Research Article
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Online gaming features in adolescents with attention-deficit/hyperactivity disorder

Year 2023, Volume: 28 Issue: 2, 198 - 207, 23.05.2023
https://doi.org/10.21673/anadoluklin.1187327

Abstract

Aim: Leisure activities in adolescents with Attention-deficit/hyperactivity disorder (ADHD) tend to focus on Internet activities, especially online games. Online gaming addiction has been observed in ADHD populations. Game genres and characteristics may affect addiction in ADHD adolescents who play online games. This study aims to contribute to the literature by examining the Internet gaming disorder (IGD) risk effects and game genres of hyperactivity/impulsivity, inattention, and ADHD index separately.

Methods: A total of 884 adolescents playing online games were included. Participants answered the online game features form, Conners-Wells’ adolescent self-report scale—long version and digital gaming addiction scale—short form under the observation of their teachers. Game genres and ADHD symptomatology (Inattention, Hyperactivity/impulsivity, ADHD index) were categorized within themselves.

Results: IGD was significant in all subcomponents of ADHD symptomatology. In all subcomponents, insulting/threatening speeches were found in the chat tab. In the Hyperactivity/impulsivity component, more hours of online gaming and spending real money on in-game advantages were found. In the Inattention and ADHD index, the amount of gaming in the social environment of the adolescents was high. In ADHD symptomatology, no significant results were found in game genres (except sports in the Inattention component).

nclusion: Although levels of online gaming are high in adolescents with ADHD, a bidirectional relationship is likely. We believe that social factors and communicative characteristics are important in relational factors in adolescents. Longitudinal studies should be conducted to answer important empirical questions about the relationship between ADHD-IGD and game genres.

References

  • Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol. 2014;43(2):434-42.
  • Carbray JA. Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. J Psychosoc Nurs Ment Health Serv. 2018;56(12):7-10.
  • American Psychiatric Association. Diagnostic and sta- tistical manual of mental disorders (DSM-5®). Am Psychiatr Publ. 2013.
  • Bolic Baric V, Hellberg K, Kjellberg A, Hemmingsson H. Internet Activities During Leisure: A Comparison Between Adolescents With ADHD and Adolescents From the General Population. J Atten Disord. 2018;22(12):1131-9.
  • Stavropoulos V, Kuss DJ, Griffiths MD, Wilson P, Motti-Stefanidi F. MMORPG gaming and hostility predict Internet Addiction symptoms in adolescents: An empirical multilevel longitudinal study. Addict Behav. 2017;64:294-300.
  • Weiss MD, Baer S, Allan BA, Saran K, Schibuk H. The screens culture: impact on ADHD. Atten Defic Hyperact Disord. 2011;3(4):327-34.
  • Chou WJ, Liu TL, Yang P, Yen CF, Hu HF. Multi-dimensional correlates of Internet addiction symptoms in adolescents with attention-deficit/hyperactivity disorder. Psychiatry Res. 2015;225(1-2):122-8.
  • Ko CH, Liu GC, Hsiao S, et al. Brain activities associated with gaming urge of online gaming addiction. J Psychiatr Res. 2009;43(7):739-47.
  • Thoma VK, Schulz-Zhecheva Y, Oser C, Fleischhaker C, Biscaldi M, Klein C. Media Use, Sleep Quality, and ADHD Symptoms in a Community Sample and a Sample of ADHD Patients Aged 8 to 18 Years. J Atten Disord. 2020;24(4):576-89.
  • Hyun GJ, Han DH, Lee YS, et al. Risk factors associated with online game addiction: A hierarchical model. Comput Hum Behav. 2015;48:706-13.
  • Park JH, Lee YS, Sohn JH, Han DH. Effectiveness of atomoxetine and methylphenidate for problematic online gaming in adolescents with attention deficit hyperactivity disorder. Hum Psychopharmacol. 2016;31(6):427-32.
  • Weinstein A, Weizman A. Emerging association between addictive gaming and attention-deficit/hyperactivity disorder. Curr Psychiatry Rep. 2012;14(5):590-7.
  • Han DH, Lee YS, Na C, et al. The effect of methylphenidate on Internet video game play in children with attention-deficit/hyperactivity disorder. Compr Psychiatry. 2009;50(3):251-6.
  • McKelvey K. The link between self-reported video game addiction symptoms and adult attention-deficit/ hyperactivity disorder symptoms. Fresno, CA: Alliant International University; 2010.
  • Yoo HJ, Cho SC, Ha J, et al. Attention deficit hyperactivity symptoms and internet addiction. Psychiatry Clin Neurosci. 2004;58(5):487-94.
  • Hupfeld KE, Abagis TR, Shah P. Living “in the zone”: hyperfocus in adult ADHD. Atten Defic Hyperact Disord. 2019;11(2):191-208.
  • Makris N, Biederman J, Monuteaux MC, Seidman LJ. Towards conceptualizing a neural systems-based anatomy of attention-deficit/hyperactivity disorder. Dev Neurosci. 2009;31(1-2):36-49.
  • Miller DK, Blum K. Overload: attention deficit disorder and the addictive brain. Salt Lake City, UT: Woodland Publishing Company; 2008.
  • World Health Organization. (2018). International classification of diseases for mortality and morbidity statistics, 11th Revision. Gaming disorder. Accessed 14 January 2020 http://www.who.int/features/qa/gaming-disorder/en/.
  • Laconi S, Pirès S, Chabrol H. Internet gaming disorder, motives, game genres and psychopathology. Comput Hum Behav. 2017;75:652-9.
  • T’ng ST, Ho KH, Sim DE, Yu CH, Wong PY. The mediating effect of Internet gaming disorder’s symptoms on loneliness and aggression among undergraduate students and working adults in Malaysia. Psych J. 2020;9(1):96-107.
  • CBS News. Warcraft or Warcrack?. 2007. (access date: 15.05.2023) Available from: https://www.cbsnews.com/video/warcraft-or-warcrack/.
  • Elliott L, Golub A, Ream G, Dunlap E. Video game genre as a predictor of problem use. Cyberpsychol Behav Soc Netw. 2012;15(3):155-61.
  • Smyth JM. Beyond self-selection in video game play: an experimental examination of the consequences of massively multiplayer online role-playing game play. Cyberpsychol Behav Soc Netw. 2007;10(5):717–21.
  • Lemmens JS, Hendriks SJ. Addictive Online Games: Examining the Relationship Between Game Genres and Internet Gaming Disorder. Cyberpsychol Behav Soc Netw. 2016;19(4):270-6.
  • Aggarwal S, Saluja S, Gambhir V, Gupta S, Satia SPS. Predicting likelihood of psychological disorders in PlayerUnknown’s Battlegrounds (PUBG) players from Asian countries using supervised machine learning. Addict Behav. 2020;101:106132.
  • Kuss DJ, Griffiths MD. Internet gaming addiction: A systematic review of empirical research. Int J Ment Health Addict. 2012;10(2):278–96.
  • Mathews CL, Morrell HE, Molle JE. Video game addiction, ADHD symptomatology, and video game reinforcement. Am J Drug Alcohol Abuse. 2019;45(1):67-76.
  • Gamefaqs. (accessed Jan. 14, 2021). Retrieved from https://gamefaqs.gamespot.com/.
  • Conners CK. (1997). Conners Wells Adolescent Self-Report Scale. Toronto: Multi-Health Systems.
  • Kaner S. ADHD symptoms in national samples of Turkish adolescents: parent, and teacher reports. Procedia Soc Behav Sci. 2011;15:3342-8.
  • Lemmens JS, Valkenburg PM, Peter J. Development and validation of a game addiction scale for adolescents. Media Psychol. 2009;12(1):77-95.
  • Yalçın Irmak A, Erdogan S. Validity and reliability of the Turkish version of the digital game addiction scale. Anatolian Journal of Psychiatry. 2015;16:10–9.
  • Oflu A, Yalcin SS. Video game use among secondary school students and associated factors. Uso de videojuegos en alumnos de la escuela secundaria y factores asociados. Arch Argent Pediatr. 2019;117(6):e584-91.
  • Desai RA, Krishnan-Sarin S, Cavallo D, Potenza MN. Video-gaming among high school students: health correlates, gender differences, and problematic gaming. Pediatrics. 2010;126(6):e1414-24.
  • Hellström C, Nilsson KW, Leppert J, Åslund C. Effects of adolescent online gaming time and motives on depressive, musculoskeletal, and psychosomatic symptoms. Ups J Med Sci. 2015;120(4):263-75.
  • Thalemann R, Wölfling K, Grüsser SM. Specific cue reactivity on computer game-related cues in excessive gamers. Behav Neurosci. 2007;121(3):614-8.
  • Han DH, Bae S, Hong J, Kim SM, Son YD, Renshaw P. Resting-State fMRI Study of ADHD and Internet Gaming Disorder. J Atten Disord. 2021;25(8):1080-95.
  • Yen JY, Liu TL, Wang PW, Chen CS, Yen CF, Ko CH. Association between Internet gaming disorder and adult attention deficit and hyperactivity disorder and their correlates: Impulsivity and hostility. Addict Behav. 2017;64:308-13.
  • Pearcy BT, McEvoy PM, Roberts LD. Internet Gaming Disorder Explains Unique Variance in Psychological Distress and Disability After Controlling for Comorbid Depression, OCD, ADHD, and Anxiety. Cyberpsychol Behav Soc Netw. 2017;20(2):126-32.
  • Mazurek MO, Engelhardt CR. Video game use in boys with autism spectrum disorder, ADHD, or typical development. Pediatrics. 2013;132(2):260-6.
  • Derella OJ, Burke JD, Stepp SD, Hipwell AE. Reciprocity in Undesirable Parent-Child Behavior? Verbal Aggression, Corporal Punishment, and Girls’ Oppositional Defiant Symptoms. J Clin Child Adolesc Psychol. 2020;49(3):420-33.
  • Anderson EL, Steen E, Stavropoulos V. Internet use and problematic internet use: A systematic review of longitudinal research trends in adolescence and emergent adulthood. Int J Adolesc Youth. 2017;22(4):430–54.
  • Gomez R, Stavropoulos V, Beard C, Pontes HM. Item response theory analysis of the recoded internet gaming disorder scale-short-form (IGDS9-SF). Int J Ment Health Addict. 2019;17:859-79.
  • Pontes HM, Stavropoulos V, Griffiths MD. Measurement Invariance of the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF) between the United States of America, India and the United Kingdom. Psychiatry Res. 2017;257:472-8.
  • Stavropoulos V, Griffiths MD, Burleigh TL, Kuss DJ, Doh YY, Gomez R. Flow on the Internet: a longitudinal study of Internet addiction symptoms during adolescence Behav Inf Technol. 2018;37(2):159-72.

Dikkat eksikliği/hiperaktivite bozukluğu olan ergenlerde çevrimiçi oyun özellikleri

Year 2023, Volume: 28 Issue: 2, 198 - 207, 23.05.2023
https://doi.org/10.21673/anadoluklin.1187327

Abstract

Amaç: Dikkat eksikliği/hiperaktivite bozukluğu (DEHB) olan ergenlerde boş zaman aktiviteleri internet aktivitelerine, özellikle online oyunlara odaklanma eğilimindedir. DEHB popülasyonlarında çevrimiçi oyun bağımlılığı gözlenmiştir. Çevrimiçi oyun oynayan DEHB’li ergenlerde oyun türleri ve özellikleri bağımlılığı etkileyebilir. Bu çalışma, hiperaktivite/dürtüsellik, dikkatsizlik ve DEHB indeksinin çevrimiçi oyun bağımlılığı risk etkilerini ve oyun türlerini ayrı ayrı inceleyerek literatüre katkı sağlamayı amaçlamaktadır.

Yöntemler: Çevrimiçi oyun oynayan toplam 884 ergen çalışmaya dahil edilmiştir. Katılımcılar, çevrimiçi oyun özellikleri formu, Conners-Wells’in ergen öz bildirim ölçeği - uzun versiyon ve dijital oyun bağımlılığı ölçeği - kısa formunu öğretmenlerinin gözetiminde yanıtladılar. Oyun türleri ve DEHB semptomatolojisi (Dikkatsizlik, Hiperaktivite/dürtüsellik, DEHB indeksi) kendi içinde kategorize edilmiştir.

Bulgular: Çevrimiçi oyun bağımlılığı, DEHB semptomatolojisinin tüm alt bileşenlerinde anlamlıydı. Tüm alt bileşenlerde sohbet sekmesinde aşağılayıcı/tehdit edici konuşmalar saptandı.
Hiperaktivite/dürtüsellik bileşeninde, daha fazla saat çevrimiçi oyun oynama ve oyun içi avantajlar için gerçek para harcama bulundu. Dikkatsizlik ve DEHB indeksinde ergenlerin sosyal çevrelerinde oyun oynama miktarı yüksek saptandı. DEHB semptomatolojisinde oyun türlerinde (Dikkatsizlik bileşenindeki sporlar hariç) anlamlı bir sonuç bulunamadı.

Sonuç: DEHB olan ergenlerde çevrimiçi oyun oynama düzeyleri yüksek olmakla birlikte çift yönlü bir ilişki olasıdır. Ergenlerde ilişkisel faktörlerde sosyal faktörlerin ve iletişimsel özelliklerin önemli olduğuna inanıyoruz. DEHB ile çevrimiçi oyun bağımlılığı ve oyun türleri arasındaki ilişki hakkında önemli ampirik soruları cevaplamak için boylamsal çalışmalar yapılmalıdır.

References

  • Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol. 2014;43(2):434-42.
  • Carbray JA. Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. J Psychosoc Nurs Ment Health Serv. 2018;56(12):7-10.
  • American Psychiatric Association. Diagnostic and sta- tistical manual of mental disorders (DSM-5®). Am Psychiatr Publ. 2013.
  • Bolic Baric V, Hellberg K, Kjellberg A, Hemmingsson H. Internet Activities During Leisure: A Comparison Between Adolescents With ADHD and Adolescents From the General Population. J Atten Disord. 2018;22(12):1131-9.
  • Stavropoulos V, Kuss DJ, Griffiths MD, Wilson P, Motti-Stefanidi F. MMORPG gaming and hostility predict Internet Addiction symptoms in adolescents: An empirical multilevel longitudinal study. Addict Behav. 2017;64:294-300.
  • Weiss MD, Baer S, Allan BA, Saran K, Schibuk H. The screens culture: impact on ADHD. Atten Defic Hyperact Disord. 2011;3(4):327-34.
  • Chou WJ, Liu TL, Yang P, Yen CF, Hu HF. Multi-dimensional correlates of Internet addiction symptoms in adolescents with attention-deficit/hyperactivity disorder. Psychiatry Res. 2015;225(1-2):122-8.
  • Ko CH, Liu GC, Hsiao S, et al. Brain activities associated with gaming urge of online gaming addiction. J Psychiatr Res. 2009;43(7):739-47.
  • Thoma VK, Schulz-Zhecheva Y, Oser C, Fleischhaker C, Biscaldi M, Klein C. Media Use, Sleep Quality, and ADHD Symptoms in a Community Sample and a Sample of ADHD Patients Aged 8 to 18 Years. J Atten Disord. 2020;24(4):576-89.
  • Hyun GJ, Han DH, Lee YS, et al. Risk factors associated with online game addiction: A hierarchical model. Comput Hum Behav. 2015;48:706-13.
  • Park JH, Lee YS, Sohn JH, Han DH. Effectiveness of atomoxetine and methylphenidate for problematic online gaming in adolescents with attention deficit hyperactivity disorder. Hum Psychopharmacol. 2016;31(6):427-32.
  • Weinstein A, Weizman A. Emerging association between addictive gaming and attention-deficit/hyperactivity disorder. Curr Psychiatry Rep. 2012;14(5):590-7.
  • Han DH, Lee YS, Na C, et al. The effect of methylphenidate on Internet video game play in children with attention-deficit/hyperactivity disorder. Compr Psychiatry. 2009;50(3):251-6.
  • McKelvey K. The link between self-reported video game addiction symptoms and adult attention-deficit/ hyperactivity disorder symptoms. Fresno, CA: Alliant International University; 2010.
  • Yoo HJ, Cho SC, Ha J, et al. Attention deficit hyperactivity symptoms and internet addiction. Psychiatry Clin Neurosci. 2004;58(5):487-94.
  • Hupfeld KE, Abagis TR, Shah P. Living “in the zone”: hyperfocus in adult ADHD. Atten Defic Hyperact Disord. 2019;11(2):191-208.
  • Makris N, Biederman J, Monuteaux MC, Seidman LJ. Towards conceptualizing a neural systems-based anatomy of attention-deficit/hyperactivity disorder. Dev Neurosci. 2009;31(1-2):36-49.
  • Miller DK, Blum K. Overload: attention deficit disorder and the addictive brain. Salt Lake City, UT: Woodland Publishing Company; 2008.
  • World Health Organization. (2018). International classification of diseases for mortality and morbidity statistics, 11th Revision. Gaming disorder. Accessed 14 January 2020 http://www.who.int/features/qa/gaming-disorder/en/.
  • Laconi S, Pirès S, Chabrol H. Internet gaming disorder, motives, game genres and psychopathology. Comput Hum Behav. 2017;75:652-9.
  • T’ng ST, Ho KH, Sim DE, Yu CH, Wong PY. The mediating effect of Internet gaming disorder’s symptoms on loneliness and aggression among undergraduate students and working adults in Malaysia. Psych J. 2020;9(1):96-107.
  • CBS News. Warcraft or Warcrack?. 2007. (access date: 15.05.2023) Available from: https://www.cbsnews.com/video/warcraft-or-warcrack/.
  • Elliott L, Golub A, Ream G, Dunlap E. Video game genre as a predictor of problem use. Cyberpsychol Behav Soc Netw. 2012;15(3):155-61.
  • Smyth JM. Beyond self-selection in video game play: an experimental examination of the consequences of massively multiplayer online role-playing game play. Cyberpsychol Behav Soc Netw. 2007;10(5):717–21.
  • Lemmens JS, Hendriks SJ. Addictive Online Games: Examining the Relationship Between Game Genres and Internet Gaming Disorder. Cyberpsychol Behav Soc Netw. 2016;19(4):270-6.
  • Aggarwal S, Saluja S, Gambhir V, Gupta S, Satia SPS. Predicting likelihood of psychological disorders in PlayerUnknown’s Battlegrounds (PUBG) players from Asian countries using supervised machine learning. Addict Behav. 2020;101:106132.
  • Kuss DJ, Griffiths MD. Internet gaming addiction: A systematic review of empirical research. Int J Ment Health Addict. 2012;10(2):278–96.
  • Mathews CL, Morrell HE, Molle JE. Video game addiction, ADHD symptomatology, and video game reinforcement. Am J Drug Alcohol Abuse. 2019;45(1):67-76.
  • Gamefaqs. (accessed Jan. 14, 2021). Retrieved from https://gamefaqs.gamespot.com/.
  • Conners CK. (1997). Conners Wells Adolescent Self-Report Scale. Toronto: Multi-Health Systems.
  • Kaner S. ADHD symptoms in national samples of Turkish adolescents: parent, and teacher reports. Procedia Soc Behav Sci. 2011;15:3342-8.
  • Lemmens JS, Valkenburg PM, Peter J. Development and validation of a game addiction scale for adolescents. Media Psychol. 2009;12(1):77-95.
  • Yalçın Irmak A, Erdogan S. Validity and reliability of the Turkish version of the digital game addiction scale. Anatolian Journal of Psychiatry. 2015;16:10–9.
  • Oflu A, Yalcin SS. Video game use among secondary school students and associated factors. Uso de videojuegos en alumnos de la escuela secundaria y factores asociados. Arch Argent Pediatr. 2019;117(6):e584-91.
  • Desai RA, Krishnan-Sarin S, Cavallo D, Potenza MN. Video-gaming among high school students: health correlates, gender differences, and problematic gaming. Pediatrics. 2010;126(6):e1414-24.
  • Hellström C, Nilsson KW, Leppert J, Åslund C. Effects of adolescent online gaming time and motives on depressive, musculoskeletal, and psychosomatic symptoms. Ups J Med Sci. 2015;120(4):263-75.
  • Thalemann R, Wölfling K, Grüsser SM. Specific cue reactivity on computer game-related cues in excessive gamers. Behav Neurosci. 2007;121(3):614-8.
  • Han DH, Bae S, Hong J, Kim SM, Son YD, Renshaw P. Resting-State fMRI Study of ADHD and Internet Gaming Disorder. J Atten Disord. 2021;25(8):1080-95.
  • Yen JY, Liu TL, Wang PW, Chen CS, Yen CF, Ko CH. Association between Internet gaming disorder and adult attention deficit and hyperactivity disorder and their correlates: Impulsivity and hostility. Addict Behav. 2017;64:308-13.
  • Pearcy BT, McEvoy PM, Roberts LD. Internet Gaming Disorder Explains Unique Variance in Psychological Distress and Disability After Controlling for Comorbid Depression, OCD, ADHD, and Anxiety. Cyberpsychol Behav Soc Netw. 2017;20(2):126-32.
  • Mazurek MO, Engelhardt CR. Video game use in boys with autism spectrum disorder, ADHD, or typical development. Pediatrics. 2013;132(2):260-6.
  • Derella OJ, Burke JD, Stepp SD, Hipwell AE. Reciprocity in Undesirable Parent-Child Behavior? Verbal Aggression, Corporal Punishment, and Girls’ Oppositional Defiant Symptoms. J Clin Child Adolesc Psychol. 2020;49(3):420-33.
  • Anderson EL, Steen E, Stavropoulos V. Internet use and problematic internet use: A systematic review of longitudinal research trends in adolescence and emergent adulthood. Int J Adolesc Youth. 2017;22(4):430–54.
  • Gomez R, Stavropoulos V, Beard C, Pontes HM. Item response theory analysis of the recoded internet gaming disorder scale-short-form (IGDS9-SF). Int J Ment Health Addict. 2019;17:859-79.
  • Pontes HM, Stavropoulos V, Griffiths MD. Measurement Invariance of the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF) between the United States of America, India and the United Kingdom. Psychiatry Res. 2017;257:472-8.
  • Stavropoulos V, Griffiths MD, Burleigh TL, Kuss DJ, Doh YY, Gomez R. Flow on the Internet: a longitudinal study of Internet addiction symptoms during adolescence Behav Inf Technol. 2018;37(2):159-72.
There are 46 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section ORIGINAL ARTICLE
Authors

Ömer Uçur 0000-0002-7303-248X

Yunus Emre Dönmez 0000-0002-7785-2805

Publication Date May 23, 2023
Acceptance Date April 3, 2023
Published in Issue Year 2023 Volume: 28 Issue: 2

Cite

Vancouver Uçur Ö, Dönmez YE. Online gaming features in adolescents with attention-deficit/hyperactivity disorder. Anatolian Clin. 2023;28(2):198-207.

13151 This Journal licensed under a CC BY-NC (Creative Commons Attribution-NonCommercial 4.0) International License.