No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, https://doi.org/10.1371/journal.pone.0240032, http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2017-10293-002&site=ehost-live&scope=site, https://casp-uk.net/wp-content/uploads/2018/01/CASP-Systematic-Review-Checklist_2018.pdf, http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2013-30916-004&site=ehost-live&scope=site, http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2011-24261-006&site=ehost-live&scope=site, http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2011-11090-003&site=ehost-live&scope=site, http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2011-02644-006&site=ehost-live&scope=site, http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2010-04134-016&site=ehost-live&scope=site, http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2010-13062-011&site=ehost-live&scope=site, http://www.ncbi.nlm.nih.gov/books/NBK209518/. More recently, Multiplayer Online Battle Arena (MOBA) games (e.g. Of the 28 studies that reported associations between anxiety and gaming disorder, results from only 22 of these studies were incorporated into reviews (Fig 6, including citations [34–75]). Due to this selective outcome reporting, incomplete outcome specification, and lack of systematic assessment of risk of bias, we found no reviews that could be considered reliable. No, Is the Subject Area "Metaanalysis" applicable to this article? Writing – review & editing, Affiliation Thus, none were classified as reliable according to prespecified quality criteria. Although there is much research to be done before we understand the full societal impact of IGD, there is already evidence of its impact on individuals. Gaming disorder is a new classification, so there is no clear treatment plan in place yet. Six studies reported additional cross-sectional depression results that were not incorporated into any review. Irish child and adolescent psychiatrists are reporting increasing presentations to their clinics of parents seeking help for their child’s gaming addiction (Kelleher, Reference Kelleher2019). An exploratory study linking psychological factors to mobile social game addiction, Gambling near-misses enhance motivation to gamble and recruit win-related brain circuitry, A national survey of online gambling behaviours, Contextual influences on mobile player experience–A game user experience model, The economics of free: Freemium games, branding and the impatience economy, Effect of playing violent video games cooperatively or competitively on subsequent cooperative behavior, Cyberpsychology, Behavior, and Social Networking, Internet gaming disorder: trends in prevalence 1998–2016, Pathological video-game use among youth ages 8 to 18: a national study, Pathological video game use among youths: a two-year longitudinal study, Association between internet gaming disorder or pathological video-game use and comorbid psychopathology: a comprehensive review, International Journal of Environmental Research And Public Health, The American Journal of Drug and Alcohol Abuse, Psychobiology of the near-miss in fruit machine gambling, Online computer gaming: advice for parents and teachers, The role of context in online gaming excess and addiction: some case study evidence, International Journal of Mental Health and Addiction, The psychosocial impact of professional gambling, professional video gaming & eSports. For more information about PLOS Subject Areas, click Reference Torres-Rodríguez, Griffiths and Carbonell2018). Gaming Disorder is characterized by: (1) impairment in controlling gaming (e.g., frequency, duration); (2) increasing salience of gaming and preference for gaming over other activities; and (3) continuation of gaming despite negative consequences (i.e., significant impairment in daily life - family, school, and work). Higher frequency of playing games and more years playing games have also been associated with the development of a gaming disorder (Mihara & Higuchi, Reference Mihara and Higuchi2017). During this time, online gaming was primarily text based, such as the classic game Oregon Trail (1971), where players could type instructions to their characters in order to complete specific objectives. This definition, in turn, was informed by items identified from the Critical Appraisal Skills Programme (CASP), A Measurement Tool to Assess systematic Reviews (AMSTAR), and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) tools [9,22,23]. Close this message to accept cookies or find out how to manage your cookie settings. Yes Various concerns identified during this summary of systematic reviews are worthy of further discussion. For example, the 2010 study by Rehbein and colleagues [34] reported two findings related to depression—a positive association between gaming disorder and suicidal thoughts in one subsample, but a null association between gaming disorder and self-reported depression in the full sample. CBT has a larger base of positive evidence compared to other treatment modalities, including medication (D. L. King et al., Reference King, Delfabbro, Wu, Doh, Kuss, Pallesen and Sakuma2017). Results suggested that Internet Gaming Disorder symptoms had similar prevalence before and after the age of 15 in males (21% vs. 19%) and in females (6% vs. 7%) respectively and was significantly associated with decreased life satisfaction in older males, even after adjusting for parental support, depression, and economic conditions. broad scope, and wide readership – a perfect fit for your research every time. The specific measurement or scale asked questions about specific symptoms of gaming disorder rather than only experiences related to video game use in general, such as time spent playing games or the experience of time loss. On sensitivity analysis, where measurement of gaming disorder also included using an Internet addiction scale in a gaming disorder clinical population, the percent remained similar, ranging from 58.6% to 93.6%. Referral pathways need to be established to manage the current presentations of gaming disorder to our services with the goal of providing the most up-to-date and effective treatment options for these patients. Reference Clark, Lawrence, Astley-Jones and Gray2009) and are associated with addiction to slot machines (Mark Griffiths, Reference Griffiths1991) as well as video games (D. King et al. Elements of outcome domains required for complete outcome specification in health research. Roles This is further explored in the following sections. For example, in one study, consumers were shown to spend more money using debit cards rather than cash payments, given the increased transparency of cash payments (Runnemark et al. }. The consequences of internet gaming disorder. Yes Commentary on: Scholars' open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal (Aarseth et al.) e0240032. and Behavioral Sciences Institute, Radboud University, Nijmegen, Netherlands, Roles Otherwise, we classified the measurement according to the original scale from which it was adapted. A commission in the United Kingdom determinedlast year that “l… Further research is required into efficacious treatment programmes for gaming disorder. MDG 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 Responsibility in Gambling Trust), a charitable body that funds its research program based on donations from the gambling industry. This is a timely inclusion because online gaming is a rapidly growing and popular industry, as evidenced by the reported revenue of over $100 billion (US) generated worldwide in 2017 (Batchelor, Reference Batchelor2018). The American Psychiatric Association recently included Internet gaming disorder (IGD) as a potential diagnosis, recommending that further study be conducted to help illuminate it more clearly. This allowed us to explore the issue of selective outcome reporting in reviews. "crossMark": true, "metricsAbstractViews": false, In this context, because five studies chose to conduct qualitative syntheses instead of quantitative syntheses (i.e., meta-analyses), we considered their results to have been combined appropriately. We described associations to be ‘positive and consistent’ at the study level if the count of statistically-significant positive associations was greater than the total number of negative or null associations. The majority of people with mobile phones engage in mobile gaming, with 72.3% of mobile users in the USA engaging in mobile gaming (WePC, 2019). We also conducted a sensitivity analysis to examine how our findings differed when other measurements (e.g., the Young Internet Addiction Test) were used with a clinical population diagnosed with gaming disorder. This data will be updated every 24 hours. Finally, in our search of PubMed we used the PubMed publication type filters of “systematic review”, “review,” or “meta-analysis”, while we broadened our search of PsycInfo to include these terms as text-words in all fields. They included a total of 196 unique studies. Reference Kato, Cole, Bradlyn and Pollock2008). Reference Song, Park, Han, Roh, Son, Choi and Lee2016). What is eSports and why do people watch it? To ensure that we evaluated this potential source of bias, we expanded the scope of our preregistered protocol to include examining study-level outcomes and how they were reported in reviews. Gaming disorder has been described as an urgent public health problem and has garnered many systematic reviews of its associations with other health conditions. https://doi.org/10.1371/journal.pone.0240032.s001, https://doi.org/10.1371/journal.pone.0240032.s002, https://doi.org/10.1371/journal.pone.0240032.s003, https://doi.org/10.1371/journal.pone.0240032.s004, https://doi.org/10.1371/journal.pone.0240032.s005, https://doi.org/10.1371/journal.pone.0240032.s006. Competing interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Dr. Colder Carras has spoken to the World Health Organization about this topic at the request of the Entertainment Software Association but has received no funding, honorarium, fees, meals, lodging, donations or reimbursement. Google Scholar | Crossref | Medline Kuss, DJ, Griffiths, MD ( 2012 ) Internet gaming addiction: A … Whether consistent or inconsistent, reviews incorporated only positive findings. Data on depression and anxiety consisted of study scale, type of analysis, direction of association (positive, negative, or null), and how each review reported the outcome of the study (positive, negative, null, unclear, or absent). Addiction to gaming is described in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is used by mental health professionals to diagnose mental disorders. However, research has shown that reviews in some fields provide low-quality evidence, are unreliable, and can be sources of bias themselves [8,10,11]. Gaming-disordered patients spent almost double the amount of time gaming per week (31 hours) compared to their non-disordered counterparts (19 hours) prior to onset of the gaming addiction in one longitudinal study (D. A. Gentile et al., Reference Gentile, Choo, Liau, Sim, Li, Fung and Khoo2011). Yes Ensuring that systematic and accurate measurement of gaming disorder in studies and accurate measurement and reporting of exposures, outcomes, and conclusions in reviews are vital to inform ongoing decision making regarding diagnosis, treatment, and public health interventions. While gaming is an important form of entertainment, excessive gaming may cause serious consequences for players. The pattern of gaming behavior may be continuous or epi-sodic and recurrent. Project administration, Reference King, Gainsbury, Delfabbro, Hing and Abarbanel2015). A recent systematic review reported the most common associations with gaming disorder are anxiety (92%), depression (89%), Attention Deficit Hyperactivity Disorder (ADHD)/hyperactivity (89%), and social phobia/obsessive-compulsive symptoms (75%) (González-Bueso et al., Reference González-Bueso, Santamaría, Fernández, Merino, Montero and Ribas2018). Three of these studies reported null findings and in one of those cases, results were null in both bivariable and multivariable analyses. Internet gaming disorder was included as a condition for further research in the 5th edition of the Diagnostic and Statistical Manual (DSM-5) and the diagnosis of gaming disorder has been added to the 11th edition of the World Health Organization (WHO) International Classification of Diseases (ICD-11) [1,2]. Most reviews discussed limitations at the study, outcome, and review level, but two reviews did not discuss limitations systematically [27,29]. Reference Shi, Renwick, Turner and Kirsh2019). As clinical and policy decisions are heavily reliant on reliable, accurate, and unbiased evidence synthesis; researchers, clinicians, and policymakers should consider the implications of selective outcome reporting. Wojtasiński, Marcin The authors are grateful to Michael M. Hughes for assistance with the graphic design and formatting of figures for publication. Formal analysis, for this article. Reference King, Delfabbro and Griffiths2010; M. D. Griffiths & Nuyens, Reference Griffiths and Nuyens2017). We described an association as ‘null’ if there were more null findings or negative associations than positive. This study was conducted using publicly-available information and therefore did not require Institutional Board (IRB) approval. Is the Subject Area "Games" applicable to this article? Internet Gaming Disorder and Its Relationships With Student Engagement and Academic Performance: 10.4018/IJCBPL.2020100102: Recently, the research community increased its investigations of the student engagement construct in association with learning and academic success. For more information about PLOS Subject Areas, click [17]. Mobile games are now the largest growing gaming market and represent the largest share of the global games market, with more than 50% of the market share (Wijman, Reference Wijman2018). Gaming disorder can present with a number of co-morbid psychopathologies. Investigation, Writing – review & editing, Affiliation Gamers can view gaming as a meaningful and purposeful activity and as a large part of their lives (Shi et al. Although these are optional side games in their respective games, they still involve betting, chance, and financial rewards (in the form of currency that can be spent within the game) (D. L. King et al., Reference King, Gainsbury, Delfabbro, Hing and Abarbanel2015). No, Is the Subject Area "Internet addiction" applicable to this article? It is possible that our findings may have been different had we included reviews in other languages. The 2018 WHO draft 11th Revision of the ICD-11 denotes the disorder as a pattern of “digital-gaming” or “video-gaming” behavior characterized by impaired control over gaming activity, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and the continuation or escalation of gaming despite the … However, using a narrow definition was our aim. On 13 May, 2018, Ireland hosted the Three Ireland EStars League, an 8-week esports competition considered the first major esports tournament in Ireland (Cocking, Reference Cocking2018). These activities, particularly massively multiplayer online role-playing games, deliver pleasure, a sense of achievement, social interaction, and an immersive experience to online gamers. David Columb has no conflicts of interest to disclose. Reference King, Delfabbro, Wu, Doh, Kuss, Pallesen and Sakuma2017). There are many reasons why people engage in online gaming. * Views captured on Cambridge Core between 01st August 2019 - 24th December 2020. When the clinical population was unclear or was not diagnosed with gaming disorder and Internet addiction scales or other specific measurements/scales/interviews were used, we did not characterize this as gaming disorder (e.g., Young Internet Addiction Test in a clinical population of patients with gambling disorder). The searches yielded 842 records, of which, seven reviews were eligible for inclusion in this overview (Fig 4). Internet gaming disorder does not qualify as a mental disorder Pravin Dullur and Vladan Starcevic Australian & New Zealand Journal of Psychiatry 2017 52 : 2 , 110-111 In recent years, the evidence regarding Internet Gaming Disorder (IGD) suggests that some personality traits are important risk factors for developing this problem. Primary concerns have been noted in a number of academic publications (see references). Published online by Cambridge University Press:  This changed with Maze War (1973) where, for the first time, online players could interact with each other within the game itself. These can be broken down into three overarching reasons for online gaming: for achievement, for social reasons, and for immersion in another world (Yee, Reference Yee2006). No reviews specified which outcomes of a study would be used in synthesis. The use of alternative currencies in these games has been described as a way to hide the true value of the purchases (Duverge, Reference Duverge2016). However, these gains tend to be short term and further support post-treatment completion is likely required (Stevens et al. In response to this gap in our understanding, the present study, a first for this research topic, estimated the period prevalence of this … In the sensitivity analysis, one additional study [65] reported inconsistent associations in bivariable and multivariable analysis and was reported as positive in the one review that contained it. Only one review assessed risk of bias. Reference Zajac, Ginley, Chang and Petry2017). Resources, An overview of structural characteristics in problematic video game playing. To our knowledge, the current analysis is the first comprehensive examination of selective outcome reporting in systematic reviews of gaming disorder, a relatively new clinical entity. Project administration, Profits from micro-transactions have been substantial, with one company reporting $4 billion (US) in revenue from micro-transactions in 2017 (Makuch, Reference Makuch2018), just over half of its total revenue for the year. The disorder is distinguished from other related disorders, such as technology overuse, Internet addiction, and social networking addiction [3]. Many recent commentaries on the need for a diagnosis of gaming disorder use terms like “Internet addiction or Gaming disorder” [6], “Internet-related disorders including gaming disorder” [4], and “Internet addiction including gaming addiction” [5], pointing to the persistent overlap in measurement of these problematic behaviors. The specific measurement or scale asked questions about computer, video, online, or digital game use in general, rather than just a single game (e.g., World of Warcraft. Completely specifying all elements of outcomes (i.e., domain, specific measurements, specific metrics, methods of aggregation, and time-points of interest) or explicitly noting whether all variations of a given outcome element will be extracted is the current standard for evidence synthesis [15,26,76]. She sometimes plays video games herself. Selective reporting of outcomes can be hard to detect, and further research into the impact of selective inclusion of results in reviews is needed to advance the understanding of this form of bias on evidence synthesis [77,78]. "lang": "en" "subject": true, Supervision, We narratively describe the characteristics of included reviews and their reliability. All extracted data and derived variables are available in S1 Dataset. Why do players buy in-game content? https://doi.org/10.1371/journal.pone.0240032.g005, https://doi.org/10.1371/journal.pone.0240032.g006. Now that gaming disorder has been recognized as a disorder by the WHO, ensuring systematic and accurate measurement of gaming disorder in studies and accurate reporting of exposures, outcomes, and conclusions in reviews are vital for ongoing decision-making regarding diagnosis, treatment, and public health interventions. Journal of Clinical Psychology: In Session 68: 1185 – 1195. Reference Stevens, King, Dorstyn and Delfabbro2018). The percentage of studies within a review that measured gaming disorder ranged from 56.8% to 93.6%. The number of included studies per review ranged from 24 to 63, with a mean of 46. In relation to specific treatment efficacy, there is a need for further research in this area. According to this definition, a review is reliable when its authors did each of the following: Because we also examined each study included in the reviews, we added an additional criterion that review authors should have: We classified a review as reliable only if all six of the criteria were met. Increasing transparency of reviews and minimizing the risk of bias requires the effort of multiple agents. All reported associations within the studies were extracted from the original study reports and characterized as present and positive, present and negative, present and null, unclear, or absent. Validation, With increased use and popularity of online gaming, there is an increased risk of developing problematic online gaming and gaming disorder for a small minority of individuals (Naskar et al.