Decisional impulsivity represents an important phenotype and a therapeutic target in Internet gaming disorder (IGD). Reality therapy and mindfulness meditation were two approaches to reduce impulsivity. This study aimed to evaluate the efficacy of a group behavioral intervention combining reality therapy and mindfulness meditation in reducing decisional impulsivity and IGD severity. Twenty-five IGD and 21 healthy comparison (HC) young adults participated in baseline tests on the delay discounting and balloon analog risk tasks to measure intertemporal and risky decision-making respectively. Among them, 18 IGD subjects participated in the intervention and were tested again at the end of intervention, and 19 HC subjects without intervention were also tested twice within a similar time period. Results indicate that: (1) at baseline, IGD subjects showed greater intertemporal and risky decisional impulsivity than HC subjects; (2) After intervention, IGD subjects were decreased in delay discounting rate and IGD severity, but did not perform differently on decisional impulsivity in risky choices, as compared with baseline. These findings suggest that decisional impulsivity is a multifaceted behavioral construct and may serve as a possible therapeutic target for IGD. In addition, these results highlight the need for further research into the roles of different forms of decisional impulsivity in the shaping, maintenance, and remission of IGD.
Individuals with Internet gaming disorder (IGD) tend to exhibit disadvantageous risky decision-making not only in their real life but also in laboratory tasks. Decision-making is a complex multifaceted function and different cognitive processes are involved in decision-making for gains and losses. However, the relationship between impaired decision-making and gain versus loss processing in the context of IGD is poorly understood. The main aim of the present study was to separately evaluate decision-making for risky gains and losses among college students with IGD using the Cups task. Additionally, we further examined the effects of outcome magnitude and probability level on decision-making related to risky gains and losses respectively. Sixty college students with IGD and 42 matched healthy controls (HCs) participated. Results indicated that IGD subjects exhibited generally greater risk taking tendencies than HCs. In comparison to HCs, IGD subjects made more disadvantageous risky choices in the loss domain (but not in the gain domain). Follow-up analyses indicated that the impairment was associated to insensitivity to changes in outcome magnitude and probability level for risky losses among IGD subjects. In addition, higher Internet addiction severity scores were associated with percentage of disadvantageous risky options in the loss domain. These findings emphasize the effect of insensitivity to losses on disadvantageous decisions under risk in the context of IGD, which has implications for future intervention studies.
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