The Relationship between Depression, Attention Deficit/Hyperactivity Disorder, and Internet Gaming Disorder Through Mediation Model

매개 모형을 통하여 고찰한 우울과 주의력결핍 과잉행동장애, 인터넷 게임장애 사이의 관계

  • Lee, Seon-Gyu (Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Dai-Jin (Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Cho, Hyun (Addiction Laboratory, Department of Psychiatry, College of Medicine, The Catholic of University of Korea)
  • 이선규 (가톨릭대학교 의과대학 서울성모병원 정신건강의학교실) ;
  • 김대진 (가톨릭대학교 의과대학 서울성모병원 정신건강의학교실) ;
  • 조현 (가톨릭대학교 의과대학 정신건강의학교실, 중독연구실)
  • Received : 2019.05.15
  • Accepted : 2019.07.26
  • Published : 2019.10.31

Abstract

Objectives Internet gaming disorder (IGD) is associated with attention deficit/hyperactivity disorder (ADHD) or depression etc. We tried to examine the mediating effects of depression in the relationship between ADHD and IGD. Methods This study was conducted on 2000 people who participated in on-line survey among 14-39 year-old men and women in 2017. And we clarified the relationship among IGD, ADHD, and depression and tested the mediation model. The mean and standard deviation of the main variables were calculated and correlation analysis was performed to confirm the relationship among the main variables. In order to test the mediating effect of depression on the relationship between ADHD and IGD, the structural equation model was implemented using AMOS 21 (IBM). Results There were significant correlations among the variables; IGD, ADHD and depression. Depression had a mediating effect 0.23 (95% confidence interval : 0.17-0.28) in the relationship between IGD and ADHD. Conclusions This study showed that depression can mediate ADHD and IGD. Therefore, the evaluation and management of depression and ADHD should be included in the diagnosis and treatment of IGD.

Keywords

References

  1. Gentile D. Pathological video-game use among youth ages 8 to 18: a national study. Psychol Sci 2009;20:594-602. https://doi.org/10.1111/j.1467-9280.2009.02340.x
  2. Argyriou E, Davison CB, Lee TTC. Response inhibition and internet gaming disorder: a meta-analysis. Addict Behav 2017;71:54-60. https://doi.org/10.1016/j.addbeh.2017.02.026
  3. Jeromin F, Nyenhuis N, Barke A. Attentional bias in excessive Internet gamers: experimental investigations using an addiction Stroop and a visual probe. J Behav Addict 2016;5:32-40. https://doi.org/10.1556/2006.5.2016.012
  4. Torres-Rodriguez A, Griffiths MD, Carbonell X, Oberst U. Internet gaming disorder in adolescence: psychological characteristics of a clinical sample. J Behav Addict 2018;7:707-718. https://doi.org/10.1556/2006.7.2018.75
  5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Arlington, VA: American Psychiatric Association;2013.
  6. Kim J, Cho O. Relationship between self-control, social and environmental factors, and internet and game addiction in middle-high school students. Educational Theory and Practice 2002;12:477-500.
  7. Bang HJ, Cho A. Relationship between Family Function and Adolescents' Internet Game-related Behavior. the korean journal of developmental psychology 2003;16:1-22.
  8. Yen JY, Ko CH, Yen CF, Wu HY, Yang MJ. The comorbid psychiatric symptoms of internet addiction: attention deficit and hyperactivity disorder (ADHD), depression, social phobia, and hostility. J Adolesc Health 2007;41:93-98. https://doi.org/10.1016/j.jadohealth.2007.02.002
  9. Kim DJ, Kim K, Lee HW, Hong JP, Cho MJ, Fava M, et al. Internet game addiction, depression, and escape from negative emotions in adulthood: a nationwide community sample of Korea. J Nerv Ment Dis 2017;205:568-573. https://doi.org/10.1097/NMD.0000000000000698
  10. Wang BQ, Yao NQ, Zhou X, Liu J, Lv ZT. The association between attention deficit/hyperactivity disorder and internet addiction: a systematic review and meta-analysis. BMC Psychiatry 2017;17:260. https://doi.org/10.1186/s12888-017-1408-x
  11. Stavropoulos V, Adams BLM, Beard CL, Dumble E, Trawley S, Gomez R, et al. Associations between attention deficit hyperactivity and internet gaming disorder symptoms: is there consistency across types of symptoms, gender and countries? Addict Behav Rep 2019;9:100158.
  12. Yoo HJ, Cho SC, Ha J, Yune SK, Kim SJ, Hwang J, et al. Attention deficit hyperactivity symptoms and internet addiction. Psychiatry Clin Neurosci 2004;58:487-494. https://doi.org/10.1111/j.1440-1819.2004.01290.x
  13. Quintero J, Morales I, Vera R, Zuluaga P, Fernandez A. The impact of adult ADHD in the quality of life profile. J Atten Disord 2019;23:1007-1016. https://doi.org/10.1177/1087054717733046
  14. Bae S, Han DH, Kim SM, Shi X, Renshaw PF. Neurochemical correlates of internet game play in adolescents with attention deficit hyperactivity disorder: a proton magnetic resonance spectroscopy (MRS) study. Psychiatry Res Neuroimaging 2016;254:10-17. https://doi.org/10.1016/j.pscychresns.2016.05.006
  15. Bahrainian SA, Alizadeh KH, Raeisoon MR, Gorji OH, Khazaee A. Relationship of internet addiction with self-esteem and depression in university students. J Prev Med Hyg 2014;55:86-89.
  16. Morozova M, Rabin RA, George TP. Co-morbid tobacco use disorder and depression: a re-evaluation of smoking cessation therapy in depressed smokers. Am J Addict 2015;24:687-694. https://doi.org/10.1111/ajad.12277
  17. Stavropoulos V, Gentile D, Motti-Stefanidi F. A multilevel longitudinal study of adolescent Internet addiction: the role of obsessive- compulsive symptoms and classroom openness to experience. Eur J Dev Psychol 2016;13:99-114. https://doi.org/10.1080/17405629.2015.1066670
  18. Anand N, Jain PA, Prabhu S, Thomas C, Bhat A, Prathyusha PV, et al. Internet use patterns, internet addiction, and psychological distress among engineering university students: a study from India. Indian J Psychol Med 2018;40:458-467. https://doi.org/10.4103/IJPSYM.IJPSYM_135_18
  19. Kim JY, Song AY, Lee J. A study of victimization from school violence, adolescent internet game addiction and mental health. Mental Health & Social Work 2008;29:150-176.
  20. Ko CH, Yen JY, Yen CF, Chen CS, Chen CC. The association between Internet addiction and psychiatric disorder: a review of the literature. Eur Psychiatry 2012;27:1-8.
  21. Ostrander R, Herman KC. Potential cognitive, parenting, and developmental mediators of the relationship between ADHD and depression. J Consult Clin Psychol 2006;74:89-98. https://doi.org/10.1037/0022-006X.74.1.89
  22. Slomkowski C, Klein RG, Mannuzza S. Is self-esteem an important outcome in hyperactive children? J Abnorm Child Psychol 1995;23:303-315. https://doi.org/10.1007/BF01447559
  23. Daviss WB. A review of co-morbid depression in pediatric ADHD: etiology, phenomenology, and treatment. J Child Adolesc Psychopharmacol 2008;18:565-571. https://doi.org/10.1089/cap.2008.032
  24. Petry NM, Rehbein F, Gentile DA, Lemmens JS, Rumpf HJ, Mossle T, et al. An international consensus for assessing internet gaming disorder using the new DSM-5 approach. Addiction 2014;109:1399-1406. https://doi.org/10.1111/add.12457
  25. Ward MF, Wender PH, Reimherr FW. The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry 1993;150:885-890 https://doi.org/10.1176/ajp.150.6.885
  26. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16:606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  27. Bandalos DL. The effects of item parceling on goodness-of-fit and parameter estimate bias in structural equation modeling. Struct Equ Modeling 2002;9:78-102. https://doi.org/10.1207/S15328007SEM0901_5
  28. Shrout PE, Bolger N. Mediation in experimental and nonexperimental studies: new procedures and recommendations. Psychol Methods 2002;7:422-445. https://doi.org/10.1037/1082-989X.7.4.422
  29. Curran PJ, West SG, Finch JF. The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychol Methods 1996;1:16-29. https://doi.org/10.1037/1082-989X.1.1.16
  30. Hong SH. The criteria for selecting appropriate fit indices in structural equation modeling and their rationales. Korean Journal of Clinical Psychology 2000;19:161-177.
  31. Przybylski AK. Electronic gaming and psychosocial adjustment. Pediatrics 2014;134:e716-e722. https://doi.org/10.1542/peds.2013-4021
  32. Kwon J, Park J, O J. The study of the comparison on factors influencing internet game addiction among male middle and high school students. J Korea Acad Industr Coop Soc 2016;17:75-86. https://doi.org/10.5762/KAIS.2016.17.2.75
  33. Korean Educational Development Institute. 2017 Comprehensive Survey on Game Overimmersion. Naju: Korea Creative Content Agency; 2018.
  34. Park JH, Hong JS, Han DH, Min KJ, Lee YS, Kee BS, et al. Comparison of QEEG findings between adolescents with attention deficit hyperactivity disorder (ADHD) without comorbidity and ADHD comorbid with internet gaming disorder. J Korean Med Sci 2017;32:514-521. https://doi.org/10.3346/jkms.2017.32.3.514
  35. Mathews CL, Morrell HER1, Molle JE. Video game addiction, ADHD symptomatology, and video game reinforcement. Am J Drug Alcohol Abuse 2019;45:67-76. https://doi.org/10.1080/00952990.2018.1472269
  36. Lee D, Lee J, Lee JE, Jung YC. Altered functional connectivity in default mode network in Internet gaming disorder: influence of childhood ADHD. Prog Neuropsychopharmacol Biol Psychiatry 2017;75:135-141. https://doi.org/10.1016/j.pnpbp.2017.02.005
  37. Eyre O, Langley K, Stringaris A, Leibenluft E, Collishaw S, Thapar A. Irritability in ADHD: associations with depression liability. J Affect Disord 2017;215:281-287. https://doi.org/10.1016/j.jad.2017.03.050
  38. Knouse LE, Zvorsky I, Safren SA. Depression in adults with attention-deficit/hyperactivity disorder (ADHD): the mediating role of cognitive-behavioral factors. Cognit Ther Res 2013;37:1220-1232. https://doi.org/10.1007/s10608-013-9569-5
  39. Semeijn EJ, Comijs HC, Kooij JJ, Michielsen M, Beekman AT, Deeg DJ. The role of adverse life events on depression in older adults with ADHD. J Affect Disord 2015;174:574-579. https://doi.org/10.1016/j.jad.2014.11.048
  40. Bonnaire C, Baptista D. Internet gaming disorder in male and female young adults: the role of alexithymia, depression, anxiety and gaming type. Psychiatry Res 2019;272:521-530. https://doi.org/10.1016/j.psychres.2018.12.158
  41. Choi J, Cho H, Kim JY, Jung DJ, Ahn KJ, Kang HB, et al. Structural alterations in the prefrontal cortex mediate the relationship between Internet gaming disorder and depressed mood. Sci Rep 2017;7:1245. https://doi.org/10.1038/s41598-017-01275-5
  42. Li W, Li Y, Yang W, Zhang Q, Wei D, Li W, et al. Brain structures and functional connectivity associated with individual differences in Internet tendency in healthy young adults. Neuropsychologia 2015;70:134-144. https://doi.org/10.1016/j.neuropsychologia.2015.02.019
  43. Ramtekkar UP, Reiersen AM, Todorov AA, Todd RD. Sex and age differences in attention-deficit/hyperactivity disorder symptoms and diagnoses: implications for DSM-V and ICD-11. J Am Acad Child Adolesc Psychiatry 2010;49:217-28.e1-e3. https://doi.org/10.1016/j.jaac.2009.11.011
  44. Altemus M, Sarvaiya N, Neill Epperson C. Sex differences in anxiety and depression clinical perspectives. Front Neuroendocrinol 2014;35:320-330. https://doi.org/10.1016/j.yfrne.2014.05.004