = very rare, 4 = very often).

Problematic gaming

Adolescents' problematic gaming was measured by the seven-item version of the Game Addiction Scale (GAS-7), developed by Lemmens et al.’s (2009). This scale was created based on seven DSM-based criteria for pathological gaming, including salience, mood management, withdrawal, tolerance, relapse, conflicts, and problems. Adolescents indicated how often they had experienced each problem in the past six months on a five-point scale (0 = never, 4 = always). To provide greater variability, we adopted a symptom-based approach rather than a diagnostic approach to measure problematic gaming, with higher mean scores indicating more severe problematic gaming (see Festl, Scharkow, & Quandt, 2013).

Parent-child relationship quality

Adolescents reported their perceived parent-child relationship quality via the 12-item short version of the Inventory of Parent and Peer Attachment (IPPA) developed by Raja, McGee, and Stanton (1992) based on the original scale of IPPA (Armsden & Greenberg, 1987). Adolescents indicated how well each statement described communication, trust, and alienation in their parent-child relationship on a five-point scale (1 = not true at all, 5 = very true).

Use of emotion regulation strategies

Adolescents reported to what extent each emotion regulation strategy was true of them (1 = not true at all, 7 = very true) using the Emotion Regulation Questionnaire (ERQ; Gross & John, 2003). The ERQ contains six items for cognitive reappraisal and four items for expressive suppression.

Potential confounders

We controlled general demographic characteristics of participants (i.e., parental age, parental gender, parents' education, family income, parents' marriage status, adolescent gender, adolescent grade in school). Additionally, we controlled adolescents' self-reported average academic performance on their latest examinations (1 = under 60 points, 5 = over 90 points).

Data analysis plan

First, we reported the prevalence of problematic gaming in the supplementary materials (see Table S3), although this is not of major interest in the current study. Second, to understand the preliminary relationships among key variables, we computed Pearson's correlations via IBM SPSS26.0. Third, to elucidate how the risk of parental psychological distress translates to adolescents' problematic gaming, we estimated a full mediation model via the Lavaan package in R program (Rosseel, 2012). As shown in Fig. 1, we tested both the direct effects of parental depression/anxiety on adolescents' problematic gaming, as well as their indirect effects via the mediator of parent-child relationship quality. We controlled a series of demographic variables (i.e., parental age, parental gender, parents' education levels, family income, parents' marital status, adolescents' grade in school, and adolescents' gender) and adolescent-reported academic performance. Maximum likelihood estimation was used to determine the values of the parameters. The bootstrapping approach (subsample = 5,000) was applied to estimate the 95% confidence intervals (CIs) of the path parameters, as well as indirect effects, direct effects, and total effects. The values were regarded as statistically significant if the 95% CI did not include zero (Hayes, 2013).

Further, we tested whether the indirect effects of parental depression/anxiety on adolescent problematic gaming via parent-child relationship quality varied depending on the levels of adolescents' use of emotion regulation strategies (i.e., moderated mediation). Specifically, the associations between parental depression/anxiety and parent-child relationship quality were contingent on adolescents' use of cognitive reappraisal and expressive suppression, respectively. To avoid multicollinearity and facilitate the interpretation of the effects, we standardized the values of parental depression, parental anxiety, adolescent reappraisal, and adolescent suppression within the sample. We also computed interaction terms as predictors, with parental psychological distress (i.e., depression or anxiety) multiplying adolescent emotion regulation strategies (i.e., reappraisal and suppression). Similarly, 95% CIs of the moderated mediation effects were estimated with 5,000 bootstrap samples. For model evaluation, we referred to the comparative fit index (acceptable fit: CFI ≥0.9), Tucker-Lewis Index (acceptable fit: TLI ≥0.9), and root mean square error of approximation (acceptable fit: RMSEA ≤0.08; Kline, 2005).

Ethics

The parents and adolescents who agreed to join this study completed the survey in a self-administrated manner by using their own electronic devices (e.g., tablet or smartphone). Before participating, both parents and adolescents had signed the informed consent form. Ethics approval was obtained from the ethics committee of Tsinghua Shenzhen International Graduate School, Tsinghua University.

Results

Prevalence rate

We followed the scoring of Festl et al. (2013). Participants who chose “sometimes”, “often” or “always” for at least four out of seven items were coded as problematic game users, and those who chose these options for all seven items were coded as addicted game users. Accordingly, we found that 16.8% and 13.1% of the adolescents demonstrated symptoms of problematic and addictive gaming, respectively (see more results and discussion in Table S3 of supplementary materials).

Mediation analysis

As shown in Table 2, Pearson correlations showed that parents' depression and anxiety were negatively associated with adolescents' perceived parent-child relationship quality and positively associated with the severity of their problematic gaming (supporting Hypotheses 1a and 1b), and parent-child relationship was negatively associated with adolescents' problematic gaming. Furthermore, in the mediation models of parental depression (CFI = 0.999; TLI = 0.996; RMSEA = 0.009) and parental anxiety (CFI = 0.999; TLI = 0.996; RMSEA = 0.009), we found significant indirect effects of parental depression (b = 0.086) and parental anxiety (b = 0.106) (see Table 3). Specifically, parental depression (b = −0.303) and anxiety (b = −0.345) were negatively associated with parent-child relationship quality, which was in turn negatively associated with adolescent problematic gaming (b = −0.284; b = −0.307). Supporting Hypotheses 2a and 2b, these findings suggest that parental psychological distress relates to the severity of adolescents' addictive gaming through the impaired parent-child relationship. The direct effects of parental depression (b = 0.342) and parental anxiety (b = 0.137) on adolescent problematic gaming remained significant, suggesting that parent-child relationship quality was not the single mediator accounting for the effects of parental depression and parental anxiety.

Table 2.

Correlations among key variables and covariates

12345678910111213
1. Parental depression
2. Parental anxiety.461***
3. Parent-child relationship−.307***−.243***
4. Adolescent problematic gaming.197***.285***−.336***
5. Reappraisal−.118***−.063***.289***−.064***
6. Suppression.092***.119***−.096***.082***.166***
7. Parental age−.026.002−.014.025.010.001
8. Parental gender.023.062***−.025.067***−.013.023.270***
9. Parental education−.147***−.069***.128***−.035*.048**−.093***.100***.072***
10. Family income−.153***−.105***.138***−.037*.070***−.073***.025.022.491***
11. Parents' marriage status−.026−.046**.021−.036*.025−.028−.051**−.042**−.016.015
12. Adolescent grade.043.048**−.069***.042**−.016−.003.153***.002−.027−.024.003
13. Adolescent gender.006.021.002.262***.018.043**.056***.174***.003−.010−.002−.001
14. Adolescents' academic performance−.195***−.129***.271***−.238***.127***−.060***.031*−.020.283***.248***.056***−.104***−.028*

Note. Gender: 1 = male, 0 = female; marital status: 1 = married, 0 = other status (i.e., single, widowed, divorced, remarried); Adolescent grade (as a continuous variable): 1 = 7th grade, 2 = 8th grade, 3 = 9th grade; *p < 0.05, **p < .01 ***p < .001.

Table 3.

Results of mediation analyses

Parental depressionParental anxiety
B (SE)p95%CIB (SE)p95%CI
PD/PA → PCR−.303 (.020)<.001[−.344, −.265]−.345 (.019)<.001[−.382, −.308]
PCR → AGAa−.284 (.016)<.001[−.316, −.252]−.307 (.016)<.001[−.339, −.276]
Indirect effect:

PD/PA → PCR → AGA
.086 (.007)<.001[.072, .101].106 (.008)<.001[.091, .122]
Direct effect:

PD/PA → AGA
.342 (.027)<.001[.288, .396].137 (.021)<.001[.095, .178]
Total effect.428 (.028)<.001[.373, .481].243 (.021)<.001[.202, .284]

Note. PD = parental depression, PA = parental anxiety, PCR = parent-child relationship, AGA = adolescents' problematic gaming. The covariates include parental age, parents' gender, parents' education, family income, parents' marital status, adolescents' grade, adolescents' gender, adolescents' self-reported academic performance; a Controlling for parental depression or parental anxiety.

Moderated mediation analysis

Moderated mediation models of parental depression (CFI = 0.989; TLI = 0.965; RMSEA = 0.020) and parental anxiety (CFI = 0.968; TLI = 0.934; RMSEA = 0.027) fitted the data well. The moderating effects and moderated mediation effects of reappraisal were not significant in both models, and thus did not support Hypotheses 3a and 3b (see Table 4). We found a significant interaction effect of parent depression and suppression (b = 0.052) and a significant interaction effect of parent anxiety and suppression (b = 0.031) on parent-child relationship quality. Also, we found significant moderated mediation effects of suppression in the models of parental depression (b = −0.015) and parental anxiety (b = −0.005). However, the findings were inconsistent with Hypothesis 3b and 4b. Specifically, when adolescents used more suppression strategies, parents' depression and anxiety were less likely to link with their parent-child relationship quality which further related to their problematic gaming. The mediating effect of parent-child relationship quality was weaker at a high level of suppression (i.e., one SD above the mean), compared with the effect at a low level of suppression (i.e., one SD below the mean).

Table 4.

Results of moderated mediation analyses

Parental DepressionParental Anxiety
B(SE)p95%CIBp95%CI
PD → PCR−.158 (.010).000[−.177, −.138]−.177 (.011).000[−.198, −.156]
Reappraisal → PCR.204 (.012).000[.182, .227].197 (.011).000[.175, .220]
Suppression → PCR−.073 (.012).000[−.097, −.051]−.077 (.011).000[−.100, −.054]
PD/PA × Reappraisal → PCR−.019 (.010).068[−.040, .001]−.017 (.011).108[−.039, .004]
PD/PA × Suppression → PCR.052 (.010).000[.032, .073].031 (.011).006[.008, .052]
PCR → AGAa−.284 (.016).000[−.315, −.253]−.159 (.008).000[−.175, −.143]
Direct effect: PD/PA → AGA.182 (.015).000[.153, .211].041 (.006).000[.029, .053]
Indirect effect.045 (.004).000[0.038, .052].028 (.002).000[.024, .033]
Conditional indirect effect_reapprasial.005 (.003).070[.000, .011].003 (.002).109[−.001, .006]
Conditional indirect effect_suppression−.015 (.003).000[−.021, −.009]−.005 (.002).007[−.008, −.001]
Total effect.226 (.015).000[.197, .256].069 (.006).000[.057, .082]
Decompose interaction effect on PCR
 High suppression−.105 (.013).000[−.131, −.079]−.146 (.016).000[−.179, −.116]
 Low suppression−.210 (.016).000[−.242, −.179]−.207 (.015).000[−.238, −.178]
Decompose conditional indirect effect
 High suppression.030 (.004).000[.022, .038].023 (.003).000[.018, .029]
 Low suppression.060 (.006).000[.049, .071].033 (.003).000[.027, .039]

Note. PD = parental depression, PA = parental anxiety, PCR = parent-child relationship, AGA = adolescents' problematic gaming; The covariates include parental age, parents' gender, parents' education, family income, parents' marital status, adolescents' grade, adolescents' gender, adolescents' self-reported academic performance. a Controlling for parental depression or parental anxiety. Bold numbers indicate significant moderation and moderated mediation effects.

Discussion

Adolescents are susceptible to problematic gaming, which has become a public concern (Fam, 2018). We investigated whether parental psychological distress is a risk factor for adolescent problematic gaming, and probed into its mechanisms by testing the “regulated relational hypothesis”. Results demonstrated that parent-reported depression and anxiety were associated with adolescent-reported problematic gaming through the mediation of adolescent-reported parent-child relationship quality. Furthermore, when adolescents used more expressive suppression to regulate emotion, their parent-child relationships were less likely to be affected by parents' distress, thus weakening the mediating effect of parent-child relationship quality. These findings contribute to the advancement of scientific research and bear significant practical implications.

This study highlights that parents' depressive and anxiety symptoms may elevate the risks for problematic gaming among adolescents and provides a potential account for understanding its mechanisms. Our findings add to the literature that has attempted to understand children and adolescents' addictive behavior in relation to parents' mental health status (e.g., Lam & Cheng, 2022; Mun & Lee, 2021, 2023). Furthermore, it might be through disruptions in parent-child relationship that parents' distress symptoms link to adolescents' elevated risk of problematic gaming. Previous studies have suggested that parent-child relationships may link parents' psychological distress to behavioral problems (McCarty & McMahon, 2003; Sellers et al., 2014). Symptomatic parents, who tend to withdraw from adaptive interactions with their offspring and display malfunctioning affect and behavior, probably impair their relationships with their adolescent offspring, at least in the eyes of the adolescents. Poor parent-child relationship quality can further increase the severity of problematic gaming because video gaming is an appealing coping strategy that allows individuals to escape from the frustrations of reality and compensate for their loss of warmth and support from family (Kardefelt-Winther, 2014). Although we could not exclude other possible mechanisms such as intergenerational transmission of mental problems (Lam, 2020), the relational perspective implies that to minimize parental influence of psychological distress, it is important to identify factors that protect the parent-child relationship.

Next, the present study extends the literature by including the role of adolescents' emotion regulation in the pathway to problematic gaming. Going beyond theories that focus on parental influences on children's behavioral problems (e.g., EST, Cummings et al., 2008), the current study highlights the importance of not only parent-child bonding but also adolescents' active role in this process. Partially inconsistent with our expectations, expressive suppression rather than cognitive reappraisal acted as a buffer in the direct effects of parental psychological distress on adolescents' problematic gaming and its indirect effects through parent-child relationship quality. This finding is also consistent with the literature that documents the “positive” role of suppression in the Chinese context where maintaining self-restraint for social harmony is highly valued (e.g., Wei et al., 2013). Moreover, past studies have suggested that in emotion-provoking situations, cognitive reappraisal that requires one to override original negative appraisal depletes considerable self-control resource (Ortner, Corno, Fung, & Rapinda, 2018; Sheppes et al., 2014). Parents with psychological distress may frequently express negative emotions (Cummings, Cheung, & Davies, 2013), potentially evoking intense and negative emotional situations. It may be too demanding to use reappraisal. In contrast, expressive suppression can be helpful because it can change the environment by changing the interaction with parents. It is plausible that adolescents' usage of expressive suppression (e.g., not displaying negativity to their symptomatic parents) helps to reduce parent-child conflict and facilitate communication. A past study found that expressive suppression could help to avoid the escalation of conflict within the relationship (van Kleef & Côté, 2007). However, as our study only investigated concurrent associations, we could not exclude the possibility that using suppression in the face of parental psychological distress might bring about detrimental impacts in the long run. Therefore, inferences about the use of suppression should be made with caution.

Limitations and future directions

This study has several limitations. First, this study has a cross-sectional design and thus could not infer causal relationships of variables and confirm the directionality of the relationships. Previous research (e.g., Da Charlie, HyeKyung, & Khoo, 2011) has suggested that adolescents' problematic gaming possibly triggers deterioration of the parent-child relationship. However, Wartberg et al. (2017) found that adolescents' gaming disorder was not a significant predictor of parental anxiety over one year. Future studies will benefit from a longitudinal design to study the possible bidirectional relationship and trace the long-term influence of parental psychological distress on adolescents' development of problematic gaming. Second, this study did not differentiate online games from offline games. Future studies could examine whether online gaming (vs. offline gaming) provides more social resources to compensate for adolescents' deficit needs for affiliation and whether the link between parental psychological distress and adolescent problematic gaming may be strengthened in an online setting. Third, mothers (vs. fathers) are overrepresented in this sample. Mothers were more responsive than fathers to the invitation probably because mothers often served as the main caregivers. Although we did not find differences by parental gender in this study, future studies might explore if the effect of parental psychological distress differs by the role of the primary caregiver. Finally, we used single informant in this study, but the literature has pointed to a divergency between parent-report and adolescent-report, particularly on family relationships (De Los Reyes, Ohannessian, & Racz, 2019). To further test the generalizability of our hypothesis, future studies would benefit from involving multiple informants (see Pivetta et al., 2023).

Conclusion

Despite the aforementioned limitations, our study provides novel insights regarding the link between parental psychological distress and adolescent problematic gaming. The findings suggest that this link may be, in part, mediated by parent-child relationship quality, and that the strength of this link may depend on adolescents' use of expressive suppression as an emotion-regulating strategy. We hope to enlighten researchers to study other addictive behaviors from this regulated relational perspective. This study also suggests that practitioners should consider parents' mental health and children's emotion regulation in their prevention or intervention of adolescent problematic gaming. Practitioners should inquire about parents' mental health status when their adolescent clients show signs of being addicted to gaming. Although it may not be advisable to encourage those adolescents to inhibit their emotional expression, the use of expression suppression in some situations might be helpful. Practitioners could discuss this strategy with those adolescents and pay more attention to their role in active regulation.

Funding sources

This research was funded by the Shenzhen Key Laboratory of next generation interactive media innovative technology (Grant No. ZDSYS20210623092001004), the Shenzhen Key Research Base of Humanities and Social Sciences (Grant No. 202003), Shenzhen Education Science 2021 Annual Project (Grant No. bskt21001), Lingnan University Research Seed Fund (Grant No. 102249), and Guangdong Philosophy and social Sciences Planning Project (Grant No. GD23SQXY01).

Authors' contribution

LL: conceptualization, formal analysis, writing - original draft. RD: conception of the project, data collection, interpretation of data, revising the manuscript critically. SN: conception of the project, data collection, supervision. All authors provided critical feedback and helped shape the research, analysis, and manuscript.

Conflict of interest

The authors declare no conflict of interest.

Supplementary material

Supplementary data to this article can be found online at https://doi.org/10.1556/2006.2023.00060.

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1

Due to the heightened concern about gaming addiction of children and adolescents, Chinese government has issued strict regulations on youngsters' video game usage since August 2021. This regulation required the gaming companies to implement a daily limit of 90 min on weekdays and three hours on weekends and holidays for their underage users.

Supplementary Materials

  • Albers, C. C., Müller, J. M., Mehring, K., & Romer, G. (2020). Is a mother's recalled parental rearing behavior, her attributions of her child's behavior, and her psychological distress associated with her mother–child relationship quality? Infant Mental Health Journal, 41(3), 378392. https://doi.org/10.1002/imhj.21850.

    • Search Google Scholar
    • Export Citation
  • American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596.

    • Search Google Scholar
    • Export Citation
  • Armsden, G. C., & Greenberg, M. T. (1987). The inventory of parent and peer attachment: Individual differences and their relationship to psychological well-being in adolescence. Journal of Youth and Adolescence, 16(5), 427454. https://doi.org/10.1007/bf02202939.

    • Search Google Scholar
    • Export Citation
  • Borelli, J. L., Margolin, G., & Rasmussen, H. F. (2015). Parental overcontrol as a mechanism explaining the longitudinal association between parent and child anxiety. Journal of Child and Family Studies, 24(6), 15591574. https://doi.org/10.1007/s10826-014-9960-1.

    • Search Google Scholar
    • Export Citation
  • Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York, NY: Basic Books.

  • Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press. https://doi.org/10.1126/science.207.4431.634.

    • Search Google Scholar
    • Export Citation
  • Brunborg, G. S., Mentzoni, R. A., Melkevik, O. R., Torsheim, T., Samdal, O., Hetland, J., … Palleson, S. (2013). Gaming addiction, gaming engagement, and psychological health complaints among Norwegian adolescents. Media Psychology, 16(1), 115128. https://doi.org/10.1080/15213269.2012.756374.

    • Search Google Scholar
    • Export Citation
  • Butler, E. A., Lee, T. L., & Gross, J. J. (2007). Emotion regulation and culture: Are the social consequences of emotion suppression culture-specific? Emotion, 7(1), 3048. https://doi.org/10.1037/1528-3542.7.1.30.

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The author instruction is available in PDF.
Please, download the file from HERE

Dr. Zsolt Demetrovics
Institute of Psychology, ELTE Eötvös Loránd University
Address: Izabella u. 46. H-1064 Budapest, Hungary
Phone: +36-1-461-2681
E-mail: jba@ppk.elte.hu

Indexing and Abstracting Services:

  • Web of Science [Science Citation Index Expanded (also known as SciSearch®)
  • Journal Citation Reports/Science Edition
  • Social Sciences Citation Index®
  • Journal Citation Reports/ Social Sciences Edition
  • Current Contents®/Social and Behavioral Sciences
  • EBSCO
  • GoogleScholar
  • PsycINFO
  • PubMed Central
  • SCOPUS
  • Medline
  • CABI
  • CABELLS Journalytics

2022  
Web of Science  
Total Cites
WoS
5713
Journal Impact Factor 7.8
Rank by Impact Factor

Psychiatry (SCIE) 18/155
Psychiatry (SSCI) 13/144

Impact Factor
without
Journal Self Cites
7.2
5 Year
Impact Factor
8.9
Journal Citation Indicator 1.42
Rank by Journal Citation Indicator

Psychiatry 35/264

Scimago  
Scimago
H-index
69
Scimago
Journal Rank
1.918
Scimago Quartile Score Clinical Psychology Q1
Medicine (miscellaneous) Q1
Psychiatry and Mental Health Q1
Scopus  
Scopus
Cite Score
11.1
Scopus
Cite Score Rank
Clinical Psychology 10/292 (96th PCTL)
Psychiatry and Mental Health 30/531 (94th PCTL)
Medicine (miscellaneous) 25/309 (92th PCTL)
Scopus
SNIP
1.966

 

 
2021  
Web of Science  
Total Cites
WoS
5223
Journal Impact Factor 7,772
Rank by Impact Factor Psychiatry SCIE 26/155
Psychiatry SSCI 19/142
Impact Factor
without
Journal Self Cites
7,130
5 Year
Impact Factor
9,026
Journal Citation Indicator 1,39
Rank by Journal Citation Indicator

Psychiatry 34/257

Scimago  
Scimago
H-index
56
Scimago
Journal Rank
1,951
Scimago Quartile Score Clinical Psychology (Q1)
Medicine (miscellaneous) (Q1)
Psychiatry and Mental Health (Q1)
Scopus  
Scopus
Cite Score
11,5
Scopus
CIte Score Rank
Clinical Psychology 5/292 (D1)
Psychiatry and Mental Health 20/529 (D1)
Medicine (miscellaneous) 17/276 (D1)
Scopus
SNIP
2,184

2020  
Total Cites 4024
WoS
Journal
Impact Factor
6,756
Rank by Psychiatry (SSCI) 12/143 (Q1)
Impact Factor Psychiatry 19/156 (Q1)
Impact Factor 6,052
without
Journal Self Cites
5 Year 8,735
Impact Factor
Journal  1,48
Citation Indicator  
Rank by Journal  Psychiatry 24/250 (Q1)
Citation Indicator   
Citable 86
Items
Total 74
Articles
Total 12
Reviews
Scimago 47
H-index
Scimago 2,265
Journal Rank
Scimago Clinical Psychology Q1
Quartile Score Psychiatry and Mental Health Q1
  Medicine (miscellaneous) Q1
Scopus 3593/367=9,8
Scite Score  
Scopus Clinical Psychology 7/283 (Q1)
Scite Score Rank Psychiatry and Mental Health 22/502 (Q1)
Scopus 2,026
SNIP  
Days from  38
submission  
to 1st decision  
Days from  37
acceptance  
to publication  
Acceptance 31%
Rate  

2019  
Total Cites
WoS
2 184
Impact Factor 5,143
Impact Factor
without
Journal Self Cites
4,346
5 Year
Impact Factor
5,758
Immediacy
Index
0,587
Citable
Items
75
Total
Articles
67
Total
Reviews
8
Cited
Half-Life
3,3
Citing
Half-Life
6,8
Eigenfactor
Score
0,00597
Article Influence
Score
1,447
% Articles
in
Citable Items
89,33
Normalized
Eigenfactor
0,7294
Average
IF
Percentile
87,923
Scimago
H-index
37
Scimago
Journal Rank
1,767
Scopus
Scite Score
2540/376=6,8
Scopus
Scite Score Rank
Cllinical Psychology 16/275 (Q1)
Medicine (miscellenous) 31/219 (Q1)
Psychiatry and Mental Health 47/506 (Q1)
Scopus
SNIP
1,441
Acceptance
Rate
32%

 

Journal of Behavioral Addictions
Publication Model Gold Open Access
Submission Fee none
Article Processing Charge 990 EUR/article for articles submitted after 30 April 2023 (850 EUR for articles submitted prior to this date)
Regional discounts on country of the funding agency World Bank Lower-middle-income economies: 50%
World Bank Low-income economies: 100%
Further Discounts Corresponding authors, affiliated to an EISZ member institution subscribing to the journal package of Akadémiai Kiadó: 100%.
Subscription Information Gold Open Access

Journal of Behavioral Addictions
Language English
Size A4
Year of
Foundation
2011
Volumes
per Year
1
Issues
per Year
4
Founder Eötvös Loránd Tudományegyetem
Founder's
Address
H-1053 Budapest, Hungary Egyetem tér 1-3.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2062-5871 (Print)
ISSN 2063-5303 (Online)

Senior editors

Editor(s)-in-Chief: Zsolt DEMETROVICS

Assistant Editor(s): Csilla ÁGOSTON

Associate Editors

  • Stephanie ANTONS (Universitat Duisburg-Essen, Germany)
  • Joel BILLIEUX (University of Lausanne, Switzerland)
  • Beáta BŐTHE (University of Montreal, Canada)
  • Matthias BRAND (University of Duisburg-Essen, Germany)
  • Ruth J. van HOLST (Amsterdam UMC, The Netherlands)
  • Daniel KING (Flinders University, Australia)
  • Gyöngyi KÖKÖNYEI (ELTE Eötvös Loránd University, Hungary)
  • Ludwig KRAUS (IFT Institute for Therapy Research, Germany)
  • Marc N. POTENZA (Yale University, USA)
  • Hans-Jurgen RUMPF (University of Lübeck, Germany)

Editorial Board

  • Max W. ABBOTT (Auckland University of Technology, New Zealand)
  • Elias N. ABOUJAOUDE (Stanford University School of Medicine, USA)
  • Hojjat ADELI (Ohio State University, USA)
  • Alex BALDACCHINO (University of Dundee, United Kingdom)
  • Alex BLASZCZYNSKI (University of Sidney, Australia)
  • Judit BALÁZS (ELTE Eötvös Loránd University, Hungary)
  • Kenneth BLUM (University of Florida, USA)
  • Henrietta BOWDEN-JONES (Imperial College, United Kingdom)
  • Wim VAN DEN BRINK (University of Amsterdam, The Netherlands)
  • Gerhard BÜHRINGER (Technische Universität Dresden, Germany)
  • Sam-Wook CHOI (Eulji University, Republic of Korea)
  • Damiaan DENYS (University of Amsterdam, The Netherlands)
  • Jeffrey L. DEREVENSKY (McGill University, Canada)
  • Naomi FINEBERG (University of Hertfordshire, United Kingdom)
  • Marie GRALL-BRONNEC (University Hospital of Nantes, France)
  • Jon E. GRANT (University of Minnesota, USA)
  • Mark GRIFFITHS (Nottingham Trent University, United Kingdom)
  • Anneke GOUDRIAAN (University of Amsterdam, The Netherlands)
  • Heather HAUSENBLAS (Jacksonville University, USA)
  • Tobias HAYER (University of Bremen, Germany)
  • Susumu HIGUCHI (National Hospital Organization Kurihama Medical and Addiction Center, Japan)
  • David HODGINS (University of Calgary, Canada)
  • Eric HOLLANDER (Albert Einstein College of Medicine, USA)
  • Jaeseung JEONG (Korea Advanced Institute of Science and Technology, Republic of Korea)
  • Yasser KHAZAAL (Geneva University Hospital, Switzerland)
  • Orsolya KIRÁLY (Eötvös Loránd University, Hungary)
  • Emmanuel KUNTSCHE (La Trobe University, Australia)
  • Hae Kook LEE (The Catholic University of Korea, Republic of Korea)
  • Michel LEJOXEUX (Paris University, France)
  • Anikó MARÁZ (Humboldt-Universität zu Berlin, Germany)
  • Giovanni MARTINOTTI (‘Gabriele d’Annunzio’ University of Chieti-Pescara, Italy)
  • Astrid MÜLLER  (Hannover Medical School, Germany)
  • Frederick GERARD MOELLER (University of Texas, USA)
  • Daniel Thor OLASON (University of Iceland, Iceland)
  • Nancy PETRY (University of Connecticut, USA)
  • Bettina PIKÓ (University of Szeged, Hungary)
  • Afarin RAHIMI-MOVAGHAR (Teheran University of Medical Sciences, Iran)
  • József RÁCZ (Hungarian Academy of Sciences, Hungary)
  • Rory C. REID (University of California Los Angeles, USA)
  • Marcantanio M. SPADA (London South Bank University, United Kingdom)
  • Daniel SPRITZER (Study Group on Technological Addictions, Brazil)
  • Dan J. STEIN (University of Cape Town, South Africa)
  • Sherry H. STEWART (Dalhousie University, Canada)
  • Attila SZABÓ (Eötvös Loránd University, Hungary)
  • Ferenc TÚRY (Semmelweis University, Hungary)
  • Alfred UHL (Austrian Federal Health Institute, Austria)
  • Róbert URBÁN  (ELTE Eötvös Loránd University, Hungary)
  • Johan VANDERLINDEN (University Psychiatric Center K.U.Leuven, Belgium)
  • Alexander E. VOISKOUNSKY (Moscow State University, Russia)
  • Aviv M. WEINSTEIN  (Ariel University, Israel)
  • Kimberly YOUNG (Center for Internet Addiction, USA)

 

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