Cross-sectional and longitudinal epidemiological studies of Internet gaming disorder: A systematic review of the literature.
01 Jul 2017-Psychiatry and Clinical Neurosciences (Psychiatry Clin Neurosci)-Vol. 71, Iss: 7, pp 425-444
TL;DR: The diagnostic criteria of Internet gaming disorder (IGD) have been included in section III of DSM‐5 and cross‐sectional and longitudinal epidemiological studies of IGD are reviewed.
Abstract: Aim
The diagnostic criteria of Internet Gaming Disorder (IGD) have been included in section III of DSM-5. This study aims to systematically review both cross-sectional and longitudinal epidemiological studies of IGD.
Methods
All publications included in PubMed and PsychINFO up to May 2016 were systematically searched to identify cross-sectional studies on prevalence and longitudinal studies of IGD. In the process of identification, articles in non-English languages, and studies focusing solely on the use of gaming were excluded, and those meeting the methodological requirements set by this review were included. As a result, 37 cross-sectional and 13 longitudinal studies were selected for review.
Results
The prevalence of IGD in the total samples ranged from 0.7% to 27.5%. The prevalence was higher among males than females in the vast majority of studies and tended to be higher among younger rather than older people in some studies. Geographical region made little difference to prevalence. Factors associated with IGD were reported in 28 of 37 cross-sectional studies. These were diverse and covered gaming, demographic and familial factors, interpersonal relations, social and school functioning, personality, psychiatric comorbidity and physical health conditions. Longitudinal studies identified risk and protective factors, and health and social consequences of IGD. The natural course of IGD was diverse but tended to be more stable among adolescents compared to adults.
Conclusion
Although existing epidemiological studies have provided useful data, differences in methodologies make it difficult to compare the findings of these studies when drawing consensus. Future international studies using reliable and uniform methods are warranted.
Citations
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University of Queensland1, Central South University2, University of Adelaide3, Heidelberg University4, University of Lübeck5, Imperial College London6, Tehran University of Medical Sciences7, Hong Kong Department of Health8, Catholic University of Korea9, Yale University10, University of Connecticut11, All India Institute of Medical Sciences12, McGill University13, Nottingham Trent University14, Prince of Songkla University15, National Institute of Mental Health and Neurosciences16, Li Ka Shing Faculty of Medicine, University of Hong Kong17, National Drug and Alcohol Research Centre18
TL;DR: 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.
Abstract: 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.
321 citations
TL;DR: The scientific literature on IGD is reviewed to provide an overview focusing on definitions, symptoms, prevalence, and aetiology.
Abstract: Aim Internet gaming disorder (IGD) is a serious disorder leading to and maintaining pertinent personal and social impairment. IGD has to be considered in view of heterogeneous and incomplete concepts. We therefore reviewed the scientific literature on IGD to provide an overview focusing on definitions, symptoms, prevalence, and aetiology. Method We systematically reviewed the databases ERIC, PsyARTICLES, PsycINFO, PSYNDEX, and PubMed for the period January 1991 to August 2016, and additionally identified secondary references. Results The proposed definition in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition provides a good starting point for diagnosing IGD but entails some disadvantages. Developing IGD requires several interacting internal factors such as deficient self, mood and reward regulation, problems of decision-making, and external factors such as deficient family background and social skills. In addition, specific game-related factors may promote IGD. Summarizing aetiological knowledge, we suggest an integrated model of IGD elucidating the interplay of internal and external factors. Interpretation So far, the concept of IGD and the pathways leading to it are not entirely clear. In particular, long-term follow-up studies are missing. IGD should be understood as an endangering disorder with a complex psychosocial background. What this paper adds In representative samples of children and adolescents, on average, 2% are affected by Internet gaming disorder (IGD). The mean prevalences (overall, clinical samples included) reach 5.5%. Definitions are heterogeneous and the relationship with substance-related addictions is inconsistent. Many aetiological factors are related to the development and maintenance of IGD. This review presents an integrated model of IGD, delineating the interplay of these factors.
290 citations
TL;DR: The worldwide prevalence of gaming disorder appears to be comparable to obsessive-compulsive disorder and some substance-related addictions, but lower than compulsive buying and higher than problem gambling.
Abstract: Background:Gaming disorder was included in the latest revision of the International Classification of Diseases (11th ed.). Worldwide, prevalence estimates of gaming disorder are considerably hetero...
255 citations
Cites background from "Cross-sectional and longitudinal ep..."
...Understanding the epidemiological aspects of GD provides valuable insight into its etiology and risk factors (Mihara and Higuchi, 2017)....
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...Another systematic review by Mihara and Higuchi (2017) of 50 GD prevalence studies—the largest to date—found prevalence rates ranged between 0.7% and 27.5%....
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...Consistent with previous reviews (Feng et al., 2017; Mihara and Higuchi, 2017), GD prevalence rates were found to be 2.5 times higher for males than for females....
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...Consistent with previous reviews (Feng et al., 2017; Mihara and Higuchi, 2017), GD prevalence rates were found to be 2....
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Stetson University1, Johns Hopkins University2, Karolinska Institutet3, Centre for Addiction and Mental Health4, University of Toronto5, IT University of Copenhagen6, Framingham State University7, Stockholm University8, Roskilde University9, Middlesex University10, Université catholique de Louvain11, University of Sydney12, Umeå University13, Ruhr University Bochum14, Bath Spa University15, Aarhus University16, Radboud University Nijmegen17, Erasmus University Rotterdam18, Edge Hill University19, Villanova University20, University of Oregon21, University of Oxford22, Uppsala University23, University of Münster24, Kore University of Enna25, Ghent University26
TL;DR: There could be benefits to formalizing gaming disorder, but they do not yet outweigh the wider societal and public health risks involved and the colleagues at the WHO are urged to err on the side of caution for now and postpone the formalization.
Abstract: We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.
219 citations
Cites background from "Cross-sectional and longitudinal ep..."
...As of this writing, the WHO appears to have proposed four separate categories for gaming disorders, all of which appear to differ from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)’s Internet gaming disorder (IGD) (WHO, 2017a, 2017b, 2017c, 2017d)....
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...It seems to have locked the research field into a confirmatory approach aiming to prove the existence, utility, and psychometric properties of the IGD criteria in various populations, rather than dealing with some of the more fundamental questions about the nature of problematic gaming raised in the commentaries, as well as this response paper....
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...For example, even the most detailed and comprehensive recent review of IGD (Mihara & Higuchi, 2017) does not include a discussion or formal assessment of bias or limitations of the reviewed studies or the systematic review itself, which is not consistent with guidelines for systematic reviews of…...
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...However, similar expectations were voiced when the DSM-5 included IGD as a proposed category for further study (Petry & O’Brien, 2013), but we have not seen any improvements with respect to more patient-centric research or a stronger evidence base....
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...Such exploratory work was unfortunately marginalized in the wake of the DSM-5’s IGD proposal and this may continue if gaming disorder is included in ICD-11....
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University of Hertfordshire1, University of Cambridge2, Hertfordshire Partnership University NHS Foundation Trust3, Eötvös Loránd University4, University of Cape Town5, Yale University6, University of Zurich7, Erwin L. Hahn Institute for Magnetic Resonance Imaging8, University of Duisburg-Essen9, University Hospital of Lausanne10, University of Luxembourg11, Tel Aviv University12, University of Adelaide13, University of Chicago14, Monash University15, University of Milan16, Stanford University17, University of Lübeck18, Albert Einstein College of Medicine19, University of Amsterdam20, Bellvitge University Hospital21, Sheba Medical Center22, Lithuanian University of Health Sciences23, McMaster University24, University of Florence25
TL;DR: Nine critical and achievable research priorities identified by the Network, needed in order to advance understanding of PUI, with a view towards identifying vulnerable individuals for early intervention are described.
190 citations
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TL;DR: This study investigated the existence of Internet addiction and the extent of problems caused by such potential misuse by developing a brief eight-item questionnaire referred to as a Diagnostic Questionnaire (DQ), which can be defined as an impulse-control disorder that does not involve an intoxicant.
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TL;DR: The related problem, loss-of-control (LOC) eating, describes recurrent binge-like eating behavior in individuals who cannot meet full criteria for BED such as post-bariatric surgery patients and children.
Abstract: Binge eating disorder (BED) is characterized by recurrent episodes of binge eating and, subsequently, significant psychological distress (e.g., shame, guilt). Recently recognized by the American Psychiatric Association (APA) as a distinct eating disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), BED is considered a significant public health problem independently and for its impact on obesity and diabetes. The related problem, loss-of-control (LOC) eating, describes recurrent binge-like eating behavior in individuals who cannot meet full criteria for BED such as post-bariatric surgery patients and children. LOC eating has detrimental psychological and physical health effects, including significant distress and symptoms of depression, as well as excess weight gain in children and suboptimal weight loss and weight regain in post-bariatric patients. Table 1 lists the diagnostic criteria for BED (as defined in the current DSM-5 and earlier, in the DSM, Fourth Edition [DSM-IV]) and frequently-used definitions of LOC eating.
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TL;DR: In this article, the authors surveyed 277 undergraduate Internet users, a population considered to be high risk for pathological Internet use (PIU), to assess incidence of PIU as well as characteristics of the Internet and of users associated with PIU.
1,257 citations
TL;DR: This study adds important information to the discussion about whether video game “addiction” is similar to other addictive behaviors, demonstrating that it can last for years and is not solely a symptom of comorbid disorders.
Abstract: OBJECTIVES: We aimed to measure the prevalence and length of the problem of pathological video gaming or Internet use, to identify risk and protective factors, to determine whether pathological gaming is a primary or secondary problem, and to identify outcomes for individuals who become or stop being pathological gamers. METHODS: A 2-year, longitudinal, panel study was performed with a general elementary and secondary school population in Singapore, including 3034 children in grades 3 ( N = 743), 4 ( N = 711), 7 ( N = 916), and 8 ( N = 664). Several hypothesized risk and protective factors for developing or overcoming pathological gaming were measured, including weekly amount of game play, impulsivity, social competence, depression, social phobia, anxiety, and school performance. RESULTS: The prevalence of pathological gaming was similar to that in other countries (∼9%). Greater amounts of gaming, lower social competence, and greater impulsivity seemed to act as risk factors for becoming pathological gamers, whereas depression, anxiety, social phobias, and lower school performance seemed to act as outcomes of pathological gaming. CONCLUSION: This study adds important information to the discussion about whether video game “addiction” is similar to other addictive behaviors, demonstrating that it can last for years and is not solely a symptom of comorbid disorders.
1,001 citations