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Online Gaming Addiction and Basic Psychological Needs Among Adolescents: The Mediating Roles of Meaning in Life and Responsibility

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• Published: 10 January 2023

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• Alican Kaya   ORCID: orcid.org/0000-0003-2933-0161 1 ,
• Nuri Türk   ORCID: orcid.org/0000-0002-7059-9528 2 ,
• Hasan Batmaz   ORCID: orcid.org/0000-0002-5979-1586 3 &
• Mark D. Griffiths   ORCID: orcid.org/0000-0001-8880-6524 4  

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Individuals whose basic needs are naturally satisfied are much less dependent on their environment and more autonomous. Basic psychological needs (i.e., the general motivators of human actions) are significant predictors of online gaming addiction. Moreover, it has been posited that meaning and responsibility in life are at the center of life from an existential point of view. Therefore, a hypothetical model was tested to examine the relationships between basic psychological needs (autonomy, competence, relatedness), online gaming addiction, responsibility, and meaning in life. Data were collected from a sample of 546 participants. Mediation analysis was conducted, and the results indicated that basic psychological needs, online gaming addiction, responsibility, and meaning in life had significant negative and positive relationships. The findings indicated that responsibility and meaning in life had a serial mediating effect in the relationship between basic psychological needs and online gaming addiction. The findings also showed that the inverse relationship between online gaming addiction and basic psychological needs was at least partially explained by meaning in life and responsibility. The results of the present study are of great importance and suggest that interventions to satisfy the basic psychological needs of adolescents may help prevent online gaming addiction.

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Introduction

Technological addictions have become an area of increasing research interest and are conceptualized as non-chemical (i.e., behavioral) addictions (Kuss & Billieux, 2017 ). Moreover, they can be engaged in actively or passively (Widyanto & Griffiths, 2006 ). For example, television addiction is a passive technological addiction, whereas smartphone addiction and Internet addiction are active technological addictions (Griffiths, 2017 ). Online addictions have increased rapidly due to the increased use of smartphones, tablets, and laptops. Furthermore, overuse of the Internet has been conceptualized in a number of different ways, including problematic Internet use (Aboujaoude et al., 2006 ; Young, 2009 ), excessive Internet use (Choi et al., 2009 ; Lee et al., 2008 ), and Internet addiction (Griffiths, 2017 ) with some considering it to be an impulsive disorder (Young & Rodgers, 2009 ). In addition, online gaming addiction, which is another addiction associated with the Internet, is defined by the American Psychiatric Association (APA, 2013 ) as the consistent and prolonged use of the Internet to play videogames, frequently with other gamers, that causes disruption and clinically impairs several aspects of a person’s life (e.g., personal relationships, occupation and/or education). Key characteristics of online gaming addiction are individuals obsessively playing online videogames to the point of neglecting everything else in their lives, which leads to social and/or psychological disorders in such individuals (Ates et al., 2018 ; Batmaz & Çelik, 2021 ).

Previous studies have indicated various variables that predict and/or are associated with gaming addiction, including attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety and depression (Andreassen et al., 2016 ), social anxiety (Karaca et al., 2020 ), low self-esteem (Kim et al., 2022 ), inter-personal competence (Lee et al., 2019 ), relationship problems and relationship problems, and hostile family environment (Sela et al., 2020 ). In addition, social skill deficits (Mun & Lee, 2022 ), social and psychological isolation (Young, 2009 ), perceived stress (Rajab et al., 2020 ), suicidality (Erevik et al., 2022 ), and aggressive behaviors (McInroy & Mishna, 2017 ) have been reported among individuals who develop gaming addiction.

Although online gaming meets the various needs of individuals, when the behavior turns into an addiction, it leads to adverse effects on individuals, especially adolescents, where it can impair their mental health (Batmaz et al., 2020 ; Purwaningsih & Nurmala, 2021 ). Among adolescents, online gaming addiction has been reported to disrupt mental health, increase depression, anxiety, and psychoticism, disrupt family relationships (De Pasquale et al., 2020 ), lower quality of life (Beranuy et al., 2020 ), increase social phobia (Wei et al., 2012 ), lower school performance, and improve sleep deprivation (Chamarro et al., 2020 ; Király et al., 2015 ). In short, online gaming addiction negatively affects adolescents’ lives in different areas (Griffiths, 2022 ; Haberlin & Atkin, 2022 ). Therefore, research is needed to delineate the causes of online gaming addiction, eliminate its adverse effects, and implement necessary treatment.

Although many studies have been conducted examining online game addiction among adolescents (see Rosendo-Rios et al., 2022 ) for a recent review of studies), there are few studies examining the relationship between basic psychological needs and online game addiction (Bekir & Celik, 2019 ). In the present study, it is posited that basic psychological needs could be predictors due to the relationship with gaming disorders and problematic gaming (Allen & Anderson, 2018 ; Liu et al., 2021 ; Yu et al., 2015 ). When basic psychological needs are not met, it pushes individuals to exhibit maladaptive behavioral reactions (i.e., online gaming addiction) (Bekir & Çelik, 2019 ). In addition, few studies have addressed the relationship between responsibility and meaning in life and online game addiction (Arslan, 2021 ; Kaya, 2021 ). Moreover, no study has ever examined the mediating role of responsibility and meaning in life in the relationship between basic psychological needs and online game addiction. For these reasons, the present study examined the mediating roles of responsibility and meaning in life in explaining the relationship between basic psychological needs and online game addiction.

Online Gaming Addiction and Basic Psychological Needs

Self-determination theory is a well-established motivational theory comprising six mini-theories (Ryan & Deci, 2017 ). One of these mini-theories is the Basic Psychological Needs Theory (BPNT), which claims that the satisfaction of basic psychological needs is associated with better health and greater psychological well-being (Ryan & Deci, 2000 ). Basic psychological needs are requirements for psychological development, integrity, and well-being (Deci & Ryan, 2000 ). In contrast to the often-frustrating real world, videogames are designed to satisfy all three psychological needs (i.e., autonomy, competence, and relatedness) (Rigby & Ryan, 2011 ). Satisfaction of the needs for competence, autonomy, and relatedness can explain large amounts of the variance in game enjoyment (Rigby & Ryan, 2011 ; Tamborini et al., 2011 ). Online gaming can fulfill the (i) need for relatedness by directing players to social relationships with real or fictional characters, (ii) need for autonomy by giving them management and control within the game, and (iii) need for competence by making them feel successful in playing challenging videogames (Allen & Anderson, 2018 ).

Individuals addicted to videogames need novelty seeking, socialization, competition, and/or entertainment (Hussain et al., 2012 ; Larrieu et al., 2022 ). Studies have shown that gaming addiction is related to basic needs (Billieux et al., 2015 ) and psychological needs such as success, independence, fun, and respect (Herodotou et al., 2012 ). The increasing demand for playing videogames shows that adolescents try to satisfy some of their psychological needs via the Internet (Shen et al., 2013 ; Turan, 2021 ). One longitudinal study found that problematic online gaming and satisfaction of basic psychological needs were positively associated (Yu et al., 2015 ). It has also been reported that adolescents whose basic psychological needs were not met and whose perceived social support was low had high levels of gaming addiction (Yıldırım & Zeren, 2021 ). In this context, some studies claim that online games are tools for satisfying basic psychological needs (Oliver et al., 2016 ). However, studies have shown that the low level of basic psychological need satisfaction in real life can be met with high need satisfaction in online gaming, which leads to addiction for a small minority (Kardefelt-Winther, 2014 ; Rigby & Ryan, 2017 ; Wu et al., 2013 ). Based on the aforementioned literature, it was expected that there would be a significant negative relationship between basic psychological needs derived from real-life and online gaming addiction.

Online Gaming Addiction and Meaning in Life

The debate about the meaning in life has been ongoing for years (Yalom, 2020 ). Because there are many definitions of meaning in life, making a standard definition of meaning in life has been difficult (King & Hicks, 2021 ; Park, 2010 ). Meaning in life is a multifaceted construct conceptualized in various ways that address the value and purpose of life, meaningful life goals, and sometimes spirituality (Jim et al., 2006 ). According to Ryff ( 1989 ), meaning in life is a sign of a sense of direction, goals, and well-being. Frankl ( 2009 ) states that meaning in life differs from individual to individual, day to day, and hour to hour. Many studies have been conducted regarding meaning in life and concepts in the literature. For instance, some of these studies assert that meaning in life increases happiness (Debats et al., 1993 ) and life satisfaction (Yıkılmaz & Demir Güdül, 2015 ) and that the presence of meaning in life positively affects psychological health (Bailey & Phillips, 2016 ) and has a high level of meaning that can lower the incidence of depression (Mascaro & Rosen, 2005 ).

Similar to the aforementioned studies, adolescents’ having meaning in life can protect them from problematic behaviors such as substance abuse and eating disorders (Brassai et al., 2011 ; Shek et al., 2019 ). Adolescence is a period of seeking identity (Erikson, 1968 ) and decision-making (Marcia, 1980 ). Steger et al., ( 2006 ) pointed out that adolescents’ experience of seeking meaning in life or having a meaning in life may be determinative for successful identity development. However, considering that questioning the meaning in life results from the search for identity, it could be speculated that adolescents who constantly play online videogames will be far from such a search. Although studies have shown that adolescents search for identity in while online gaming (Monacis et al., 2017 ; Subrahmanyam & Šmahel, 2011 ; Tanhan & Özlem, 2015 ), it has been reported that excessive online gaming can also make this exploration more maladaptive, and this may lead to online gaming addiction (King & Delfabbro, 2014 ; Kokkini et al., 2022 ). One study reported that as gaming addiction decreases among adolescents, the level of meaning in life increases (Kaya, 2021 ). In general, it is expected in the present study that the existence of meaning in life in among adolescents will reduce online gaming addiction.

Online Gaming Addiction and Responsibility

One of the characteristic features of online gaming addiction is that individuals spend their time playing online games by procrastinating and/or not doing their daily work (Thatcheret al., 2008 ). According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, one criterion for Internet gaming disorder is that individuals continue to play online games despite being aware of psychosocial problems (American Psychiatric Association, 2013 ). Here, individuals fail to engage in important day-to-day responsibilities and play online games instead. Similarly, it has been shown that online gaming addicts jeopardize or lose their job, education, and/or career opportunities to play online games (Kardefelt-Winther, 2014 ). Time spent playing games instead of engaging in life’s more important tasks can be viewed as a lack of responsibility by individuals themselves, their families, and/or friends (Wartberg et al., 2017 ; Zhang et al., 2019 ).

Responsibility consists of three elements: accountability, liability, and imputability (Robinson, 2009 ). Imputability refers to individuals being responsible for their actions and decisions, accountability refers to fulfilling contractual expectations, and liability refers to assuming a moral responsibility without a contract (Holdorf & Greenwald, 2018 ). The concept of responsibility therapy is defined as the ability of individuals to meet their own needs while allowing others around them to meet their needs (Corey, 2015 ). Being conscious of responsibility means that individuals are aware of themselves and their feelings, thoughts, and pain (Yalom, 2020 ). Dökmen ( 2019 ) defines it as a responsibility to accept the consequences on others of what an individual does or does not do based on his thoughts.

In addition, it is discussed in the literature under two dimensions: emotion (Berkowitz & Daniels, 1963 ; Özen, 2013 ) and behavior (Glasser, 2005 ; Taylı, 2006 ). Individuals with a sense of responsibility have characteristics such as acting with awareness of their own and others’ rights, respecting others, and attempting to fulfill their responsibilities (Özen, 2011 ; Yough et al., 2022 ). On the other hand, individuals who do not have a sense of responsibility make themselves and others feel worthless while living without a plan or program (Cüceloğlu, 2015 ). Studies have shown that a low sense of responsibility can lead to aggression, lying, and avoidance of responsibility, while a high level of responsibility can trigger perfectionism, leading to anxiety, depression, and obsessive-compulsive disorders (Taylı, 2013 ; Wang et al., 2022 ).

The behavior of responsibility, the second sub-dimension of responsibility (Yalom, 2020 ), means that individuals can take responsibility by bearing the consequences of their behavior without attributing it to someone else (Douglass, 2001 ; Shahzadi et al., 2022 ). It has a function that improves positive activities and prevents harmful activities (Kesici, 2018 ). For example, individuals who act responsibly are respected by society and avoid punishment (Douglass, 2001 ). On the other hand, during adolescence, when serious responsibilities begin to be undertaken, a minority of individuals may move away from social life due to gaming addiction. Because of this situation, other people in the individual’s social life (e.g., family and friends) become unimportant to adolescents with low awareness of responsibility. Recent studies have observed that adolescents who excessively play videogames have difficulty fulfilling their responsibilities (Dinçer & Kolan, 2020 ; Doğan & Pamuk, 2022 ). In the present study, it was expected that adolescents with higher levels of responsibility would be less addicted to online gaming (i.e., an inverse relationship).

Basic Psychological Needs, Meaning in Life, Responsibility, and Online Game Addiction

Basic Psychological Needs Theory (BPNT) focuses on the satisfaction and frustration of psychological needs and argues that these needs significantly impact individuals’ psychological health and well-being (Ryan & Deci, 2000 ). Lack of fulfillment of basic psychological needs leads to negative consequences (e.g., depression, stress, and addiction) (Cantarero et al., 2021 ; Levine et al., 2022 ; Orkibi & Ronen, 2017 ; Xiao & Zheng, 2022 ). However, satisfying these needs is associated with positive outcomes such as general self-efficacy (İhsan et al., 2011 ), mental resilience (Kilinç & Gürer, 2019 ), subjective well-being (Akbağ & Ümmet, 2018 ), and obtaining meaning in life (Çelik & Gazioğlu, 2017 ). Furthermore, Weinstein et al. ( 2012 ) suggested that the search for meaning increased significantly when these needs were satisfied. Individuals whose needs are fulfilled are more prone to seek meaning in their life and, therefore, to experience meaning in their life, whereas individuals whose needs are not fulfilled experience a sense of meaninglessness (Eakman, 2013 ). According to Steger ( 2006 ), although individuals continue to search for meaning in one area of their lives, they may have meaning in a different area of their life. Meaning in life is defined as the purpose and importance of the life that individuals derive from their experiences (Baumeister & Vohs, 2002 ; Steger et al., 2006 ). Frankl ( 1969 ) posited that to achieve the meaning of life, an individual must take responsibility for realizing their potential, even at a young age. Therefore, a meaningful life requires individuals taking responsibility for themselves and others.

Responsibility refers to the individual’s sense of duty toward family, friends, and society (Geçtan, 2006 ), and can be examined in personal and social dimensions (Arslan & Wong, 2022 ). Personal responsibility means that an individual is accountable to themselves and to the needs or well-being of others (Ruyter, 2002 ). It also emphasizes self-responsibility by representing the individual’s behaviors and choices that can affect themselves and others (Mergler & Shield, 2016 ). Social responsibility relates to values that support individuals’ moral and prosocial behavior (Wray-Lake & Syvertsen, 2011 ). It includes decisions and actions that benefit others and society (Martins et al., 2015 ). Moreover, it is an important source of support in strengthening individuals’ mental health and improving their life skills (Martins et al., 2017 ) as well as coping with addictions (Amini et al., 2020 ). Therefore, individuals’ personal and social responsibility can protect them against negative situations such as developing addictions (e.g., online gaming addiction) (Chiou & Wan, 2007 ).

Online games allow individuals to meet other players, have fun, achieve status, and obtain financial benefits (Ballabio et al., 2017 ; Columb et al., 2022 ). In addition, escaping from the problems of real life, even temporarily, and achieving relaxation are among the benefits that individuals gain through gaming (Yee, 2006 ). Consequently, online gaming can lead individuals to play online games frequently and for long periods of time, which in turn can lead to the risk of addiction (Luciana, 2010 ; Sachdeva & Verma, 2015 ). The 11th revision of the International Classification of Diseases (ICD-11) characterized gaming disorder as a repetitive or persistent pattern of gaming behavior (World Health Organization, 2019 ). Individuals that are affected by online gaming addiction have also been reported to experience problems with interpersonal relationships (Wongpakaran et al., 2021 ), occupation (Lelonek-Kuleta et al., 2021 ), and health (Chan et al., 2022 ). As such, online gaming addiction can lead to situations that threaten the lives and functionality of individuals through the process and its consequences.

The Present Study

The present study was framed according to self-determination and existentialist positive psychology theories. Self-determination theory (SDT) suggests that the non-satisfaction or inhibition of basic psychological needs can lead to negative consequences (i.e., online gaming addiction). In addition, it emphasizes that behaviors emerge from the individual’s beliefs, meaning, and value judgments rather than external factors (i.e., social norms and group pressure). According to the SDT, need (autonomy, competence, and relatedness) predicts meaning in life (Eakman, 2013 ). Moreover, in a longitudinal study based on SDT, individuals whose basic psychological needs were fulfilled had increased meaning in life (Zhang et al., 2022 ). In addition, the existentialist theory of positive psychology suggests that the meaning in life, which individuals create themselves, can be sustained through responsibility. Individuals having responsibility can also enable them to lead a meaningful life (Arslan & Yıldırım, 2021 ; Wong, 2019 ). According to Wong ( 2010 ), meaning consists of the components of purpose, understanding, responsibility, and enjoyment (PURE). In addition to responsibility being one of the basic concepts that constitute meaning, the search for meaning in life continues intensely during adolescence (Steger, 2012 ). This is especially the case for adolescents who begin to question people and the world deeply, having a meaningful life can protect them from behavioral addictions (Qiu et al., 2022 ; Zhao et al., 2020 ). Considering the role of responsibility and meaning in the life of adolescents, it is important to examine online game addiction, which may be affected by basic psychological needs. Therefore, a serial mediation model was determined based on the assumptions of self-determination and existential positive psychotherapy theory.

In addition to the aforementioned theoretical framework, studies have shown that unfulfilled basic psychological needs are predictors of online gaming addiction (Allen & Anderson, 2018 ; Liang et al., 2021 ; Mills & Allen, 2020 ; Yu et al., 2015 ). However, studies conducted with adolescents have found a relationship between online gaming addiction and responsibility and meaning in life (Doğan & Pamuk, 2022 ; Kaya, 2021 ). In the present study, which also considers the different dynamics in online gaming addiction, a new model is proposed to examine the relationship between basic psychological needs and online gaming addiction through responsibility and meaning in life. In this context, the present study assessed whether basic psychological needs (i.e., autonomy, relatedness, competence) affect the relationship between online gaming addiction, meaning in life, and responsibility among adolescents. Four research questions were investigated: Do basic psychological needs predict online gaming addiction? (RQ1); Does the level of responsibility have a mediating effect on the relationship between basic psychological needs and online game addiction? (RQ2); Does meaning in life have a mediating effect on the relationship between basic psychological needs and online game addiction? (RQ3); Do responsibility and meaning in life have a serial mediating effect on the relationship between basic psychological needs and online game addiction? (RQ4).

Participants

Power analysis was performed via the G* Power 3.1.9.7 program to determine the sample size required for the present study. For this purpose, at the conventional significance level of 0.05 and power at 0.80, a small effect size is determined as r = 0.20 (Cohen, 2013 ). As a result of the analysis, it was determined that the required sample size was 395. The sample in the present study comprised 546 individuals (393 females and 153 males). The participants ranged from 15 to 18 years old, with a mean age of 16.25 years (SD ± 0.82). Just below half the sample of the participants were in the 9th grade ( n =252; 46.2%), 156 were in the 10th grade (28.6%), 74 were in the 11th grade (13.6%), and 64 were in the 12th grade (11.7%). Over one-third of the sample self-reported their socioeconomic status (SES) as being low ( n =210; 38.5%), 224 reported it as being medium (41.0%), and 112 reported it as being high (20.5%). Participants stated that they played videogames 3.56 h daily on average (SD ± 3.12). The number of devices they used to play online videogames was 2.09 (SD ± 0.96).

Basic Psychological Needs Scale (BPNS)

The 21-item BPNS (Deci & Ryan, 2000 ; Turkish version: Kesici et al., 2003 ) was used to assess basic psychological needs. The scale consists of three subscales: (i) autonomy (AU), (ii) competence (CMP), and (iii) relatedness (RLT). The scale has 21 items that tap into the satisfaction of autonomy (e.g., “I feel free to decide how to live my life”), relatedness (e.g., “There aren’t many people in my life that I feel close to”), and competence (e.g., “The people I know say that I am successful in what I do”) which are rated on five-point Likert scale from 1 ( strongly disagree ) to 5 ( strongly agree ). The higher the score, the greater fulfillment of autonomy, competence, and relatedness. In the present study, the scale’s internal reliabilities for the need for autonomy were α=.76, McDonald’s ω= 76; the need for competence were α =.67, McDonald’s ω= 68; and the need for relatedness were α =.82, McDonald’s ω= 83.

Meaning in Life Questionnaire Scale (MILQS)

The 10-item MILQS (Steger et al., 2006 ; Turkish version: Demirbaş-Çelik and İşmen-Gazioğlu, 2015 ) was used to assess meaning in life. Items (e.g., “I’m always looking for my life’s purpose”) are rated on seven-point Likert scale from 1 ( definitely disagree ) to 7 ( definitely agree ). The total score ranges between 10 and 70. The higher the score, the higher the individual’s level of search for meaning in life. In the present study, the internal reliability for the existence of meaning in life was α=.85 and for seeking meaning in life was α=.82. For the overall scale, Cronbach’s α was .67, and McDonald’s ω was .72.

Sense of Responsibility and Behavior Scale (SRBS)

The 18-item SRBS (Özen, 2013 ) was used to assess responsibility. Items (e.g., “I feel responsible for being a member of charitable organizations”) are rated on four-point scale ranging from 1 ( never ) to 4 ( always ). The total score ranges between 18 and 72. The higher the score, the greater the level of responsibility. The SRBS consists of two subscales and each can be used separately. The sense of responsibility sub-dimension was used in the present study. For this sub-dimension, Cronbach’s α was .86, and McDonald’s ω was .87.

Online Game Addiction Scale (OGAS)

The 21-item OGAS (Başol & Kaya, 2018 ) was used to assess online gaming addiction. Items (e.g., “My friendships were damaged/broken due to online games”) are rated on a five-point Likert scale ranging from 1 ( absolutely disagree ) to 5 ( absolutely agree ). The total score ranges between 21 and 105 points. The higher the score, the greater the risk of online gaming addiction. In the present study, Cronbach’s α was .88, and McDonald’s ω was .89.

Procedure and Ethics

Participants were selected from three different high schools in Turkey in the cities of Ağrı, Karabük, and Siirt. The schools were informed about the purpose and duration of the study. The researchers visited the schools, and informed consent forms were distributed. Written informed consent forms were obtained from the legal guardians or parents of the adolescents who volunteered to participate in the study. The purpose of the study was explained to the participants. The eligibility criteria for participation in the study were being an adolescent and being an individual who played (or used to play) one or more online videogames. An online link to the survey was sent to the participants, and each participant was allowed to complete the survey only once. All data were collected using Google Forms in the classroom. Participants were reminded that they might stop answering at any stage of the survey process if they wanted to. Participants were asked not to provide personal information to ensure anonymity and confidentiality. Ethics committee approval of this research was obtained from Ağrı İbrahim Çeçen University (reference number: 110), and every research stage was carried out in accordance with the Declaration of Helsinki.

Data Analysis

All analyses were carried out using SPSS version 26, Hayes’ ( 2018 ) PROCESS Macro (version 3), and G* Power 3.1.9.7 programs. Before starting the analysis, the necessary assumptions to perform the analysis were tested. The kurtosis and skewness values were examined to understand whether the assumptions required for the prerequisites of parametric tests were met. The skewness and kurtosis values for a normal distribution have acceptable threshold values if they are ±2 (George, 2010 ). There were no assumption violations in the research data. In addition, it was found that the correlation between the study variables was not high. The correlations ranged between .17 and .63 ( p <.001). The research variables were also examined to ensure there were no multicollinearity issues. When the tolerance, variance inflation factor (VIF), and confidence interval (CI) values were examined, these values were all within acceptable limits. It was determined that VIF was between 1.12 and 1.48, the tolerance value was between .67 and .89, and CI was between 7.21 and 17.88. The limit values required to avoid multicollinearity problems are more than 0.20 for the tolerance value, less than 10 for the VIF value, and less than 30 for the CI value (Albayrak, 2005 ; Büyüköztürk, 2016 ; Şata, 2020 ). Consequently, no multicollinearity problems were detected. Mahalanobis distance values were examined to determine whether there were outliers in the sample. A total of 21 outliers were identified in the dataset. These outliers were excluded from the analysis, meaning the final sample size was 546. SPSS PROCESS macro was utilized to conduct mediation analyses (Hayes, 2018 ). The bootstrapping method was employed with 5000 resampling and 95% confidence intervals (CIs) to test the significance of the mediating pathways. An effect is deemed significant if the confidence interval does not contain zero (Preacher & Hayes, 2008 ).

Table 1 shows the correlations between all the main variables in the study (basic psychological needs (autonomy, competence, relatedness), online gaming addiction, responsibility, and meaning in life). Pearson correlations indicated that all variables were significantly (albeit moderately and weakly) related.

Serial Multiple Mediational Analyses—Modeling Data

Table 2 , Table 3 , and Table 4 show the results of the serial mediation analysis. First, there was a direct effect of autonomy on online gaming addiction ( β =−.67, p <.001). Moreover, the relationship between competence and online gaming addiction was examined. There was a direct effect of competence on online gaming addiction ( β =−.63, p < . 001). When the relationship between relatedness, the last of the basic psychological needs, and online gaming addiction was examined, there was a direct effect of relatedness on online gaming addiction ( β =−.48, p < . 001). There was also a significant indirect effect of autonomy on online gaming addiction via responsibility (indirect effect=−.12, SE=.02, 95% CI= [−.20, −.06]). Also, the indirect effect of competence on online gaming addiction via responsibility was significant (indirect effect=−.19, SE=.02, 95% CI= [−.31, −.10]). Lastly, the indirect effect of relatedness on online gaming addiction via responsibility was significant (indirect effect=−.17, SE=.01, 95% CI= [−.26, −.10]).

When indirect effects were examined, there was a significant indirect effect of autonomy on online gaming addiction via meaning in life (indirect effect=−.07, SE=.02, 95% CI= [−.14, −.00]). Also, the indirect effect of competence on online gaming addiction via meaning in life was significant (indirect effect=−.11, SE=.02, 95% CI= [−.22, −.00]). Lastly, the indirect effect of relatedness on online gaming addiction via meaning in life was significant (indirect effect=−.05, SE=.01, 95% CI= [−.10, −.01]).

Moreover, the indirect effects of autonomy on online gaming addiction via meaning in life and responsibility were tested. The effect was significant (testing serial multiple mediation; effect=−.04 SE=.01, 95% CI= [−.07, −.01]). Also, the indirect effects of competence on online gaming addiction via meaning in life and responsibility were tested. The effect was significant (testing serial multiple mediation; effect=−.02 SE=.01, 95% CI= [−.04, −.00]). Moreover, the indirect effects of relatedness on online gaming addiction via meaning in life and responsibility were tested. The effect was significant (testing serial multiple mediation; effect=−.02 SE=.01, 95% CI= [−.06, −.01]). In the relationship between basic psychological needs (autonomy, competence, relatedness) and online gaming addiction, meaning in life and responsibility had serial mediating effects.

The results indicated that autonomy predicted online gaming addiction. When autonomy was entered as the predictor, it significantly predicted online gaming addiction ( β  = −0.67, t = −5.58,  p  < .001), and accounted for 5.4% of the variance in the model. Figure 1  shows the regression coefficients of the mediation model. The indirect path mediated by responsibility ( β =−.12, 95% CI= [−.20, −.06]) produced a higher change in variance than the indirect path mediated by meaning in life ( β =−.07, 95% CI= [−.14, −.00]) in the relationship between relatedness and online gaming addiction (see Table 2 ). Therefore, responsibility appeared to have a higher effect than meaning in life. Autonomy predicted a higher level of meaning in life. It also predicted a higher level of responsibility. Higher meaning in life was associated with a higher level of responsibility. Higher level of responsibility was associated with lower online gaming addiction. Consequently, the results indicated that the relationship between autonomy and online gaming addiction was partially mediated by meaning in life and responsibility (see Fig. 1 ).

The results of the serial multiple mediational models

It was also found that competence predicted online gaming addiction. There was also an indirect relationship between competence and online gaming addiction ( β = −0.64, t = −4.13, p < .001), accounting for 4.7% of the variance in the model. Competence predicted meaning and responsibility in life. The indirect path mediated by responsibility ( β =−.19, 95% CI= [−.31, −.10]) produced a higher change in variance than the indirect path mediated by meaning in life ( β =−.11, 95% CI= [−.22, −.00]) in the relationship between competence and online gaming addiction Furthermore, the relationship between competence and online gaming addiction was mediated by meaning in life and responsibility separately (see Table 3 ). The results also showed that meaning in life and responsibility had serial mediation effects in the relationship between competence and online gaming addiction (see Fig. 2 ).

Lastly, the results indicated that relatedness predicted online gaming addiction ( β = −0.48, t = −4.63, p < .001). When relatedness was included in the model, it was found that it accounted for 3.8% of the variance. Moreover, there was also an indirect relationship between relatedness and online gaming addiction. When the indirect effects are examined, the indirect path mediated by responsibility ( β =−.17, 95% CI= [−.26, −.10]) produced a higher change in variance than the indirect path mediated by meaning in life ( β =−.05, 95% CI= [−.10, −.01]) in the relationship between relatedness and online gaming addiction (see Table 4 ). The results suggested that the relationship between relatedness and online gaming addiction was partially mediated by meaning in life and responsibility (see Fig. 3 ).

In self-determination theory (SDT), basic psychological needs comprise autonomy, competence, and relatedness. In SDT (Deci & Ryan, 2000 ), basic psychological needs are expressed as essential psychological nutrients for psychological development, integrity, and well-being. Negative psychological consequences occur when requirements are not met, neglected, or prevented (Deci & Ryan, 2000 ). If individuals cannot satisfy a basic need, they engage in activities that give pleasure to individuals momentarily, even if they do not satisfy them (Antunes et al., 2020 ; Deci & Ryan, 2011 ). One of these activities is online gaming, which has an incredibly interactive structure. At the same time, online videogames are appreciated because they create an environment where both the need for relatedness and autonomy are met in the virtual world. Individuals naturally seek new challenges to experience a sense of efficacy even when no external rewards (e.g., money) are earned (Dindar, 2018 ; Matsumoto, 2009 ). The fact that online games have a reward mechanism is suitable for activating feelings of competence among individuals. It is thought that adolescents tend to meet their basic psychological needs (need for autonomy, competence, and relatedness) that they cannot fully meet from their parents or close friends through online gaming.

The present study examined the mediating role of meaning in life and the level of responsibility in the relationship between online gaming addiction and basic psychological needs (i.e., autonomy, competence, and relatedness) among adolescents. Findings showed that autonomy predicted online game addiction. In other words, autonomy had significant negative effect on online game addiction. Considering that addiction is related to reduced autonomy (Amatem, 2008 ), it can be said that the finding is compatible with the literature. However, there is a study in which there was a negative relationship between the need for autonomy and digital game addiction among adolescents (Dursun and Çapan, 2018 ), which supports the research finding. On the contrary, there is a study in which autonomy and online game addiction had significant positive relationships (Bekir and Çelik, 2019 ). Similarly, it is known that the need for autonomy has a positive relationship with social media addiction (Young-Ju et al., 2018 ) and a negative relationship with Internet addiction (Piri et al., 2018 ; Zeren & Can, 2019 ). These studies, which have obtained different results, make the relationship between the need for autonomy and digital addictions open to discussion but also show that further research is needed.

According to the present study’s findings, it was found that relatedness and competence, as well as autonomy, predicted online gaming addiction. Studies have shown that competence and relatedness have significant relationships with online gaming addiction (Bekir and Çelik, 2019 ; Dursun and Çapan, 2018 ). In addition, research has shown that relatedness has a negative relationship with short-form video addiction (Yang et al., 2022 ), and relatedness dissatisfaction positively correlates with Internet gaming disorder (Hui et al., 2019 ). Moreover, significant negative relationships have been found between competence and smartphone addiction (Gao et al., 2022 ; Sun et al., 2020 ) and Internet addiction (Zeren & Can, 2019 ; Canoğulları, 2014 ). Based on these results concerning technological addictions, it can be said that the literature findings and the results of the present study are compatible.

The tendency of individuals to play online videogames may be to meet their autonomy, competence, and relatedness needs (Ryan et al., 2006 ). In addition, when basic psychological needs are prevented, technological addictions (gaming addiction, smartphone addiction, social network addiction, and Internet addiction) increase (Gugliandolo et al., 2020 ). This may be the compensation for unmet basic psychological needs through addiction (Kuss et al., 2017 ; Mills et al., 2018 ). Therefore, fulfilling basic psychological needs in real life and eliminating the problems that prevent this satisfaction can be a protective factor against online gaming addiction.

Another finding of the present study was that the level of responsibility hads a mediating effect on the relationship between basic psychological needs and online gaming addiction. However, there was a positive and significant relationship between basic psychological needs and responsibility. In contrast, a significant negative relationship was found between responsibility and online gaming addiction. Considering that the components of responsibility (accountability, liability, and imputability) in Robinson’s ( 2009 ) definition appear less important in online environments, it is assumed that adolescents who are addicted to online gaming experience less sense of responsibility. A recent study found that a higher level of responsibility significantly predicted online gaming addiction, whereas a lower level of responsibility negatively affected online gaming addiction (Kesici, 2020 ).

Research conducted by Arslan ( 2021 ) found that secondary school students’ sense of responsibility and behavior had a crucial predictive role in online gaming addiction. Another study reported a significant negative relationship between the students’ videogame addiction and their personal and social responsibility behavior (Dinçer & Kolan, 2020 ). Based on previous studies and the results of the present study, it is thought that increasing the level of responsibility of secondary and high school students would reduce gaming addiction. Adolescents whose level of responsibility increases are also more likely to engage in responsible behavior. This is supported by studies in the literature that physical education and sports play an essential role in helping adolescents acquire responsible behavior (Bayraktar et al., 2016 ; Bugdayci, 2019 ; Tazegül, 2014 ). These studies’ results are considered necessary regarding online gaming addiction because such behavior leads to a sedentary lifestyle (Cómez-Mármol et al., 2017 ).

Findings indicated that meaning in life had a mediating effect on the relationship between basic psychological needs and online gaming addiction. However, there was a positive and significant relationship between basic psychological needs and meaning in life. In contrast, a significant negative relationship between meaning in life and online gaming addiction was found. These findings demonstrate the importance of meaning in life in preventing online gaming addiction among adolescents. A study by Kaya ( 2021 ) on adolescent online gaming addiction found that as the level of online gaming addiction decreased, the level of meaning in life increased. These results suggest that meaning in life affects online gaming addiction as a cause and consequence. Considering that having a meaningful life increases resilience (Batmaz et al., 2021 ; Doğrusever et al., 2022 ), low resilience increases gaming addiction (Canale et al., 2019 ), and gaming addiction reduces happiness (Kaya, 2021 ; Turan, 2021 ), meaning in life seems to be an essential variable that can affect gaming addiction.

What makes the present study unique to the online gaming addiction literature is that responsibility and meaning in life had a serial mediating effect on the relationship between basic psychological needs and online gaming addiction. In other words, the results indicated that the relationship between relatedness, competence, and autonomy with online gaming addiction was partially mediated by meaning in life and responsibility. This finding suggests that the need for autonomy, competence, and relatedness increases the level of meaning in life, which in turn reduces online game addiction. Similarly, online game addiction can decrease as the need for autonomy, competence, and relatedness increases the level of responsibility. In addition, based on the serial mediation effect, it suggests that meeting the need for autonomy, competence, and relatedness can reduce adolescents’ online game addiction by increasing their meaning in life and their level of responsibility.

To the best of the authors’ knowledge, the present study is the first to examine the mediating role of responsibility and meaning in life between basic psychological needs and online gaming addiction. The associations between these variables provide greater understanding and knowledge concerning online gaming addiction and provide additional insight into the significant causes that underlie playing games online (which may be potential factors in the acquisition, development, and maintenance of online gaming addiction among adolescents). Moreover, fulfilling basic psychological needs appears to increase responsibility and meaning in life and reduce susceptibility to online gaming addiction. The findings enrich the literature because it suggests new protective factors that might prevent adolescents from developing online gaming addiction.

The findings offer relevant practical implications for adolescents, educators, families, private and public health institutions, and mental health professionals to assist them in designing addiction prevention strategies and policies. Results also suggest that basic psychological need satisfaction fulfilment in real life plays an important role in the development and maintenance of online gaming addiction among adolescents. Educators, parents, and adolescents could utilize awareness of the factors contributing to online gaming addiction to help them take preventive measures against it. In addition, if adolescents have high levels of responsibility and meaning in life, it may help reduce online game addiction. Considering the findings, it is recommended that mental health professionals provide training and services that increase the level of responsibility among adolescents and enable them to have meaning in their lives to prevent the onset of online gaming addiction. In addition, private and public health institutions should implement training programs to improve the skills of parents, such as digital parenting, to cope with online gaming addiction. This training should also ensure that parents behave with awareness of the basic psychological needs of adolescents in the family and that they gain thoughts and approaches that can add responsibility and meaning in life.

Limitations

As in all studies, the present study also has some limitations. The first is that the study was cross-sectional. Conducting a cross-sectional study means that causality between the study variables cannot be determined. Second, completing the survey online may have influenced respondents’ responses (with those without home Internet access unable to participate). The online data were also collected during the COVID-19 pandemic. Therefore, adolescents living in isolated environments may have increased their gaming during this period. This unusual situation may have resulted in a lower sense of responsibility and a less meaningful life. This is consistent with the present study’s findings. Another limitation is that the participants were high school students studying in different schools in Turkish provinces, so the findings are not necessarily generalizable to all Turkish schoolchildren. The sample was also limited because it did not include other education levels, such as primary and secondary schools and children from different geographical and cultural regions in Turkey and/or other countries. Future studies are needed with different age groups, such as primary school, secondary school, university students, adults, and various geographical regions in the sample groups (both in and outside Turkey). Such studies are needed to confirm the findings reported here and should include other research designs (e.g., longitudinal studies to determine causality between variables) and other types of data (e.g., qualitative interview data to attain richer data). Another limitation of the present study was that the participant’s responses were self-report and therefore subject to well-established method biases (e.g., social desirability, memory recall).

The study’s findings indicated that adolescents whose basic psychological needs were met exhibited lower levels of online gaming addiction than adolescents whose basic psychological needs were not met. Consequently, the adverse effects of online gaming addiction may be reduced by interventions that meet adolescents’ basic psychological needs. Similarly, a significant negative relationship was found between responsibility and online gaming addiction. Consequently, it appears that adolescents who fulfill the requirements of individual and social responsibilities (studying, spending time with family, going out with friends, etc.) have greater protection from the more negative effects of online gaming. However, when meaning in life and responsibility are included in the relationship between basic psychological needs and online gaming addiction, the effect of basic psychological needs on online game addiction decreases. This suggests that meaning in life and responsibility have a serial mediating role between basic psychological needs and online gaming addiction.

Data Availability

The data that support the findings of this study are available from the first author upon reasonable request.

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Study conception/design: AK, HB, NT, and MDG. Data collection: AK, HB, and NT. analysis: AK and HB. Drafting of manuscript: AK, HB, NT, and MDG. Editing: MDG. Statistical expertise: AK and HB. Administrative/technical/material support: HB and HYK.

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The authors declare no competing interests except for MDG. MDG’s university has received research funding from Norsk Tipping (the gambling operator owned by the Norwegian Government). MDG has also received funding for a number of research projects in the area of gambling education for young people, social responsibility in gambling and gambling treatment from Gamble Aware (formerly the Responsible Gambling Trust) , a charitable body which funds its research program based on donations from the gambling industry. MDG regularly undertakes consultancy for various gambling companies in the area of player protection and social responsibility in gambling.

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Kaya, A., Türk, N., Batmaz, H. et al. Online Gaming Addiction and Basic Psychological Needs Among Adolescents: The Mediating Roles of Meaning in Life and Responsibility. Int J Ment Health Addiction (2023). https://doi.org/10.1007/s11469-022-00994-9

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ORIGINAL RESEARCH article

The association between video gaming and psychological functioning.

• 1 Department of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
• 2 Department of Psychosomatic Medicine, University Medical Center, Mainz, Germany

Video gaming is an extremely popular leisure-time activity with more than two billion users worldwide ( Newzoo, 2017 ). However, the media as well as professionals have underscored the potential dangers of excessive video gaming. With the present research, we aimed to shed light on the relation between video gaming and gamers’ psychological functioning. Questionnaires on personality and psychological health as well as video gaming habits were administered to 2,734 individuals (2,377 male, 357 female, M age = 23.06, SD age = 5.91). Results revealed a medium-sized negative correlation between problematic video gaming and psychological functioning with regard to psychological symptoms, affectivity, coping, and self-esteem. Moreover, gamers’ reasons for playing and their preferred game genres were differentially related to psychological functioning with the most notable findings for distraction-motivated players as well as action game players. Future studies are needed to examine whether these psychological health risks reflect the causes or consequences of video gaming.

Introduction

Video gaming is a very popular leisure activity among adults ( Pew Research Center, 2018 ). The amount of time spent playing video games has increased steadily, from 5.1 h/week in 2011 to 6.5 h/week in 2017 ( The Nielsen Company, 2017 ). Video gaming is known to have some benefits such as improving focus, multitasking, and working memory, but it may also come with costs when it is used heavily. By spending a predominant part of the day gaming, excessive video gamers are at risk of showing lower educational and career attainment, problems with peers, and lower social skills ( Mihara and Higuchi, 2017 ). On the one hand, video game use is widespread, and it may come with certain precursors as well as consequences. On the other hand, little is known about the relations between various video gaming habits and psychological functioning. This study aims to shed light on these important relations using a large sample.

A video game is defined as “a game which we play thanks to an audiovisual apparatus and which can be based on a story” ( Esposito, 2005 ). In the last few years, the amount of scientific research devoted to video game playing has increased (e.g., Ferguson, 2015 ; Calvert et al., 2017 ; Hamari and Keronen, 2017 ). Most scientific studies in this area of research have focused on the extent of video game play and its diverse correlates. While some researchers have emphasized the benefits of game playing and even suggested a therapeutic use of video games ( Primack et al., 2012 ; Granic et al., 2014 ; Colder Carras et al., 2018 ), others have been intrigued by its potential dangers ( Anderson et al., 2010 ; Müller and Wölfling, 2017 ).

Parents and professionals may be worried about their excessively playing children being “addicted.” However, problematic and potentially addictive video game use goes beyond the extent of playing (in hours per week; Skoric et al., 2009 ). It also includes such issues as craving, loss of control, and negative consequences of excessive gaming. While it is still a matter of debate whether problematic video game play should be considered a behavioral addiction , its status as a mental disorder has been clarified since the release of the DSM-5 in 2013. In the DSM-5, the American Psychiatric Association (2013) defined Internet Gaming Disorder with diagnostic criteria closely related to Gambling Disorder. Generally, this decision has been supported by many researchers (e.g., Petry et al., 2014 ) but has also caused controversies. Researchers have criticized the selection of diagnostic criteria and the vague definition of the Internet Gaming Disorder construct, which excludes offline games from being related to addictive use (e.g., Griffiths et al., 2016 ; Bean et al., 2017 ).

Several studies, literature reviews, and meta-analyses have focused on the correlates of problematic video gaming, usually assessed as a continuum with addiction marking the upper end of the scale (e.g., Ferguson et al., 2011 ; Kuss and Griffiths, 2012 ). The degree of addictive video game use has been found to be related to personality traits such as low self-esteem ( Ko et al., 2005 ) and low self-efficacy ( Jeong and Kim, 2011 ), anxiety, and aggression ( Mehroof and Griffiths, 2010 ), and even to clinical symptoms of depression and anxiety disorders ( Wang et al., 2018 ). Potential consequences of video game use have been identified as well, such as a lack of real-life friends ( Kowert et al., 2014a ), stress and maladaptive coping ( Milani et al., 2018 ), lower psychosocial well-being and loneliness ( Lemmens et al., 2011 ), psychosomatic problems ( Müller et al., 2015 ; Milani et al., 2018 ), and decreased academic achievement ( Chiu et al., 2004 ; Gentile, 2009 ). Effect sizes have varied widely across studies ( Ferguson et al., 2011 ). There seem to be sex and age differences with regard to video gaming behavior: potentially problematic video gaming was found to be more likely among males than females (e.g., Greenberg et al., 2010 ; Estévez et al., 2017 ), and among younger gamers ( Rehbein et al., 2016 ).

In addition to looking at problematic video game use and its relation to psychological functioning, it is relevant to also focus on why individuals play video games. Players use video games for very different reasons ( Ryan et al., 2006 ; Yee, 2006 ) such as to distract themselves from daily hassles or because they enjoy the social relationships they have developed in the virtual world. Potentially problematic video gaming has been found to be related to various reasons for playing such as coping and escape ( Hussain and Griffiths, 2009 ; Schneider et al., 2018 ), socialization ( Laconi et al., 2017 ), and personal satisfaction ( Ng and Wiemer-Hastings, 2005 ). Coping ( Laconi et al., 2017 ), social interaction, and competition were among the main reasons for gaming among males but not among females ( Lucas and Sherry, 2004 ). Mixed results emerged concerning age differences ( Greenberg et al., 2010 ), but especially younger gamers seemed to be motivated for video gaming by social interactions ( Hilgard et al., 2013 ). However, so far it remains unclear to what extent people’s various reasons for playing video games are differentially related to their psychological functioning.

Besides investigating the links between potentially problematic video game use and psychological functioning as well as between reasons for playing video games and psychological functioning, it is relevant to also look at which game genres individuals prefer. Correlates of preferences for certain game genres (e.g., simulation, strategy, action, role-playing) are cognitive enhancement ( Dobrowolski et al., 2015 ; Bediou et al., 2018 ), but also the amount of time spent playing ( Lemmens and Hendriks, 2016 ; Rehbein et al., 2016 ) and psychopathological symptoms ( Laconi et al., 2017 ). Males were shown to prefer action and strategy games, whereas females showed a preference for games of skill ( Scharkow et al., 2015 ; Rehbein et al., 2016 ). Younger gamers seemed to prefer action games, older players more so games of skill ( Scharkow et al., 2015 ). However, it is not yet understood to what extent preferences for certain video game genres are differentially related to psychological functioning.

Typically, research has focused merely on violent video games (e.g., Anderson and Bushman, 2001 ; Elson and Ferguson, 2014 ) or one specific game within one specific game genre (frequently World of Warcraft; Graham and Gosling, 2013 ; Visser et al., 2013 ; Herodotou et al., 2014 ), thereby neglecting the variety of possible gaming habits across various game genres.

In the present study, our objective was to examine the relation between video gaming and psychological functioning in a fine-grained manner. For this purpose, we examined psychological functioning by employing various variables such as psychological symptoms, coping strategies, and social support. Likewise, we assessed video gaming in a similarly detailed way, ranging from (a) problematic video game use, (b) the reasons for playing, to (c) the preferred game genres. This strategy prevented us from making potentially invalid generalizations about video gaming in general and allowed us to examine the spectrum of gaming habits and the respective relations between such habits and a diverse set of variables representing psychological functioning.

Playing video games excessively should be appealing to individuals with poor psychological functioning because games allow people to avoid their everyday problems and instead immerse themselves in another environment ( Taquet et al., 2017 ). Moreover, video games offer people a chance to connect with other people socially despite any more or less evident psychological problems they may have ( Kowert et al., 2014b ; Mazurek et al., 2015 ). On the other hand, potentially problematic video game use may also lead to psychological problems because it reduces the amount of time and the number of opportunities gamers have to practice real-life behavior ( Gentile, 2009 ). Thus, we expected to find a negative correlation between problematic video gaming and variables representing psychological functioning such that we expected more potentially problematic video game use to be related to dysfunctional coping strategies ( Wood and Griffith, 2007 ), negative affectivity ( Mathiak et al., 2011 ), and poor school performance ( Mihara and Higuchi, 2017 ). Moreover, we expected to find differential correlates of people’s reasons for playing video games and their psychological functioning: Playing for escape-oriented reasons such as distraction should go along with diverse indices of poor psychological functioning ( Király et al., 2015 ), whereas playing for gain-oriented reasons such as the storyline or the social connections in the game should be related to adequate psychological functioning ( Longman et al., 2009 ). Also, we expected to find people’s preferred game genres (e.g., strategy, action) to be differentially related to their psychological functioning ( Park et al., 2016 ). Finally, we aimed to shed light on the unique contribution of each measure of psychological functioning to the prediction of problematic video game use.

Materials and Methods

Participants 1.

A total of N = 2,891 individuals (2,421 male, 470 female) with a mean age of 23.17 years ( SD = 5.99, Range: 13–65) participated in our study. Of these participants, N = 2,734 (95%) confirmed their use of video games and were thus included in further analyses (2,377 male, 357 female, with a mean age of 23.06 years; SD = 5.91, Range: 13–65). The distribution of participants with regard to sex and age mirrors the findings of past research with males and younger individuals being more likely to play video games (e.g., Griffiths et al., 2004 ). Participants’ place of residence was Germany.

Procedure and Instruments 2

We posted links to our online questionnaire on various online forums as well as on popular online game sites. To achieve heterogeneity of the sample, no exclusion criteria other than having access to the Internet and understanding German were specified. As an incentive to participate in the study, four vouchers of 50€ were raffled.

Video Gaming

Potentially problematic video game use.

The AICA-S, the Scale for the Assessment of Internet and Computer game Addiction ( Wölfling et al., 2016 ), was used to assess participants’ gaming behavior with regard to potential problematic use. Based on the DSM criteria for Internet Gaming Disorder (tolerance, craving, loss of control, emotion regulation, withdrawal, and unsuccessful attempts to cut back), this standardized self-report scale consists of 15 items usually with a five-point scale ranging from 1 ( never ) to 5 ( very often ). The final score (Min = 0, Max = 27 points) is computed using weighted scoring (items with an item-total correlation > 0.55 in the norm sample are weighted double; Wölfling et al., 2011 ). The AICA-S score can be used to differentiate between regular (0–6.5 points) and problematic use of video games (7–13 points: abuse; 13.5–27 points: addiction). In our sample, N = 2,265 (83%) were identified as regular gamers, and N = 469 (17%) as problematic gamers. We used the AICA-S as a continuous variable for all further analyses ( M = 3.98, SD = 3.22, Range: 0–24). The instrument has been validated for different age groups in the general population and in clinical samples ( Müller et al., 2014a , 2019 , but note small sample size; Müller et al., 2014b ). Cronbach’s alpha was α = 0.70. As expected, the AICA-S score was correlated with male sex ( r = 0.17 ∗∗∗ ) and age ( r = –0.15 ∗∗∗ ). On average, participants played video games for M = 4.09 hours per weekday ( SD = 4.44, Range: 0–24), and M = 4.21 h per day at the weekend ( SD = 2.99, Range: 0–24).

Reasons for playing

Gamers indicated how often they played video games for certain reasons. They rated each of 10 reasons separately on Likert scales ranging from 1 ( never ) to 4 ( very often ). The most prevalent reasons were relaxation ( M = 2.96, SD = 0.91), amusement ( M = 2.94, SD = 0.85), and because of the storyline ( M = 2.67, SD = 1.10).

Game genres

Gamers were asked how often they usually played various video game subgenres such as first-person shooter, round-based strategy, massively multiplayer online role-playing games (MMORPGs), life simulations, and others. Ratings were made on Likert scales ranging from 1 ( never ) to 4 ( very often ). Using Apperley’s (2006) classification of game genres, we categorized the subgenres into the main genres action ( M = 2.54, SD = 0.84), strategy ( M = 2.13, SD = 0.80), role-playing ( M = 2.01, SD = 0.73), and simulation ( M = 1.58, SD = 0.44). A cluster for unclassified subgenres ( M = 1.54, SD = 0.39) was added to additionally account for such subgenres as jump’n’runs and games of skill. Descriptive statistics and intercorrelations for all measures (including sex and age) are presented in Supplementary Tables S1–S4 .

Psychological Functioning

Participants provided ratings of their psychological functioning on the following constructs:

General psychopathology

The SCL-K-9 ( Klaghofer and Brähler, 2001 ), a short version of the SCL-90-R ( Derogatis, 1975 ), was administered to assess participants’ subjective impairment regarding psychological symptoms (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism). The SCL-K-9 score is strongly correlated with the original score of the SCL-90-R ( r = 0.93). The 9 items were answered on 5-point Likert-type scales ranging from 1 ( do not agree at all ) to 5 ( agree completely ). Cronbach’s alpha was satisfactory (α = 0.77).

We assessed 10 coping strategies with the Brief COPE ( Carver, 1997 ; German version by Knoll et al., 2005 ), which is the shorter version of the COPE ( Carver et al., 1989 ): self-distraction, denial, substance use, venting, self-blame, behavioral disengagement, acceptance, active coping, planning, and positive reframing. The two items per subscale were administered on 5-point Likert-type scales ranging from 1 ( never ) to 5 ( very often ). Intercorrelations of the two items per subscale ranged from r = 0.32, p < 0.001 for positive reframing to r = 0.78, p < 0.001 for substance use (with one exception: r = -0.05, p = 0.01 for self-distraction).

We measured general affect as a trait and affect during video gaming as a state using the German version ( Krohne et al., 1996 ) of the Positive and Negative Affect Schedule (PANAS; Watson et al., 1988 ). On a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ), participants rated the intensity of 20 adjectives. Cronbach’s alpha was α = 0.78 for general positive affect, α = 0.83 for general negative affect, α = 0.85 for positive affect while playing, and α = 0.83 for negative affect while playing.

The measure for the assessment of shyness in adults ( Asendorpf, 1997 ) consists of 5 items that were answered on a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

We administered the German version ( Elbing, 1991 ) of the NYU Loneliness Scale ( Rubenstein and Shaver, 1982 ). The 4 items were answered on 5- to 6-point Likert-type scales. Cronbach’s alpha was satisfactory (α = 0.79).

Preference for solitude

A 10-item measure of preference for solitude ( Nestler et al., 2011 ) was answered on a 6-point Likert-type scale ranging from 1 ( not at all ) to 6 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

Life satisfaction

Participants answered a one-item life satisfaction measure on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ).

Self-esteem

We administered the German version ( von Collani and Herzberg, 2003 ) of the Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1979 ). The 10 items were answered on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ). Cronbach’s alpha was excellent (α = 0.88).

Self-efficacy

We administered a 10-item generalized self-efficacy scale ( Schwarzer and Jerusalem, 1995 ), which was answered on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

Social support and friends

We administered the perceived available social support subscale from the Berlin Social Support Scales (BSSS; Schwarzer and Schulz, 2003 ). The 8 items were answered on a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ). Cronbach’s alpha was excellent (α = 0.94). Participants indicated how many offline friends and offline acquaintances they had ( r = 0.44, p < 0.001) as well as how many online friends and online acquaintances they had ( r = 0.33, p < 0.001). Due to left-skewed distributions, we logarithmized the data before aggregation.

Participants reported their grade point average. German grades are assessed on a scale that ranges from 1 ( excellent ) to 6 ( insufficient ). Thus, higher scores indicate worse grades.

Participants further reported their sex and age. Both were used as control variables in further analyses.

In a first step, we computed zero-order correlations between the video gaming variables and the measures of psychological functioning. In a second step, we computed partial correlations in which we controlled for sex and age because past research has repeatedly shown that sex and age are correlated with both video gaming ( Homer et al., 2012 ; Mihara and Higuchi, 2017 ) and psychological functioning ( Kessler et al., 2007 ; Nolen-Hoeksema, 2012 ). Finally, we explored the unique contribution of each measure of psychological functioning to the prediction of potentially problematic video gaming. Therefore, we computed regressions with potentially problematic video gaming as the dependent variable and sex, age, and the measures of psychological functioning as predictors (entered simultaneously into the regression equation). By employing this procedure, we were able to determine the effect that each variable had over and above the other ones. For instance, we could identify whether general psychopathology was predictive of potentially problematic video game use when the influence of all other variables (e.g., shyness, loneliness, and others) was held constant.

Additionally, we included analyses regarding sex and age differences in the link between video gaming and psychological functioning. Since we collected a self-selected sample where different sexes and age groups were not represented equally, our findings are only preliminary, but may stimulate future research.

Potentially Problematic Video Game Use and Psychological Functioning

First, we examined whether potentially problematic video game use was related to various psychological functioning variables. As can be seen in Table 1 , the results for the zero-order correlations were similar to those for the partial correlations in which we controlled for sex and age. A medium-sized positive relation to the potentially problematic use of video games emerged for the presence of psychological symptoms including depression, anxiety, and hostility. Furthermore, several coping strategies were differentially associated with the potentially problematic use of video games: Self-blame and behavioral disengagement showed the strongest positive relations to potentially problematic video game use, followed by denial, acceptance, substance use, self-distraction, and venting. Planning, active coping, and, to a lesser extent, positive reframing were negatively associated with the potentially problematic use of video games. Moreover, the association with potentially problematic video game use was negative for general positive affect and positive and larger in size for general negative affect. However, potentially problematic video game use was clearly positively associated with the experience of both positive and negative affect while playing. Further, a preference for solitude, shyness, and loneliness were positively correlated with the potentially problematic use of video games. Lower self-esteem, lower life satisfaction, and, to a lesser extent, poorer perceived social support and lower self-efficacy went along with potentially problematic video game use. There was an association between fewer offline friends and acquaintances but more online connections with potentially problematic video gaming. Finally, poorer performance in school (i.e., higher grades) was related to the potentially problematic use of video games. These results suggest that potentially problematic video gaming goes along with poor psychological functioning and vice versa.

Table 1. Associations between potentially problematic video gaming and psychological functioning.

Reasons for Playing Video Games and Psychological Functioning

Second, we investigated whether players’ reasons for playing video games were differentially related to the psychological functioning variables. Table 2 presents the partial correlations, controlling for sex and age. Using video games to distract oneself from stress was clearly connected to a high level of psychological symptoms. Distraction-motivated gamers preferred coping strategies such as self-blame, behavioral disengagement, self-distraction, denial, substance use, venting, and acceptance, but they neglected active coping and planning. They showed less general positive affect and more negative affect both in general and while playing as well as more positive affect while playing. These gamers further reported low self-esteem and low life satisfaction, loneliness, a preference for solitude, shyness, a lack of self-efficacy and social support, and poor achievement in school. A similar but somewhat less extreme picture was revealed for gamers who played video games in order to have something to talk about . However, these gamers reported more online connections. Gamers who played video games to improve their real-life abilities also reported more online connections. In addition, these gamers showed higher levels of general positive affect. The strongest association with online friends and acquaintances emerged, as expected, for gamers who played because of the social relations in the virtual world. Although all reasons for playing video games were related to positive affect while playing, the strongest associations emerged for gamers who played because of the social relations , to stimulate their imagination , and for curiosity . It is interesting that, for gamers who played video games because of the storyline and for relaxation , there was a relation only to positive but not to negative affect while playing. Reasons for playing were only weakly related to sex and age (see Supplementary Table S2 ). In sum, several reasons for playing video games were differentially associated with psychological functioning.

Table 2. Associations between reasons for playing video games and psychological functioning.

Video Game Genre and Psychological Functioning

Third, we examined whether players’ preferences for different video game genres were differentially associated with the measures of psychological functioning. Table 3 shows the partial correlations in which we controlled for sex and age. There was a weak connection between general psychological symptoms and all of the video game genres we investigated except strategy. A preference for action games had the strongest association with affect while playing. Thus, action games seem to be both rewarding and a source of frustration. A preference for action games went along with poorer school performance. Gamers who preferred role-playing games scored higher on shyness and a preference for solitude and lower on self-esteem; they also reported fewer offline connections. By contrast, preferences for games of the unclassified category on average went along with a larger number of offline friends and more positive affect, both while playing and in general. Two game genres (i.e., role-playing and unclassified games) were related to the coping strategy of self-distraction. Because preferred game genre was related to participants’ sex (see Supplementary Table S3 ), we had a more detailed look at the correlations between preferred game genre and psychological functioning separately for both sexes: For males ( n = 2,377), the strongest correlation between general psychopathology and game genre emerged for action ( r = 0.08, p < 0.001), followed by role playing ( r = 0.07, p < 0.01), and unclassified ( r = 0.07, p < 0.01). For females ( n = 357), the strongest relation between general psychopathology and game genre emerged for simulation ( r = 0.17, p < 0.01). Differences were also found regarding the strength of the relation between number of friends online and the genre action: r = 0.06, p < 0.01 for males, and r = 0.27, p < 0.001 for females. Similarly, preferred game genre was related to participants’ age (see Supplementary Table S3 ). However, there were merely differences with regard to the relation of psychological functioning and game genre, when analyzed separately for different age groups (<19 years, n = 557; 19–30 years, n = 1916; >31 years, n = 261). In sum, our results speak to the idea that individuals with different levels of psychological functioning differ in their choices of game genres and vice versa.

Table 3. Associations between preferred video game genre and psychological functioning.

Predicting Potentially Problematic Video Game Use by Psychological Functioning Variables

In a final step, we entered all of the investigated psychological functioning variables as well as sex and age as predictors of the potentially problematic use of video games. By employing this procedure, we were able to determine the unique contribution of each psychological functioning variable when the influence of all other variables was held constant. As Table 4 shows, the number of online friends and acquaintances as well as positive affect while playing were most predictive of potentially problematic video game use over and above all other variables. General psychopathology, a lack of offline connections, and poor school performance were weaker but still relevant predictors of potentially problematic video game use.

Table 4. Prediction of potentially problematic video game use by psychological functioning variables.

With this study, we aimed to shed light on the association of diverse video gaming habits with gamers’ psychological functioning. Drawing on a large sample, our results revealed a medium-sized relation between potentially problematic video game use and poor psychological functioning with regard to general psychological symptoms, maladaptive coping strategies, negative affectivity, low self-esteem, and a preference for solitude as well as poor school performance. These findings are in line with those of prior work (e.g., Kuss and Griffiths, 2012 ; Milani et al., 2018 ). Also, reasons for playing video games were differentially related to psychological functioning with the most pronounced findings for escape-oriented in contrast to gain-oriented motives. Specifically, distraction-motivated gaming went along with higher symptom ratings, lower self-esteem, and more negative affectivity, whereas playing to establish social relationships in the virtual world was related to a larger number of online connections and more positive affect while playing. Furthermore, there were only weak relations between the preferred game genres and psychological functioning. The action games genre was associated with the strongest ratings of affect while playing. These results on reasons and genres may help to explain conflicting findings of former studies, because in our work we examined various reasons for playing, several game genres, and various aspects of psychological functioning simultaneously. Finally, positive affect while playing and a larger number of online friends were the strongest unique predictors of potentially problematic video game use, followed by psychological symptoms, a lack of offline connections, and poor school performance. These findings suggest that, on the one hand, independent of one’s psychological conditions, enjoying oneself during gaming (i.e., experiencing positive affect, connecting with online friends) may go along with potentially problematic use of video games. On the other hand, poor psychological functioning seems to be a unique risk factor for potentially problematic video gaming.

The presented results are generally in line with previous work that has identified a connection between video gaming and psychological health, academic problems, and social problems ( Ferguson et al., 2011 ; Müller et al., 2015 ). However, our study moved beyond prior research by providing in-depth analyses of both video gaming habits (including potentially problematic use, reasons for playing, and preferred game genre) and psychological functioning (including psychological symptoms, coping styles, affectivity, as well as variables that are related to individuals and their social environments). In addition, we identified unique predictors of potentially problematic video game use.

How can the findings on differential relations between video gaming and various indices of psychological functioning – ranging from beneficial results ( Latham et al., 2013 ) to unfavorable results ( Barlett et al., 2009 ; Möller and Krahé, 2009 ; Anderson et al., 2010 ) – be integrated? According to Kanfer and Phillips (1970) , problematic behavior (e.g., excessive video gaming) can be understood as a function of the situation (e.g., being rejected by a peer); the organism (e.g., low self-esteem); the person’s thoughts, physical reactions, and feelings (e.g., sadness, anger); and finally, the short- as well as long-term consequences of the behavior (termed SORKC model). In the short run, according to our results, playing video games may be a way to distract oneself from everyday hassles and may lead to positive affect while playing and a feeling of being connected to like-minded people, all of which are factors that have an immediate reinforcing value. In the long run, however, spending many hours per day in front of a computer screen may prevent a person from (a) developing and practicing functional coping strategies, (b) finding friends and support in the social environment, and (c) showing proper school achievement, factors that are potentially harmful to the person. Thus, differentiating between short- and long-term perspectives may help us understanding the differential correlates of intensive video gaming.

When is it appropriate to speak of video game addiction? More and more researchers have suggested a continuum between engagement ( Charlton and Danforth, 2007 ; Skoric et al., 2009 ) and pathological gaming/addiction, instead of a categorical perspective. In part, this recommendation has also been followed in the DSM-5 ( American Psychiatric Association, 2013 ) where Internet Gaming Disorder is classified with different degrees of severity, ranging from mild to moderate to severe, according to the functional impairment associated with it. The AICA-S also allows for a differential perspective on gaming behavior by providing ways to assess both the time spent playing video games and the main DSM criteria that indicate Internet Gaming Disorder. However, in our study we did not aim at making a diagnosis, but at having a closer look at potentially problematic gaming behavior and its correlates in a non-clinical sample.

In sum, it seems relevant to assess not only the extent of video game use but also the reasons behind this behavior (e.g., distraction) and the concrete rewards that come from playing (e.g., the experience of strong affect while playing action games) to fully understand the relation between video gaming and psychological functioning.

Limitations and Future Directions

With the present study, we aimed to uncover the association between video gaming and psychological functioning. Our approach was cross-sectional and warrants interpretative caution because correlations cannot determine the direction of causation. It remains unclear whether potentially problematic gaming is a factor that contributes to the development of psychological dysfunction or whether psychological dysfunction contributes to potentially problematic gaming. Also, a third factor (e.g., preexisting mental difficulties) may produce both psychological dysfunction and potentially problematic gaming. Thus, longitudinal studies that are designed to identify the causal pathway may provide a promising avenue for future research. Future studies may also answer the question whether the link between video gaming and psychological functioning is moderated by sex, age, the reasons for playing, or the preferred game genre. In addition, it is important not to forget that the present results are based on a self-selected sample in which potentially problematic video gamers were overrepresented (e.g., Festl et al., 2013 , for a representative sample). Thus, future research should replicate our findings in a representative sample. Further, we relied on self-reported data, which is a plausible method for assessing inner affairs such as people’s reasons for their behaviors, but it would be helpful to back up our findings with evidence derived from sources such as peers, caregivers, and health specialists. Our work reflects only a first approach to the topic, and future work may additionally collect in-game behavioral data from the players ( McCreery et al., 2012 ; Billieux et al., 2013 ) to objectively and more specifically investigate diverse patterns of use. Furthermore, one must not forget that the used taxonomy to classify video game genres is only one of various possible options and one should “think of each individual game as belonging to several genres at once” ( Apperley, 2006 , p. 19). Finally, some of the effects reported in our paper were rather modest in size. This is not surprising considering the complexity and multiple determinants of human behavior. In our analyses, we thoroughly controlled for the influence of sex and age and still found evidence that video gaming was differentially related to measures of psychological functioning.

The current study adds to the knowledge on gaming by uncovering the specific relations between video gaming and distinct measures of psychological functioning. Potentially problematic video gaming was found to be associated with positive affect and social relationships while playing but also with psychological symptoms, maladaptive coping strategies, negative affectivity, low self-esteem, a preference for solitude, and poor school performance. Including gamers’ reasons for playing video games and their preferred game genres helped deepen the understanding of the specific and differential associations between video gaming and psychological health. This knowledge might help developing adequate interventions that are applied prior to the occurrence of psychological impairments that may go along with potentially problematic video gaming.

Ethics Statement

In our online survey, participants were given information on voluntary participation, risks, confidentiality/anonymity, and right to withdraw. Whilst participants were not signing a separate consent form, consent was obtained by virtue of completion. We implemented agreed procedures to maintain the confidentiality of participant data.

Author Contributions

BB, BE, JH, and KM conceived and designed the study. BB, JH, and KM collected and prepared the data. JH analyzed the data. BE and JH wrote the manuscript.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01731/full#supplementary-material

• ^ The data were gathered as part of a larger project ( Stopfer et al., 2015 ; Braun et al., 2016 ). However, the analyses in the present article do not overlap with analyses from previous work.
• ^ Other measures were administered, but they were not relevant to the present research questions and are thus not mentioned in this paper. The data set and analysis script supporting the conclusions of this manuscript can be retrieved from https://osf.io/emrpw/?view_only=856491775efe4f99b407e258c2f2fa8d .

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Keywords : computer games, video gaming behavior, game genres, coping, psychological health

Citation: von der Heiden JM, Braun B, Müller KW and Egloff B (2019) The Association Between Video Gaming and Psychological Functioning. Front. Psychol. 10:1731. doi: 10.3389/fpsyg.2019.01731

Received: 14 September 2018; Accepted: 11 July 2019; Published: 26 July 2019.

Reviewed by:

Copyright © 2019 von der Heiden, Braun, Müller and Egloff. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Juliane M. von der Heiden, [email protected]

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Video gaming addiction and its association with memory, attention and learning skills in Lebanese children

• Youssef Farchakh 1 ,
• Chadia Haddad 2 , 3 ,
• Hala Sacre 4 ,
• Sahar Obeid 2 , 4 , 5   na1 ,
• Pascale Salameh 4 , 6 , 7   na1 &
• Souheil Hallit   ORCID: orcid.org/0000-0001-6918-5689 1 , 4   na1  

Child and Adolescent Psychiatry and Mental Health volume  14 , Article number:  46 ( 2020 ) Cite this article

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Examining whether any association exists between addiction to video games and cognitive abilities in children could inform ongoing prevention and management of any possible harm. The objective of this study was to investigate the associations between addiction to video games, and memory, attention and learning abilities among a sample of Lebanese school children.

This cross-sectional study, conducted between January and May 2019, enrolled 566 school children aged between 9 and 13 years. Three private schools were chosen conveniently for this study. Students were randomly chosen from the list given by the school administration. The students’ parents are those who responded to the questionnaire.

The results showed that higher addiction to video gaming salience was significantly associated with worse episodic memory, problem solving, basic reading skills, written expression skills and worse clinical attention. Higher addiction to video gaming tolerance were significantly associated with worse novel problem solving and worse attention. Higher addiction to video gaming withdrawal were significantly associated with worse attention, factual memory, attention, processing speed, visual spatial organization, sustained sequential processing, working memory, novel problem solving and worse written expression skills.

The results suggest a correlation between addiction to video games and worse memory, attention, as well as cognitive and academic abilities among school children. Those findings indicate the need for more extensive research, and serve to highlight vital next steps needed in future papers, such as identifying predicting factors that could aid in early detection of video gaming addiction in children.

Recent advances in new technologies have made video games the top leisure time occupation for children, who are particularly susceptible for addiction. Currently, video games have become the most famous type played worldwide among children. Nielsen reports that total weekly time spent playing games increased expeditiously from 5.1 to 6.3 h in 2011 and 2013 respectively [ 1 ]. In a study involving children aged between 9 and 12, from 12 different countries, it was found that 8.6 h per day were spent on playing video games [ 2 ]. Importantly, the emerging phenomenon of video game addiction represents a real and potential widespread problem that defies easy solutions and prevention methods, and requires further investigations, especially in the childhood population.

In fact, despite the benefits that video games have, such as socialization and entertainment, empirical and clinical studies have frequently demonstrated that the excessive use of video games may drive to adverse consequences in miscellaneous areas of psychological development and can result in an addiction among a small portion of gamers [ 3 ]. Impaired control over gaming and increasing priority over daily activities and other life interests could manifest as an evidence of gaming addiction [ 4 ]. In its fifth edition, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identified video game addiction in the form of internet gaming disorder, as a condition in need of supplementary studies [ 5 ]. Additionally, the 11th revision of International Classification of Diseases (ICD-11) defined gaming disorder as a recurrent gaming behavior pattern that carries both offline and online gaming [ 6 ]. Science suggests that addictions arise from a mixture of a genetic predisposition and a repeated exposure to a particular substrate [ 7 ].

Along with that, there has been growing public concerns about potential adverse effects, including the possibility that video games might affect memory in children [ 8 ]: as an important process for comprehension, memory updating and working memory, among other cognitive skills, have usually been reported to be damaged across different behavioral disorder individuals and addictive populations [ 9 ]. Even though there are some studies that investigate the effect of video games on cognitive functions and academic performance in children [ 10 , 11 ], consequences on memory are still a prevalent subject of debate.

Although video gaming is a free time activity, it does cause problems for some children, affecting their attention competencies. Both a meta-analysis and a systematic review conducted by Ho et al. and Carli et al. respectively suggested an association between inattention and internet/gaming addiction [ 12 ]. Moreover, plenty of other studies supported this finding and proved a strong correlation between the severity of inattention in attention deficit hyperactivity disorder (ADHD) and internet/gaming addiction [ 13 ], even after regulating the effects of depression and anxiety symptoms, as well as personality traits [ 12 ].

Unsurprisingly, video gaming advancements have led to concerns from parents and educators that the exaggerated amount of time consumed by children on video games, may result in decreased learning and academic abilities [ 11 ]. Handful of studies have generated inconclusive results regarding a possible association between poor school grades and problematic gaming [ 11 , 14 ]. Furthermore, in cross-sectional studies, pathological video gaming has been connected to a range of negative consequences, such as lower school and academic performances, but the need for further research to explore this finding is mandatory [ 11 ]. Moreover, researchers have been attempting to shed light on addiction to video games and its association with children’s development and behaviors. Despite all the efforts made, the literature still lacks sufficient studies on the subject.

In Lebanon, adolescents showed a 43.6% of moderate to severe problematic internet use [ 15 ]. Children are affected by video gaming and its related addiction. According to a Lebanese research study published in 2018, gaming disorder was associated with being younger. Moreover, Lebanese children are witnessing devastating long-term adverse effects on their behavioral, physical and psychological health, due to the rapidly advancing technology, which makes it very essential to focus on this particular Lebanese age group [ 14 ]. From the research point of view, only three Lebanese studies were detected concerning video games addiction [ 14 , 16 , 17 ]. Two of them worked on the development and validation of specific scales for video games addiction and internet gaming disorder [ 15 , 16 ], while the third one explored the relationships between gaming disorders, sleep habits, and academic achievement in Lebanese adolescents [ 14 ]. The last study showed that the pooled prevalence of internet gaming disorder was 9.2% [ 14 ]. Examining whether any association exists between addiction to video games and cognitive abilities in children could inform ongoing prevention and management of any possible harm. The objective of this study was to investigate the associations between addiction to video games, and memory, attention and learning abilities among a sample of Lebanese schoolchildren.

Participants

This study was a cross-sectional, conducted between January and May 2019. Three private schools were chosen conveniently for this study. Students were randomly chosen from the list given by the school administration. All participants between the age of 9 and 13 years of age were eligible to participate. The students’ parents are those who answered the questionnaire. Prior to participation, parents were briefed on the study objectives and methodology, and were assured of the anonymity of their participation. Parents had the right to accept or refuse participation in the study, with no financial compensation provided in return.

Sample size calculation

The Epi info program [Centers for Disease Control and Prevention (CDC), Epi Info™] was employed for the calculation of the required sample size for our study, with a prevalence of internet gaming disorder of 9.2% among 524 Lebanese high school students from a study done by Hawi et al. [ 14 ], with an acceptable margin of error of 5% and design effect of 2. The youth population is estimated to be 585,000 according to the UNDP statistics in Lebanon; the result showed that the biggest required sample size is 256 participants.

The questionnaire was distributed to each student in the classroom to be taken home. Parents filled it within 25 min approximately. The completed questionnaires were collected back and sent for data entry. During the data collection process, the anonymity of the participants was guaranteed.

Questionnaire

The self-administered questionnaire used was in Arabic, the native language of Lebanon. The first part assessed the sociodemographic details of the participants (i.e. age, gender, grade, and father and mother education level). The second part of the questionnaire included the following scales:

Game Addiction Scale for Children (GASC)

The 21-item Gaming Addiction Scale (GASC) is an instrument based on DSM criteria to assess gaming addiction. The seven items in the GAS are rated using a five-point Likert scale ranging from 1 (never) to 5 (very often). A higher score on the GAS indicates more problematic use of online gaming. The scale measures 7 criteria of computer addiction: salience, tolerance, mood modification, withdrawal, relapse, conflict and problems [ 18 ]. In this study, the Cronbach alpha values for the GAS was 0.948.

Children’s Memory Questionnaire (CMQ)

The CMQ is a 36-item questionnaire designed to assess parents’ perceptions of their children’s memory. The CMQ requires parents to assess their child’s memory based on five possible options: 1 = never or almost never happens; 2 = happens less than once a week; 3 = happens once or twice in a week; 4 = happens about once a day; and 5 = happens more than once a day [ 19 ]. Three subscales derived from the total scale representing the episodic memory, visual memory and working memory and attention. The higher the scores, the greater the impairment in the cognition domain [ 19 ]. In this study, the Cronbach alpha values for the episodic memory subscale was 0.888, for the visual memory was 0.770 and for the working memory was 0.845.

Clinical attention problems scale

The scale measures the frequency of activity and attention by asking the parent and teacher to respond to a series of 12 statements and their applicability to their child in the morning and afternoon. Response options range from “not true” (0), “somewhat or sometimes true” (1), “very often” or often true (2). The higher the scores, the greater the attention problems exist [ 20 ]. In this study, the Cronbach alpha values for the clinical attention problem in the morning and in the afternoon were 0.844 and 0.839 respectively.

Learning, Executive and Attention Functioning (LEAF) Scale

The LEAF is a 55 item self-report questionnaire that assesses executive functions, related neurocognitive functions, and academic skills in children and adults. The LEAF evaluates a broad set of core cognitive abilities as well as related cognitive learning and academic abilities. Cognitive areas assessed by the LEAF include attention, processing speed (including visual-spatial organization skills), and sustained sequential processing to achieve goals (e.g., planning and executing goal-directed behavior), working memory, and novel problem-solving. Also, LEAF includes comprehension and concept formation, declarative/factual memory, and academic functioning. The LEAF contains Academic subscales assessing reading, writing, and math fluency and abilities. LEAF items are grouped by subscale, and all subscales have the same number of items.

The subscales of the LEAF are: (1) comprehension and conceptual learning (tracking and understanding information), (2) factual memory (memorization and retention of facts); (3) attention (sustained focus); (4) processing speed (speed of completing cognitive and behavioral tasks that involve a component of focus and concentration); (5) visual-spatial organization (organization and visual-constructive skills); (6) sustained sequential processing (planning and sustaining effort in order to follow and complete multistep directions and sequences); (7) working memory (remembering and processing multiple things at the same time); and (8) novel problem solving (initiating effort toward processing new or unfamiliar information). (9) Mathematics skills (math calculation difficulty); (10) basic reading skills (reading/phonics difficulty); and (11) written expression skills (limited/impoverished or slow/effortful written expression). Individual items are rated on a 0–3 scale, and a raw subscale score for each of the 11 content areas is created by summing the 5 constituent items, such that higher scores indicate more cognitive problems [ 21 ]. In this study, the Cronbach alpha values for the subscales was: comprehension and conceptual learning = 0.961; factual memory = 0.792; attention = 0.901; processing speed = 0.866; visual-spatial organization = 0.729; sustained sequential processing = 0.768; working memory = 0.816; novel problem solving = 0.811; mathematics skills = 0.871; basic reading skills = 0.923 and written expression skills = 0.905.

Translation procedure

The forward translation was done by one translator. An expert committee formed by healthcare professionals and a language professional verified the Arabic translated version. A backward translation was then performed by a second translator, unaware of the initial English version. The back-translated English questionnaire was subsequently compared to the original English one, by the expert committee. Discrepancies related to inadequate expressions and concepts, confusing in meaning and slightly off in meaning during the reconciliation of the back translated questionnaire with the original source were resolved by consensus.

Statistical analysis

SPSS software version 23 was used to conduct data analysis. Cronbach’s alpha values were recorded for reliability analysis for all the scales. A descriptive analysis was done using the counts and percentages for categorical variables and mean and standard deviation for continuous measures. A multivariate analysis of covariance (MANCOVA) was carried out to compare multiple measures (each scale was taken as a dependent variable) taking the GAS as the major independent variable, controlling for potential confounding variables: age, gender, family monthly income, and mother and father education level. A p-value less than 0.05 was considered significant.

Out of 700 distributed questionnaires, 566 (80.86%) questionnaires were completed and collected back. The sociodemographic characteristics of the participants are summarized in Table 1 . The mean age was 10.77 ± 1.38 years, with 55.2% male. Also, higher education level in parents was found in 58.9% among mother and 39.4% among father.

Description of the scales used

The description of all the scales used in terms of mean, standard deviation, median, minimum and maximum is summarized in Table 2 .

Bivariate analysis

The bivariate analysis of the sociodemographic variables associated with the memory and attention scores is summarized in Tables 3 and 4 .

Higher addiction to video gaming salience, tolerance, relapse, withdrawal, conflict and problems scores were significantly correlated with lower/worse episodic memory, working memory, visual memory, clinical attention in the morning and in the afternoon, comprehension and conceptual learning, factual memory, LEAF attention, processing speed, visual spatial organization, sustained sequential processing, LEAF working memory, novel problem solving, mathematics skills, basic reading and written expression skills scores, except for the mood modification that was not associated with the visual memory and mathematics skills scores (Table 5 ).

Multivariate analysis

The MANCOVA analysis was performed taking the scales as the dependent variables and the addiction to video gaming salience as the independent variable, adjusting for the covariates (age, gender, family monthly income, and mother and father education levels).

Higher addiction to video gaming salience was significantly associated with higher episodic memory score (worse episodic memory), higher novel problem solving score (worse problem solving), higher basic reading skills score (worse basic reading skills), higher written expression skills score (worse written expression skills) and higher clinical attention in the morning and afternoon scores (worse episodic memory and attention).

Higher addiction to video gaming tolerance were significantly associated with higher novel problem solving score (worse novel problem solving) and higher clinical attention in the morning and afternoon scores (worse attention).

Higher addiction to video gaming withdrawal were significantly associated with higher clinical attention in the afternoon score (worse attention), higher factual memory score (worse factual memory), higher attention score (worse attention), higher processing speed score (worse processing speed), higher visual spatial organization score (worse visual spatial organization), higher sustained sequential processing score (worse sustained sequential processing), higher working memory score (worse working memory), higher novel problem solving score (worse novel problem solving) and higher written expression skills score (worse written expression skills) (Table 6 ).

Thus far, this is the first study to be conducted on Lebanese school children to evaluate the association between addiction to video games, memory, attention and learning abilities. Taking into consideration that intensive video gaming has frequently been linked to the development of addictive-like behaviors among children, we found highly important to assess some cognitive factors that could be affected in this delicate population. The results showed that higher addiction to video gaming was significantly associated with higher memory score (worse memory), with higher attention score (worse attention), and higher LEAF scale and subscales scores (worse cognitive and academic abilities). We also found that having a father with university education level was significantly associated with lower attention score (better attention) and lower LEAF scale and subscales scores (better cognitive and academic abilities).

Higher addiction to video gaming was significantly associated with higher memory score (worse memory). When the different studies were reviewed, the results were found to be contradictory. Some of the studies argued that video games have negative effects on memory, while other ones did not support this finding [ 22 ]. Moreover, an observational study comparing patients with internet gaming disorder against healthy control groups revealed that the formers had lower working memory functioning [ 8 ]. This particular result regarding memory may relate to the fact that spending too much time playing the same type of games could be harming their abilities to retain and boost memories.

Moreover, higher addiction to video gaming was significantly associated with higher attention score (worse attention). Similar to our results, increasing behavioral studies proved that video games addicts showed attention deficits. De facto, Zhou et al. [ 23 ] demonstrated that when performing the attention-related task, more total error rates was observed in subjects with internet gaming addiction in comparison to controls. To boot, Song et al. [ 24 ] established a positive correlation between inattention and internet gaming addiction severity, while lack of attention was verified to be a high predictor of online gaming addiction by Ko et al. [ 25 ]. The finding we obtained could be interpreted by the instant rewards and constant stimulation of video games that raise the threshold for children to pay attention in less stimulating situations, where working harder is required to get rewards. Another theory could be that children suffering from attentional problems become captivated by video games as a coping strategy of their behavioral disorder.

Likewise, higher addiction to video gaming was significantly associated with higher LEAF scale and subscales scores (worse cognitive and academic abilities). Correspondingly, Gentile et al. [ 26 ] found that video games addiction among Singaporean adolescents predicted worse school grades and cognitive well-being. In contrast, another study conducted by Regina et al. [ 11 ] demonstrated no evidence that excessive video gaming negatively affects adolescents’ school performances. Our result may be understood in the light of the fact that more time spent on video games means less time spent on academic activities, as well as less hours of sleep overall, which generally make children with heavy video gaming attitudes, less alert and more susceptible to cognitive errors.

In addition to the previous findings, having a father with university education level was significantly associated with lower attention score (better attention) and lower LEAF scale and subscales scores (better cognitive and academic abilities). To our knowledge, no study in the literature discussed the education level of the parents, particularly the father, in this particular context. The cause for our result could be that highly educated fathers raise their children in a similar educative way, which enhances their cognitive and academic skills.

Clinical implications

The current study provides many valuable contributions to the literature. Despite growing numbers of published studies examining cognitive skills in children playing video games, there is a paucity of rigorous ones from which to draw firm conclusions. This study procures firm evidence that addiction to video games is linked to worse memory, attention, as well as cognitive and academic skills in school children. This analysis constitutes a vital first step towards a better understanding of video games addiction in children, supporting its evidence as a plausible entity with detrimental association. By this, the study encourages parents of children addicted to video games to set particular gaming rules (such as limiting gaming time and avoiding exploration of new games), advocates schools to introduce children to other fun activities to do, and highlights the importance of consulting a therapist in extreme cases.

Limitations

There are several limitations that should be noted. First of all, all scales were self-rated, which may only show high risk of addiction to video gaming rather than the diagnosis. Second, residual confounding bias is also possible, since there could be factors related to video gaming such as pre-existing attention problems, ADHD diagnosis that were not measured in this study. Moreover, parents might have over-or underestimated the answers to the questions, possibly predisposing us to information bias. A selection bias is also possible because of the enrollment of the students from three schools only and because of the convenient sample. The group of students chosen in this study were not representative of most of students in their age. Students’ parents filled up the video gaming addiction scale, which could lead to information bias since this scale is not applicable to them. To add on that, since this study is cross-sectional, the findings of this study cannot address the causal relationships among the primary constructs of interest. Finally, the scales used have not been validated in Lebanon. The use of a random sample is an important advantage to the study, thus, the results we obtained can be generalized to the whole population. The results cannot be generalized to the whole population since it only recruited students from private schools, as well as a high percentage of well-educated mothers. A prospective longitudinal study is needed to better follow up the cognitive function of children over time.

In conclusion, the results suggest a correlation between addiction to video games and worse memory, attention, as well as cognitive and academic abilities among school children. Those findings indicate the need for more extensive research, and serve to highlight vital next steps needed in future papers, such as identifying predicting factors that could aid in early detection of video gaming addiction in children.

Availability of data and materials

There is no public access to all data generated or analyzed during this study to preserve the privacy of the identities of the individuals. The dataset that supports the conclusions is available to the corresponding author upon request.

Abbreviations

Diagnostic and Statistical Manual of Mental Disorders

11th Revision of International Classification of Diseases

Attention deficit hyperactivity disorder

Game Addiction Scale for Children

Children’s Memory Questionnaire

Learning, Executive and Attention Functioning Scale

Multivariate analysis of covariance

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Acknowledgements

The authors would like to thank the mothers for accepting to be part of this study.

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Sahar Obeid, Pascale Salameh, and Souheil Hallit are last co-authors

Authors and Affiliations

Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon

Youssef Farchakh & Souheil Hallit

Research and Psychology Departments, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon

Chadia Haddad & Sahar Obeid

INSERM, Univ. Limoges, CH Esquirol, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France

Chadia Haddad

INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique Et Toxicologie-Liban, Beirut, Lebanon

Hala Sacre, Sahar Obeid, Pascale Salameh & Souheil Hallit

Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon

Sahar Obeid

Faculty of Pharmacy, Lebanese University, Beirut, Lebanon

Pascale Salameh

Faculty of Medicine, University of Nicosia, Nicosia, Cyprus

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Contributions

The authors would like to thank Mr. Jihad Gerges, Mr. Joseph Chahine and the following persons of College Central des Moines Libanais Maronites—Jounieh: Father Superior Antoine Salame, General Director Father Dr. Wadih Al Skayem, Mrs. Hélène Chbeir—Director of the kindergarten, Mr. Joseph Rassi—Director of the primary cycle as well as the teachers of the primary cycle for their help in the data collection. The authors would like to thank Pr. William G. Kronenberger for giving us the permission to use the LEAF scale. Special thanks to the parents who participated in this study and for Ms. Marine Arisdakessian for her help in the data entry. All authors read and approved the final manuscript.

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Correspondence to Sahar Obeid or Souheil Hallit .

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Farchakh, Y., Haddad, C., Sacre, H. et al. Video gaming addiction and its association with memory, attention and learning skills in Lebanese children. Child Adolesc Psychiatry Ment Health 14 , 46 (2020). https://doi.org/10.1186/s13034-020-00353-3

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DOI : https://doi.org/10.1186/s13034-020-00353-3

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The Association Between Video Gaming and Psychological Functioning

Juliane m. von der heiden.

1 Department of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany

Beate Braun

2 Department of Psychosomatic Medicine, University Medical Center, Mainz, Germany

Kai W. Müller

Boris egloff, associated data.

Video gaming is an extremely popular leisure-time activity with more than two billion users worldwide ( Newzoo, 2017 ). However, the media as well as professionals have underscored the potential dangers of excessive video gaming. With the present research, we aimed to shed light on the relation between video gaming and gamers’ psychological functioning. Questionnaires on personality and psychological health as well as video gaming habits were administered to 2,734 individuals (2,377 male, 357 female, M age = 23.06, SD age = 5.91). Results revealed a medium-sized negative correlation between problematic video gaming and psychological functioning with regard to psychological symptoms, affectivity, coping, and self-esteem. Moreover, gamers’ reasons for playing and their preferred game genres were differentially related to psychological functioning with the most notable findings for distraction-motivated players as well as action game players. Future studies are needed to examine whether these psychological health risks reflect the causes or consequences of video gaming.

Introduction

Video gaming is a very popular leisure activity among adults ( Pew Research Center, 2018 ). The amount of time spent playing video games has increased steadily, from 5.1 h/week in 2011 to 6.5 h/week in 2017 ( The Nielsen Company, 2017 ). Video gaming is known to have some benefits such as improving focus, multitasking, and working memory, but it may also come with costs when it is used heavily. By spending a predominant part of the day gaming, excessive video gamers are at risk of showing lower educational and career attainment, problems with peers, and lower social skills ( Mihara and Higuchi, 2017 ). On the one hand, video game use is widespread, and it may come with certain precursors as well as consequences. On the other hand, little is known about the relations between various video gaming habits and psychological functioning. This study aims to shed light on these important relations using a large sample.

A video game is defined as “a game which we play thanks to an audiovisual apparatus and which can be based on a story” ( Esposito, 2005 ). In the last few years, the amount of scientific research devoted to video game playing has increased (e.g., Ferguson, 2015 ; Calvert et al., 2017 ; Hamari and Keronen, 2017 ). Most scientific studies in this area of research have focused on the extent of video game play and its diverse correlates. While some researchers have emphasized the benefits of game playing and even suggested a therapeutic use of video games ( Primack et al., 2012 ; Granic et al., 2014 ; Colder Carras et al., 2018 ), others have been intrigued by its potential dangers ( Anderson et al., 2010 ; Müller and Wölfling, 2017 ).

Parents and professionals may be worried about their excessively playing children being “addicted.” However, problematic and potentially addictive video game use goes beyond the extent of playing (in hours per week; Skoric et al., 2009 ). It also includes such issues as craving, loss of control, and negative consequences of excessive gaming. While it is still a matter of debate whether problematic video game play should be considered a behavioral addiction , its status as a mental disorder has been clarified since the release of the DSM-5 in 2013. In the DSM-5, the American Psychiatric Association (2013) defined Internet Gaming Disorder with diagnostic criteria closely related to Gambling Disorder. Generally, this decision has been supported by many researchers (e.g., Petry et al., 2014 ) but has also caused controversies. Researchers have criticized the selection of diagnostic criteria and the vague definition of the Internet Gaming Disorder construct, which excludes offline games from being related to addictive use (e.g., Griffiths et al., 2016 ; Bean et al., 2017 ).

Several studies, literature reviews, and meta-analyses have focused on the correlates of problematic video gaming, usually assessed as a continuum with addiction marking the upper end of the scale (e.g., Ferguson et al., 2011 ; Kuss and Griffiths, 2012 ). The degree of addictive video game use has been found to be related to personality traits such as low self-esteem ( Ko et al., 2005 ) and low self-efficacy ( Jeong and Kim, 2011 ), anxiety, and aggression ( Mehroof and Griffiths, 2010 ), and even to clinical symptoms of depression and anxiety disorders ( Wang et al., 2018 ). Potential consequences of video game use have been identified as well, such as a lack of real-life friends ( Kowert et al., 2014a ), stress and maladaptive coping ( Milani et al., 2018 ), lower psychosocial well-being and loneliness ( Lemmens et al., 2011 ), psychosomatic problems ( Müller et al., 2015 ; Milani et al., 2018 ), and decreased academic achievement ( Chiu et al., 2004 ; Gentile, 2009 ). Effect sizes have varied widely across studies ( Ferguson et al., 2011 ). There seem to be sex and age differences with regard to video gaming behavior: potentially problematic video gaming was found to be more likely among males than females (e.g., Greenberg et al., 2010 ; Estévez et al., 2017 ), and among younger gamers ( Rehbein et al., 2016 ).

In addition to looking at problematic video game use and its relation to psychological functioning, it is relevant to also focus on why individuals play video games. Players use video games for very different reasons ( Ryan et al., 2006 ; Yee, 2006 ) such as to distract themselves from daily hassles or because they enjoy the social relationships they have developed in the virtual world. Potentially problematic video gaming has been found to be related to various reasons for playing such as coping and escape ( Hussain and Griffiths, 2009 ; Schneider et al., 2018 ), socialization ( Laconi et al., 2017 ), and personal satisfaction ( Ng and Wiemer-Hastings, 2005 ). Coping ( Laconi et al., 2017 ), social interaction, and competition were among the main reasons for gaming among males but not among females ( Lucas and Sherry, 2004 ). Mixed results emerged concerning age differences ( Greenberg et al., 2010 ), but especially younger gamers seemed to be motivated for video gaming by social interactions ( Hilgard et al., 2013 ). However, so far it remains unclear to what extent people’s various reasons for playing video games are differentially related to their psychological functioning.

Besides investigating the links between potentially problematic video game use and psychological functioning as well as between reasons for playing video games and psychological functioning, it is relevant to also look at which game genres individuals prefer. Correlates of preferences for certain game genres (e.g., simulation, strategy, action, role-playing) are cognitive enhancement ( Dobrowolski et al., 2015 ; Bediou et al., 2018 ), but also the amount of time spent playing ( Lemmens and Hendriks, 2016 ; Rehbein et al., 2016 ) and psychopathological symptoms ( Laconi et al., 2017 ). Males were shown to prefer action and strategy games, whereas females showed a preference for games of skill ( Scharkow et al., 2015 ; Rehbein et al., 2016 ). Younger gamers seemed to prefer action games, older players more so games of skill ( Scharkow et al., 2015 ). However, it is not yet understood to what extent preferences for certain video game genres are differentially related to psychological functioning.

Typically, research has focused merely on violent video games (e.g., Anderson and Bushman, 2001 ; Elson and Ferguson, 2014 ) or one specific game within one specific game genre (frequently World of Warcraft; Graham and Gosling, 2013 ; Visser et al., 2013 ; Herodotou et al., 2014 ), thereby neglecting the variety of possible gaming habits across various game genres.

In the present study, our objective was to examine the relation between video gaming and psychological functioning in a fine-grained manner. For this purpose, we examined psychological functioning by employing various variables such as psychological symptoms, coping strategies, and social support. Likewise, we assessed video gaming in a similarly detailed way, ranging from (a) problematic video game use, (b) the reasons for playing, to (c) the preferred game genres. This strategy prevented us from making potentially invalid generalizations about video gaming in general and allowed us to examine the spectrum of gaming habits and the respective relations between such habits and a diverse set of variables representing psychological functioning.

Playing video games excessively should be appealing to individuals with poor psychological functioning because games allow people to avoid their everyday problems and instead immerse themselves in another environment ( Taquet et al., 2017 ). Moreover, video games offer people a chance to connect with other people socially despite any more or less evident psychological problems they may have ( Kowert et al., 2014b ; Mazurek et al., 2015 ). On the other hand, potentially problematic video game use may also lead to psychological problems because it reduces the amount of time and the number of opportunities gamers have to practice real-life behavior ( Gentile, 2009 ). Thus, we expected to find a negative correlation between problematic video gaming and variables representing psychological functioning such that we expected more potentially problematic video game use to be related to dysfunctional coping strategies ( Wood and Griffith, 2007 ), negative affectivity ( Mathiak et al., 2011 ), and poor school performance ( Mihara and Higuchi, 2017 ). Moreover, we expected to find differential correlates of people’s reasons for playing video games and their psychological functioning: Playing for escape-oriented reasons such as distraction should go along with diverse indices of poor psychological functioning ( Király et al., 2015 ), whereas playing for gain-oriented reasons such as the storyline or the social connections in the game should be related to adequate psychological functioning ( Longman et al., 2009 ). Also, we expected to find people’s preferred game genres (e.g., strategy, action) to be differentially related to their psychological functioning ( Park et al., 2016 ). Finally, we aimed to shed light on the unique contribution of each measure of psychological functioning to the prediction of problematic video game use.

Materials and Methods

Participants 1.

A total of N = 2,891 individuals (2,421 male, 470 female) with a mean age of 23.17 years ( SD = 5.99, Range: 13–65) participated in our study. Of these participants, N = 2,734 (95%) confirmed their use of video games and were thus included in further analyses (2,377 male, 357 female, with a mean age of 23.06 years; SD = 5.91, Range: 13–65). The distribution of participants with regard to sex and age mirrors the findings of past research with males and younger individuals being more likely to play video games (e.g., Griffiths et al., 2004 ). Participants’ place of residence was Germany.

Procedure and Instruments 2

We posted links to our online questionnaire on various online forums as well as on popular online game sites. To achieve heterogeneity of the sample, no exclusion criteria other than having access to the Internet and understanding German were specified. As an incentive to participate in the study, four vouchers of 50€ were raffled.

Video Gaming

Potentially problematic video game use.

The AICA-S, the Scale for the Assessment of Internet and Computer game Addiction ( Wölfling et al., 2016 ), was used to assess participants’ gaming behavior with regard to potential problematic use. Based on the DSM criteria for Internet Gaming Disorder (tolerance, craving, loss of control, emotion regulation, withdrawal, and unsuccessful attempts to cut back), this standardized self-report scale consists of 15 items usually with a five-point scale ranging from 1 ( never ) to 5 ( very often ). The final score (Min = 0, Max = 27 points) is computed using weighted scoring (items with an item-total correlation > 0.55 in the norm sample are weighted double; Wölfling et al., 2011 ). The AICA-S score can be used to differentiate between regular (0–6.5 points) and problematic use of video games (7–13 points: abuse; 13.5–27 points: addiction). In our sample, N = 2,265 (83%) were identified as regular gamers, and N = 469 (17%) as problematic gamers. We used the AICA-S as a continuous variable for all further analyses ( M = 3.98, SD = 3.22, Range: 0–24). The instrument has been validated for different age groups in the general population and in clinical samples ( Müller et al., 2014a , 2019 , but note small sample size; Müller et al., 2014b ). Cronbach’s alpha was α = 0.70. As expected, the AICA-S score was correlated with male sex ( r = 0.17 ∗∗∗ ) and age ( r = –0.15 ∗∗∗ ). On average, participants played video games for M = 4.09 hours per weekday ( SD = 4.44, Range: 0–24), and M = 4.21 h per day at the weekend ( SD = 2.99, Range: 0–24).

Reasons for playing

Gamers indicated how often they played video games for certain reasons. They rated each of 10 reasons separately on Likert scales ranging from 1 ( never ) to 4 ( very often ). The most prevalent reasons were relaxation ( M = 2.96, SD = 0.91), amusement ( M = 2.94, SD = 0.85), and because of the storyline ( M = 2.67, SD = 1.10).

Game genres

Gamers were asked how often they usually played various video game subgenres such as first-person shooter, round-based strategy, massively multiplayer online role-playing games (MMORPGs), life simulations, and others. Ratings were made on Likert scales ranging from 1 ( never ) to 4 ( very often ). Using Apperley’s (2006) classification of game genres, we categorized the subgenres into the main genres action ( M = 2.54, SD = 0.84), strategy ( M = 2.13, SD = 0.80), role-playing ( M = 2.01, SD = 0.73), and simulation ( M = 1.58, SD = 0.44). A cluster for unclassified subgenres ( M = 1.54, SD = 0.39) was added to additionally account for such subgenres as jump’n’runs and games of skill. Descriptive statistics and intercorrelations for all measures (including sex and age) are presented in Supplementary Tables S1–S4 .

Psychological Functioning

Participants provided ratings of their psychological functioning on the following constructs:

General psychopathology

The SCL-K-9 ( Klaghofer and Brähler, 2001 ), a short version of the SCL-90-R ( Derogatis, 1975 ), was administered to assess participants’ subjective impairment regarding psychological symptoms (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism). The SCL-K-9 score is strongly correlated with the original score of the SCL-90-R ( r = 0.93). The 9 items were answered on 5-point Likert-type scales ranging from 1 ( do not agree at all ) to 5 ( agree completely ). Cronbach’s alpha was satisfactory (α = 0.77).

We assessed 10 coping strategies with the Brief COPE ( Carver, 1997 ; German version by Knoll et al., 2005 ), which is the shorter version of the COPE ( Carver et al., 1989 ): self-distraction, denial, substance use, venting, self-blame, behavioral disengagement, acceptance, active coping, planning, and positive reframing. The two items per subscale were administered on 5-point Likert-type scales ranging from 1 ( never ) to 5 ( very often ). Intercorrelations of the two items per subscale ranged from r = 0.32, p < 0.001 for positive reframing to r = 0.78, p < 0.001 for substance use (with one exception: r = -0.05, p = 0.01 for self-distraction).

We measured general affect as a trait and affect during video gaming as a state using the German version ( Krohne et al., 1996 ) of the Positive and Negative Affect Schedule (PANAS; Watson et al., 1988 ). On a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ), participants rated the intensity of 20 adjectives. Cronbach’s alpha was α = 0.78 for general positive affect, α = 0.83 for general negative affect, α = 0.85 for positive affect while playing, and α = 0.83 for negative affect while playing.

The measure for the assessment of shyness in adults ( Asendorpf, 1997 ) consists of 5 items that were answered on a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

We administered the German version ( Elbing, 1991 ) of the NYU Loneliness Scale ( Rubenstein and Shaver, 1982 ). The 4 items were answered on 5- to 6-point Likert-type scales. Cronbach’s alpha was satisfactory (α = 0.79).

Preference for solitude

A 10-item measure of preference for solitude ( Nestler et al., 2011 ) was answered on a 6-point Likert-type scale ranging from 1 ( not at all ) to 6 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

Life satisfaction

Participants answered a one-item life satisfaction measure on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ).

Self-esteem

We administered the German version ( von Collani and Herzberg, 2003 ) of the Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1979 ). The 10 items were answered on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ). Cronbach’s alpha was excellent (α = 0.88).

Self-efficacy

We administered a 10-item generalized self-efficacy scale ( Schwarzer and Jerusalem, 1995 ), which was answered on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

Social support and friends

We administered the perceived available social support subscale from the Berlin Social Support Scales (BSSS; Schwarzer and Schulz, 2003 ). The 8 items were answered on a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ). Cronbach’s alpha was excellent (α = 0.94). Participants indicated how many offline friends and offline acquaintances they had ( r = 0.44, p < 0.001) as well as how many online friends and online acquaintances they had ( r = 0.33, p < 0.001). Due to left-skewed distributions, we logarithmized the data before aggregation.

Participants reported their grade point average. German grades are assessed on a scale that ranges from 1 ( excellent ) to 6 ( insufficient ). Thus, higher scores indicate worse grades.

Participants further reported their sex and age. Both were used as control variables in further analyses.

In a first step, we computed zero-order correlations between the video gaming variables and the measures of psychological functioning. In a second step, we computed partial correlations in which we controlled for sex and age because past research has repeatedly shown that sex and age are correlated with both video gaming ( Homer et al., 2012 ; Mihara and Higuchi, 2017 ) and psychological functioning ( Kessler et al., 2007 ; Nolen-Hoeksema, 2012 ). Finally, we explored the unique contribution of each measure of psychological functioning to the prediction of potentially problematic video gaming. Therefore, we computed regressions with potentially problematic video gaming as the dependent variable and sex, age, and the measures of psychological functioning as predictors (entered simultaneously into the regression equation). By employing this procedure, we were able to determine the effect that each variable had over and above the other ones. For instance, we could identify whether general psychopathology was predictive of potentially problematic video game use when the influence of all other variables (e.g., shyness, loneliness, and others) was held constant.

Additionally, we included analyses regarding sex and age differences in the link between video gaming and psychological functioning. Since we collected a self-selected sample where different sexes and age groups were not represented equally, our findings are only preliminary, but may stimulate future research.

Potentially Problematic Video Game Use and Psychological Functioning

First, we examined whether potentially problematic video game use was related to various psychological functioning variables. As can be seen in Table 1 , the results for the zero-order correlations were similar to those for the partial correlations in which we controlled for sex and age. A medium-sized positive relation to the potentially problematic use of video games emerged for the presence of psychological symptoms including depression, anxiety, and hostility. Furthermore, several coping strategies were differentially associated with the potentially problematic use of video games: Self-blame and behavioral disengagement showed the strongest positive relations to potentially problematic video game use, followed by denial, acceptance, substance use, self-distraction, and venting. Planning, active coping, and, to a lesser extent, positive reframing were negatively associated with the potentially problematic use of video games. Moreover, the association with potentially problematic video game use was negative for general positive affect and positive and larger in size for general negative affect. However, potentially problematic video game use was clearly positively associated with the experience of both positive and negative affect while playing. Further, a preference for solitude, shyness, and loneliness were positively correlated with the potentially problematic use of video games. Lower self-esteem, lower life satisfaction, and, to a lesser extent, poorer perceived social support and lower self-efficacy went along with potentially problematic video game use. There was an association between fewer offline friends and acquaintances but more online connections with potentially problematic video gaming. Finally, poorer performance in school (i.e., higher grades) was related to the potentially problematic use of video games. These results suggest that potentially problematic video gaming goes along with poor psychological functioning and vice versa.

Associations between potentially problematic video gaming and psychological functioning.

Reasons for Playing Video Games and Psychological Functioning

Second, we investigated whether players’ reasons for playing video games were differentially related to the psychological functioning variables. Table 2 presents the partial correlations, controlling for sex and age. Using video games to distract oneself from stress was clearly connected to a high level of psychological symptoms. Distraction-motivated gamers preferred coping strategies such as self-blame, behavioral disengagement, self-distraction, denial, substance use, venting, and acceptance, but they neglected active coping and planning. They showed less general positive affect and more negative affect both in general and while playing as well as more positive affect while playing. These gamers further reported low self-esteem and low life satisfaction, loneliness, a preference for solitude, shyness, a lack of self-efficacy and social support, and poor achievement in school. A similar but somewhat less extreme picture was revealed for gamers who played video games in order to have something to talk about . However, these gamers reported more online connections. Gamers who played video games to improve their real-life abilities also reported more online connections. In addition, these gamers showed higher levels of general positive affect. The strongest association with online friends and acquaintances emerged, as expected, for gamers who played because of the social relations in the virtual world. Although all reasons for playing video games were related to positive affect while playing, the strongest associations emerged for gamers who played because of the social relations , to stimulate their imagination , and for curiosity . It is interesting that, for gamers who played video games because of the storyline and for relaxation , there was a relation only to positive but not to negative affect while playing. Reasons for playing were only weakly related to sex and age (see Supplementary Table S2 ). In sum, several reasons for playing video games were differentially associated with psychological functioning.

Associations between reasons for playing video games and psychological functioning.

Video Game Genre and Psychological Functioning

Third, we examined whether players’ preferences for different video game genres were differentially associated with the measures of psychological functioning. Table 3 shows the partial correlations in which we controlled for sex and age. There was a weak connection between general psychological symptoms and all of the video game genres we investigated except strategy. A preference for action games had the strongest association with affect while playing. Thus, action games seem to be both rewarding and a source of frustration. A preference for action games went along with poorer school performance. Gamers who preferred role-playing games scored higher on shyness and a preference for solitude and lower on self-esteem; they also reported fewer offline connections. By contrast, preferences for games of the unclassified category on average went along with a larger number of offline friends and more positive affect, both while playing and in general. Two game genres (i.e., role-playing and unclassified games) were related to the coping strategy of self-distraction. Because preferred game genre was related to participants’ sex (see Supplementary Table S3 ), we had a more detailed look at the correlations between preferred game genre and psychological functioning separately for both sexes: For males ( n = 2,377), the strongest correlation between general psychopathology and game genre emerged for action ( r = 0.08, p < 0.001), followed by role playing ( r = 0.07, p < 0.01), and unclassified ( r = 0.07, p < 0.01). For females ( n = 357), the strongest relation between general psychopathology and game genre emerged for simulation ( r = 0.17, p < 0.01). Differences were also found regarding the strength of the relation between number of friends online and the genre action: r = 0.06, p < 0.01 for males, and r = 0.27, p < 0.001 for females. Similarly, preferred game genre was related to participants’ age (see Supplementary Table S3 ). However, there were merely differences with regard to the relation of psychological functioning and game genre, when analyzed separately for different age groups (<19 years, n = 557; 19–30 years, n = 1916; >31 years, n = 261). In sum, our results speak to the idea that individuals with different levels of psychological functioning differ in their choices of game genres and vice versa.

Associations between preferred video game genre and psychological functioning.

Predicting Potentially Problematic Video Game Use by Psychological Functioning Variables

In a final step, we entered all of the investigated psychological functioning variables as well as sex and age as predictors of the potentially problematic use of video games. By employing this procedure, we were able to determine the unique contribution of each psychological functioning variable when the influence of all other variables was held constant. As Table 4 shows, the number of online friends and acquaintances as well as positive affect while playing were most predictive of potentially problematic video game use over and above all other variables. General psychopathology, a lack of offline connections, and poor school performance were weaker but still relevant predictors of potentially problematic video game use.

Prediction of potentially problematic video game use by psychological functioning variables.

With this study, we aimed to shed light on the association of diverse video gaming habits with gamers’ psychological functioning. Drawing on a large sample, our results revealed a medium-sized relation between potentially problematic video game use and poor psychological functioning with regard to general psychological symptoms, maladaptive coping strategies, negative affectivity, low self-esteem, and a preference for solitude as well as poor school performance. These findings are in line with those of prior work (e.g., Kuss and Griffiths, 2012 ; Milani et al., 2018 ). Also, reasons for playing video games were differentially related to psychological functioning with the most pronounced findings for escape-oriented in contrast to gain-oriented motives. Specifically, distraction-motivated gaming went along with higher symptom ratings, lower self-esteem, and more negative affectivity, whereas playing to establish social relationships in the virtual world was related to a larger number of online connections and more positive affect while playing. Furthermore, there were only weak relations between the preferred game genres and psychological functioning. The action games genre was associated with the strongest ratings of affect while playing. These results on reasons and genres may help to explain conflicting findings of former studies, because in our work we examined various reasons for playing, several game genres, and various aspects of psychological functioning simultaneously. Finally, positive affect while playing and a larger number of online friends were the strongest unique predictors of potentially problematic video game use, followed by psychological symptoms, a lack of offline connections, and poor school performance. These findings suggest that, on the one hand, independent of one’s psychological conditions, enjoying oneself during gaming (i.e., experiencing positive affect, connecting with online friends) may go along with potentially problematic use of video games. On the other hand, poor psychological functioning seems to be a unique risk factor for potentially problematic video gaming.

The presented results are generally in line with previous work that has identified a connection between video gaming and psychological health, academic problems, and social problems ( Ferguson et al., 2011 ; Müller et al., 2015 ). However, our study moved beyond prior research by providing in-depth analyses of both video gaming habits (including potentially problematic use, reasons for playing, and preferred game genre) and psychological functioning (including psychological symptoms, coping styles, affectivity, as well as variables that are related to individuals and their social environments). In addition, we identified unique predictors of potentially problematic video game use.

How can the findings on differential relations between video gaming and various indices of psychological functioning – ranging from beneficial results ( Latham et al., 2013 ) to unfavorable results ( Barlett et al., 2009 ; Möller and Krahé, 2009 ; Anderson et al., 2010 ) – be integrated? According to Kanfer and Phillips (1970) , problematic behavior (e.g., excessive video gaming) can be understood as a function of the situation (e.g., being rejected by a peer); the organism (e.g., low self-esteem); the person’s thoughts, physical reactions, and feelings (e.g., sadness, anger); and finally, the short- as well as long-term consequences of the behavior (termed SORKC model). In the short run, according to our results, playing video games may be a way to distract oneself from everyday hassles and may lead to positive affect while playing and a feeling of being connected to like-minded people, all of which are factors that have an immediate reinforcing value. In the long run, however, spending many hours per day in front of a computer screen may prevent a person from (a) developing and practicing functional coping strategies, (b) finding friends and support in the social environment, and (c) showing proper school achievement, factors that are potentially harmful to the person. Thus, differentiating between short- and long-term perspectives may help us understanding the differential correlates of intensive video gaming.

When is it appropriate to speak of video game addiction? More and more researchers have suggested a continuum between engagement ( Charlton and Danforth, 2007 ; Skoric et al., 2009 ) and pathological gaming/addiction, instead of a categorical perspective. In part, this recommendation has also been followed in the DSM-5 ( American Psychiatric Association, 2013 ) where Internet Gaming Disorder is classified with different degrees of severity, ranging from mild to moderate to severe, according to the functional impairment associated with it. The AICA-S also allows for a differential perspective on gaming behavior by providing ways to assess both the time spent playing video games and the main DSM criteria that indicate Internet Gaming Disorder. However, in our study we did not aim at making a diagnosis, but at having a closer look at potentially problematic gaming behavior and its correlates in a non-clinical sample.

In sum, it seems relevant to assess not only the extent of video game use but also the reasons behind this behavior (e.g., distraction) and the concrete rewards that come from playing (e.g., the experience of strong affect while playing action games) to fully understand the relation between video gaming and psychological functioning.

Limitations and Future Directions

With the present study, we aimed to uncover the association between video gaming and psychological functioning. Our approach was cross-sectional and warrants interpretative caution because correlations cannot determine the direction of causation. It remains unclear whether potentially problematic gaming is a factor that contributes to the development of psychological dysfunction or whether psychological dysfunction contributes to potentially problematic gaming. Also, a third factor (e.g., preexisting mental difficulties) may produce both psychological dysfunction and potentially problematic gaming. Thus, longitudinal studies that are designed to identify the causal pathway may provide a promising avenue for future research. Future studies may also answer the question whether the link between video gaming and psychological functioning is moderated by sex, age, the reasons for playing, or the preferred game genre. In addition, it is important not to forget that the present results are based on a self-selected sample in which potentially problematic video gamers were overrepresented (e.g., Festl et al., 2013 , for a representative sample). Thus, future research should replicate our findings in a representative sample. Further, we relied on self-reported data, which is a plausible method for assessing inner affairs such as people’s reasons for their behaviors, but it would be helpful to back up our findings with evidence derived from sources such as peers, caregivers, and health specialists. Our work reflects only a first approach to the topic, and future work may additionally collect in-game behavioral data from the players ( McCreery et al., 2012 ; Billieux et al., 2013 ) to objectively and more specifically investigate diverse patterns of use. Furthermore, one must not forget that the used taxonomy to classify video game genres is only one of various possible options and one should “think of each individual game as belonging to several genres at once” ( Apperley, 2006 , p. 19). Finally, some of the effects reported in our paper were rather modest in size. This is not surprising considering the complexity and multiple determinants of human behavior. In our analyses, we thoroughly controlled for the influence of sex and age and still found evidence that video gaming was differentially related to measures of psychological functioning.

The current study adds to the knowledge on gaming by uncovering the specific relations between video gaming and distinct measures of psychological functioning. Potentially problematic video gaming was found to be associated with positive affect and social relationships while playing but also with psychological symptoms, maladaptive coping strategies, negative affectivity, low self-esteem, a preference for solitude, and poor school performance. Including gamers’ reasons for playing video games and their preferred game genres helped deepen the understanding of the specific and differential associations between video gaming and psychological health. This knowledge might help developing adequate interventions that are applied prior to the occurrence of psychological impairments that may go along with potentially problematic video gaming.

Ethics Statement

In our online survey, participants were given information on voluntary participation, risks, confidentiality/anonymity, and right to withdraw. Whilst participants were not signing a separate consent form, consent was obtained by virtue of completion. We implemented agreed procedures to maintain the confidentiality of participant data.

Author Contributions

BB, BE, JH, and KM conceived and designed the study. BB, JH, and KM collected and prepared the data. JH analyzed the data. BE and JH wrote the manuscript.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

1 The data were gathered as part of a larger project ( Stopfer et al., 2015 ; Braun et al., 2016 ). However, the analyses in the present article do not overlap with analyses from previous work.

2 Other measures were administered, but they were not relevant to the present research questions and are thus not mentioned in this paper. The data set and analysis script supporting the conclusions of this manuscript can be retrieved from https://osf.io/emrpw/?view_only=856491775efe4f99b407e258c2f2fa8d .

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01731/full#supplementary-material

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