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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 21  |  Issue : 2  |  Page : 71-76

Online gaming and its association with emotional and behavioral problems among adolescents – A study from Northeast India


1 Department of Psychiatric Social Work, Lokopriya Gopinath Bordoloi, Regional Institute of Mental Health, Tezpur, Assam, India
2 Department of Psychology, Guwahati University, Gauhati, Assam, India

Date of Submission19-May-2020
Date of Acceptance11-Sep-2020
Date of Web Publication14-Jan-2021

Correspondence Address:
Mr. Abhijeet Singh
Department of Psychiatric Social Work, Lokopriya Gopinath Bordoloi, Regional Institute of Mental Health, Tezpur, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AMH.AMH_20_20

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  Abstract 


Context: Online game addiction has emerged as a public health concern. Effects of online game addiction on physical and mental health are well documented.
Aim: The aim of this study was to find the prevalence of online game addiction and to see its correlation with emotional and behavioral problems among adolescents.
Methods: This was a cross-sectional descriptive study conducted at two schools from Sonitpur and Kamrup districts of Assam using a convenience sampling technique. Total enumeration method was used to recruit a total of 415 respondents (standard 8th, 9th, and 10th), out of which only 409 respondents were taken for final analysis. Sociodemographic datasheet, Strengths and Difficulties Questionnaire, Online Gaming Addiction Scale, and Short Self-Regulation Scale (SSRQ) were administered. The study was approved by the Scientific Committee and Institute Ethics Committee of LGBRIMH, Tezpur.
Results: Online gaming behavior was found to have a significant positive correlation with emotional problem (r = 0.392, P = 0.01), conduct problem (r = 0.484, P = 0.01), hyperactivity problem (r = 0.335, P = 0.01), peer problem (r = 0.355, P = 0.01), and difficulty score (r = 0.506, P = 0.01). Online gaming showed a negative correlation with SSRQ (r = 0.0160, P = 0.01). Emotional problem (B = 1.139, t = 3.024, P = 0.001), conduct problem (B = 2.163, t = 5.661, P = 0.001), and total difficulty score (B = 1.196, t = 11.630, P = 0.001) contributed significantly to the prediction of online gaming addiction among adolescents (F[6,402] = 27.261, P = 0.001) accounting for 2.89% of variance.
Conclusion: Online gaming behavior was found to have an association with emotional and behavioral problems among adolescents. Psychosocial interventions at individual and family levels can enhance self-regulation and control online gaming addiction among adolescents.

Keywords: Adolescents, emotional and behavioral problems, mental health, online gaming addiction, self-regulation


How to cite this article:
Singh A, Ali A, Choudhury M, Gujar NM. Online gaming and its association with emotional and behavioral problems among adolescents – A study from Northeast India. Arch Ment Health 2020;21:71-6

How to cite this URL:
Singh A, Ali A, Choudhury M, Gujar NM. Online gaming and its association with emotional and behavioral problems among adolescents – A study from Northeast India. Arch Ment Health [serial online] 2020 [cited 2021 Dec 7];21:71-6. Available from: https://www.amhonline.org/text.asp?2020/21/2/71/306861




  Introduction Top


Research on gaming addiction dates back to 1983, when the first report emerged, suggesting that video gaming addiction is a problem for adolescents.[1] Shortly thereafter, the first empirical study on gaming addiction was published based on self-reports of young male players who claimed that they were “hooked” on their games.[2] In the 2000s, online game became widespread among masses and gained rapid growth among both youth and adults. Online playing games and the first massively multiplayer online role-playing game were launched in Korea in 2004. The trend of online games has set its platforms among youths.[3] The early studies suffered from a lack of standardized psychometric instruments used for assessing online gaming addiction[4] when adolescents whose lives are dominated by online gaming often experience problems such as consequent sleep deprivation, day–night reversal, dehydration, malnutrition, seizures, and pressure sores, as well as irritability, physical aggression, depression, and a range of social, academic, and vocational problems.[5],[6],[7]

A cross-sectional study was conducted between March 2017 to July 2018. This study found prevalence of 73.9% online video game addiction among 575 adolescents. Adolescents who were addicted to online video game had a play time of 7 hours per day accounting to 20 hours of game play on mobile phones per week.[8] Another study highlighted that 18% of the students are using video game with control, 20% of the students are excessively using video games, and 17.5% of the students fall under addiction category.[9] The prevalence rate ranging between 19% to 29% of the children were spending more than 3 h/day for game and met all the criteria of gaming addiction according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.[10] A study on Internet addiction showed that about 63% of the students were using mobile phones to access the Internet in which 12.3% of the students uses the Internet for online game.[11]

Game addiction has emerged as a public health concern. Effects of game addiction on physical and mental health are well documented. However, no study has been carried out on online game addiction, especially in the northeast region of Assam, India, among school-going adolescents. The present study aims to find the prevalence of online game addiction and to see its correlation with emotional and behavioral problems among adolescents.


  Methods Top


A cross-sectional descriptive study design was used for the present study. Two schools were selected from Sonitpur and Kamrup districts of Assam using a convenience sampling technique. Total enumeration method was used to select the respondents. The sample was selected from class 8th, 9th, and 10th. Krejcie and Morgan method[12] was used to determine the sample size. A total of 415 adolescents participated in the study, out of which only 409 respondents were taken for final analysis. Participants were explained about the purpose of the study and consent was taken from them. Proper instructions about the procedure involved in the study were explained to the respondent. Tools administered were sociodemographic datasheet, Strengths and Difficulties Questionnaire, Online Gaming Addiction Scale, and Short Self-Regulation Scale (SSRQ). After administration of tools, data were analyzed using the Statistical package for the social sciences 25.0, SPSS South Asia Pvt. Ltd., Bangalore- 560043, India.[13] The study was undertaken with the approval of the Scientific Committee and Ethical Committee of LGBRIMH, Tezpur, Assam, India.

Description of tools

  1. Sociodemographic data sheet: It includes details regarding age, sex, education, occupation, religion, caste, domicile, family income, etc.
  2. Semi-structured questionnaire: It was developed by the researcher to assess use, purpose, time spent on online game, etc., The questionnaire was validated by the field experts
  3. Strengths and Difficulties Questionnaire:[14] It is a 25-item questionnaire intended for 11–17-year-old adolescents. It assesses strengths and difficulties across five domains: emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behavior. A three-point response scale is used and answered as “0 = not true,” “1 = somewhat true,” or “2 = certainly true” on the basis of how things have been over the last 6 months. The total difficulty score ranges from 0 to 40 and is calculated by summing the 20 items relating to difficulties with emotion, conduct, hyperactivity, and peers. Reliability was satisfactory, Cronbach's α: 0.73, cross-informant correlation was 0.34, and retest stability was 0.62 after 4–6 months (Goodman, 2001)
  4. Online Gaming Addiction Scale:[15] The game addiction scale consisted of 21 items. Three items were created for each domain: salience, tolerance, mood modification, relapse, withdrawal, and conflict. Scoring: if a person met 4 or more than 4 criteria, he/she is an excessive user. If a person met all the criteria, he/she is a pathological user. Criteria are met when a person is scoring 3 (sometimes) in a 5-point (1 = never, 2 = rarely, 3 = sometimes, 4 = often, and 5 = very often) Likert scale. Reliability and validity are found to be satisfactory, Cronbach's α = 0.85 (Lemmens et al., 2009)
  5. The SSRQ:[16] The SSRQ is a 31-item inventory designed to quantify an individual's ability to self-regulate his/her behavior. The SSRQ uses a 5-point (1 = strongly disagree, 2 = disagree, 3 = uncertain or unsure, 4 = agree, and 5 = strongly agree) Likert scale. Scoring: reverse score items 2, 3, 4, 6, 7, 9, 10, 11, 16, 19, 22, 23, 27, 31, and sum all items to obtain a total score.



  Results Top


The sociodemographic profile of the respondents reflects that the mean age was 14.6 (standard deviation = 0.95) and the academic grade of the respondents was 71.4 (13.7). Majority of the respondents were male (64.1%) of standard 10th (37.4%), Hindu (87.8%), and hailing from middle socioeconomic background (82.2%) of urban locality (68.5%) with nuclear family type (72.6%) [Table 1].
Table 1: Sociodemographic profile of the respondents (n=409)

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Around half percentage (52.3%) of the respondents were indulge in playing PUBG and selected it as their favorite online game and used to spent around 2–3 h (54.5%) playing online game on mobile phone (91.0%) and enjoyed it (87.8%). Majority of the respondents (78.7%) preferred online game partners while playing, without parental consent (34.0%) and restriction (22.0%). Irritation and anger were found in majority of the respondents (71.4%) when game is interrupted and craving of playing online game was also found to be high (56.6%), even it was seen that game plan was used to excite more than half percentage of the respondents (69.4%) when they used to feel low. Nearly half of the respondents were found to be engaged in playing online game round the clock (49.1%) and developed a tendency to escape from work (50.4%) in order to play online game for long time (51.3%) and even compromise their sleep for the same (53.3%). The current table also reflected that out of guilt (of playing online game), around 62.8% of the respondents uninstall game apps but again reinstall it because of craving (56.7%) which hampered their interpersonal relationship (50.9%), because they remain restricted them to gadgets only (61.6%). Majority of the respondents (53.8%) felt unable to take responsibility, get irritated or defensive when people asked to stop gaming (66.5%), more than half (50.9%) of the respondents reported an increased in time spent on games and even borrowed money from others (60.9%) to buy new games and had isolated themselves from peer (47.9%) in order to play online game without disturbance. Intense feeling of high, low, and irritation was also found in majority of the respondents (66.0%) [Table 2].
Table 2: Descriptive information regarding online gaming (n=409)

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[Table 3] showed that around 45.2% of the respondents were falling in the abnormal range on difficulty score of the Strengths and Difficulties Questionnaire, followed by emotional problem (39.9%), peer problem (39.6%), hyperactivity problem (32.8%), emotional problem (21.0%), and prosocial behavior (2.2%). Majority of the respondents (45.2%) were found to be excessive users (polythetic users) of online game, and around 40.3% of the respondents were found to be pathological users (monothetic users) of online gaming, according to the Online Game Addiction Scale [Table 4].
Table 3: Prevalence of emotional and behavioral problems among respondents (n=409)

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Table 4: Prevalence of online game addiction among respondents (n=409)

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Online game total score was found to be significantly positive correlated with emotional problem (r = 0.392, P = 0.01), conduct problem (r = 0.484, P = 0.01), hyperactivity problem (r = 0.335, P = 0.01), peer problem (r = 0.355, P = 0.01), and total difficulty score (r = 0.506, P = 0.01).

It was also found that online gaming has a negative correlation with SSRQ (r = 0.160, P = 0.01) [Table 5]. Emotional problems (B = 1.139, t = 3.024, P = 0.001), conduct problems (B = 2.163, t = 5.661, P = 0.001), and total difficulty score (B = 1.196, t = 11.630, P = 0.001) contribute significantly to the prediction of online gaming addiction among adolescents (F{6,402} =27.261, P = 0.001) accounting for 2.89% variance. The remaining 97.1% was attributed to variable not included in the study [Table 6].
Table 5: Pearson's coefficient correlation between online gaming addiction (total score), total difficulties score, domain of Strengths and Difficulties Questionnaire (emotional, conduct, hyperactivity, and peer problem) and Short Self-Regulation Questionnaire (n=409)

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Table 6: Regression analysis of strength and difficulty and self.regulation on online game addiction (n=409)

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  Discussion Top


In the present study, majority of the respondents were male, Hindu, and hailing from middle socioeconomic background of nuclear family type. Other studies conducted in urban setting of India were found to have similar sociodemographic characteristics.[17],[18]

In the current study, the prevalence of online game addiction was found to be 40.3%. Other studies conducted worldwide and India also came up with a similar result. Studies conducted in India reflected a prevalence rate ranging from 12.3% to 73.9%.[8],[9],[10],[11] The worldwide picture showed a prevalence rate ranging from 17% to 30.9%.[19],[20] In the present study, it was seen that around 53.0% of the respondents spend more than 2–3 h/day in playing online games, which is 21 h/week. The state of online gaming market research report[21] highlights the latest findings in an ongoing series of consumer surveys about online activities and perceptions and concluded that globally 41.4% of the respondents spend more than 20 h/week in playing online games in smartphones. The report showed that single player games were more popular among adolescents with gaming addiction, but in the present study it was found that adolescents preferred online partner to play multi-player games. Of the respondents who reported frustrations with downloading games, the prime frustrations were the length of time to download, when it does not work, and when the process is interrupted and has to be restarted. In our study, around 50.5% of the respondents were found to neglect work and play games during working hours and had often missed daily activities, and around 60.0% said that they had missed sleep while gaming which was similar to the online gaming market research report.[21]

Studies have highlighted the relationship between mobile game addiction and mental health outcomes. An adolescent with mobile game addiction has higher self-reported depression, social anxiety, fear, loneliness, and other behavioral problems.[22],[23] A study[8] highlighted the negative impact of gaming on behavioral aspect of adolescents such as psychosocial disturbances, anxiety, depression, mood disorders, sleep disturbances, headache, lack of social activities, and impairment in education.

In our study, a significant relationship was found between online gaming addiction and behavioral problems such as emotional problems, conduct problems, hyperactivity problems, and peer problems. Studies conducted in the past also reflected that behaviors such as emotional, conduct, hyperactivity, peer problems, and prosocial were associated with online gaming addiction and problems such as frequent complaints of headache, worrying a lot, remaining unhappy and being downhearted, and becoming nervous in new situations were common in persons with gaming addiction.[10],[24]

In regression analysis, it was found that emotional problems, conduct problems, and total difficulty score contribute significantly to the predictors of online game addiction. Other studies also concluded that online game addiction affects the psychological health of adolescents in the form of immaturity, emotional instability, unconsolidated identity, low self-esteem and indecision, lack of self-control, frustration, low resilience, high sensation search, deficit of social skills, inhibition, and extreme shyness.[25],[26]

Limitations

  1. Generalization of the findings of this study is limited because the study used a convenience sample of adolescents in Assam from public schools which is not randomly selected
  2. This study is a cross-sectional design, and thus, we could not determine a causal link between study variables
  3. All the tools were self-reported
  4. We are not able to assess the short-term and long-term impact of online gaming on adolescents.



  Conclusion Top


In our study, a significant relationship was found between online gaming addiction and behavioral problems such as emotional problems, conduct problems, hyperactivity problems, and peer problems. Emotional problems, conduct problems, and total difficulty score contribute significantly to the predictors of online game addiction. Future studies could incorporate multidimensional factors (ecological perspective, cultural, and societal factors) of behavior meaning to gain more depth understanding of the determinants that influence adolescents. Therefore, mental health professionals should be aware of the negative effects caused by online gaming, as this is such a common phenomenon today. School awareness program on online gaming addiction and mental health issues can be of great help for adolescents.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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