Problematic Gaming and Gambling among Adolescents

The overall aims of this thesis were to develop and evaluate a screening instrument designed to detect gaming addiction symptoms in adolescents, to study associations between problematic gaming and psychiatric symptoms, to investigate the stability of problematic gaming, and to examine possible associations between gaming at baseline (W1) with problem gambling three years later (W2). The study population consisted of adolescents from the Survey of Adolescent Life in Västmanland SALVe Cohort (adolescents in Västmanland born in 1997 and 1999, and their parents), in two waves (2012, n = 1887; 2015, n = 1576), and adolescents from child and adolescent psychiatric clinics in Västmanland (2014, n = 242). The development of the Gaming Addiction Identification Test (GAIT) was based upon the research literature on gaming, gambling, and addiction. An expert panel estimated the content validity of the GAIT and found it to be excellent. Additional psychometric evaluations of the GAIT and the parent version, GAIT-P, were conducted and it was found that both versions showed promising psychometric results, with high internal consistency, high concurrent validity, high concordance, unidimensionality, and high factor loadings, although poor model fit in exploratory factor analysis. Self- and parent-rated prevalence of gaming addiction symptoms were estimated at 1.3% with the GAIT and 2.4% with the GAIT-P in 13- and 15-year-olds. Self-rated problematic gaming above the cutoff had a boy to girl ratio of approximately 5:1 in both the SALVe Cohort and the clinical sample, whereas more girls than boys reported symptoms above the cutoff for ADHD, depression, anxiety, and psychotic-like-experiences. ADHD, depression, and anxiety symptoms were associated with odds ratios of 2.43, 2.47, and 2.06, respectively, in relation to coexisting problematic gaming. Furthermore, problematic gaming was stable over time, and problematic gaming at the first wave was associated with problem gambling three years later. It is important to screen for possible co-occurring symptoms among those who seek treatment and among those who appear to have symptoms of gaming, gambling, or psychiatric symptoms. Ongoing evaluation of adequate screening and diagnostic measurements, and the development and evaluation of treatments for problematic gaming, gaming addiction, and comorbid conditions are needed