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To investigate the comorbidity of adolescent depression and Internet gaming disorder (IGD) and their shared and unique cognitive-behavioral factors (i.e., self-esteem, dysfunctional attitudes, hopelessness, and coping), a large-scale school-based survey was conducted among 3147 Chinese secondary school students in Hong Kong. Probable depression and IGD were screened using the Centre for Epidemiological Studies-Depression Scale and DSM-5 IGD checklist, respectively. Multinomial logistic regression was performed to identify the associations between different condition statuses and cognitive-behavioral factors. Four groups were identified, including comorbidity group (having probable depression and IGD), IGD group (having probable IGD alone), depression group (probable depression alone), and healthy group (neither condition). Comorbidity group showed the worst cognitive-behavioral statuses, followed by depression group and then IGD group. Compared with healthy group, those with lower self-esteem and higher hopelessness and dysfunctional attitudes were more likely to be classified into depression group and comorbidity group, while maladaptive coping was positively associated with all three disorder groups. The results suggest that depression and IGD may share common cognitive-behavioral mechanisms (e.g., maladaptive coping) but also own their uniqueness regarding specific factors (e.g., hopelessness and self-esteem). A transdiagnostic intervention approach targeting the common factors may effectively address the comorbidity. [ABSTRACT FROM AUTHOR]

Objective: This study tested the mediation effect of maladaptive cognition of internet gaming and moderation effect of internet gaming history in the relationship between internet gaming engagement and internet gaming disorder in adolescents. Method: A total of 2,902 secondary school students were surveyed in Hong Kong from February 2021 to December 2021. The proposed moderated mediation model was tested by PROCESS. Results: Internet gaming engagement, internet gaming history and maladaptive cognition were positively associated with internet gaming disorder symptoms. Maladaptive cognition significantly mediated the association between internet gaming engagement and internet gaming disorder symptoms in both males and females. In addition, a significant interaction between internet gaming engagement and internet gaming history was detected among females but not for males, namely, the positive relationships of internet gaming engagement with maladaptive cognition and internet gaming disorder symptoms were weaker with the increased years of internet gaming. Conclusions: Our study provides a better understanding of the underlying mechanism and boundary condition in the association between internet gaming engagement and internet gaming disorder among adolescents. Preventing interventions should aim to reduce maladaptive cognition and internet gaming engagement. Interventions targeting internet gaming engagement maybe more effective among female gamers who are beginners and all male gamers. [ABSTRACT FROM AUTHOR]

Psychological flexibility may reduce addictive behaviours by adaptive and flexible emotional and cognitive processes. This study tested a mediation model of internet gaming disorder (IGD) in which psychological flexibility would reduce depression and maladaptive cognitions related to internet gaming and in turn lower the risk of IGD. A cross-sectional study surveyed 2102 secondary 1–4 students from seven schools during March to November 2021 in Hong Kong, China. The results showed that 12.7% and 52.2% of the students were classified as having probable IGD and depression, respectively. The proposed mediation model fitted the data well: χ2/df = 8.00, CFI =.99, NNFI =.99, RMSEA =.01. Psychological inflexibility was directly and positively associated with IGD (B =.01, β =.07, p =.003) and indirectly and positively associated with IGD via depressive symptoms (B =.01, β =.07, p =.001, PM = 23.7%) and maladaptive cognitions (B =.03, β =.15, p =.001, PM = 50.8%). Multi-group analyses showed that gender significantly moderated the associations between psychological inflexibility and maladaptive cognitions (Δχ2/Δdf = 8.69/1, p <.05), between maladaptive cognitions and IGD (Δχ2/Δdf = 4.33/1, p <.05), and between psychological inflexibility and IGD (Δχ2/Δdf = 5.46/1, p <.05). Depression and maladaptive cognitions may be significant mediators that could explain the relationship between psychological flexibility and IGD. Also, gender difference may exist. Based on the findings, intervention strategies for IGD reduction are discussed. [ABSTRACT FROM AUTHOR]