Skip to main content

Advertisement

Log in

Prevalence and Correlates of Problematic Online Gaming: a Systematic Review of the Evidence Published in Chinese

  • Technology Addiction (J Billieux, Section Editor)
  • Published:
Current Addiction Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

With the ongoing debate about whether problematic online gaming (POG) constitutes a genuine mental disorder, it is important for all available evidence in the field to be accessible. In this systematic review, we summarize the numerous results related to POG published in Chinese in order to make them more accessible to the international community.

Recent Findings

We identified 36 relevant studies published in Chinese (7 epidemiological, 21 related to psychological factors, and 8 related to neurocognitive exploration, involving 362,328 participants in total). According to the literature, the prevalence rates of POG in China range from 3.5 to 17%, which is higher than those reported worldwide. Overall, the data published in Chinese are consistent with the international literature. Some distinctive findings emerged, however, in particular in relation to familial, scholastic, and social factors; cognitive impairments; and functional changes in neural circuits.

Summary

This review is the first to render available articles on POG in Chinese for the international community, which could contribute to the current debate on the status of POG as a genuine mental health condition. Crucially, findings from the Chinese literature often resulted from studies conducted on large random or clinical samples. This is important because a repeated criticism about the recognition of POG as a genuine disorder is the fact that the evidence-based results rely heavily on convenience samples of nonclinical participants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Newzoo. An overview of 2017’s key trends, revenues, and projections. In: 2017 Global Games Market Report. Newzoo. 2017. http://resources.newzoo.com/global-games-market-report-light-2017. Accessed 4 April 2018.

  2. China Internet Network Information Center. Development on recreational on-line applications. In: The 41st china statistical report on internet development. CINIC. 2018. http://www.cnnic.net.cn/hlwfzyj/hlwxzbg/hlwtjbg/201803/P020180305409870339136.pdf. Accessed 5 March 2018.

  3. • Billieux J, King DL, Higuchi S, Achab S, Bowden-Jones H, Hao W, et al. Functional impairment matters in the screening and diagnosis of gaming disorder: commentary on: scholars’ open debate paper on the World Health Organization ICD-11 gaming disorder proposal (Aarseth et al.). J Behav Addict 2017;6(3):285–9. The article provides background information of the debate on the inclusion of “gaming disorder” in ICD-11. It emphasizes the importance of functional impairment in the diagnosis of gaming disorder and reviews existing evidence on this issue.

    Article  PubMed  PubMed Central  Google Scholar 

  4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Press; 2013.

    Book  Google Scholar 

  5. World Health Organization. ICD-11 beta draft (mortality and morbidity statistics) [database on the internet]. WHO. 2016. https://icd.who.int/dev11/l-m/en. Accessed 5 March 2018.

  6. •• Zhu J, Zhang W, Yu C, Bao Z. Early adolescent Internet game addiction in context: how parents, school, and peers impact youth. Comput Hum Behav. 2015;50(C):159–68. This study conducted in China (published in English) emphasizes the importance of familial, scholastic, and social factors in gaming disorder.

    Article  Google Scholar 

  7. Han DH, Lyoo IK, Renshaw PF. Differential regional gray matter volumes in patients with on-line game addiction and professional gamers. J Psychiatr Res. 2012;46(4):507–15.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Han DH, Lee YS, Shi X, Renshaw PF. Proton magnetic resonance spectroscopy (MRS) in on-line game addiction. J Psychiatr Res. 2014;58:63–8.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Sun MK, Han DH, Lee YS, Renshaw PF. Combined cognitive behavioral therapy and bupropion for the treatment of problematic on-line game play in adolescents with major depressive disorder. Comput Hum Behav. 2012;28(5):1954–9.

    Article  Google Scholar 

  10. Mentzoni RA, Brunborg GS, Molde H, Myrseth H, Skouverøe KJ, Hetland J, et al. Problematic video game use: estimated prevalence and associations with mental and physical health. Cyberpsychol Behav Soc Netw. 2011;14(10):591–6.

    Article  PubMed  Google Scholar 

  11. Petry NM, O'Brien CP. Internet gaming disorder and the DSM-5. Addiction. 2013;108:1186–7.

    Article  PubMed  Google Scholar 

  12. Liu J, Li W, Zhou S, Zhang L, Wang Z, Zhang Y, et al. Functional characteristics of the brain in college students with internet gaming disorder. Brain Imaging Behav. 2016;10(1):60–7.

    Article  PubMed  Google Scholar 

  13. Jin C, Zhang T, Cai C, Bi Y, Li Y, Yu D, et al. Abnormal prefrontal cortex resting state functional connectivity and severity of internet gaming disorder. Brain Imaging and Behav. 2016;10(3):719–29.

    Article  Google Scholar 

  14. Du X, Qi X, Yang Y, Du G, Gao P, Zhang Y, et al. Altered structural correlates of impulsivity in adolescents with Internet gaming disorder. Front Hum Neurosci. 2016;10(4).

  15. Dong G, Wang L, Du X, Potenza MN. Gaming increases craving to gaming-related stimuli in individuals with Internet gaming disorder. Biol Psychiatry Cogn Neurosci Neuroimaging. 2017;2(5):404–12.

    Article  PubMed  Google Scholar 

  16. Dong G, Lin X, Potenza MN. Decreased functional connectivity in an executive control network is related to impaired executive function in Internet gaming disorder. Prog Neuro-Psychopharmacol Biol Psychiatry. 2015;57:76–85.

    Article  Google Scholar 

  17. Cai C, Yuan K, Yin J, Feng D, Bi Y, Li Y, et al. Striatum morphometry is associated with cognitive control deficits and symptom severity in internet gaming disorder. Brain Imaging Behav. 2016;10(1):12–20.

    Article  PubMed  Google Scholar 

  18. Zhang Y, Lin X, Zhou H, Xu J, Du X, Dong G. Brain activity toward gaming-related cues in Internet gaming disorder during an addiction stroop task. Front Psychol. 2016;7(714).

  19. Aarseth E, Bean AM, Boonen H, Colder Carras M, Coulson M, Das D, et al. Scholars’ open debate paper on the World Health Organization ICD-11 gaming disorder proposal. J Behav Addict. 2017;6(3):267–70.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Saunders JB, Hao W, Long J, King DL, Mann K, Fauth-Bühler M, et al. Gaming disorder: its delineation as an important condition for diagnosis, management, and prevention. J Behav Addict 2017;6(3):271–9.

    Article  PubMed  PubMed Central  Google Scholar 

  21. van Rooij AJ, Ferguson CJ, Colder Carras M, Kardefelt-Winther D, Shi J, Aarseth E, et al. A weak scientific basis for gaming disorder: let us err on the side of caution. J Behav Addict 2018:1–9.

  22. Yu ZW, Sun PZ, Zhang SH, Huang J. Internet game addiction and influential factors of middle school students in Guangzhou. Chin J Clin Psych. 2009;17(04):473–5.

    Google Scholar 

  23. Ye N, Zuo B, Zhang L. The relations between internet game addiction and motivation among college students. Heilongjiang Researches on Higher Education. 2009;04:97–9.

    Google Scholar 

  24. Zhao YQ, Yu Q, Feng X. Internet game addiction and its related factors among college students. Chin J Public Health. 2009;25(11):1392–3.

    CAS  Google Scholar 

  25. Yu ZW, Sun PZ, Zhang SH, Huang J, Guo XR. Prevalence of Internet game addiction and its relations to game behavior among middle school students in Guangdong. Chin J School Health. 2010;31(05):570–1.

    Google Scholar 

  26. Zuo B, Ma HY. Prevalence of Internet game addiction among adolescents: a research cross 10 provinces and municipalities in China. Journal of Central China Normal University (humanities and social sciences). 2010;49(04):117–22.

    Google Scholar 

  27. Chen JL, Xiao GB, Shi XC. Popularity of a network social game among 862 residents in Jiangsu province. Chinese Journal of Disease Control & Prevention. 2012;16(03):208–11.

    CAS  Google Scholar 

  28. Pan SD, Zhuang X, Cheng P, Sun LF, Feng SQ. Internet game addiction and its related factors among students of five-year higher vocational schools in Changzhou. Chin J School Health. 2013;34(12):1439–41.

    Google Scholar 

  29. Zhang JP, Ruan MY. Internet game addiction among 3050 university and secondary school students in Kunming. Journal of Ningxia University (Humanities & Social Sciences Edition). 2009;31(03):159–70.

    Google Scholar 

  30. Yu Q, Yu L, Zhao YQ, Fan QD. Study on online game addiction of college students and its influential factors. Modern Preventive Medicine. 2010;37(21):4082–3+6.

    Google Scholar 

  31. Zhou H, Zhao X, Dong GH, Peng RY. Mood state, cognitive emotion regulation and online game addiction of college students. Chin J Clin Psych. 2011;19(02):215–7.

    Google Scholar 

  32. He C, Xia M, Jiang GR, Wei H. Mediation role of self-control between Internet game addiction and self-esteem. Chin J Clin Psych. 2012;20(01):58–60.

    Google Scholar 

  33. Wei H, Zhou ZK, Tian Y, Bao N. Internet game addiction: the effect and mechanism of flow experience. Psychological Development and Education. 2012;28(06):651–7.

    Google Scholar 

  34. Wei H, Zhou H, Li X, Luo Q, Gao J. Internet game addiction and event stress among college students: the mediating effect of escapism. Studies of Psychology and Behavior. 2014;12(03):357–61.

    Google Scholar 

  35. Wei C, Xu Q, Zhou SS, Chen XM, Lu HX, Zhang BY. Relationship between online gaming addiction and gratitude/social support in the left-behind children. Chinese Journal of Child Health Care. 2014;22(12):1253–6.

    Google Scholar 

  36. Wei C, Xu Q, Sun GJ, Yu CF, Lu HX, Zhang W. The relationship between gratitude, coping styles and online gaming addiction in left-behind children. Chin J Clin Psych. 2014;22(05):804–7.

    Google Scholar 

  37. Wang T, Wei H, Zhou ZK, Xiong J, Li X, Yang X. Relationships of peer player proportion, maladaptive cognition and online game addiction. Chin J Clin Psych. 2015;23(03):487–9+93.

    Google Scholar 

  38. Wei C, Jin ZY, Liu S, Li ZX, Wang Y, Yu CF. Gratitude and online gaming addiction among left-behind children: the mediating effect of perceptions of school climate. Chin J School Health. 2015;36(08):1161–3.

    Google Scholar 

  39. Zhang GH, Lei L. Mechanism of internet game addiction: research on technology acceptance model. Psychological Development and Education. 2015;31(04):437–44.

    CAS  Google Scholar 

  40. Su BY, Zhang W, Su Q, Yu CF. Internet game addiction and parental supervision: a moderated mediation model. Psychological Development and Education 2016;32(05):604–613.

  41. Wei H, Zhou ZK, Tian Y, Ding Q, Xiong J. The influence of competition, cooperation and flow experience on Internet game addiction. Studies of Psychology and Behavior. 2016;14(02):264–9.

    Google Scholar 

  42. Li FJ, Sun J, He J, Yang BS, Wang X. Internet addictive behavior and the associated factors among middle school students in Henan. Chin J School Health. 2017;38(09):1342–4.

    Google Scholar 

  43. Ma N, Zhang W, Yu CF, Zhu JJ, Jiang YP, Wu T. Perceived school climate and Internet gaming disorder in junior school students: a moderated mediation model. Chin J Clin Psych. 2017;25(01):65–9+74.

    Google Scholar 

  44. • Yu CF, Liu S, Wu T, Zhang W. Parental corporal punishment and Internet game addiction among adolescent: a moderated mediation model. Journal of South China Normal University (Social Science Edition). 2017(04):92–8+191. This cross-sectional study with a large Chinese sample (published in Chinese) reported the relationships between POG, parental corporal punishment, and school connectedness.

  45. Zhang YZ, Su P, Ye YX, Zhen SJ. Internet game addiction and psychosocial factor among college students: the mediating effect of maladaptive cognition. Journal of South China Normal University (Social Science Edition). 2017(04):86–91+191.

  46. He J, Guo Y, Ke S, Zhao L. Cognition deficit in internet-game addicts: an auditory oddball P300 study. Psychol Sci. 2008;31(2):380–74.

    CAS  Google Scholar 

  47. Zhang ZJ. Heavy online-game user’s attention bias and its ERP patterns. Chinese Journal of Applied Psychology. 2008;14(4):291–6.

    CAS  Google Scholar 

  48. Xu HY, Fu XM, Qian RB. Event-related potentials contingent negative variation study in adolescents with Internet game addiction. Chinese Journal of Minimally Invasive Neurosurgery. 2010;15(5):218–20.

    Google Scholar 

  49. Dai SY, Ma QG, Wang XY. Attentional bias to addiction-related stimuli in internet addiction patients: an ERP study. Journal of Psychological Science. 2011;34(6):1302–7.

    Google Scholar 

  50. Zhang N, Wang K. Investigation on executive function of the Internet-game addicts. Chinese Journal of Disease Control & Prevention. 2012;16(5):431–4.

    Google Scholar 

  51. Zhang B, Huang S, Feng ZZ. Study on deficits of switching function in video game addicts. Chongqing Medicine. 2013;42(29):3527–8+31.

    Google Scholar 

  52. Li ZJ, Li Y, Guo W. Pre-potent response inhibition functions under “cold” and “hot” representations in excessive internet use college students. Chin Ment Health J. 2014;28(5):374–80.

    Google Scholar 

  53. Zhang B, Huang S, Hou QX. The deficit characteristics of attentional focus switching function in online game addicts. Psychological Development and Education. 2014;30(5):533–9.

    Google Scholar 

  54. Ding WN, Sun JH, Sun YW. The fMRI study of reward system in adolescents with Internet gaming addiction. Journal of Clinical Radiology. 2013;32(9):1226–9.

    Google Scholar 

  55. Du GJ, Li XD, Zhang Q, Yang YX, Zhao ST, Li FZ, et al. Fractional amplitude of low-frequency fluctuation study of resting-state functional MRI in internet gaming addicts of adolescents. Journal of China Clinic Medical Imaging. 2014;25(8):555–9.

    Google Scholar 

  56. • Li L, Chen X, Sun JH, Sun YW, Zhuang ZG, Ding WN, et al. Abnormalities of perfusion in adolescents with Internet gaming addiction. Chinese Computed Medical Imaging. 2015;21(1):11–5. The arterial spin-labeling study from China (published in Chinese) reported the changes of cerebral blood flow distribution in POG.

    CAS  Google Scholar 

  57. • Han X, Li L, Wang Y, Sun Y, Ding W, Jiang W, et al. Combination of resting-state and dynamic functional connectivity in evaluation of amygdala in subjects with internet gaming disorder. Chin J Med Imag Technol. 2017;33(7):969–74. This fMRI study from China (published in Chinese) reported the altered functional connectivity of the amygdala in POG.

    Google Scholar 

  58. Feng W, Ramo DE, Chan SR, Bourgeois JA. Internet gaming disorder: trends in prevalence 1998-2016. Addict Behav. 2017;75:17–24.

    Article  PubMed  PubMed Central  Google Scholar 

  59. •• Mihara S, Higuchi S. Cross-sectional and longitudinal epidemiological studies of Internet gaming disorder: a systematic review of the literature. Psychiatry Clin Neurosci. 2017;71(7):425–44. This recent systematic review of POG reports separately the findings from cross-sectional and longitudinal research.

    Article  PubMed  Google Scholar 

  60. Kuss DJ, Griffiths MD. Internet gaming addiction: a systematic review of empirical research. Int J Ment Heal Addict. 2012;10(2):278–96.

    Article  Google Scholar 

  61. Kardefelt-Winther D. Problematizing excessive online gaming and its psychological predictors. Comput Hum Behav. 2014;31:118–22.

    Article  Google Scholar 

  62. Rehbein F, Psych G, Kleimann M, Mediasci G, Mößle T. Prevalence and risk factors of video game dependency in adolescence: results of a German nationwide survey. Cyberpsychol Behav Soc Netw. 2010;13(3):269–77.

    Article  PubMed  Google Scholar 

  63. Jeong EJ, Kim DH. Social activities, self-efficacy, game attitudes, and game addiction. Cyberpsychol Behav Soc Netw. 2011;14(4):213–21.

    Article  PubMed  Google Scholar 

  64. Che DX, Hu JP, Zhen SJ, Yu CF, Li B, Chang X, Zhang W Dimensions of emotional intelligence and online gaming addiction in adolescence: the indirect effects of two facets of perceived stress. Front Psychol 2017;8(1206).

  65. Kardefelt-Winther D. A conceptual and methodological critique of Internet addiction research: towards a model of compensatory internet use. Comput Hum Behav. 2014;31:351–4.

    Article  Google Scholar 

  66. Long J, Liu TQ, Liao YH, Qi C, He HY, Chen SB, et al. Prevalence and correlates of problematic smartphone use in a large random sample of Chinese undergraduates. BMC Psychiatry. 2016;16(408):1–12.

    Google Scholar 

  67. Gao Y, Li LP, Kim JH, Congdon N, Lau J, Griffiths S. The impact of parental migration on health status and health behaviours among left behind adolescent school children in China. BMC Public Health. 2010;10:56.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Hu H, Gao J, Jiang H, Jiang H, Guo S, Chen K, et al. A comparative study of behavior problems among left-behind children, migrant children and local children. Int J Environ Res Public Health. 2018;15(655):1–15.

    Google Scholar 

  69. •• Schneider LA, King DL, Delfabbro PH. Family factors in adolescent problematic Internet gaming: a systematic review. J Behav Addict 2017;6(3):321–33. This comprehensive review of family factors in POG underlines the important role of familial influences on POG among adolescents.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Yu C, Li X, Zhang W. Predicting adolescent problematic online game use from teacher autonomy support, basic psychological needs satisfaction, and school engagement: a 2-year longitudinal study. Cyberpsychol Behav Soc Netw. 2015;18(4):228–33.

    Article  PubMed  Google Scholar 

  71. Lo S-K, Wang C-C, Fang W. Physical interpersonal relationships and social anxiety among online game players. Cyberpsychol Behav. 2005;8(1):15–20.

    Article  PubMed  Google Scholar 

  72. Deleuze J, Christiaens M, Nuyens F. Shoot at first sight! First person shooter players display reduced reaction time and compromised inhibitory control in comparison to other video game players. Comput Hum Behav. 2017;72:570–6.

    Article  Google Scholar 

  73. Chou T-J, Ting C-C. The role of flow experience in cyber-game addiction. Cyberpsychol Behav. 2003;6(6):663–75.

    Article  PubMed  Google Scholar 

  74. Zhou Z, Yuan G, Yao J. Cognitive biases toward Internet game-related pictures and executive deficits in individuals with an Internet game addiction. PLoS One. 2012;7(11):e48961.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Monsell S, Sumner P, Waters H. Task-set reconfiguration with predictable and unpredictable task switches. Mem Cogn. 2003;31(3):327–42.

    Article  Google Scholar 

  76. Kübler A, Murphy K, Garavan H. Cocaine dependence and attention switching within and between verbal and visuospatial working memory. Eur J Neurosci. 2005;21(7):1984–92.

    Article  PubMed  Google Scholar 

  77. Fauth-Bühler M, Mann K. Neurobiological correlates of internet gaming disorder: similarities to pathological gambling. Addict Behav. 2017;64:349–56.

    Article  PubMed  Google Scholar 

  78. Grant JE, Brewer JA, Potenza MN. The neurobiology of substance and behavioral addictions. CNS Spectrums. 2006;11(12):924–30.

    Article  PubMed  Google Scholar 

  79. Potenza MN. The neurobiology of pathological gambling and drug addiction: an overview and new findings. Philos Trans R Soc B: Biol Sci. 2008;363(1507):3181–9.

    Article  Google Scholar 

  80. Volkow ND, Fowler JS, Wang GJ. The addicted human brain: insights from imaging studies. J Clin Investig. 2003;111(10):1444–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Volkow ND, Wang G-J, Fowler JS, Tomasi D, Telang F, Baler R. Addiction: Decreased reward sensitivity and increased expectation sensitivity conspire to overwhelm the brain's control circuit. Bioessays 2010;32(9):748–55.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Clark L, Robbins TW. Decision-making deficits in drug addiction. Trends Cogn Sci. 2002;6(9):361–3.

    Article  PubMed  Google Scholar 

  83. 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(5):487–94.

    Article  PubMed  Google Scholar 

  84. Beard KW, Wolf EM. Modification in the proposed diagnostic criteria for Internet addiction. Cyberpsychol Behav 2001;4(3):377–83.

    Article  CAS  PubMed  Google Scholar 

  85. Han DH, Kim SM, Lee YS, Renshaw PF. The effect of family therapy on the changes in the severity of on-line game play and brain activity in adolescents with on-line game addiction. Psychiatry Res Neuroimaging. 2012;202(2):126–31.

    Article  Google Scholar 

Download references

Funding

The study was supported by the National Natural Science of China (Grant No. 81371465 and Grant No. 81671324), National Key R&D Program of China (2017YFC1310400), and the provincial Natural Science Foundation of Hunan (Grant No. 2015JJ2180).

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Tieqiao Liu or Joël Billieux.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest. This article has been edited by Editor-in-Chief Marc Potenza instead of Joël Billieux, as Joël Billieux is the Section Editor of the “Technological Addictions” topical collection.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Technology Addiction

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Long, J., Liu, T., Liu, Y. et al. Prevalence and Correlates of Problematic Online Gaming: a Systematic Review of the Evidence Published in Chinese. Curr Addict Rep 5, 359–371 (2018). https://doi.org/10.1007/s40429-018-0219-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40429-018-0219-6

Keywords

Navigation