Face validity evaluation of screening tools for gaming disorder: Scope, language, and overpathologizing issues

Aim: 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. Methods: A systematic review of databases identified 29 instruments. An item bank (n5417 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. Findings: 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. Conclusions: 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 activitie

Gaming disorder and stigma‐related judgements of gaming individuals: An online randomized controlled trial

The inclusion of gaming disorder (GD) in the International Classification of Diseases 11th Revision (ICD-11) has generated scholarly debate, including claims about its potential stigmatizing effects on the wider gaming population. The present study aimed to estimate the effect of addiction-based and non-addiction-based conceptualizations of problem gaming on stigma of gamers. This preregistered experiment involved a 2 (health information: addiction-related or non-addiction-related) × 3 (vignette: problem, regular or casual gamer) randomized, between-subjects design. An international sample of participants was recruited via Prolific in June and July 2021. Participants were eligible (n = 1228) if they were aged 35 to 50 years, played video games for no more than 6 hours per week and did not endorse DSM-5 or ICD-11 criteria for GD. Participants were provided with an explanation of problem gaming as related to either an addictive disorder (i.e. 'addiction' explanation) or personal choice and lifestyle factors (i.e. 'non-addiction' explanation). The Attribution Questionnaire (AQ) and Universal Stigma Scale (USS) assessed stigma toward each gamer vignette. Vignettes described a problem gamer (with features of GD); a regular gamer (frequent gaming; some life interference); and a casual gamer (infrequent gaming; no life interference). Problem gamer vignettes (mean [M] = 113.3; 95% CI = 111.5-115.4) received higher AQ stigma ratings than regular (M = 94.0; 95% CI = 91.9-95.9) and casual gamers (M = 80.1; 95% CI = 78.2-82.1). Although significant, the effect of health information type on AQ stigma ratings was negligible (addiction group [M = 97.6; 95% CI = 95.9-99.1], non-addiction group [M = 94.1; 95% CI = 92.6-95.8]). However, the addiction information group scored lower on USS blame and responsibility than the non-addiction information group with at least a small effect (99.1% confidence). Framing of problem gaming as an addictive disorder or non-addictive activity appears to have a negligible effect on stigma of different gamers among middle-age adults with minimal gaming experience. The concept of 'gaming addiction' seems unlikely to be an important influence on public stigma of gaming

Mindfulness mediates relations between anxiety with problematic smartphone use severity

A growing body of literature has demonstrated relations between mood- and anxiety-related psychopathology with problematic smartphone use (PSU) symptom severity. However, there has been little empirical inquiry of potential mediators of these relationships. The current study examined trait mindfulness and smartphone use expectancies as mediators of the relation between depression/anxiety and PSU severity in 352 undergraduate students. Participants completed an online survey that measured depression, anxiety, smartphone use expectancies, and PSU severity. Structural equation modeling demonstrated that trait mindfulness was inversely associated, and smartphone use expectancies were positively associated, with PSU severity. Trait mindfulness significantly mediated relations between anxiety and PSU severity. Results provide implications for understanding PSU within the context of theoretical models of PSU’s development, and highlight the role of mindfulness as an emotion regulation strategy and potential treatment for PS

Online gaming and prolonged self-isolation: evidence from Italian gamers during the COVID-19 outbreak

Objective: The self-isolation measures employed during the COVID-19 pandemic made it difficult for basic needs to be met, thus increasing emotional distress. It has been suggested that socially meaningful online gaming buffered emotional distress during the lockdown. This study aimed to test the protective effect of online gaming during the lockdown and to investigate the differences between highly involved gamers (those who play videogames intensely without adverse consequences) and problematic gamers in this regard. Method: Capitalizing on a data collection that started before the pandemic, we adopted a cross-sectional between-groups study design in which gaming patterns, gaming related variables and levels of emotional distress were compared between a pre-COVID group (N=298) and a COVID group (N=366). Results: Compared to the pre-COVID group, high involvement in gaming was more prominent and emotional distress was decreased in the COVID group. Moderated regression analyses further revealed that the interaction between social compensation via gaming and highly involved gaming was associated with lower levels of emotional distress in the COVID-19 group. In contrast, the interaction between gaming-related relaxation and problematic gaming predicted higher emotional distress in the COVID-19 group. Conclusions: This study suggests that gaming for social compensation might mitigate the experienced emotional distress during pandemic related self-isolation, whereas maladaptive gaming patterns could constitute a vulnerability factor deserving clinical attention

Problematic smartphone use: investigating contemporary experiences using a convergent design

Internet-enabled smartphones are increasingly ubiquitous in the Western world. Research suggests a number of problems can result from mobile phone overuse, including dependence, dangerous and prohibited use. For over a decade, this has been measured by the Problematic Mobile Phone Use Questionnaire (PMPU-Q). Given the rapid developments in mobile technologies, changes of use patterns and possible problematic and addictive use, the aim of the present study was to investigate and validate an updated contemporary version of the PMPU-Q (PMPU-Q-R). A mixed methods convergent design was employed, including a psychometric survey (N = 512) alongside qualitative focus groups (N = 21), to elicit experiences and perceptions of problematic smartphone use. The results suggest the PMPU-Q-R factor structure can be updated to include smartphone dependence, dangerous driving, and antisocial smartphone use factors. Theories of problematic mobile phone use require consideration of the ubiquity and indispensability of smartphones in the present day and age, particularly regarding use whilst driving and in social interactions

Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools

Background and aims: Despite its inclusion in the 11th revision of the International Classification of Diseases, there is a virtual paucity of high-quality scientific evidence about compulsive sexual behavior disorder (CSBD), especially in underrepresented and underserved populations. Therefore, we comprehensively examined CSBD across 42 countries, genders, and sexual orientations, and validated the original (CSBD-19) and short (CSBD-7) versions of the Compulsive Sexual Behavior Disorder Scale to provide standardized, state-of-the-art screening tools for research and clinical practice. Method: Using data from the International Sex Survey (N = 82,243; Mage = 32.39 years, SD = 12.52), we evaluated the psychometric properties of the CSBD-19 and CSBD-7 and compared CSBD across 42 countries, three genders, eight sexual orientations, and individuals with low vs. high risk of experiencing CSBD. Results: A total of 4.8% of the participants were at high risk of experiencing CSBD. Country- and gender-based differences were observed, while no sexual-orientation-based differences were present in CSBD levels. Only 14% of individuals with CSBD have ever sought treatment for this disorder, with an additional 33% not having sought treatment because of various reasons. Both versions of the scale demonstrated excellent validity and reliability. Discussion and conclusions: This study contributes to a better understanding of CSBD in underrepresented and underserved populations and facilitates its identification in diverse populations by providing freely accessible ICD-11-based screening tools in 26 languages. The findings may also serve as a crucial building block to stimulate research into evidence-based, culturally sensitive prevention and intervention strategies for CSBD that are currently missing from the literature

Game Addiction Scale Assessment Through a Nationally Representative Sample of Young Adult Men: Item Response Theory Graded–Response Modeling

The 7-item Game Addiction Scale (GAS) has been validated under standard confirmatory factor analysis and exhibits good psychometric properties. Whether this scale satisfies the necessary conditions for consideration by item response theory (IRT) modeling remains unknown. However, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) recently proposed criteria, in its section 3, to define internet gaming disorder (IGD) to promote research on this possible condition. The objective of our study was to (1) analyze GAS in the context of IRT (graded-response) modeling; (2) investigate differential item functioning (DIF), a feature of IRT modeling, in 2 subsamples; and (3) contribute to the ongoing (IGD) debate related to the validity of the DSM-5 criteria using GAS items as a proxy. We assessed 2 large representative samples of Swiss men (3320 French-speaking and 2670 German-speaking) with GAS. All items comprised high discrimination parameters. GAS items such as relapse, conflict, withdrawal, and problems (loss of interests) were endorsed more frequently in more severe IGD stages, whereas items related to tolerance, salience (preoccupation), and mood modification (escape) were endorsed more widely among participants (including in less severe IGD stages). Several DIF effects were found but were classified as negligible. The results of the analyses partly support the relevance of using IRT to further establish the psychometric properties of the GAS items. This study contributes to testing the validity of the IGD criteria, although cautious generalization of our findings is required with GAS being only a proxy of the IGD criteria

The role of childhood emotional maltreatment and body image dissatisfaction in problematic smartphone use among adolescents

Growing empirical evidence has identified specific psychological and contextual risk factors associated with problematic smartphone use (PSU). However, the potential direct and indirect impact of childhood emotional maltreatment (CEM) on PSU remains largely unexplored, despite the established role of CEM in the onset of other excessive, problematic, and addictive behaviors. Consequently, the purpose of the present study was to test the direct and indirect relationships of emotional abuse and neglect (two facets of CEM) with PSU via specific mediational pathways including body image dissatisfaction (BID), social anxiety, and depression. The sample comprised 443 adolescents who completed a questionnaire that included assessment tools of aforementioned variables. Multiple mediation model results indicated that CEM was directly and indirectly associated with PSU via BID, depression, BID-related depression, and BID-related social anxiety. Results suggested that emotionally traumatic experiences were associated with PSU in adolescents and that this relationship may partially be explained by BID and psychosocial risk factors. The present study draws caution to the amplifying roles of CEM and BID on increased PSU. The results of the study have important clinical and public health implications, but additional research is needed before interventions can be developed and implemented on the basis of present results