Assessment of the Prevalence, Risk factors of Internet Gaming Disorder and Psychological correlates in general population of North India

 

Aitisam F. Shah1*, Jahangir H. Khan2, R.K. Patil3, Ramit Gupta4

1Pharm. D, Adesh Institute of Pharmacy and Biomedical Sciences, Bathinda, 151101, Punjab, India.

2Pharm. D, Adesh Institute of Pharmacy and Biomedical Sciences, Bathinda, 151101, Punjab, India.

3Professor and Head of Department, Adesh Institute of Pharmacy and Biomedical Sciences,

Bathinda, Punjab, India.

4Assistant Professor, Department of psychiatry-psychology, Adesh Hospital, Bathinda, 151101, Punjab, India.

*Corresponding Author E-mail: shahshanu072@gmail.com

 

ABSTRACT:

Background: In 2013 American psychiatric association decided to incorporate internet gaming disorder as non-substance addiction. This study aimed to find the prevalence and risk factors. Methodology: It was a cross-section observational study conducted on a general population. The sample size was time limited. A valid standard questionnaire (PHQ-9, IGDS, GAD-7 Scales) was used to collect data. Result: There was 82 male and 43 female involved in this study. The prevalence of internet gaming disorder was 16.8%. Out of 125 subjects, a total of 21 had internet gaming disorder. There was a significant association between internet gaming disorder and age, gender, economics, profession, living alone, spending more than 3 hours on games, and non-functional family. Anxiety and depression were significantly associated with internet gaming disorder at a value of 0.015.

 

KEYWORDS: Internet games, Gaming disorder, Depression, Anxiety, Students.

 

 


INTRODUCTION:

Globally fast expansion in internet use; gaming has become quite possibly the most well-known internet-based activity. In 2013, American psychiatric association decided to incorporated internet gaming disorder as non substance addiction in the vth edition of the Diagnostic and Statistical Manual of Mental Disorder (DSM-V).1,2

 

Internet gaming disorder is characterized as the persistent and repetitive use of internet to participate in games which leads to clinical impairment. It does not involve the addiction of only online video games but also offline games. It means both offline and online games pattern which significantly impaired family, personal, social, occupational, educational functioning.3,4

 

In 2017, WHO (World Health Organization) has also recognized that gaming addiction is public concern worldwide. In 2018, gaming addiction was categorized as gaming disorder according to specific diagnose criteria in 11th edition of International Classification of disease (ICD). In 2019, WHO officially voted for the recognition of gaming disorder as medical disorder.5

 

More negative consequences are present in person having internet gaming disorder. It leads to high rate of irritability, low mood and sleep related problems. Rate of occurrence of social phobias, and psychiatric disorders (anxiety and depression) are more in individuals have IGD. The addiction of the internet gaming effect individual’s life and society similarly as substance uses disorder6,

 

Addiction of Social media and games is responsible for health behavioural changes.7 Some researches represent that depression leads to initiation of internet gaming disorder, depressive person leads to more time on internet which is an avoidant coping strategy that leaves real-life problems intact rather than solving them.8 IGD itself elicits more depressive symptoms due to disturbance of real life social interaction.9 According to neurocognitive model internet games alter brain functions and cognitive processes which enhance the likelihood of developing depressive symptoms.10

 

It is highly concern matter that negative insight of games leads to stigma of mental diseases. Worldwide it is arisen as a serious public health concern due to increasing prevalence day by day. Its prevalence rate varies across country to country due to different characteristic. Prevalence rate is from 0.7% to 15%. The prevalence data of IGD gives information for the requirement of health policies and effectiveness of such policies. However, there is no prevalence research on adult population of Indian community and lacking of IGD information in adults despite the higher vulnerability of adults to IGD, it is important to examine the prevalence of IGD in the general adult population.11,12

 

METHODOLOGY:

Research design and subjects:

The observational cross-sectional survey was conducted for a period of 6 months from 2021-2022. Data was collected from the general population of Bathinda, district which is in North western part of Punjab, India. Data was collected from 125 individuals.

 

Data collection:

Data was collected by using standard questionnaire which consist of questions regarding general demographic data age, gender, residence, occupation, marital status, living alone or with family, smoking, alcoholic, device used for games, total time spent on games, functional family type. IGDS scale, GAD -7 scales, PHQ-9 scale.

 

PHQ-9 scale:

It was 9 items scale. Items reflect to diagnostics statics and manual of mental disorder 4th edition criteria for depression. Each question is based on likert type scale it has four responses (not at all, several days, more than half of the days, almost every day) each question scoring from 0-3). All responses are summed up for total scoring range 0-27. Increasing score represents severity of depression. Scoring 0-4 indicates no depression, 5-9 indicates mild depression, 10-14 indicates moderate depression, 15-19 indicates moderately severe depression, 20-27 indicates severe depression.13

 

GAD-7: General anxiety disorder scale. It consists of 7 questions. Question is based on Likert type scale having 4 responses (not at all, several days, more than half of the days, almost every day) scoring from 0-3. All the responses are summed up for total coring from 0-21. Scoring 0-4 indicates no anxiety, 5-9 indicates mild anxiety, 10-14 indicates moderate anxiety, 15-21 indicates severe anxiety.14

 

IGDS: Internet gaming disorder scale:

It determines the severity in last 12 months. It consists of 9 questions each question having binary response (yes/no) 1= yes, 0=2, all the responses are summed and positive score 5or more indicates Internet gaming disorder.15

 

Statistical Analysis:

Data collected from community population was evaluated by using SPSS version 22. Data was represented using descriptive statistics using Frequency and percentage. Chi square test was used to find association between at significance level ≤ 0.05.

 

Ethical consideration:

The research was conducted after approval from AIPBS Departmental Research Committee and Ethics Committee of Biomedical and Health Research, Adesh University Bathinda. Informed Consents were obtained from all the individuals.

 

RESULTS:

Prevalence of internet gaming disorder:

The figure 1 represents the prevalence of internet gaming disorder. It was found to be 16.8% in general population of Bathinda District. Out of 125 individuals, 21 individuals had internet gaming disorder. Total 82.2% (104 individuals) did not have internet gaming disorder. It is new emerging disorder. (Figure 1)

 

Figure 1: Represents the prevalence of internet gaming disorder

 

Details of distribution of data:

The majority of the individuals were belonging to rural area 59.2% and 48.8% individuals belonged to urban area. Majority of the respondents were male 65.6%, and 34.4% were females. 67.2% individuals had higher education followed by matriculation 21.6%, 8.8% individuals had primary education and 2.4% were illiterate. Majority of the individuals belonged to middle class about 45.6%, followed by upper class 39.2%. and 15.2% individuals belonged to lower class. 45% students followed by employees 21.6% further 19.2% individuals were farmer and housewives, 8% individuals did not have any job categorized as unemployed and 10 individuals belonged to other professions. 81.6% individuals were single and 18.4% were couple. (Table 1)

 

Table 1: Frequency and percentage distribution of individuals according to sociodemographic data

Variables

Frequency

Percentage

Residence

Urban

51

40.8

Rural

74

59.2

Age group

18-25

72

57.6%

25-30

33

25.6%

Above 30

20

16,8%

Gender

Male

82

65.6

Female

43

34.4

Education

Illiterate

3

2.4%

Primary

11

8.8%

Matriculation

27

21.6%

Higher

84

67.2%

Economics

Upper class

49

39.2%

Middle class

57

45.6%

Low class

19

15.2%

Profession

Employee

27

21.6%

Student

55

44%

Housework/Farmer

24

19.2%

Un employee

10

8%

Others

10

7.2%

Marital Status

Single

102

81.6%

 

Details of Distribution of life style data:

Majority of the respondents 45.6% were lived in joint families, 44% individuals belonged to small family, and 10.4% individuals were living alone. 18.4% were smoking regularly and 40.8% were drinking alcohol regularly. Smart phone was the most device used by 80%individuals for games, 10.4%p individuals played games on tablet and 8.8% individuals played games on computer. 16.4% individuals spent more than 3 hours on games on every day, 20.8% individuals spent 2-3 hours, 13.6% individuals spent 1-2 hours, and 48% individuals spent less than 1 hour. 68% individuals belonged to functional family, and 32% individuals belonged to non-functional families. (Table 2)

 

Table 2: Table shows the percentage and frequency distribution of other life style variables

Variables

Frequency

Percentage

Currently living Status

Alone

13

10.4%

Small family

55

44%

Joint family

57

45.6%

Smoking

Yes

23

18.4%

No

102

81.6%

Alcoholic

Yes

52

40.8%

No

73

59.2%

Device used for games

Smart phone

101

80%

Computer

11

8.8%

Tablet

13

10.4%

Time spent on games

30 minutes-1 hours

61

48%

1-2 hours

17

13.6%

2-3 hours

26

20.8%

More than 3 hours

21

16.8%

Functional family

Yes

85

68%

No

40

32%

 

Details of association between variables and internet gaming disorder:

There is association find between IGD and sociodemographic factors such as age group 18-25 age group at p value 0.04, male gender p value0.043, economic (upper class) p value 0.045, students and unemployed, p value 0.028, living alone p value 0.01, drinking alcohol p value 0.035, time spent more than 2-3 hours on games, p value 0.000, non-functional family, p value 0.01.

 

There is no association between IGD and sociodemographic factors such as residence, education, marital status, smoking, and device used for games. (Table 3, Table 4)


 

Table 3: Represents the association between IGD and sociodemographic factors

Variables

IGD

Association

Yes

No

Chi value

Df

P value

Significance

Residence

Urban

9

42

0.044

1

1.000

Not significant

Rural

12

62

Age group

18-25

16

56

4.53

2

0.04

Significant

25-30

4

29

Above 30

1

19

Gender

Male

18

64

4.52

1

0.043

Significant

Female

3

40

Education

Illiterate

0

3

2.7

3

0.42

Not significant

Primary

1

10

Matriculation

7

20

Higher

13

71

Economics

Upper class

13

36

6.18

2

0.045

Significant

Middle class

7

50

Low class

1

18

Profession

Employee

3

24

10.87

4

0.028

Significant

Student

13

42

Housework/Farmer

1

23

Unemployed

4

6

Others

0

9

 

Table 4: Represents the association between IGD and lifestyle factors.

Variables

IGD

Association

Yes

No

Chi value

df

P value

Significance

Marital status

Single

19

83

1.3

1

0.250

Not significant

Couple

2

21

Current living status

Alone

7

6

14.5

2

0.01

Significant

Small family

8

47

Joint family

6

51

Smoking

Yes

5

17

0.845

1

0.655

Not significant

No

16

87

Alcoholic

Yes

13

39

4.284

1

0.035

Significant

No

8

65

Device used for games

Smart phone

18

83

0.562

2

0.7

Not significant

Computer

1

10

Tablet

2

11

Others

 

 

Time spent on games

30-minute -1 hour

0

61

31.55

3

0.00

Significant

1-2 hours

2

15

2-3 hours

10

16

More than 3 hours

9

12

Functional family

Yes

8

77

10.37

1

0.01

Significant

 


Prevalence and association of anxiety:

Total out of 125 individuals 38 individuals did not have anxiety, 37 individuals had mild anxiety, 42 had moderate anxiety, and 8 had severe anxiety. There was significant association between anxiety and IGD with (χ2alue = 10.77), p value 0.015. The prevalence of IGD is more in those who had moderate and severe anxiety. (Table 5)

 

Table 5: Represents the association between IGD and anxiety

Variables

IGD

Association

Anxiety

Yes

No

Chi value

df

p value

Association

None

3

35

 

10.77

 

3

 

0.015

 

Significant

Mild

3

30

Moderate

12

34

Severe

3

5

 

Prevalence and association of depression:

Total out of 125 individuals 34 had no depression, 51 had mild depression, 26 had moderate depression, 11 had moderately severe depression, and 3 had severe depression. Above table 7 represents the association between depression and IGD. Chi square test was used to find the association. There was significant association between depression and IGD with (χ2= 15.15), p value 0.004. The prevalence of IGD is more in those who had moderate depression. (table 6)

 

Table 6: Represents the association between IGD and depression

Variables

IGD

Association

Depression

Yes

No

Chi value

df

P value

Association

None

3

31

 

 

 

15.15

 

 

 

4

 

 

 

0.004

 

 

 

Significant

Mild

4

47

Moderate

8

18

Moderately severe

5

6

 

DISCUSSION:

In this study the prevalence of IGD was found to be 16.8%. Total out of 125 subjects 21 had IGD. Internet gaming disorder is the new emerging disorder in society. A study by Wartberg et al. (2017) reveals prevalence of 5.6%, The study by Khan, et al. (2021) represented prevalence of IGD was 9.1%.15,16. Study by Aggarwal et al. (2019) represented prevalence of 9.2%. The study by Bisht et al. (2021) represented the prevalence of IGD was 23%. The prevalence rate was varying according to different populations cultures, geographical area.17,18

 

In this study it was found that area of residence was not associated with IGD. IGD was found approximately equal in both urban and rural area. Similar result was found by Bisht et al. (2021).17

 

In this study it was found that Gender was highly significant with disease. IGD was more prevalent in male gender. Similar result was found by the studies done by Chiang et al (2022), Taechoyotin et al. (2020) and Undavalli et al. (2020). These studies suggest that male gender was more prone to developing IGD. The probably due to increase the use of internet to maintain leisure time or due to social isolation behaviour and tried to maladaptive techniques (drinking alcohol, internet addiction, spent time on games are also one of technique) to cope out with their own problems.19,20,21

 

In this study it was found that prevalence of internet gaming disorder was more in age group 18-25. Similar result was found in study by Khan et al. (2021). They revealed youth population are more vulnerable to develop IGD. 18 At this age many individuals feels low self esteem, less time socializing with friends and families, poor social skills that leads to spent most times on games.

 

In this study it was found that education was not significant with IG. Similar result was found in study by Severo et al. (2020). Their study represented that education and economics was not significant with IGD.22 However in this study economics status was significant. Those who belong to upper class had high prevalence rate this was due to easy access to internet more money spent upon new online games.

 

In this study it was found that profession was associated with IGD. The prevalence was more in students followed by un-employees. It may due to education stress, family stress, and poor social skills. In this study it was found that marital status was not associated with IGD.

 

In this study it was found that prevalence of IGD was more in those who living alone. In this study it was also found that individuals who did not belong to functional family also had high rate of IGD. Similar results were explained by a study done by Taechoyotin et al. (2020). They revealed the individual not living with both of parents and having non intact family had more chances for developing IGD.20 When parents neglect their children it leads to addictive disorders.

 

In this study it was found that drinking alcohol was associated with IGD. Smoking was not associated with IGD. The variability of result was due to small sample size. More researches are required with large sample size.

 

In this study it was found that who spent more than 3 hours on games had more prevalence of IGD. Similar result was found in study by Severo et al. (2020).22

 

In this study it was found that IGD was significantly associated with anxiety and depression. The prevalence of IGD was more in those who had moderate to severe anxiety and depression. Similar results was found in study by Wartberg et al. (2017), a study by Bisht et al. (2021)15,18 and a Researchers found there was bidirectional relationship between IGD and anxiety, depression. Excessive gaming is associated with adverse effects, such as sleep disturbances, stress, and relationship deterioration which lead towards depression. This was also represented in studies by Jeong et al. (2019), and Ostovar et al. (2016). The study by Sreelekshmi S et al also represented that there is mild to moderate effect of continuous playing games on Bio- psychosocial behaviour of young students.23,24,25

 

CONCLUSION:

It was concluded that the prevalence rate of internet gaming disorder was higher in young individuals. The factors which were associated with IGD were age group 18-25, gender, economics status, more prevalent in students, unemployed, living alone, alcoholic, more than 3 hours spent on games, non functional family. There was also significant association between IGD and anxiety, depression. More longitudinal researches will be required to conduct to explore more relationship between internet gaming disorder and (anxiety, depression). There is the need of time to develop more health policies, counselling and education programs to improve psychological and social well being among those having IGD. There must be government policies so that young population spent time towards good physical activities rather than on games.

 

CONFLICT OF INTEREST:

The authors have no conflicts of interest regarding this investigation.

 

ACKNOWLEDGMENTS:

The authors would like to thank the entire management of the Adesh Institute of Pharmacy and Biomedical Sciences and Adesh Hospital for providing necessary information required for research work. The authors also appreciate all the members of class of 2016 for their support.

 

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Received on 17.01.2023         Modified on 10.04.2023

Accepted on 06.07.2023   ©Asian Pharma Press All Right Reserved

Asian J. Pharm. Res. 2023; 13(4):227-232.

DOI: 10.52711/2231-5691.2023.00042