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A longitudinal study on psychosocial causes and consequences of Internet gaming disorder in adolescence

Wartberg, Lutz, Kriston, Levente, Zieglmeier, Matthias, Lincoln, Tania, Kammerl, Rudolf·2019·Psychological Medicine

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Abstract

Background: In 2013, Internet gaming disorder (IGD) was incorporated in the current version of the DSM-5. IGD refers to a problematic use of video games. Longitudinal studies on the etiology of IGD are lacking. Furthermore, it is currently unclear to which extent associated psychopathological problems are causes or consequences of IGD. In the present survey, longitudinal associations between IGD and adolescent and parental mental health were investigated for the first time, as well as the temporal stability of IGD. Methods: In a cross-lagged panel design study, family dyads (adolescent with a parent each) were examined in 2016 (t1) and again 1 year later (2017, t2). Overall, 1095 family dyads were assessed at t1 and 985 dyads were re-assessed at t2 with standardized measures of IGD and several aspects of adolescent and parental mental health. Data were analyzed with structural equation modeling (SEM). Results: Male gender, a higher level of hyperactivity/inattention, self-esteem problems and IGD at t1 were predictors of IGD at t2. IGD at t1 was a predictor for adolescent emotional distress at t2. Overall, 357 out of the 985 adolescents received a diagnosis of IGD at t1 or t2: 142 (14.4%) at t1 and t2, 100 (10.2%) only at t1, and 115 (11.7%) only at t2. Conclusions: Hyperactivity/inattention and self-esteem problems seem to be important for the development of IGD. We found first empirical evidence that IGD could prospectively contribute to a deterioration of adolescent mental health. Only a subgroup of affected adolescents showed IGD consistently over 1 year.

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More stringent criteria are needed for diagnosing internet gaming disorder: Evidence from regional brain features and whole-brain functional connectivity multivariate pattern analyses
Dong, G., Wang, Z., Dong, H., Wang, M., Zheng, Y., Ye, S., Zhang, J., & Potenza, M. N. (2020) · Journal of Behavioral Addictions · doi:10.1556/2006.2020.00065 · Cited by 29
Reliability, and Convergent and Discriminant Validity of Gaming Disorder Scales: A Meta-Analysis
Yoon, S., Yang, Y., Ro, E., Ahn, W., Kim, J., Shin, S.-H., Chey, J., & Choi, K. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.764209 · Cited by 29
“Studies have reported that just as problematic gaming increases psychological distress, psychological factors such as low selfesteem and loneliness also bidirectionally affect or predict problematic gaming (Lemmens et al., 2011; Tian et al., 2017; Tras, 2019; Wartberg et al., 2019).”
Background
Metacognitions as a predictor of online gaming in adolescents: Psychometric properties of the metacognitions about online gaming scale among Iranian adolescents
Akbari, M., Bahadori, M. H., Milan, B. B., Caselli, G., & Spada, M. M. (2021) · Addictive Behaviors · doi:10.1016/j.addbeh.2021.106904 · Cited by 28
Diminished cognitive control in Internet gaming disorder: A multimodal approach with magnetic resonance imaging and real-time heart rate variability
Lee, D., Park, J., Namkoong, K., Hong, S. J., Kim, I. Y., & Jung, Y. (2020) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2020.110127 · Cited by 29
Internet gaming disorder and its relationship with behavioral disorder and mother’s parenting styles in primary school students according to gender in Iran
Areshtanab, H. N., Fathollahpour, F., Bostanabad, M. A., Ebrahimi, H., Hosseinzadeh, M., & Fooladi, M. M. (2021) · BMC Psychology · doi:10.1186/s40359-021-00616-4 · Cited by 27
“Some of the studies have explored the relationship between IGD and adolescents’ mental health problems [34, 35].”
Background
Problematic Use of Internet Associates with Poor Quality of Life via Psychological Distress in Invididuals with ADHD
Chen, C., Lee, K.-Y., Fung, X. C. C., Chen, J., Lai, Y.-C., Potenza, M. N., Chang, K., Fang, C., Pakpour, A. H., & Lin, C. (2024) · Psychology Research and Behavior Management · doi:10.2147/prbm.s449369 · Cited by 28
“22,23 Given that impulsivity, hyper-activity, and inattention are features of ADHD, we speculated that people with ADHD may experience more significant psychological distress resulting from online gaming activities and possibly other types of PUI.”
The Influence of Maternal and Paternal Phubbing on Adolescents’ Problematic Gaming: A Two-Wave Mediation Model
Pivetta, E., Marino, C., Bottesi, G., Pastore, M., Vieno, A., & Canale, N. (2023) · Computers in Human Behavior · doi:10.1016/j.chb.2023.108058 · Cited by 27
Association of Extensive Video Gaming and Cognitive Function Changes in Brain-Imaging Studies of Pro Gamers and Individuals With Gaming Disorder: Systematic Literature Review
Choi, E., Shin, S.-H., Ryu, J.-K., Jung, K.-I., Hyun, Y., Kim, J., & Park, M.-H. (2021) · JMIR Serious Games · doi:10.2196/25793 · Cited by 26
“According to the WHO’s announcement, the diagnosis of GD should be based on the report of symptoms for more than 12 months [7]; only a subgroup of individuals were found to show persistent symptoms of GD over 12 months [44].”
Method
Cumulative Family Risk and Internet Gaming Disorder Among Adolescents: A Serial Mediating Model of Personal Growth Initiative and Gratitude
Gan, X., Xiang, G.-X., Li, H., Shao-hua, W., Jin, X., & Zhu, C.-S. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.819324 · Cited by 26
Long-term effects of psychosocial interventions on internet-related disorders: A meta-analysis
Lo, C. K. M., Chan, K. L., Yu, L., Chui, W. W. H., & Ip, P. (2022) · Computers in Human Behavior · doi:10.1016/j.chb.2022.107465 · Cited by 29
Internet addiction and depressive and anxious symptoms among Chinese rural left‐behind adolescents: Mediating roles of resilience and friendship quality
Shang, R., Pang, H.-S., Jiang, J., Ji, Y., Liu, Q., Zhang, M., Yang, R., Li, S., Li, Y., & Liu, Q. (2023) · Child Care Health and Development · doi:10.1111/cch.13160 · Cited by 26
Uncovering the symptom relationship between anxiety, depression, and internet addiction among left-behind children: A large-scale purposive sampling network analysis
Shen, X., Zhou, X., Liao, H., McDonnell, D., & Wang, J. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.01.025 · Cited by 31
Internet Gaming Disorder in Early Adolescents: Gender and Depression Differences in a Latent Growth Model
Wang, R., Yang, S., Yan, Y., Tian, Y., & Wang, P. (2021) · Healthcare · doi:10.3390/healthcare9091188 · Cited by 23
“(2019) showed that the IGT at T1 significantly positively predicted IGD at T2, that is, IGD is on the rise [22].”
BackgroundMethodInfluential
Problematic internet gaming and non-suicidal self-injury in Chinese adolescents: Moderating and mediating roles of anxiety
Xu, P., Hao, X., Luo, D., Lai, M., Sun, X., & Xu, J. (2023) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2023.152398 · Cited by 22
Psychopathology and Gaming Disorder in Adolescents
Falcione, K., & Weber, R. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.28532 · Cited by 21
Subtyping treatment-seeking gaming disorder patients
Granero, R., Fernández-Aranda, F., Castro-Calvo, J., Billieux, J., Valero-Solís, S., Mora-Maltas, B., Rivas-Pérez, S., Valenciano-Mendoza, E., del Pino-Gutiérrez, A., Gómez-Peña, M., et al. (2021) · Addictive Behaviors · doi:10.1016/j.addbeh.2021.107086 · Cited by 23
Academic expectation stress and online gaming disorder among Chinese adolescents: The mediating role of psychological distress and the moderating role of stress mindset
Cheng, Y., Jiang, S., & Chen, J. (2024) · Children and Youth Services Review · doi:10.1016/j.childyouth.2024.107492 · Cited by 26
Identifying individuals in need of help for their uncontrolled gaming: A narrative review of concerns and comments regarding gaming disorder diagnostic criteria
Ko, C., Király, O., Demetrovics, Z., Chang, Y.-M., & Yen, J. (2020) · Journal of Behavioral Addictions · doi:10.1556/2006.2020.00058 · Cited by 22
Joint effects of children’s emotional problems and parental depressive symptoms on the occurrence of internet gaming disorder among children and adolescents: A longitudinal study
Jeong, H., Yim, H. W., Lee, S., Lee, H. K., Potenza, M. N., & Park, M. (2021) · Journal of Behavioral Addictions · doi:10.1556/2006.2021.00030 · Cited by 22
Altered Functional Connectivity of the Nucleus Accumbens and Amygdala in Cyber Addiction: A Resting State Functional Magnetic Resonance Imaging Study
Ko, M., Chi, S., Lee, J., Suh, S., & Lee, M. (2023) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2023.21.2.304 · Cited by 22
“associated with cyber addiction symptoms [50,51].”
The relationship between maladaptive personality functioning and problematic technology use in adolescence: A cluster analysis approach
Amendola, S., Spensieri, V., Biuso, G. S., & Cerutti, R. (2020) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12664 · Cited by 23
An empirical investigation of the externalizing and internalizing pathways to disordered gaming behavior: A longitudinal study across childhood and adolescence
Richard, J., Temcheff, C. E., Fletcher, É., Lemieux, A., Derevensky, J. L., & Déry, M. (2021) · Computers in Human Behavior · doi:10.1016/j.chb.2021.107096 · Cited by 20
Identifying research streams in online gambling and gaming literature: A bibliometric analysis
Stehmann, J. (2019) · Computers in Human Behavior · doi:10.1016/j.chb.2019.106219 · Cited by 20
Validity and Psychometric Properties of the Internet Gaming Disorder Scale in Three Large Independent Samples of Children and Adolescents
Paschke, K., Sack, P., & Thomasius, R. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18031095 · Cited by 19
“Convergent validity is supported by small to medium correlations of the IGDS sum score with psychological constructs like aggressiveness and antisocial behavior, anger control and hyperactivity, loneliness and emotional distress, low self-esteem, life satisfaction, and prosocial behavior [19,24,25].”
Background
Estimated Prevalence of Unreported IGD Cases in Routine Outpatient Children and Adolescent Psychotherapy
Kewitz, S., Vonderlin, E., Wartberg, L., & Lindenberg, K. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18136787 · Cited by 19
“However, our findings contradict previous findings on comorbid IGD and depressive disorders [14,17,21].”
ResultSelf-citation
How Does Family Dysfunction Influence Internet Gaming Disorder? Testing a Moderated Serial Mediation Model Among Chinese Adolescents
Gan, X., Xiang, G.-X., Jin, X., Zhu, C.-S., & Yu, C. (2022) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-022-00895-x · Cited by 19
“In a longitudinal study, Wartberg et al., (2019) have repeatedly indicated that self-esteem is an effective predictor of IGD 1 year later during early adolescence.”
From game engagement to craving responses – The role of gratification and compensation experiences during video-gaming in casual and at-risk gamers
Antons, S., Liebherr, M., Brand, M., & Brandtner, A. (2023) · Addictive Behaviors Reports · doi:10.1016/j.abrep.2023.100520 · Cited by 19
“However, when individuals engage excessively in videogames, the positive effects sometimes turn into negative ones, affecting important areas of daily life and/or causing marked distress (Altintas et al., 2019; Mihara & Higuchi, 2017; Montag & Pontes, 2023; Wartberg et al., 2019).”
Background
Prevalence, predictive factors, and impacts of internet gaming disorder among adolescents: A population-based longitudinal study
Meng, Y., Shi, X., Cai, D., Ran, M., Ye, A., & Qiu, C. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.06.020 · Cited by 19
Neuropsychological Constructs in Gaming Disorders: a Systematic Review
Legault, M. C. B., Liu, H. Z., & Balodis, I. M. (2021) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-021-00230-z · Cited by 18
Neural mechanisms of behavioral addiction: An ALE meta-analysis and MACM analysis
Li, Z., He, Q., Elhai, J. D., Montag, C., & Yang, H. (2025) · Journal of Behavioral Addictions · doi:10.1556/2006.2024.00082 · Cited by 18
“…comorbid mental disorders, such as atten-tion-de ﬁ cit/hyperactivity disorder (ADHD) (Michael & Seymour, 2023; Wang, Yin, Wang, King, & Rost, 2024; Wartberg, Kriston, Zieglmeier, Lincoln, & Kammerl, 2019) or depression and anxiety disorders (Qu et al., 2024; Teng, Pontes, Nie, Grif ﬁ ths, & Guo,…”
Bidirectional relationship between gaming disorder, internalizing psychopathology, psychological distress, and well-being: A systematic review with meta-analysis of longitudinal studies
Amendola, S., Bernath, J., Presaghi, F., Waller, G., & Hengartner, M. P. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.04.108 · Cited by 21
Wanting-liking dissociation and altered dopaminergic functioning: Similarities between internet gaming disorder and tobacco use disorder
Ma, X., Wang, M., Zhou, W., Zhang, Z., Ni, H., Jiang, A., Zheng, Y., Du, X., Potenza, M. N., & Dong, G. (2024) · Journal of Behavioral Addictions · doi:10.1556/2006.2024.00011 · Cited by 18
The Influence of Online Game Behaviors on the Emotional State and Executive Function of College Students in China
Zhao, W., Wei, T., Zhou, R., Wang, Y., Wang, Y., Ren, Z., Shao, W., Luo, H., Zhou, Y., Chen, N., et al. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.713364 · Cited by 17
The Role of Self-Control Dimensions, Game Motivation, Game Genre, and Game Platforms in Gaming Disorder: Cross-Sectional and Longitudinal Findings
Cudo, A., Kopiś-Posiej, N., & Griffiths, M. D. (2023) · Psychology Research and Behavior Management · doi:10.2147/prbm.s435125 · Cited by 20
The relationship of sexual objectification with internet addiction and its implications for mental health
Chau, C., Chan, R. S. W., Liang, J., & Poon, K. (2024) · Computers in Human Behavior · doi:10.1016/j.chb.2024.108179 · Cited by 20
From Evidence to Practice: A Comprehensive Analysis of Side Effects in Synthetic Anti-Depressant Therapy
Pannu, A. S., & Goyal, R. K. (2024) · Current Drug Safety · doi:10.2174/0115748863301630240417071353 · Cited by 21

Authors: Wartberg, L., Kriston, L., Zieglmeier, M., Lincoln, T., & Kammerl, R.
Affiliations: University Medical Center Hamburg-Eppendorf (DE)
Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
Universität Hamburg (DE)
Corresponding author: Wartberg, Lutz
ORCID: Wartberg, Lutz
Kriston, Levente
Lincoln, Tania
Kammerl, Rudolf
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 2018-04-06
Volume: 49
Issue: 2
Pages: 287-294
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s003329171800082x
OpenAlex: W2795455895
Cited by: 270
References: 28
Citations by year: 2026: 23 · 2025: 49 · 2024: 40 · 2023: 39 · 2022: 34 · 2021: 39 · 2020: 32 · 2019: 12 · 2018: 2
FWCI: 48.35
Type: journal article
Language: en
Open access: closed
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: Deutsche Forschungsgemeinschaft
Topics: Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
Keywords: internet gaming disorder, adolescents, psychosocial etiology, hyperactivity/inattention, self-esteem problems, emotional distress, parental mental health, family dyads, temporal stability, DSM-5
MeSH terms: Psychological Distress, Adolescent, Adolescent Behavior, Adult, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Longitudinal Studies, Male, Self Concept, Behavior, Addictive, Video Games, Internet

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A longitudinal study on psychosocial causes and consequences of Internet gaming disorder in adolescence

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