心理科学进展, 2019, 27(1): 83-95 doi: 10.3724/SP.J.1042.2019.00083

研究前沿

网络游戏成瘾研究的争议及趋势

靳宇倡,, 余梦, 胡云龙

四川师范大学教师教育与心理学院, 成都 610068

The controversies and tendency of Internet Gaming Disorder research

JIN Yuchang,, YU Meng, HU Yunlong

School of Teacher Education and Psychology, Sichuan Normal University, Chengdu 610068, China

通讯作者: 靳宇倡, E-mail: jinyuchang@gmail.com

收稿日期: 2017-11-20   网络出版日期: 2019-01-15

基金资助: * 国家自然科学基金.  71673032
国家社会科学基金.  15BSH025
四川网络文化研究中心2018年度课题(WLWH-18-30)及川师研([2018]3-21)

Received: 2017-11-20   Online: 2019-01-15

摘要

网络游戏成瘾(Internet Gaming Disorder, IGD)是否能被确认为独立的精神障碍?目前的争议来自三个方面:概念上难以明确IGD与正常游戏行为,其他精神障碍之间的差异, 且上瘾对象仅为网络游戏或包含线下游戏并不明确; 鉴定标准上DSM-5总结的9条标准没能刻画IGD的本质特征, 现行的18种诊断工具在内容,诊断阈限等方面参差不齐; 研究方法上缺乏理论支撑, 过分依赖问卷数据, 忽视电子游戏的积极作用.争议内容体现出研究者对网络游戏行为本身缺乏理解, 因此难以判断正常与异常的游戏行为.未来研究应考虑回退到对网络游戏行为的研究, 对网络游戏类型特点,影响网络游戏行为的各因素以及电子游戏的积极贡献做深入探讨, 以达到从本质上明确网络游戏成瘾的特质.

关键词: 网络游戏成瘾(IGD) ; 电子游戏 ; 行为成瘾 ; DSM-5诊断标准 ; 精神障碍

Abstract

There are three aspects of controversy disputing whether Internet Gaming Disorder (IGD) should be defined as an independent psychiatric disorder. Conceptually, it is difficult to clarify the differences between IGD and normal gaming behavior or other mental disorders, and it is not clear that the object of addiction is restricted to online games only, or contained offline games at the same time. With respect to the identification standards, the 9 criteria summarized by DSM-5 failed to depict the essential characteristics of IGD, and with inconsistent levels on content, diagnostic threshold etc. based on existing 18 diagnostic tools. Further, the research methods lack theoretical support, relaying too much on questionnaire data and ignoring the positive effects of video games. The contents of the controversies reveal that researchers lack an understanding of online gaming behavior. Therefore, it is difficult to distinguish normal and abnormal gaming behavior. Research in future should consider stepping back to study the online gaming behavior, exploring the characteristics of different types of internet games and analyzing factors which affect the behavior of Internet gaming and digging the positive contribution of video games, so as to define a clear description of the nature of Internet Gaming Disorder.

Keywords: Internet Gaming Disorder (IGD) ; gaming disorder ; behavioral addiction ; DSM-5 diagnose criteria ; mental disorder

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本文引用格式

靳宇倡, 余梦, 胡云龙. (2019). 网络游戏成瘾研究的争议及趋势 . 心理科学进展, 27(1), 83-95

JIN Yuchang, YU Meng, HU Yunlong. (2019). The controversies and tendency of Internet Gaming Disorder research. Advances in Psychological Science, 27(1), 83-95

2013年, 美国精神病学会(American Psychiatric Association)首次在《精神障碍诊断与统计手册》第五版(The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-5)第三章的需进一步研究对象名单(condition for further study)中介绍了网络游戏成瘾(Internet Gaming Disorder, IGD)1以及其9条IGD诊断标准.但IGD是否应该被作为一项独立的精神障碍纳入“物质相关及成瘾障碍分类”中却引发了剧烈的争论.

在DSM-5中, 继病理性赌博(pathological gambling)首次更名为赌博(成瘾)障碍(gambling disorder), 成为第一个被正式认可的行为成瘾(behavioral addiction)之后, 网络游戏成瘾(IGD)成为了第二个正式提名的行为成瘾.尽管Petry等(2014)为IGD领域首次统一标准而欣喜, 将9标准的内涵进行了阐述, 挑选出了他们认为最合适的标准测试条目, 期望建立标准的IGD测量工具, 借以推动整个研究领域向前发展, 却受到许多 研究者的质疑.为什么IGD会从各种提名的成瘾行为中脱颖而出?9条标准是否能够准确检验 出IGD?成瘾对象只是在线网络游戏(Online or Internet game)还是包括线下游戏(offline game, 非联网游戏)?甚至有学者提出IGD研究领域至今仍缺乏基本的理论,定义和标准有效的测量工具(van Rooij, & Kardefeltwinther, 2017).IGD的研究是否真的达成了国际共识?行为成瘾杂志(Journal of Behavioral addiction, 2017, 6(2) )设专刊讨论IGD, 使该领域的争议达到顶峰.

2018年6月18日, 世界卫生组织(World Health Organization, WHO)发布的第11版《国际疾病分类》手册(International Classification of Diseases, ICD-11)中, 在行为成瘾障碍下增加了游戏成瘾(Gaming disorder, GD), 并明确提出成瘾对象为电子游戏(video game, 在线与线下视频游戏的总称, 在线游戏等同于网络游戏) (WHO, 2018).然而, 对IGD概念提出质疑的学者们对GD概念怀有相同的质疑.

早在2016年11月, 26名学者联名向WHO议题顾问组寄去了一封对GD提出争议的信, 并随后发表在行为成瘾杂志(Journal of Behavioral addiction) 2017年第6卷第3期上.信中23名来自不同的与GD研究相关领域的学者恳切地提出GD概念的实证研究基础从根本上存在问题, 认为该概念的正式提出会给医学,科学,公共卫生,社会,人权等方面带来负面的附带后果, 应该慎重考虑, 建议WHO取消该分类(Aarseth et al., 2017).虽然WHO没有采纳该建议, 研究者们依然认为GD概念的提出缺乏清晰的证据基础, 游戏成瘾(GD)与网络游戏成瘾(IGD)之间的界限不明.与IGD研究相同, 依然有许多关于成瘾对象,特异症状,共病因果关系的问题需要解答(van Rooij et al., 2018).

在此背景之下, 本文旨在梳理并归类IGD研究中的重要争议, 希望从激烈的争论中搜寻到重要启示, 为游戏成瘾领域未来的研究明确方向.

1 IGD概念上的争议

一些研究报告证明了过量使用网络游戏带来的严重后果, 包括因为连续多日玩网络游戏, 缺乏充足的睡眠或食物引起的痉挛(Chuang, 2006)和死亡(BBC News. “South Korean Dies after Gaming Session”, 2005), IGD因此成为了全世界关注的公共卫生问题.DSM-5工作组评估了来自不同的出版物上240多份相关主题的文献, 包括游戏或者网络使用障碍(gaming or internet use disorder),游戏/网络成瘾或者依赖(gaming or internet addiction or dependence),病理性或者问题型游戏(pathological or problematic gaming)等, 最终将IGD纳入DSM-5的候选名单, 但仍称IGD缺乏标准定义(American Psychiatric Association, 2013).研究者们从不同角度对IGD这个概念本身提出了质疑.

1.1 精神疾病or过度病态化

一部分学者质疑IGD能否被定义为独立的精神障碍.一方面是对IGD患病率数据的质疑; 另一方面, 学者们认为IGD的出现是源于道德恐慌, 实际IGD造成的功能性损伤很小.

首先, 对IGD患病率数据的质疑.在DSM-5中缺少了IGD的发展与病程(Development and Course)这一项, 这主要是由于IGD的临床报告中缺乏该症状的自然发展过程的描述(Kaptsis, King, Delfabbro, & Gradisar, 2016).无法以IGD的临床发展过程为依据提出准确的定义, 也由此影响了IGD患病率数据的获得.DSM-5中只提到在亚洲的一项研究中12~19岁青少年的患病率是男性8.4%, 女性4.5%, 实际全球患病率并不清楚(American Psychiatric Association, 2013).然而很多学者的研究结果都低于这个数值.如Ferguson, Coulson和Barnett (2011)对17篇文献进行元分析发现, 平均所有研究的患病率为6%, 而实际玩电子游戏者样本中只有3%左右的人有发展成障碍的风险.2017年, Feng, Ramo, Chan和Bourgeois通过27篇文献对1998至2016年IGD的患病率做了系统性回溯, 结果令人惊讶, 发现IGD的患病率并未像电脑普及率一样呈指数型上升, 而是维持在4.7%左右, 最低只有0.7%.

2016年, Przybylski, Weinstein和Murayama使用DSM-5的标准对来自美国,英国,加拿大,德国总共19000人的被试进行了IGD患病率的评估, 并测量了他们的社交状况,身体健康和心理健康程度.被试都在近期持续使用网络电子游戏, 接近65%的被试报告他们没有任何IGD相关的症状.在其4组不同国家的被试中, 网络游戏者符合IGD症状5条以上者的比例最高只有1%, 最低仅为0.5%.

其次, IGD实际造成的功能性损伤很小, 提出IGD可能源于道德恐慌.Billieux, Schimmenti, Khazaal, Maurage和Heeren (2015)指出, 行为成瘾的定义没有解决功能损伤和稳定性这两个问题.IGD造成的功能性损伤的严重程度显著低于物质成瘾.虽然尼古丁成瘾造成的功能性损伤也低, 但尼古丁造成的损伤是生理性的.在西方国家, 吸烟是导致生病和死亡的第一因素, IGD却没有这样的影响.一项研究发现在他们报告有电子游戏问题的样本中不到50%的人在重要人际关系上存在困难(Porter, Starcevic, Berle, & Fenech, 2010).而Przybylski (2016)等人的研究结果证明那些符合IGD诊断标准的被试在行为和临床表现上与没有IGD症状的被试没有显著差异, 区别只是玩电子游戏的时间更长而已.一些学者指出青少年选择一种活动而放弃其他的活动, 是他们正常身心发展的一部分(Kuss, Griffiths, & Pontes, 2017a).大多数电子游戏者都能够高效率地工作并拥有和谐的社会生活(Markey, & Ferguson, 2017).

一些个体出于自由意志参与到游戏中, 感到这样的行为是与自我协调的(Kardefelt-Winther, 2015b; van & Prause, 2014), 也是出于社交需求的.然而父母常忽视孩子玩电子游戏的正当理由(Kardefelt- Winther, 2015a, 2015b), 只关注他们玩游戏的时间和因为游戏而放弃掉的其他活动.有证据表明, 一些家长将子女送到医院要求进行针对“网络游戏成瘾”的治疗, 是由于媒体铺天盖地的报道引起的恐慌(Quandt, 2017).而在一些案例中, 这些儿童游戏时间相对并不长, 也没有表现出有临床诊断意义的特征(Billieux, Schimmenti, Khazaal, Maurage, & Heeren, 2015).研究者认为, 没有造成不良后果的过度游戏行为不应该被纳入心理障碍(Kuss, Griffiths, & Pontes, 2017b; Krossbakken, Pallesen, Molde, Mentzoni, & Finserås, 2017).

这些证据使得研究者们怀疑IGD作为精神症状的真实存在性, 不止一个学者认为提出IGD是将一个真实存在却不普遍的问题过于夸大化了(Barnett & Coulson, 2010; Ferguson, 2010; Kardefelt- winther, 2015a; Olson, 2010).

1.2 行为成瘾or其他障碍

一部分学者认为, IGD是精神障碍, 但可能归属于其他类别.

神经成像研究证明IGD与物质相关的成瘾在分子,神经生理学和认知层面非常相似(Kuss & Griffiths, 2012; Pontes, Kuss, & Griffiths, 2017).而寻求专业帮助的IGD相关问题的个体确实体验到较高程度的痛苦和在学业,专业,个人生活上的消极后果(Kuss & Griffiths, 2015).因而不少学者认为应该将IGD当做精神障碍对待(Martin & Petry, 2005; Griffiths & Pontes, 2014).

然而, IGD作为第二个正式提出的行为成瘾, 其临床表现与其他成瘾(包括赌博成瘾)区别较大(Petry et al., 2014).大部分IGD患者只是表现出过度的游戏行为即一周30个小时以上的游戏时间(American Psychiatric Association, 2013), 但没有明显的社会功能损伤(Przybylski et al., 2016).过度的行为虽然时间长但是可控, 而成瘾者不愿尝试停止行为且无法停止, 过度的行为在医学上并不从属于“成瘾”概念(Davies, 1998).在分析IGD的特征时, Kardefelt-Winther等人(2017)提出符合下面四条的行为不应该被列入成瘾分类之下:1)某种行为能被一个已有的障碍很好地解释(如抑郁或者强迫症).2)这个活动是出于自愿的选择, 即使无法避免受到功能性损伤, 例如高水平运动.3)一个高度卷入性的活动被暂时地延长, 虽然消耗更长时间且减少了对生活其他方面的关注, 但是并没有造成明显的功能性损伤或让个体感到痛苦.4)这种行为是一种应对策略.IGD刚好符合以上4点, 因此被认为不属于成瘾类别.

尽管Griffiths (2017)针对此观点提出反对, 因为多数成瘾行为都有以下三个特点:1)常与其他疾病共病(comorbidity); 2)也是自愿行为(吸毒和赌博); 3)常作为一种应对方式.但另一个问题在于, 目前的研究不能很好地解释网络游戏成瘾与其他的心理障碍和生理失调的共病关系, 包括抑郁,焦虑障碍,肥胖症,注意缺陷多动症,社交恐惧症(Henchoz et al., 2016; Pontes & Griffiths, 2016; Turel, Romashkin, & Morrison, 2016; Yen et al., 2016; Sioni, Burleson, & Bekerian, 2017).对其他精神障碍进行治疗的同时, 网络成瘾和游戏成瘾就自然好转(Kuss & Lopez-Fernandez, 2016), 此时IGD更像是由其他精神障碍所致.Kardefelt- Winther (2014)就认为过量游戏可能属于不良的应对方式问题.Starcevic和Aboujaoude (2017)比较了IGD与强迫症(OCD)相似性研究和IGD与物质成瘾(substance use disorder)的相似性研究, 发现IGD与强迫症的相似性高于与物质成瘾的相似性, 认为IGD更近似于冲动控制障碍(impulsive-control disorder)而非行为成瘾.

1.3 在线or离线

另有部分学者认为, IGD只是游戏成瘾的一种亚型.DSM-5中提到, 网络游戏成瘾的对象主要是在线电子游戏, 但也可以是非在线的电子游戏(American Psychiatric Association, 2013), 这让“Internet”一词难以解释, 成为研究争论的焦点 之一.

游戏行为问题的研究开始于离线游戏(offline game) (Soper & Miller, 1983), 不同的研究中多使用“电子游戏” (video game)一词, 包含了在线(online)和离线(offline)视频游戏(例如, King & Delfabbro, 2013; van Rooij et al., 2014; Wölfling & Müller, 2010).最近的一个研究测量了2720种游戏的2442名(13~40岁)游戏者, 检验了9类电子游戏与IGD的关系, 结果发现在线和离线两类游戏的玩耍时间都与IGD相关, 但确实在线游戏与IGD的正相关系数更高(Lemmens & Hendriks, 2016).这与Wenzel, Bakken, Johansson, Götestam和Øren (2009)的发现相符.在线和离线游戏都能使人上瘾, 因此Kuss等人(2017a)提出“Internet” 不是IGD的核心要素.

这些研究者更倾向于使用“游戏成瘾” (Gaming disorder, GD)将在线与离线游戏包含在内.Carbonell (2017)甚至提出, IGD的范围是否可以拓展到更宽泛的游戏, 例如下棋,网球引起的成瘾?甚至“游戏成瘾”还要改名为“玩耍成瘾” (playing disorder).

2 IGD鉴定标准上的争议

2.1 9标准模棱两可

DSM-5中IGD的诊断标准为:在过去12个月中持续体验到以下9条标准的5条以上:沉湎于游戏(preoccupation),戒断反应(withdrawal),耐受性增加(tolerance),试图减少使用但失败(unsuccessful control),对其他活动失去兴趣(loss of interest),失去重要关系或机会(lose relationships/opportunities),逃避不良情绪(escape negative mood),忽视已存在的社会心理问题而继续游戏(continue despite problems),为游戏而欺骗(deception) (American Psychiatric Association, 2013).针对9标准, 学者们提出了大量的疑问.

2.1.1 对9标准内容的争议

2014年Petry等人对9条标准进行了详细的解释并拟出了每条标准最适合用在测量工具中的表述, 希望借此建立IGD的标准诊断工具, 却并未得到认可.Carbonell (2017)质疑9标准主要来自中国的一个关于网络成瘾诊断标准的研究报告(Tao et al., 2010), 其效仿了物质滥用和赌博障碍的诊断标准且被试过于年轻化.

King和Delfabbro (2014)最先提出沉湎标准中应该同时包含时间消耗和认知变化的具体表述.此外, 戒断症状(“Withdrawal refers to symptoms that emerge when one is unable to engage in a behavior or is attempting to reduce or stop it”, Petry et al., 2014, p. 4)和耐受性(“Tolerance is characterized by an increasing dosage or amount of time spent in an activity to feel its desired effects”, Petry et al., 2014, p. 4)引起了热议.这两个症状因为其对物质成瘾的高诊断力而被纳入了IGD的诊断标准.然而Kaptsis等人(2016)回溯了34项研究(10份定性研究,17份心理测量工具的报告,7份治疗报告), 发现IGD患者表现出普遍意义上的戒断症状的证据非常不足, 治疗报告中也缺乏该症状的自然发展过程的描述, 表明戒断不是游戏问题的普遍症状.Starcevic (2016)提出, DSM-5中对IGD的耐受性标准的解释——需要增加参与网络游戏的时间——没有提及增加时间的原因, 过于含糊.比如物质成瘾中的耐受性是指, 为了再次体验当初的或者期望中的满足和兴奋而增加某项活动时间.反观网络游戏玩家, 常是因为随着游戏的推进而被要求完成更多且更复杂的任务(King & Delfabbro, 2016), 不一定更满足或更兴奋, 这种时间增加与耐受性可能不相关(e.g., Billieux, Schimmenti, Khazaal, Maurage, & Heeren, 2015).不过Kuss等人(2017b)认为, IGD表现出的耐受性和戒断症状可能是存在的, 只是与传统的物质成瘾表现的形式不同而已.

Griffiths等人(2016)对Petry等人(2014)的观点有针对性地提出质疑.首先, Petry的专家团队具备的专业性和对不同文化的代表性并未阐明.其次, 对每一条标准的解释和标准评估条目的筛选上存在很多疑点和漏洞.他们汇集了来自不同的研究者超过11条的争议内容, 主要针对三个方面.第一, IGD的9条诊断标准对IGD症状缺乏代表性.例如最受争议的戒断反应, 作为最典型的物质成瘾的症状, 被同样作为典型症状用在行为成瘾的诊断中是否合适?第二, 9标准难以区分高投入者(high engagement) (例如, 职业游戏竞技选手, 职业游戏测试员)与真实成瘾者.再如对沉湎的解释(“Pre-occupation relates to spending substantial amounts of time thinking about an activity”, Petry et al., 2014, p. 4)和评估条目(“Do you spend a lot of time thinking about games even when you are not playing, or planning when you can play next?”, Petry et al., 2014, p. 3), 不仅无法分辨高投入者和成瘾者, 甚至不足以说明被诊断的行为是否属于成瘾行为.第三, 9标准的表述过于简单, 没有考虑其他因素的交互影响.例如欺骗/掩饰(Deception “refers to individuals lying to others about, or covering up the extent of, behaviors”, Petry et al., 2014, p. 5)与社会文化背景和玩家的生活环境有密切关系, 但DSM-5 (American Psychiatric Association, 2013)和Petry等人(2014)的解释中均未提及.

显然, 提出争议的学者认为DSM-5给出的IGD诊断标准并未描述出其代表性症状, 内容表述不够明确, 可操作性十分有限, 因而诊断效度不高.甚至认为这个标准潜在地提高了病态化正常游戏行为的风险(Krossbakken et al., 2017).

2.1.2 对9标准诊断阈值的质疑

尽管APA也认为在确定最佳诊断标准和诊断阈值(threshold for diagnosis)之前, 诊断IGD必须采取符合5条标准及以上的保守方案, 但仍有反对的声音.Starcevic (2017)强调, 9条标准各自与IGD的相关程度有明显差异, 满足5条即可确诊过于简单.任意5条标准组合的方式很多, 测出的患者是大范围的连续体集合, 这个集合包含了从症状轻微到有严重成瘾症状的个体.因此9标准的诊断结果并不能区分疑似成瘾者和真实成瘾者, 也不能区分出成瘾患者和高投入者.于是多位学者提出IGD诊断标准应该有主次结构, 但区分主次的意见却不一致.一些学者认为沉湎,耐受性和心境改变相关的内容应作为次级标准, 而其他与成瘾的核心症状更接近的标准, 例如戒断反应,试图减少使用但失败等(Brunborg et al., 2013; Charlton & Danforth, 2007; Ferguson et al., 2011)应该作为核心标准.但Brunborg, Hanss, Mentzoni和Pallesen (2015)的一篇采用因素分析的报告发现沉湎,戒断反应,逃避不良情绪应该是IGD诊断的次要标准.

区分9条标准主次程度不仅影响了阈值的设定, 而且影响了达到确诊要求的病程时间跨度的设定.若患者核心症状表现明显, 即使时间较短也应该确诊.Carbonell (2017)认为12个月的考察期更适合诊断青少年, 因为他们行为特征还不稳定.DSM-5中大部分诊断的病程参考都设定为6个月, 但IGD和赌博成瘾都是以12个月为限.Krossbakken等人(2017)提出, 时间跨度需要与实际情境相结合来考虑.

2.2 对测量工具的质疑

一是测量工具杂乱.由于DSM-5给出的IGD诊断标准还在争论之中, IGD依然缺乏权威性的通用诊断工具.2013年一篇综述发现, 63项与IGD相关的量化研究中使用了18种不同的测量工具(King, Haagsma, Delfabbro, Gradisar, & Griffiths, 2013), 大部分测量工具中的条目是直接沿用物质成瘾的(Anderson, 2001), 另一些则借用DSM-4中病理性赌博的标准(Gentile, 2009), 或采用强迫症及其他标准(Aboujaoude, Koran, Gamel, Large, & Serpe, 2006; Desai, Krishnansarin, Cavallo, & Potenza, 2010; Shapira, Goldsmith, Keck, Khosla, & Mcelroy, 2000).

因为诊断标准不一, 造成不同工具的诊断阈值,时间跨度,确认IGD的核心要素也各异.一些诊断工具规定个体符合1条或者少数标准即是成瘾(Hur, 2006), 有些要求满足多数或者全部的标准才能确诊(Tao et al., 2010; Festl, Scharkow, & Quandt, 2013; Haagsma, Pieterse, & Peters, 2012).即使遇到类似的标准, 也采取了不同的表达方式, 例如沉湎这条, 被分别表述为“你期待再次上网的次数有多频繁?” “你在游戏上花费多少时间?” “有多少次你是直到最后一刻才离线?” (Huang, Wang, Qian, Zhong, & Tao, 2007; Meerkerk, van Den Eijnden, Vermulst, & Garretsen, 2009).

二是测量工具不全面.目前的IGD诊断工具缺乏细分, 针对青少年和成年人的量表不做区分, 他评,自评以及对不同游戏的玩家使用的测量工具也不做区分.Carbonell (2017)认为, 不同游戏类型吸引的玩家的特质不同, 因此不同游戏的成瘾者应该具备不同的特征, 即症状表现的侧重点不同.混乱且不全面的诊断工具都存在跨文化效度和跨年龄效度的问题, 这大大降低了评定者信度和疾病预测效度, 使得IGD患病率在1% (Festl et al., 2013; Mentzoni et al., 2011; Ferguson et al., 2011)到接近15%之间浮动(Choo et al., 2010; Gentile, Coyne, & Bricolo, 2013).

显然, 迫切需要一个更加细化,针对不同人群的标准测量工具, 这是确诊患者和有效治疗的基础, 是世界范围内IGD领域研究者交流的前提.

3 研究方法上的争议

3.1 研究方法缺乏理论支撑

在Young (1998)提出网络成瘾(Internet Addiction)以后, 成瘾的概念先入为主地成为理解过量的特定网络行为的框架.目前检验新的行为成瘾的方法十分简单, 包含三个步骤:第一步, 基于对某些轶事的观察, 瞄准一个目标行为, 将其预设为成瘾行为.第二步, 根据传统的物质成瘾的诊断标准建立一个筛查工具.第三步, 用研究检验某些引发及维持物质成瘾的风险因子是否与预设的成瘾行为相关(Billieux, Schimmenti, Khazaal, Maurage, & Heeren, 2015; James & Tunney, 2017).这种非理论的,验证性的研究方法的缺陷在于忽略了不同行为的特异性.并且, 大多数鉴别新的行为成 瘾的研究忽视了对两个必要性元素的检验:功 能性损伤和失调行为的稳定性(Griffiths, King, & Demetrovics, 2014).

Starcevic (2017)从四个方面提出了直接套用成瘾框架的缺陷:1)限制了将其放在其他概念框架下的研究思路; 2) IGD患者不能通过延长玩游戏时间来缓解戒断症状, 这与成瘾表现明显不符; 3)成瘾通常在不治疗的情况下会逐步加深, 但IGD存在很多自愈的情况; 4)游戏问题常与各种心理疾病伴随出现, 无法检验因果关系.

IGD领域在这种缺乏理论性的方法下虽然得出了丰富的研究成果, 但缺乏初步的定性研究帮助我们理解该问题行为的特异性表现, 无法基于该行为本身特性建立理论模型, 对其影响因子和发展过程的假设更多只能依靠主观的猜想.因此可能一些研究一开始就建立在错误的假设上, 而无法经受实证研究的检验(Müller & Wölfling, 2017).近期一个纵向研究发现过量游戏问题的发展过程往往是偶然的,短暂的, 不治疗的情况下可能自动消退, 缺乏时间稳定性(Konkolÿ Thege, Woodin, Hodgins, & Williams, 2015), 显然, 与成瘾概念不符.

3.2 研究数据过分依赖问卷调查

虽然大多数精神障碍的诊断都是以问卷为基础(Kuss et al., 2017a), 但问卷的作用是评定精神障碍的严重程度, 无法单独用于确诊, 因此有学者明确指出IGD的患病率数据与进入医疗系统的病人数量间存在巨大的差异(van Rooij, Schoenmakers & van de Mheen, 2017).Ferguson等人(2011)提到, 对先进科技产品过度使用的调查可能将被试分为3类, A类是没有问题的使用者(group A: non- problematic), B类是体验到轻微问题的使用者(group B: problematic users); C类是有严重问题, 有潜在功能性损伤的但还能正常生活的使用者(group C: functional impairment).问卷只能测出A类,B类和一小部分C类, 例如对IGD的测量, 即便问卷的临床效标效度很高, 理论上可以有效检测出功能损伤者, 但实际操作中功能损伤者因为认知或者其他功能的损伤是无法完成问卷的, 问卷测出的主要还是有轻微问题的游戏使用者.因此使用问卷无法准确检测出人群中IGD患者的真实比例和行为特征.

大量使用问卷的同时, 临床研究数据却十分匮乏.由于目前IGD还未正式纳入精神障碍清单, 定义及诊断标准都有待研究, 许多临床医生并未认可IGD的真实存在.欧洲的一些医院和门诊并未设立针对IGD的初步问诊项目, 也不会对病人执行IGD的诊断(Müller & Wölfling, 2017), 对IGD的自然发展过程的研究并未受重视.

虽然现在通过其他研究方法, 例如神经成像研究发现, IGD与传统的成瘾在神经和生物学上确有相关(Kuss & Griffiths, 2012; Pontes et al., 2017), 也有越来越多临床的实证研究证明IGD的存在(例如, Sakuma et al., 2017; Yao et al., 2017; Young, 2013), 但这些研究方法的使用率远低于问卷法, 难以确定IGD在人群中的真实情况.再加上目前IGD诊断工具的混乱局面, 既无法准确诊断IGD, 也无法确定IGD与其他心理问题共病的因果关系, 如抑郁等(van Rooij & Kardefeltwinther, 2017).对IGD的研究需要更系统和更有针对性的多种研究方法的支持.

3.3 电子游戏的积极作用被忽视

对电子游戏的研究过于聚焦于电子游戏的消极作用, 忽视其许多方面的积极作用.在美国, 97%的儿童和青少年每天至少玩1小时电子游戏(Granic, Lobel, & Rutger, 2014).成年人中, 50%的男性和48%的女性玩电子游戏(Duggan & Maeve, 2015).从IGD患病率的数据来看, 至少90%以上的玩家没有成瘾症状.不同的游戏带来的人机互动体验不同, 而体验式的快乐是持续最长久且记忆最深刻的(Dunn, Gilbert, & Wilson, 2011), 对游戏行为的研究应该更多关注这绝大部分正常游戏者的积极体验.

事实上, 游戏和认知能力之间的研究已经开展了近30年(Spence & Feng, 2010).玩电子游戏需要以认知技能为基础, 如专心,集中,反应时间,记忆力, 在游戏过程中, 手眼协调能力,数学能力和语言能力得到提高(Barlett, Vowels, Vowels, Crow, & Miller, 2009).从游戏庞大的分类系统和复杂的设计就能预见这一点.第一人称射击游戏的研究(Feng, Spence, & Pratt, 2007),电子游戏对注意转移和注意瞬脱(attention blink)的作用(Green & Bavelier, 2003),基本和复杂空间加工的研究(Green & Bavelier, 2003; Li, Polat, Makous, & Bavelier, 2009; Feng et al., 2007)都证明了电子游戏能训练个体的认知能力.在进行训练后, 由电子游戏带来的认知能力的提高会持续数月甚至数年(Spence & Feng, 2010; Feng et al., 2007).在电子游戏影响孩子学习成绩的问题上, van Schie和Wiegman (1997)对346名儿童(平均年龄11.5岁)进行了研究, 结果表明, 玩游戏的时间长短和学习成绩之间没有显著相关.事实上, 如果不玩游戏, 那些时间也会被看电视,看报纸和漫画书,玩无组织的体育活动,玩室内游戏,在电脑上工作消耗掉.

已有研究表明, 一方面电子游戏具有积极 的道德作用.游戏可以提高玩家的亲社会思维(Greitemeyer & Osswald, 2011), 因为游戏中的同情和互助行为与现实世界中相类似.因此一些学者(Lavergne Boudier & Dambach, 2010)喜欢使用“严肃游戏” (serious game)称呼具有积极道德作用的游戏.这个称谓涵盖了多种情况, 如寓教于乐的软件,模拟演练活动(驾驶,外科手术,企业管理等),肢体运动和智力训练的电子游戏.另一方面, 电子游戏还能应用于预防功能衰退和对特殊人群的干预(老年人,学习吃力的儿童, 超重等).旨在改变儿童行为的健康计划中, 游戏中的“故事背景”可以成功提高儿童的注意力, 增加娱乐性, 可以促进行为改变(Baranowski, Cullen, Nicklas, Thompson, & Baranowski, 2002; Summerbell, 2007).Gil-Gomez, Lloréns, Alcañiz和Colomer (2011)对遭受脑损伤人群进行调查, 结果发现在Wii (任天堂公司推出的一款家用游戏机)平台进行的训练对传统治疗是一种有效的辅助手段, 可以改善这些人的静态平衡能力.

4 争议带来的启示

从以上争论中可以看出, 无法准确定义IGD是研究者对网络游戏行为本身还缺乏全面的认识.网络游戏行为不像药物滥用或者赌博行为, 一旦发生便可以认定其有害于健康.因此最核心的问题在于如何区分正常游戏者与成瘾者.由于不了解正常的游戏行为, 因而难以定义失常的游戏行为.

从重新认识游戏行为的角度, 网络游戏行为似乎是科技进步,文化融合,经济发展等社会因素影响下, 一种生活方式的新趋势.很明显, 现在大多数青少年已经选择了网络游戏作为日常重要的休闲社交甚至社会化的工具(Granic et al., 2014).目前被看作是社会功能受到损害的表现或许在不远的将来会成为人们正常的生活方式.由于道德恐慌造成的夸大IGD影响的现状, 从侧面反映出的是人类社会对于科技产品迅速改变生活方式带来的不适应, 对IGD的争论反映出的是人类社会新旧生活方式之间的冲突.研究者需要退一步思考的是, 我们是否能接受网络游戏包括其带来的潜在危害作为一种生活方式存在, 例如冲浪爱好者冒着葬身大海的风险, 投入大量时间练习冲浪.而目前电竞已然成为一种职业, 网络游戏可能是许多需要投入大量时间并可能对健康造成危害的工作之一.研究者需要判断是否网络游戏行为存在潜在危害但并不是需要治疗的疾病.

从区分正常与失常游戏行为的角度, IGD作为第一个网络技术发展带来的潜在精神障碍, 无法简单地依据过去定义其它精神障碍的经验来判断.是否把它纳入成瘾或者其他精神障碍, 显然不能只是通过患病率,社会功能损伤,使用时间等单一指标来判断.IGD是一个新事物, 需要从了解该事物本身的特性着手, 从游戏设计目的角度分析网络游戏的特点.一部分研究者已经尝试从联网与IGD的关系角度探索网络游戏的成瘾潜质.还需要分析线下游戏的成瘾机制, 以说明线上游戏与线下游戏之间的本质差异.

除了对游戏行为本身的研究之外, 确定IGD的成瘾特质还应该考虑其他因素的相互作用.从患病率很低并且在接近20年的时间里一直保持平稳的数据可以看出, IGD与网络游戏玩家爆发式的增长状况不成比例.这预示着IGD的发生与网络游戏使用量不是直接相关, 而可能受到其它潜在因素的影响, 例如人格特质.而诊断工具的杂乱一方面反应出IGD缺乏标准定义的问题, 一方面反映出不同社会文化的影响.亚洲报告的IGD案例最多(American Psychiatric Association, 2013), 从侧面表现出的是集体主义文化对于个人化的游戏行为的排斥.网络游戏行为的研究必须要考虑个人心理特质和社会因素以及游戏本身特点的交互作用.

将失常的网络游戏行为放在成瘾,强迫症以及其他概念框架下进行检验, 这是IGD研究的方法之一, 但不应该是主要方法.研究者需要花更多时间依据网络游戏本身的特点建立IGD概念的理论框架, 对理论框架进行检验.依赖问卷的研究方法必定不再符合对网络游戏行为以及其他网络行为这类新事物的研究需求.James和Tunney (2017)提出对行为成瘾应该进行行为分析.从联想学习和强化模型的角度来解释IGD的成瘾机制可能是IGD研究方法的突破点.

5 IGD的研究趋势

5.1 对游戏类型的研究

要区分正常的游戏行为和IGD, 首先要对游戏行为有全面的理解.对游戏本身特点的研究和游戏行为的研究应该同时进行.目前游戏产业丰厚的经济产出推动游戏设计迅速地推陈出新.游戏开发者以留住玩家为目的加入尽量多的强化游戏行为的元素, 例如游戏中对战后随机掉落的装备带来的随机奖励,升级目标带来的成就感以及各种炫目视觉刺激, 任何一种因素都可能是吸引玩家甚至造成上瘾的因素.不同因素对不同个体的吸引程度差异可能对应了不同的游戏动机和身心特质的差异.

研究过程中应该区分在线与离线游戏之间差异, 还需分辨不同的游戏类型之间的差别.与联网相关的社交功能应该是在线和离线游戏上瘾机制差异研究中首先需要检验的内容.目前对最易上瘾的网络游戏MMORPGs (Massively Multiplayer Online Role-Playing Games, 大型多人在线角色扮演游戏)的研究已经发现, 这类游戏最大的特点就是社交功能突出, 而游戏者能够在在虚拟的世界中获得社会身份认同(Billieux, Deleuze, Griffiths, & Kuss, 2015; Gabbiadini, Mari, Volpato, & Grazia Monaci, 2016).而网络游戏里, FPS (First Person Shooter, 第一人称射击游戏),MOBA (Multiplayer Online Battle Arena, 多人在线战术竞技游戏)及其他类型游戏的主要特点和上瘾特质还不明确, 游戏类型与IGD的关系需要研究者给予关注.从游戏本身的特点对不同游戏者的吸引程度的角度深入研究, 可能是区分不同的网络游戏成瘾亚型的关键.

5.2 对影响网络游戏行为各因素的研究

大五人格与IGD关系的研究发现低责任心是显著的预测因子(Müller, Beutel, Egloff, & Wölfling, 2014), 脑科学的研究发现抑制功能的损伤和奖赏机制的缺陷与IGD有关(Argyriou, Davison, & Lee, 2017).但是这些因素与IGD的因果关系尚不明了, 还需进一步研究.个体的认知风格,态度以及患有其他精神障碍如何影响游戏行为, 这是从个人特质角度的重要研究内容.需要增加IGD患者临床数据的研究报告, 了解完整的IGD发展与病程.

DSM-5工作组发现目前240多篇已发表的文献中, 亚洲研究中的患病率普遍高于欧美国家(American Psychiatric Association, 2013), 有研究者推测这是由于集体主义文化对个人化的游戏行为容忍度更低(Carbonell, 2017; Griffiths, 2013), 未来可以通过游戏行为的跨文化差异对比研究进行验证.已有的研究证明了游戏体验与社会文化情境之间的相关(e.g., Kuss, 2013a, 2013b).

另外, 个人特质与社会环境因素之间的相互影响, 也是影响游戏行为的重要方面, 例如社会情境对个体拥有社会身份认同的要求, 可能促使患社交恐惧的个体通过网络游戏行为更轻松地获得社会身份认同, 已有研究发现社交恐惧患者网络游戏时间更长(Wei, Chen, Huang & Bai, 2012), 且社交恐惧症与IGD症状正相关(Sioni et al., 2017).正如Carbonell (2017)提出的从玩家动机入手有助于鉴别高投入者与成瘾者.因此, 未来的研究需要证明这些假设.

5.3 对游戏行为积极作用的研究

电子游戏正逐步改变我们的生活方式, 研究者应当将电子游戏的积极影响放在同样重要的地位, 增加更多关于电子游戏对身体运动功能和脑功能改善方面的研究, 使电子游戏能在教育,智力开发,干预治疗中充分发挥其积极作用.从目前对电子游戏积极意义的研究数据来看, 未来的电子游戏将会有更大的应用空间.

尤其应该关注的是, 电子游戏逐渐取代了传统游戏, 占据了儿童的游戏时间以后, 对儿童,青少年的社会化的影响.

未来研究从以上3个方面着手, IGD研究者的视野将被拓宽, 研究方法将得到改进, IGD的定义将更加准确, 建立在对游戏行为充分了解的基础上, IGD的诊断标准将更加的明确.目前最紧迫的也许不是让IGD的定义和诊断标准迅速达成共识, 研究者需要更多时间更全面更深刻地理解游戏行为, 才能给出恰当的评价.

参考文献

Aarseth E., Bean A., Boonen H., Colder Carras M., Coulson M., Das D ., .. van Rooij, A. J. (2017).

Scholars’ open debate paper on the world health organization ICD-11 gaming disorder proposal.

Journal of Behavioral Addictions, 6(3), 267.

URL     PMID:5700734      [本文引用: 1]

Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world.

Aboujaoude E., Koran L. M., Gamel N., Large M. D., & Serpe R. T . (2006).

Potential markers for problematic internet use: A telephone survey of 2,513 adults.

CNS Spectrums, 11(10), 750-755.

URL     PMID:17008818      [本文引用: 1]

The Internet has positively altered many aspects of life. However, for a subset of users, the medium may have become a consuming problem that exhibits features of impulse control disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. This is the first large-scale epidemiological study of problematic Internet use through a random-digit-dial telephone survey of 2,513 adults in the United States. Given the lack of validated criteria, survey questions were extrapolated from established diagnostic criteria for impulse control disorders, obsessivecompulsive disorder, and substance abuse. Four possible diagnostic criteria sets were generated.The least restrictive set required the respondent to report an unsuccessful effort to reduce Internet use or a history of remaining online longer than intended, Internet use interfering with relationships, and a preoccupation with Internet use when offline. The response rate was 56.3%. Interviews averaged 11.3 minutes in duration. From 3.7% to 13% of respondents endorsed 1 markers consistent with problematic Internet use. The least restrictive proposed diagnostic criteria set yielded a prevalence of problematic Internet use of 0.7%. Potential markers of problematic Internet use seem present in a sizeable proportion of adults. Future studies should delineate whether problematic Internet use constitutes a pathological behavior that meets criteria for an independent disorder, or represents a symptom of other psychopathologies.

American Psychiatric Association. DSM-5 Task Force. (2013).

Diagnostic and Statistical Manual of Mental Disorders: DSM-5™. Arlington, VA.

US.

[本文引用: 8]

Anderson K.J . (2001).

Internet use among college students: An exploratory study.

Journal of American College Health, 50(1), 21-26.

URL     PMID:11534747      [本文引用: 1]

The author and associates surveyed 1,300 college students in classrooms at eight academic institutions to identify how the students'' use of the Internet has affected their social or academic lives. Although the typical Internet-using student uses the Internet for 100 minutes per day, a small group of students use the Internet to a degree that interferes with other aspects of their lives. Most of them are men and are found among the hard science academic majors. Some ideas for dealing with this problem are suggested.

Argyriou E., Davison C. B., & Lee T. T . (2017).

Response inhibition and internet gaming disorder: A meta-analysis.

Addictive Behaviors, 71, 54-60.

URL     PMID:28264786      [本文引用: 1]

Abstract Previous research has demonstrated that Internet Gaming Disorder (IGD) has multiple negative effects in psychological functioning and health. This makes the identification of its underpinnings, such as response inhibition, essential for the development of relevant interventions that target these core features of the disorder resulting in more effective treatment. Several empirical studies have evaluated the relationship between response inhibition deficits and IGD using neurocognitive tasks, but provided mixed results. In this study, we conducted a meta-analysis of studies using three neurocognitive tasks, the Go/No Go, the Stroop, and the Stop-Signal tasks, to integrate existing research and estimate the magnitude of this relationship. We found a medium overall effect size (d=0.56, 95% CI [0.32, 0.80]) indicating that compared with healthy individuals, individuals with IGD are more likely to exhibit impaired response inhibition. This finding is in alignment with literature on inhibition and addictive and impulsive behaviors, as well as with neuroimaging research. Theoretical implications regarding the conceptualization of IGD as a clinical disorder, shared commonalities with externalizing psychopathology, and clinical implications for treatment are discussed. Copyright 2017 Elsevier Ltd. All rights reserved.

Baranowski T., Cullen K. W., Nicklas T., Thompson D., & Baranowski J . (2002).

School-based obesity prevention: A blueprint for taming the epidemic.

American Journal of Health Behavior, 26(6), 486-493.

URL     PMID:12437023      [本文引用: 1]

To review the literature on school-based obesity prevention programs to identify what can be done to minimize the increasing levels of obesity. Twenty articles reporting school-based dietary or physical activity change programs were identified that used BMI or skinfolds as part of the evaluation. Seven studies obtained change in BMI and differed from those not finding change in 3 ways: program implementers were not classroom teachers; intervention targeted middle or high schools; and inactivity reduction was promoted. An 8-step research strategy was delineated to develop and evaluate programs with a maximum chance of taming the obesity epidemic.

Barlett C. P., Vowels C. L., Shanteau J., Crow J., & Miller T . (2009).

The effect of violent and non-violent computer games on cognitive performance.

Computers in Human Behavior, 25(1), 96-102.

URL     Magsci     [本文引用: 1]

Two studies were conducted in order to determine the impact computer games had on the cognitive performance. Study 1 evaluated a measure of cognition, which incorporates aspects of short-term working memory, visual attention, mathematical decision making, and auditory perception. Study 2 measured the cognitive performance between those who did not play video games versus those who played either a violent or non-violent video game. Results from Study 1 indicate participants needed approximately four trials to reach asymptotic performance on the cognitive measure. Results of Study 2 showed that participants who did not play any video game did not have a change in their cognitive performance, while those who played either a violent or non-violent video game had an increase in their cognitive performance.

Barnett J., & Coulson M. (2010).

Virtually real: A psychological perspective on massively multiplayer online games.

Review of General Psychology, 14(2), 167-179.

URL     [本文引用: 1]

Massively multiplayer games (MMOs) are immersive virtual three-dimensional fantasy worlds in which people cooperate and compete with each other, as well as with the computer-generated denizens of that particular game world. Although typically seen as games, their strong social aspect suggests that they are a form of online communication tool, with which players interact to form friendships, create communities, and work together to accomplish a variety of goals. After an introduction to MMOs, this review explores how social aspects of the game imitate the real world in terms of choices that players make when interacting with others. Furthermore, player-to-player interactions are examined in terms of in-game group formation and how efficient communication is imperative for goal achievement. The review also explores how leadership skills learned in-game may be transferred to real-world scenarios. The reasonswhy people play MMOs are examined in terms of player motivations and how aspects of game play may have both positive and negative consequences for a player well being. The latter half of the review describes how MMOs are used as afterschool virtual teaching environments where students can use aspects of game play to learn, for example, leadership qualities. The review concludes with recommendations for using MMOs as virtual laboratories to explore aspects of human behavior.

BBC News.

South Korean Dies after Gaming Session. Retrieved June 25, 2017, 2005from

South Korean Dies after Gaming Session. Retrieved June 25, 2017, 2005from

URL    

Billieux J., Deleuze J., Griffiths M. D., & Kuss D. J . (2015).

Internet gaming addiction: The case of massively multiplayer online role-playing games.

In Textbook of addiction treatment: International perspectives(pp. 1515- 1525). Springer, Milano.

URL     [本文引用: 3]

Internet gaming disorder is one of the main types of Internet-related disorders. Recently, and despite inconsistencies in classification and limited data regarding the etiology of the condition, Internet gaming disorder has been included in Sect. 3 (research appendix) of the DSM-5. The focus of the current chapter was the dysfunctional involvement in a specific type of video game which has some inherent characteristics reinforcing its addictive nature: Massively Multiplayer Online Role-Playing Games (MMORPGs). MMORPGs are indeed one of the most recent and popular types of video games played worldwide, and problematic and uncontrolled involvement in playing MMORPGs is the most frequently reported activity by people seeking help for an Internet-related problem. In this chapter, we first described the specific structural characteristics of MMORPGs themselves (e.g., permanent world, reinforcement schedule, advancement systems, interface favoring social exchanges) and explained how they can increase their ddictive potential. Then, the main psychological factors (motives to play, impulsivity traits) were reviewed alongside neurobiological features (e.g., changes in neural circuitry involved in controlled regulation of behavior and reward drive) related to the development and maintenance of MMORPG addiction. The few available studies having tested the efficacy of treatments targeting Internet and video game addictions were also briefly considered. Limitations of existing data are emphasized, and avenues for further research proposed (both at the theoretical and clinical levels).

Billieux J., Schimmenti A., Khazaal Y., Maurage P., & Heeren A . (2015).

Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research.

Journal of Behavioral Addictions, 4(3), 119-123.

URL     PMID:4627675      [本文引用: 1]

This commentary supports the argument that there is an increasing tendency to subsume a range of excessive daily behaviors under the rubric of non-substance related behavioral addictions. The concept of behavioral addictions gained momentum in the 1990s with the recent reclassification of pathological gambling as a non-substance behavioral addiction in DSM-5 accelerating this process. The propensity to label a host of normal behaviors carried out to excess as pathological based simply on phenomenological similarities to addictive disorders will ultimately undermine the credibility of behavioral addiction as a valid construct. From a scientific perspective, anecdotal observation followed by the subsequent modification of the wording of existing substance dependence diagnostic criteria, and then searching for biopsychosocial correlates to justify classifying an excessive behavior resulting in harm as an addiction falls far short of accepted taxonomic standards. The differentiation of normal from non-substance addictive behaviors ought to be grounded in sound conceptual, theoretical and empirical methodologies. There are other more parsimonious explanations accounting for such behaviors. Consideration needs to be given to excluding the possibility that excessive behaviors are due to situational environmental/social factors, or symptomatic of an existing affective disorder such as depression or personality traits characteristic of cluster B personalities (namely, impulsivity) rather than the advocating for the establishment of new disorders.

Brunborg G. S., Hanss D., Mentzoni R. A., & Pallesen S . (2015).

Core and peripheral criteria of video game addiction in the game addiction scale for adolescents.

Cyberpsychology, Behavior, and Social Networking, 18(5), 280-285.

URL     PMID:4432774      [本文引用: 2]

Abstract Assessment of video game addiction often involves measurement of peripheral criteria that indicate high engagement with games, and core criteria that indicate problematic use of games. A survey of the Norwegian population aged 16-74 years (N=10,081, response rate 43.6%) was carried out in 2013, which included the Gaming Addiction Scale for Adolescents (GAS). Confirmatory factor analysis showed that a two-factor structure, which separated peripheral criteria from core criteria, fitted the data better (CFI=0.963; RMSEA=0.058) compared to the original one-factor solution where all items are determined to load only on one factor (CFI=0.905, RMSEA=0.089). This was also found when we analyzed men aged 0909¤33 years, men aged >33 years, women aged 0909¤33 years, and women aged >33 years separately. This indicates that the GAS measures both engagement and problems related to video games. Multi-group measurement invariance testing showed that the factor structure was valid in all four groups (configural invariance) for the two-factor structure but not for the one-factor structure. A novel approach to categorization of problem gamers and addicted gamers where only the core criteria items are used (the CORE 4 approach) was compared to the approach where all items are included (the GAS 7 approach). The current results suggest that the CORE 4 approach might be more appropriate for classification of problem gamers and addicted gamers compared to the GAS 7 approach.

Brunborg G. S., Torsheim T., Melkevik O. R., Mentzoni R. A., Samdal O., Hetland J ., et al. Palleson, S. (2013).

Gaming addiction, gaming engagement and psychological health complaints among Norwegian adolescents.

Media Psychology, 16(1), 115-128.

URL     Magsci    

Distinguishing high engagement with games from gaming addiction has been a challenge for researchers. We present evidence that an established self-report instrument can be used to distinguish addicted gamers from highly engaged gamers. The study used data from the World Health Organization's survey, Health Behaviour in School-Aged Children. A nationally representative sample of Norwegian eighth graders completed the Game Addiction Scale for Adolescents. Respondents who endorsed all four of the core criteria for addiction (relapse, withdrawal, conflict, and problems) were categorized as addicted gamers. Respondents who endorsed two or three of the core criteria were categorized as problem gamers. Those who endorsed all three peripheral criteria (salience, tolerance, and mood modification), but not more than one of the addiction criteria, were categorized as highly engaged gamers. Controlling for gender and physical exercise, gaming addicts and problem gamers had greater risk of feeling low, feeling irritable or in a bad mood, feeling nervous, feeling tired and exhausted, and feeling afraid. The highly engaged gamers did not have greater risk of psychological health complaints. This suggests that it is possible to distinguish addicted and problem gamers with psychological health complaints from adolescents who are merely highly engaged gamers.

Carbonell X. . (2017).

From pong to pokemon go, catching the essence of the internet gaming disorder diagnosis.

Journal of Behavioral Addictions, 6(2), 124-127.

[本文引用: 1]

Charlton J.P., &Danforth I. D.W . (2007).

Distinguishing addiction and high engagement in the context of online game playing.

Computers in Human Behavior, 23(3), 1531-1548.

URL     Magsci     [本文引用: 2]

This study considered whether the distinction between core and peripheral criteria for behavioral addiction, previously drawn with respect to computing activities in general, applies in the specific area of Massively Multiplayer Online Game playing. Questionnaire items were administered over the Internet to 442 game players. Factor-analysis of the data supported the previous findings for computing in general. An addiction factor loaded on items tapping previously identified core criteria (conflict, withdrawal symptoms, relapse and reinstatement and behavioral salience) and a (non-pathological) engagement factor loaded on items tapping previously identified peripheral criteria (cognitive salience, tolerance and euphoria). Analysis of response frequencies supported the existence of a developmental process whereby peripheral criteria are met before core criteria. Players who might be considered addicted using a monothetic classification system involving only the core criteria were shown to spend a significantly greater amount of time playing per week than those endorsing only the peripheral criteria. It is concluded that the study supports the idea that it is inappropriate to use some of the previously used criteria for addiction when researching or diagnosing computer-related addictions. Implications of the present findings for Internet-mediated data collection methodologies are also discussed.

Choo H., Gentile D. A., Sim T., Li D. D., Khoo A., & Liau A. K . (2010).

Pathological video-gaming among singaporean youth.

Annals Academy Medicine, 39(11), 822-829.

URL     PMID:21165520     

Increase in internet use and video-gaming contributes to public concern on pathological or obsessive play of video games among children and adolescents worldwide. Nevertheless, little is known about the prevalence of pathological symptoms in video-gaming among Singaporean youth and the psychometric properties of instruments measuring pathological symptoms in video-gaming.A total of 2998 children and adolescents from 6 primary and 6 secondary schools in Singapore responded to a comprehensive survey questionnaire on sociodemographic characteristics, video-gaming habits, school performance, somatic symptoms, various psychological traits, social functioning and pathological symptoms of video-gaming. After weighting, the survey data were analysed to determine the prevalence of pathological video-gaming among Singaporean youth and gender differences in the prevalence. The construct validity of instrument used to measure pathological symptoms of video-gaming was tested.Of all the study participants, 8.7% were classified as pathological players with more boys reporting more pathological symptoms than girls. All variables, including impulse control problem, social competence, hostility, academic performance, and damages to social functioning, tested for construct validity, were significantly associated with pathological status, providing good evidence for the construct validity of the instrument used.The prevalence rate of pathological video-gaming among Singaporean youth is comparable with that from other countries studied thus far, and gender differences are also consistent with the findings of prior research. The positive evidence of construct validity supports the potential use of the instrument for future research and clinical screening on Singapore children and adolescents' pathological video-gaming.

Chuang Y.C . (2006).

Massively multiplayer online role-playing game-induced seizures: A neglected health problem in internet addiction.

Cyberpsychology & Behavior, 9(4), 451-456.

URL     PMID:16901249      [本文引用: 1]

As the Internet has become rapidly and widely integrated into society, Internet addiction has become a growing psychosocial problem. However, epileptic seizure, another out-of-the-ordinary health problem, is often neglected in this regard. Ten patients who experienced epileptic seizures while playing the newest genre of electronic games -- Massively Multiplayer Online Role-Playing Games (MMORPGs) -- were investigated. Patients were predominantly male young adults, and most of the events were generalized tonic-clonic seizures, myoclonic seizures, and absences. These patients should be categorized into idiopathic generalized epilepsies. Even though photosensitivity was an important factor, behavioral and higher mental activities also seemed to be significant seizure precipitants. Results demonstrated that MMORPG-induced seizures were not analogous to the ordinary video game-induced seizures. Significantly, an epileptic seizure warning did not always appear on the websites of MMORPGs and instructions for the software. While the prevalence of MMORPG-induced seizures remains unknown, it may exceed our expectations and impact our society. Not only for clinical neurologists but also for the primary physicians, educators, sociologists, and global online game publishers, there should be an awareness of this special form of reflex seizures in order to provide an appropriate health warning to MMORPG players.

Davies J.B . (1998).

Pharmacology versus social process: Competing or complementary views on the nature of addiction?

Pharmacology & Therapeutics, 80(3), 265-275.

URL     PMID:9888697      [本文引用: 1]

Pharmacological/physiological models and social process/cognitive models of addiction are compared. These are discussed both in terms of the types of data produced and the philosophies of knowledge that underlie the two approaches. It is suggested that the notion of addiction confounds these two sets of issues, especially with respect to the notions of volition and compulsion. The problem is highlighted by data that reveal verbal reports to be variable and context dependent. It is concluded that a better understanding of the nature of addiction requires a clearer distinction between the pharmacological/physiological approach and the social process/cognitive approach. Both approaches contribute usefully to knowledge and have predictive value. Confusion arises, however, where workers fail to see not merely the benefits, but also the limitations, of these two approaches to the addiction problem.

Desai R. A., Krishnan-Sarin S., Cavallo D., & Potenza M. N . (2010).

Video game playing in high school students: Health correlates, gender differences and problematic gaming.

Pediatrics, 126(6), 1414-1424.

URL     PMID:21078729      [本文引用: 1]

Abstract OBJECTIVE: Video game playing may negatively impact youth. However, the existing literature on gaming is inconsistent and often has focused on aggression rather than the health correlates of gaming and the prevalence and correlates of problematic gaming. METHODS: We anonymously surveyed 4028 adolescents about gaming and reported problems with gaming and other health behaviors. A total of 51.2% of the sample reported gaming (76.3% of boys and 29.2% of girls). RESULTS: There were no negative health correlates of gaming in boys and lower odds of smoking regularly; however, girls who reported gaming were less likely to report depression and more likely to report getting into serious fights and carrying a weapon to school. Among gamers, 4.9% reported problematic gaming, defined as reporting trying to cut back, experiencing an irresistible urge to play, and experiencing a growing tension that could only be relieved by playing. Boys were more likely to report these problems (5.8%) than girls (3.0%). Correlates of problematic gaming included regular cigarette smoking, drug use, depression, and serious fights. Results suggest that gaming is largely normative in boys and not associated with many health factors. In girls, however, gaming seems to be associated with more externalizing behaviors and fewer internalizing symptoms. CONCLUSIONS: The prevalence of problematic gaming is low but not insignificant, and problematic gaming may be contained within a larger spectrum of externalizing behaviors. More research is needed to define safe levels of gaming, refine the definition of problematic gaming, and evaluate effective prevention and intervention strategies.

Duggan. &Maeve . (2015).

Gaming and Gamers.

Pew Research Center.

[本文引用: 1]

Dunn E. W., Gilbert D. T., & Wilson T. D . (2011).

If money doesn't make you happy, then you probably aren't spending it right.

Journal of Consumer Psychology, 21(2), 115-125.

URL     Magsci     [本文引用: 3]

The relationship between money and happiness is surprisingly weak, which may stem in part from the way people spend it. Drawing on empirical research, we propose eight principles designed to help consumers get more happiness for their money. Specifically, we suggest that consumers should (1) buy more experiences and fewer material goods; (2) use their money to benefit others rather than themselves; (3) buy many small pleasures rather than fewer large ones; (4) eschew extended warranties and other forms of overpriced insurance; (5) delay consumption; (6) consider how peripheral features of their purchases may affect their day-to-day lives; (7) beware of comparison shopping; and (8) pay close attention to the happiness of others.

Feng J., Spence I., & Pratt J . (2007).

Playing an action video game reduces gender differences in spatial cognition.

Psychological Science, 18(10), 850-855.

[本文引用: 1]

Feng W., Ramo D. E., Chan S. R., & Bourgeois J. A . (2017).

Internet gaming disorder: Trends in prevalence 1998-2016.

Addictive Behaviors, 75, 17-24.

URL     PMID:28662436     

The activity of play has endured throughout human history and more recently, the Internet has emerged as a playground increasingly populated by gamblers, gamers, shoppers, and social networkers. Research suggests that a minority of online users experience symptoms raditionally associated with substance-related addictions, including mood modification, tolerance, conflict, and salience. Previous... [Show full abstract]

Ferguson C.J . (2010).

Blazing angels or resident evil? can violent video games be a force for good?

Review of General Psychology, 14(2), 68-81.

URL     [本文引用: 3]

Violent video games have been a source of controversy in the United States and elsewhere for several decades. Considerable concern has been raised in the public and scientific communities about the alleged deleterious effects of violent games. These concerns may coincide with periodic moral panics about media's influence, particularly on youth. This paper argues that the negative effects of violent games have been exaggerated by some elements of the scientific community, fitting with past cycles of media-focused moral panics. By contrast, potential positive effects of violent video game play have been ignored in the debate on violent games. The current paper considers research in several areas, including aggression, but also the nascent research fields of visuospatial cognition, social networking, and use as educational tools. It is argued that the debate on video game violence should be broadened to include both potential negative and positive effects.

Ferguson C. J., Coulson M., & Barnett J . (2011).

A meta- analysis of pathological gaming prevalence and comorbidity with mental health, academic and social problems.

Journal of Psychiatric Research, 45(12), 1573-1578.

URL     PMID:21925683      Magsci     [本文引用: 1]

BackgroundMental health professionals, policy makers and the general public continue to debate the issue of pathological video gaming. Scholars disagree on the prevalence and diagnostic criteria for this potential new disorder. The current meta-analysis considers existing scholarship to examine how differing measurement methods influence prevalence rates and associations with other mental health problems.MethodThirty three published studies and doctoral dissertations were analyzed in meta-analysis. Prevalence rates and comorbidity with other mental health problems were examined according to measurement method.ResultsPrevalence estimates and comorbidity with other problems varied widely between studies. Measurement which attempted to replicate athological gambling approaches produced higher prevalence estimates and lower comorbidity estimates than methods which focused on the interfering nature of pathological gaming. The most precise measures produce an overall prevalence rate of 3.1%.InterpretationDiagnostic analogies with pathological gambling may produce spuriously high prevalence estimates, potentially over identifying non-pathological players as pathological. Diagnostic approaches focused on the interfering nature on other life needs and responsibilities may have greater validity and utility.

Festl R., Scharkow M., & Quandt T . (2013).

Problematic computer game use among adolescents, younger and older adults.

Addiction, 108(3), 592-599.

URL     PMID:23078146      [本文引用: 1]

AimsPlaying digital games has been associated with forms of addictive behavior. Past research on the subject has often been criticized on theoretical and empirical grounds, due mainly to measurement or sampling issues. The present study aims to overcome these two limitations, and presents data from a representative study in Germany using an already established instrument for measuring problematic game use.DesignLarge-scale, representative study using a computer-assisted telephone survey.SettingGermany.ParticipantsA total of 580 adolescents between 14 and 18 years of age, 1866 younger adults between 19–39 years and 1936 older adults aged 4065years and older (overall n65=654382).MeasurementsProblematic game use was measured with the Gaming Addiction Short Scale (GAS), which covers seven criteria including salience, withdrawal and conflicts. Additionally, differential aspects of personality, as well as gaming behaviour, were measured.FindingsOnly seven respondents [0.2%, 95% confidence interval (CI): 0.1, 0.3] met all criteria of the GAS Scale. In contrast, 3.7% (95% CI: 3.1, 4.3) of the respondents can be considered problematic users, meeting at least half these conditions. The percentage of problematic gamers among adolescents is above average (7.6%, 95% CI: 5.6, 10.1). High GAS scores are associated with aggression, low sociability and self-efficacy and lower satisfaction with life. Additionally, these scores correspond with intensive use and preferences for certain gaming genres across all age groups.ConclusionsFollowing Gaming Addiction Short Scale criteria, gaming addiction is currently not a widespread phenomenon among adolescents and adults in Germany. Gaming Addiction Short Scale scores are associated with intensive use, as well as certain problematic aspects of individuals' personalities and social lives.

Gabbiadini A., Mari S., Volpato C., & Grazia Monaci M . (2016).

Identification processes in online groups: Identity motives in the virtual realm of mmorpgs.

Journal of Media Psychology Theories, Methods, and Applications, 26(3), 141-152.

URL     [本文引用: 1]

Online video games are a popular leisure activity around the world; such virtual environments enable new ways for social identity to develop. This study investigated the motives affecting social identification processes in the massive multiplayer online role-playing game (MMORPG) World of Warcraft (WoW). In this video game, players interact with other players in a tridimensional virtual world through their avatar. A sample of 92 WoW players took part in a data collection Web survey. Building on the theory of social identity, we tested the predictive power of three identification motives: self-esteem enhancement, optimal distinctiveness, and uncertainty reduction. Additionally, considering previous research on MMORPGs, we added identification with the game character and membership duration as further predictors of virtual group identification. The construct of virtual group identification was analyzed at two levels: identification with the faction and guild of the character. Furthermore, the current study ...

Gentile D. . (2009).

Erratum: Pathological video-game use among youth ages 8 to 18: A national study.

Psychological Science, 20(5), 594-602.

[本文引用: 1]

Gentile D. A., Coyne S. M. , & Bricolo, F.(2013). Pathological technology addictions:What is scientifically known and what remains to be learned In K E Dill (Ed), Oxford library of psychology The Oxford handbook of media psychology (pp 382-402) New York, NY, US: Oxford University Press What is scientifically known and what remains to be learned. In K. E. Dill (Ed.), Oxford library of psychology. The Oxford handbook of media psychology (pp. 382-402) . New York, NY, US: Oxford University Press.

[本文引用: 1]

Gil-Gómez J., Lloréns R., Alcañiz M., & Colomer C . (2011).

Effectiveness of a Wii balance board-based system (eBaVIR) for balance rehabilitation: A pilot randomized clinical trial in patients with acquired brain injury.

Journal of Neuroengineering and Rehabilitation, 8(1), 30.

URL     PMID:21600066      [本文引用: 1]

Background Acquired brain injury (ABI) is the main cause of death and disability among young adults. In most cases, survivors can experience balance instability, resulting in functional impairments that are associated with diminished health-related quality of life. Traditional rehabilitation therapy may be tedious. This can reduce motivation and adherence to the treatment and thus provide a limited benefit to patients with balance disorders. We present eBaViR (easy Balance Virtual Rehabilitation), a system based on the Nintendo?? Wii Balance Board?? (WBB), which has been designed by clinical therapists to improve standing balance in patients with ABI through motivational and adaptative exercises. We hypothesize that eBaViR, is feasible, safe and potentially effective in enhancing standing balance. Methods In this contribution, we present a randomized and controlled single blinded study to assess the influence of a WBB-based virtual rehabilitation system on balance rehabilitation with ABI hemiparetic patients. This study describes the eBaViR system and evaluates its effectiveness considering 20 one-hour-sessions of virtual reality rehabilitation (n = 9) versus standard rehabilitation (n = 8). Effectiveness was evaluated by means of traditional static and dynamic balance scales. Results The final sample consisted of 11 men and 6 women. Mean ?? SD age was 47.3 ?? 17.8 and mean ?? SD chronicity was 570.9 ?? 313.2 days. Patients using eBaViR had a significant improvement in static balance (p = 0.011 in Berg Balance Scale and p = 0.011 in Anterior Reaches Test) compared to patients who underwent traditional therapy. Regarding dynamic balance, the results showed significant improvement over time in all these measures, but no significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way. There were no serious adverse events during treatment in either group. Conclusions The results suggest that eBaViR represents a safe and effective alternative to traditional treatment to improve static balance in the ABI population. These results have encouraged us to reinforce the virtual treatment with new exercises, so an evolution of the system is currently being developed.

Granic I., Lobel A., & Engels R. C . (2014).

The benefits of playing video games.

American Psychologist, 69(1), 66-78.

Magsci     [本文引用: 1]

Video games are a ubiquitous part of almost all children's and adolescents' lives, with 97% playing for at least one hour per day in the United States. The vast majority of research by psychologists on the effects of "gaming" has been on its negative impact: the potential harm related to violence, addiction, and depression. We recognize the value of that research; however, we argue that a more balanced perspective is needed, one that considers not only the possible negative effects but also the benefits of playing these games. Considering these potential benefits is important, in part, because the nature of these games has changed dramatically in the last decade, becoming increasingly complex, diverse, realistic, and social in nature. A small but significant body of research has begun to emerge, mostly in the last five years, documenting these benefits. In this article, we summarize the research on the positive effects of playing video games, focusing on four main domains: cognitive, motivational, emotional, and social. By integrating insights from developmental, positive, and social psychology, as well as media psychology, we propose some candidate mechanisms by which playing video games may foster real-world psychosocial benefits. Our aim is to provide strong enough evidence and a theoretical rationale to inspire new programs of research on the largely unexplored mental health benefits of gaming. Finally, we end with a call to intervention researchers and practitioners to test the positive uses of video games, and we suggest several promising directions for doing so.

Green C.S ., Bavelier, D. (2003).

Action-video-game experience alters the spatial resolution of vision.

Psychological Science, 18(1), 88-94.

URL     PMID:17362383      [本文引用: 2]

ABSTRACT Playing action video games enhances several different aspects of visual processing; however, the mechanisms underlying this improvement remain unclear. Here we show that playing action video games can alter fundamental characteristics of the visual system, such as the spatial resolution of visual processing across the visual field. To determine the spatial resolution of visual processing, we measured the smallest distance a distractor could be from a target without compromising target identification. This approach exploits the fact that visual processing is hindered as distractors are brought close to the target, a phenomenon known as crowding. Compared with nonplayers, action-video-game players could tolerate smaller target-distractor distances. Thus, the spatial resolution of visual processing is enhanced in this population. Critically, similar effects were observed in non-video-game players who were trained on an action video game; this result verifies a causative relationship between video-game play and augmented spatial resolution.

Greitemeyer T., & Osswald S. (2011).

Playing prosocial video games increases the accessibility of prosocial thoughts.

Journal of Social Psychology, 151(2), 121-128.

URL     PMID:21476457      Magsci     [本文引用: 1]

Past research has provided abundant evidence that playing violent video games increases aggressive tendencies. In contrast, evidence on possible positive effects of video game exposure on prosocial tendencies has been relatively sparse. The present research tested and found support for the hypothesis that exposure to prosocial video games increases the accessibility of prosocial thoughts. These results provide support to the predictive validity of the General Learning Model (Buckley & Anderson, 2006) for the effects of exposure to prosocial media on social tendencies. Thus, depending on the content of the video game, playing video games can harm but may also benefit social relations.

Griffiths M.D . (2013).

Internet addiction in adolescence: Challenges, prevention and intervention.

In M. Kim (Ed.),Saving children from the Internet(pp. 19-45). Seoul: Kachi Books.

[本文引用: 1]

Griffiths M.D . (2017).

Behavioural addiction and substance addiction should be defined by their similarities not their dissimilarities.

Addiction, 112(10), 1718-1720

URL     PMID:28419617     

react-text: 236 1. Study the relationship between different game structures and gambling behaviour. 2. Study how different game features influence gambling behaviour. 3. Study the relationship between monetary out…" /react-text react-text: 237 /react-text [more]

Griffiths M.D., &Pontes H.M . (2014).

Internet addiction disorder and internet gaming disorder are not the same.

Addiction Research & Theory, 5(4), e124.

[本文引用: 1]

Griffiths M. D., King D. L., & Demetrovics Z . (2014).

DSM-5 internet gaming disorder needs a unified approach to assessment.

Neuropsychiatry, 4(1), 1-4.

Magsci     [本文引用: 1]

Griffiths M. D., van Rooij A. J., Kardefelt-Winther D., Starcevic V., Király O., & Pallesen S., .. Demetrovics Z . (2016).

Working towards an international consensus on criteria for assessing internet gaming disorder: A critical commentary on Petry et al. (2014).

Addiction, 111(1), 167-175.

URL     PMID:26669530     

Keywords: Gaming addiction; gaming addiction assessment; IGD assessment; internet gaming disorder; problematic gaming; video game addiction

Haagsma M. C., Pieterse M. E., & Peters O . (2012).

The prevalence of problematic video gamers in the Netherlands.

Cyberpsychology, Behavior, and Social Networking, 15(3), 162-168.

URL     PMID:22313358      [本文引用: 1]

This study surveyed Dutch adolescents and adults about their video gaming behavior to assess the prevalence of problematic gaming. A representative national panel of 902 respondents aged 14 to 81 took part in the study. The results show that gaming in general is a wide-spread and popular activity among the Dutch population. Browser games (small games played via the internet) and offline casual games (e.g., offline card games) were reported as most popular type of game. Online games (e.g., massively multiplayer online role-playing games) are played by a relatively small part of the respondents, yet considerably more time is spent on these online games than on browser games, offline casual games, and offline games (e.g., offline racing games). The prevalence of problematic gaming in the total sample is 1.3 percent. Among adolescents and young adults problematic gaming occurs in 3.3 percent of cases. Particularly male adolescents seem to be more vulnerable to developing problematic gaming habits.

Henchoz Y., Studer J., Deline S., N’Goran A. A., Baggio S., & Gmel G . (2016).

Video gaming disorder and sport and exercise in emerging adulthood: A longitudinal study.

Behavioral Medicine, 42(2), 105-111.

URL     PMID:25258243     

Among the negative consequences of video gaming disorder, decreased participation in sport and exercise has received little attention. This study aimed to assess the longitudinal association between video gaming disorder and the level of sport and exercise in emerging adult men. A questionnaire was completed at baseline and 15-month follow-up by a representative national sample of 4,933 respondents. The seven items of the Game Addiction Scale were used to construct a latent variable representing video gaming disorder. Level of sport and exercise was also self-reported. Cross-lagged path modeling indicated a reciprocal causality between video gaming disorder and the level of sport and exercise, even after adjusting for a large set of confounders. These findings support the need for better promotion of sport and exercise among emerging adults in order to contribute to the prevention of video gaming disorder, and to raise the level of sport and exercise activity in addicted gamers.

Huang Z., Wang M., Qian M., Zhong J., & Tao R . (2007).

Chinese internet addiction inventory: Developing a measure of problematic internet use for Chinese college students.

Cyberpsychology & Behavior, 10(6), 805-812.

URL     PMID:18085968      [本文引用: 2]

The current study developed a psychometrically sound multidimensional measure of Internet addiction: the Chinese Internet Addiction Inventory (CIAI). Data were collected from 1,029 Chinese undergraduate students from 14 universities and colleges. The initial sample was split randomly into two samples ( N1 = 516; N2 = 513). An exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were conducted on the two samples respectively. Findings from the EFA suggest that this measure assesses three dimensions of Internet addiction: conflicts, mood modification, and dependence. Items in each dimension showed high internal consistency and acceptable test09“retest reliability. Findings from the CFA further confirmed the three-factor measurement structure of CIAI. Test of criterion-related validity also showed good abilities for all three CIAI subscales to discriminate between an Internet addictive group and non09“Internet addictive group. The theoretical and clinical implications of CIAI and its limitations are discussed.

Hur M.H . (2006).

Demographic, habitual, and socioeconomic determinants of internet addiction disorder: An empirical study of Korean teenagers.

Cyberpsychology & behavior, 9(5), 514-525.

URL     PMID:17034317      [本文引用: 1]

Abstract The objective of this study was to analyze the demographic, socioeconomic, and habitual causes of juvenile Internet addiction. All do not agree that Internet addiction disorder (IAD) is a new type of addiction, but they agree that the IAD phenomenon has widely spread over recent years. This is also true in Korea. For this study, six schools in Korea were selected to collect data: two from Seoul, two from suburban areas, and two from rural areas. Two hundred and forty copies were collected out of some 700 copies distributed. Multiple regression models were employed to explore significant predictors of IAD. This study showed that at least two out of 100 teenagers in Korea are seriously suffering from IAD and that approximately one out of two is exposed to a kind of IAD. The causes of IAD are not only associated with habitual backgrounds for use of the Internet, but also demographic and socioeconomic backgrounds. Therefore, it can be said that the development of IAD is an interactive process between juveniles' habits of using Internet, and their demographic and socioeconomic backgrounds. As IAD progresses, a single type of intervention such as parent interventions or school interventions does not work effectively. Multimodal interventions are required to provide counseling services for individuals suffering from IAD.

James R. J.E., &Tunney R.J . (2017).

The need for a behavioural analysis of behavioral addictions.

Clinical Psychology Review, 52, 69-76.

URL     PMID:28013082      [本文引用: 1]

61Research into behavioural addictions rarely focuses on behaviour.61We argue that research on gambling may not generalise to other behavioural addictions because the schedules of reinforcement may not be comparable.61The review explores the application of gambling to internet gaming disorder and other potential forms of behavioural addiction.61Our analysis has implications for designing interventions for behavioural addictions.

Kaptsis D., King D. L., Delfabbro P. H., & Gradisar M . (2016).

Withdrawal symptoms in internet gaming disorder: A systematic review.

Clinical Psychology Review, 43, 58-66.

URL     PMID:26704173      [本文引用: 1]

61We review the literature on Internet gaming withdrawal and craving.61Clinical qualitative studies of gaming withdrawal offer limited description.61We identify 25 different scale items that measure withdrawal as an affective state.61Internet gaming problems may arise without associated withdrawal symptoms.61Research on the salient stimuli of Internet gaming may advance knowledge.

Kardefelt-Winther D. . (2014).

A conceptual and methodological critique of internet addiction research: Towards a model of compensatory internet use.

Computers in Human Behavior, 31, 351-354.

URL    

Internet addiction is a rapidly growing field of research, receiving attention from researchers, journalists and policy makers. Despite much empirical data being collected and analyzed clear results and conclusions are surprisingly absent. This paper argues that conceptual issues and methodological shortcomings surrounding internet addiction research have made theoretical development difficult. An alternative model termed compensatory internet use is presented in an attempt to properly theorize the frequent assumption that people go online to escape real life issues or alleviate dysphoric moods and that this sometimes leads to negative outcomes. An empirical approach to studying compensatory internet use is suggested by combining the psychological literature on internet addiction with research on motivations for internet use. The theoretical argument is that by understanding how motivations mediate the relationship between psychosocial well-being and internet addiction, we can draw conclusions about how online activities may compensate for psychosocial problems. This could help explain why some people keep spending so much time online despite experiencing negative outcomes. There is also a methodological argument suggesting that in order to accomplish this, research needs to move away from a focus on direct effects models and consider mediation and interaction effects between psychosocial well-being and motivations in the context of internet addiction. This is key to further exploring the notion of internet use as a coping strategy; a proposition often mentioned but rarely investigated.

Kardefelt-Winther D. . (2015 a).

A critical account of DSM-5 criteria for internet gaming disorder.

Addiction Research & Theory, 23(2), 93-98.

URL     [本文引用: 2]

The inclusion of assessment criteria for internet gaming disorder in the DSM-5 appendix means that research in this area is likely to increase. However, a standardized assessment instrument is contingent on identifying criteria that adequately captures the phenomenon. I argue in this article that issues with the proposed criteria are consistently overlooked. First, there has been a tendency to adhere to DSM-4 criteria for substance use disorders or pathological gambling when defining the assessment criteria, rather than aiming to capture the unique determinants of internet gaming disorder. Furthermore, a diagnostic instrument for gaming in particular needs to account for cultural and social divides that are a non-issue when assessing substance use. Finally, some of the proposed criteria make little sense within the context of gaming and seem to be included as residuals from existing disorders. In this article, I discuss critically each proposed criterion. I conclude that deception is socially or culturally subjective and depends on people close to the player, rather than the player himself. Symptoms like preoccupation, withdrawal, tolerance and a loss of interest in other activities may all be preceded by legitimate explanations for excessive use following widespread popularity of online gaming, which makes them unreliable in an assessment instrument. Finally, I argue that tolerance does not make sense within a gaming context and is a residual criterion from substance use disorders. A reappraisal of these criteria would benefit the development of a standardized assessment instrument for internet gaming disorder.

Kardefelt-Winther D. . (2015 b).

Excessive internet use - Fascination or compulsion?(Unpublished doctorial dissertation).

The London School of Economics and Political Science, London, UK.

[本文引用: 2]

Kardefelt-Winther D., Heeren A., Schimmenti A., van Rooij A. J., Maurage P., Carras M ., et al. Billieux, J. (2017).

How can we conceptualize behavioral addiction without pathologizing common behaviors?

Addiction, 112(10), 1709-1715.

URL     PMID:28198052     

Following the recent changes to the diagnostic category for addictive disorders in DSM-5, it is urgent to clarify what constitutes behavioural addiction to have a clear direction for future researc ...

King D.L., &Delfabbro P.H . (2013).

Issues for DSM-5: Video-gaming disorder? Australian & New Zealand

Journal of Psychiatry, 47(1), 20-22.

[本文引用: 2]

King D.L., &Delfabbro P.H . (2014).

The cognitive psychology of internet gaming disorder.

Clinical Psychology Review, 34(4), 298-308.

URL     PMID:24786896      Magsci    

61We review 36 studies on Internet gaming disorder cognition.61IGD treatment studies employing CT tend to lack cognition-based measures.61Four types of cognition may underlie Internet gaming disorder.61Implications for criterion A of DSM-5 Internet gaming disorder are discussed.61We outline areas for future research on Internet gaming disorder.

King D.L., Delfabbro, P. H . (2016).

Defining tolerance in internet gaming disorder: Isn't it time?

Addiction, 111(11), 2064-2065.

URL     PMID:27297731      [本文引用: 1]

Keywords: Addiction; behavioural addiction; DSM-5; internet gaming disorder; MMO; multiplayer games; tolerance

King D. L., Haagsma M. C., Delfabbro P. H., Gradisar M., & Griffiths M. D . (2013).

Toward a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools.

Clinical Psychology Review, 33(3), 331-42.

URL     PMID:23396015      Magsci    

78 We review the psychometric properties of eighteen instruments for pathological video-gaming. 78 Available measures may be broadly characterized as inconsistent. 78 Research consensus suggests three key symptoms of pathological video-gaming. 78 Instruments are limited by differing theoretical orientations, and some psychometric inadequacies. 78 Areas of improvement for future research on the proposed DSM-V disorder are outlined.

Konkolÿ Thege B., Woodin E. M., Hodgins D. C., & Williams R. J . (2015).

Natural course of behavioral addictions: A 5-year longitudinal study.

BMC Psychiatry, 15(1), 4.

URL     PMID:25608605      [本文引用: 2]

BackgroundResolving the theoretical controversy on the labeling of an increasing number of excessive behaviors as behavioral addictions may also be facilitated by more empirical data on these behavioral problems. For instance, an essential issue to the classification of psychiatric disorders is information on their natural course. However, longitudinal research on the chronic vs. episodic nature of behavioral addictions is scarce. The aim of the present study, therefore, was to provide data on prevalence, substance use comorbidity, and five-year trajectories of six excessive behaviors?namely exercising, sexual behavior, shopping, online chatting, video gaming, and eating.MethodsAnalyses were based on the data of the Quinte Longitudinal Study, where a cohort of 4,121 adults from Ontario, Canada was followed for 5?years (2006 to 2011). The response rate was 21.3%, while retention rate was 93.9%. To assess the occurrence of each problem behavior, a single self-diagnostic question asked people whether their over-involvement in the behavior had caused significant problems for them in the past 12?months. To assess the severity of each problem behavior reported, the Behavioral Addiction Measure was administered. A mixed design ANOVA was used to investigate symptom trajectories over time for each problem behavior and whether these symptom trajectories varied as a function of sex.ResultsThe large majority of people reported having problematic over-involvement for just one of these behaviors and just in a single time period. A main effect of time was found for each problem behavior, indicating a moderately strong decrease in symptom severity across time. The time x sex interaction was insignificant in each model indicating that the decreasing trend is similar for males and females. The data also showed that help seeking was very low in the case of excessive sexual behavior, shopping, online chatting, and video gaming but substantially more prevalent in the case of excessive eating and exercising.ConclusionsThe present results indicate that self-identified excessive exercising, sexual behavior, shopping, online chatting, video gaming, and/or eating tend to be fairly transient for most people. This aspect of the results is inconsistent with conceptualizations of addictions as progressive in nature, unless treated.

Krossbakken E., Pallesen S., Molde H., Mentzoni R. A., & Finserås T. R . (2017).

Not good enough? Further comments to the wording, meaning, and the conceptualization of internet gaming disorder.

Journal of Behavioral Addictions, 6(2), 114-117.

URL     PMID:28301964      [本文引用: 1]

In their commentary, Kuss, Griffiths, and Pontes (2016) criticize the use of the term “Internet” in the recently proposed diagnosis for Internet Gaming Disorder (IGD) and its use as one of the included diagnostic criteria. We agree with the exclusion of the term “Internet” in the diagnosis, but have some considerations to the comments regarding the nine criteria for IGD. Specifically, we discuss the meaning, the wording, and the importance of the criteria, as well as the importance of distress or functional impairment in the proposed diagnosis. We also address the possibility of categorizing IGD as a subtype of a general behavioral addiction diagnosis.

Kuss D. J. (2013a).

For the Horde! How playing world of warcraft reflects our participation in popular media culture.

LAP LAMBERT Academic Publishing.

[本文引用: 1]

Kuss D.J . (2013b).

Internet gaming addiction: Current perspectives.

Psychology Research & Behavior Management, 6, 125-137.

[本文引用: 1]

Kuss D.J., &Griffiths M.D . (2012).

Internet and gaming addiction: A systematic literature review of neuroimaging studies.

Brain Science, 2(3), 347-374.

URL     PMID:4061797      [本文引用: 2]

In the past decade, research has accumulated suggesting that excessive Internet use can lead to the development of a behavioral addiction. Internet addiction has been considered as a serious threat to mental health and the excessive use of the Internet has been linked to a variety of negative psychosocial consequences. The aim of this review is to identify all empirical studies to date that used neuroimaging techniques to shed light upon the emerging mental health problem of Internet and gaming addiction from a neuroscientific perspective. Neuroimaging studies offer an advantage over traditional survey and behavioral research because with this method, it is possible to distinguish particular brain areas that are involved in the development and maintenance of addiction. A systematic literature search was conducted, identifying 18 studies. These studies provide compelling evidence for the similarities between different types of addictions, notably substance-related addictions and Internet and gaming addiction, on a variety of levels. On the molecular level, Internet addiction is characterized by an overall reward deficiency that entails decreased dopaminergic activity. On the level of neural circuitry, Internet and gaming addiction led to neuroadaptation and structural changes that occur as a consequence of prolonged increased activity in brain areas associated with addiction. On a behavioral level, Internet and gaming addicts appear to be constricted with regards to their cognitive functioning in various domains. The paper shows that understanding the neuronal correlates associated with the development of Internet and gaming addiction will promote future research and will pave the way for the development of addiction treatment approaches.

Kuss D.J., &Griffiths M.D . (2015).

Internet addiction in psychotherapy. UK:.

Palgrave Macmillan.

[本文引用: 1]

Kuss D. J., Griffiths M. D., & Pontes H. M . (2017a).

Chaos and confusion in DSM-5 diagnosis of internet gaming disorder: Issues, concerns, and recommendations for clarity in the field.

Journal of Behavior Addiction, 6(2), 103-109.

URL     PMID:27599673      [本文引用: 2]

The umbrella term “Internet addiction” has been criticized for its lack of specificity given the heterogeneity of potentially problematic behaviors that can be engaged in online as well as different underlying etiological mechanisms. This has led to the naming of specific online addictions, the most notable being Internet Gaming Disorder (IGD). Using the contemporary literature concerning IGD and cognate topics, issues and concerns relating to the concept of IGD are examined. Internet addiction and IGD are not the same, and distinguishing between the two is conceptually meaningful. Similarly, the diagnosis of IGD as proposed in the appendix of the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) remains vague regarding whether or not games need to be engaged in online, stating that IGD typically involves specific Internet games, but can also include offline games, adding to the lack of clarity. A number of authors have voiced concerns regarding the viability of including the word “Internet” in IGD, and instead proposed to use the term “video gaming disorder” or simply “gaming disorder,” suggesting addiction to video gaming can also occur offline. The DSM-5 has caused more confusion than clarity regarding the disorder, reflected by researchers in the field contesting a supposedly reached consensus for IGD diagnosis.

Kuss D. J., Griffiths M. D., & Pontes H. M . (2017b).

DSM-5 diagnosis of internet gaming disorder: Some ways forward in overcoming issues and concerns in the gaming studies field.

Journal of Behavioral Addictions, 6(2), 133-141.

URL     PMID:5520128      [本文引用: 1]

The current DSM-5 diagnosis of Internet Gaming Disorder (IGD; American Psychiatric Association [APA], 2013) has led to a number of issues and concerns that we highlighted in our recent paper (Kuss, Griffiths, & Pontes, 2017). Experts in the field responded to our evaluation of these issues resulting in six commentaries. In this paper, we offer responses to the six commentaries to move the scientific field forward. All of the responses to our original paper highlighted many conceptual, theoretical, and/or methodological problems with the proposed IGD diagnosis as outlined in the DSM-5. We outline some ways forward in overcoming issues and concerns in the gaming studies field. We argue that rather than stigmatizing gaming per se, the role of scientists and practitioners is to establish a clear-cut distinction between someone who may use games excessively but non-problematically and someone who is experiencing significant impairment in their daily lives as a consequence of their excessive gaming. This responsibility needs to be shared by popular media who are often quick to build a moral panic around gaming behaviors, often based on cherry-picking specific case studies and pieces of research which support their headlines. Researchers, practitioners, gaming developers, and the media need to work together and collaboratively to build a realistic and comprehensive understanding of gaming as a normal, enjoyable, and often beneficial sociocultural practice, which for a small minority of excessive users may be associated with the experience of addiction-related symptoms that may require professional support.

Kuss D.J., & Lopez-Fernandez O. (2016).

Internet addiction and problematic internet use: A systematic review of clinical research.

World Journal of Psychiatry, 6(1), 143-176.

URL     PMID:27014605      [本文引用: 2]

AIM: To provide a comprehensive overview of clinical studies on the clinical picture of Internet-use related addictions from a holistic perspective. A literature search was conducted using the database Web of Science.METHODS: Over the last 15 years, the number of Internet users has increased by 1000%, and at the same time, research on addictive Internet use has proliferated. Internet addiction has not yet been understood very well, and research on its etiology and natural history is still in its infancy. In 2013, the American Psychiatric Association included Internet Gaming Disorder in the appendix of the updated version of the Diagnostic and Statistical Manual for Mental Disorders(DSM-5) as condition that requires further research prior to official inclusion in the main manual, with important repercussions for research and treatment. To date, reviews have focused on clinical and treatment studies of Internet addiction and Internet Gaming Disorder. This arguably limits the analysis to a specific diagnosis of a potential disorder that has not yet been officially recognised in the Western world, rather than a comprehensive and inclusive investigation of Internet-use related addictions(including problematic Internet use) more generally. RESULTS: The systematic literature review identified a total of 46 relevant studies. The included studies used clinical samples, and focused on characteristics of treatment seekers and online addiction treatment. Four main types of clinical research studies were identified, namely research involving(1) treatment seeker characteristics;(2) psychopharmacotherapy;(3) psychological therapy; and(4) combined treatment. CONCLUSION: A consensus regarding diagnostic criteria and measures is needed to improve reliability across studies and to develop effective and efficient treatment approaches for treatment seekers.

Lavergne Boudier, V., & Dambach Y. (2010).

Serious game, la révolution pédagogique (Hermès Sciences)

.Paris. France.

Lemmens J.S., &Hendriks S.J . (2016).

Addictive online games: Examining the relationship between game genres and internet gaming disorder.

Cyberpsychology, Behavior, and Social Networking, 19(4), 270-276.

URL     PMID:26959285      [本文引用: 1]

Abstract Internet gaming disorder (IGD) is the most recent term used to describe problematic or pathological involvement with computer or video games. This study examined whether this disorder is more likely to involve pathological involvement with online (i.e., Internet) games as opposed to offline games. We also explored the addictive potential of nine video game genres by examining the relationship between IGD and 2,720 games played by a sample of 13- to 40-year olds (N65=652,442). Although time spent playing both online and offline games was related to IGD, online games showed much stronger correlations. This tendency is also reflected within various genres. Disordered gamers spent more than four times as much time playing online role-playing games than nondisordered gamers and more than thrice as much time playing online shooters, whereas no significant differences for offline games from these genres were found. Results are discussed within the frame of social interaction and competition provided by online games.

Li R. J., Polat U., Makous W., & Bavelier D . (2009).

Enhancing the contrast sensitivity function through action video game training.

Nature Neuroscience, 12(5), 549-551.

[本文引用: 1]

Markey P.M., &Ferguson C.J . (2017).

Internet gaming addiction: Disorder or moral panic?

The American Journal of Psychiatry, 174(3), 195-196.

URL     PMID:28245695      [本文引用: 1]

Research on the influence of video games on academic achievement has been controversial and inconsistent. Scholars have been examining the potential for both positive and negative influence of video games on academic achievement. As of yet, such research remains limited, controversial, and sometimes limited by methodological problems. Pathological gaming appears to be problematic for about... [Show full abstract]

Martin P.R., &Petry N.M . (2005).

Are non-substance- related addictions really addictions?

The American Journal on Addictions, 14(1), 1-7.

URL     PMID:15804872      [本文引用: 1]

Previous studies that have examined the effects of specific aspects of 12-step participation and social network composition on abstinence have focused mostly on alcohol-related outcomes and have screened out drug dependent persons. This article explores whether these predictors differentially affect abstinence based on DSM-III-R substance dependence disorder (alcohol dependence, drug dependence, and both alcohol and drug dependence). A heterogeneous community sample of treatment seekers (N = 302) randomized to day treatment programs were followed at 6 and 12 months. Bivariate and multivariate regression models were used to test whether engagement in 12-step practices and social network influences to drink or use drugs predicted total abstinence from alcohol and drugs differentially by dependence disorder. Chi-square automatic interaction detector (CHAID) segmentation analyses were then conducted to identify the specific 12-step activities and social network thresholds that best distinguished higher rates of abstinence in each dependence category. Results showed that the number of 12-step meetings attended and number of prescribed 12-step activities engaged in similarly predicted abstinence for alcoholics, drug addicts, and those dependent on both alcohol and drugs. However, specific activities were associated with abstinence differentially by dependence disorder. While many activities differentiated abstinence for drug addicts and those dependent on both alcohol and drugs, for alcoholics only two Alcoholics Anonymous (AA) activities distinguished abstinence (having a sponsor and doing service). Key predictors of abstinence (CHAID) varied by follow-up and dependence disorder, except for doing service in AA and/or Narcotics Anonymous, which was the only specific 12-step activity that was a best predictor of abstinence in all three categories one year following treatment. Thus, "giving back'' to one's peer community through service work, an important 12-step belief, seems to be universally valuable later in recovery. As for social network influences, a multivariate regression model showed that having a higher proportion of abstinent individuals in the network was associated with abstinence for alcoholics at 6 months only and for drug dependent persons at 12 months only. CHAID models supported these results and provided specific thresholds for 12-step measures ( e. g., > 20 meetings for alcoholics, 2 or more nondrinkers in the social network, 3 or more persons supporting reduction for those dependent on both alcohol and drugs, and having 2 or more nondrinkers for those dependent on drugs only). These results support the value of treatment providers prioritizing certain 12-step-related practices and social network changes based on their client dependence profiles. Early on, those with an alcohol diagnosis need to make a commitment to meetings and obtain a sponsor; also, they need to place themselves

Meerkerk G. J., van den Eijnden, R. J. J. M., Vermulst A. A ., & Garretsen, H. F. L. (2009).

The compulsive internet use scale (CIUS): Some psychometric properties.

Cyberpsychology & Behavior, 12(1), 1-6.

URL     PMID:19072079      [本文引用: 2]

The present study aimed to develop a short, easily administered, psychometrically sound, and valid instrument to assess the severity of compulsive Internet use. A set of criteria was determined based on the addiction literature. Next, the internal consistency and convergent validity were determined, and the set was tested as a one-factor solution in two representative samples of heavy Internet users (n 447 and n 229) and in one largeconvenience sample of regular Internet users (n 16,925). In these three studies, respondents were asked about their online behavior and about problems related to Internet use. In the first study, the Online Cognition Scale (OCS) was included to determine concurrent validity. The newly developed Compulsive Internet Use Scale (CIUS) contains 14 items ratable on a 5-point Likert scale. The instrument showed good factorial stability across time and across different samples and subsamples. The internal consistency is high, and high correlations with concurrent and criterion variables demonstrate good validity.

Mentzoni R. A., Brunborg G. S., Molde H., Myrseth H., Skouverøe K. J. M., & Hetland J., & Pallesen S . (2011).

Problematic video game use: Estimated prevalence and associations with mental and physical health.

Cyberpsychology, Behavior, and Social Networking, 14(10), 591-596.

URL     PMID:21342010     

A nationwide survey was conducted to investigate the prevalence of video game addiction and problematic video game use and their association with physical and mental health. An initial sample comprising 2,500 individuals was randomly selected from the Norwegian National Registry. A total of 816 (34.0 percent) individuals completed and returned the questionnaire. The majority (56.3 percent) of respondents used video games on a regular basis. The prevalence of video game addiction was estimated to be 0.6 percent, with problematic use of video games reported by 4.1 percent of the sample. Gender (male) and age group (young) were strong predictors for problematic use of video games. A higher proportion of high frequency compared with low frequency players preferred massively multiplayer online role-playing games, although the majority of high frequency players preferred other game types. Problematic use of video games was associated with lower scores on life satisfaction and with elevated levels of anxiety and depression. Video game use was not associated with reported amount of physical exercise.

Müller K. W., Beutel M. E., Egloff B., & Wölfling K . (2014).

Investigating risk factors for internet gaming disorder: A comparison of patients with addictive gaming, pathological gamblers and healthy controls regarding the big five personality traits.

European Addiction Research, 20(3), 129-136.

URL     PMID:24247280      Magsci     [本文引用: 1]

Engaging in online games has become increasingly important as a part of leisure activity in adolescents and adults. While the majority of people use these games in a healthy way, epidemiological studies show that some develop excessive use and symptoms that are related to those of substance-related addictions. Despite increasing research concerning the epidemiology of internet gaming disorder (IGD), predisposing factors have been examined to a lesser extent. Knowing about specific risk factors would help clarify the nosological features of IGD and enhance prevention and intervention. This study aimed to evaluate the relationships between personality traits and IGD. A total of 115 patients meeting the criteria for IGD were compared to 167 control subjects displaying either regular or intense use of online games. Additionally, 115 patients meeting diagnostic criteria for pathological gambling were included. IGD was associated with higher neuroticism, decreased conscientiousness and low extraversion. The comparisons to pathological gamblers indicate that low conscientiousness and low extraversion in particular are characteristic of IGD. An integration of personality variables into an etiopathological model describing presumable mechanisms fostering and maintaining addictive online gaming is proposed. This model could be helpful for the theoretical understanding of addictive gaming, public health campaigns and psychoeducation within therapeutic settings.

Müller K.W., & Wölfling K. (2017).

Both sides of the story: Addiction is not a pastime activity.

Journal of Behavioral Addictions, 6(2), 118-120.

URL     [本文引用: 2]

The proposed inclusion of Internet gaming disorder (IGD) into the upcoming ICD-11 has caused mixed reactions. Having a sound diagnostic framework for defining this new phenomenon has been applauded but concerns have risen regarding overpathologizing a mere pastime activity. The review by Aarseth et al. (2016) provides a fine but one-sided impression on IGD. What has been totally left out in the argumentation is the clinical perspective. Although the concerns depicted must not be ignored, the conclusion provided by the authors is reflecting quite subjective speculations while objectivity would rather be needful.

Olson C.K . (2010).

Children's motivations for video game play in the context of normal development.

Review of General Psychology, 14(2), 180-187.

URL     [本文引用: 2]

ABSTRACT Electronic games are now an everyday part of childhood and adolescence. The debate has moved from whether children should play video games to how to maximize potential benefits and to identify and minimize potential harms. To do this, we must understand what motivates children to play electronic games and what needs the games meet. Drawing on a survey of 1,254 middle school children, focus groups with boys and their parents, and findings from other quantitative and qualitative research, the author describes a variety of motivations for video game play (including games with violent content) and how these may vary based on factors such as mood, environment, personality, and developmental stage. The findings are put into the context of normal development, and suggestions are given for parents, educators, and researchers. A number of studies indicate that electronic games are now a routine part of normal childhood and adolescence (e.g., Greenberg, Sherry, Lachlan, Lucas, & Holmstrom, 2008; Ito et al., 2008; Lenhart et al., 2008; Olson et al., 2007; Roberts, Foehr, & Rideout, 2005). Until recently, most studies on video games have focused on potential harms to children from exposure to inappropriate game content. Some researchers are now exploring what children can gain from electronic games, often emphasizing their potential to teach academic skills. The potential benefits and uses of elec-tronic games are best understood in the context of children's motivations for play. Parents choosing appropriate leisure-time games, educators seeking games to supplement classroom teach-ing, game developers creating games to teach, and mental health professionals using games in clinical situations all need to know what is likely to engage a child and what emotional or develop-mental needs a young person may (consciously or not) seek to address through games (von Salisch, Oppl, & Kristen, 2006). This article reviews research and ideas that may advance this under-standing. I also draw on survey data collected from 1,254 students attend-ing Grades 7 and 8 (98% 12 to 14 years of age) in public schools in South Carolina and Pennsylvania (Olson et al., 2007) concern-ing patterns of media use and self-reported reasons for playing electronic games. Children responded to 17 possible motivations for playing electronic games on a 4-point scale from strongly disagree to strongly agree. A write-in option was included, but drew few responses. (In the survey, electronic games were defined as computer, video, or handheld games. In this article, I use the common term video games to refer to all of these.) Figure 1 displays the percentages of boys and girls who strongly agreed with each reason. The only reason selected more often by girls than boys was, "It's something to do when I'm bored," although the difference was not statistically significant. Boys were significantly more likely than girls to play for fun, to compete with other people and to win, for the challenge of figuring the game out, and for several emotional reasons (excitement, relaxation, and coping with anger). This was also true for liking to "mod" games (defined as changing the game using computer code), playing because friends like to play, and enjoying "the guns and other weapons." Roughly equal proportions of boys and girls were strongly motivated by creativity ("I like to create my own world") and curiosity ("I like to learn new things").

Petry N. M., Rehbein F., Gentile D. A., Lemmens J. S., Rumpf H. J., & Mößle T., .. O'Brien C. P . (2014).

An international consensus for assessing internet gaming disorder using the new DSM-5 approach.

Addiction, 109(9), 1399-1406.

URL     PMID:24456155      Magsci    

AbstractAimsFor the first time, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduces non-substance addictions as psychiatric diagnoses. The aims of this paper are to (i) present the main controversies surrounding the decision to include internet gaming disorder, but not internet addiction more globally, as a non-substance addiction in the research appendix of the DSM-5, and (ii) discuss the meaning behind the DSM-5 criteria for internet gaming disorder. The paper also proposes a common method for assessing internet gaming disorder. Although the need for common diagnostic criteria is not debated, the existence of multiple instruments reflect the divergence of opinions in the field regarding how best to diagnose this condition.MethodsWe convened international experts from European, North and South American, Asian and Australasian countries to discuss and achieve consensus about assessing internet gaming disorder as defined within DSM-5.ResultsWe describe the intended meaning behind each of the nine DSM-5 criteria for internet gaming disorder and present a single item that best reflects each criterion, translated into the 10 main languages of countries in which research on this condition has been conducted.ConclusionsUsing results from this cross-cultural collaboration, we outline important research directions for understanding and assessing internet gaming disorder. As this field moves forward, it is critical that researchers and clinicians around the world begin to apply a common methodology; this report is the first to achieve an international consensus related to the assessment of internet gaming disorder.

Pontes H.M., &Griffiths M.D . (2016).

Portuguese validation of the Internet Gaming Disorder Scale-Short- Form.

CyberPsychology, Behavior, and Social Networking, 19(4), 288-293.

URL     PMID:26974853      [本文引用: 2]

Abstract In the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Internet Gaming Disorder (IGD) was included as a tentative disorder worthy of future research. Since then, several psychometric instruments to assess IGD have emerged in the literature, including the nine-item Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), the most brief tool available to date. Research on the effects of IGD in Portugal has been minimal and may be due to the lack of a psychometrically validated tool to assess this construct within this particular cultural background. Therefore, the aim of the present study was to develop and examine the psychometric properties of the Portuguese IGDS9-SF. A total of 509 adolescents were recruited to the present study. Construct validity of the IGDS9-SF was assessed in two ways. First, confirmatory factor analysis was performed to investigate the factorial structure of the IGDS9-SF in the sample, and the unidimensional structure of the IGDS9-SF fitted the data well. Second, nomological validation of the IGDS9-SF was carried out and the nomological network analyzed was replicated as expected, further supporting the construct validity of the IGDS9-SF. Criterion validity of the IGDS9-SF was also established using key criterion variables. Finally, the IGDS9-SF also showed satisfactory levels of reliability using several indicators of internal consistency. Based on the results found, the IGDS9-SF appears to be a valid and reliable instrument to assess IGD among Portuguese adolescents and further research on IGD in Portugal is warranted.

Pontes H. M., Kuss D. J. , & Griffiths, M. D.(2017).Psychometric assessment of internet gaming disorder in neuroimaging studies: A systematic review. Internet Addiction (pp. 181-208). Springer International Publishing.

[本文引用: 1]

Porter G., Starcevic V., Berle D., & Fenech P . (2010).

Recognizing problem video game use.

Australian & New Zealand Journal of Psychiatry, 44(2), 120-128.

URL     PMID:20113300      [本文引用: 2]

Abstract OBJECTIVES: It has been increasingly recognized that some people develop problem video game use, defined here as excessive use of video games resulting in various negative psychosocial and/or physical consequences. The main objectives of the present study were to identify individuals with problem video game use and compare them with those without problem video game use on several variables. METHOD: An international, anonymous online survey was conducted, using a questionnaire with provisional criteria for problem video game use, which the authors have developed. These criteria reflect the crucial features of problem video game use: preoccupation with and loss of control over playing video games and multiple adverse consequences of this activity. RESULTS: A total of 1945 survey participants completed the survey. Respondents who were identified as problem video game users (n = 156, 8.0%) differed significantly from others (n = 1789) on variables that provided independent, preliminary validation of the provisional criteria for problem video game use. They played longer than planned and with greater frequency, and more often played even though they did not want to and despite believing that they should not do it. Problem video game users were more likely to play certain online role-playing games, found it easier to meet people online, had fewer friends in real life, and more often reported excessive caffeine consumption. CONCLUSIONS: People with problem video game use can be identified by means of a questionnaire and on the basis of the present provisional criteria, which require further validation. These findings have implications for recognition of problem video game users among individuals, especially adolescents, who present to mental health services. Mental health professionals need to acknowledge the public health significance of the multiple negative consequences of problem video game use.

Przybylski A. K., Weinstein N., & Murayama K . (2016).

Internet gaming disorder: Investigating the clinical relevance of a new phenomenon.

The American Journal of Psychiatry, 174(3), 230-236.

URL     PMID:27809571     

The American Psychiatric Association identified Internet Gaming Disorder as a new potential psychiatric disorder and has recognized that little is known about the prevalence, validity, or cross-cultural robustness of proposed Internet Gaming Disorder criteria. In response to this gap in our understanding, this project estimated the period prevalence of this new potential psychiatric disorder using APA guidance, examined the validity of its proposed indicators, evaluated reliability cross-culturally and across genders, compared it to gold-standard research on gambling addiction and problem gaming, and estimated its impact on physical, social, and mental health. To do so, in a first for this research topic, four survey studies (n = 18,932) with large international cohorts employed an open-science methodology wherein the analysis plans for confirmatory hypotheses were registered prior to data collection. Results showed that of those who play games, more than 2 in 3, did not report any symptoms of Internet Gaming Disorder, and findings showed a very small proportion of the general population between 0.3% and 1.0% might qualify for a potential acute diagnosis of Internet Gaming Disorder. Comparison to Gambling Disorder revealed that Internet-based games may be significantly less addictive than gambling and similarly dysregulating as electronic games more generally. The evidence linking Internet Gaming Disorder to game engagement was strong, but links to physical, social, and mental health outcomes were decidedly mixed.

Quandt T. . (2017).

Stepping back to advance: Why IGD needs an intensified debate instead of a consensus.

Journal of Behavioral Addictions, 6(2), 121-123.

URL     [本文引用: 1]

Sakuma H., Mihara S., Nakayama H., Miura K., Kitayuguchi T., & Maezono M., .. Higuchi S . (2017).

Treatment with the self-discovery camp (SDIC) improves internet gaming disorder.

Addictive Behaviors, 64, 357-362.

URL     PMID:27321966      [本文引用: 1]

61We devised a therapeutic residential camp for Internet gaming disorder.61This Self-Discovery Camp led to decreased gaming time at a 3-month follow-up.61Problem recognition and self-efficacy scores similarly increased after the camp.61Onset age of Internet gaming disorder and problem recognition were correlated.

Shapira N. A., Goldsmith T. D., Keck P. E. Jr., Khosla U. M., & Mcelroy S. L . (2000).

Psychiatric features of individuals with problematic internet use.

Journal of Affective Disorders, 57(1-3), 267-272.

URL     PMID:10708842      [本文引用: 2]

Background: Problematic internet use has been described in the psychological literature as ‘internet addiction’ and ‘pathological internet use’. However, there are no studies using face-to-face standardized psychiatric evaluations to identify behavioral characteristics, psychiatric comorbidity or family psychiatric history of individuals with this behavior. Methods: Twenty individuals with problematic internet use were evaluated. Problematic internet use was defined as (1) uncontrollable, (2) markedly distressing, time-consuming or resulting in social, occupational or financial difficulties and (3) not solely present during hypomanic or manic symptoms. Evaluations included a semistructured interview about subjects’ internet use, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (SCID-IV), family psychiatric history and the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) modified for internet use. Results: All (100%) subjects’ problematic internet use met DSM-IV criteria for an impulse control disorder (ICD) not otherwise specified (NOS). All 20 subjects had at least one lifetime DSM-IV Axis I diagnosis in addition to their problematic internet use (mean±SD=5.1±3.5 diagnoses); 14 (70.0%) had a lifetime diagnosis of bipolar disorder (with 12 having bipolar I disorder). Limitations: Methodological limitations of this study included its small sample size, evaluation of psychiatric diagnoses by unblinded investigators, and lack of a control group. Conclusions: Problematic internet use may be associated with subjective distress, functional impairment and Axis I psychiatric disorders.

Sioni S. R., Burleson M. H., & Bekerian D. A . (2017).

Internet gaming disorder: Social phobia and identifying with your virtual self.

Computers in Human Behavior, 71, 11-15.

URL     [本文引用: 1]

Online role-playing video games provide opportunities to connect socially and can enhance self-esteem. For some players, however, overuse fosters dependency leading to negative psychosocial and health consequences. Per the American Psychiatric Association, criteria for diagnosis of Internet gaming disorder (IGD) follow an addiction model, and include characteristics such as preoccupation, tolerance, and withdrawal. Though useful, this approach lacks a focus on underlying motivations that may partially explain vulnerability to IGD. This study explored relationships among IGD symptoms and two potential risk factors: social phobia and player-avatar identification. Participants ( N =394; 50% female) were recruited from game-related internet forums and surveyed online. We tested a model in which a positive relationship between social phobia and IGD symptoms was partially mediated by stronger avatar identification. Social phobia, avatar identification, and IGD symptoms were strongly positively related, and we found modest support for mediation as proposed. Accordingly, we suggest that fundamental needs for social connection and approval are potent motivators to play, particularly for socially phobic players uncomfortable with face-to-face contact. Vicarious interactions through a gaming avatar may fulfill these needs, reinforcing stronger self-identification with the avatar, which in turn can offer players a stronger and more positive sense of self. Such influences may work synergistically to motivate increasing intensity of and preoccupation with gameplay, contributing to IGD. These results support the use of player-avatar identification in assessing risk for IGD, developing treatment options, and reaching a better understanding of how socialization and identity can be influenced by virtual interactions and accomplishments.

Soper W.B., &Miller M.J . (1983).

Junk-time junkies: An emerging addiction among students.

School Counselor, 31(1), 40-43.

URL     [本文引用: 1]

ABSTRACT Examines the question of control over a person's video game play. Factors involved in the appeal of the games include sophistication of the multisensual and sentientlike stimulation; interpersonal competition; possible ways to release hostility; rewards to the player of increased skill; attractive locations (e.g., restaurants); and seductive packaging. It is suggested that the potential usefulness or harm of video games is still open to empirical validation; however, the potential for abuse is inherent. (9 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Spence I., & Feng J. (2010).

Video games and spatial cognition.

Review of General Psychology, 14(2), 92-104.

URL     [本文引用: 2]

ABSTRACT Video game enthusiasts spend many hours at play, and this intense activity has the potential to alter both brain and behavior. We review studies that investigate the ability of video games to modify processes in spatial cognition. We outline the initial stages of research into the underlying mechanisms of learning, and we also consider possible applications of this new knowledge. Several experiments have shown that playing action games induces changes in a number of sensory, perceptual, and attentional abilities that are important for many tasks in spatial cognition. These basic capacities include contrast sensitivity, spatial resolution, the attentional visual field, enumeration, multiple object tracking, and visuomotor coordination and speed. In addition to altering performance on basic tasks, playing action video games has a beneficial effect on more complex spatial tasks such as mental rotation, thus demonstrating that learning generalizes far beyond the training activities in the game. Far transfer of this sort is generally elusive in learning, and we discuss some early attempts to elucidate the brain functions that are responsible. Finally, we suggest that studying video games may contribute not only to an improved understanding of the mechanisms of learning but may also offer new approaches to teaching spatial skills.

Starcevic V. . (2016).

Tolerance and withdrawal symptoms may not be helpful to enhance understanding of behavioral addictions.

Addiction, 111(7), 1307-1308.

URL     PMID:27095413     

Keywords: Addiction; behavioural addiction; tolerance; withdrawal

Starcevic V. . (2017).

Internet gaming disorder: Inadequate diagnostic criteria wrapped in a constraining conceptual model.

Journal of Behavioral Addictions, 6(2), 110-113.

URL     [本文引用: 1]

Starcevic V., & Aboujaoude E. (2017).

Internet gaming disorder, obsessive-compulsive disorder, and addiction.

Current Addiction Reports, 4(3), 317-322.

URL    

To examine the degree of relatedness between Internet gaming disorder (IGD), obsessive-compulsive disorder (OCD), and substance use disorders. IGD is phenomenologically distinct from OCD, and its rela

Summerbell C. . (2007).

Interventions for preventing obesity in children (review).

Cochrane Database Syst Rev, 5(2), 45-46.

URL     PMID:16034868      [本文引用: 3]

BACKGROUND: prevention is an international public health priority. The prevalence of and overweight is increasing in child populations throughout the world, impacting on short and long-term health. prevention strategies for children can change but efficacy in terms of preventing remains poorly understood.: To assess the effectiveness of interventions designed to prevent through diet, physical activity and/or lifestyle and social support.: MEDLINE, PsycINFO, EMBASE, CINAHL and CENTRAL were searched from 1990 to February 2005. Non-English language papers were included and experts contacted.: Randomised controlled trials and controlled clinical trials with minimum duration twelve weeks.: Two reviewers independently extracted data and assessed study quality.: Twenty-two studies were included; ten long-term (at least 12 months) and twelve short-term (12 weeks to 12 months). Nineteen were school/preschool-based interventions, one was a community-based intervention targeting low-income families, and two were family-based interventions targeting non-children of or overweight parents. Six of the ten long-term studies combined dietary education and physical activity interventions; five resulted in no difference in overweight status between groups and one resulted in improvements for girls receiving the intervention, but not boys. Two studies focused on physical activity alone. Of these, a multi-media approach appeared to be effective in preventing . Two studies focused on nutrition education alone, but neither were effective in preventing . Four of the twelve short-term studies focused on interventions to increase physical activity levels, and two of these studies resulted in minor reductions in overweight status in favour of the intervention. The other eight studies combined advice on diet and physical activity, but none had a significant impact. The studies were heterogeneous in terms of study design, quality, target population, theoretical underpinning, and outcome measures, making it impossible to combine study findings using statistical methods. There was an absence of cost-effectiveness data. AUTHORS': The majority of studies were short-term. Studies that focused on combining dietary and physical activity approaches did not significantly improve BMI, but some studies that focused on dietary or physical activity approaches showed a small but positive impact on BMI status. Nearly all studies included resulted in some improvement in diet or physical activity. Appropriateness of development, design, duration and intensity of interventions to prevent needs to be reconsidered alongside comprehensive reporting of the intervention scope and process.

Tao R., Huang X. J., Wang J. N., Zhang H. M., Zhang Y., & Li M. C . (2010).

Proposed diagnostic criteria for internet addiction.

Addiction, 105(3), 556-564.

URL     PMID:20403001     

Objective The objective of this study was to develop diagnostic criteria for internet addiction disorder (IAD) and to evaluate the validity of our proposed diagnostic criteria for discriminating non-dependent from dependent internet use in the general population. Methods This study was conducted in three stages: the developmental stage (110 subjects in the survey group; 408 subjects in the training group), where items of the proposed diagnostic criteria were developed and tested; the validation stage ( n = 405), where the proposed criteria were evaluated for criterion-related validity; and the clinical stage ( n = 150), where the criteria and the global clinical impression of IAD were evaluated by more than one psychiatrist to determine inter-rater reliability. Results The proposed internet addiction diagnostic criteria consisted of symptom criterion (seven clinical symptoms of IAD), clinically significant impairment criterion (functional and psychosocial impairments), course criterion (duration of addiction lasting at least 3 months, with at least 6 hours of non-essential internet usage per day) and exclusion criterion (exclusion of dependency attributed to psychotic disorders). A diagnostic score of 2 + 1, where the first two symptoms (preoccupation and withdrawal symptoms) and at least one of the five other symptoms (tolerance, lack of control, continued excessive use despite knowledge of negative effects/affects, loss of interests excluding internet, and use of the internet to escape or relieve a dysphoric mood) was established. Inter-rater reliability was 98%. Conclusion Our findings suggest that the proposed diagnostic criteria may be useful for the standardization of diagnostic criteria for IAD.

Turel O., Romashkin A., & Morrison K. M . (2016).

Health outcomes of information system use lifestyles among adolescents: Videogame addiction, sleep curtailment and cardiometabolic deficiencies.

PLOS One, 11(5), e0154764.

URL     PMID:27149512      [本文引用: 2]

Obesity is a rising problem among adolescents in modern societies; it results in long-term cardio-metabolic problems. Possible overlooked drivers of obesity and its consequent cardio-metabolic deficits include videogame addiction and the resulting curtailed sleep; both are growing problems among adolescents. The objective of this study is to examine possible associations among these concepts in adolescents, as a means to point to plausible interventions. Data were collected from 94 adolescents who play videogames and are enrolled in outpatient clinics, using surveys, wearable sleep monitors (FitBit), physical exams, and blood tests at three points in time. These data were subjected to structural equation modeling (SEM) analyses and bootstrapping-based mediation testing procedures. Videogame addiction among adolescents was negatively associated with sleep duration (β = -0.24). Sleep duration was negatively associated with obesity (β = -0.30), which in turn was associated with elevated blood pressure (β = 0.26), low high-density lipoprotein cholesterol (β = -0.18), high triglycerides (β = 0.61), and high insulin resistance (β = 0.39). The model explained 36.2% of the variation in sleep duration, 32.7% of the variation in obesity, and between 12.8% and 28.1% of the variation in cardio-metabolic indicators. Post-hoc analyses indicated that curtailed sleep is a possible full mediator of the association between videogame addiction, abdominal obesity and the associated cardio-metabolic deficits. The findings point to possible information systems use lifestyle-health links, which behooves researchers and practitioners to pay closer attention to possible adverse health outcomes of technology-related addictions. Interventions that target problematic video-gaming and sleep should be devised as a possible means for improving adolescents’ long-term cardio-metabolic health.

van A. R., & Prause N. (2014).

A critical review of “internet addiction” criteria with suggestions for the future.

Journal of Behavioral Addictions, 3(4), 203-213.

Magsci     [本文引用: 2]

Aims: In the last 5 years a deluge of articles on the topic of Internet addiction (IA) has proposed many candidate symptoms as evidence of this proposed disease. We critically reviewed the current approach to the measurement and identification of this new excessive behavior syndrome. Methods: Three popular models of IA were discussed: Griffith's components model; Young's Internet Addiction Test (IAT); and the criteria by Tao et al. (2010). We selected these models because they are widely cited and propose specific criteria for IA disorder. Our approach is not meant to provide an exhaustive review, but to discuss and critique the most salient trends in the field. Results: The models of Internet addiction share some criteria, including feeling a loss of control over Internet use; ensuing psychological, social, or professional conflict or problems; and preoccupation when not using the Internet. Other criteria inconsistently mentioned include: mood management, tolerance, withdrawal, and craving/anticipation. The models studied here share the assumption that the Internet can produce a qualitative shift to a diseased state in humans. Conclusions: We critically discussed the above criteria and concluded that the evidence base is currently not strong enough to provide support for an Internet addiction disorder. Future research areas are suggested: (1) Focusing on common impaired dimensions, (2) exploring neuroimaging as a model building tool, and (3) identifying shifts in the rewarding aspects of Internet use. Given the lack of consensus on the subject of Internet addiction, a focus on problem behaviors appears warranted.

van Rooij A. J., Ferguson C. J., Colder C. M., Kardefelt-Winther D., Shi J., & Aarseth E., .. Przybylski A. K . (2018).

A weak scientific basis for gaming disorder: Let us err on the side of caution.

Journal of Behavior Addiction, 7(1), 1-9.

URL     PMID:29529886      [本文引用: 3]

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 evidenceandthe 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.

vanRooij A.J., & Kardefeltwinther D. (2017).

Lost in the chaos: Flawed literature should not generate new disorders.

Journal of Behavioral Addictions, 6(2), 128-132.

URL     PMID:28301968     

The inclusion of Internet Gaming Disorder as a preliminary diagnosis subsumed in Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has provoked mixed reactions. On the one hand, it has been appreciated as an important sign stressing the negative health-related impact of that disorder. Likewise, the definition of diagnostic criteria helps scientists and clinicians to refer to mandatory indicators associated with a health problem. On the other hand, it has been objected that this new diagnosis bears the danger of pathologizing normal behaviors that are a feature of healthy recreational activity for many people. However, the existence of diagnostic criteria is meant to avoid this danger. This emphasizes the necessity of being able to refer to as accurate defined criteria as possible. In its current version, the DSM criteria display not only strengths but also ambiguities. Both types will be discussed and necessary ideas to resolve those ambiguities will be presented for further research.

van Rooij A. J., Kuss D. J., Griffiths M. D., Shorter G. W., Schoenmakers M. T ., & van de Mheen, D. (2014).

The (co-)occurrence of problematic video gaming, substance use, and psychosocial problems in adolescents.

Journal of Behavioral Addictions, 3(3), 157-165.

URL     PMID:4189309      Magsci    

Aims: The current study explored the nature of problematic (addictive) video gaming (PVG) and the association with game type, psychosocial health, and substance use. Methods: Data were collected using a paper and pencil survey in the classroom setting. Three samples were aggregated to achieve a total sample of 8478 unique adolescents. Scales included measures of game use, game type, the Video game Addiction Test (VAT), depressive mood, negative self-esteem, loneliness, social anxiety, education performance, and use of cannabis, alcohol and nicotine (smoking). Results: Findings confirmed problematic gaming is most common amongst adolescent gamers who play multiplayer online games. Boys (60%) were more likely to play online games than girls (14%) and problematic gamers were more likely to be boys (5%) than girls (1%). High problematic gamers showed higher scores on depressive mood, loneliness, social anxiety, negative self-esteem, and self-reported lower school performance. Nicotine, alcohol, and cannabis using boys were almost twice more likely to report high PVG than non-users. Conclusions: It appears that online gaming in general is not necessarily associated with problems. However, problematic gamers do seem to play online games more often, and a small subgroup of gamers specifically boys showed lower psychosocial functioning and lower grades. Moreover, associations with alcohol, nicotine, and cannabis use are found. It would appear that problematic gaming is an undesirable problem for a small subgroup of gamers. The findings encourage further exploration of the role of psychoactive substance use in problematic gaming.

van Rooij A. J., Schoenmakers T. M ., & van de Mheen, D. (2017).

Clinical validation of the c-vat 2.0 assessment tool for gaming disorder: A sensitivity analysis of the proposed DSM-5 criteria and the clinical characteristics of young patients with 'video game addiction'.

Addictive Behaviors, 64, 269-274.

URL     PMID:26526624     

Clinicians struggle with the identification of video gaming problems. To address this issue, a clinical assessment tool (C-VAT 2.0) was developed and tested in a clinical setting. The instrument allows exploration of the validity of the DSM-5 proposal for ‘internet gaming disorder’. Using C-VAT 2.0, the current study provides a sensitivity analysis of the proposed DSM-5 criteria in a clinical youth sample (13–23years old) in treatment for video gaming disorder (N=32). The study also explores the clinical characteristics of these patients. The patients were all male and reported spending extensive amounts of time on video games. At least half of the patients reported playing online games (n=15). Comorbid problems were common (n=22) and included (social) anxiety disorders, PDD NOS, ADHD/ADD, Parent–Child relationship problem, and various types of depressive mood problems. The sensitivity of the test was good: results further show that the C-VAT correctly identified 91% of the sample at the proposed cut-off score of at least 5 out of 9 of the criteria. As our study did not include healthy, extreme gamers, we could not assess the specificity of the tool: future research should make this a priority. Using the proposed DSM-5 cut-off score, the C-VAT 2.0 shows preliminary validity in a sample of gamers in treatment for gaming disorder, but the discriminating value of the instrument should be studied further. In the meantime, it is crucial that therapists try to avoid false positives by using expert judgment of functional impairment in each case.

vanSchie E.G., & Wiegman O. (1997).

Children and videogames: Leisure activities, aggression, social integration, and school performance.

Journal of Applied Social Psychology, 27(13), 1175-1194.

URL    

A survey was conducted among 346 children from the 7th and 8th grade of 7 elementary schools to examine possible positive and negative effects of playing videogames. Analyses revealed that playing videogames did not appear to take place at the expense of children's other leisure activities, social integration, and school performance. A gender difference arose: Boys spent more time playing videogames than did girls. There was no significant relationship between the amount of time children spent on videogames and aggressive behavior. A negative relationship between time spent playing videogames and prosocial behavior was found; however, this relationship did not appear in separate analyses for boys and girls. Furthermore, a positive relationship was found between time spent on videogames and a child's intelligence.

Wei H. T., Chen M. H., Huang P. C., & Bai Y. M . (2012).

The association between online gaming, social phobia, and depression: An internet survey.

BMC Psychiatry, 12(1), 92.

URL     PMID:22839747      [本文引用: 1]

Background Online gaming technology has developed rapidly within the past decade, and its related problems have received increasing attention. However, there are few studies on the psychiatric symptoms associated with excessive use of online games. The aim of this study is to investigate the characteristics of online gamers, and the association between online gaming hours, social phobia, and depression using an internet survey. Methods An online questionnaire was designed and posted on a popular online game websites, inviting the online gamers to participate the survey. The content of the questionnaire included demographic data, profiles of internet usage and online gaming, and self-rating scales of Depression and Somatic Symptoms Scale (DSSS), Social Phobia Inventory (SPIN), and Chen Internet Addiction Scale (CIAS). Results A total of 722 online gamers with a mean age of 21.8????????4.9???years completed the online survey within one month. 601 (83.2%) participants were male, and 121 (16.8%) were female. The mean weekly online gaming time was 28.2????????19.7 hours, which positively associated with history of online gaming (r???=???0.245, p???<???0.001), total DSSS (r???=???0.210, p???<???0.001), SPIN (r???=???0.150, p???<???0.001), and CIAS (r???=???0.290, p???<???0.001) scores. The female players had a shorter history of online gaming (6.0????????3.1 vs. 7.2????????3.6???years, p???=???0.001) and shorter weekly online gaming hours (23.2????????17.0 vs. 29.2????????20.2 hours, p???=???0.002), but had higher DSSS (13.0????????9.3 vs. 10.9????????9.7, p???=???0.032) and SPIN (22.8????????14.3 vs. 19.6????????13.5, p???=???0.019) scores than the male players. The linear regression model showed that higher DSSS scores were associated with female gender, higher SPIN scores, higher CIAS scores, and longer weekly online gaming hours, with controlling for age and years of education. Conclusion The online gamers with longer weekly gaming hours tended to have a longer history of online gaming, and more severe depressive, social phobic, and internet addiction symptoms. Female online gamers had fewer weekly online gaming hours and a shorter previous online gaming history, but tended to have more severe somatic, pain, and social phobic symptoms. The predictors for depression were higher social phobic symptom, higher internet addiction symptoms, longer online gaming hours, and female gender.

Wenzel H. G., Bakken I. J., Johansson A., Götestam K. G., & Øren A . (2009).

Excessive computer game playing among Norwegian adults: Self-reported consequences of playing and association with mental health problems.

Psychological Reports, 105(3), 1237-1247.

URL     PMID:20229923     

Computer games are the most advanced form of gaming. For most people, the playing is an uncomplicated leisure activity; however, for a minority the gaming becomes excessive and is associated with negative consequences. The aim of the present study was to investigate computer game-playing behaviour in the general adult Norwegian population, and to explore mental health problems and self-reported consequences of playing. The survey includes 3,405 adults 16 to 74 years old (Norway 2007, response rate 35.3%). Overall, 65.5% of the respondents reported having ever played computer games (16-29 years, 93.9%; 30-39 years, 85.0%; 40-59 years, 56.2%; 60-74 years, 25.7%). Among 2,170 players, 89.8% reported playing less than 1 hr. as a daily average over the last month, 5.0% played 1-2 hr. daily, 3.1% played 2-4 hr. daily, and 2.2% reported playing > 4 hr. daily. The strongest risk factor for playing > 4 hr. daily was being an online player, followed by male gender, and single marital status. Reported negative consequences of computer game playing increased strongly with average daily playing time. Furthermore, prevalence of self-reported sleeping problems, depression, suicide ideations, anxiety, obsessions/ compulsions, and alcohol/substance abuse increased with increasing playing time. This study showed that adult populations should also be included in research on computer game-playing behaviour and its consequences.

WHO. (2018.

6C51 Gaming disorder

July 18, 2018, from .

URL     [本文引用: 1]

Wölfling K., &Müller K.W . (2010).

Pathological gambling and computer game-addiction. Current state of research regarding two subtypes of behavioral addiction.

Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 53(4), 306-312.

URL     PMID:20195558      [本文引用: 2]

Abstract Behavioral addictions, like pathological gambling and computer game addiction (or internet addiction), have become a growing concern in research and public interest. Currently similarities between behavioral addictions and substance dependency are controversially discussed in the scientific community. Unfortunately a mismatch exists between the large number of people seeking treatment and the small number of scientific studies on pathological gambling and computer game addiction. Prevalence of pathological gambling among the German population is estimated to be 0.2-0.5%. These estimations are comparable to prevalence rates reported for drug dependency. Latest research states that about 3% of German adolescents and young adults are believed to suffer from computer game addiction. Therefore, it is important to enhance investigations regarding the clinical and neuroscientific basis of computer game addiction. This review offers a summary of current results of research regarding pathological gambling and internet addiction. The phenomenological description of these two disorders is meant to allow a deeper understanding of behavioral addictions.

Yao Y. W., Chen P. R., Li C. S. R., Hare T. A., Li S., Zhang J. T., .. Fang X. Y . (2017).

Combined reality therapy and mindfulness meditation decrease intertemporal decisional impulsivity in young adults with internet gaming disorder.

Computers in Human Behavior, 68(5), 210-216.

URL     [本文引用: 1]

Decisional impulsivity represents an important phenotype and a therapeutic target in Internet gaming disorder (IGD). Reality therapy and mindfulness meditation were two approaches to reduce impulsivity. This study aimed to evaluate the efficacy of a group behavioral intervention combining reality therapy and mindfulness meditation in reducing decisional impulsivity and IGD severity. Twenty-five IGD and 21 healthy comparison (HC) young adults participated in baseline tests on the delay discounting and balloon analog risk tasks to measure intertemporal and risky decision-making respectively. Among them, 18 IGD subjects participated in the intervention and were tested again at the end of intervention, and 19 HC subjects without intervention were also tested twice within a similar time period. Results indicate that: (1) at baseline, IGD subjects showed greater intertemporal and risky decisional impulsivity than HC subjects; (2) After intervention, IGD subjects were decreased in delay discounting rate and IGD severity, but did not perform differently on decisional impulsivity in risky choices, as compared with baseline. These findings suggest that decisional impulsivity is a multifaceted behavioral construct and may serve as a possible therapeutic target for IGD. In addition, these results highlight the need for further research into the roles of different forms of decisional impulsivity in the shaping, maintenance, and remission of IGD.

Yen J. Y., Liu T. L., Wang P. W., Chen C. S., Yen C. F., & Ko C. H . (2016).

Association between internet gaming disorder and adult attention deficit and hyperactivity disorder and their correlates: Impulsivity and hostility.

Addictive Behaviors, 64, 308-313.

Young K.S . (1998).

Internet addiction: The emergence of a new clinical disorder.

Cyberpsychology & Behavior, 1(3), 237-244.

Young K.S . (2013).

Treatment outcomes using CBT-IA with internet-addicted patients.

Journal of Behavioral Addictions, 2(4), 209-215.

URL     PMID:4154573      [本文引用: 1]

Background and Aims: Internet Gaming Disorder, a subtype of Internet Addiction, is now classified in Section 3 of the DSM-5. Cognitive behavioral therapy (CBT) has been suggested in treating Internet addiction as this modality has been shown to be an effective treatment for similar impulse control disorders. Given the daily and necessary use of the Internet and technology in general compared to other compulsive syndromes, a specialized form of CBT has been developed called Cognitive-Behavioral Therapy for Internet Addiction (CBT-IA). CBT-IA is a comprehensive three phase approach that includes behavior modification to control compulsive Internet use, cognitive restructuring to identify, challenge, and modify cognitive distortions that lead to addictive use, and harm reduction techniques to address and treat co-morbid issues associated with the disorder. Methods: As the first model of its kind, this study examines 128 clients to measure treatment outcomes using CBT-IA. Clients were evaluated using the Internet Addiction Test (IAT) to classify subjects and were administered twelve weekly sessions of CBT-IA. Treatment outcomes were measured at the end of the twelve weeks, one-month, three months and at six month post-treatment. Results: Results showed that over 95% of clients were able to manage symptoms at the end of the twelve weeks and 78% sustained recovery six months following treatment. Discussion and Conclusions: Results found that CBT-IA was effective at ameliorating symptoms associated with Internet addiction after twelve weekly sessions and consistently over one-month, three months, and six months after therapy. Further research implications such as investigating long-term outcome effects of the model with larger client populations and treatment differences among the subtypes of Internet addiction or with other cultural populations using CBT-IA are discussed.

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