Internet gaming disorder, motives, game genres and psychopathology

Highlights

• In our sample, the prevalence of Internet gaming disorder (IGD) was nearly 2%.

• IGD was predicted by several variables with gender differences.

• Game genre also had a different influence on IGD scores among men and women.

• Problematic gamers had higher scores of psychopathology than non-problematic gamers.

• Problematic gamers had higher scores of social, escape, coping and fantasy motives.

Abstract

Since Internet gaming disorder recently appeared in the section III of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), little investigation has been performed. Besides, more data on Internet gaming behaviors is needed in French samples. Therefore, the main purpose of this study was to assess the prevalence of Internet gaming disorder in a sample of French young Internet users and to explore the relationships between Internet gaming disorder, time spent on the Internet, gaming time and motives, game genre, and psychopathology. Our sample consisted of 418 online gamers recruited online, aged from 18 to 30 years (M = 22; SD = 3) and constituted of 206 women (49%) and 212 men. They completed several scales assessing characteristics of Internet use and gaming behaviors as well as depression and self-esteem. The prevalence of Internet gaming disorder was nearly 2% (n = 8). Hierarchical regression analysis revealed that time spent on the Internet, gaming motives and depressive symptoms were significant predictors of Internet gaming disorder scores, with differences according to gender. Problematic gamers had higher mean scores of social, escape, coping and fantasy motives and psychopathology than non-problematic gamers. This study highlights the relationships between Internet gaming disorder, motives, game genres and psychopathological variables, as differences between gamers with and without Internet gaming disorder. Motives such escape appears as a highly important factor, highlighting why internet gaming disorder could be considered as a dysfunctional coping strategy.

Introduction

The fifth edition of the Diagnostic and Statistical Manual of mental disorders (DSM-5; American Psychiatric Association [APA], 2013) drew attention to the Internet Gaming Disorder (IGD) which has been added to the section III, listing all disorders that require additional scientific research. According to the APA (2013), the IGD is defined as a “persistent and recurrent use of the Internet to engage in games, often with other players, leading to impairment or clinically significant distress” (p. 795). Based on pathological gambling and substance dependence, nine diagnostic criteria have been proposed. Gamers must fulfill at least five of the following symptoms for at least a 12-month period: 1) Preoccupation with Internet games, 2) Withdrawal symptoms when Internet gaming is taken away, 3) Tolerance with the need to spend increasing amounts of time engaged in Internet games, 4) Unsuccessful attempts to control the participation in Internet games, 5) Loss of interests in previous hobbies and entertainment as a result of, and with the exception of, Internet games, 6) Continued excessive use of Internet games despite knowledge of psychosocial problems, 7) Has deceived family members, therapists, or others regarding the amount of Internet gaming, 8) Use of Internet games to escape or relieve a negative mood, and 9) Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of participation in Internet games (APA, 2013).

Despite of this precise definition and diagnostic criteria, IGD is the subject of many debates (Griffiths et al., 2016, Király et al., 2015). Indeed, in the DSM-5, IGD “most often involves specific Internet games, but it could involve non-Internet computerized games as well” (APA, 2013, p. 796). Consequently, the word Internet in IGD seems to have been used to describe electronic or technological gaming while terminology, definition and diagnostic criteria enclose the specific use of the Internet. Far from being a simple detail, this implies that online and offline gaming addictions are identical, and consequently that Internet does not have a particular influence on gaming behaviors. However, Internet is not just a tool to satisfy some behaviors but it also brought a social dimension, which impacts obviously gamers and gaming experiences (Carlisle and Carrington, 2015, Király et al., 2014a). Online gaming has become a space of virtual socialization in which the player experiences social interactions as integral parts of the gaming process. Besides, in a recent study “time spent playing online games showed stronger correlations with IGD than time spent playing offline games” (Lemmens & Hendriks, 2016, p. 6). Furthermore, it is specified in the DSM-5 that “IGD (also commonly referred to as Internet use disorder, Internet addiction, or gaming addiction) has merit as an independent disorder” (APA, 2013, p. 796). This part of the definition reflects the lack of clarity and differentiation between Internet addiction and addiction to other Internet-related disorders (Schimmenti, Caretti, & La Barbera, 2014) such as online gaming while Internet addiction is a concept combining a set of heterogeneous sub-parts such as the IGD or addiction to pornographic sites. These distinct and specific sub-parts of Internet addictions involving different symptomatology (Laconi, Tricard, & Chabrol, 2015), it would be a mistake not to distinguish them from the general concept (Király et al., 2015, Rehbein and Mößle, 2013). In addition, other critics have been made against the IGD criteria which are copied/pasted from pathological gambling and substance use disorder (Kardefelt-Winther, 2014), incomplete, inaccurate, or not applicable to all populations or situations (Kardefelt-Winther; Ko et al., 2014, Petry et al., 2014).

Several assessment tools have been developed since the last years (Pontes & Griffiths, 2014). The Internet Gaming Disorder Test-20 (IGD-20T; Pontes, Király, Demetrovics, & Griffiths, 2014) and its short form the Internet Gaming Disorder scale-Short-Form (IGDS9-SF; Pontes & Griffiths, 2015) were the first created scales for assessing online and offline gaming behaviors. The Internet Gaming Disorder Test-10 (IGDT-10; Király, Griffiths et al., 2015) is composed of 10 items based on the nine DSM-5 criteria. Finally, the Internet Gaming Disorder Scales (IGDS; Lemmens, Valkenburg, & Gentile, 2015) have been developed, with a 9 and 27-items version and with a dichotomous and a polytomous form. The Personal Internet Gaming Disorder Evaluation-9 (PIE-9; Pearcy, Roberts, & McEvoy, 2016) is composed of 9 items rated on a 5-point scale. Some studies simply used the 9 criteria of the DSM-5 (Kim et al., 2016, Ko et al., 2014).

Because of its recent introduction, little contribution has been done on IGD as such (Pontes & Griffiths, 2015). Before the DSM-5, a meta-analysis of data published between 2001 and 2011 retrieved 6% of pathological video game use (Ferguson, Coulson, & Barnett, 2011). Recent studies on IGD showed very heterogeneous rates, from 1 to 15% in Europe. The majority of studies found higher prevalence of IGD among men than women (Ko, 2014, Pontes et al., 2014, Wittek et al., 2015), even though some did not (Lemmens et al., 2015). This large gap and these inconsistencies could find an explanation in the methodological differences and particularly with the different measures used (American Psychiatric Association, 2013, Ferguson et al., 2011) as in samples characteristics (e.g., age, sex ratio and culture). Gender and cultural differences should be further studied (American Psychiatric Association, 2013, Ko, 2014, Kuss, 2013).

Moreover, a recent study showed that excessive gaming time may depend on gender but also on game genres preferences (Rehbein, Staudt, Hanslmaier, & Kliem, 2016). Therefore, it appears crucial to explore the possible influence of game genre on IGD (American Psychiatric Association, 2013, Wittek et al., 2015). Role playing games and shooter games seem to contribute to higher gaming time, particularly in males (Rehbein et al., 2016). Compared to other game genres, MMORPG (Massively Multiplayers Online Role Playing Games) seem particularly related to IGD (Eichenbaum et al., 2015b, Eichenbaum et al., 2015a). One other study found a stronger relationship with MMORPG and FPS (First Person Shooter) games, contrarily to action and puzzle games which were barely linked to IGD (Lemmens & Hendriks, 2016). MMORPG are also associated to higher psychopathology and lower well-being (Caplan et al., 2009, Fuster et al., 2016, Ko, 2014, Park et al., 2015). Flash-games or casual games are more and more opposed to MMORPG and others hard core games, because of its playing characteristics (e.g., simple, free, very short playing time and the gamer play most of the time alone). These types of games seem to be preferred by women (Rehbein et al., 2016). Few studies have been conducted on the relation between these games and online IGD, yet it can be assumed that this game genre can be as addictive or at least as problematic as others, with compulsive use and increasing amount of gaming time (Willson & Leaver, 2016).

Furthermore, gaming motives also emerge as important risk factors of IGD (Király et al., 2014b, Kneer and Rieger, 2015, Kuss et al., 2012) and seem to influence gaming genres preferences (Ko, 2014). Motives and game preferences can explain gender differences given for example that women are more prone to game for building intimacy while men preferred competition (Yee, 2006). However, among MMORPG gamers, almost one third of gamers played to relieve stress and annoyances of the real world (Hussain & Griffiths, 2009). Other authors highlight the importance of social motives among MMORPG gamers (Cole and Griffiths, 2007, Yee, 2006). For FPS gamers, gaming motives are rather related to competition and sense of control (Kuss, 2013). It is still unclear whether motives play a role on the development of IGD, but online gaming appears as a dysfunctional coping strategy to reduce psychological distress and to escape reality (Kardefelt-Winther, 2014, Schimmenti et al., 2012). Besides, escapism and competition have been related to higher psychiatric symptoms and problematic video game use (Király, Urbán et al. 2015). In the same direction, a Hellström and al. survey showed that escape motives had an influence on psychosomatic or depressive symptoms, while social and entertainment motives could reduce these risks (Hellström, Nilsson, Leppert, & Ǻslund, 2015).

Lastly, as mentioned in the DSM-5: depressive disorders, attention-deficit/hyperactivity disorder, or obsessive-compulsive disorder have been related to IGD, even if the direction of causality is not clear yet (Király, Sleczka et al. 2015). Besides, no information is given about the specificity of the evaluated gaming behavior (e.g., online/offline/both). Recent studies on IGD found significant relationships between IGD and low self-esteem (Lemmens et al., 2015) or the nine dimensions of the Brief Symptom Inventory (e.g., depression, anxiety, phobic anxiety, interpersonal sensitivity, hostility) among adults (Kim et al., 2016). Previous studies conducted on online gaming have already highlighted the relationship between problematic gaming and poor psychological well-being, low satisfaction of life (Ko, Yen, Chen, Chen, & Yen, 2005), low self-esteem (Schmit, Chauchard, Chabrol, & Séjourné, 2011), loneliness (Lemmens, Valkenburg, & Peter, 2011), substance use (van Rooij, Kuss, Griffiths, Shorter, Schoenmakers, & van de Mheen, 2014), or more difficulties in social, financial or professional areas (Achab et al., 2011).

The main objective of this study was to explore the prevalence of IGD in a sample of young adults and gamers characteristics. The second objective was to compare Internet and gaming-related and psychopathological variables among gamers with and without an IGD. The last objective was to examine the relationships between IGD and the studied variables (i.e., time spent online, playing time online, motives, depressive symptoms and self-esteem) and the contribution of these variables to IGD. Given the previous contribution, statistical analyses were performed separately in men and women.