Cue-reactivity to distal cues in individuals at risk for gaming disorder

Martin Diers; Silke M Müller; Lukas Mallon; Anna M Schmid; Tobias A Thomas; Lena Klein; Kseniya Krikova; Rudolf Stark; Elisa Wegmann; Sabine Steins-Loeber; Matthias Brand; Stephanie Antons

doi:10.1016/j.comppsych.2023.152399

Cue-reactivity to distal cues in individuals at risk for gaming disorder

Compr Psychiatry. 2023 Aug:125:152399. doi: 10.1016/j.comppsych.2023.152399. Epub 2023 Jul 4.

Authors

Affiliations

¹ Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany. Electronic address: martin.diers@rub.de.
² General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
³ Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany.
⁴ Department of Clinical Psychology and Psychotherapy, Otto-Friedrich University of Bamberg, Bamberg, Germany.
⁵ Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.
⁶ General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany.
⁷ Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, Giessen, Germany; Clinical Psychology and Psychotherapy, University Siegen, Siegen, Germany; Bender Institute for Neuroimaging, Justus Liebig University, Giessen, Germany.
⁸ Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, Giessen, Germany; Bender Institute for Neuroimaging, Justus Liebig University, Giessen, Germany; Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Germany.

PMID: 37437451
DOI: 10.1016/j.comppsych.2023.152399

Abstract

Background: Gaming disorder (GD) is a disorder due to addictive behaviors (ICD-11). Cue-reactivity and craving are relevant mechanisms in the development and maintenance of addictive behaviors. When confronted with cues showing in-game content (proximal cues) individuals with higher symptom severity show increased cue-reactivity. Based on conditioning and addiction theories on incentive sensitization, cue-reactivity responses may generalize to more distal cues, e.g. when individuals at risk of developing a GD are confronted with a starting page of an online game. In cue-reactivity paradigms so far, only proximal gaming cues have been used.

Methods: We investigated the effect of distal gaming cues compared to gaming-unrelated control cues on cue-reactivity and craving in 88 individuals with non-problematic use of online games (nPGU) and 69 individuals at risk for GD (rGD). The distal cues showed the use of an electronic device (e.g., desktop PC or smartphone) whose screen showed starting pages of either games (target cues), shopping- or pornography sites (control cues) from a first-person perspective.

Findings: We found significantly higher urge and arousal ratings as well as longer viewing times for gaming-related compared to gaming-unrelated control cues in rGD compared to nPGU. Valence ratings did not differ between groups.

Interpretation: The results demonstrate that already distal gaming-specific cues lead to cue-reactivity and craving in rGD. This finding indicates that based on conditioning processes, cue-reactivity and craving develop during the course of GD and generalize to cues that are only moderately related to the specific gaming activity.

Keywords: Addictive behaviors; Cue-reactivity; Distal cues; Internet addiction; Risky gaming users.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Behavior, Addictive* / diagnosis
Craving / physiology
Cues
Humans
Magnetic Resonance Imaging / methods
Oligopeptides
Video Games* / adverse effects

Substances

Oligopeptides