The relationship between probable ADHD and playing MMORPGs with the severity of disordered gaming: The effect of gaming motivations

Objective: The main aim of the present study was to consider the impact of gaming motivations among young adults when evaluating the relationship between probable attention deficit hyperactivity disorder (ADHD) and massively multiplayer online role-playing games (MMORPGs), with disordered gaming. Method: In the present study, participants were assessed with the Adult ADHD Self-Report Scales (ASRS-v1.1), the Motives for Online Gaming Questionnaire (MOGQ), and the nine-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF). Results: Participants with probable ADHD (n=143, 19.2%) and without probable ADHD (n=602, 80.8%) did not differ according to the current age, gender, presence of romantic relationship, marital status, where and with whom they are living, employment status and time spent on the gaming. Compared to participants without probable ADHD, those with probable ADHD had higher rates of having a game console, purchasing games, gaming more than usual on weekends, having problems related to gaming, probable internet gaming disorder (IGD) according to IGDS9-SF cut-off score and higher scales scores (IGDS9-SF and MOGQ), whereas they had a lower age at first gaming. Among different game types, those with probable ADHD were gaming more with multiplayer online battle arena games, social network games, music games, MMORPGs, sports games/car games, and horror-themed/survival games. Scores of all six types of gaming motives were higher among those with probable ADHD, and among them coping/escape, social, skill development, and fantasy distinguished the presence of probable ADHD. In the ANCOVA analysis, the presence of probable ADHD and the use of MMORPGs (as well as online gaming motives [coping/escape, recreation, fantasy, social and competition]) predicted the severity of IGD symptoms, and also these effects also interacted, involving probable ADHD and using MMORPGs. Conclusion: These findings suggest that those with probable ADHD may have different gaming characteristics than those without probable ADHD. Probable ADHD and using MMORPGs are related to the severity of disordered gaming, along with almost all type of online gaming motivations. Also, the effects of probable ADHD and MMORPGs use interacted with each other.

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1. López-Fernández FJ, Mezquita L, Griffiths MD, Ortet G, Ibáñez MI. The role of personality on disordered gaming and game genre preferences in adolescence: gender differences and personenvironment transactions. Adicciones 2020; 0:1370.

2. Griffiths MA. A “components” model of addiction within a biopsychosocial framework. J Subst Use 2005; 10:191-197. [CrossRef]

3. Lemmens JS, Valkenburg P, Peter J. Development and validation of a game addiction scale for adolescents. Media Psychol 2009; 12:77-95. [CrossRef]

4. Gentile DA, Choo H, Liau A, Sim T, Li D, Fung D, et al. Pathological video game use among youths: a two-year longitudinal study. Pediatrics 2011; 127:e319-329 [CrossRef].

5. Aggarwal S, Saluja S, Gambhir V, Gupta S, Satia SPS. Predicting likelihood of psychological disorders in PlayerUnknown’s Battlegrounds (PUBG) players from Asian countries using supervised machine learning. Addict Behav 2020; 101:106132. [CrossRef]

6. Saunders JB, Hao W, Long J, King DL, Mann K, Fauth-Bühler M, et al. Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention. J Behav Addict 2017; 6:271-279 [CrossRef].

7. Petry NM, O’Brien CP. Internet gaming disorder and the DSM-5. Addiction 2013; 108:1186-1187. [CrossRef]

8. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth ed., Arlington, VA: American Psychiatric Association, 2013. [CrossRef]

9. World Health Organization. Addictive behaviours: Gaming disorder. https://www.who.int/features/qa/gaming-disorder/en/. Accessed February 19, 2021.

10. Carli V, Durkee T, Wasserman D, Hadlaczky G, Despalins R, Kramarz E, et al. The association between pathological internet use and comorbid psychopathology: a systematic review. Psychopathology 2013; 46:1-13. [CrossRef]

11. Ho RC, Zhang MW, Tsang TY, Toh AH, Pan F, Lu Y, et al. The association between internet addiction and psychiatric co-morbidity: a meta-analysis. BMC Psychiatry 2014; 14:183. [CrossRef]

12. Dalbudak E, Evren C. The relationship of Internet addiction severity with attention deficit hyperactivity disorder symptoms in Turkish university students; impact of personality traits, depression and anxiety. Compr Psychiatry 2014; 55:497-503.

13. Dalbudak E, Evren C, Aldemir S, Taymur I, Evren B, Topcu M. The impact of sensation seeking on the relationship between attention deficit/hyperactivity symptoms and severity of Internet addiction risk. Psychiatry Res 2015; 228:156-161. [CrossRef]

14. Kim BS, Chang SM, Park JE, Seong SJ, Won SH, Cho MJ. Prevalence, correlates, psychiatric comorbidities, and suicidality in a community population with problematic Internet use. Psychiatry Res 2016; 244:249-256. [CrossRef]

15. Kitazawa M, Yoshimura M, Murata M, Sato-Fujimoto Y, Hitokoto H, Mimura M, et al. Associations between problematic Internet use and psychiatric symptoms among university students in Japan. Psychiatry Clin Neurosci 2018; 72:531-539. [CrossRef]

16. Bielefeld M, Drews M, Putzig I, Bottel L, Steinbüchel T, Dieris- Hirche J, et al. Comorbidity of Internet use disorder and attention deficit hyperactivity disorder: Two adult case-control studies. J Behav Addict 2017; 6:490-504. [CrossRef]

17. Kim D, Lee D, Lee J, Namkoong K, Jung YC. Association between childhood and adult attention deficit hyperactivity disorder symptoms in Korean young adults with Internet addiction. J Behav Addict 2017; 6:345-353. [CrossRef]

18. Leménager T, Hoffmann S, Dieter J, Reinhard I, Mann K, Kiefer F. The links between healthy, problematic, and addicted Internet use regarding comorbidities and self-concept-related characteristics. J Behav Addict 2018; 7:31-43. [CrossRef]

19. Bioulac S, Arfi L, Bouvard MP. Attention deficit/hyperactivity disorder and video games: a comparative study of hyperactive and control children. Eur Psychiatry 2008; 23:134-141. [CrossRef]

20. Evren B, Evren C, Dalbudak E, Topcu M, Kutlu N. Neuroticism and introversion mediates the relationship between probable ADHD and symptoms of Internet gaming disorder: results of an online survey. Psychiatry Clin Psychopharmacol 2019; 29:90- 96. [CrossRef]

21. Ha JH, Yoo HJ, Cho IH, Chin B, Shin D, Kim JH. Psychiatric comorbidity assessed in Korean children and adolescents who screen positive for Internet addiction. J Clin Psychiatry 2006; 67:821-826. [CrossRef]

22. Han DH, Kim SM, Bae S, Renshaw PF, Anderson JS. Brain connectivity and psychiatric comorbidity in adolescents with Internet gaming disorder. Addict Biol 2017; 22:802-812. [CrossRef]

23. González-Bueso V, Santamaría JJ, Fernández D, Merino L, Montero E, Ribas J. Association between internet gaming disorder or pathological video-game use and comorbid psychopathology: a comprehensive review. Int J Environ Res Public Health 2018;15:668. [CrossRef]

24. Baer S, Bogusz E, Green DA. Stuck on screens: Patterns of computer and gaming station use in youth seen in a psychiatric clinic. J Can Acad Child Adolesc Psychiatry 2011; 20:86-94.

25. Hyun GJ, Han DH, Lee YS, Kang KD, Yoo SK, Chung US, et al. Risk factors associated with online game addiction: a hierarchical model. Comput Hum Behav 2015; 48:706-713. [CrossRef]

26. Panagiotidi M. Problematic video game play and ADHD traits in an adult population. Cyberpsychol Behav Soc Netw 2017; 20:292- 295. [CrossRef]

27. Yen JY, Liu TL, Wang PW, Chen CS, Yen CF, Ko CH. Association between Internet gaming disorder and adult attention deficit and hyperactivity disorder and their correlates: Impulsivity and hostility. Addict Behav 2017; 64:308-313. [CrossRef]

28. Vadlin S, Åslund C, Hellström C, Nilsson KW. Associations between problematic gaming and psychiatric symptoms among adolescents in two samples. Addict Behav 2016; 61:8-15. [CrossRef]

29. Wartberg L, Kriston L, Kramer M, Schwedler A, Lincoln TM, Kammerl R. Internet gaming disorder in early adolescence: Associations with parental and adolescent mental health. Eur Psychiatry 2017; 43:14-18. [CrossRef]

30. Strittmatter E, Kaess M, Parzer P, Fischer G, Carli V, Hoven CW, et al. Pathological Internet use among adolescents: Comparing gamers and non-gamers. Psychiatry Res 2015; 228:128-135.

31. Evren C, Evren B, Dalbudak E, Topcu M, Kutlu N. Relationships of Internet addiction and Internet gaming disorder symptom severities with probable attention deficit/hyperactivity disorder, aggression and negative affect among university students. Atten Defic Hyperact Disord 2019; 11:413-421. [CrossRef]

32. Evren C, Evren B, Dalbudak E, Topcu M, Kutlu N, Elhai JD. Relationship between internet gaming disorder symptoms with attention deficit hyperactivity disorder and alexithymia symptoms among university students. Addicta: The Turkish Journal on Addictions 2020; 7:1-9. [CrossRef]

33. Jung D, Shim EJ, Park H, Lee K, Lee S, Kim EY, et al. The association between excessive internet gaming behavior and immersive tendency, mediated by attention deficit/hyperactivity disorder symptoms, in Korean male university students. Psychiatry Investig 2020; 17:403-411. [CrossRef]

34. Stavropoulos V, Adams BLM, Beard CL, Dumble E, Trawley S, Gomez R, et al. Associations between attention deficit hyperactivity and internet gaming disorder symptoms: Is there consistency across types of symptoms, gender and countries? Addict Behav Rep 2019; 9:100158. [CrossRef]

35. Chang CH, Chang YC, Cheng H, Tzang RF. Treatment efficacy of internet gaming disorder with attention deficit hyperactivity disorder and emotional dysregulaton. Int J Neuropsychopharmacol 2020; 23:349-355. [CrossRef]

36. Van Rooij AJ, Schoenmakers TM, Vermulst AA, Van den Eijnden RJ, Van de Mheen D. Online video game addiction: identification of addicted adolescent gamers. Addiction 2011; 106:205-212.

37. Zanetta Dauriat F, Zermatten A, Billieux J, Thorens G, Bondolfi G, Zullino D, et al. Motivations to play specifically predict excessive involvement in massively multiplayer online roleplaying games: evidence from an online survey. Eur Addict Res 2011; 17:185-189. [CrossRef]

38. Elliott L, Golub A, Ream G, Dunlap E. Video game genre as a predictor of problem use. Cyberpsychol Behav Soc Netw 2012; 15:155-161. [CrossRef]

39. Elliott L, Ream G, McGinsky E, Dunlap E. The contribution of game genre and other use patterns to problem video game play among adult video gamers. Int J Ment Health Addict 2012; 10:948-969. [CrossRef]

40. Rehbein F, Kleimann M, Mössle T. Prevalence and risk factors of video game dependency in adolescence: results of a German nationwide survey. Cyberpsychol Behav Soc Netw 2010; 13:269- 277. [CrossRef]

41. Billieux J, Van der Linden M, Achab S, Khazaal Y, Paraskevopoulos L, Zullino D, et al. Why do you play World of Warcraft? An in-depth exploration of self-reported motivations to play online and in-game behaviours in the virtual world of Azeroth. Comput Hum Behav 2013;29:103-109. [CrossRef]

42. Lemmens JS, Hendriks SJ. Addictive online games: examining the relationship between game genres and internet gaming disorder. Cyberpsychol Behav Soc Netw 2016; 19:270-276. [CrossRef]

43. Kuss DJ, Griffiths MD. Online gaming addiction in children and adolescents: A review of empirical research. J Behav Addict 2012; 1:3-22. [CrossRef]

44. Lee MS, Ko YH, Song HS, Kwon KH, Lee HS, Nam M, Jung IK. Characteristics of Internet use in relation to game genre in Korean adolescents. Cyberpsychol Behav 2007; 10:278-285.

45. Stavropoulos V, Kuss DJ, Griffiths MD, Wilson P, Motti-Stefanidi F. MMORPG gaming and hostility predict Internet Addiction symptoms in adolescents: An empirical multilevel longitudinal study. Addict Behav 2017; 64:294-300. [CrossRef]

46. Eichenbaum A, Kattner F, Bradford D, Gentile DA, Green CS. Role-playing and real-time strategy games associated with greater probability of internet gaming disorder. Cyberpsychol Behav Soc Netw 2015; 18:480-485. [CrossRef]

47. Na E, Choi I, Lee TH, Lee H, Rho MJ, Cho H, Jung DJ, Kim DJ. The influence of game genre on Internet gaming disorder. J Behav Addict 2017; 6:1-8. [CrossRef]

48. Han H, Jeong H, Jo SJ, Son HJ, Yim HW. Relationship between the experience of online game genre and high risk of Internet gaming disorder in Korean adolescents. Epidemiol Health 2020; 42:e2020016. [CrossRef]

49. Bertran E, Chamarro A. Video gamers of League of Legends: The role of passion in abusive use and in performance. Adicciones 2016; 28:28-34. [CrossRef]

50. Kuss DJ, Louws J, Wiers RW. Online gaming addiction? Motives predict addictive play behavior in massively multiplayer online role-playing games. Cyberpsychol Behav Soc Netw 2012; 15:480- 485. [CrossRef]

51. Chang HY, Wong LL, Yap KZ, Yap KY. Gaming Preferences, Motivations, and Experiences of Pharmacy Students in Asia. Games Health J 2016; 5:40-49. [CrossRef]

52. Hussain Z, Griffiths MD, Baguley T. Online gaming addiction: classification, prediction and associated risk factors. Addict Res Theory 2012; 20:359-371. [CrossRef]

53. Müller KW, Janikian M, Dreier M, Wölfling K, Beutel ME, Tzavara C, et al. Regular gaming behavior and internet gaming disorder in European adolescents: results from a cross-national representative survey of prevalence, predictors, and psychopathological correlates. Eur Child Adolesc Psychiatry 2015; 24:565-574. [CrossRef]

54. Stetina BU, Kothgassner OD, Lehenbauer M, Kryspin-Exner I. Beyond the fascination of online-games: probing addictive behavior and depression in the World of online-gaming. Comput Hum Behav 2011; 27:473-479. [CrossRef]

55. Billieux J, Deleuze J, Griffiths MD, Kuss DJ. Internet gaming addiction: the case of massively multiplayer online role-playing games: In el-Guebaly N, Carrà G, Galanter M (editors). Textbook of Addiction Treatment: International Perspectives. Milan: Springer, 2015, 1515-1525. [CrossRef]

56. Billieux J, Thorens G, Khazaal Y, Zullino D, Achab S, Van der Linden M. Problematic involvement in online game: a cluster analytic approach. Comput Hum Behav 2015; 43:242-250.

57. Montag C, Schivinski B, Sariyska R, Kannen C, Demetrovics Z, Pontes HM. Psychopathological symptoms and gaming motives in disordered gaming-a psychometric comparison between the WHO and APA diagnostic frameworks. J Clin Med 2019; 8:1691. [CrossRef]

58. Yee N. The demographics, motivations, and derived experiences of users of massively multi-user online graphical environments. Presence: Teleoperators and Virtual Environments 2006; 15:309- 329. [CrossRef]

59. Yee N. Motivations for play in online games. Cyberpsychol Behav 2006; 9:772-775. [CrossRef]

60. Demetrovics Z, Urbán R, Nagygyörgy K, Farkas J, Zilahy D, Mervó B, et al. Why do you play? The development of the motives for online gaming questionnaire (MOGQ). Behav Res Methods 2011; 43:814-825. [CrossRef]

61. King DL, Delfabbro PH, Perales JC, Deleuze J, Király O, Krossbakken E, et al. Maladaptive player-game relationships in problematic gaming and gaming disorder: A systematic review. Clin Psychol Rev 2019; 73:101777. [CrossRef]

62. Fuster H, Carbonell X, Chamarro A, Oberst U. Interaction with the game and motivation among players of massively multiplayer online role-playing games. Span J Psychol 2013; 16:E43. [CrossRef]

63. Kaczmarek LD, Drążkowski D. MMORPG escapism predicts decreased well-being: examination of gaming time, game realism beliefs, and online social support for offline problems. Cyberpsychol Behav Soc Netw 2014; 17:298-302. [CrossRef]

64. Floros G, Siomos K. Patterns of choices on video game genres and Internet addiction. Cyberpsychol Behav Soc Netw 2012; 15:417-424. [CrossRef]

65. Király O, Urbán R, Griffiths MD, Ágoston C, Nagygyörgy K, Kökönyei G, et al. The mediating effect of gaming motivation between psychiatric symptoms and problematic online gaming: an online survey. J Med Internet Res 2015; 17:e88. [CrossRef]

66. Wu AM, Lai MH, Yu S, Lau JT, Lei MW. Motives for online gaming questionnaire: Its psychometric properties and correlation with Internet gaming disorder symptoms among Chinese people. J Behav Addict 2017; 6:11-20. [CrossRef]

67. Evren E, Evren B, Dalbudak E, Topcu M, Kutlu N. Psychometric Validation of the Turkish Motives for Online Gaming Questionnaire (MOGQ) across university students and video game players. Addicta: The Turkish Journal on Addictions 2020; 7:81-89. [CrossRef]

68. Pontes HM, Griffiths MD. Measuring DSM-5 Internet gaming disorder: Development and validation of a short psychometric scale. Comput Human Behav 2015; 45:137-143. [CrossRef]

69. Evren C, Dalbudak E, Topcu M, Kutlu N, Evren B, Pontes HM. Psychometric validation of the Turkish nine-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF). Psychiatry Res 2018; 265:349-354. [CrossRef]

70. Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 2005; 35:245-256. [CrossRef]

71. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: fourth edition (DSM-IV-TR). Washington, DC: American Psychiatric Association, 2000.

72. Dogan S, Oncu B, Varol-Saracoglu G, Kucukgoncu S. Validity and reliability of the Turkish version of the Adult ADHD Self-Report Scale (ASRS-v1.1). Anatolian Journal of Psychiatry 2009; 10:77-87.

73. Chamberlain SR, Ioannidis K, Leppink EW, Niaz F, Redden SA, Grant JE. ADHD symptoms in non-treatment seeking young adults: relationship with other forms of impulsivity. CNS Spectr 2017; 22:22-30. [CrossRef]

74. Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry 2006; 163:716-723. [CrossRef]

75. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62:617-627. [CrossRef]

76. Kandri TA, Bonotis KS, Floros GD, Zafiropoulou MM. Alexithymia components in excessive internet users: a multifactorial analysis. Psychiatry Res 2014; 220:348-355. [CrossRef]

77. Weinstein A, Weizman A. Emerging association between addictive gaming and attention-deficit/hyperactivity disorder. Curr Psychiatry Rep 2012; 14:590-597. [CrossRef]

78. Blasi MD, Giardina A, Giordano C, Coco GL, Tosto C, Billieux J, Schimmenti A. Problematic video game use as an emotional coping strategy: Evidence from a sample of MMORPG gamers. J Behav Addict 2019; 8:25-34. [CrossRef]

79. Bonnaire C, Baptista D. Internet gaming disorder in male and female young adults: The role of alexithymia, depression, anxiety and gaming type. Psychiatry Res 2019; 272:521-530. [CrossRef]

80. Wei HT, Chen MH, Huang PC, Bai YM. The association between online gaming, social phobia, and depression: an internet survey. BMC Psychiatry 2012; 12:92. [CrossRef]

81. Evren C, Dalbudak E, Ozen S, Evren B. The relationship of social anxiety disorder symptoms with probable attention deficit hyperactivity disorder in Turkish university students; impact of negative affect and personality traits of neuroticism and extraversion. Psychiatry Res 2017; 254:158-163. [CrossRef]

82. Park JH, Han DH, Kim BN, Cheong JH, Lee YS. Correlations among social anxiety, self-esteem, impulsivity, and game genre in patients with problematic online game playing. Psychiatry Investig 2016;13:297-304. [CrossRef]

83. Crowe N. ‘It’s like my life but more, and better!’ – Playing with the Cathaby Shark Girls: MMORPGs, young people and fantasybased social play. Int J Adolesc Youth 2011;16: 201-223. [CrossRef]

84. Donati MA, Chiesi F, Ammannato G, Primi C. Versatility and addiction in gaming: the number of video-game genres played is associated with pathological gaming in male adolescents.
Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi-Cover
  • ISSN: 1018-8681
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1984
  • Yayıncı: Kare Yayıncılık
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