Gaming disorder is a growing concern affecting adolescents, exacerbated by the impact of recent COVID-19 restrictions. The World Health Organization has recently included gaming disorder in the 11th International Classification of Diseases (ICD-11). However, there is still an ongoing debate about the validity and reliability of the proposed clinical criteria, despite growing neurobiological evidence in this cohort. Systematic reviews in this area have focused mainly on adults or mixed adult/adolescent populations. Therefore, this systematic review explored the neuroimaging literature in adolescents (under 18 years old) with gaming disorder.

Using PRISMA 2020 guidelines, 3288 primary studies were identified from PubMed, CINAHL Plus, PsycINFO and Web of Science. After applying inclusion and exclusion criteria (appropriate title, abstract, comparison group used within study, English-language, neuroimaging and mean age under 18), 24 studies were included in this review.

Functional and structural brain alterations in adolescent gaming disorder were noted across several imaging modalities, including electroencephalogram (EEG), functional magnetic resonance imaging (fMRI) and structural magnetic resonance imaging (MRI). Compared with healthy controls, adolescents with gaming disorder demonstrated neurological changes comparable to substance addiction, namely impairments in emotional regulation, reward-seeking, inhibition and increased risky decision-making. Positive brain adaptations in the areas of visuospatial processing and memory were observed.

A number of key brain regions are affected in adolescent gaming disorder. These findings can help clinicians understand adolescent presentations with gaming disorder from a neurobiological perspective. Future studies should focus on forming a robust neurobiological and clinical framework for adolescent gaming disorder.

ICD-11 describes Gaming disorder as a behavioral pattern characterized by impaired control over gaming, increased gaming priority, and escalation despite consequences. This description is similar to other addictive behaviors with minor specifics. However, it is unclear if gaming disorder has any specific psychopathological profile.

The study aimed to investigate gaming disorder’s connection to primary psychopathological symptomatology.

515 gamers aged 16-56 (75% male) anonymously completed online questionnaires: SCL-90-R and Video Games Addiction Scale (VGAS) – our new 26-items questionnaire based on ICD-11 criteria for gaming disorder. VGAS showed good reliability (Cronbach`s α=0.858) and external validity (positive correlation with Chen Internet Addiction Scale, r=0.472, p=0.000).

Gaming disorder severity showed positive correlations (p=0.000) with all SCL-90-R scales. Pearson`s r ranged from 0.311 (phobic anxiety) to 0.431 (depression). Thus, gaming disorder showed no specific combination of psychopathological symptoms. Instead, all symptoms had almost equal correlations with the VGAS score.

Gaming disorder is not linked to any particular combination of psychopathological symptoms. On the contrary, as suggested by our study, different symptoms are almost equally related to excessive gaming. Several interpretations are possible. Problematic gaming can be a way for psychologically distressed people to deal with different symptoms. Conversely, gaming disorder can itself lead to psychological maladjustment. Thus, further thorough research is required, specifically when deciding on the primary diagnosis in comorbid cases or choosing the therapeutic aims.

No significant relationships.

Video games are among the most popular leisure time activities. While majority of gamers play in a healthy manner, a minority shows gaming disorder (GD) symptoms and experiences detrimenting effects in their lives. Even though gaming time is moderately associated with gaming disorder symtoms, research suggests that it is not a reliable predictor by itself.

The aim of the present study is to explore whether depression symptoms, self-esteem, attention-deficit/hyperactivity disorder (ADHD) and escapism (when gaming is motivated by the avoidance of everyday problems) moderate the association between gaming time and GD symptoms and whether this is different for boys and girls.

Data was collected from a representative sample of 5th grade students of public education institutions in Budapest. Sample selection was carried out by one-step sampling stratified for school type, district, and maintainer; the sampling unit was the class. Data from 2126 students were analyzed (49.3% male, mean age 10.7 years, SD=0.54).

Depression symptoms moderated the association between gaming time and GD symtoms in both genders. For those with higher depression symptoms the aforementioned association was stronger. Furthermore, self-esteem had a moderator effect only among girls, while escapism motivation and ADHD only among boys. In these cases, the association between gaming time and GD symptoms was stronger among those with lower self-esteem, and higher ADHD and escapism scores.

Results suggest that gaming time is more strongly connected to GD symptoms in certain conditions, but its predictive value is limited even in those cases.

Funding statement: This study was supported by the Hungarian National Research, Development and Innovation Office (KKP126835). Orsolya Király was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences and by the ÚNKP-21-5

Studies about Game Transfer Phenomena (GTP) have demonstrated lingering effects of playing video games manifesting as sensory, cognitive, and motoric intrusions (e.g., seeing images or hearing voices from the game after playing), transient changes in perception and self-agency. GTP are common among non-clinical players, though those with mental disorders are more susceptible. Gamers tend to appraise GTP as pleasant. Distress has been reported when GTP are experienced frequently and with specific content.

To show the interplay between GTP and patients’ symptomatology and the benefits of using the GTP framework in clinical contexts.

GTP were assessed via clinical interviews and with a validated GTP scale (three cases, males, 10-16 years old, playing time 6-10 h/day).

The cases were characterised by i) incorporation of videogame content into hallucinations and delusions, ii) identification with a videogame character and subsequent distress provoked by hearing the character’s voice and iii) self-induced GTP as self-soothing behaviour when reducing playing time. Main GTP manifestations were in the auditory modality as sounds or voices. The primary clinical diagnoses were gaming disorder, depressive disorder, and psychosis.

On one hand, GTP can be pleasurable and a way to cope with withdrawal symptoms from gaming disorder, though it can lead to compulsive behaviours and dissociation. On the other hand, GTP can be interpreted negatively and fulfil delusions that provoke distress and compromise mental stability. The cases reveal that the GTP framework can be an effective psycho-pedagogic method and support differential diagnosis.

No significant relationships.

Previous literature has extensively investigated the brain activity during response inhibition in adults with addiction. Inconsistent results including both hyper- and hypo-activities in the fronto-parietal network (FPN) and the ventral attention network (VAN) have been found in adults with addictions, compared with healthy controls (HCs).

Voxel-wise meta-analyses of abnormal task-evoked regional activity were conducted for adults with substance dependence (SD) and behavioral addiction during response inhibition tasks to solve previous inconsistencies. Twenty-three functional magnetic resonance imaging studies including 479 substance users, 38 individuals with behavioral addiction and 494 HCs were identified.

Compared with HCs, all addictions showed hypo-activities in regions within FPN (inferior frontal gyrus and supramarginal gyrus) and VAN (inferior frontal gyrus, middle temporal gyrus, temporal pole and insula), and hyper-activities in the cerebellum during response inhibition. SD subgroup showed almost the same activity patterns, with an additional hypoactivation of the precentral gyrus, compared with HCs. Stronger activation of the cerebellum was associated with longer addiction duration for adults with SD. We could not conduct meta-analytic investigations into the behavioral addiction subgroup due to the small number of datasets.

This meta-analysis revealed altered activation of FPN, VAN and the cerebellum in adults with addiction during response inhibition tasks using non-addiction-related stimuli. Although FPN and VAN showed lower activity, the cerebellum exhibited stronger activity. These results may help to understand the neural pathology of response inhibition in addiction.

The aim of this study was to carry out the first ever study of gaming characteristics of individuals engaging in online gaming in Ireland and to ascertain whether features of gaming disorder are present in this population.

An online survey (comprising 21 questions – 3 demographic questions and 18 questions related to gaming and gaming disorder) was distributed on numerous Irish online gaming forums and Irish online gaming communities. Participants were self-selected and invited to compete the online survey containing questions related to gaming behaviours (age of onset, hours played on weekdays/weekends, type of device used), mobile gaming, motives for online gaming, use of microtransactions, engagement in esports, and a screening tool for the presence of gaming disorder.

A total of 166 participants engaged in the online survey. Among this study population of regular gamers in Ireland, 2.4% of the study population were classified as having gaming disorder, with up to 5.4% showing some evidence of disordered gaming. The main motivation for online gaming in the non-disordered gaming group was recreation (13.3, sd = 2.7) but only the fourth main motivation in the disordered gaming group behind competition (16.3, sd = 3.7), escape (16.2, sd = 4.3), and coping (15.1, sd = 3.7). Increased hours of gameplay on weekdays and weekends were noted in the disordered gaming group compared to non-disordered gamers.

A small percentage of gamers in Ireland demonstrate disordered gaming characteristics and gaming disorder, consistent with data from other international studies. Epidemiological studies are required in Ireland to enhance our knowledge of this disorder.