Structural Equation Modeling (SEM): Gaming Disorder Leading Untreated Attention-Deficit/Hyperactivity Disorder to Disruptive Mood Dysregulation

Abstract

(1) Background: Internet gaming disorder (IGD) in youths likely leads to disruptive mood dysregulation, especially among those with attention-deficit/hyperactivity disorder (ADHD). Whether IGD mediates the pathways leading ADHD to disruptive emotional dysfunction remains unclear. This study aims to elucidate the direct or indirect influence of IGD on ADHD; (2) Method: The Swanson, Nolan, and Pelham Version IV questionnaire was used to evaluate symptoms of ADHD and oppositional defiant disorder, and the Chen gaming disorder scale was used to measure IGD. A psychiatrist diagnosed ADHD, IGD, and disruptive mood dysregulation disorder (DMDD)-like symptoms. Structural equation modeling was applied to evaluate the role of IGD in mediating ADHD progression to disruptive mood dysregulation; (3) Results: Among a total of 102 ADHD youths, 53 (52%) of them with IGD were significantly more likely to have poor interpersonal relationships (p < 0.01) and DMDD-like symptoms (p < 0.01) than ADHD youths without IGD. IGD played a mediating role in increasing the risk of disruptive mood dysregulation in ADHD youths; (4) Conclusions: The findings suggest that IGD mediates ADHD’s progression to disruptive mood dysregulation. Intensive biopsychosocial interventions are warranted for ADHD youths with IGD. More children and adolescents became mood-dysregulated after excessive gaming during the COVID-19 pandemic; this study’s results suggest that child mental health experts develop earlier detection and prevention strategies for children and adolescents hidden behind internet addiction.

ADHD-Gaming Disorder Comorbidity in Children and Adolescents: A Narrative Review

“…As visible in Table 1 , the optimal diagnostic assessment of GD is still in progress and there is a non-unanimous modality, as different studies have used different rating scales or interviews for assessing its prevalence in children and adolescents with ADHD. Among these, four studies used the Young’s Internet Addiction Scale (YIAS) [ 19 , 20 , 21 , 22 ], three used the Chen Internet Addiction Scale (CIA) [ 23 , 24 , 25 ], two the Internet Addiction Test (IAT) [ 26 , 27 ], one used the Internet Gaming Disorder Interview (IGDI) [ 28 ], one the Gaming Addiction Identification Test (GAIT) [ 29 ], one the Korean Young’s Internet Addiction Rating Scale (YIAS-K) [ 30 ], one the ADITEC questionnaire [ 31 ], one the Internet-Gaming Disorder Scale-Short Form (IGDS9-SF) [ 27 ], one the Game Addiction Scale for Adolescents (GASA) [ 32 ], one the Problem Video Game-Playing Test (PVGT) [ 33 ], and one the Computer and Video Game Addiction Scale [ 34 ]. Finally, one did not use any rating scales but only the criteria proposed by the DSM-5 [ 15 ], and two used reports by parents, teachers, or participants regarding the time spent gaming [ 35 , 36 ].…”

“…Children and adolescents with ADHD and IGD/GD were characterized by poor interpersonal relationships [ 24 , 25 ], more withdrawal tendencies, and a greater loss of control than those without GD and with more emotional problems and disruptive mood dysregulation [ 23 , 24 ]. GD appeared to play a mediating role in raising the risk of disruptive mood dysregulation in children and adolescents with ADHD [ 25 ].…”

“…Children and adolescents with ADHD and IGD/GD were characterized by poor interpersonal relationships [ 24 , 25 ], more withdrawal tendencies, and a greater loss of control than those without GD and with more emotional problems and disruptive mood dysregulation [ 23 , 24 ]. GD appeared to play a mediating role in raising the risk of disruptive mood dysregulation in children and adolescents with ADHD [ 25 ]. Males were exposed to more severe consequences than females, and the negative consequences of excessive gaming were more prevalent in the social domain for males and in the emotional domain for girls [ 32 ], who appeared to be characterized by a more unstable mood and with more symptoms of depression [ 29 ].…”