Working towards improved conceptualisation and identification of gaming disorder and co-occurring addictions in gamers

This doctoral research thesis investigated the neurophysiological underpinnings of gaming disorder (GD), and the way in which co-occurrence can influence and correlate with GD in a clinical and a multi-cultural context. The unique contribution of knowledge was (i) the assessment of the neurophysiological expression of gamers using a novel spiking neural network (SNN) methodology; (ii) exploring co-occurrence in gamers and substance abstinent gamers; and (iii) exploring co-occurrence in gamers across three different individualistic countries (i.e., Australia, New Zealand, and the United Kingdom). The conceptualisation of GD and related methodologies were explored using multiple systematic research methods. A number of methodologies were then employed, including the use of electroencephalographic (EEG) data, a machine learning (ML) approach which utilised a novel SNN architecture (i.e., the NeuCube), and the use of surveys to reach a clinical cohort and three cohorts spanning three different countries in an effort to investigate the way in which co-occurrence may influence gamers and at-risk gamers. The results of the empirical studies indicated that: (i) problematic gamers experience different neurophysiological expression than those who recreational game and that ML methodologies are an effective method of classifying recreational and problematic gamers when using EEG data; (ii) maladaptive coping strategies were significantly associated to gaming scores, and that gamers appeared to experience co-occurrence more so than their non-gamer counterparts; (iii) at-risk and high-risk gamers may utilise gaming as a maladaptive coping strategy and other accompanying potentially addictive behaviour, or substance use may be influenced as a result; (iv) the manifestation of maladaptive coping strategies and potentially addictive behaviours can be influenced by the country in which an individual resides. Taken together, the present doctoral project further clarified the conceptualisation of GD, utilising a neurophysiological underpinning, which is further supported with observed behaviour as suggested by the National Institute of Mental Health. In addition, it places an emphasis on the importance of understanding co-occurrence and specific at-risk factors (e.g., coping) which may contribute to the development and maintenance of problematic or disordered gaming in both a clinical sample and general population samples

Internet Gaming Disorder: the interplay between physical activity and user–avatar relationship

Understanding both the risk and protective factors associated with Internet Gaming Disorder (IGD) has been viewed by many in the gaming studies field as an area of research priority. The present study focused on the potential risk and protective effects of user-avatar (game figure) relationship and physical activity (PA) respectively. To address these aims, a cross-sectional and a longitudinal mixed-methods design were combined (comprising both psychological and physiological assessments). A sample of 121 emerging adult gamers (18%29 years) residing in Australia, who played massively multiplayer online games, were assessed in relation to their IGD behaviors using the nine-item Internet Gaming Disorder Scale-Short Form. Additionally, the Proto-Self-Presence scale was used to evaluate the extent to which gamers identified with the body of their avatar. Finally, a PA monitor (Fit Bit Flex ) measured levels of energy consumed during real world daily activities (active minutes). A number of linear regressions and moderation analyses were conducted. Findings confirmed that Proto-Self-Presence functioned as an IGD risk factor and that PA acted protectively, weakening the association between Proto-Self-Presence and IGD behaviors. Implications of these findings are discussed in relation to IGD treatment and gaming development aspects

Internet pornography viewing preference as a risk factor for adolescent Internet addiction: the moderating role of classroom personality factors

Background and aims: Adolescent Internet pornography viewing has been significantly increased in the last decade with research highlighting its association with Internet addiction (IA). However, there is little longitudinal data on this topic, particularly in relation to peer context effects. This study aimed to examine age- and context-related variations in the Internet pornography–IA association. Methods: A total of 648 adolescents, from 34 classrooms, were assessed at 16 years and then at 18 years to examine the effect of Internet pornography preference on IA in relation to the classroom context. IA was assessed using the Internet Addiction Test (Young, 1998), Internet pornography preference (over other Internet applications) was assessed with a binary (yes/no) question, and classroom introversion and openness to experience (OTE) with the synonymous subscales within the Five Factor Questionnaire (Asendorpf & Van Aken, 2003). Results: Three-level hierarchical linear models were calculated. Findings showed that viewing Internet pornography exacerbates the risk of IA over time, while classroom factors, such as the average level of OTE and introversion, differentially moderate this relationship. Discussion and conclusion: The study demonstrated that the contribution of Internet pornography preference (as an IA risk factor) might be increased in more extroverted classrooms and decreased in OTE classrooms

Depression, Internet Gaming Disorder, and the moderating effect of the gamer-avatar relationship: an exploratory longitudinal study

Research into Internet Gaming Disorder (IGD) literature largely uses cross-sectional designs and seldom examines gaming context-related factors. Therefore, the present study combined a cross-sectional and longitudinal design to examine depression and the gamer-avatar relationship (GAR) as risk factors in the development of IGD among emerging adults. IGD behaviors of 125 gamers (64 online gamers, Mage = 23.3 years, SD= 3.4; 61 offline gamers, Mage = 23.0 years, SD= 3.4) were assessed using the nine-item Internet Gaming Disorder Scale Short Form (IGDS-SF9; Pontes & Griffiths, 2015). The Self-Presence Scale (Ratan & Dawson, 2015) and the Beck Depression Inventory (Beck, Steer, & Brown, 1996) were also used to assess gamers’ levels of GAR and depressive symptoms respectively. Regression and moderation analyses revealed that depression and the GAR act as individual risk factors in the development of IGD over time. Furthermore, the GAR exacerbates the IGD risk effect of depression

Coping and co-occurrence of gaming disorder and substance use in recovering substance users

Background: There are a wide range of negative effects associated with both substance use disorders and behavioural disorders and their co-occurrence. Understanding the way in which at-risk populations (e.g., substance-abstinent users) interact with potentially addictive behaviours (e.g., gaming) and substance use—while navigating life stressors through differing coping styles—can inform preventative strategies. Methods: Therefore, the present study investigated 64 clinical participants and 138 general population participants. Each cohort was required to complete a battery of psychometric scales exploring problematic behaviours, problematic substance use, co-occurrence, and coping styles. Additional exploratory direct comparisons of gamers in the clinical cohort and gamers in the general cohort were carried out. Results: The study’s findings suggest that gamers from different populations (i.e., general and clinical) share similar at-risk behaviours. These problematic behaviours were more pronounced among abstinent substance use gamers, and more specifically among poly-substance use gamers. Conclusions: The findings of the present study add to the literature and suggest that dysfunctional coping style and the co-occurrence of problematic behaviours may have an impact on the assessment and potential treatment of substance abstinent gamers. The findings offer support for an integrated treatment approach, wherein both substance use and the other problematic behaviours (e.g., gaming) are considered in tandem

Avoidant romantic attachment in adolescence: gender, excessive internet use and romantic relationship engagement effects

Romantic development is a distinctive characteristic of puberty. However, a significant proportion of adolescents present with avoidant romantic attachment (ARA) tendencies, which have significant impact on their general adaptation. ARA variations have been suggested in relation to age, gender, engagement with a romantic partner and Excessive Internet Use (EIU) behaviours. In this longitudinal, two-wave study of a normative sample of 515 Greek adolescents at 16 and 18 years, ARA was assessed with the relevant subscale of the Experiences in Close Relationships-Revised and EIU with the Internet Addiction Test. A three-level hierarchical linear model found ARA tendencies to decrease between 16 and 18 while engagement in a romantic relationship and EIU were associated with lower and higher ARA tendencies respectively. Gender did not differentiate ARA severity either at the age of 16 or its changes over time. Results highlight the need of adopting a longitudinal-contextualized approach and provide implications for prevention and intervention initiatives in relation to the romantic development of adolescents

A systematic review of the co-occurrence of gaming disorder and other potentially addictive behaviors

Purpose of review: The playing of videogames has become an everyday occurrence among many adolescents and emerging adults. However, gaming can be problematic and potentially addictive and problematic gamers can experience co-occurring behavioral or substance use-related problems. The aims of the present review were to (i) determine the co-occurrence of potentially addictive behaviors with problematic and disordered gaming, and (ii) elucidate the potential risk factors in the development and maintenance of co-occurrence within disordered gaming. Recent findings: The main findings demonstrated that there are few empirical studies (N = 20) examining (i) co-occurrence of gaming disorder with other addictive behaviors; (ii) longitudinal risk of disordered gaming with co-occurring addictive behaviors; and (iii) mechanisms of co-occurrence in disordered gaming with co-occurring potentially addictive behaviors. Results suggest that disordered gaming can co-occur with a variety of other addictive behaviors (e.g., alcohol use disorder or addictive use of social media), and that research into the co-occurrence of addictive behaviors and substance use is increasing. Summary: Based on this systematic review, findings suggest that gamers engage in a number of potentially addictive behaviors and substance use which can have detrimental effects on health and wellbeing. While a majority of the reviewed studies consider prevalence rates from a range of geographical locations, there are fewer papers which investigate individual and environmental risk factors

Does Pain at an Earlier Stage of Chondropathy Protect Female Mice Against Structural Progression After Surgically Induced Osteoarthritis?

OBJECTIVE: Female C57BL/6 mice exhibit less severe chondropathy than male mice. This study was undertaken to test the robustness of this observation and explore underlying mechanisms. METHODS: Osteoarthritis was induced in male and female C57BL/6 or DBA/1 mice (n = 6-15 per group) by destabilization of the medial meniscus (DMM) or partial meniscectomy (PMX). Some mice were ovariectomized (OVX) (n = 30). In vivo repair after focal cartilage defect or joint immobilization (sciatic neurectomy) following DMM was assessed. Histologic analysis, evaluation of gene expression in whole knees, and behavioral analysis using Laboratory Animal Behavior Observation Registration and Analysis System (LABORAS) and Linton incapacitance testing (n = 7-10 mice per group) were performed. RESULTS: Female mice displayed less severe chondropathy (20-75% reduction) across both strains and after both surgeries. Activity levels after PMX were similar for male and female mice. Some repair-associated genes were increased in female mouse joints after surgery, but no repair differences were evident in vivo. Despite reduced chondropathy, female mice developed pain-like behavior at the same time as male mice. At the time of established pain-like behavior (10 weeks after PMX), pain-associated genes were significantly up-regulated in female mice, including Gdnf (mean ± SEM fold change 2.54 ± 0.30), Nrtn (6.71 ± 1.24), Ntf3 (1.92 ± 0.27), and Ntf5 (2.89 ± 0.48) (P < 0.01, P < 0.01, P < 0.05, and P < 0.001, respectively, versus male mice). Inflammatory genes were not regulated in painful joints in mice of either sex. CONCLUSION: We confirm strong structural joint protection in female mice that is not due to activity or intrinsic repair differences. Female mice develop pain at the same time as males, but induce a distinct set of neurotrophins. We speculate that heightened pain sensitivity in female mice protects the joint by preventing overuse

Co-occurrence of gaming disorder and other potentially addictive behaviours between Australia, New Zealand, and the United Kingdom

Background: Evidence suggests that gamers can have varying experiences of disordered gaming behaviours due to coping mechanisms and how they can act as risk or protective factor in the development and/or maintenance of disordered behaviours. A particular area of interest is how this may manifest across different countries. Understanding the interplay of these potential risk and protective factors within different countries will aid identifying and preventing disordered behaviours. Methods: Three cohorts were recruited from Australia, New Zealand, and the United Kingdom. Each cohort was required to complete a battery of psychometric scales exploring problematic behaviours, problematic substance use, co-occurrence, coping styles, and personality. A latent profile analysis was conducted to examine the differences between cohorts and further investigated with additional analyses. Results: The findings suggested that a minority of gamers were affected by gaming disorder, and there appeared an at-risk cohort who utilise gaming as a maladaptive coping strategy. Other accompanying potentially addictive behaviour or substance use may be exacerbated as a result, the manifestation of which can be influenced by cultural elements. Conclusions: When considering gamers from countries which hold similar views, it is important to be cognisant of the variations found in the manifestations of disordered gaming and accompanying potentially addictive behaviours. This will allow for a more precise identification of at-risk behaviours, which will result in more favourable treatment outcomes for those who are considered at-risk or high-risk individuals

Fibroblast growth factor 2 drives changes in gene expression following injury to murine cartilage in vitro and In Vivo

Objective The articular cartilage is known to be highly mechanosensitive, and a number of mechanosensing mechanisms have been proposed as mediators of the cellular responses to altered mechanical load. These pathways are likely to be important in tissue homeostasis as well as in the pathogenesis of osteoarthritis. One important injury-activated pathway involves the release of pericellular fibroblast growth factor 2 (FGF-2) from the articular cartilage. Using a novel model of murine cartilage injury and surgically destabilized joints in mice, we examined the extent to which FGF-2 contributes to the cellular gene response to injury. Methods Femoral epiphyses from 5-week-old wild-type mice were avulsed and cultured in serum-free medium. Explant lysates were Western blotted for phospho-JNK, phospho-p38, and phospho-ERK or were fixed for immunohistochemical analysis of the nuclear translocation of p65 (indicative of NF-κB activation). RNA was extracted from injured explants, rested explants that had been stimulated with recombinant FGF-2 or FGF-18, or whole joints from either wild-type mice or FGF-2−/− mice. Reverse transcription–polymerase chain reaction was performed to examine a number of inflammatory response genes that had previously been identified in a microarray analysis. Results Murine cartilage avulsion injury resulted in rapid activation of the 3 MAP kinase pathways as well as NF-κB. Almost all genes identified in murine joints following surgical destabilization were also regulated in cartilage explants upon injury. Many of these genes, including those for activin A (Inhba), tumor necrosis factor–stimulated gene 6 (Tnfaip6), matrix metalloproteinase 19 (Mmp19), tissue inhibitor of metalloproteinases 1 (Timp1), and podoplanin (Pdpn), were significantly FGF-2 dependent following injury to cartilage in vitro and to joint tissues in vivo. Conclusion FGF-2–dependent gene expression occurs in vitro and in vivo in response to cartilage/joint injury in mice