Internet gaming disorder (IGD) is an increasing public health concern, particularly among adolescents. This study aimed to investigate the associations between IGD, executive functions, occupational balance, and quality of life in adolescents. A cross-sectional study was conducted online with 62 adolescents aged from 12 to 18 years, including 31 diagnosed with IGD and 31 healthy controls. Measures included the Internet Gaming Disorder Test, Teenage Executive Functioning Inventory, Adolescent Occupational Balance Scale, and Pediatric Quality of Life Inventory. Adolescents with IGD had significantly lower executive functioning (p < .001), occupational balance (p = .00), and quality of life (p = .00) compared to controls. A moderate correlation was found between IGD severity and executive dysfunction (r = .457, p = .01). Findings suggest that IGD is associated with lower executive functions, occupational balance, and quality of life in adolescents, and that a moderate positive association was also found between executive functions and IGD.
Plain-Language Summary
Internet Gaming Disorder: Links Between Executive Function, Balance, and Quality of Life
Internet gaming disorder (IGD) is an increasing public health concern, particularly among adolescents. IGD may affect the development of executive functions, such as planning, reasoning, and task management, which are still maturing in this age group. It may also disrupt balanced participation in daily activities, including schoolwork, hobbies, and rest, thereby reducing overall quality of life. This study examined the associations between IGD, executive functions, occupational balance, and quality of life. A total of 62 adolescents aged from 12 to 18 years participated in the study, including 31 with IGD and 31 healthy adolescents. Participants completed online assessments measuring their gaming behavior, thinking skills, daily activity balance, and well-being. The results showed that adolescents with IGD had weaker executive functioning, poorer occupational balance, and lower quality of life compared to their healthy peers. In addition, more severe IGD symptoms were linked to greater executive function difficulties. These findings highlight links between excessive gaming and challenges in daily functioning, suggesting that IGD may be related to difficulties in managing responsibilities and maintaining well-being.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
2.
ArgyriouE.DavisonC. B.LeeT. T. (2017). Response inhibition and Internet gaming disorder: A meta-analysis. Addictive Behaviors, 71, 54–60. https://doi.org/10.1016/j.addbeh.2017.02.026
3.
BarkusE. (2020). Effects of working memory training on emotion regulation: Transdiagnostic review. PsyCh Journal, 9(2), 258–279. https://doi.org/10.1002/pchj.353
4.
BediouB.AdamsD. M.MayerR. E.TiptonE.GreenC. S.BavelierD. (2018). Meta-analysis of action video game impact on perceptual, attentional, and cognitive skills. Psychological Bulletin, 144(1), 77. https://doi.org/10.1037/bul0000130
5.
BrandM.RumpfH.-J.DemetrovicsZ.KingD. L.PotenzaM. N.WegmannE. (2019). Gaming disorder is a disorder due to addictive behaviors: Evidence from behavioral and neuroscientific studies addressing cue reactivity and craving, executive functions, and decision-making. Current Addiction Reports, 6, 296–302. https://doi.org/10.1007/s40429-019-00258-y
6.
CohenJ. (2013). Statistical power analysis for the behavioral sciences (2nd ed.). Routledge.
7.
Dell’OssoB.Di BernardoI.VismaraM.PiccoliE.GiorgettiF.MolteniL.FinebergN. A.VirzìC.Bowden-JonesH.TruzoliR. (2021). Managing problematic usage of the Internet and related disorders in an era of diagnostic transition: An updated review. Clinical Practice and Epidemiology in Mental Health: CP & EMH, 17, 61. https://doi.org/10.2174/1745017902117010061
8.
Digital Health Task Force, Canadian Paediatric Society. (2019). Digital media: Promoting healthy screen use in school-aged children and adolescents. Paediatrics & Child Health, 24(6), 402–408. https://doi.org/10.1093/pch/pxz095
9.
DuX.YangY.GaoP.QiX.DuG.ZhangY.LiX.ZhangQ. (2017). Compensatory increase of functional connectivity density in adolescents with Internet gaming disorder. Brain Imaging and Behavior, 11(6), 1901–1909. https://doi.org/10.1007/s11682-016-9655-x
10.
EklundM.TjörnstrandC.SandlundM.ArgentzellE. (2017). Effectiveness of Balancing Everyday Life (BEL) versus standard occupational therapy for activity engagement and functioning among people with mental illness–a cluster RCT study. BMC Psychiatry, 17, 1–12. https://doi.org/10.1186/s12888-017-1524-7
11.
FaulF.ErdfelderE.LangA. G.BuchnerA. (2007). G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191. https://doi.org/10.3758/BF03193146
12.
ForbesE. E.RodriguezE. E.MusselmanS.NarendranR. (2014). Prefrontal response and frontostriatal functional connectivity to monetary reward in abstinent alcohol-dependent young adults. PLOS ONE, 9(5), Article e94640. https://doi.org/10.1371/journal.pone.0094640
13.
FriedmanN. P.RobbinsT. W. (2022). The role of prefrontal cortex in cognitive control and executive function. Neuropsychopharmacology, 47(1), 72–89. https://doi.org/10.1038/s41386-021-01132-0
14.
GaoL.GanY.WhittalA.LippkeS. (2020). Problematic Internet use and perceived quality of life: Findings from a cross-sectional study investigating work-time and leisure-time Internet use. International Journal of Environmental Research and Public Health, 17(11), 4056. https://doi.org/10.3390/ijerph17114056
15.
GoldbergB.BrintnellE. S.GoldbergJ. (2002). The relationship between engagement in meaningful activities and quality of life in persons disabled by mental illness. Occupational Therapy in Mental Health, 18(2), 17–44. https://doi.org/10.1300/J004v18n02_03
16.
GomesA. C.RebeloM. A. B.de QueirozA. C.de Queiroz HerkrathA. P. C.HerkrathF. J.Rebelo VieiraJ. M.PereiraJ. V.VettoreM. V. (2020). Socioeconomic status, social support, oral health beliefs, psychosocial factors, health behaviours and health-related quality of life in adolescents. Quality of Life Research, 29(1), 141–151. https://doi.org/10.1007/s11136-019-02279-6
17.
GriffithsM. D.PontesH. M.KussD. J. (2016). Online addictions: Conceptualizations, debates, and controversies. Addicta: The Turkish Journal on Addictions, 3(2), 1–14. https://doi.org/10.15805/addicta.2016.3.0101
18.
Güney YılmazG.AvcıH.AkıE. (2023). A new tool to measure occupational balance: Adolescent occupational balance scale (A-OBS). Scandinavian Journal of Occupational Therapy, 30(6), 782–795. https://doi.org/10.1080/11038128.2022.2154262
19.
HomerB. D.PlassJ. L.RaffaeleC.OberT. M.AliA. (2018). Improving high school students’ executive functions through digital game play. Computers & Education, 117, 50–58. https://doi.org/10.1016/j.compedu.2017.09.011
20.
IoannidisK.HookR.GoudriaanA. E.VliesS.FinebergN. A.GrantJ. E.ChamberlainS. R. (2019). Cognitive deficits in problematic Internet use: Meta-analysis of 40 studies. The British Journal of Psychiatry, 215(5), 639–646. https://doi.org/10.1192/bjp.2019.3
21.
JangJ. H.ChungS. J.ChoiA.LeeJ. Y.KimB.ParkM.ParkS.ChoiJ. S. (2021). Association of general cognitive functions with gaming use in young adults: A comparison among excessive gamers, regular gamers and non-gamers. Journal of Clinical Medicine, 10(11), 2293. https://doi.org/10.3390/jcm10112293
22.
KertzmanS.VainderM.AizerA.KotlerM.DannonP. N. (2017). Pathological gambling and impulsivity: Comparison of the different measures in the behavior inhibition tasks. Personality and Individual Differences, 107, 212–218. https://doi.org/10.1016/j.paid.2016.11.042
23.
LamY. T.ChengC. (2022). Parental depression and leisure activity engagement on children’s gaming disorder: A dyadic study. International Journal of Environmental Research and Public Health, 19(10), 5880. https://doi.org/10.3390/ijerph19105880
24.
LarrieuM.BillieuxJ.DécampsG. (2022). Problematic gaming and quality of life in online competitive videogame players: Identification of motivational profiles. Addictive Behaviors, 133, 107363. https://doi.org/10.1016/j.addbeh.2022.107363
25.
LiebermanD. A. (2012). What can we learn from playing interactive games? In VordererP.BryantJ. (Eds.), Playing video games: Motives, responses, and consequences (p. 1987). Routledge.
26.
LimJ. A.LeeJ.-Y.JungH. Y.SohnB. K.ChoiS.-W.KimY. J.KimD. J.ChoiJ. S. (2016). Changes of quality of life and cognitive function in individuals with Internet gaming disorder: A 6-month follow-up. Medicine, 95(50), e5695. https://doi.org/10.1097/MD.0000000000005695
27.
LinX.ZhouH.DongG.DuX. (2015). Impaired risk evaluation in people with Internet gaming disorder: fMRI evidence from a probability discounting task. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 56, 142–148. https://doi.org/10.1016/j.pnpbp.2014.08.016
MüllerK. W.JanikianM.DreierM.WölflingK.BeutelM. E.TzavaraC.RichardsonC.TsitsikaA. (2015). Regular gaming behavior and Internet gaming disorder in European adolescents: Results from a cross-national representative survey of prevalence, predictors, and psychopathological correlates. European Child & Adolescent Psychiatry, 24, 565–574. https://doi.org/10.1007/s00787-014-0611-2
30.
MutluC.BirinciT.SenelA.MustafaogluR.Bulanık KocE.KaracetinG.Kaya MutluE. (2023). A multi-dimensional assessment of Internet gaming disorder in children and adolescents: A case-control study. Work, 77, 1089–1099. https://doi.org/10.3233/WOR-220652
31.
ParongJ.MayerR. E.FiorellaL.MacNamaraA.HomerB. D.PlassJ. L. (2017). Learning executive function skills by playing focused video games. Contemporary Educational Psychology, 51, 141–151. https://doi.org/10.1016/j.cedpsych.2017.07.002
32.
PontesH. M.KiralyO.DemetrovicsZ.GriffithsM. D. (2014). The conceptualisation and measurement of DSM-5 Internet gaming disorder: The development of the IGD-20 Test. PLOS ONE, 9(10), Article e110137. https://doi.org/10.1371/journal.pone.0110137
33.
RehbeinF.KliemS.BaierD.MößleT.PetryN. M. (2015). Prevalence of Internet gaming disorder in German adolescents: Diagnostic contribution of the nine DSM-5 criteria in a state-wide representative sample. Addiction, 110(5), 842–851. https://doi.org/10.1111/add.12849
34.
Romero-TébarA.Rodríguez-HernándezM.Segura-FragosoA.Cantero-GarlitoP. A. (2021). Analysis of occupational balance and its relation to problematic Internet use in university occupational therapy students. Healthcare, 9(2), 197. https://doi.org/10.3390/healthcare9020197
35.
StevensM. W.DorstynD.DelfabbroP. H.KingD. L. (2021). Global prevalence of gaming disorder: A systematic review and meta-analysis. Australian & New Zealand Journal of Psychiatry, 55(6), 553–568. https://doi.org/10.1177/0004867420962851
36.
StrittmatterE.KaessM.ParzerP.FischerG.CarliV.HovenC. W.WassermanC.SarchiaponeM.DurkeeT.ApterA. (2015). Pathological Internet use among adolescents: Comparing gamers and non-gamers. Psychiatry Research, 228(1), 128–135. https://doi.org/10.1016/j.psychres.2015.04.029
37.
ThorellL. B.LazarevićN.MilovanovićI.Bugarski IgnjatovićV. (2020). Psychometric properties of the Teenage Executive Functioning Inventory (TEXI): A freely available questionnaire for assessing deficits in working memory and inhibition among adolescents. Child Neuropsychology, 26(6), 857–864. https://doi.org/10.1080/09297049.2020.1726885
38.
VarniJ. W.SeidM.KurtinP. S. (2001). PedsQL™ 4.0: Reliability and validity of the pediatric quality of life inventory™ version 4.0 generic core scales in healthy and patient populations. Medical Care, 39(8), 800–812.
39.
VarniJ. W.SeidM.RodeC. A. (1999). The PedsQL™: Measurement model for the pediatric quality of life inventory. Medical Care, 37(2), 126–139.
40.
WagmanP.HåkanssonC.BjörklundA. (2012). Occupational balance as used in occupational therapy: A concept analysis. Scandinavian Journal of Occupational Therapy, 19(4), 322–327. https://doi.org/10.3109/11038128.2011.596219
41.
WartbergL.KristonL.KammerlR. (2017). Associations of social support, friends only known through the Internet, and health-related quality of life with Internet gaming disorder in adolescence. Cyberpsychology, Behavior, and Social Networking, 20(7), 436–441. https://doi.org/10.1089/cyber.2016.0535
WhangL. S. M.LeeS.ChangG. (2003). Internet over-users’ psychological profiles: A behavior sampling analysis on Internet addiction. Cyberpsychology & Behavior, 6(2), 143–150. https://doi.org/10.1089/109493103321640338
YoonE. J.ChoiJ. S.KimH.SohnB. K.JungH. Y.LeeJ. Y.KimD. J.ParkS. W.KimY. K. (2017). Altered hippocampal volume and functional connectivity in males with Internet gaming disorder comparing to those with alcohol use disorder. Scientific Reports, 7(1), 5744. https://doi.org/10.1038/s41598-017-06057-7
47.
ZastrowM. (2017). Is video game addiction really an addiction?Proceedings of the National Academy of Sciences, 114(17), 4268–4272. https://doi.org/10.1073/pnas.1705077114
ZhouZ.ZhouH.ZhuH. (2016). Working memory, executive function and impulsivity in Internet-addictive disorders: A comparison with pathological gambling. Acta Neuropsychiatrica, 28(2), 92–100. https://doi.org/10.1017/neu.2015.54
50.
ZhuS.ZhuangY.LeeP.LiC. M.WongP. W. (2021). Leisure and problem gaming behaviors among children and adolescents during school closures caused by COVID-19 in Hong Kong: Quantitative cross-sectional survey study. JMIR Serious Games, 9(2), e26808. https://doi.org/10.2196/26808
