Internet gaming as a coping method among schizophrenic patients facing psychological distress

Abstract Background and aims Patients with schizophrenia are known to use potentially addictive psychoactive substances as self-medication and to ease psychological distress. Other potentially addictive behaviors such as online gaming are also used to self-medicate and ease psychological distress. However, the role of online gaming and problematic gaming (in the form of internet gaming disorder [IGD]) has not previously been investigated for patients with schizophrenia facing distress. Methods One hundred and four participants diagnosed with schizophrenia were recruited and completed a number of psychometric scales including the Personal and Social Performance Scale (PSPS), Internet Gaming Disorder Scale-Short Form (IGDS-SF9), Self-Stigma Scale-Short (SSS-S), and Depression, Anxiety, Stress Scale (DASS-21). Results The results showed significant negative associations between PSPS, IGDS-SF9, and DASS-21, and significant positive correlations between the IGDS-SF-9, SSS-S and DASS-21. Moreover, IGD did not mediate the association between self-stigma and depression. However, IGD significantly mediated the association between self-stigma and anxiety, and the association between self-stigma and stress. In addition, (i) age and self-stigma were significant predictors for IGD; (ii) social function and self-stigma were significant predictors for depression; (iii) social function, self-stigma, and IGD were significant predictors for anxiety; and (iv) self-stigma and IGD were significant predictors for stress. Conclusion The findings suggest that online gaming may be a coping strategy for individuals with schizophrenia with psychological stress and self-stigma and that for some of these individuals, their gaming may be problematic.

[1]  Sook-Jung Lee,et al.  Content Analysis of News Coverage on Games after the Inclusion of Gaming Disorder in ICD-11 , 2021, Journal of Korea Game Society.

[2]  A. Pakpour,et al.  Measurement invariance across young adults from Hong Kong and Taiwan among three internet-related addiction scales: Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), and Internet Gaming Disorder Scale-Short Form (IGDS-SF9) (Study Part A). , 2020, Addictive behaviors.

[3]  Chung-Ying Lin,et al.  Depression negatively affects patient-reported knee functional outcome after intraarticular hyaluronic acid injection among geriatric patients with knee osteoarthritis , 2019, Journal of orthopaedic surgery and research.

[4]  A. Pakpour,et al.  Psychological distress and quality of life in Iranian adolescents with overweight/obesity: mediating roles of weight bias internalization and insomnia , 2019, Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity.

[5]  Tyrone L. Burleigh,et al.  A Systematic Review of the Co-occurrence of Gaming Disorder and Other Potentially Addictive Behaviors , 2019, Current Addiction Reports.

[6]  B. Egloff,et al.  The Association Between Video Gaming and Psychological Functioning , 2019, Front. Psychol..

[7]  A. Pakpour,et al.  Internet addiction and sleep problems: A systematic review and meta-analysis. , 2019, Sleep medicine reviews.

[8]  S. Higuchi Sharpening the focus on gaming disorder , 2019, Bulletin of the World Health Organization.

[9]  A. Pakpour,et al.  Social media addiction and sexual dysfunction among Iranian women: The mediating role of intimacy and social support , 2019, Journal of Behavioral Addictions.

[10]  Sung-Wan Kim,et al.  Contribution of stress and coping strategies to problematic Internet use in patients with schizophrenia spectrum disorders. , 2018, Comprehensive psychiatry.

[11]  A. Pakpour,et al.  Psychometric Testing of Three Chinese Online-Related Addictive Behavior Instruments among Hong Kong University Students , 2018, Psychiatric Quarterly.

[12]  Daniel L. King,et al.  The concept of “harm” in Internet gaming disorder , 2018, Journal of behavioral addictions.

[13]  Chung-Ying Lin,et al.  Adolescent Internet Use, Social Integration, and Depressive Symptoms: Analysis from a Longitudinal Cohort Survey , 2018, Journal of developmental and behavioral pediatrics : JDBP.

[14]  B. Minaei-Bidgoli,et al.  The Beneficial or Harmful Effects of Computer Game Stress on Cognitive Functions of Players , 2018, Basic and clinical neuroscience.

[15]  Nazir S. Hawi,et al.  Internet gaming disorder in Lebanon: Relationships with age, sleep habits, and academic achievement , 2018, Journal of behavioral addictions.

[16]  A. Pakpour,et al.  The Mediation Role of Self-Esteem for Self-Stigma on Quality of Life for People With Schizophrenia: A Retrospectively Longitudinal Study , 2018 .

[17]  Stéphanie Laconi,et al.  Internet gaming disorder, motives, game genres and psychopathology , 2017, Comput. Hum. Behav..

[18]  Christina Athanasopoulou,et al.  Internet use, eHealth literacy and attitudes toward computer/internet among people with schizophrenia spectrum disorders: a cross-sectional study in two distant European regions , 2017, BMC Medical Informatics and Decision Making.

[19]  Chung-Ying Lin,et al.  Effects of Family Context on Adolescents’ Psychological Problems: Moderated by Pubertal Timing, and Mediated by Self-Esteem and Interpersonal Relationships , 2016 .

[20]  N. Shah,et al.  Factors affecting marriage in schizophrenia: A cross-sectional study , 2016 .

[21]  Chung-Ying Lin,et al.  Dynamic changes of self-stigma, quality of life, somatic complaints, and depression among people with schizophrenia: A pilot study applying kernel smoothers , 2016 .

[22]  Joël Billieux,et al.  Problematic digital gaming behavior and its relation to the psychological, social and physical health of Finnish adolescents and young adults , 2015, Journal of behavioral addictions.

[23]  Dan J Stein,et al.  Anxiety in Patients with Schizophrenia: Epidemiology and Management , 2015, CNS Drugs.

[24]  F. Wang,et al.  The influence of marital status on the social dysfunction of schizophrenia patients in community , 2015 .

[25]  S. Maloney,et al.  Smoking in schizophrenic patients: A critique of the self-medication hypothesis. , 2015, World journal of psychiatry.

[26]  Chung-Ying Lin,et al.  Further Psychometric Evaluation of the Self-Stigma Scale-Short: Measurement Invariance across Mental Illness and Gender , 2015, PloS one.

[27]  Chung-Ying Lin,et al.  Psychometric Evaluation of the Internalized Stigma of Mental Illness Scale for Patients with Mental Illnesses: Measurement Invariance across Time , 2014, PloS one.

[28]  Wei Hua,et al.  Shyness and Internet Use , 2013 .

[29]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[30]  A. Hayes Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach , 2013 .

[31]  Shin-Min Lee,et al.  Validation of the Taiwanese Mandarin version of the Personal and Social Performance scale in a sample of 655 stable schizophrenic patients , 2013, Schizophrenia Research.

[32]  P. Corrigan,et al.  Self-Stigma, Self-Esteem, and Co-occurring Disorders , 2013 .

[33]  S. Sawang,et al.  Using the Depression Anxiety Stress Scale 21 (DASS-21) across cultures. , 2013, International journal of psychology : Journal international de psychologie.

[34]  J. Blanchard,et al.  Internalized stigma in schizophrenia: Relations with dysfunctional attitudes, symptoms, and quality of life , 2013, Psychiatry Research.

[35]  K. Chen,et al.  Intercorrelations Between the Personal and Social Performance Scale, Cognitive Function, and Activities of Daily Living , 2011, The Journal of nervous and mental disease.

[36]  D. Roe,et al.  The Impact of Illness Identity on Recovery from Severe Mental Illness , 2010, American journal of psychiatric rehabilitation.

[37]  L. Šprah,et al.  Comorbid anxiety in patients with psychosis. , 2009, Psychiatria Danubina.

[38]  Keith A. Markus,et al.  Pathways between internalized stigma and outcomes related to recovery in schizophrenia spectrum disorders. , 2008, Psychiatric services.

[39]  H. Nasrallah,et al.  Reliability, validity and ability to detect change of the Personal and Social Performance scale in patients with stable schizophrenia , 2008, Psychiatry Research.

[40]  A. Malhotra,et al.  Patterns of stress in schizophrenia , 2008, Psychiatry Research.

[41]  Y. Barak,et al.  Self-stigma, self-esteem and age in persons with schizophrenia , 2008, International Psychogeriatrics.

[42]  Veena Kumari,et al.  Nicotine use in schizophrenia: The self medication hypotheses , 2005, Neuroscience & Biobehavioral Reviews.

[43]  I. Figueira,et al.  Anxiety disorders in schizophrenia. , 2004, Comprehensive psychiatry.

[44]  W. Horan,et al.  Emotional responses to psychosocial stress in schizophrenia: the role of individual differences in affective traits and coping , 2003, Schizophrenia Research.

[45]  D. Malaspina,et al.  Could Stress Cause Psychosis in Individuals Vulnerable to Schizophrenia? , 2002, CNS Spectrums.

[46]  J. Krystal,et al.  A neurobiological basis for substance abuse comorbidity in schizophrenia , 2001, Biological Psychiatry.

[47]  L. Dixon,et al.  Dual diagnosis of substance abuse in schizophrenia: prevalence and impact on outcomes , 1999, Schizophrenia Research.

[48]  J. Addington,et al.  Reasons for substance use in schizophrenia , 1997, Acta psychiatrica Scandinavica.

[49]  D S Rae,et al.  Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. , 1990, JAMA.

[50]  P. Corrigan,et al.  Self-stigma of people with schizophrenia as predictor of their adherence to psychosocial treatment. , 2008, Psychiatric rehabilitation journal.

[51]  D. Vogel,et al.  Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling. , 2007 .

[52]  B. Major,et al.  The social psychology of stigma. , 2005, Annual review of psychology.

[53]  E. Stip,et al.  [Schizophrenia and addiction: An evaluation of the self-medication hypothesis]. , 2003, L'Encephale.

[54]  F. Dickerson,et al.  Experiences of stigma among outpatients with schizophrenia. , 2002, Schizophrenia bulletin.