Autism in relation to gaming disorder and internet addiction: A systematic review

Abstract

The habitual use of electronic devices is commonly observed in populations on the autism spectrum. However, few reviews have examined the extent to which such use becomes problematic and/or disordered (e.g., gaming disorder) in these populations. This review was designed to critically evaluate the literature on autism in relation to gaming disorder (GD) and so-called internet addiction (IA). A systematic search of five databases was conducted, which identified 31 studies. Study quality was generally moderate, with the main weakness across studies tending to relate to psychometrics. A total of 78,442 participants were included across the studies of GD and 14,474 participants in studies of IA. The results showed that, although these conditions appear to be overrepresented in autistic populations, there are no true prevalence studies due to methodological limitations. The frequency rates reported in survey and clinical studies were highly variable and exceeded 20% in some studies. Variables that predict greater risk of problems include being male; adolescent; co-occurring ADHD symptoms; lack of parental rules around devices; parent-child conflict; and high parental stress. There is a need for clinical studies that differentiate excessive gaming and internet use behaviors as either related to impaired control (i.e., addiction) or features of autism (i.e., restricted interests) and determine how these profiles affect overall functioning. Research in this area requires more sophisticated measurement approaches to avoid misclassification of clinical issues that implicate digital technology.