Gaming disorder: Unraveling the role of problematic affective, cognitive, and executive functioning - A systematic review and meta-analytic structural equation modeling

Abstract

Objective

This study aims to critically analyze and synthesize mediating models that elucidate the complex interplay of variables associated with Gaming Disorder (GD), spanning affective, cognitive, and executive domains, to highlight significant mediation effects.

Methods

We reviewed 171 studies, involving 185,991 participants, exploring GD as the dependent variable and psychosocial variables as mediators. We utilized standard psychometric scales and reported effect sizes (e.g., Pearson correlation coefficients). Extensive database searches, from inception to August 10, 2023, included MEDLINE, PsycINFO, EMBASE, PubMed, Web of Science, CNKI, and Wanfang Data. Publication bias assessments and study quality evaluations were conducted. Pooled mediating effect sizes were determined using one-stage meta-analytic structural equation modeling (MASEM).

Results

We identified 13 crucial models through MASEM, with the impulsivity-delay discounting model displaying the most significant effect sizes, underscoring its pivotal role in elucidating the dynamics of GD. Eight models, including emotional problems-escapism models, underscore GD's multifaceted nature driven by mood-modifying and needs-fulfilling mechanisms. Among cognitive dimensions, avatar identification-oriented models emerged as significant mediators, emphasizing the importance of beliefs regarding in-game characters. Sensitivity analysis confirmed the robustness of results against outliers and publication bias.

Conclusion

The synthesized models shed light on the mechanisms underpinning GD, showcasing the dynamic interplay among affective, cognitive, and executive factors. Strategies including reducing delay discounting, addressing emotional underpinnings, and reshaping thoughts tied to avatars and gaming behaviors hold promise for effective GD intervention. However, limitations, including reliance on cross-sectional data and limited studies for mediational models, warrant consideration.