Internet Gaming Addiction, Problematic Use of the Internet, and Sleep Problems: A Systematic Review
Abstract The effect of problematic use of the Internet on mental health, particularly depression among young people, has been established but without a probable model for the underlying mechanism. In this study, a model is presented to describe possible pathways for the linkage between Internet gaming addiction and depression possibly mediated by sleep problems. A systematic review was conducted to gather epidemiological evidence to support or refute the link between addictive Internet gaming, problematic Internet use, and sleep problems including insomnia and poor sleep quality. Seven studies were identified through a systematic literature search, of these three related to addictive Internet gaming and four on problematic Internet uses and sleep problems. Information was extracted and analysed systematically from each of the studies and tabulated as a summary. Results of the review suggest that additive gaming, particularly massively multiplayer online role-playing games MMORPG, might be associated with poorer quality of sleep. Results further indicated that problematic Internet use was associated with sleep problems including subjective insomnia and poor sleep quality.
Keywords Internet gaming addiction . Computer gaming . Internet addiction . Excessive Internet use . Pathological Internet use . Problematic Internet Use . Sleep problems . Insomnia . Sleep quality . Review . Systematicreview .Epidemiology studyExcess use of the Internet has long been a concern as a (problematic behaviour of human interactions with information and communication technologies ). Researchers have used different ways to describe such behaviour including: “compulsive computer use”; “Internet dependency”; “pathological Internet use”; and “Internet addiction”. While the condition called “ Internet addiction” is not yet fully recognised as an established disorder and the controversial debate is still on-going, Internet Gaming Addiction (IGA) has been listed as an emerging disorder worthy of further investigation in the latest version of the Diagnostic and Statistical Manual of Mental Disorder V (DSMV) .
The association between problematic or pathological Inter-net use (PIU) and mental health, particularly depression, among adolescents has been well documented and reported in the literature. In the most recent review of studies up to early 2010 on the relationship between pathological Internet use and psychopathological comorbidities, it was reported that depression had the most significant and consistent association with PIU among a number of the psychopathologies investigated . However, a major drawback from these studies was that all but one were cross-sectional studies, thus limiting the ability of the review to draw any conclusion on the causality of the relationship. In attempting to establish the possible causal relationship between PIU and depression, a longitudinal study on healthy young people, aged between 13 and 18 years who were depression free, was conducted by Lam et al. in China . Results indicated that, after 9 months of exposure to the Internet, moderate and severe problematic users were about 2.5 times more likely to develop depressive symptoms and scored high enough on the Zung Depression Scale to be clinically significant in comparison to the normal users . Other longitudinal studies conducted subsequently also yielded similar result. These studies suggest a potentially causal relationship between PIU and depression.
In terms of the usage of the Internet, particularly among adolescents, studies suggest that the most common purpose was playing games. Furthermore, playing online games were shown to be significantly associated with PIU.An experimental study was conducted on the effects of playing different types of video game, including the massively multiplayer online role-playing games (MMORPGs) that involved many players playing an online role playing game, other single player Internet games, and games playing with a con-sole, upon the general health and psychosocial wellbeing of university students. It was found that students who had played MMORPGs for a month differed significantly from other types of games with worse health, sleep quality and academic work.Hence, it would be logical to assume that the most problematic use of the Internet is online gaming. In line with this thought would be that the association between problematic Internet use and depression is likely to be a reflection of the relationship between Internet gaming addiction, in the context of the current DSM V conceptualisation, and depression.Hence, the primary focus of the current study will be on Internet gaming. However general problematic Internet use is still a concern and will be included in this study as a secondary focus.
Many explanations could be offered for the association, or a potential causal relationship, between Internet gaming ad-diction and depression. Figure 1 depicts a possible conceptual model for the hypothesised explanatory causal pathways. Among many other possible pathways that may involve different risk factors, three major components have been pro-posed in this model. First, it is hypothesised that addictive Internet gaming may induce sleep problems, including insomnia, short sleep duration and poor quality of sleep, and in turn, lead to the development of depression. Second, the addiction to Internet games may generate stress and anxiety in gamers and becomes the procuring conditions for depression directly.This model also hypothesises that stress and anxiety may also interact with sleep problems in inducing depression. Third, as suggested by the finding of a growing number of studies on PIU using neuroimaging techniques, there is a strong possibility of a linkage between addictive Internet gaming and depression via some bio-phy
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Internet Gaming Addiction, Problematic Use of the Internet, and Sleep Problems: A Systematic Review
Abstract The effect of problematic use of the Internet on mental health, particularly depression among young people, has been established but without a probable model for the underlying mechanism. In this study, a model is presented to describe possible pathways for the linkage between Internet gaming addiction and depression possibly mediated by sleep problems. A systematic review was conducted to gather epidemiological evidence to support or refute the link between addictive Internet gaming, problematic Internet use, and sleep problems including insomnia and poor sleep quality. Seven studies were identified through a systematic literature search, of these three related to addictive Internet gaming and four on problematic Internet uses and sleep problems. Information was extracted and analysed systematically from each of the studies and tabulated as a summary. Results of the review suggest that additive gaming, particularly massively multiplayer online role-playing games MMORPG, might be associated with poorer quality of sleep. Results further indicated that problematic Internet use was associated with sleep problems including subjective insomnia and poor sleep quality.
Keywords Internet gaming addiction . Computer gaming . Internet addiction . Excessive Internet use . Pathological Internet use . Problematic Internet Use . Sleep problems . Insomnia . Sleep quality . Review . Systematic review .Epidemiology study Excess use of the Internet has long been a concern as a (problematic behaviour of human interactions with information and communication technologies ). Researchers have used different ways to describe such behaviour including: “compulsive computer use”; “Internet dependency”; “pathological Internet use”; and “Internet addiction”. While the condition called “ Internet addiction” is not yet fully recognised as an established disorder and the controversial debate is still on-going, Internet Gaming Addiction (IGA) has been listed as an emerging disorder worthy of further investigation in the latest version of the Diagnostic and Statistical Manual of Mental Disorder V (DSMV) .
The association between problematic or pathological Inter-net use (PIU) and mental health, particularly depression, among adolescents has been well documented and reported in the literature. In the most recent review of studies up to early 2010 on the relationship between pathological Internet use and psychopathological comorbidities, it was reported that depression had the most significant and consistent association with PIU among a number of the psychopathologies investigated . However, a major drawback from these studies was that all but one were cross-sectional studies, thus limiting the ability of the review to draw any conclusion on the causality of the relationship. In attempting to establish the possible causal relationship between PIU and depression, a longitudinal study on healthy young people, aged between 13 and 18 years who were depression free, was conducted by Lam et al. in China . Results indicated that, after 9 months of exposure to the Internet, moderate and severe problematic users were about 2.5 times more likely to develop depressive symptoms and scored high enough on the Zung Depression Scale to be clinically significant in comparison to the normal users . Other longitudinal studies conducted subsequently also yielded similar result. These studies suggest a potentially causal relationship between PIU and depression.
In terms of the usage of the Internet, particularly among adolescents, studies suggest that the most common purpose was playing games. Furthermore, playing online games were shown to be significantly associated with PIU.An experimental study was conducted on the effects of playing different types of video game, including the massively multiplayer online role-playing games (MMORPGs) that involved many players playing an online role playing game, other single player Internet games, and games playing with a con-sole, upon the general health and psychosocial wellbeing of university students. It was found that students who had played MMORPGs for a month differed significantly from other types of games with worse health, sleep quality and academic work.Hence, it would be logical to assume that the most problematic use of the Internet is online gaming. In line with this thought would be that the association between problematic Internet use and depression is likely to be a reflection of the relationship between Internet gaming addiction, in the context of the current DSM V conceptualisation, and depression.Hence, the primary focus of the current study will be on Internet gaming. However general problematic Internet use is still a concern and will be included in this study as a secondary focus.
Many explanations could be offered for the association, or a potential causal relationship, between Internet gaming ad-diction and depression. Figure 1 depicts a possible conceptual model for the hypothesised explanatory causal pathways. Among many other possible pathways that may involve different risk factors, three major components have been pro-posed in this model. First, it is hypothesised that addictive Internet gaming may induce sleep problems, including insomnia, short sleep duration and poor quality of sleep, and in turn, lead to the development of depression. Second, the addiction to Internet games may generate stress and anxiety in gamers and becomes the procuring conditions for depression directly.This model also hypothesises that stress and anxiety may also interact with sleep problems in inducing depression. Third, as suggested by the finding of a growing number of studies on PIU using neuroimaging techniques, there is a strong possibility of a linkage between addictive Internet gaming and depression via some bio-p
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