Comprehensive Evaluation of Internet Gaming Disorder : Clinical and Neurobiological Assessments

Soo-Hyun Paik; Hyun Cho; Jeong-Seok Choi; Sam-Wook Choi; Dai-Jin Kim

doi:10.4306/jknpa.2016.55.4.334

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Paik, Cho, Choi, Choi, and Kim: Comprehensive Evaluation of Internet Gaming Disorder : Clinical and Neurobiological Assessments

Review Article

Journal of Korean Neuropsychiatric Association 2016; 55(4): 334-342.

Published online: 30 November 2016

DOI: https://doi.org/10.4306/jknpa.2016.55.4.334

Comprehensive Evaluation of Internet Gaming Disorder : Clinical and Neurobiological Assessments

Soo-Hyun Paik, MD¹, Hyun Cho, MS¹, Jeong-Seok Choi, MD, PhD^2,³, Sam-Wook Choi, MD, PhD^4,⁵, Dai-Jin Kim, MD, PhD¹

¹Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

²Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.

³Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Korea.

⁴Korea Institute on Behavioral Addictions, True Mind Clinic, Seoul, Korea.

⁵Healthcare and Information Research Institute, Namseoul University, Seoul, Korea.

Address for correspondence: Dai-Jin Kim, MD, PhD. Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. Tel +82-2-2258-7586, Fax +82-2-594-3870, kdj922@catholic.ac.kr

Received 4 October 2016 Revised 15 October 2016 Accepted 24 October 2016

Abstract

A growing body of evidence supports that Internet gaming disorder (IGD) is considered as ‘behavioral addiction’ with neurobiological alterations. We have reviewed previous research into the clinical and neurobiological features of IGD, and suggest a flowchart for the comprehensive evaluation of IGD. Several self-rating screening tests based on Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-5) IGD criteria were developed. IGD is often comorbid with depressive disorder, social anxiety disorder, attention deficit/hyperactivity disorder (ADHD), and smartphone addiction. Individuals with IGD are prone to act impulsively and make risky decisions, especially in response to game-related cues. Functional neuroimaging results have shown altered functional activities in prefrontal cortex, cingulate cortex, superior temporal gyrus and nucleus accumbens (NAc). Structural neuroimaging demonstrated gray matter volume changes in prefrontal cortex and NAc, while showing white matter integrity disruption in thalamus and posterior cingulate cortex. There are few evidences on the attribution of specific genes to IGD. To evaluate IGD comprehensively, self-rating scales based on DSM-5 are useful, but a diagnostic interview by a clinician is more helpful to assess functional impairments of IGD. Presence of psychiatric comorbidities such as depressive disorder, social anxiety disorder, ADHD, and smartphone addiction should be evaluated. Neurocognitive tests that assess impulsivity, decision-making under risk, and cue-reactivity are helpful when planning individualized IGD treatment.

Keywords: Internet gaming disorder, Screening, Comorbidity, Neurocognitive function, Neuroimaging

Figures and Tables

Fig. 1

Flow chart for Comprehensive Evaluation of Internet Gaming Disorder. IGD-20 test : Internet Gaming Disorder Test, IGDS9-SF : Internet Gaming Disorder Scale-Short Form, IGDS : Internet Gaming Disorder Scale, IGUESS : Internet Gaming Use-Elicited Symptom Screen, ADHD : Attention deficit/hyperactivity disorder.

Table 1

Neurocognitive impairments associated with Internet gaming disorder

BIS-11 : Barratt Impulsiveness Scale version 11, SST : Stop signal test, CANTAB : Cambridge Neuropsychological Test Automated Battery

Notes

^{Conflicts of Interest} The authors have no financial conflicts of interest.

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