Adverse childhood experiences on internet gaming disorder mediated through insomnia in Chinese young people

Front Public Health. 2023 Nov 22:11:1283106. doi: 10.3389/fpubh.2023.1283106. eCollection 2023.

Abstract

Background: Adverse childhood experiences (ACEs) have been associated with addictions such as substance use disorders. Few have examined ACEs on internet gaming disorder (IGD) as a newly established behavioral addiction, and the potential mediating role of insomnia remains unclear. We examined the associations between ACE number and types, IGD, and insomnia.

Methods: Participants included 1, 231 Chinese university students (54.5% male; 56.9% aged 18-20 years) who had played internet games at least once in the previous month. ACEs were measured using the 10-item ACE questionnaire (yes/no). Symptoms of insomnia and IGD were measured using the Insomnia Severity Index and the 9-item Internet Gaming Disorder Scale-Short-Form, respectively. Multivariable regressions examined the associations, adjusting for sex, age, maternal and paternal educational attainment, monthly household income, smoking, and alcohol drinking. The mediating role of insomnia symptoms was explored.

Results: The prevalence of ACEs≥1 was 40.0%. Childhood verbal abuse was the most prevalent (17.4%), followed by exposure to domestic violence (17.1%) and childhood physical abuse (15.5%). More ACE numbers showed an association with IGD symptoms (adjusted OR = 1.11, 95% CI 1.04, 1.17). Specifically, IGD symptoms were observed for childhood physical neglect, emotional neglect, sexual abuse, parental divorce or separation, and household substance abuse. Insomnia symptoms mediated the associations of ACE number and types with IGD symptoms (proportion of total effect mediated range 0.23-0.89).

Conclusion: The number and specific types of ACEs showed associations with IGD mediated through insomnia. Screening of ACEs is recommended in future studies on IGD. Longitudinal data are warranted to determine the causality of the observed associations.

Keywords: adverse childhood experiences; insomnia; internet gaming disorder; life course; mediation.

MeSH terms

  • Adolescent
  • Adverse Childhood Experiences*
  • Domestic Violence* / psychology
  • Female
  • Humans
  • Internet Addiction Disorder / epidemiology
  • Male
  • Risk Factors
  • Sleep Initiation and Maintenance Disorders* / epidemiology

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by the National Natural Science Foundation of China (82304261) and Shanghai Science and Technology Development Funds of the Rising Star Sailing Program (23YF1421100). NG and LW received support from Shanghai Jiao Tong University School of Medicine: Nursing Development Program (SJTUHLXK2021 and SJTUHLXK2022). The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the study; or decision to submit the study for publication.