Gaming, substance use and distress within a cohort of online gamblers

  • Frida André
    Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden. https://orcid.org/0000-0003-2909-8470
  • Anders Håkansson
    Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund; Region Skåne, Malmö Addiction Centre, Gambling Disorder Unit, Malmö, Sweden. https://orcid.org/0000-0002-5800-8975
  • Emma Claesdotter-Knutsson
    Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund; Region Skåne, Child and Adolescent Psychiatry, Regional Out-patient Care, Lund University Hospital, Lund, Sweden. https://orcid.org/0000-0002-6832-2482

ABSTRACT

Background: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included Internet Gaming Disorder (IGD) as a tentative diagnosis and inquires for additional research. The research on gaming is inconsistent regarding measurement approach and diagnostic cut-offs. Some scholars suggest the core approach, accentuating some of the diagnostic criteria to avoid pathologizing harmless behavior. Also, the co-occurrence of gaming and other addictions, gambling in specifically, is frequently reported but poorly understood. The present study aimed to explore gaming within a population of online gamblers in order to evaluate the core approach but also to investigate the possible co-occurrence of different addictions.
Design and Methods: The present study is derived from material collected for a study on online gambling. The study addressed 1007 adult individuals from the general population who had gambled for money on an online casino site or an online betting site, on at least 10 occasions during the past 12 months.
Results: Both the level of distress and problem gambling increased as the severity of gaming increased. The co-occurrence of problems with alcohol, illicit drug use/prescription sedatives/strong painkillers and gambling was roughly 50% among the addictive gamers.
Conclusion: The present study suggests that the core approach manages to distinguish in severity of gaming in regards to interference and comorbidity. We also brought light to the occurrence of gaming within a population of gamblers and our results indicate that this specific group of addicted gamers are particularly burdened by co-occurrent addictive behaviors and severe distress.

REFERENCES

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association, 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596

Yau YHC, Potenza MN. Gambling disorder and other behavioral addictions. Harvard Rev Psychiatr 2015;23:134-46.

Organization WH. International classification of diseases for mortality and morbidity statistics (11th Revision). 2018.

Ferguson CJ, Coulson M, Barnett J. A meta-analysis of pathological gaming prevalence and comorbidity with mental health, academic and social problems. J Psychiatr Res 2011;45:1573-8. DOI: https://doi.org/10.1016/j.jpsychires.2011.09.005

González-Bueso V, Santamaría JJ, Fernández D, et al. Association between internet gaming disorder or pathological video-game use and comorbid psychopathology: A comprehensive review. Int J Environ Res Public Health 2018;15:668. DOI: https://doi.org/10.3390/ijerph15040668

Lemmens JS, Valkenburg PM, Peter J. Psychosocial causes and consequences of pathological gaming. Comput Hum Behav 2011;27:144-52. DOI: https://doi.org/10.1016/j.chb.2010.07.015

Turel O, Bechara A. Little video-gaming in adolescents can be protective, but too much is associated with increased substance use. Subst Use Misuse 2019;54:384-95. DOI: https://doi.org/10.1080/10826084.2018.1496455

Marmet S, Studer J, Wicki M, et al. Unique versus shared associations between self-reported behavioral addictions and substance use disorders and mental health problems: A commonality analysis in a large sample of young Swiss men. J Behav Addict 2019;8:664-77. DOI: https://doi.org/10.1556/2006.8.2019.70

Sanders J, Williams R. The relationship between video gaming, gambling, and problematic levels of video gaming and gambling. J Gambl Stud 2019;35:559-69. DOI: https://doi.org/10.1007/s10899-018-9798-3

Walther B, Morgenstern M, Hanewinkel R. Co-occurrence of addictive behaviours: personality factors related to substance use, gambling and computer gaming. Eur Addict Res 2012;18:167-74. DOI: https://doi.org/10.1159/000335662

Sussman S, Lisha N, Griffiths M. Prevalence of the addictions: a problem of the majority or the minority? Eval Health Prof 2011;34:3-56. DOI: https://doi.org/10.1177/0163278710380124

Konkoly Thege B, Hodgins DC, Wild TC. Co-occurring substance-related and behavioral addiction problems: A person-centered, lay epidemiology approach. J Behav Addict 2016;5:614-22. DOI: https://doi.org/10.1556/2006.5.2016.079

King DL, Ejova A, Delfabbro PH. Illusory control, gambling, and video gaming: an investigation of regular gamblers and video game players. J Gambl Stud 2012;28:421-35. DOI: https://doi.org/10.1007/s10899-011-9271-z

Paulus FW, Ohmann S, von Gontard A, Popow C. Internet gaming disorder in children and adolescents: a systematic review. Dev Med Child Neurol 2018;60:645-59. DOI: https://doi.org/10.1111/dmcn.13754

Yau YH, Potenza MN. Gambling disorder and other behavioral addictions: recognition and treatment. Harv Rev Psychiatry 2015;23:134-46. DOI: https://doi.org/10.1097/HRP.0000000000000051

Aarseth E, Bean AM, Boonen H, et al. Scholars' open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal. J Behav Addict 2017;6:267-70. DOI: https://doi.org/10.1556/2006.5.2016.088

Stevens MW, Dorstyn D, Delfabbro PH, King DL. Global prevalence of gaming disorder: A systematic review and meta-analysis. Aust N Z J Psychiatry 2021;55:553-68. DOI: https://doi.org/10.1177/0004867420962851

Brunborg GS, Hanss D, Mentzoni RA, Pallesen S. Core and peripheral criteria of video game addiction in the game addiction scale for adolescents. Cyberpsychol Behav Soc Netw 2015;18:280-5. DOI: https://doi.org/10.1089/cyber.2014.0509

Brunborg GS, Mentzoni RA, Melkevik OR, et al. Gaming addiction, gaming engagement, and psychological health complaints among Norwegian adolescents. Media Psychol 2013;16:115-28. DOI: https://doi.org/10.1080/15213269.2012.756374

Charlton JP, Danforth IDW. Distinguishing addiction and high engagement in the context of online game playing. Comput Hum Behavr 2007;23:1531-48. DOI: https://doi.org/10.1016/j.chb.2005.07.002

Lehenbauer-Baum M, Klaps A, Kovacovsky Z, et al. Addiction and engagement: An explorative study toward classification criteria for internet gaming disorder. Cyberpsychol Behav Soc Netw 2015;18:343-9. DOI: https://doi.org/10.1089/cyber.2015.0063

Lemmens JS, Valkenburg PM, Peter J. Development and validation of a game addiction scale for adolescents. Media Psychol 2009;12:77-95. DOI: https://doi.org/10.1080/15213260802669458

King DL, Chamberlain SR, Carragher N, et al. Screening and assessment tools for gaming disorder: A comprehensive systematic review. Clin Psychol Rev 2020;77:101831. DOI: https://doi.org/10.1016/j.cpr.2020.101831

Mentzoni R, Brunborg G, Molde H, et al. Problematic video game use: Estimated prevalence and associations with mental and physical health. Cyberpsychol Behav Soc Netw 2011;14:591-6. DOI: https://doi.org/10.1089/cyber.2010.0260

Finseras TR, Pallesen S, Mentzoni RA, et al. Evaluating an internet gaming disorder scale using Mokken scaling analysis. Front Psychol 2019;10:911. DOI: https://doi.org/10.3389/fpsyg.2019.00911

Charlton JP. A factor-analytic investigation of computer ‘addiction' and engagement. Br J Psychol 2002;93):329-44. DOI: https://doi.org/10.1348/000712602760146242

Snodgrass JG, Zhao W, Lacy MG, et al. Distinguishing core from peripheral psychiatric symptoms: addictive and problematic internet gaming in North America, Europe, and China. Cult Med Psychiatry 2019;43:181-210. DOI: https://doi.org/10.1007/s11013-018-9608-5

Andre F, Broman N, Hakansson A, Claesdotter-Knutsson E. Gaming addiction, problematic gaming and engaged gaming – Prevalence and associated characteristics. Addict Behav Rep. 2020;12:100324. DOI: https://doi.org/10.1016/j.abrep.2020.100324

Håkansson A, Widinghoff C. Gambling despite nationwide self-exclusion-A survey in online gamblers in Sweden. Front Psychiatry 2020;11:599967. DOI: https://doi.org/10.3389/fpsyt.2020.599967

Hakansson A, Widinghoff C. Over-indebtedness and problem gambling in a general population sample of online gamblers. Front Psychiatry 2020;11:7. DOI: https://doi.org/10.3389/fpsyt.2020.00007

Wynne H. Introducing the Canadian problem gambling index. 2021.

Romild U, Volberg R, Abbott M. The Swedish Longitudinal Gambling Study (Swelogs): design and methods of the epidemiological (EP-) track. Int J Methods Psychiatr Res 2014;23:372-86. DOI: https://doi.org/10.1002/mpr.1449

Håkansson A. Impact of COVID-19 on online gambling – A general population survey during the pandemic. Front Psychol 2020;11:568543. DOI: https://doi.org/10.3389/fpsyg.2020.568543

Kessler RC, Andrews G, Colpe LJ, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002;32:959-76. DOI: https://doi.org/10.1017/S0033291702006074

Prochaska JJ, Sung HY, Max W, et al. Validity study of the K6 scale as a measure of moderate mental distress based on mental health treatment need and utilization. Int J Methods Psychiatr Res 2012;21:88-97. DOI: https://doi.org/10.1002/mpr.1349

McCarthy S, Thomas SL, Bellringer ME, Cassidy R. Women and gambling-related harm: a narrative literature review and implications for research, policy, and practice. Harm Reduct J 2019;16:18. DOI: https://doi.org/10.1186/s12954-019-0284-8

Rattray J, Jones MC. Essential elements of questionnaire design and development. J Clin Nurs 2007;16:234-43. DOI: https://doi.org/10.1111/j.1365-2702.2006.01573.x