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BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering

Internet gaming disorders among youth: Prevalence, course, predictors, outcome and evaluation of diagnostic criteria

Awarded: NOK 4.0 mill.

It has for long been acknowledged that excessive and problematic use of Internet games may have serious consequences for some young people. Accordingly, Internet gaming disorder (IGD) was listed as an Addendum to DSM-5 as a condition for further study, and diagnostic criteria were suggested. Our knowledge on basic phenomena of IGD such as prevalence, course, risk and protective factors and the adequacy of the proposed criteria is limited. In part, this is due to the lack of prospective studies and agreement on diagnostic criteria, as well as valid diagnostic instruments. We have therefore, for the first time, developed a diagnostic interview to assess IGD and we interview participants when they were 10 (n=702) and 12 years old (n=663) in the Trondheim Early Secure Study (TESS). The TESS started when the participants were 4 years old, and has continued with biennial assessments. We will thus chronicle a) prevalence, b) course from 10 to 12 years, predictors of the IGD and symptoms thereof, and d) consequences of IGD or a high level of IGD symptoms. In addition, we will assess to what extent the symptoms capture one underlying disorder or not. Predictors and consequences encompass a wide variety of factors such as socio-economic and demographics, parental factors (e.g., global parenting skills, limit setting with respect to IGD, own gaming and use of Internet), child factors (e.g., temperament, social skills, peer-relations, school factors, mental health, sleep, physical activity, bullying/social inclusion, self-esteem, intelligence, executive functions), but also types of games played. The 5th data collection wave is finalized and interviews have been coded, also including reliability check with recodings of interviews by blinded raters. In all, 663 participants were included; the attrition rate is very low, to illustrate, 702 participants met at the 4th data collection wave. At age 12 the prevalence of DSM-5 defined IGD was 1.7% (3.0 among boys, 0.5% among girls). Two dimensions were revealed: one tapping into heavy gaming involvement (preoccupation, withdrawal, tolerance, unsuccessful attempts to control, escape or relieve negative mood) and negative consequences (loss of interest in other activities, continued excessive use despite acknowledged negative consequences, jeopardized or lost relationship or educational opportunity). However, three core addictive symptoms were poorly associated with the disorders (through low positive predictive value): withdrawal, tolerance, and lack of control. High level of symptoms were only weakly correlated with symptoms of other common psychiatric disorders in childhood and adolescence. From a long list of potential predictors (demographic, family/parental factors, personality factors), only poor social competence and emotion regulation did predict age 12 IGD symptoms.

Problematic Internet gaming has been recognized a prevalent problem in youth with serious consequences. However, research on the prevalence, potential courses and consequences has been limited by the lack of commonly agreed upon criteria and prospective s tudies. Hence, it has not been possible to discern effects of the problem from its consequences. The DSM-5 which was launched fall 2013 and include Internet gaming disorder (IGD) as a condition for further study and describes its symptoms. Based on these DSM-5 criteria we have developed the first semi-structured clinical interview of IGD. In the current research we will: 1) estimate the prevalence and 2-year stability of IGD among 10-13 year olds 2) identify early risk and protective factors for IGD ac cording to a theoretical model of IGD consisting of background factors (e.g., SES and gender); opportunities to game (e.g., availability of games and gaming devices); parent and parenting characteristics (e.g., parental mental health, limit setting, own I nternet use); child characteristics (e.g., social competence, executive functioning, and alternate leisure activities) which may act directly or moderate the effect of other influences on IGD 3) identify consequences of IGD, including changes in risk and protective factors (above), but also sleep, school adjustment, and additional psychopathologies 4) describe IGD comorbidity with other psychiatric disorders 5) evaluate to what extent the symptoms suggested in DSM-5 define the disorder. Defined propor tions of two birth cohorts in the city of Trondheim has been followed up bi-annually in 4 waves since they were 4 years old (n = 999). After 5 waves of data collection we estimate to still retain 65%. Parents and children complete a structured diagnostic interview and a range of observational, laboratory, questionnaire and interview measures (4 hours per family). Teachers complete questionnaires as well.

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BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering