Risk and protective factors of Internet gaming disorder among Chinese people: A meta-analysis

Objectives: Effective prevention and intervention of Internet gaming disorder require the identification of risk and protective factors. This study aims to exhaustively review the risk and protective factors of Internet gaming disorder among Chinese people. Method: We searched for articles published from database inception to February 2020 in MEDLINE, PsycINFO, Embase, PubMed, Web of Science and two Chinese databases, CNKI and Wanfang Data. Studies were included in the meta-analysis if they addressed Internet gaming disorder, sampled people in China, presented correlational factors of Internet gaming disorder and reported the effect sizes for correlations. Reviewers independently selected the studies, assessed their validity and extracted the data. Pooled Pearson’s correlations were calculated using the random effects model. Result: In the meta-analysis, 153 studies covering 115,975 subjects were included. We identified 56 risk factors and 28 protective factors. Most risk factors strongly correlated with Internet gaming disorder fell into the category of maladaptive cognitions and motivations. Other factors that showed high effect sizes fell into various categories, including psychopathological characteristics, personality traits, cognition emotion regulation style and gaming-related factors. The only protective factor strongly correlated with Internet gaming disorder was self-control. We found that the factors related to the ‘environments’ show modest effect sizes compared to those related to the individual. The pooled effect sizes for most factors were not influenced by outliers and publication bias. Conclusion: Factors strongly correlated with Internet gaming disorder, especially maladaptive cognitions and motivations, are more likely to be proximal correlates of Internet gaming disorder and may be considered the focus of interventions. We encourage further empirical and experimental studies to examine the causal pathway and the treatment efficacy.

Associations Among the Big Five Personality Traits, Maladaptive Cognitions, and Internet Addiction Across Three Time Measurements in 3 Months During the COVID-19 Pandemic

The present study examined the longitudinal association among the Big Five personality traits, maladaptive cognitions, and Internet addiction during the COVID-19 pandemic. A total of 481 Chinese university students (247 men; mean age = 20.31 years) were surveyed three times (interval of 1 month) by using the Chinese version of the Big Five Personality Traits Scale, Maladaptive Cognitions Scale, and Internet Addiction Scale. The results of a cross-lagged panel analysis highlighted that (i) extraversion, agreeableness, conscientiousness, and openness were negatively associated with maladaptive cognitions and Internet addiction, whereas neuroticism was found to be positively associated with maladaptive cognitions and Internet addiction across time; (ii) associations among the Big Five personality traits, maladaptive cognitions, and Internet addiction were dynamic and bidirectional; and (iii) maladaptive cognitions played mediating roles in extraversion, agreeableness, conscientiousness, openness, and Internet addiction across time. The Big Five personality traits, maladaptive cognitions, and Internet addiction predicted each other across time, and maladaptive cognitions were likely to be the key mediating factor in the associations between the Big Five personality traits and Internet addiction, which supported and expanded the Davis’ cognitive–behavioral model.

Mindfulness for Sustainable Internet Use in Chinese Junior Secondary School Students: A Dual-Path Mediation Model

Mindfulness training can reduce Internet addiction and promote sustainable development, but the possible mediators of this impact have not been thoroughly explored. This study explored the mediating roles of self-control and maladaptive cognitions in the association between mindfulness and Internet addiction to fill this gap. Altogether, 771 Chinese adolescents (M = 13.87 years, SD = 0.78 years) were surveyed about their mindfulness, self-control, maladaptive cognitions, and Internet addiction. The confirmed model presented a good model fit and revealed that (i) mindfulness, self-control, maladaptive cognitions, and Internet addiction were significantly correlated; (ii) mindfulness had indirect negative effects on Internet addiction, mediated by self-control; (iii) mindfulness had an indirect negative impact on Internet addiction, mediated by the path of self-control to maladaptive cognitions; and (iv) this dual-path mediation model might apply to male and female adolescents. The results of the present study suggest that both self-control and maladaptive cognitions are key factors in the association between mindfulness and Internet addiction.

Awareness and Potential Impacts of the Medicalization of Internet Gaming Disorder: Cross-sectional Survey Among Adolescents in China

Background The Eleventh Revision of International Classification of Diseases (ICD-11) newly listed gaming disorder, including internet gaming disorder (IGD), as a disease. The level of awareness and potential positive and negative impacts of this medicalization among adolescents were unknown. Objective This study investigated the levels, associated factors, and potential positive and negative impacts of awareness of the medicalization of IGD among adolescents in China. Methods In a cross-sectional survey, 1343 middle school students in Guangzhou, China, self-administered an anonymous questionnaire in classrooms (October to December 2019). Three risk subgroups were identified: those who scored ≥5 items in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition checklist (IGD-S), those who self-perceived having IGD currently (IGD-PC), and those who self-perceived having IGD within 12 months (IGD-P12M). Results Of the internet gamers, 48.3% (460/952) were aware of the medicalization of IGD; they were more likely to belong to the IGD-P12M/IGD-S risk subgroups. Within the IGD-PC/IGD-P12M (but not IGD-S) risk subgroups, IGD medicalization awareness was positively associated with favorable outcomes (reduced internet gaming time in the past 12 months, seeking help from professionals if having IGD, and fewer maladaptive cognitions). After being briefed about the ICD-11 inclusion of IGD, 54.2% (516/952) and 32.8% (312/952) expressed that it would lead to the reduction of gaming time and help-seeking behaviors, respectively; however, 17.9% (170/952), 21.5% (205/952), 15.9% (151/952), and 14.5% (138/952) perceived self-doubt for being diseased, stronger pressure from family members, negative emotional responses, and labeling effect, respectively. With a few exceptions, such perceived positive or negative impacts were stronger among the IGD-S, IGD-PC, and IGD-P12M risk subgroups. Conclusions The exploratory study shows that the medicalization of IGD may have benefits that need maximization and potentially harmful effects that need minimization. Future studies should test the efficacies of health promotion that increases IGD medicalization awareness.