Maladaptive cognitions, loneliness, and social anxiety as potential moderators of the association between Internet gaming time and Internet gaming disorder among adolescent Internet gamers in China.

The significance of Internet gaming time's dosage effect on Internet gaming disorder (IGD) may depend on gamers' characteristics. Majority of the gamers with extensive gaming time do not develop IGD. This study investigated moderation effects of cognitive/psychosocial factors on the association between Internet gaming time and probable IGD among adolescent Internet gamers in China. The cross-sectional, self-administered, and anonymous survey was conducted from October to December of 2018 among seven conveniently selected secondary school students in Chengdu and Guangzhou, China. Probable IGD was measured by using the DSM-5 checklist. The cognitive/psychosocial moderators were assessed by using validated instruments. Of the 2,503 students who had played Internet games (past 12 months), the prevalence of probable IGD was 17.7%. Internet gaming time [adjusted odds ratio (ORa) = 1.06], the three maladaptive cognitions specific to Internet gaming (perceived overvaluation of rewards, perceived urges, and perceived unwillingness to stop playing) (ORa = 1.17 to 1.44), and the two types of psychosocial factors (loneliness and social anxiety) (ORa = 1.09 to 1.13) were independent risk factors of probable IGD. Moderation analyses showed that overall maladaptive cognitions, perceived urges, and loneliness (but not the other two types of cognitions and social anxiety) were significant moderators of the association between Internet gaming time and probable IGD. The dose-effect relationship of Internet gaming time on probable IGD was significantly and slightly stronger among those with higher levels of perceived urges and loneliness. Interventions to reduce the levels of such moderators may reduce probable IGD directly and buffer the dosage effect among adolescents.