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Internet gaming disorder (IGD) is a new disorder that warrants further investigation, as recently noted in the research criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Offering controlled environments that increase cue-induced craving, virtual reality cue-exposure therapy has been shown to be effective for some addiction disorders. To assess the feasibility of virtual reality for patients with IGD, this study aimed to develop virtual environments that represent risk situations for inducing craving, and assess the effect of virtual reality in cue reactivity. A total of 64 male adolescents and young adults (34 with IGD and 30 without) were recruited for participation. We developed a virtual internet café environment and the participants were exposed to four different tasks. As the primary feasibility outcome, cravings were measured with a visual analogue scale measuring current urge to play a game after exposure to each task. The virtual internet café induced significantly greater cravings in patients with IGD compared to controls. Additionally, patients exhibited a significantly higher acceptance rate of an avatar’s invitation to play a game together than that of controls. In IGD, craving response to the tasks was positively associated with the symptom severity score as measured by Young's Internet Addiction Test. These findings reveal that virtual reality laden with complex game-related cues could evoke game craving in patients with IGD and could be used in the treatment of IGD as a cue-exposure therapy tool for eliciting craving.

Background and aims: Discrepancy between ideal self-guide and actual self-concept evoke dejection-related feeling, and often individuals with internet gaming disorder (IGD) use games as the tool to escape those negative emotions. The aim of this study was to evaluate the pattern of self-discrepancy based on actual and ideal self-images and elucidate the neural correlates underlying the distorted self in individuals with IGD.Methods: Nineteen male individuals with IGD and 20 healthy controls (HCs) underwent functional magnetic resonance imaging where they decided on whether they agreed with the adjectives describing their actual or ideal self on a four-point Likert Scale. Two-sample t-test on the self-discrepancy contrast was conducted for neuroimaging analysis and correlation analysis was performed between the behavioral data and regional activities.Results: The IGD group evaluated both their ideal self and actual self more negatively than the HC group. Actual self-concept was associated with satisfaction with psychological needs as opposed to ideal self-guide. Brain activity in the inferior parietal lobule was significantly decreased in individuals with IGD relative to HCs in the self-discrepancy contrast. In addition, neural activity during evaluating actual self-concept showed a significant group difference.Conclusion: These results provide novel evidence for distorted self-concept of people with IGD. Individuals with IGD had a negative ideal and actual self-image. Neurobiologically, dysfunction in the inferior parietal lobule associated with emotional regulation and negative self-evaluation was found in IGD. Considering the characteristics of IGD that often develop in adolescence, this self-concept problem should be noted and applied with appropriate therapy.

The current study confirms that eye gaze behaviour of social anxiety disorder patients is aversive and that their anxiety symptoms are more dependent on the nature of topic.

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