Leisure and Problem Gaming Behaviors Among Children and Adolescents During School Closures Caused by COVID-19 in Hong Kong: Quantitative Cross-sectional Survey Study

Abstract

Background School closures during the COVID-19 pandemic may have exacerbated students’ loneliness, addictive gaming behaviors, and poor mental health. These mental health issues confronting young people are of public concern. Objective This study aimed to examine the associations between loneliness and gaming addiction behaviors among young people in Hong Kong and to investigate how familial factors, psychological distress, and gender differences moderate these relationships. Methods This cross-sectional study was conducted in June 2020 when schools reopened after 6 months of school closures. Participants included 2863 children and adolescents in primary (Grades 4 to 6) and secondary (Grades 7 and 8) schools (female participants: 1502/2863, 52.5%). Chi-square tests, one-way analyses of variance, and independent-samples t tests were performed to compare the differences of distribution in gaming addiction behaviors across gender, age, and other sociodemographic characteristics. Multinomial logistic regression analyses were conducted to identify factors that relate to excessive or pathological gaming behaviors separately, in comparison with leisure gaming. Results A total of 83.0% (2377/2863) of the participants played video games during the COVID-19 pandemic. The prevalence of excessive and pathological game addiction behaviors was 20.9% (597/2863) and 5.3% (153/2863), respectively. More male students had gaming addiction symptoms than female students. The multinomial logistic regressions showed that feeling lonely was associated with more problematic gaming behaviors, and the association was stronger for older female students. Low socioeconomic status, less parental support and less supervision, and poor mental health were risk factors for gaming addiction behaviors, especially among primary school students. Conclusions Loneliness was associated with gaming addiction behaviors; the findings from this study suggested that this association was similar across gender and age groups among young people. Familial support and supervision during school closures can protect young people from developing problematic gaming behaviors. Results of this study have implications for prevention and early intervention on behalf of policy makers and game developers.

Impacts on Children and Adolescents’ Lifestyle, Social Support and Their Association with Negative Impacts of the COVID-19 Pandemic

“…Parents may need to work longer to secure a job and maintain the daily necessities for the family [ 44 ]. The holistic quality of life of students in low-income families is more likely to be threatened [ 45 ] and their risk of psychosocial problems and problem behaviors is higher [ 15 , 46 ]. For example, inadequate digital devices and unsatisfactory internet access may limit their social connection with peers and teachers, limit the access to health-related information and knowledge, and increase risks of exposure to gaming temptation during lockdown [ 46 ].…”

“…The holistic quality of life of students in low-income families is more likely to be threatened [ 45 ] and their risk of psychosocial problems and problem behaviors is higher [ 15 , 46 ]. For example, inadequate digital devices and unsatisfactory internet access may limit their social connection with peers and teachers, limit the access to health-related information and knowledge, and increase risks of exposure to gaming temptation during lockdown [ 46 ]. Families trapped in smaller apartment may have greater difficulties of maintaining life quality [ 45 ] especially for low SES families.…”

Addictive Internet Gaming Usage among Korean Adolescents before and after the Outbreak of the COVID-19 Pandemic: A Comparison of the Latent Profiles in 2018 and 2020

“…In Italy, anxiety was found to be a predictor for online videogame and addiction [ 19 ], and a study from Japan indicated an increased prevalence of IGD, especially in the younger population [ 20 ]. In addition, one study from Hong Kong indicated that female children and adolescents felt more loneliness during the pandemic, while showing a significant relationship between loneliness and gaming addiction [ 21 ].…”

Policy Recommendations for Preventing Problematic Internet Use in Schools: A Qualitative Study of Parental Perspectives

“…COVID-19 caused rising infection rates and prompted variable lockdown measures, including three waves of lockdown in the UK (March 2020, November 2020, and January–April 2021) [ 156 ] with considerable negative psychosocial implications (i.e., worry, stress, helplessness) for young people [ 157 ] and mental health impacts such as depression and anxiety [ 158 ]. COVID-19-related distress impacted young people directly or indirectly in several ways, through disruption of individuals’ activities, the enforcement of restrictions, the closing of schools, the challenges of online learning, health problems, and lack of face-to-face social or physical activity and play [ 159 ]. This prolonged period of isolation and restriction of real life interactions led to an increased reliance on screen time [ 160 ] and recreational online activities, such as gaming and social media use to maintain social connections [ 161 ] or for escapism [ 162 ], posing risks for more vulnerable young people [ 163 ].…”