Background: Gaming disorder was included in the latest revision of the International Classification of Diseases (11th ed.). Worldwide, prevalence estimates of gaming disorder are considerably heterogeneous and often appear to be exceedingly high. However, few studies have examined the methodological, cultural and/or demographic factors that might explain this phenomenon. This review employed meta-analytic techniques to compute the worldwide-pooled prevalence of gaming disorder and evaluate the potential contributing factors for varied prevalence estimates. Method: Prevalence estimates were extracted from 53 studies conducted between 2009 and 2019, which included 226,247 participants across 17 different countries. Study findings were meta-analyzed using a random-effects model. Subgroup and moderator analyses examined potential sources of heterogeneity, including assessment tool and cut-off, participant age and gender, sample size and type, study region, and year of data collection. Results: The worldwide prevalence of gaming disorder was 3.05% (confidence interval: [2.38, 3.91]); this figure was adjusted to 1.96% [0.19, 17.12] when considering only studies that met more stringent sampling criteria (e.g. stratified random sampling). However, these estimates were associated with significant variability. The choice of screening tool accounted for 77% of the variance, with the Lemmens Internet gaming disorder-9, Gaming Addiction Identification Test and Problematic Videogame Playing scales associated with the highest estimates. Adolescent samples, lower cut-off scores and smaller sample size were significant predictors of higher prevalence. Gaming disorder rates were approximately 2.5:1 in favor of males compared to females. Conclusion: The worldwide prevalence of gaming disorder appears to be comparable to obsessive-compulsive disorder and some substance-related addictions, but lower than compulsive buying and higher than problem gambling. Gaming disorder prevalence rates appear to be inflated by methodological characteristics, particularly measurement and sampling issues.

Study design: Cross-sectional survey. Objective: To examine factors that contribute to the process of positive adjustment, or resilience, in an adult community sample with spinal cord injury (SCI). Setting: South Australian Spinal Cord Injury Service, Hampstead Rehabilitation Centre, South Australia, Australia Methods: A postal survey comprising standardised measures of resilience (Connor-Davidson Resilience Scale-10 item), self-efficacy (Moorong Self-Efficacy Scale), locus of control (Locus of Control of Behaviour Scale) and psychological distress (Depression Anxiety Stress Scale-21 item). Results: Of 60 respondents, 58% reported moderate to high levels of resilience. Resilience correlated significantly with high selfefficacy (r ¼ 0.68, Po0.01), internal locus of control (r ¼ À0.52, Po0.01) and low psychological distress (depression r ¼ À0.68, Po0.01; anxiety r ¼ À0.55, Po0.01; stress r ¼ À0.67, Po0.01). In comparison, resilience was not significantly influenced by degree of neuropathic pain (r ¼ À0.23, P40.05), time since injury (r ¼ À0.14, P40.05), gender (t (58) ¼ À0.92, P40.05), lesion completeness (t (57) ¼ À0.86, P40.05), or SCI diagnosis (t (58) ¼ À1.21, P40.05). A multiple regression indicated that psychological distress and self-efficacy were the only two variables that uniquely contributed to resilient behaviour. Conclusion: Resilience is an important psychological process in the longer-term management of SCI which can be promoted by targeting rehabilitation interventions towards mood management in addition to self efficacy beliefs. Larger-scale research will help to validate these results.

Objective Although there is sufficient research and clinical evidence to support the inclusion of gaming disorder in the latest revision of the International Classification of Diseases, relatively little is known about the effectiveness of first‐line psychological treatment for gaming disorder or internet gaming disorder (IGD) as it is listed in the Diagnostic and Statistical Manual. This systematic review employed meta‐analytic techniques to determine the effectiveness of cognitive–behavioural therapy (CBT) for IGD on four key outcomes: IGD symptoms, anxiety, depression, and time spent gaming. Method A database search identified 12 independent CBT studies. Effect size estimates (Hedges' g) with associated confidence intervals, prediction intervals, and p values for each pre–post treatment outcome, were calculated. Study reporting quality was evaluated in accordance with the Consolidated Standards of Reporting Trials guidelines. Subgroup and moderator analyses were undertaken to investigate potential sources of heterogeneity. Results CBT demonstrated high efficacy in reducing IGD symptoms (g = 0.92; [0.50, 1.34]) and depression (g = 0.80, [0.21, 1.38]), and showed moderate efficacy in reducing anxiety (g = 0.55, [0.17, 0.93]) at post‐test. There was insufficient power to determine whether CBT was capable of reducing time spent gaming. Treatment gains at follow‐up were nonsignificant across the four treatment outcomes. Conclusions The pooled findings suggest that CBT for IGD is an effective short‐term intervention for reducing IGD and depressive symptoms. However, the effectiveness of CBT for reducing actual time spent gaming was unclear. Given the limitations of this evidence base, there is a need for more rigorous studies to determine the potential long‐term benefits of CBT for IGD. Public Health Significance Statement Given the rise in treatment demand for internet gaming disorder (IGD) and problematic gaming, it is necessary to determine which treatments are most effective for whom and under which conditions. This review shows that cognitive‐behavioural therapy for IGD, which is often considered the first‐line therapy, can improve IGD symptoms and comorbid depression. However, treatment gains tend to be short‐term and their effect in reducing time spent gaming is unclear. Programs that target problematic gaming may be improved by additional support beyond the standard program of therapy sessions. More funding and resources are needed to support the development of a more rigorous evidence base on IGD and its treatment.

The concept of resilience remains under-researched in the multiple sclerosis literature. Consequently, current understanding of the unique and joint contribution of disability-specific variables, cognitive-behavioural skills and social resources to this dynamic process is limited. A holistic model of resilience was therefore developed and tested. Results of an online survey completed by 196 adults with multiple sclerosis revealed both direct and indirect pathways to resilience, with positive affect and self-efficacy being the strongest predictors. The findings lend support to psychological interventions which focus on promoting the personal resources and assets needed to cope effectively with multiple sclerosis.

The effectiveness of psychological services provided remotely, telepsychology, for the management of Posttraumatic Stress Disorder (PTSD) was evaluated. Eleven studies (n = 472 participants) were identified from electronic database searches. Study quality was assessed, with studies characterised by small and underpowered samples. Effect sizes and associated confidence intervals (CIs) were calculated to determine the direction and magnitude of treatment change. Short-term treatment gains were reported for internet and video-based interventions. This included significant medium to large improvements (d range = 0.66-3.22) in cognitive and behavioural symptoms of depression, generalised anxiety and posttraumatic stress. However, the equivalence of telepsychology and face-to-face psychotherapy could not be determined, with few comparative studies available. Both treatment gains and deterioration were noted 1 to 6 months following treatment cessation, although this was based on limited follow-up data. Further larger scale and longitudinal research will help to ascertain the minimum requirements for the management and treatment of PTSD in a technology-supported environment.

Caregivers of patients with AD experience poor mental health in comparison to the general population, with female caregivers being disproportionately affected. Further exploration of the psychosocial variables that contribute to these group differences is needed to inform effective support services and, in turn, help caregivers manage the emotional demands of AD.

MR Hayter and DS DorstynStudy design: Cross-sectional survey. Objectives: To examine factors that may enhance and promote resilience in adults with spina bifida. Setting: Community-based disability organisations within Australia. Methods: Ninety-seven adults with a diagnosis of spina bifida (SB) completed a survey comprising of demographic questions in addition to standardised self-report measures of physical functioning (Craig Handicap Assessment and Reporting Technique), resilience (Connor-Davidson Resilience Scale, 10 item), self-esteem (Rosenberg Self-esteem Scale), self-compassion (Selfcompassion Scale) and psychological distress (Depression Anxiety Stress Scales, 21 item). Results: The majority (66%) of respondents reported moderate to high resilience. Physical disability impacted on coping, with greater CD-RISC 10 scores reported by individuals who were functionally independent in addition to those who experienced less medical co-morbidities. Significant correlations between resilience and psychological traits (self-esteem r ¼ 0.36, Po0.01; self-compassion r ¼ 0.40, Po0.01) were also noted. However, the combined contribution of these variables only accounted for 23% of the total variance in resilience scores (R 2 ¼ 0.227, F(5,94) ¼ 5.23, Po0.01). Conclusion: These findings extend current understanding of the concept of resilience in adults with a congenital physical disability. The suggestion is that resilience involves a complex interplay between physical determinants of health and psychological characteristics, such as self-esteem and self-compassion. It follows that cognitive behavioural strategies with a focus on self-management may, in part, contribute to the process of resilience in this group. Further large-scale and longitudinal research will help to confirm these findings.

The association between employment and psychological health in adults with multiple sclerosis was examined ( N = 33 studies). Standardised mean differences (Hedges' g) between those employed and those not in the workforce were calculated. Employed peers reported significantly greater quality of life and mood, cited fewer work and multiple sclerosis-related difficulties and were more likely to adopt problem-focused coping strategies, considered to be more effective in managing specific stressors. These data are consistent with the positive by-products of maintaining work with multiple sclerosis. Further research is needed to determine the longitudinal course of coping for those who remain employed.