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Loot boxes are digital containers of randomised rewards available in many video games. Due to similarities between some loot boxes and traditional forms of gambling, concerns regarding the relationship between spending on loot boxes in video games and symptoms of problematic gambling have been expressed by policy makers and the general public. We present the first investigation of these concerns in large cross-sectional cross-national samples from three countries (Aotearoa New Zealand, Australia, and the United States). A sample of 1,049 participants were recruited through Qualtrics' Survey Targeting service from a broad cross-section of the population in Australia (n = 339), Aotearoa New Zealand (n = 323), and the United States (n = 387). Participants answered a survey assessing problem gambling, problem gaming symptomology, and how much they spent on loot boxes per month. On average, individuals with problem gambling issues spent approximately $13 USD per month more on loot boxes than those with no such symptoms. Loot box spending was also associated with both positive and negative moods, albeit with small effect sizes. Analyses showed both interactions and correlations between problematic gambling and problematic gaming symptoms, indicating both some commonality in the mechanisms underlying, and independent contributions made by, these proposed diagnostic criteria. These results provide context for dialogues regarding how best to reduce the impacts of loot box spending among those with problematic gambling symptoms.

SUMMARYVideo-gaming is an increasingly prevalent activity among children and adolescents that is known to influence several areas of emotional, cognitive and behavioural functioning. Currently there is insufficient experimental evidence about how extended video-game play may affect adolescents' sleep. The aim of this study was to investigate the shortterm impact of adolescents' prolonged exposure to violent video-gaming on sleep. Seventeen male adolescents (mean age = 16 ± 1 years) with no current sleep difficulties played a novel, fast-paced, violent videogame (50 or 150 min) before their usual bedtime on two different testing nights in a sleep laboratory. Objective (polysomnography-measured sleep and heart rate) and subjective (single-night sleep diary) measures were obtained to assess the arousing effects of prolonged gaming. Compared with regular gaming, prolonged gaming produced decreases in objective sleep efficiency (by 7 ± 2%, falling below 85%) and total sleep time (by 27 ± 12 min) that was contributed by a near-moderate reduction in rapid eye movement sleep (Cohen's d = 0.48). Subjective sleep-onset latency significantly increased by 17 ± 8 min, and there was a moderate reduction in self-reported sleep quality after prolonged gaming (Cohen's d = 0.53). Heart rate did not differ significantly between video-gaming conditions during pre-sleep game-play or the sleep-onset phase. Results provide evidence that prolonged video-gaming may cause clinically significant disruption to adolescent sleep, even when sleep after video-gaming is initiated at normal bedtime. However, physiological arousal may not necessarily be the mechanism by which technology use affects sleep.

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