Ji Yoon Lee

The human brain is constantly active, even at rest. Alpha coherence is an electroencephalography (EEG) rhythm that regulates functional connectivity between different brain regions. However, the relationships between resting-state alpha coherence and N2/P3 components associated with response inhibition and cognitive processes have not been investigated in addictive disorders. The present study investigated the relationships between alpha coherence during the resting state and N2/P3 components of event-related potentials during the Go/Nogo task in healthy controls (HCs) and patients with Internet gaming disorder (IGD). A total of 64 young adults (HC: n = 31; IGD: n = 33) participated in this study. Alpha coherence values at left fronto-central and bilateral centro-temporal electrode sites were significantly correlated with P3 latency in HCs, whereas inverse correlations were observed in patients with IGD. Furthermore, significant differences were observed in the correlation values between the groups. Our results suggest that patients with IGD lack dynamic interactions of functional connectivity between the fronto-centro-temporal regions during the resting state and the event-related potential (ERP) index during cognitive tasks. The findings of this study may have important implications for understanding the neurophysiological mechanisms linking resting-state EEG and task-related ERPs underlying IGD.

This study aimed to examine the relationship of general cognitive function with gaming use, and to identify elements of intelligence predicting increased gaming use. In total, 160 young adults participated in this study. Two clinical groups (n = 97) were defined: excessive gaming users diagnosed with internet gaming disorder (IGD) (n = 64) and the high-risk users (n = 33). The control group (n = 63) was also divided into regular gamers (n = 14) and non-gamers (n = 49). Participants completed the Wechsler Adult Intelligence Scale-IV and self-reported questionnaires regarding IGD severity and gaming hours. The IGD group had significantly lower Full Scale Intelligence Quotient (FSIQ), Verbal Comprehension Index (VCI), and Processing Speed Index (PSI) scores, compared with regular gamers and non-gamers. The IGD group also exhibited lower Working Memory Index (WMI) scores, compared with non-gamers. The high-risk group demonstrated significantly lower PSI score, compared with non-gamers. Furthermore FSIQ, VCI, WMI, and PSI scores were significant predictors of gaming hours in the IGD group. For the high-risk group, FSIQ, WMI, and VCI scores were negatively associated with gaming hours. Our study demonstrates the need to address the importance of enhancing working memory and verbal ability, thus, preventing the development of gaming addiction among individuals at high-risk gamers.

This study investigated differences in the self-efficacy and clinical characteristics which were found relevant to addictive behaviors in young adults according to time spent gaming. To our knowledge, this is the first study to explore self-efficacy in casual gamers relative to patients with internet gaming disorder (IGD) and non-gamers. In total, 158 young adults participated in this study and were divided into three groups: excessive gamers, who were diagnosed with IGD based on the Diagnostic and Statistical Manual of Mental Disorder-fifth edition (DSM-5, n = 71); casual gamers, who played games regularly but did not meet the criteria for IGD (n = 37); and non-gamers/controls, who did not engage in gaming (n = 50). All participants completed self-administered questionnaires, including measures of self-efficacy and clinical features such as the Barratt Impulsiveness Scale, Beck Depression Inventory, Beck Anxiety Inventory, Behavioral Activation/Inhibition Systems, aggression, and psychosocial well-being. There were significant differences in the self-efficacy according to the extent of gaming (excessive gamers < casual gamers < non-gamers). In addition, aggression, impulsivity, depression, anxiety, level of stress, and behavioral inhibition system scores were significantly higher in excessive gamers than in casual gamers and non-gamers. These findings showed that individuals who spend more time playing games tend to have lower self-efficacy. Our study suggests that self-efficacy may protect against or constitute a risk of excessive gaming, particularly among casual gamers. It is necessary to pay attention to enhancing psychological well-being through self-efficacy to prevent addiction in young adult gamers.

Internet gaming disorder (IGD) is a new disease proposed by the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5), and has been studied extensively in relation to depression and impulsivity. The relationship between resilience and disease has been found in a variety of addictive disorders, but studies on IGD are lacking. In this study, 71 IGD patients and 78 healthy controls (HCs) were recruited. Impulsivity, resilience, affects, and the degree of internet game addiction were measured using formal tools. The measured values were analyzed by mediation analysis to evaluate the mediating role of affects on resilience and impulsivity related to IGD symptoms. The IGD group showed higher impulsivity, lower resilience, lower positive affect, and higher negative affect than the HC group. The mediation analysis showed that a positive affect was a mediator between impulsivity and the severity of addiction in both groups. Negative affect mediated impulsivity/resilience and the severity of addiction only in the IGD group. Although the results of this study are based on a narrow category of subjects, who are young male adults around 25 years of age, the results suggest that positive affect can be strengthened to prevent the IGD illness, and that illness symptoms may be alleviated by reducing negative affect.

The increased prevalence of Internet Gaming Disorder (IGD) and the inclusion of IGD in DSM-5 and ICD-11 emphasizes the importance of measuring and describing the IGD symptoms. We examined the psychometric properties of the Diagnostic Interview for Internet Addiction (DIA), a semi-structured diagnostic interview tool for IGD, and verified the application of DIA in clinical practice for Korean adolescents. The DIA is conducted in a manner that interviews both adolescents and their caregivers, and each item has a standardized representative question and various examples. It consists of 10 items based on the DSM-5 IGD diagnostic criteria, which is cognitive salience, withdrawal, tolerance, difficulty in regulating use, loss of interest in other activities, persistent use despite negative results, deception regarding Internet/games/SNS use, use of Internet/games/SNS to avoid negative feelings, interference with role performance, and craving. The study included 103 adolescents divided into three subgroups (mild risk, moderate risk, and addicted group) based on the total score of DIA. Demographic and clinical characteristics were compared among the DIA subgroups using the chi-square test and analysis of variance (ANOVA), and correlation analysis was used to examine the associations of IGD symptoms with clinical variables (e.g., impulsivity, aggression, depression, anxiety, self-esteem). The DIA total score was significantly correlated with Internet and smartphone addiction, depression, state anxiety, self-esteem, impulsivity, aggression, and stress. Furthermore, the moderate risk and addicted group showed significantly higher levels of Internet and smartphone addiction, anxiety, depression, impulsivity, aggression, stress, and lower self-esteem compared with the mild risk group. The Junior Temperament and Character Inventory (JTCI), which measures temperament and character traits, revealed that the mild risk group had higher levels of persistence and self-directedness than did the addicted group. Our findings confirmed the psychometric properties of DIA and the application of the DIA classifications in Korean adolescents.

Background: Resilience, an important protective factor against Internet gaming disorder (IGD), is the ability to recover from negative emotional experiences and constitutes a flexible adaptation to stress. Despite the importance of resilience in predicting IGD, little is known about the relationships between resilience and the neurophysiological features of IGD patients. Methods: We investigated these relationships using resting-state electroencephalography (EEG) coherence, by comparing IGD patients (n = 35) to healthy controls (n = 36). To identify the resilience-related EEG features, the IGD patients were divided into two groups based on the 50th percentile score on the Connor–Davidson Resilience Scale: IGD with low resilience (n = 16) and IGD with high resilience (n = 19). We analyzed differences in EEG coherence among groups for each fast frequency band. The conditional indirect effects of resilience were examined on the relationships between IGD and resilience-related EEG features through clinical symptoms. Results: IGD patients with low resilience had higher alpha coherence in the right hemisphere. Particularly, resilience moderated the indirect effects of IGD on alpha coherence in the right hemisphere through depressive symptoms and stress level. Conclusion: These neurophysiological findings regarding the mechanisms underlying resilience may help to establish effective preventive measures against IGD.

The behavioral inhibition/activation systems (BIS/BAS) have been considered to be predictors of Internet addiction, mediated by clinical variables such as anxiety and depression. However, resilience has been suggested as a protective factor toward Internet addiction, and certain sex differences in resilience buffering the effects of vulnerability have been reported. Thus, the aim of this study was to identify any role of resilience that might moderate the effects of BIS/BAS on Internet addiction through multiple clinical variables in boys and girls. A total of 519 middle-school students (268 boys and 251 girls, all 14 years old) were administered a questionnaire battery that measures Internet addiction, BIS/BAS, depression, anxiety, impulsivity, anger, and resilience. We used the PROCESS macro in SPSS to perform moderation and mediation analysis. Findings revealed that although a somewhat similar mediation model was supported in both sexes, moderating effects of resilience only emerged in girls. The results showed a protective role of resilience differing between sexes. These results suggest that clinicians should consider sex in the way resilience works as a protective factor against Internet addiction and focus on mitigating the effects of vulnerability by enhancing resilience in female Internet addicts.

Background: This study aimed to explore relationships between impulsivity, interpersonal relationships, depression, and Internet Gaming Disorder (IGD) symptoms. Methods: A total of 118 young adults participated in this study: 67 IGD patients who met five or more of the DSM-5 diagnostic criteria for IGD and 56 healthy controls. We administered questionnaires to assess IGD symptoms (Young’s Internet Addiction Test; Y-IAT), impulsivity (Barratt Impulsiveness Scale; BIS-11), interpersonal relationship (Relationship Change Scale; RCS), and depression (Beck Depression Inventory; BDI). We used PROCESS macro in SPSS to perform mediation analysis. Results: IGD symptom was positively related to depression and impulsivity, and negatively related to the quality of interpersonal relationships. Mediation analysis revealed full mediation effects of interpersonal relationships and depression on the association between impulsivity and IGD symptoms in the IGD group. Specifically, even after adjusting for gender as a covariate, high impulsivity was associated with greater difficulty with interpersonal relationships; which further affected depression and increased the risk of IGD. Conclusions: These results demonstrate the importance of early intervention in IGD patients, particularly in young adults with high impulsivity. When intervening in adults’ IGD, we should consider not only individual factors (e.g., depression) but also socioenvironmental factors (e.g., interpersonal relationships).