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Cited by 6Impact of Technology on AdolescentsDigital Mental Health InterventionsCOVID-19 and Mental Health

Online Self-Help Acceptance and Commitment Therapy Module for College Students with Higher Gaming Disorder During COVID-19: A Pilot Study

Open access
Ding, Dongyan, Pan, Mengdie, Wang, Wenjuan, Wang, Xiucheng, Ma, Simin, Yang, Yuqing, Huang, Yonghui, Guo, Menghui +1 more·2023·Behaviour Change
DOI 10.1017/bec.2023.6
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Abstract

During the COVID-19 pandemic, there was an increase in online gaming behaviour among college students. This study aimed to examine the impact of online self-help interventions consisting of different components within the Acceptance and Commitment Therapy (ACT) framework on college students' gaming disorder and gaming frequency. Additionally, it evaluated the effectiveness of both interventions in addressing psychological distress among college students during the COVID-19 pandemic. One intervention was a full ACT program, which consists of six core components, while the other intervention focused on the engaged components of ACT (specifically targeting value-based actions). The study employed a 2 conditions (Full ACT vs. Engaged ACT) × 3 times (pre-, mid- and post-program) design to examine the effectiveness of these interventions. Each intervention consisted of 10 sessions, delivered at a frequency of five sessions per week over a 2-week period for both groups. The participants in this study were enrolled in two online classes. Participants with gaming disorder scores in the top 20% were selected and assigned to either the Full group (N = 49) or the Engaged group (N = 41) for the interventions. The study assessed outcome variables, including gaming disorder, psychological flexibility, daily gaming hours, weekly gaming days and psychological distress, at pre-intervention, mid-intervention, post-intervention and one-month follow-up for both groups. No significant differences were observed between the two groups on these outcomes at the pre-intervention stage. The findings of this study indicate that both interventions effectively reduced gaming disorder and weekly gaming frequency, while enhancing psychological flexibility. Nonetheless, the Engaged group exhibited a significant reduction in daily gaming hours. There was no substantial change in psychological distress in either group during and after the intervention. The implications and limitations of this study were also reported. Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Australian Association for Cognitive and Behaviour Therapy.

Integrity signals

Registry

Crossref · 10.1017/bec.2023.6

Cites

57 of 58 references verified0 citation errors · 1 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

23 of 43 cited sources checked · 11 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    People who realise their values and life goals have greater motivation to engage in health-related behaviour.

    “People who realise their own values and life goals would have greater motivation to engage in good health-related behaviour and adhere to them (Chew, Fernandez, & Shariff-Ghazali, 2018).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Chew, Fernandez, & Shariff-Ghazali, 2018 source
  • Premisecitation

    Gaming behaviour was exacerbated during the COVID-19 pandemic as young people spent more time on internet games to cope with psychological distress.

    “It was worth noting that this addictive behaviour of games was exacerbated during the COVID-19 pandemic as young people are spending more time on internet games to cope with their psychological distress (i.e.anxiety, depression and stress) (Teng, Pontes, Nie, Griffiths, & Guo, 2021;Wang, Liu, Zhang, & Zhang, 2022).”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites Teng, Pontes, Nie, Griffiths, & Guo, 2021 source

      The Conclusions and implications section (page not supplied) reports increased videogame use among both children and adolescents, but increased gaming-disorder severity only among adolescents. It also reports that pre-pandemic depression and anxiety predicted later gaming and interprets this as consistent with coping; it does not establish that distress caused young people to spend more time gaming, or that addictive behaviour worsened across both age groups. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites Wang, Liu, Zhang, & Zhang, 2022 source

      The Introduction (page not provided) says that teenagers experienced anxiety, depression, and stress during the COVID-19 outbreak and chose internet games to cope with negative emotions. It does not establish that they spent more time gaming than before the pandemic or that gaming addiction worsened during it. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Premisecitation

    Web-based self-help intervention programs offer an excellent alternative to preventing mental health problems and behavioural disorders.

    “Past studies showed that web-based self-help intervention programs offer an excellent alternative to preventing mental health problems (Levin et al., 2016) and behavioural disorders (Kass et al., 2014).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Levin et al., 2016 source
    • cites Kass et al., 2014 source

      The Conclusion supports internet-based self-help for reducing eating-disorder risk factors in college students at high risk. But the Discussion says this trial did not assess whether it prevented eating-disorder onset. The citation therefore supports a narrower claim than prevention of behavioural disorders generally; the sentence's mental-health claim is attributed to a different source. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Premisecitation

    CBT has a more substantial body of evidence supporting its efficacy in reducing gaming disorder than other therapies.

    “However, psychosocial intervention such as cognitive behavioural therapy (CBT) has a more substantial body of evidence supporting its efficacy in reducing GD compared to other therapies in different countries (King et al., 2017;Sudhir, 2018;Xiang et al., 2020).”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites King et al., 2017 source
    • cites Sudhir, 2018 source

      The Introduction describes CBT as evidence-based for addictive behaviours, and the Summary and future directions says it applies to behavioural addictions. Neither passage establishes that CBT has a stronger evidence base than other therapies specifically for gaming disorder, or compares findings across countries. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites Xiang et al., 2020 source

      The treatment discussion in “Comprehensive Intervention Principles and Measures” identifies CBT as one of several psychosocial interventions effective in reducing uncontrolled gaming behavior. It does not say CBT has a larger body of evidence than other therapies or establish that comparison across countries. No page number is available in our copy. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
  • Interpretationcitation

    Having therapists learn each new full treatment protocol may be redundant and unnecessary.

    “Many evidence-based psychosocial interventions share core components and target analogous psychological processes, so having therapists learn each new full treatment protocol may be redundant and unnecessary (Chorpita et al., 2011;Villatte et al., 2016).”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites Chorpita et al., 2011 source
    • cites Villatte et al., 2016 source
  • May combine two claims. 30
  • Classified as probably not a substantial claim. 25

  • May combine two claims.

    Premisecitation

    There are no specific effective interventions or treatment guidelines for gaming disorders in China.

    “To date, there are no specific effective interventions and treatment guidelines for gaming disorders in China (Xiang et al., 2020).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Xiang et al., 2020 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Engaged component of ACT showed more significant improvements in value-based behaviours than the Open component.

    “Similarly, the previous study found that the Engaged component of ACT showed more significant improvements in value-based behaviours than the Open component (Villatte et al., 2016)”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Villatte et al., 2016 source

  • May combine two claims.

    Premisecitation

    Gaming disorder is linked to poor sleep, academic underachievement, poor social interaction, and depression.

    “correlational studies have found links between GD and poor sleep, academic underachievement, poor social interaction and depression (Brunborg, Mentzoni, & Frøyland, 2014;Velotti, Rogier, Beomonte Zobel, & Billieux, 2021;Zhao et al., 2021).”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites Brunborg, Mentzoni, & Frøyland, 2014 source

      The Discussion (page unavailable) reports associations between video game addiction, poorer academic achievement, and higher depression. It does not report an association with poor sleep. The Introduction mentions conflict in personal relationships as a proposed feature of addiction, but that does not establish the claimed correlational link with poor social interaction. (LLM, conf=0.90)

      Experimental — accuracy not yet measured
    • cites Velotti, Rogier, Beomonte Zobel, & Billieux, 2021 source
    • cites Zhao et al., 2021 source

      The Introduction reports that internet gaming addiction may reduce sleep quality and is correlated with depression. The Discussion also reports more serious depressive traits among online gaming abusers. Our copy does not establish links with academic underachievement or poor social interaction; this study also reports that none of its participants met its scale’s threshold for gaming addiction. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Online self-help prevention programs are cost-effective, anonymous, and can be tailored to different groups.

    “An online self-help prevention program is cost-effective, anonymous, and can be tailored to the needs of different groups in various formats (written, video, audio), so it would be convenient for participants and may increase their engagement (Amstadter, Broman-Fulks, Zinzow, Ruggiero, & Cercone, 2009;Levin, Hayes, Pistorello, & Seeley, 2016).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Amstadter, Broman-Fulks, Zinzow, Ruggiero, & Cercone, 2009 source
    • cites Levin, Hayes, Pistorello, & Seeley, 2016 source

  • May combine two claims.

    Premisecitation

    College students are more vulnerable to negative events and tend to feel more anxious, depressed or stressed during COVID-19 than in normal times.

    “This may be because college students are more vulnerable to negative events and tend to feel more anxious, depressed or stressed during COVID-19 than during normal times (Gloster et al., 2020;Lee, 2020;Tuo et al., 2021).”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites Gloster et al., 2020 source

      The Introduction says anxiety and depression could increase during the pandemic, and the Discussion reports substantial stress and depressive symptoms in an international sample. The paper does not establish that college students are especially vulnerable to negative events or compare their symptoms during COVID-19 with normal times. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites Lee, 2020 source

      The Features section says college and university students were stressed by pandemic-related disruptions, that final-year students were anxious about the job market, and that college students were vulnerable under current academic and financial burdens. It does not say college students were more anxious, depressed, or stressed than in normal times, or report depression specifically among college students. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites Tuo et al., 2021

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The Engaged components of ACT (values and committed action) could increase more adaptive behavioural regulation and improve more on valued action than other components.

    “The research indicated that the Engaged components of ACT (i.e.intervention converged values and committed action) could increase more adaptive behavioural regulation and improve more on valued action than other components (Villatte et al., 2016).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Villatte et al., 2016 source

  • May combine two claims.

    Premisecitation

    ACT has efficacy for improving mental health and reducing behavioural disorders in adults and children.

    “Some meta-analyses and reviews have found that ACT has efficacy for improving mental health and reducing behavioural disorders in adults and children (A-Tjak et al., 2015;Fang & Ding, 2020b;Graham, Gouick, Krahe, & Gillanders, 2016;Powers, Vording, & Emmelkamp, 2009)”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites A-Tjak et al., 2015 source

      The Discussion reports that ACT outperformed control conditions and supports its use for anxiety disorders, depression, and addiction. The Introduction specifies that the meta-analysis examined adults with specific disorders; it does not establish efficacy in children, so the age-spanning claim exceeds this source. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites Fang & Ding, 2020b

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Graham, Gouick, Krahe, & Gillanders, 2016 source

      The ‘Efficacy of ACT in other contexts’ section reports small-to-medium effects across mental-health conditions, and ‘Parenting of children with long-term conditions’ reports improvements in child behavioural and emotional problems. The review does not establish a general reduction in behavioural disorders across adults and children: its child findings concern specific long-term conditions and ACT-enhanced parenting interventions. Page numbers are unavailable in our copy. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    Component research could provide training and guidance in an effective, flexible and easily updated way.

    “Therefore, component research could provide training and guidance in an effective, flexible and easily updated way (Villatte et al., 2016).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Villatte et al., 2016 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Online dating may increase internet gaming disorder.

    “Previous studies found that online dating could reflect higher psychological distress (Stevens & Morris, 2007) and may increase internet GD (Taechoyotin et al., 2020).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Taechoyotin et al., 2020 source

  • May combine two claims.

    Findingown data

    Both the Full and Engaged self-help ACT programs reduced the number of days of gaming per week.

    “The findings of this study indicate that both interventions effectively reduced gaming disorder and weekly gaming frequency, while enhancing psychological flexibility.”
    • Also stated in: § Discussion · boosted
      “Both groups demonstrated significant reductions in gaming disorder scores and days of game playing per week, as well as improvements in psychological flexibility over time.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The Full group showed significant decreases in days of gaming per week from pre to post and from pre to follow-up.

    “However, the Full condition only exhibited significant decreases in days per week from pre to post and follow-up (d = -.54,p < .01,d = -.56,p < .01).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Both the Full and Engaged self-help ACT programs reduced gaming disorder symptoms over time.

    “The findings of this study indicate that both interventions effectively reduced gaming disorder and weekly gaming frequency, while enhancing psychological flexibility.”
    • Also stated in: § Gaming disorder scores · hedged
      “the effect of time was significant (B = -.66,p < .01),suggesting that both groups experienced a decrease in gaming disorder over time”
    • Also stated in: § Discussion · boosted
      “Both groups demonstrated significant reductions in gaming disorder scores and days of game playing per week, as well as improvements in psychological flexibility over time.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There were significant baseline differences between the two groups in gender, grade, and relationship status.

    “There were significant differences between the two groups in gender (χ 2 = 4.94, p < .05),grade (χ 2 = 76.51,p < .001)and whether or not they were in a relationship (χ 2 = 6.95, p < .05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Females and individuals not in a romantic relationship experienced lower levels of anxiety.

    “For instance, gender and relationship status were significantly associated with anxiety in Step 1, suggesting that females and individuals not in a romantic relationship experienced lower levels of anxiety.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Both the Full and Engaged self-help ACT programs increased psychological flexibility over time.

    “The findings of this study indicate that both interventions effectively reduced gaming disorder and weekly gaming frequency, while enhancing psychological flexibility.”
    • Also stated in: § Secondary outcomes · hedged
      “the effect of time was significant (B = -.53,p < .01),indicating that both groups demonstrated an increase in psychological flexibility over time.”
    • Also stated in: § Discussion · plain
      “Both groups demonstrated significant reductions in gaming disorder scores and days of game playing per week, as well as improvements in psychological flexibility over time.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Gender and grade had significant effects on hours of gaming per day, and grade had a significant effect on days of gaming per week.

    “Additionally, grade had a significant effect on days of gaming per week (Grade, B = -.27,p < .01),and both gender and grade had a significant effect on hours of gaming per day (Gender, B = -.54,p < .01;Grade, B = -.33,p < .01).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    At follow-up, the Engaged group appeared to have lower anxiety than the Full group, although no significant within-group difference was found.

    “It is worth noting that at the follow-up assessment, the Engaged group appeared to have lower levels of anxiety compared to the Full group, although no significant difference was found before and after the intervention within either group.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The Engaged group showed significant decreases in hours of gaming per day and days of gaming per week from pre to post and from pre to follow-up.

    “Regarding gaming frequency, both hours per day and days per week demonstrated significant decreases from pre to post and follow-up in the Engaged condition.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    The greater reduction in daily gaming hours in the Engaged group does not indicate that the Engaged condition outperforms the Full condition in improving gaming disorders, because the finding was specific to hours-per-day and based on pilot data.

    “However, it did not indicate that the Engaged condition outperforms the Full condition in improving gaming disorders as this finding was specific to the measure of hours-per-day and was based on pilot data, which may limit the generalizability of the results.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    All analyses were conducted using multilevel modelling because of the nested nature of the data.

    “Given the nested nature of the data, all analyses were conducted using multilevel modelling with the packages nlme and gglot2 in R (R Core Team, 2016).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites R Core Team, 2016

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    CBT is an effective short-term intervention for reducing internet gaming disorder, but its effects are not maintained in the long term.

    “A systematic review and meta-analysis about the efficacy of CBT for internet GD concluded that CBT is an effective short-term intervention for reducing internet GD, but the effects could not be maintained in the long term (Stevens, King, Dorstyn, & Delfabbro, 2019)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Stevens, King, Dorstyn, & Delfabbro, 2019 source

  • May combine two claims.

    Study design and conductnone given

    Participants did not engage in any other interventions or use medication to alleviate their symptoms.

    “It is worth noting that these students did not engage in any other interventions or utilise medication to alleviate their symptoms.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The DASS-21 has good reliability and validity and can be used to investigate negative emotion in Chinese college students.

    “The DASS-21 has good reliability and validity, and it can be used as an effective tool to investigate the negative emotion level of Chinese college students (Tuo et al., 2021).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Tuo et al., 2021

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Gender, grade, and relationship status were included as covariates in the models.

    “Thus, gender, grade and whether in a relationship were covariates for models.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    In this study, the DASS-21 had a Cronbach's alpha of 0.94 overall, 0.86 for depression, 0.81 for anxiety, and 0.83 for stress.

    “In the present study, Cronbach's α was 0.94 for the whole scale, 0.86 for the subscale of depression, 0.81 for anxiety and 0.83 for stress.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    This study was approved by the Ethical Committee of Bengbu Medical College.

    “This study was approved by the Ethical Committee of Bengbu Medical College.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The AAQ-II has shown good reliability and validity in China.

    “The scale has shown good reliability and validity in China (Fang & Ding, 2020a).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fang & Ding, 2020a

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    Given the widespread negative effects of COVID-19 and social restrictions on mental well-being, it is unsurprising that a brief self-help intervention failed to reduce measures of psychological distress.

    “Due to the pervasive negative impacts of COVID-19 and social restrictions on mental well-being, it is not surprising that a brief self-help intervention was insufficient to reduce measures of psychological distress.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Individuals with subclinical gaming disorder symptoms may experience significant impairments and may be susceptible to developing full-blown gaming disorder.

    “indicating that individuals with subclinical gaming disorder symptoms may experience significant impairments in areas such as interpersonal relationships, coping strategies and developmental adaptation.Furthermore, they may be susceptible to developing fullblown gaming disorder (Hong et al., 2023;Milani et al., 2017).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Hong et al., 2023 source
    • cites Milani et al., 2017

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    Values matter in approach behaviours.

    “Values matter in approach behaviours (Flynn & Hebert, 2022).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Flynn & Hebert, 2022 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    The intervention content was developed by ACT experts based on existing, empirically validated ACT protocols.

    “ACT experts developed intervention content based on existing, empirically validated ACT protocols.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The SUS is a gold-standard measure of usability.

    “and it was a gold-standard measure of usability (Levin et al., 2020).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Levin et al., 2020 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In this study, the AAQ-II had a Cronbach's alpha of 0.88.

    “In the present study, Cronbach's α was 0.88.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The IGD-20 has shown good reliability and validity in China.

    “The scale has shown good reliability and validity in China (Cheng, Liu, & Tong, 2020;Qin et al., 2020).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Cheng, Liu, & Tong, 2020

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Qin et al., 2020

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Spending more than 2 hours a day on online gaming is considered an important threshold for addiction.

    “According to previous research, spending more than 2 h a day on online gaming is considered an important threshold for addiction (Tian & Wang, 2022).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Tian & Wang, 2022

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Informed consent was obtained from all students.

    “Informed consent was obtained for all students.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study was limited to the use of self-reports, so individual reports may be subjective.

    “This study was also limited to the use of self-reports, so individual reports may be subjective.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Individuals with lower levels of gaming disorder may exhibit different characteristics, experiences and treatment needs compared to those in the higher-scoring group.

    “It is important to recognise that individuals with lower levels of gaming disorder may exhibit different characteristics, experiences and treatment needs compared to those in the higher-scoring group.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    It was difficult to know how participants perceived and understood the intervention content and whether it was similar to the face-to-face ACT components.

    “Although the content was delivered in the online platform in a highly controlled manner and based on an established validated intervention trail, it was difficult to know how the participants perceived and understood the content and whether it was similar to the face-to-face ACT components.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Online dating is associated with higher psychological distress.

    “Previous studies found that online dating could reflect higher psychological distress (Stevens & Morris, 2007) and may increase internet GD (Taechoyotin et al., 2020).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Stevens & Morris, 2007 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Informed consent was obtained from all individual participants included in the study.

    “Informed consent was obtained from all individual participants included in the study.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

    “The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Study design and conductnone given

    The intervention content was delivered online in a highly controlled manner and was based on an established validated intervention trial.

    “Although the content was delivered in the online platform in a highly controlled manner and based on an established validated intervention trail, it was difficult to know how the participants perceived and understood the content and whether it was similar to the face-to-face ACT components.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    An open-only condition and an aware-only condition were missing from the study.

    “Finally, it must be acknowledged that an open-only condition and an aware-only condition were missing from this study.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was approved by the Psychology and Ethics Committee of Bengbu Medical College.

    “The study was approved by the Psychology and Ethics Committee of Bengbu Medical College.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    This specific selection criterion may introduce selection bias and limit the generalizability of the findings to individuals with lower levels of gaming disorder.

    “This specific selection criterion may introduce selection bias and limit the generalizability of the findings to individuals with lower levels of gaming disorder.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    The pilot test supported the feasibility and potential efficacy of the self-help online ACT components, which could be cost-effective and efficient for future intervention approaches.

    “Besides, this pilot test supported the feasibility and potential efficacy of the self-help online ACT components, which could be cost-effective and efficient for future intervention approaches.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The measures of gaming disorder used (self-reported hours of gaming per day and days of gaming per week) may not capture the full extent of gaming disorder.

    “While these measures provide valuable information about participants' gaming habits, they may not capture the full extent of gaming disorder.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Gaming disorder involves more than the quantity of gaming.

  • May combine two claims.

    Study design and conductreasoning

    Participants were students with higher gaming disorder scores, but not all of them met the clinical diagnostic criteria for gaming disorder (scores greater than 71).

    “It should be noted that the individuals included in this study were students with higher gaming disorder scores, but not all of these individuals met the clinical diagnostic criteria for gaming disorders (scores greater than 71).”
    Quote in the paperNot a substantial claim
49 of 49

  • The paper relies on this without support.

    The efficacy of ACT for gaming disorders had not been explored before this study.

    “To date, the efficacy of ACT for gaming disorders has not been explored.”

  • The paper relies on this without support.

    Gaming disorder involves more than the quantity of gaming.

    “It is important to acknowledge that gaming disorder involves more than just the quantity of gaming.”
2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Daily gaming-hours result points to a figure captioned for weekly hours

    Minor

    The text directs readers to Figure 2 for hours of gaming per day, but its caption says hours of gaming per week.

  • Full-group gaming-disorder effect size differs from Table 4

    Minor

    The outcome narrative reports a pre-to-follow-up effect size of −.53 for the Full group, whereas Table 4 reports −.43 for that comparison.

  • Weekly gaming-days result points to a figure captioned for daily hours

    Minor

    The text directs readers to Figure 1 for gaming days per week, but the Figure 1 caption identifies it as hours of gaming per day.

  • Gaming-days response options use hours instead of days

    Minor

    One item asks for the number of gaming days in a week, but the stated response options for both items are exclusively ranges of hours per day.

  • Grade effect is assigned the wrong significance threshold

    Minor

    The text says the grade effect on gaming days has p < .01, whereas the corresponding Table 5 entry is p = .02.

  • Figure 2 caption does not match the cited outcome

    Minor

    The results cite Figure 2 for hours of gaming per day, while its caption says hours of gaming per week.

  • Reported session completion conflicts with group averages

    Minor

    The procedure says all students completed the sessions, but the reported averages are below the ten sessions specified for each group.

7 of 7

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. Tian, 2022, Research on the use and impact of online games on minors, Youth Exploration, 05, 65
  2. Qin, 2020, Reliability and validity of 20-item Internet Gaming Disorder Test for Chinese college students, Chinese Journal of Clinical Psychology, 28, 33
  3. Cheng, 2020, Prevalence of gaming disorder and the influencing factors among adolescents in Jianaxi province, Journal of International Psychiatry, 47, 1157

Cited by

Sorted by citations

Related

Authors
Ding, D., Pan, M., Wang, W., Wang, X., Ma, S., Yang, Y., Huang, Y., Guo, M., & Wu, Y.
Affiliations
Bengbu Medical College (CN)
Corresponding author
  • Pan, Mengdie
  • Wang, Wenjuan
ORCID
Venue
Behaviour Change
Publisher
Cambridge University Press (CUP)
Published
2023-09-28
Volume
40
Issue
4
Pages
278-296
ISSN
  • 0813-4839 (ISSN-L)
  • 2049-7768
DOI
10.1017/bec.2023.6
OpenAlex
W4387118165
Semantic Scholar
6fc576c8f69648d6b85931eaa6094def2fef4ef9
Cited by
6
References
58
Citations by year
2026: 2 · 2025: 4
FWCI
2.87
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
Behaviour Change (publishedVersion)
Topics
  • Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords
gaming disorder, online self-help intervention, acceptance and commitment therapy, university students, COVID-19 pandemic, psychological flexibility, gaming frequency, psychological distress

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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