View in EDS HTML Full Text PDF Full Text

Correlation between Attention Deficit Hyperactivity Disorder, Internet Gaming Disorder or Gaming Disorder

Saved in:
Bibliographic Details
Title: Correlation between Attention Deficit Hyperactivity Disorder, Internet Gaming Disorder or Gaming Disorder
Language: English
Authors: Ji Sun Hong, Sujin Bae, Vladan Starcervic (ORCID 0000-0002-6772-6995), Doug Hyun Han (ORCID 0000-0002-8314-0767)
Source: Journal of Attention Disorders. 2023 27(11):1252-1262.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 11
Publication Date: 2023
Document Type: Journal Articles
Reports - Research
Descriptors: Correlation, Attention Deficit Hyperactivity Disorder, Psychopathology, Mental Disorders, Late Adolescents, Young Adults, Computer Games, Addictive Behavior, Foreign Countries, Individual Characteristics, Symptoms (Individual Disorders)
Geographic Terms: South Korea
DOI: 10.1177/10870547231176861
ISSN: 1087-0547
1557-1246
Abstract: Objective: Individuals with internet gaming disorder (IGD) or gaming disorder (GD) had a higher prevalence of ADHD than individuals without IGD or GD. The overpathologizing of excessive gaming behaviors may be associated with the functional impairment due to ADHD in individuals with GD. Methods: The present study was designed to compare the gaming patterns, accompanying psychopathology, and co-occurring psychiatric disorders, especially ADHD, between clinical and general gamer samples (17-29 years old). Results: Out of the nine IGD criteria, the item "functional impairment" had low diagnostic accuracy in participants with IGD or GD. The IGD (GD) group had a higher prevalence of ADHD compared to the general gamer group. Conversely, there was a higher prevalence of IGD (GD) in the ADHD group compared to the non-ADHD group. Discussion: The possibility of ADHD should be considered when IGD or GD is diagnosed in patients with problematic Internet gaming.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1450053
Database: ERIC
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
    Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwFf6kR_BDFqRpHDoYXki5EvAAAA4jCB3wYJKoZIhvcNAQcGoIHRMIHOAgEAMIHIBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDPlOsqA6z6EuSYyGCwIBEICBmtTTH6uCLlAx6waeQO-3HbaxLHERItivr2BdBG6NCeA1HzWsCEeEwXK2Mz0PL8LW-CARfw2ezFu_Jt2XG4i5tXV2V-N8H8sKLkaHAlOHFyaBTo_34GM55nZbgrX9h6Z5d4qbhMUBvmy3ug1H0gkEiyjBo1yZpnoTTzOfRmZEQ3wE_WlJO-tFKxYyvLi1-TEf7z-hzzuurnVlxTk=
Text:
  Availability: 1
  Value: <anid>AN0171103550;gs001sep.23;2023Sep01.05:19;v2.2.500</anid> <title id="AN0171103550-1">Correlation Between Attention Deficit Hyperactivity Disorder, Internet Gaming Disorder or Gaming Disorder </title> <p>Objective: Individuals with internet gaming disorder (IGD) or gaming disorder (GD) had a higher prevalence of ADHD than individuals without IGD or GD. The overpathologizing of excessive gaming behaviors may be associated with the functional impairment due to ADHD in individuals with GD. Methods: The present study was designed to compare the gaming patterns, accompanying psychopathology, and co-occurring psychiatric disorders, especially ADHD, between clinical and general gamer samples (17–29 years old). Results: Out of the nine IGD criteria, the item "functional impairment" had low diagnostic accuracy in participants with IGD or GD. The IGD (GD) group had a higher prevalence of ADHD compared to the general gamer group. Conversely, there was a higher prevalence of IGD (GD) in the ADHD group compared to the non-ADHD group. Discussion: The possibility of ADHD should be considered when IGD or GD is diagnosed in patients with problematic Internet gaming.</p> <p>Keywords: internet gaming disorder; ADHD; over-pathologizing; functional impairment</p> <hd id="AN0171103550-2">Introduction</hd> <p>Over the past several decades, access to computers and the internet has radically expanded, resulting in internet usage, and internet gaming becoming very popular activities, especially for children and adolescents. ([<reflink idref="bib7" id="ref1">7</reflink>]; [<reflink idref="bib10" id="ref2">10</reflink>], [<reflink idref="bib11" id="ref3">11</reflink>]; [<reflink idref="bib37" id="ref4">37</reflink>]). Internet gaming can be considered as a spectrum, ranging from a pleasurable activity to problematic usage ([<reflink idref="bib16" id="ref5">16</reflink>]; [<reflink idref="bib30" id="ref6">30</reflink>]; [<reflink idref="bib32" id="ref7">32</reflink>]).</p> <p>In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5) suggested diagnostic criteria for Internet Gaming Disorder (IGD) in section III ("condition for further study") ([<reflink idref="bib4" id="ref8">4</reflink>]). In 2018, gaming disorder (GD) was introduced and categorized as an addictive disorder in the International Classification of Diseases, 11th Revision (ICD–11) by the World Health Organization ([<reflink idref="bib48" id="ref9">48</reflink>]). Gaming disorder is classified as a behavioral addiction, like gambling disorder, and physiological concepts, such as withdrawal and tolerance, as recommended in the DSM–5 IGD diagnostic criteria are excluded from the ICD–11 GD criteria ([<reflink idref="bib6" id="ref10">6</reflink>]; [<reflink idref="bib19" id="ref11">19</reflink>]; [<reflink idref="bib28" id="ref12">28</reflink>]). Furthermore, criteria with debatable validity, such as escaping negative feelings and deceptive behaviors, were also excluded ([<reflink idref="bib28" id="ref13">28</reflink>]). Importantly, the criterion of functional impairment was defined as a mandatory requirement for GD ([<reflink idref="bib5" id="ref14">5</reflink>]; [<reflink idref="bib27" id="ref15">27</reflink>]; [<reflink idref="bib29" id="ref16">29</reflink>]).</p> <p>Debates have existed regarding the introduction of IGD and GD in DSM–5 and ICD–11 to define problematic gaming from various viewpoints. Several clinicians and researchers have argued that introducing GD in the ICD–11 may be hasty because of the lack of scientific evidence ([<reflink idref="bib45" id="ref17">45</reflink>]). Data regarding the diagnostic validity of these criteria are still lacking, and more empirical information is necessary to avoid over-pathologizing and inadequately identifying individuals who need professional help ([<reflink idref="bib1" id="ref18">1</reflink>]; [<reflink idref="bib6" id="ref19">6</reflink>]; [<reflink idref="bib46" id="ref20">46</reflink>]). Numerous scholars have raised concerns about the definition of GD as an addictive disorder because it restricts the testing and understanding of alternative conceptual frameworks, underlying psychiatric comorbidities, and etiological heterogeneity of excessive gaming ([<reflink idref="bib43" id="ref21">43</reflink>]; [<reflink idref="bib46" id="ref22">46</reflink>]).</p> <p>Of the numerous psychiatric comorbidities of IGD, attention hyperactivity disorder (ADHD) is proposed to be the most frequent psychiatric comorbidity due to its prevalence and conceptual overlap ([<reflink idref="bib14" id="ref23">14</reflink>]; [<reflink idref="bib35" id="ref24">35</reflink>]; [<reflink idref="bib44" id="ref25">44</reflink>]; [<reflink idref="bib49" id="ref26">49</reflink>]). In a systematic review of the relationship between ADHD and GD, [<reflink idref="bib14" id="ref27">14</reflink>] described that the ADHD inattention scale was strongly associated with GD. Our previous study of IGD and GD criteria also advised of a relationship and the extent of conceptual overlap between ADHD and GD ([<reflink idref="bib44" id="ref28">44</reflink>]). [<reflink idref="bib49" id="ref29">49</reflink>] conveyed the shared features of impulsivity and hostility in ADHD and IGD. In a 3 year clinical cohort study, ADHD comorbidity predicted a poor clinical course of IGD, wherein the changes in ADHD symptoms were associated with alterations in IGD symptoms ([<reflink idref="bib35" id="ref30">35</reflink>]).</p> <p>ADHD and IGD also share similar biological features ([<reflink idref="bib9" id="ref31">9</reflink>]; [<reflink idref="bib17" id="ref32">17</reflink>]; [<reflink idref="bib47" id="ref33">47</reflink>]). Several resting-state functional magnetic resonance imaging (MRI) studies of the shared conditions between ADHD and IGD illustrated diminished functional connectivity within the attentional network and cortico-subcortical circuits ([<reflink idref="bib9" id="ref34">9</reflink>]; [<reflink idref="bib47" id="ref35">47</reflink>]). In a 1 year longitudinal study of IGD and ADHD subjects, [<reflink idref="bib17" id="ref36">17</reflink>] informed similar changes in functional connectivity between the cortex and subcortex in response to treatment. Simultaneously, ADHD medications, including methylphenidate and atomoxetine, improve IGD symptoms ([<reflink idref="bib18" id="ref37">18</reflink>]; [<reflink idref="bib41" id="ref38">41</reflink>]).</p> <p>Therefore, the present study was designed to compare the gaming patterns, accompanying psychopathology, and co-occurring psychiatric disorders, especially ADHD, between clinical and general gamer samples. We hypothesized that individuals with IGD (GD) had a higher prevalence of ADHD than individuals without IGD. In addition, over-pathologizing of excessive gaming behaviors is associated with functional impairment due to ADHD in individuals with IGD (GD).</p> <hd id="AN0171103550-3">Methods</hd> <p></p> <hd id="AN0171103550-4">Participants</hd> <p>The data of the two participant groups in the current study were gathered over 2 years. One group included patients who visited hospitals (Chung Ang University Hospital in Seoul, Konkuk Choongju University Hospital in Choongju, and Daegu Catholic University Hospital in Daegu) to seek medical help for problematic Internet gaming (clinical group). Of 172 consecutive prospective patients, 136 agreed to participate in the current study. The participants were screened as follows: (<reflink idref="bib1" id="ref39">1</reflink>) at least 13 years of age, (<reflink idref="bib2" id="ref40">2</reflink>) no history of schizophrenia and intellectual disability, and (<reflink idref="bib3" id="ref41">3</reflink>) no history of mental disorders caused by a neurological condition or brain damage.</p> <p>The other group included participants from the general population (general gamer group) who were invited from the bulletin board of Chung Ang University and an online research company (Embrane<sups>®</sups>, Seoul, Korea). The inclusion criteria were as follows: (<reflink idref="bib1" id="ref42">1</reflink>) age ≥13 years, (<reflink idref="bib2" id="ref43">2</reflink>) playing Internet games for more than 1 hr at least once per week, (<reflink idref="bib3" id="ref44">3</reflink>) no history of visiting a hospital or mental health institution due to problematic Internet gaming, and (<reflink idref="bib4" id="ref45">4</reflink>) no history of schizophrenia, intellectual disability, or mental disorders caused by a neurological condition or brain damage. A total of 165 general gamers were recruited for the current study. They received 50 000 won (₩) as compensation for participation in the study.</p> <hd id="AN0171103550-5">Procedure and Process of Study</hd> <p>The subjects listened to the study procedures and agreed to participate in the study. Our study was approved by the Chung Ang University Institutional Review Board (reference number: 1811-019-349). Adult participants (over 18 years old) signed consent forms, whereas adolescent participants agreed, and their parents or legal guardians provided written consent. This study was conducted following the Declaration of Helsinki. In the first analysis in a previous article ([<reflink idref="bib44" id="ref46">44</reflink>]), we used data from 100 individuals each in the clinical group and the general gamer group. In the current study, we added data from 36 individuals in the clinical group and 65 individuals in the general population group.</p> <hd id="AN0171103550-6">Assessment Tools</hd> <p></p> <hd id="AN0171103550-7">Gaming Diagnostic Interview</hd> <p>To compare the verification of the validity for IGD and GD, we developed a semi-structured diagnostic interview (Gaming Diagnostic Interview). It consisted of nine items that correspond to the nine diagnostic criteria for IGD and four diagnostic criteria for GD. Each item was confirmed through 2 to 10 questions (Table 1). The total time taken to complete the interview was about 30 min. As stated in a previous article, the investigators were trained to achieve high inter-rater reliability (0.91).</p> <p>Graph</p> <p>Table 1. Gaming Diagnostic Interview.</p> <p> <ephtml> <table><colgroup><col align="left" /></colgroup><thead><tr><th align="center">1. Preoccupation</th></tr></thead><tbody><tr><td>1-1. Do you have recurrent thoughts about playing games when you are not playing?1-2. For example, thinking a lot about the previous game or the game that you are about to play?1-3. Is gaming constantly on your mind?1-4. Do you feel that playing games has become so important that you can hardly imagine your life without it?</td></tr><tr><th align="center">2. Withdrawal symptoms</th></tr><tr><td>2-a-1. Do you usually feel irritable, moody, restless, nervous, anxious, angry, or sad when you are unable to play or when you try to stop playing?2-a-2. Do you have any other feeling?2-a-3. If so, do these feelings go away when you are able to play again?2-a-4. how do you feel and how long do these feelings last? ____________________________2-a-5. Do you have these feelings only when you are forced by others to stop playing?2-b-1. Do you usually have some unpleasant physical symptoms (for example, sweating or feeling sick in the stomach) when you are unable to play or when you try to stop playing?2-b-2. If so, do these symptoms go away when you are able to play again?2-b-3. If so, what are these symptoms? ________________________________</td></tr><tr><th align="center">3. Tolerance</th></tr><tr><td>3-1. Do you need to spend more time playing?3-2. If so, is this to experience a "buzz," excitement, satisfaction, a sense of accomplishment, or some other pleasant feeling?3-3. What is it that you want to experience by playing more? _______________________</td></tr><tr><th align="center">4. Loss of control</th></tr><tr><td>4-1. Have you made repeated unsuccessful attempts to control, cut back, or stop playing?4-2. Were these attempts unsuccessful even when you were not forced to cut back or stop playing?</td></tr><tr><th align="center">5. Loss of interest</th></tr><tr><td>5-1. Have you given up (or lost interest in) one or more social or recreational activities or hobbies (such as playing sport, going out with friends, or watching movies) because of gaming or in order to increase time spent playing?5-2. If so, which interests have you lost? _________________________________</td></tr><tr><th align="center">6. Continued gaming despite negative consequences</th></tr><tr><td>6-1. Do you continue to play despite knowing that it has led to some problems?For example, gaming has led to conflicts with your parents or a partner or you have not had the time to complete your assignment or work duties.6-2. If so, which problems have you experienced?</td></tr><tr><th align="center">7. Deception/lying</th></tr><tr><td>Have you lied to others about your gaming, for example how much it means to you or about the amount of time spent playing?</td></tr><tr><th align="center">8. Game as an escape</th></tr><tr><td>8-1. Do you play games to escape from a problem or an unpleasant or bad feeling (for example, feeling helpless, guilty, depressed, irritable, tense, anxious, "stressed out", or bored) or to make it easier to bear such a feeling?8-2. If so, which are these feelings? ________________________________________</td></tr><tr><th align="center">9. Functional impairment</th></tr><tr><td>9-a-1 Have you had major problems or conflicts in your significant relationships (or lost some of these relationships) because of gaming or the amount of time spent playing?9-a-2. If so, what problems/conflicts have you had? _____________________________9-b-1 Has your school or university performance been negatively affected because of gaming or the amount of time spent playing?9-b-2. If so, how was it affected? ___________________________________________9-c-1 Has your work performance been negatively affected or have you lost a job because of gaming or the amount of time spent playing?9-c-2. If so, how was it affected? ___________________________________________9-d-1 Have you lost educational or career opportunities because of gaming or the amount of time spent playing?9-d-2. If so, which opportunities have you lost? ________________________________9-e-1 Have you neglected anything important in your life because of gaming or the amount of time spent playing?9-e-2. If so, what have you neglected? ______________________________________</td></tr></tbody></table> </ephtml> </p> <hd id="AN0171103550-8">Demographic Questionnaire, Including Gaming Habits and Patterns</hd> <p>Demographic data included age, sex, and years of education. Gaming habits and patterns were assessed using questions on the number of years engaged in gaming, time spent gaming, main genre of gaming, motivation for gaming, number of online, and offline friends, the "self-realization that gaming is a problem," and the opinions of important or close people on whether the person's gaming is problematic (Table 2).</p> <p>Graph</p> <p>Table 2. Demographic Data and Clinical Scales in Clinical and General Gamer Groups.</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th /><th align="center">Clinical group (<italic>N</italic> = 136)</th><th align="center">General gamer group (<italic>N</italic> = 165)</th><th align="center">Statistics</th></tr></thead><tbody><tr><td>Age (mean ± <italic>SD</italic>)</td><td>21.56 ± 4.63</td><td>21.9 ± 2.51</td><td><italic>t</italic> = −0.87, <italic>p</italic> =.38</td></tr><tr><td>Number of males</td><td>128 (94.1)</td><td>156 (94.5)</td><td><italic>χ</italic>2 = 0.03, <italic>p</italic> < 1.00</td></tr><tr><td>Number of years of education (mean ± <italic>SD</italic>)</td><td>11.90 ± 2.36</td><td>12.87 ± 1.78</td><td><italic>t</italic> = −4.05, <italic>p</italic> <.01</td></tr><tr><td>Number of years gaming<xref ref-type="table-fn" rid="tfn2">a</xref> (mean ± <italic>SD</italic>)</td><td>8.2 ± 5.2</td><td>10.8 ± 4.8</td><td><italic>t</italic> = −4.32, <italic>p</italic> <.01</td></tr><tr><td colspan="4">Time spent playing (hours/day)</td></tr><tr><td> Weekdays (mean ± <italic>SD</italic>)</td><td>4.8 ± 3.4</td><td>2.7 ± 2.6</td><td><italic>t</italic> = 5.93, <italic>p</italic> <.01</td></tr><tr><td> Weekends (mean ± <italic>SD</italic>)</td><td>5.6 ± 3.5</td><td>3.0 ± 2.4</td><td><italic>t</italic> = 7.53, <italic>p</italic> <.01</td></tr><tr><td colspan="4">Main genre of game played</td></tr><tr><td> First person shooter (FPS)</td><td>35 (25.7)</td><td>33 (20.1)</td><td rowspan="5"><italic>χ</italic>2 = 6.32,<italic>p</italic> =.18</td></tr><tr><td> Role-playing games (RPG)</td><td>21 (15.4)</td><td>15 (8.8)</td></tr><tr><td> Multiplayer online battle arena (MOBA)</td><td>48 (35.4)</td><td>64 (38.9)</td></tr><tr><td> Real time strategy (RTS)</td><td>9 (6.6)</td><td>18 (11.3)</td></tr><tr><td> Other</td><td>23 (16.9)</td><td>35 (20.8)</td></tr><tr><td>Number of online friends (mean ± <italic>SD</italic>)</td><td>15.0 ± 32.7</td><td>3.2 ± 9.1</td><td><italic>t</italic> = 4.31, <italic>p</italic> <.01</td></tr><tr><td>Number of offline friends (mean ± <italic>SD</italic>)</td><td>16.4 ± 37.9</td><td>25.8 ± 54.4</td><td><italic>t</italic> = −1.35, <italic>p</italic> =.18</td></tr><tr><td colspan="4">Main reason for gaming<xref ref-type="table-fn" rid="tfn3">b</xref></td></tr><tr><td> Achievement</td><td>23 (16.9)</td><td>5 (3.0)</td><td rowspan="4"><italic>χ</italic>2 = 38.77, <italic>p</italic> <.01</td></tr><tr><td> Social relationship</td><td>11 (8.1)</td><td>9 (6.6)</td></tr><tr><td> Coping</td><td>49 (36.0)</td><td>31 (18.7)</td></tr><tr><td> Entertainment</td><td>53 (39.0)</td><td>120 (72.7)</td></tr><tr><td>Recognition that gaming is a problem<xref ref-type="table-fn" rid="tfn4">c</xref>(yes/perhaps/no)</td><td>74/7/55</td><td>49/9/107</td><td><italic>χ</italic>2 = 19.41, <italic>p</italic> <.01</td></tr><tr><td>Suggestion by others that gaming is a problem<xref ref-type="table-fn" rid="tfn5">d</xref> (yes/perhaps/no)</td><td>67/7/62</td><td>15/2/148</td><td><italic>χ</italic>2 = 68.82, <italic>p</italic> <.01</td></tr><tr><td>Met diagnostic criteria for Internet gaming disorder (IGD)</td><td>85 (62.5%)</td><td>51 (37.5%)</td><td><italic>χ</italic>2 = 30.04, <italic>p</italic> <.01</td></tr><tr><td>Met diagnostic criteria for gaming disorder (GD)</td><td>54 (39.7%)</td><td>23 (13.9%)</td><td><italic>χ</italic>2 = 26.00, <italic>p</italic> <.01</td></tr><tr><td colspan="4">Co-occurring disorders</td></tr><tr><td> ADHD</td><td>78 (57.4)</td><td>32 (19.4)</td><td><italic>χ</italic>2 = 46.32, <italic>p</italic> <.01</td></tr><tr><td> Major depressive disorder</td><td>28 (20.6)</td><td>13 (7.9)</td><td><italic>χ</italic>2 = 10.24, <italic>p</italic> <.01</td></tr><tr><td> Bipolar disorder</td><td>17 (12.5)</td><td>6 (3.6)</td><td><italic>χ</italic>2 = 8.30, <italic>p</italic> <.01</td></tr><tr><td> OCD</td><td>15 (11.0)</td><td>5 (3.0)</td><td><italic>χ</italic>2 = 7.69, <italic>p</italic> <.01</td></tr><tr><td> Social anxiety disorder</td><td>22 (16.2)</td><td>5 (3.0)</td><td><italic>χ</italic>2 = 15.78, <italic>p</italic> <.01</td></tr><tr><td> Other anxiety disorders</td><td>19 (14.0)</td><td>4 (2.4)</td><td><italic>χ</italic>2 = 14..08, <italic>p</italic> <.01</td></tr><tr><td colspan="4">Psychopathology and symptom measures</td></tr><tr><td> PHQ-9 (mean ± <italic>SD</italic>)</td><td>8.40 ± 6.86</td><td>3.52 ± 3.54</td><td><italic>t</italic> = 7.86, <italic>p</italic> <.01</td></tr><tr><td> ASRS (mean ± <italic>SD</italic>)</td><td>24.35 ± 16.23</td><td>14.90 ± 10.30</td><td><italic>t</italic> = 9.45, <italic>p</italic> <.01</td></tr><tr><td> PHQ-15 (mean ± <italic>SD</italic>)</td><td>5.47 ± 4.91</td><td>3.49 ± 3.01</td><td><italic>t</italic> = 4.24, <italic>p</italic> <.01</td></tr><tr><td> OCI-R (mean ± <italic>SD</italic>)</td><td>12.34 ± 11.18</td><td>10.77 ± 9.44</td><td><italic>t</italic> = 1.31, <italic>p</italic> =.19</td></tr><tr><td> AQ (mean ± <italic>SD</italic>)</td><td>61.40 ± 15.89</td><td>53.70 ± 9.60</td><td><italic>t</italic> = 4.48, <italic>p</italic> <.01</td></tr><tr><td> GAD-7 (mean ± <italic>SD</italic>)</td><td>5.42 ± 5.47</td><td>2.59 ± 3.12</td><td><italic>t</italic> = 5.57, <italic>p</italic> <.01</td></tr><tr><td> SIAS (mean ± <italic>SD</italic>)</td><td>25.96 ± 17.32</td><td>14.99 ± 9.85</td><td><italic>t</italic> = 6.83, <italic>p</italic> <.01</td></tr><tr><td> SPS (mean ± <italic>SD</italic>)</td><td>18.96 ± 17.95</td><td>8.17 ± 9.95</td><td><italic>t</italic> = 6.53, <italic>p</italic> <.01</td></tr><tr><td> IAT (mean ± <italic>SD</italic>)</td><td>49.50 ± 20.33</td><td>36.59 ± 12.87</td><td><italic>t</italic> = 6.59, <italic>p</italic> <.01</td></tr></tbody></table> </ephtml> </p> <p>1 <emph>Note</emph>. ADHD = Attention deficit/hyperactivity disorder; OCD = Obsessive-compulsive disorder; Other anxiety disorders = Panic disorder, generalized anxiety disorder and other phobic disorders. PHQ-9 = Patient Health Questionnaire – 9; ASRS = Adult ADHD Self-Report Scale; PHQ-15 = Patient Health Questionnaire – 15; OCI-R = Obsessive-Compulsive Inventory – Revised; AQ = Buss-Perry Aggression Questionnaire; GAD-7 = Generalized Anxiety Disorder 7-Item Scale; SIAS = Social Interaction Anxiety Scale; SPS = Social Phobia Scale; IAT = Internet Addiction Test.</p> <ulist> <item>2 Number of years gaming = number of years playing video games at least on a weekly basis.</item> <item>3 Achievement: playing for game mastery, competition, receiving recognition/rewards, or gaining power within the game; Social relationship: playing to interact with others and develop in-game relationships; Coping: playing to cope with stress or boredom, distract from real-life problems, or escape from unpleasant feelings; Entertainment: playing to have a good time, get excited, or relax.</item> <item>4 Recognition that gaming is a problem: "Feeling that gaming is a problem for you or that you need to play less."</item> <item>5 Suggestion by others that gaming is a problem: "People important or close to you consider your gaming a problem."</item> </ulist> <hd id="AN0171103550-9">Psychiatric Comorbidities and Psychological Scales</hd> <p>To screen for comorbidity of psychiatric diseases, the Korean version of the Mini International Neuropsychiatric Interview (MINI) was applied to all participants ([<reflink idref="bib50" id="ref47">50</reflink>]). The Korean version of the Patient Health Questionnaire–9 (PHQ–9) was used to measure the severity of depressive symptoms over the preceding 2 weeks ([<reflink idref="bib34" id="ref48">34</reflink>]). The Korean version of the Adult ADHD Self-Report Scale (ASRS) was employed to screen for ADHD and measure its severity over the preceding 6 months ([<reflink idref="bib21" id="ref49">21</reflink>]).</p> <p>Although this adult ADHD scale should be applied to populations aged 18 years or older, previous studies have demonstrated good validity of applying the ASRS to adolescents aged 13 to 17 years for the purpose of brief ADHD assessment ([<reflink idref="bib2" id="ref50">2</reflink>]; [<reflink idref="bib15" id="ref51">15</reflink>]; [<reflink idref="bib42" id="ref52">42</reflink>]). The participants who got four or more responses in six ASRS part A symptoms were evaluated for diagnosis of ADHD through a face-to-face interview with child-adolescent psychiatrists (DHH, THK, or TYC). The inter-rater reliability among the three doctors ranged from 0.97 to 0.99.</p> <p>The Korean version of the Patient Health Questionnaire–15 (PHQ–15) was utilized to measure the severity of somatic symptoms over the preceding 4 weeks ([<reflink idref="bib38" id="ref53">38</reflink>]). The Korean version of the Obsessive-Compulsive Inventory–Revised (OCI–R) measured the symptoms of obsessive–compulsive disorder over the preceding month ([<reflink idref="bib36" id="ref54">36</reflink>]). The Korean version of the Buss-Perry Aggression Questionnaire (AQ) gauged overall aggression and four components (physical aggression, verbal aggression, anger, and hostility) of aggression on separate subscales ([<reflink idref="bib23" id="ref55">23</reflink>]).</p> <p>The Korean version of the Generalized Anxiety Disorder 7-Item Scale (GAD–7) determined the severity of anxiety over the preceding 2 weeks ([<reflink idref="bib3" id="ref56">3</reflink>]). Korean versions of the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS) assessed social interaction anxiety and social performance anxiety, respectively ([<reflink idref="bib22" id="ref57">22</reflink>]). The Korean version of the Internet Addiction Test (IAT) evaluated problematic Internet usage, also referred to as Internet addiction ([<reflink idref="bib33" id="ref58">33</reflink>]). The details of the psychometric properties and validity were described in our previous article ([<reflink idref="bib44" id="ref59">44</reflink>]).</p> <hd id="AN0171103550-10">Statistical Analysis</hd> <p>The differences in demographic data, rates of co-occurring disorders, and the psychopathology and symptom measures between the clinical and general gamer groups were analyzed using the Chi-square test for categorical variables and the independent <emph>t</emph>-test for continuous variables.</p> <p>For all participants (<emph>N</emph> = 301), we calculated the sensitivity, specificity, positive, and negative predictive values, and the diagnostic accuracy of each DSM–5 criterion for IGD, depending on whether they met the criteria for IGD, ICD–11 gaming disorder, and ADHD.</p> <hd id="AN0171103550-11">Results</hd> <p></p> <hd id="AN0171103550-12">Demographic Data and Clinical Scales in clinical and General Gamer Groups</hd> <p>In a comparison between the clinical group and general gamer group, the clinical group showed more time spent gaming on both weekdays and weekends, with many online friends and their problematic gaming was more likely to be recognized by themselves and others (Table 2). The clinical group played an Internet game for achievement and coping, whereas the general gamer group played an Internet game for entertainment. The clinical group had fewer years of education and had spent fewer years engaged in Internet gaming.</p> <p>A large proportion of the clinical group met the diagnostic criteria for IGD (62.5%vs. 37.5%) and GD (39.7%vs. 13.9%), as compared to the general gamer group, respectively (Table 2). The clinical group exhibited a higher rate of co-occurring mental disorders, including ADHD, major depressive disorder, bipolar disorder, obsessive–compulsive disorder, social anxiety disorder, and other anxiety disorders, as compared to the general gamer group. In all psychological scales, including the PHQ–9, ASRS, PHQ–15, OCI–R, AQ, GAD–7, SIAS, SPS, and IAT, the clinical group displayed higher scores than the general gamer group (Table 2).</p> <hd id="AN0171103550-13">Comparison of the Prevalence of ADHD Between Participants With IGD (IGD) and Without IGD (GD)</hd> <p>Among all participants, individuals with IGD presented a respective higher rate of ADHD than subjects without IGD (58.8%vs. 18.2%), and individuals with ADHD demonstrated a higher rate of IGD as compared to participants without ADHD (72.7%vs. 29.3%) (Table 3). Individuals with GD had a higher rate of ADHD than persons without GD (81.8%vs. 21.0%), and subjects with ADHD displayed a higher rate of GD as compared to those without ADHD (57.3%vs. 42.7%), respectively (Table 3).</p> <p>Graph</p> <p>Table 3. The Comparison of the Prevalence of ADHD Between Participants with IGD (GD) and Without IGD (GD).</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th align="left" colspan="4">Participants with IGD vs. Participants without IGD</th></tr><tr><th /><th align="center">IGD (−)</th><th align="center">IGD (+)</th><th align="center">Total</th></tr><tr><th align="center" colspan="4">ADHD (−)</th></tr></thead><tbody><tr><td><italic>N</italic></td><td>135</td><td>56</td><td>191</td></tr><tr><td> % at ADHD</td><td>70.7</td><td>29.3</td><td>100.0</td></tr><tr><td> % at IGD</td><td>81.8</td><td>41.2</td><td>65.2</td></tr><tr><td> % at total</td><td>44.9</td><td>18.6</td><td>63.5</td></tr><tr><th align="center" colspan="4">ADHD (+)</th></tr><tr><td><italic>N</italic></td><td>30</td><td>80</td><td>110</td></tr><tr><td> % at ADHD</td><td>27.3</td><td>72.7</td><td>100</td></tr><tr><td> % at IGD</td><td>18.2</td><td>58.8</td><td>36.5</td></tr><tr><td> % at total</td><td>10.0</td><td>26.6</td><td>36.5</td></tr><tr><td>Total</td><td /><td /><td /></tr><tr><td><italic>N</italic></td><td>165</td><td>136</td><td>301</td></tr><tr><td> % at ADHD</td><td>54.8</td><td>45.2</td><td>100.0</td></tr><tr><td> % at IGD</td><td>100.0</td><td>100.0</td><td>100.0</td></tr><tr><td> % at total</td><td>54.8</td><td>45.2</td><td>100.0</td></tr><tr><th align="center" colspan="4">Participants with GD vs. Participants without GD*</th></tr><tr><th /><th align="center">GD (−)</th><th align="center">GD (+)</th><th align="center">Total</th></tr><tr><th align="center" colspan="4">ADHD (−)</th></tr><tr><td><italic>N</italic></td><td>177</td><td>14</td><td>191</td></tr><tr><td> % at ADHD</td><td>92.7</td><td>7.3</td><td>100.0</td></tr><tr><td> % at IGD</td><td>79.0</td><td>18.2</td><td>63.5</td></tr><tr><td> % at total</td><td>58.8</td><td>4.7</td><td>63.5</td></tr><tr><td colspan="4">ADHD (+)</td></tr><tr><td><italic>N</italic></td><td>47</td><td>63</td><td>110</td></tr><tr><td> % at ADHD</td><td>42.7</td><td>57.3</td><td>100.0</td></tr><tr><td> % at GD</td><td>21.0</td><td>81.8</td><td>36.5</td></tr><tr><td> % at total</td><td>15.6</td><td>20.9</td><td>36.5</td></tr><tr><td colspan="4">Total</td></tr><tr><td><italic>N</italic></td><td>224</td><td>77</td><td>301</td></tr><tr><td> % at ADHD</td><td>74.4</td><td>25.6</td><td>100.0</td></tr><tr><td> % at GD</td><td>100.0</td><td>100.0</td><td>100.0</td></tr><tr><td> % at total</td><td>74.4</td><td>25.6</td><td>100.0</td></tr></tbody></table> </ephtml> </p> <hd id="AN0171103550-14">Diagnostic Validity of Each DSM–5 Criterion for IGD in All Participants, Depending on Whether...</hd> <p>Among all participants, the diagnostic accuracy for each criterion was as follows:</p> <p></p> <ulist> <item> For the "preoccupation" criterion in the IGD of DSM–5, it was 72.4%, and in the GD of ICD–11, it was 58.4%;</item> <p></p> <item> For the "withdrawal" criterion in the IGD of DSM–5, and in the GD of ICD-11, it was 75.9% and 68.5%, respectively;</item> <p></p> <item> For the "tolerance" criterion in the IGD of DSM–5, it was 61.6%, and in the GD of ICD–11, it was 73.5%;</item> <p></p> <item> For the "loss of control" criterion in the IGD of DSM–5 (76.3%), and in the GD of ICD–11 (70.3%);</item> <p></p> <item> For the "loss of interest" criterion in the IGD of DSM–5, it was 78.5% and in the GD of ICD–11, it was 83.2%;</item> <p></p> <item> For the "negative consequence" criterion in the IGD of DSM–5 (82.4%) and for the GD of ICD–11 (76.3%);</item> <p></p> <item> For the "lying/deceiving" criterion in the IGD of DSM–5, and in the GD of ICD–11, it was 72.8% and 65.2%, respectively;</item> <p></p> <item> For "gaming as an escape" criterion in the IGD of DSM–5 (73.5%), and in the GD of ICD–11 (68.8%);</item> <p></p> <item> For the "functional impairment" criterion in the IGD of DSM–5, it was 73.1%, and in the GD of ICD–11, it was 55.6% (Table 4).</item> </ulist> <p>Graph</p> <p>Table 4. Sensitivity, Specificity, Positive, and Negative Predictive Values and Diagnostic Accuracy of Each DSM-5 Criterion for Internet Gaming Disorder (IGD) in all Participants (N = 301), Depending on Whether or not They Meet the Criteria for IGD/ICD-11 Gaming Disorder (GD).</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th /><th align="center" colspan="2">All participants with IGD (<italic>n</italic> = 136)</th><th align="center" colspan="2">All participants without IGD (<italic>n</italic> = 165)</th><th align="center" rowspan="2">Positive predictive value (%)</th><th align="center" rowspan="2">Negative predictive value (%)</th><th align="center" rowspan="2">Diagnostic accuracy (%)</th></tr><tr><th /><th align="center">Number who endorsed the criterion</th><th align="center">Sensitivity (%)</th><th align="center">Number who endorsedthe criterion</th><th align="center">Specificity (%)</th></tr></thead><tbody><tr><td>Preoccupation</td><td>110</td><td>81.0</td><td>57</td><td>65.4</td><td>65.8</td><td>80.6</td><td>72.4</td></tr><tr><td>Withdrawal</td><td>88</td><td>65.1</td><td>25</td><td>85.0</td><td>78.1</td><td>74.7</td><td>75.9</td></tr><tr><td>Tolerance</td><td>35</td><td>26.2</td><td>15</td><td>90.8</td><td>70.2</td><td>59.9</td><td>61.6</td></tr><tr><td>Loss of control</td><td>114</td><td>84.1</td><td>50</td><td>69.9</td><td>69.7</td><td>84.3</td><td>76.3</td></tr><tr><td>Loss of interest</td><td>98</td><td>72.2</td><td>27</td><td>83.7</td><td>78.4</td><td>78.5</td><td>78.5</td></tr><tr><td>Negative consequences</td><td>114</td><td>84.1</td><td>31</td><td>81.0</td><td>78.5</td><td>86.1</td><td>82.4</td></tr><tr><td>Lying/deceiving</td><td>95</td><td>69.8</td><td>41</td><td>75.2</td><td>69.8</td><td>75.2</td><td>72.8</td></tr><tr><td>Gaming as an escape</td><td>87</td><td>63.5</td><td>30</td><td>81.7</td><td>74.1</td><td>73.1</td><td>73.5</td></tr><tr><td>Functional impairment</td><td>132</td><td>96.8</td><td>77</td><td>53.6</td><td>63.2</td><td>95.3</td><td>73.1</td></tr><tr><th /><th align="center" colspan="2">All participants with GD (<italic>n</italic> = 77)</th><th align="center" colspan="2">All participants without GD (<italic>n</italic> = 224)</th><th align="center" rowspan="2">Positive predictive value (%)</th><th align="center" rowspan="2">Negative predictive value (%)</th><th align="center" rowspan="2">Diagnostic accuracy (%)</th></tr><tr><th /><th align="center">Number who endorsed the criterion</th><th align="center">Sensitivity (%)</th><th align="center">Number who endorsed the criterion</th><th align="center">Specificity (%)</th></tr><tr><td>Preoccupation</td><td>60</td><td>78.3</td><td>108</td><td>51.9</td><td>34.8</td><td>87.9</td><td>58.4</td></tr><tr><td>Withdrawal</td><td>48</td><td>62.3</td><td>66</td><td>70.5</td><td>41.0</td><td>85.1</td><td>68.5</td></tr><tr><td>Tolerance</td><td>23</td><td>30.4</td><td>28</td><td>87.6</td><td>44.7</td><td>79.3</td><td>73.5</td></tr><tr><td>Loss of control</td><td>77</td><td>100.0</td><td>88</td><td>60.5</td><td>45.4</td><td>100.0</td><td>70.3</td></tr><tr><td>Loss of interest</td><td>77</td><td>100.0</td><td>50</td><td>77.6</td><td>57.7</td><td>100.0</td><td>83.2</td></tr><tr><td>Negative consequences</td><td>77</td><td>100.0</td><td>70</td><td>68.6</td><td>51.1</td><td>100.0</td><td>76.3</td></tr><tr><td>Lying/deceiving</td><td>55</td><td>71.0</td><td>78</td><td>63.3</td><td>38.9</td><td>86.9</td><td>65.2</td></tr><tr><td>Gaming as an escape</td><td>50</td><td>65.2</td><td>67</td><td>70.0</td><td>41.7</td><td>86.0</td><td>68.8</td></tr><tr><td>Functional impairment</td><td>77</td><td>100.0</td><td>132</td><td>41.0</td><td>35.8</td><td>100.0</td><td>55.6</td></tr></tbody></table> </ephtml> </p> <hd id="AN0171103550-15">Diagnostic Validity of Each DSM–5 Criterion for IGD in All Participants, Depending on Whether...</hd> <p>For the criterion of ADHD, the diagnostic accuracy in all participants was as follows: for the "preoccupation" criterion (60.6%); for the "withdrawal" criterion (67.7%); for the "tolerance" criterion (66.3%); for the "loss of control" criterion (61.6%); for the "loss of interest" criterion (71.7%); for the "negative consequence" criterion (72.0%); for the "lying/deceiving" criterion (60.9%); for the "gaming as an escape" criterion (62.4%); and for the "functional impairment" criterion (59.1%; Table 5).</p> <p>Graph</p> <p>Table 5. Sensitivity, Specificity, Positive, and Negative Predictive Values and Diagnostic Accuracy of Each DSM-5 Criterion for Internet Gaming Disorder (IGD) in all Participants (N = 301), Depending on Whether or not They Meet the Criteria for ADHD.</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th /><th align="center" colspan="2">All participants with ADHD (<italic>n</italic> = 110)</th><th align="center" colspan="2">All participants without ADHD (<italic>n</italic> = 191)</th><th align="center" rowspan="2">Positive predictive value (%)</th><th align="center" rowspan="2">Negative predictive value (%)</th><th align="center" rowspan="2">Diagnostic accuracy (%)</th></tr><tr><th /><th align="center">Number who endorsed the criterion</th><th align="center">Sensitivity (%)</th><th align="center">Number who endorsed the criterion</th><th align="center">Specificity (%)</th></tr></thead><tbody><tr><td>Preoccupation</td><td>81</td><td>73.2</td><td>88</td><td>53.8</td><td>45.8</td><td>79.0</td><td>60.6</td></tr><tr><td>Withdrawal</td><td>63</td><td>57.7</td><td>51</td><td>73.1</td><td>53.3</td><td>76.4</td><td>67.7</td></tr><tr><td>Tolerance</td><td>28</td><td>25.8</td><td>23</td><td>87.9</td><td>53.2</td><td>69.0</td><td>66.3</td></tr><tr><td>Loss of control</td><td>81</td><td>73.2</td><td>85</td><td>55.5</td><td>46.7</td><td>79.5</td><td>61.6</td></tr><tr><td>Loss of interest</td><td>76</td><td>69.1</td><td>51</td><td>73.1</td><td>57.8</td><td>81.6</td><td>71.7</td></tr><tr><td>Negative consequences</td><td>87</td><td>79.4</td><td>61</td><td>68.1</td><td>57.0</td><td>86.1</td><td>72.0</td></tr><tr><td>Lying/deceiving</td><td>65</td><td>58.8</td><td>72</td><td>62.1</td><td>45.2</td><td>73.9</td><td>60.9</td></tr><tr><td>Gaming as an escape</td><td>57</td><td>51.5</td><td>61</td><td>68.1</td><td>46.3</td><td>72.5</td><td>62.4</td></tr><tr><td>Functional impairment</td><td>100</td><td>90.7</td><td>110</td><td>42.3</td><td>45.6</td><td>89.5</td><td>59.1</td></tr></tbody></table> </ephtml> </p> <hd id="AN0171103550-16">Discussion</hd> <p>Out of the nine IGD criteria, the item "functional impairment" had low diagnostic accuracy in participants with IGD or GD. The IGD (GD) group had a higher prevalence of ADHD as compared to the general gamer group. Conversely, there was a higher occurrence of IGD (GD) in the ADHD group as compared to the non-ADHD group.</p> <p>According to diagnostic accuracy values, each criterion of IGD criteria of DSM–5 can be classified as follows 0.9 to 1.0: excellent, 0.8 to 0.9: very good, 0.7 to 0.8: good, 0.6 to 0.7: sufficient, 0.5 to 0.6: bad, and <0.5: test not useful. When the participants were assessed for IGD of DSM–5 criteria, all criteria except for "tolerance" showed "good" diagnostic accuracy. The criterion for "tolerance" showed "sufficient" diagnostic accuracy (Table 3). When the participants were evaluated for GD of the ICD–11 criteria, the criteria of "tolerance," "loss of control," "loss of interest," and "negative consequences" indicated "good" diagnostic accuracy. The criteria of "withdrawal," "lying/deceiving," and "gaming as an escape" revealed "sufficient" diagnostic accuracy. The criteria of "preoccupation" and "functional impairment" showed "bad" diagnostic accuracy (Table 3).</p> <p>The diagnostic accuracy was lower when diagnosed with GD based on the ICD–11 criteria, as compared to the IGD of the DSM–5. Only the four criteria of "tolerance," "loss of control," "loss of interest," and "negative consequence" showed "good" and "very good" diagnostic accuracy, ranging from 70.3% to 83.2%. The differences in diagnostic accuracy between IGD and GD may be due to the high sensitivity of GD within the four criteria: "loss of control," "loss of interest," "negative consequences," and "functional impairments."</p> <p>The criterion of "functional impairment" showed poor diagnostic accuracy due to a very low specificity in the current study. However, the criterion of "functional impairment" is regarded as the most important criterion for the four GD criteria and mandatory requirements ([<reflink idref="bib5" id="ref60">5</reflink>]; [<reflink idref="bib27" id="ref61">27</reflink>]; [<reflink idref="bib29" id="ref62">29</reflink>]). Compared to other studies, the diagnostic criterion of "functional impairment" in the current study was significantly worse ([<reflink idref="bib28" id="ref63">28</reflink>]; [<reflink idref="bib40" id="ref64">40</reflink>]). The reason for the different findings between the current study and the other three studies we conducted may be due to dissimilarities in participants. We recruited a clinical sample to seek medical help for problematic Internet gaming, whereas another study recruited patients from the general population and classified them into two or three groups using IGD diagnostic criteria.</p> <p>The low diagnostic accuracy of "functional impairment" in the current study may have several implications. First, several scholars have examined the validity, threshold, and appropriateness of these diagnostic criteria ([<reflink idref="bib1" id="ref65">1</reflink>]; [<reflink idref="bib31" id="ref66">31</reflink>]; [<reflink idref="bib43" id="ref67">43</reflink>]). It has also been argued that the proposed criteria for IGD and GD are not suitable for distinguishing between highly engaged and problematic gamers ([<reflink idref="bib8" id="ref68">8</reflink>]; [<reflink idref="bib12" id="ref69">12</reflink>]; [<reflink idref="bib13" id="ref70">13</reflink>]; [<reflink idref="bib20" id="ref71">20</reflink>]; [<reflink idref="bib43" id="ref72">43</reflink>]). Reliable diagnostic criteria are essential to clarify the psychiatric manifestation of problematic gaming and to facilitate the development of operative treatment strategies for individuals who need qualified intervention ([<reflink idref="bib25" id="ref73">25</reflink>], [<reflink idref="bib26" id="ref74">26</reflink>]; [<reflink idref="bib31" id="ref75">31</reflink>]).</p> <p>Second, clinical samples might include patients with comorbid diseases, including major depressive disorder, and ADHD ([<reflink idref="bib31" id="ref76">31</reflink>]; [<reflink idref="bib43" id="ref77">43</reflink>]; [<reflink idref="bib45" id="ref78">45</reflink>]). Our sample in the current study also exhibited a high rate of comorbidity with ADHD. In this context, we tested the diagnostic accuracy of each DSM–5 criterion for ADHD. Only "functional impairment" showed poor diagnostic accuracy. The results were similar when we tested the diagnostic accuracy of nine criteria for ADHD in the clinical and general gamer groups separately. Diagnostic criteria other than "tolerance" showed sufficient to good diagnostic accuracy in the clinical group and diagnostic criteria other than "preoccupation," "loss of control," and "functional impairment" showed sufficient to good diagnostic accuracy. These findings may imply that diagnostic criteria for IGD could identify patients with ADHD; in other words, it is difficult to distinguish patients with IGD/GD from ADHD patients using IGD/GD diagnostic criteria. Clarification is needed as to whether these results are due to the inadequacy of diagnostic criteria ([<reflink idref="bib8" id="ref79">8</reflink>]; [<reflink idref="bib12" id="ref80">12</reflink>]; [<reflink idref="bib13" id="ref81">13</reflink>]; [<reflink idref="bib20" id="ref82">20</reflink>]; [<reflink idref="bib43" id="ref83">43</reflink>]), or whether treatment-seeking gaming behavior is driven by comorbid ADHD ([<reflink idref="bib31" id="ref84">31</reflink>]; [<reflink idref="bib43" id="ref85">43</reflink>]; [<reflink idref="bib45" id="ref86">45</reflink>]), or whether the problematic gaming behavior itself is a manifestation of the underlying ADHD ([<reflink idref="bib20" id="ref87">20</reflink>]; [<reflink idref="bib29" id="ref88">29</reflink>]). Overall, our findings confirm a close association between ADHD and IGD/GD in accordance with previous studies ([<reflink idref="bib39" id="ref89">39</reflink>]; [<reflink idref="bib44" id="ref90">44</reflink>]; [<reflink idref="bib49" id="ref91">49</reflink>]).</p> <p>Many studies have intimated psychiatric comorbidities and conceptual overlap between ADHD and IGD in terms of clinical and biological aspects ([<reflink idref="bib9" id="ref92">9</reflink>]; [<reflink idref="bib14" id="ref93">14</reflink>]; [<reflink idref="bib44" id="ref94">44</reflink>]; [<reflink idref="bib47" id="ref95">47</reflink>]). Several studies have described a high co-occurrence of ADHD in patients with IGD ([<reflink idref="bib14" id="ref96">14</reflink>]; [<reflink idref="bib35" id="ref97">35</reflink>]; [<reflink idref="bib44" id="ref98">44</reflink>]; [<reflink idref="bib49" id="ref99">49</reflink>]). Some imaging studies have proposed similar brain activity in the resting state ([<reflink idref="bib9" id="ref100">9</reflink>]; [<reflink idref="bib47" id="ref101">47</reflink>]) and brain changes in response to ADHD treatment ([<reflink idref="bib17" id="ref102">17</reflink>]). It has also been assumed that problematic gaming behavior could be a facet of another mental disorder or a phenotype of the underlying psychopathologies, such as ADHD ([<reflink idref="bib20" id="ref103">20</reflink>]; [<reflink idref="bib24" id="ref104">24</reflink>]; [<reflink idref="bib29" id="ref105">29</reflink>]; [<reflink idref="bib43" id="ref106">43</reflink>]; [<reflink idref="bib45" id="ref107">45</reflink>]).</p> <p>This study has several limitations. First, the questionnaires were self-reported, which could lead to recall bias, or underestimation of clinical symptoms. Additional information collected from other sources, such as parents or other family members, may offer further details. Second, although this study recruited participants 13 years of age or older, the minimum age of participants actually recruited was 17 years old. Considering the means/SDs of age (21.5 ± 64.63, 21.9 ± 2.51), the majority of study participants were young adults, including a small number of late adolescents. Therefore, caution should be taken in generalizing the age range of adolescents and adults. Moreover, the extent to which the results of this Korean study can be generalized is uncertain. Gaming patterns and treatment-seeking behaviors are largely influenced by cultural factors. Especially in Korea, there are various treatment centers for individuals with problematic gaming, and visiting these centers for gaming behaviors tends to be socially acceptable as compared to other countries. Thus, the representative participants of the clinical group, treatment-seeking gamers, would have to be carefully generalized. Nevertheless, the strength of this study is that psychiatrists thoroughly interviewed all participants with highly reliable semi-structured diagnostic interviews and confirmed diagnoses of IGD/GD with their professional experience.</p> <hd id="AN0171103550-17">Conclusion</hd> <p>In the clinical sample, our results displayed stable diagnostic accuracy for the IGD criterion when diagnosed with IGD based on the DSM–5 criteria but not when diagnosed according to GD on the WHO criteria. The criterion of "functional impairment" in GD induced by ADHD may lead to low specificity in poor diagnostic accuracy. In addition, the possibility of ADHD should be considered when IGD or GD is diagnosed in patients with problematic Internet gaming.</p> <ref id="AN0171103550-18"> <title> References </title> <blist> <bibl id="bib1" idref="ref18" type="bt">1</bibl> <bibtext> Aarseth E., Bean A. M., Boonen H., Colder Carras M., Coulson M., Das D., Deleuze J., Dunkels E., Edman J., Ferguson C. J., Haagsma M. C., Helmersson Bergmark K., Hussain Z., Jansz J., Kardefelt-Winther D., Kutner L., Markey P., Nielsen R. K. L., Prause N.,.. Van Rooij A. J. (2017). Scholars' open debate paper on the World Health Organization ICD-11 gaming disorder proposal. Journal of Behavioral Addictions, 6(3), 267–270. https://doi.org/10.1556/2006.5.2016.088</bibtext> </blist> <blist> <bibl id="bib2" idref="ref40" type="bt">2</bibl> <bibtext> Adler L. A., Shaw D. M., Spencer T. J., Newcorn J. H., Hammerness P., Sitt D. J., Minerly C., Davidow J. V., Faraone S. V. (2012). Preliminary examination of the reliability and concurrent validity of the attention-deficit/hyperactivity disorder self-report scale v1.1 symptom checklist to rate symptoms of attention-deficit/hyperactivity disorder in adolescents. Journal of Child and Adolescent Psychopharmacology, 22(3), 238–244. https://doi.org/10.1089/cap.2011.0062</bibtext> </blist> <blist> <bibl id="bib3" idref="ref41" type="bt">3</bibl> <bibtext> Ahn J. K., Kim Y., Choi K. H. (2019). The psychometric properties and clinical utility of the Korean version of GAD-7 and GAD-2. Frontiers in Psychiatry, 10, 127.</bibtext> </blist> <blist> <bibl id="bib4" idref="ref8" type="bt">4</bibl> <bibtext> American Psychiatric Association, DSM–5 Task Force.(2013). Diagnostic and statistical manual of mental disorders: DSM–5™ (5th ed.). American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596</bibtext> </blist> <blist> <bibl id="bib5" idref="ref14" type="bt">5</bibl> <bibtext> Billieux J., King D. L., Higuchi S., Achab S., Bowden-Jones H., Hao W., Long J., Lee H. K., Potenza M. N., Saunders J. B., Poznyak V. (2017). Functional impairment matters in the screening and diagnosis of gaming disorder. Journal of Behavioral Addictions, 6(3), 285–289. https://doi.org/10.1556/2006.6.2017.036</bibtext> </blist> <blist> <bibl id="bib6" idref="ref10" type="bt">6</bibl> <bibtext> Billieux J., Schimmenti A., Khazaal Y., Maurage P., Heeren A. (2015). Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. Journal of Behavioral Addictions, 4(3), 119–123. https://doi.org/10.1556/2006.4.2015.009</bibtext> </blist> <blist> <bibl id="bib7" idref="ref1" type="bt">7</bibl> <bibtext> Cade R., Gates J. (2017). Gamers and video game culture: An introduction for counselors. Family Journal, 25(1), 70–75. https://doi.org/10.1177/1066480716679809</bibtext> </blist> <blist> <bibl id="bib8" idref="ref68" type="bt">8</bibl> <bibtext> Carbonell X. (2017). From pong to pokemon go, catching the essence of the Internet Gaming Disorder diagnosis. Journal of Behavioral Addictions, 6(2), 124–127. https://doi.org/10.1556/2006.6.2017.010</bibtext> </blist> <blist> <bibl id="bib9" idref="ref31" type="bt">9</bibl> <bibtext> Castellanos F. X., Aoki Y. (2016). Intrinsic functional connectivity in attentiondeficit/hyperactivity disorder: A science in development. Biological Psychiatry Cognitive Neuroscience and Neuroimaging, 1(3), 253–261. https://doi.org/10.1016/j.bpsc.2016.03.004</bibtext> </blist> <blist> <bibtext> de Freitas S., Griffiths M. (2007). Online gaming as an educational tool in learning and training. British Journal of Educational Technology, 38(3), 535–537. https://doi.org/10.1111/j.1467-8535.2007.00720.x</bibtext> </blist> <blist> <bibtext> de Freitas S., Griffiths M. (2008). The convergence of gaming practices with other media forms: What potential for learning? A review of the literature. Learning Media & Technology, 33(1), 1011–1020. https://doi.org/10.1080/17439880701868796</bibtext> </blist> <blist> <bibtext> Deleuze J., Nuyens F., Rochat L., Rothen S., Maurage P., Billieux J. (2017). Established risk factors for addiction fail to discriminate between healthy gamers and gamers endorsing DSM-5 Internet gaming disorder. Journal of Behavioral Addictions, 6(4), 516–524. https://doi.org/10.1556/2006.6.2017.074</bibtext> </blist> <blist> <bibtext> Dowling N. A. (2014). Issues raised by the DSM-5 internet gaming disorder classification and proposed diagnostic criteria. Addiction, 109(9), 1408–1409. https://doi.org/10.1111/add.12554</bibtext> </blist> <blist> <bibtext> Dullur P., Krishnan V., Diaz A. M. (2021). A systematic review on the intersection of attention-deficit hyperactivity disorder and gaming disorder. Journal of Psychiatric Research, 133, 212–222. https://doi.org/10.1016/j.jpsychires10.1016/j.jpsychires.2020.12.026</bibtext> </blist> <blist> <bibtext> Green J. G., DeYoung G., Wogan M. E., Wolf E. J., Lane K. L., Adler L. A. (2019). Evidence for the reliability and preliminary validity of the adult ADHD self-report scale v1.1 (ASRS v1.1) screener in an adolescent community sample. International Journal of Methods in Psychiatric Research, 28(1), e1751. https://doi.org/10.1002/mpr.1751</bibtext> </blist> <blist> <bibtext> Grüsser S. M., Thalemann R., Griffiths M. D. (2007). Excessive computer game playing: Evidence for addiction and aggression? CyberPsychology & Behavior, 10(2), 290–292. https://doi.org/10.1089/cpb.2006.9956</bibtext> </blist> <blist> <bibtext> Han D. H., Bae S., Hong J., Kim S. M., Son Y. D., Renshaw P. (2021). Resting-state fMRI study of ADHD and Internet Gaming Disorder. Journal of Attention Disorders, 25(8), 1080–1095. https://doi.org/10.1177/1087054719883022</bibtext> </blist> <blist> <bibtext> Han D. H., Lee Y. S., Na C., Ahn J. Y., Chung U. S., Daniels M. A., Haws C. A., Renshaw P. F. (2009). The effect of methylphenidate on Internet video game play in children with attentiondeficit/hyperactivity disorder. Comprehensive Psychiatry, 50(3), 251–256. https://doi.org/10.1016/j.comppsych.2008.08.011</bibtext> </blist> <blist> <bibtext> Kaptsis D., King D. L., Delfabbro P. H., Gradisar M. (2016). Withdrawal symptoms in internet gaming disorder: A systematic review. Clinical Psychology Review, 43, 58–66. https://doi.org/10.1016/j.cpr.2015.11.006</bibtext> </blist> <blist> <bibtext> Kardefelt-Winther D. (2014). Meeting the unique challenges of assessing internet gaming disorder. Addiction, 109(9), 1568–1570. https://doi.org/10.1111/add.12645</bibtext> </blist> <blist> <bibtext> Kim J. H., Lee E. H., Joung Y. S. (2013). The WHO adult ADHD self-report scale: Reliability and validity of the Korean version. Psychiatry Investigation, 10(1), 41–46.</bibtext> </blist> <blist> <bibtext> Kim S. J., Kim S. J., Kwon J. (2016). Treatment response of cognitive behavioral group therapy for social anxiety disorder: Indicators of treatment response and process of change. Korean Journal of Clinical Psychology, 35, 309–333.</bibtext> </blist> <blist> <bibtext> Kim E., Yim H. W., Jeong H., Jo S. J., Lee H. K., Son H. J., Han H. H. (2018). The association between aggression and risk of Internet gaming disorder in Korean adolescents: The mediation effect of father-adolescent communication style. Epidemiology and Health, 40, e2018039.</bibtext> </blist> <blist> <bibtext> King D. L., Delfabbro P. H. (2014). The cognitive psychology of Internet gaming disorder. Clinical Psychology Review, 34(4), 298–308. https://doi.org/10.1016/j.cpr.2014.03.006</bibtext> </blist> <blist> <bibtext> King D. L., Delfabbro P. H., Potenza M. N., Demetrovics Z., Billieux J., Brand M. (2018). Internet gaming disorder should qualify as a mental disorder. Australian and New Zealand Journal of Psychiatry, 52(7), 615–617. https://doi.org/10.1177/0004867418771189</bibtext> </blist> <blist> <bibtext> King D. L., Delfabbro P. H., Potenza M. N., Demetrovics Z., Billieux J., Brand M. (2019). Logic, evidence, and consensus: Towards a more constructive debate on gaming disorder. Australian and New Zealand Journal of Psychiatry, 53(11), 1047–1049. https://doi.org/10.1177/0004867419864435</bibtext> </blist> <blist> <bibtext> Ko C. H. (2014). Internet gaming disorder. Current Addiction Reports, 1(3), 177–185. https://doi.org/10.1007/s40429-014-0030-y10.1007/s40429-014-0030-y</bibtext> </blist> <blist> <bibtext> Ko C. H., Yen J. Y., Chen S. H., Wang P. W., Chen C. S., Yen C. F. (2014). Evaluation of the diagnostic criteria of Internet gaming disorder in the DSM-5 among young adults in Taiwan. Journal of Psychiatric Research, 53, 103–110. https://doi.org/10.1016/j.jpsychires.2014.02.008</bibtext> </blist> <blist> <bibtext> Krossbakken E., Pallesen S., Molde H., Mentzoni R. A., Finserås T. R. (2017). Not good enough? Further comments to the wording, meaning, and the conceptualization of Internet gaming disorder. Journal of Behavioral Addictions, 6(2), 114–117. https://doi.org/10.1556/2006.6.2017.013</bibtext> </blist> <blist> <bibtext> Kuss D. J., Griffiths M. D. (2012). Internet gaming addiction: A systematic review of empirical research. International Journal of Mental Health and Addiction, 10(2), 278–296. https://doi.org/10.1007/s11469-011-9318-510.1007/s11469-011-9318-5</bibtext> </blist> <blist> <bibtext> Kuss D. J., Griffiths M. D., Pontes H. M. (2017). Chaos and confusion in DSM-5 diagnosis of Internet Gaming Disorder: Issues, concerns, and recommendations for clarity in the field. Journal of Behavioral Addictions, 6(2), 103–109. https://doi.org/10.1556/2006.5.2016.062</bibtext> </blist> <blist> <bibtext> Larose R., Mastro D., Eastin M. S. (2001). Understanding Internet usage: A socialcognitive approach to uses and gratifications. Social Science Computer Review, 19(4), 395–413. https://doi.org/10.1177/089443930101900401</bibtext> </blist> <blist> <bibtext> Lee K., Lee H. K., Gyeong H., Yu B., Song Y. M., Kim D. (2013). Reliability and validity of the Korean version of the Internet Addiction Test among college students. Journal of Korean Medical Science, 28(5), 763–768.</bibtext> </blist> <blist> <bibtext> Lee S. Y., Huh Y., Kim J., Han C. (2014). Finding optimal cut off points of the Korean version of the Patient Health Questionnaire-9 (PHQ-9) for screening depressive disorders. Journal of Korean Society for Depressive and Bipolar Disorders, 12, 32–36.</bibtext> </blist> <blist> <bibtext> Lee J., Bae S., Kim B. N., Han D. H. (2021). Impact of attention-deficit/hyperactivity disorder comorbidity on longitudinal course in Internet gaming disorder: aA 3-year clinical cohort studycohort studundefined. Journal of Child Psychology and Psychiatry, 62, 1110–1119. https://doi.org/10.1111/jcpp.13380 2021 Mar 9.</bibtext> </blist> <blist> <bibtext> Lim J. S., Kim S. J., Jeon W. T., Cha K. R., Park J. H., Kim C. H. (2008). Reliability and validity of the Korean version of Obsessive-Compulsive Inventory-Revised in a non-clinical sample. Yonsei Medical Journal, 49(6), 909–916.</bibtext> </blist> <blist> <bibtext> Loton D., Borkoles E., Lubman D., Polman R. (2016). Video game addiction, engagement, and symptoms of stress, depression, and anxiety: The mediating role of coping. International Journal of Mental Health and Addiction, 14(4), 565–578. https://doi.org/10.1007/s11469-015-9578-610.1007/s11469-015-9578-6</bibtext> </blist> <blist> <bibtext> Lyoo Y. C., Ju S., Kim E., Kim J. E., Lee J. H. (2014). The Patient Health Questionnaire-15 and its abbreviated version as screening tools for depression in Korean college and graduate students. Comprehensive.Psychiatry, 55(3), 743–748.</bibtext> </blist> <blist> <bibtext> Marmet S., Studer J., Grazioli V. S., Gmel G. (2018). Bidirectional associations between self-reported gaming disorder and adult attention deficit hyperactivity disorder: Evidence from a sample of young Swiss men. Frontiers in Psychiatry, 9, 649. https://doi.org/10.3389/fpsyt.2018.00649</bibtext> </blist> <blist> <bibtext> Müller K. W., Beutel M. E., Dreier M., Wölfling K. J. (2019). A clinical evaluation of the DSM-5 criteria for Internet Gaming Disorder and a pilot study on their applicability to further Internet-related disorders. Journal of Behavioral Addictions, 8(1), 16–24. https://doi.org/10.1556/2006.7.2018.140</bibtext> </blist> <blist> <bibtext> Park J. H., Lee Y. S., Sohn J. H., Han D. H. (2016). Effectiveness of atomoxetine and methylphenidate for problematic online gaming in adolescents with attention deficit hyperactivity disorder. Human Psychopharmacology, 31(6), 427–432. https://doi.org/10.1002/hup.2559</bibtext> </blist> <blist> <bibtext> Sonnby K., Skordas K., Olofsdotter S., Vadlin S., Nilsson K. W., Ramklint M. (2015). Validation of the World Health Organization Adult ADHD self-report scale for adolescents. Nordic Journal of Psychiatry, 69(3), 216–223. https://doi.org/10.3109/08039488.2014.968203</bibtext> </blist> <blist> <bibtext> Starcevic V. (2017). Internet gaming disorder: Inadequate diagnostic criteria wrapped in a constraining conceptual model. Journal of Behavioral Addictions, 6(2), 110–113. https://doi.org/10.1556/2006.6.2017.012</bibtext> </blist> <blist> <bibtext> Starcevic V., Choi T. Y., Kim T. H., Yoo S. K., Bae S., Choi B. S., Han D. H. (2020). Internet gaming disorder and gaming disorder in the context of seeking and not seeking treatment for video-gaming. Journal of Psychiatric Research, 129, 31–39. https://doi.org/10.1016/j.jpsychires.2020.06.007</bibtext> </blist> <blist> <bibtext> van Rooij A. J., Ferguson C. J., Colder Carras M., Kardefelt-Winther D., Shi J., Aarseth E., Bean A. M., Bergmark K. H., Brus A., Coulson M., Deleuze J., Dullur P., Dunkels E., Edman J., Elson M., Etchells P. J., Fiskaali A., Granic I., Jansz J., Przybylski A. K. (2018). A weak scientific basis for gaming disorder: Let us err on the side of caution. Journal of Behavioral Addictions, 7(1), 1–9. https://doi.org/10.1556/2006.7.2018.19</bibtext> </blist> <blist> <bibtext> Van Rooij A. J., Kardefelt-Winther D. (2017). Lost in the chaos: Flawed literature should not generate new disorders. Journal of Behavioral Addictions, 6(2), 128–132. https://doi.org/10.1556/2006.6.2017.015</bibtext> </blist> <blist> <bibtext> Weinstein A., Livny A., Weizman A. (2017). New developments in brain research of internet and gaming disorder. Neuroscience and Biobehavioral Reviews, 75, 314–330. https://doi.org/10.1016/j.neubiorev.2017.01.040</bibtext> </blist> <blist> <bibtext> WHO. (2019). The 11th revision of the international classification of diseases. World Health Organization.</bibtext> </blist> <blist> <bibtext> Yen J. Y., Liu T. L., Wang P. W., Chen C. S., Yen C. F., Ko C. H. (2017). Association between Internet gaming disorder and adult attention deficit and hyperactivity disorder and their correlates: Impulsivity and hostility. Addictive Behaviors, 64, 308–313. https://doi.org/10.1016/j.addbeh.2016.04.024</bibtext> </blist> <blist> <bibtext> Yoo S. W., Kim Y. S., Noh J. S., Oh K. S., Kim C. H., Nam K., Chae J. H., Lee G. C., Jeon S. I., Min K. J., Oh D. J., Joo E. J., Park H. J., Choi Y. H., Kim S. J. (2006). Validity of Korean version of the mini-international neuropsychiatric Interview. Anxiety and Mood, 1, 50–55.</bibtext> </blist> </ref> <ref id="AN0171103550-19"> <title> Footnotes </title> <blist> <bibtext> The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.</bibtext> </blist> <blist> <bibtext> The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Ministry of Culture, Sports and Tourism, Republic of Korea, 2018-2019</bibtext> </blist> <blist> <bibtext> Vladan Starcervic</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0000-0002-6772-6995 Doug Hyun Han</bibtext> </blist> <blist> <bibtext>Graph https://orcid.org/0000-0002-8314-0767</bibtext> </blist> </ref> <aug> <p>By Ji Sun Hong; Sujin Bae; Vladan Starcervic and Doug Hyun Han</p> <p>Reported by Author; Author; Author; Author</p> <p></p> <p>Ji Sun Hong is an assistant professor in the department of psychiatry at Chung-Ang University Gwangmyeong Hospital with ten years of experience in the field. She holds a medical degree from Chung-Ang University College of Medicine, and obtained a Ph.D. from the same graduate school. Ji Sun's area of specialization lies in child-adolescent psychiatry, with a particular focus on anxiety disorders and internet gaming disorder.</p> <p>Sujin Bae is a research professor in the Office of Research at Chung-Ang University. He graduated from Chung-Ang University with a major in psychology and received his bachelor's degree and Ph.D. in brain science from Seoul National University, going on to study at the University of Utah for his post-doctoral fellowship. Sujin Bae's interests are internet gaming disorder and brain analysis research.</p> <p>Dr. Doug Hyun Han hold the esteemed positions of Professor and Director at the Department of Psychiatry, Chung-Ang University Hospital. He holds a medical degree from Chung-Ang University College of Medicine, and he further pursued his academic journey by obtaining a Ph.D. from the same graduate school. He possesses expertise in various specialized areas, including addiction, sports psychiatry, and child-adolescent psychiatry. Dr. Han's invaluable contributions to these fields make him a respected authority in the field.</p> </aug> <nolink nlid="nl1" bibid="bib10" firstref="ref2"></nolink> <nolink nlid="nl2" bibid="bib11" firstref="ref3"></nolink> <nolink nlid="nl3" bibid="bib37" firstref="ref4"></nolink> <nolink nlid="nl4" bibid="bib16" firstref="ref5"></nolink> <nolink nlid="nl5" bibid="bib30" firstref="ref6"></nolink> <nolink nlid="nl6" bibid="bib32" firstref="ref7"></nolink> <nolink nlid="nl7" bibid="bib48" firstref="ref9"></nolink> <nolink nlid="nl8" bibid="bib19" firstref="ref11"></nolink> <nolink nlid="nl9" bibid="bib28" firstref="ref12"></nolink> <nolink nlid="nl10" bibid="bib27" firstref="ref15"></nolink> <nolink nlid="nl11" bibid="bib29" firstref="ref16"></nolink> <nolink nlid="nl12" bibid="bib45" firstref="ref17"></nolink> <nolink nlid="nl13" bibid="bib46" firstref="ref20"></nolink> <nolink nlid="nl14" bibid="bib43" firstref="ref21"></nolink> <nolink nlid="nl15" bibid="bib14" firstref="ref23"></nolink> <nolink nlid="nl16" bibid="bib35" firstref="ref24"></nolink> <nolink nlid="nl17" bibid="bib44" firstref="ref25"></nolink> <nolink nlid="nl18" bibid="bib49" firstref="ref26"></nolink> <nolink nlid="nl19" bibid="bib17" firstref="ref32"></nolink> <nolink nlid="nl20" bibid="bib47" firstref="ref33"></nolink> <nolink nlid="nl21" bibid="bib18" firstref="ref37"></nolink> <nolink nlid="nl22" bibid="bib41" firstref="ref38"></nolink> <nolink nlid="nl23" bibid="bib50" firstref="ref47"></nolink> <nolink nlid="nl24" bibid="bib34" firstref="ref48"></nolink> <nolink nlid="nl25" bibid="bib21" firstref="ref49"></nolink> <nolink nlid="nl26" bibid="bib15" firstref="ref51"></nolink> <nolink nlid="nl27" bibid="bib42" firstref="ref52"></nolink> <nolink nlid="nl28" bibid="bib38" firstref="ref53"></nolink> <nolink nlid="nl29" bibid="bib36" firstref="ref54"></nolink> <nolink nlid="nl30" bibid="bib23" firstref="ref55"></nolink> <nolink nlid="nl31" bibid="bib22" firstref="ref57"></nolink> <nolink nlid="nl32" bibid="bib33" firstref="ref58"></nolink> <nolink nlid="nl33" bibid="bib40" firstref="ref64"></nolink> <nolink nlid="nl34" bibid="bib31" firstref="ref66"></nolink> <nolink nlid="nl35" bibid="bib12" firstref="ref69"></nolink> <nolink nlid="nl36" bibid="bib13" firstref="ref70"></nolink> <nolink nlid="nl37" bibid="bib20" firstref="ref71"></nolink> <nolink nlid="nl38" bibid="bib25" firstref="ref73"></nolink> <nolink nlid="nl39" bibid="bib26" firstref="ref74"></nolink> <nolink nlid="nl40" bibid="bib39" firstref="ref89"></nolink> <nolink nlid="nl41" bibid="bib24" firstref="ref104"></nolink>
Header DbId: eric
DbLabel: ERIC
An: EJ1450053
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Correlation between Attention Deficit Hyperactivity Disorder, Internet Gaming Disorder or Gaming Disorder
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Ji+Sun+Hong%22">Ji Sun Hong</searchLink><br /><searchLink fieldCode="AR" term="%22Sujin+Bae%22">Sujin Bae</searchLink><br /><searchLink fieldCode="AR" term="%22Vladan+Starcervic%22">Vladan Starcervic</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-6772-6995">0000-0002-6772-6995</externalLink>)<br /><searchLink fieldCode="AR" term="%22Doug+Hyun+Han%22">Doug Hyun Han</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-8314-0767">0000-0002-8314-0767</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+Attention+Disorders%22"><i>Journal of Attention Disorders</i></searchLink>. 2023 27(11):1252-1262.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 11
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2023
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Correlation%22">Correlation</searchLink><br /><searchLink fieldCode="DE" term="%22Attention+Deficit+Hyperactivity+Disorder%22">Attention Deficit Hyperactivity Disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Psychopathology%22">Psychopathology</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Disorders%22">Mental Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Late+Adolescents%22">Late Adolescents</searchLink><br /><searchLink fieldCode="DE" term="%22Young+Adults%22">Young Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Computer+Games%22">Computer Games</searchLink><br /><searchLink fieldCode="DE" term="%22Addictive+Behavior%22">Addictive Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Individual+Characteristics%22">Individual Characteristics</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms+%28Individual+Disorders%29%22">Symptoms (Individual Disorders)</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22South+Korea%22">South Korea</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1177/10870547231176861
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1087-0547<br />1557-1246
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Individuals with internet gaming disorder (IGD) or gaming disorder (GD) had a higher prevalence of ADHD than individuals without IGD or GD. The overpathologizing of excessive gaming behaviors may be associated with the functional impairment due to ADHD in individuals with GD. Methods: The present study was designed to compare the gaming patterns, accompanying psychopathology, and co-occurring psychiatric disorders, especially ADHD, between clinical and general gamer samples (17-29 years old). Results: Out of the nine IGD criteria, the item "functional impairment" had low diagnostic accuracy in participants with IGD or GD. The IGD (GD) group had a higher prevalence of ADHD compared to the general gamer group. Conversely, there was a higher prevalence of IGD (GD) in the ADHD group compared to the non-ADHD group. Discussion: The possibility of ADHD should be considered when IGD or GD is diagnosed in patients with problematic Internet gaming.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2024
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1450053
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1450053
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1177/10870547231176861
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 11
        StartPage: 1252
    Subjects:
      – SubjectFull: Correlation
        Type: general
      – SubjectFull: Attention Deficit Hyperactivity Disorder
        Type: general
      – SubjectFull: Psychopathology
        Type: general
      – SubjectFull: Mental Disorders
        Type: general
      – SubjectFull: Late Adolescents
        Type: general
      – SubjectFull: Young Adults
        Type: general
      – SubjectFull: Computer Games
        Type: general
      – SubjectFull: Addictive Behavior
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Individual Characteristics
        Type: general
      – SubjectFull: Symptoms (Individual Disorders)
        Type: general
      – SubjectFull: South Korea
        Type: general
    Titles:
      – TitleFull: Correlation between Attention Deficit Hyperactivity Disorder, Internet Gaming Disorder or Gaming Disorder
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Ji Sun Hong
      – PersonEntity:
          Name:
            NameFull: Sujin Bae
      – PersonEntity:
          Name:
            NameFull: Vladan Starcervic
      – PersonEntity:
          Name:
            NameFull: Doug Hyun Han
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 09
              Type: published
              Y: 2023
          Identifiers:
            – Type: issn-print
              Value: 1087-0547
            – Type: issn-electronic
              Value: 1557-1246
          Numbering:
            – Type: volume
              Value: 27
            – Type: issue
              Value: 11
          Titles:
            – TitleFull: Journal of Attention Disorders
              Type: main
ResultId 1