Reference
Mangat, H. S., Király, O., Urbán, R., Yu, S. M., Griffiths, M. D., Paksi, B., Felvinczi, K., Demetrovics, Z., & Czakó, A. (2026). Esports bettors versus traditional sports bettors: Differences in demographics, impulsivity, psychopathological symptoms, and gaming and gambling behavior. Comprehensive Psychiatry, 152667. https://doi.org/10.1016/j.comppsych.2026.152667

Abstract
This study compared individuals who bet on esports with those who bet exclusively on traditional sports across the UK, Hungary, and Canada (N = 685). Findings showed that esports bettors tend to be younger and more likely to report higher levels of problem gambling risk severity and gaming disorder symptoms. Esports bettors also reported greater impulsivity, stress, anxiety, and depression symptoms, and were more likely to gamble for coping, social, and financial reasons.

Gaming disorder symptoms remained a significant predictor of esports betting even after controlling for other psychological and motivational factors. The findings suggest that esports bettors represent a distinct and potentially more vulnerable subgroup within the wider betting population, highlighting the need for targeted awareness and harm-reduction strategies.

Reference
Magi, A., Horváth, Z., Villalba-García, C., Paksi, B., Eisinger, A., Felvinczi, K., Stewart, S., Bőthe, B., Kökönyei, G., Demetrovics, Z., & Czakó, A. (2025). An extended model of gambling motives: The first results with the long and short versions of the gambling motives questionnaire-revised. Comprehensive Psychiatry, 152633. https://doi.org/10.1016/j.comppsych.2025.152633

Abstract
This study presents the first empirical results of an extended model of gambling motives, building on the widely used Gambling Motives Questionnaire (GMQ). Using two large samples – a player panel from a gambling service provider (N = 1,829) and a nationally representative adult sample from Hungary (N = 437) – the authors examined whether additional motivational dimensions could improve the assessment of gambling-related motivations. The analyses identified four key motivational factors: coping and escapism, social motives, enhancement and pleasure, and financial motives. These factors were supported through exploratory and confirmatory factor analyses, and a shorter 14-item version of the revised questionnaire was also developed for practical use. Importantly, coping and escapism emerged as particularly relevant motives in relation to problematic and potentially addictive gambling behaviours. The findings suggest that a more comprehensive assessment of gambling motives may improve differentiation between recreational and problem gambling, with clear implications for research, screening, and targeted interventions.

Reference
Ling, H., Yu, S. M., Jimenez‐Murcia, S., Zhou, H., Zhang, H., Sun, R., & Wu, A. M. S. (2025). Risky loot box behaviors and gambling disorder among Chinese adult purchasers: A network analysis approach. Computers in Human Behavior, 173, 108771. https://doi.org/10.1016/j.chb.2025.108771

Abstract
This study explored the symptomatic associations between risky loot box behaviours and gambling disorder symptoms among Chinese adult gamers using a network analysis approach. Drawing on survey data from 699 adults who had purchased loot boxes in the previous year, the authors examined symptom-level associations between gambling disorder and specific risky loot box behaviours. The results showed a significant positive association between overall gambling disorder severity and risky loot box engagement. Network analysis identified “unsuccessful efforts to control gambling” as the most central symptom, while “putting off important activities to earn or buy loot boxes” and “compulsive loot box opening” acted as key bridge symptoms. Gender differences were observed in gambling disorder severity but not in risky loot box behaviours or network structure. These findings provide novel insights into the psychological mechanisms connecting loot box engagement and gambling disorder, highlighting potential targets for prevention and harm-reduction strategies, particularly those aimed at improving self-control and responsible purchasing practices.

Reference
Czakó, A., Potenza, M. N., Hodgins, D. C., Yu, S. M., Wu, A. M. S., Jiménez-Murcia, S., Bowden-Jones, H., King, D., Billieux, J., Bőthe, B., Stein, D. J., Gambling Research Priority Setting Consortium, & Demetrovics, Z. (2025). Research priorities in gambling: Findings of a large-scale expert study. Journal of Behavioral Addictions, 14(3), 1222–1249. https://doi.org/10.1556/2006.2025.00072

Abstract
This large-scale international study aimed to identify global research priorities in the field of gambling using a systematic, transparent, and democratic methodology. Over 300 leading gambling researchers from 35 countries contributed more than 1,300 research questions, which were consolidated into 102 research options. These options were evaluated across multiple criteria, including feasibility, effectiveness, equity, and potential for harm reduction, with additional weighting provided by key stakeholders. The top-ranked priorities highlighted critical gaps in knowledge related to the epidemiology, etiology, and consequences of gambling-related harm, with particular emphasis on vulnerable and minority populations, young people, technological innovations, advertising, the convergence of gaming and gambling, and co-occurring mental health conditions. The findings also stressed the importance of improving existing prevention and treatment approaches rather than focusing solely on developing new interventions. Overall, this study provides a clear roadmap for future gambling research and offers valuable guidance for researchers, funders, and policymakers.

Reference
Losaberidze, M., Mallorquí-Bagué, N., Demetrovics, Z., Jiménez-Murcia, S., Potenza, M. N., Soborun, Y., Romero, P., Reinhardt, M., Kökönyei, G., Mestre-Bach, G., & Czakó, A. (2025). Scars, screens, and stakes: Link between non-suicidal self-injury and problem gambling, problem gaming, and problematic internet use – A systematic review. Journal of Behavioral Addictions. https://doi.org/10.1556/2006.2025.00079

Abstract
This systematic review examined the associations between non-suicidal self-injury (NSSI) and three forms of problematic digital and behavioural engagement: problem gambling, problem gaming, and problematic internet use. Following PRISMA guidelines, the authors reviewed 40 empirical studies published between 2009 and 2025. The findings indicate that NSSI is consistently associated with problem gambling, problem gaming, and problematic internet use across adolescent and adult populations. Impulsivity emerged as a shared vulnerability factor, while anxiety often acted as a mediator or moderator of these relationships. Social support appeared to buffer the association between problematic internet use and NSSI. Neurobiological and psychological parallels between NSSI and behavioural addictions were also identified, supporting conceptual links between these phenomena. Despite methodological limitations in the existing literature, including reliance on self-report measures and cross-sectional designs, the review highlights the importance of considering co-occurring behavioural addictions and self-harm in both research and clinical practice. The authors emphasise the need for integrated screening, prevention, and intervention approaches targeting shared risk factors.

Villalba-García, C., Griffiths, M. D., Demetrovics, Z., & Czakó, A. (2025). The relationship between loot box buying, gambling, internet gaming, and mental health: Investigating the moderating effect of impulsivity, depression, anxiety, and stress. Computers in Human Behavior, 166, 108579. https://doi.org/10.1016/j.chb.2025.108579

Our most recent paper, which was published in a highly-cited international scientific journal, Computers in Human Behavior, reveals important findings on video game loot boxes and mental health. A ‘loot box’ is a virtual item in video games that provides players with random rewards (such as weapons or cosmetics). Analyzing a relatively large sample of adults (1416 individuals), we found that loot box buying was positively associated with problem gambling and problematic video game use. We also found that anxiety and impulsivity can strengthen these relationships, while depression showed mixed effects. Our results suggest that, at least to some extent, loot box purchasing shares similar mental health risk factors with other behavioral addictions. This research provides valuable insights into responsible gaming practices and player protection.

Brand, M., Antons, S., Bőthe, B., Demetrovics, Z., Fineberg, N. A., Jimenez-Murcia, S., King, D. L., Mestre-Bach, G., Moretta, T., Müller, A., Wegmann, E., & Potenza, M. N. (2024). Current Advances in Behavioral Addictions: From Fundamental Research to Clinical Practice. American Journal of Psychiatry, appi.ajp.20240092. https://doi.org/10.1176/appi.ajp.20240092

Gambling disorder is the only behavioural addiction recognized as a clinical disorder in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, while the 11th edition of WHO’s International Classification of Diseases categorizes both gambling and gaming disorders as disorders due to addictive behaviours. However, additional behavioural addictions may include compulsive sexual behaviour disorder, compulsive buying-shopping disorder, and problematic use of social media. This paper summarizes the current state of knowledge regarding these five (potential) disorders. As behavioural addictions frequently co-occur with other psychiatric disorders, they may often go undiagnosed and untreated, thus the importance of active screening and treatment are indicated. The authors also stress the importance of expanding public health considerations and a more intense investigation regarding the impacts of modern technologies.

Ngetich, R., Villalba-García, C., Soborun, Y., Vékony, T., Czakó, A., Demetrovics, Z., & Németh, D. (2024). Learning and memory processes in behavioural addiction: A systematic review. Neuroscience & Biobehavioral Reviews, 163, 105747. https://doi.org/10.1016/j.neubiorev.2024.105747

This systematic review investigated the relationship between learning and memory processes and behavioural addictions (BAs), as well as their underlying neural mechanisms. Following PRISMA guidelines, the researchers systematically searched four databases (PsycINFO, PubMed, Scopus, and Web of Science), identifying 65 eligible studies. The findings revealed that behavioural addictions are associated with altered executive function-dependent learning processes and enhanced habit learning. The relationship between working memory and behavioural addiction varied depending on addiction type, working memory aspect, and task nature. Additionally, long-term memory showed inconsistent patterns in individuals with addictive behaviours. Neurophysiological evidence indicated alterations in brain areas and networks involved in learning and memory processes in behavioural addictions, similar to patterns seen in substance use disorders. The authors conclude that alterations in learning and memory processes may underlie both the development and maintenance of behavioural addictions.

Koncz, P., Demetrovics, Z., Urbán, R., Griffiths, M. D., & Király, O. (2024). Gender-specific motivational pathways in ADHD-related inattention and gaming disorder symptoms. Addictive Behaviors, 158, 108120. https://doi.org/10.1016/j.addbeh.2024.108120

This study examined gender differences in the relationship between ADHD symptoms and gaming disorder (GD) through gaming motivations. Using data from 14,740 gamers, the research found that inattention symptoms were linked to GD severity through immersion/escapism motivation for both genders. However, pathways through habit/boredom and competition motives were significant only for males. The findings suggest that while gamers with ADHD symptoms may use gaming as maladaptive coping, males develop additional problematic patterns through habitual play and competition.

Horváth, Z., Paksi, B., Fernández-Aranda, F., Jiménez-Murcia, S., & Demetrovics, Z. (2023). The Predictive Role of Tolerance and Health Problems in Problem Gambling: A Cross-Sectional and Cross-Lagged Network Analyses. Journal of Gambling Studies, 39(4), 1781-1798. https://doi.org/10.1007/s10899-023-10191-5

This study used network analysis to examine gambling disorder symptoms in a representative sample of young adult gamblers (N=335) across two time points. The research employed both cross-sectional and longitudinal cross-lagged network analyses. Results showed limited replicability of cross-sectional symptom networks between time points. The longitudinal analysis revealed that tolerance and health problems predicted the subsequent presence of multiple gambling disorder symptoms. The findings suggest these symptoms might play a crucial role in the development and maintenance of gambling problems.

Katz, D., Horváth, Z., Pontes, H. M., Koncz, P., Demetrovics, Z., & Király, O. (2024). How much gaming is too much? An analysis based on psychological distress. Journal of Behavioral Addictions. https://doi.org/10.1556/2006.2024.00036

This study investigated the relationship between weekly gaming time and gaming disorder (GD) symptoms, as well as psychological distress among highly engaged gamers (N=14,740). The research found that individuals at risk of GD played approximately 42 hours per week. Using Latent Profile Analysis, four profiles of psychological distress were identified. Notably, 41.9% of participants showed no psychological distress despite playing 26 hours weekly, while those reporting high psychological distress (4.2%) averaged 33 hours of gaming per week. The findings suggest that the relationship between gaming time and psychological distress is complex, as extended gaming time can be unproblematic for many players.

Horváth, Z., Paksi, B., Eisinger, A., Felvinczi, K., Demetrovics, O., & Demetrovics, Z. (2023). Longitudinal joint trajectories of gambling disorder and hypo mentalization: A latent class growth analysis among young adults. Comprehensive Psychiatry, 126, 152409.

https://doi.org/10.1016/j.comppsych.2023.152409

The study investigated the longitudinal relationship between risk for gambling disorder (GD) and hypomentalization (difficulties in understanding one’s own and others’ mental states) among young adult gamblers over a 3-year period, aiming to identify subgroups with different joint trajectories of risk for GD and hypomentalization, and compare these subgroups on impulsivity, sensation seeking, and depression. Four subgroups were identified through latent class growth analysis, with only one subgroup (6% of the sample) showing consistently elevated levels of both risk for GD and hypomentalization over time, while the other three subgroups had low risk for GD but varying trajectories of hypomentalization. There was little evidence that risk for GD and hypomentalization change in the same direction over time, except in the one high-risk subgroup, which also had higher levels of sensation seeking and depression compared to the other subgroups. Impulsivity and sensation seeking were associated with subgroup membership. The authors conclude that while elevated hypomentalization co-occurs with risk for GD, the two constructs don’t necessarily have convergent longitudinal trajectories; however, they note limitations like the low prevalence of GD symptoms in the sample, suggesting that more research in clinical populations is needed to clarify the role of mentalization.

Romero, P., Czakó, A., van den Brink, W., Demetrovics Z. (2023) Psychedelic-Assisted Therapy for people with gambling disorder? Journal of Behavioral Addictions.

https://doi.org/10.1556/2006.2024.00004

“This article discusses the potential use of psychedelic-assisted therapy (PAT) as a treatment option for gambling disorder, a serious mental health issue with harmful consequences that current treatments have limited effectiveness in addressing, leading to high relapse rates. The authors highlight recent studies showing promising results using PAT to treat anxiety, depression, PTSD, and substance use disorders. Considering the similarities between gambling disorder and other addictive disorders, they suggest that PAT could be an effective treatment for gambling disorder as well. The article reviews the history of therapeutic psychedelic use, current theories on how psychedelics work, and recent studies demonstrating PAT’s effectiveness for various disorders. It emphasizes the need for further research into PAT as a potential novel treatment approach for gambling disorder and other behavioural addictions.”

Mangat, H. S., Griffiths, M. D., Yu, S. M., Felvinczi, K., Ngetich, R. K., Demetrovics, Z., & Czakó, A. (2023). Understanding Esports-related Betting and Gambling: A Systematic Review of the Literature.

Journal of Gambling Studies. https://doi.org/10.1007/s10899-023-10256-5

This review evaluated all English-language peer-reviewed empirical studies on esports betting. We found that esports bettors were more likely to be male, younger, and come from non-Caucasian ethnic backgrounds compared to their comparison groups (like sports bettors). We also found that esports bettors were likely to score higher on problematic gambling measures, compared to other types of gamblers, and non-gamblers. A positive relationship between esports spectatorship and esports betting was also evident in the results. The review shows that despite increasing research in esports-related gambling, there is much scope for more expansive research.

Granero, G., Fernández-Aranda, F., Demetrovics, Z., Ayala-Rojas, R. E., Gómez-Peña, M., Moragas, L., Jiménez-Murcia, S., (2021). Profile of Treatment-Seeking Gaming Disorder Patients: a Network Perspective. Journal of Gambling Studies.

https://link.springer.com/article/10.1007%2Fs10899-021-10079-2

This study explored the network structure of correlates of gaming disorder (sociodemographic, personality and other clinical measures) in treatment-seeking patients. The network analysis carried out in this study provided insight into the structure of the main contributing factors of gaming disorder. The central nodes in the network were global psychological distress, chronological age, and age of onset of gaming related problems.

Linkage analysis also identified psychopathological status and age as the variables with the most valuable information in the model. Identification of such variables can be useful for developing precise management plans to prevent and treat gaming disorder related problems.

Shaw, C.A., Hodgins, D.C., Williams, R.J. et al. (2021). Gambling in Canada During the COVID Lockdown: Prospective National Survey. Journal of Gambling Studies (2021).

https://link.springer.com/article/10.1007%2Fs10899-021-10073-8

This study aimed to investigate the extent to which the COVID pandemic lockdown influenced gambling and problem gambling in Canada. The re-surveying of AGRI National project’s online panel participants (n=3449) allowed for a quantitative comparison of gambling behaviours during the pandemic relative to six months prior. Findings showed that nearly one-third of gamblers ceased gambling completely during the lockdown. Whereas for those who continued, gambling decreased across nearly all engagements metrics including gambling frequency, time spent in gambling sessions, money spent, and the number of game types engaged in.

Over 17% of participants migrated from pre-pandemic land based gambling to online gambling during the lockdown. Further studies are required to assess if these changes herein remain stable or revert to pre-pandemic levels.

Bányai, F., Zsila, Á., Kökönyei, G., Griffiths, M. D., Demetrovics, Z., Király, O., (2021). The moderating role of coping mechanisms and being an e-sport player between psychiatric symptoms and gaming disorder: Online survey. JMIR Mental Health, 8(3):e21115  [https://mental.jmir.org/2021/3/e21115/PDF]

This study aimed to investigate the effect of coping strategies and type of videogame usage (i.e., professional/esport vs. recreational use) on the relationship between psychiatric symptoms (e.g., depression, anxiety) and videogame addiction. The results showed that there is a moderately strong relation between psychiatric symptoms and videogame addiction and that neither coping strategies, nor the type of videogame usage have a considerable effect on this relation.

Murray, A., Koronczai, B., Király, O., Griffiths, M. D., Mannion, A., Leader, G., Demetrovics, Z. (2021). Autism, Problematic Internet Use, and Gaming Disorder: A Systematic Review. Review Journal of Autism and Developmental Disorders, in press [https://link.springer.com/content/pdf/10.1007/s40489-021-00243-0.pdf]

This literature review investigated the relationship between autism and problematic internet use and videogame addiction. A systematic literature search was conducted, and 21 studies were identified examining this question. The majority of the studies found a weak or moderate relationship between internet addiction and autistic-like traits and a relationship with varying strength between internet addiction and clinically diagnosed Autism Spectrum Disorder. Additionally, individuals with Autism Spectrum Disorder were more likely to exhibit symptoms of videogame addiction, however there is a lack of studies investigating the relationship between autistic-like traits and videogame addiction.

Rafiemanesh, H., Farnam, R., Rahimi, J., Hamzehzadeh, M., Ghani, K., Jobehdar, M. M., Amin-Esmaeili, M., Shadloo, B., Demetrovics, Z., Király, O., Rahimi-Movaghar, A. (2021). Online Gaming and Internet Gaming Disorder in Iran: Patterns, Motivations, and Correlates. Current Psychology [https://link.springer.com/article/10.1007/s12144-021-02490-0]

The aim of this study was to assess patterns and motivations of online gaming, the symptomatology and prevalence of Gaming Disorder (GD) and its health implications, and the correlates of these phenomena in an Iranian population of online gamers. The study was carried out as part of a national survey collaboration with a cross-cultural study. The findings showed prevalence estimate of GD was 3.7% amongst the 791 participating gamers, and higher game time and GD was 9.4 times more prevalent amongst males. Additionally, time spent on gaming, younger age, using a PC rather than smartphones and “escape” and “fantasy” gaming motivations and psychiatric symptoms were associated with the GD as well. This study concludes that a small minority of Iranian online gamers may be at risk of pathological gaming and its associated harms, especially those of a young age who play long hours with “fantasy” related incentives.

Király, O., Zhang, J., Demetrovics, Z., & Browne, D. T. (2021). Gambling Features and Monetization in Video Games Creates Challenges for Young People, Families, and Clinicians. Journal of the American Academy of Child & Adolescent Psychiatry, S089085672102044X.
[https://www.jaacap.org/article/S0890-8567(21)02044-X/fulltext]

This article highlights how “loot boxes” (in-game consumable virtual items, that can be purchased with real money or obtained in games as a reward) may act as a gateway to problem gambling and in turn, the impact this may have on children from a developmental perspective, disruptions within families and barriers faced by paediatric clinicians. This study includes key areas of research that need to be considered to be able to facilitate effective prevention methods.

Spritzer, D. T., Machado, W. D., Yates, M. B., Astolfi, W., Laskoski, P. B., Pessi, C. P., Laconi, S., Kaliszewska-Czeremska, K., Demetrovics, Z., Király, O., Passos, I. C., Hauck, S. (2021). Psychometric properties of the nine-item Problematic Internet Use Questionnaire in a Brazilian general population sample. Frontiers in Psychiatry, 12:660186 [https://www.frontiersin.org/articles/10.3389/fpsyt.2021.660186/full]

This study aimed to adapt and examine the psychometric properties of the Brazilian version of the Problematic Internet Use Questionnaire (PIUQ-SF-9) in the framework of a multicentric project carried out in 16 countries investigating the cross-cultural aspects of problematic internet and smartphone use. The PIUQ-SF-9 is the short form of the original 18-item PIUQ developed by Demetrovics et al., 2008. It is a nine-item comprehensive screening tool assessing three basic areas of problematic internet use: obsession (i.e., preoccupation and withdrawal symptoms); neglect (i.e., negligence of everyday activities and basic needs); and control disorder (i.e., trouble in controlling internet use). The sample consisted of Brazilian Internet users between the ages of 18 and 89. According to the results the Brazilian Portuguese version of the PIUQ-SF-9 proved to be a valid and reliable instrument to be used in future studies on problematic internet use in Brazil.

Horváth, Z., Király, O., Demetrovics, Z., Németh, Á., Várnai, D., & Urbán, R. (2021). Polysubstance Use Is Positively Associated with Gaming Disorder Symptom Severity: A Latent Class Analytical Study. European Addiction Research, 1-11. [https://pubmed.ncbi.nlm.nih.gov/34284387/]

The aim of the present study was to explore alcohol and illicit drug use classes among adolescents and how gaming disorder is associated with these. The final sample consisted of 2768 students (ninth and eleventh graders), with a mean age of 16.73 years. Four subgroups were identified: polysubstance users, high-risk alcohol users, moderate alcohol users, and infrequent substance users. Based on the results severe gaming disorder was associated with various drug use, which may be due to the intention to increase performance in the game. There may be common psychological mechanisms in the background (e.g., sensation-seeking tendencies), and shared neurobiological mechanisms may also explain the relationship. The level of alcohol consumption did not correlate with the severity of the symptoms of gaming disorder.

Kótyuk, E., Urbán, R., Hende, B., Richman, M., Magi, A., Király, O., Barta, C., Griffiths, M. D., Potenza, M. N., Badgaiyan, R. D., Blum, K., & Demetrovics, Z. (2022). Development and validation of the Reward Deficiency Syndrome Questionnaire (RDSQ-29). Journal of Psychopharmacology, 026988112110691. [IF: 4.153] [https://journals.sagepub.com/doi/10.1177/02698811211069102]

This present study developed and validated a 29-item reward deficiency syndrome questionnaire (RSDQ-29) containing four subscales to assess psychological and behavioural characteristics that may contribute to addictions generally. Reward deficiency syndrome (RDS) seems to have a crucial role in the development of addictive behaviours. While former studies described carefully the neurobiological and genetical background of the reward deficiency syndrome until now the psychological description of the phenomenon was not available. The currently developed scale fills this gap by providing a psychometrically sound instrument to assess RDS and its components.

Williams, R. J., Shaw, C. A., Belanger, Y. D., Christensen, D. R., el-Guebaly, N., Hodgins, D. C., McGrath, D. S., & Stevens, R. M. G. (2022). Etiology of problem gambling in Canada. Psychology of Addictive Behaviors. Advance online publication. https://doi.org/10.1037/adb0000843

A large-scale national cohort study has been conducted to identify the current etiological risk factors for problem gambling in Canada. A cohort of 10,119 Canadian gamblers completed a comprehensive self-administered online questionnaire in 2018 and were reassessed in 2019. The strongest multivariate predictors of current and future problem gambling were “gambling-related” variables, such as current and past problem gambling, intensive gambling involvement, playing electronic gambling machines, gambling fallacies, socializing with other people having gambling-related problems, and family history of having gambling-related problems. Beyond gambling-related variables, greater impulsivity and lower household income were robustly predictive.

Király, O., Billieux, J., King, D. L., Urbán, R., Koncz, P., Polgár, E., & Demetrovics, Z. (2022). A comprehensive model to understand and assess the motivational background of video game use: The Gaming Motivation Inventory (GMI). Journal of Behavioral Addictions. https://doi.org/10.1556/2006.2022.00048

This study aimed to create a comprehensive motivation inventory applicable to any gaming genre and to evaluate its psychometric properties in a large sample of highly engaged video gamers. A sample of 14,740 video gamers were recruited via an online survey, and the findings showed that 26 gaming motives clustered into six higher-order dimensions (Mastery, Immersion/Escapism, Competition, Stimulation, Social, Habit/Boredom).  Gaming motives had moderate relationships with variables such as competitiveness, sociability, and positive and negative affect. Gaming disorder symptoms were directly predicted by depression symptoms and indirectly via immersion/escapism, habit/boredom, and competition motives. The authors conclude that the Gaming Motivation Inventory is a useful tool for gaining insights into factors underlying gaming behaviours.

Király, O., Browne, D., Demetrovics, Z. (2022). Developmental and Family Implications of State Controlled Videogame Play in China. JAMA Pediatrics, [IF: 16.193] https://doi.org/10.1001/jamapediatrics.2022.0322

Recently, China imposed laws limiting children younger than 18 to 1 hour of online gaming between 8 and 9 PM on Fridays, Saturdays, Sundays, and public holidays. There are potential benefits and risks associated with state control of children’s video game play. These regulations have been welcomed by some, but there is evidence that video game play can have several benefits, including helping players master skills and be part of a community. The rules may also stigmatize an activity that is harmless for most people. From a family systems perspective, the regulations may externalize the problem of parent-child conflict over video game play outside the family, meaning parents and children now work together to find new ways to spend time. Alternatively, they could form a coalition against the regulation. The regulations could strengthen family relationships, but they may also inhibit the independent negotiation of media use within parent-child dyads, which is an important opportunity for families to work through challenging issues.

Nower, L., & Glynn, J. (2022). Adopting an affordability approach to responsible gambling and harm reduction: considerations for implementation in a North American context. Gaming law review, glr2.2022.0020. Https://doi.org/10.1089/glr2.2022.0020

The proliferation of gambling opportunities worldwide has generated concern over how to protect individuals and families from harm caused by excessive spending. In response, researchers and operators have worked with big data to develop models that identify indicators of problem gambling. Such models are generally proprietary, non-transparent, and non-generalizable across games, jurisdictions, or player populations, rendering them impractical as regulatory tools. In the UK and elsewhere, regulations have shifted to a model of shared responsibility that targets ‘affordability,’ the amount individual players can afford to lose. This approach avoids the need for regulators and operators to be clinicians, attempting to identify disorder. We discuss approaches to operationalizing affordability guidelines in a North American context – to promote the objective identification of players who are spending beyond their means and reduce related harm.

Király, O., Potenza, M. N., & Demetrovics, Z. (2022). Gaming disorder: Current research directions. Current Opinion in Behavioral Sciences, 47, 101204. https://doi.org/10.1016/j.cobeha.2022.101204

Gaming disorder (GD) is a condition that involves recurrent videogaming behaviour that leads to serious functional impairment in personal, social, family, occupational, and educational areas. GD is characterized by poor control, increasing priority given to gaming over other interests and activities, and continuation of gaming despite negative consequences. The World Health Organization (WHO) has recognized GD as an official diagnosis, and research into this disorder is growing, resulting in new research directions.research directions are proposed The present narrative review covers important recent studies of GD between 2019 and 2021, and addresses topics such as  conceptualization, assessment, and prevalence; comparison of DSM-5 and ICD-11 frameworks; clinical studies; neurobiological studies; gambling elements in video games; and impacts of the COVID-19 pandemic on gaming and GD. : (conceptualization, assessment, and prevalence, (2) comparison of GD frameworks proposed by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the International Classification of Diseases 11th Revision, (3) clinical studies, (4) neurobiological studies, (5) gambling elements in video games, and (6) impacts of the COVID-19 pandemic on gaming and GD. The authors discuss the most important findings and propose future directions of research.

Mackey-Simpkin, S., Williams, R. J., Shaw, C. A., & Russell, G. E. H. (2022). Prevalence and predictors of illegal gambling in Canada. International Gambling Studies, 1–16. https://doi.org/10.1080/14459795.2022.2149833

 This study investigated the prevalence of illegal gambling in Canada in 2018. The researchers conducted a survey of 10,199 Canadian adults as part of a larger national study on gambling. They found that the prevalence of illegal gambling was very low, with only 0.05% of respondents reporting using illegal betting shops or bookies, 0.07% patronizing illegal casinos or card rooms, 0.09% participating in illegal animal contests, and 1.59% engaging in illegal online gambling. The study identified several factors that were associated with an increased likelihood of participating in illegal gambling, including the presence of gambling problems, male gender, younger age, and engagement in a larger number of gambling formats. Overall, the study found that legal forms of gambling may have largely displaced illegal forms, but illegal gambling does continue to exist among certain groups, particularly those who are heavily involved in gambling.

Akbari, M., Bahadori, M. H., Khanbabaei, S., Milan, B. B., Horvath, Z., Griffiths, M. D., & Demetrovics, Z. (2023). Psychological predictors of the co-occurrence of problematic gaming, gambling, and social media use among adolescents. Computers in Human Behavior, 140, 107589. https://doi.org/10.1016/j.chb.2022.107589

This study aimed to identify psychosocial predictors associated with different co-occurrence patterns  of problematic gambling, problematic social media use and problematic gaming among adolescents. The study surveyed 2390 Iranian adolescents between the ages of 13 and 18, and found that four different latent classes emerged: a non-problematic behavior group, a group with problematic gambling, a group with problematic social media use and gaming disorder, and a group with disordered gambling and problematic social media use. The study found that different psychological risk factors were associated with these different groups, and that specialized prevention and treatment programs may be needed for adolescents who experience co-occurring addictive behaviors.

Lucas, I., Granero, R., Fernández-Aranda, F., Solé-Morata, N., Demetrovics, Z., Baenas, I., Gómez-Peña, M., Moragas, L., Mora-Maltas, B., Lara-Huallipe, M. L., & Jiménez-Murcia, S. (2023). Gambling disorder duration and cognitive behavioural therapy outcome considering gambling preference and sex. Journal of Psychiatric Research, 158, 341–349. https://doi.org/10.1016/j.jpsychires.2022.12.031

This study aimed to evaluate the effect of illness duration on the treatment outcome of different profiles of gambling disorder (GD) patients according to their gambling preference and sex. 1699 patients diagnosed with GD were analysed, all of whom received cognitive-behavioural therapy. Results showed that patients who presented a preference for strategic forms of gambling and women had a higher risk of poor treatment outcomes since the first stages of the disorder. These results highlight the importance of early intervention in these specific patients to prevent the chronicity of the disorder.

Király, O., Koncz, P., Griffiths, M. D., & Demetrovics, Z. (2023). Gaming disorder: A summary of its characteristics and aetiology. Comprehensive Psychiatry, 122, 152376. https://doi.org/10.1016/j.comppsych.2023.152376

The article provides a comprehensive review of the factors that can influence Gaming Disorder (GD) including gaming-related factors, individual factors, and environmental factors. Gaming-related factors such as structural characteristics, game design elements, and monetization techniques can increase player involvement and have an addictive potential. Online games have been found to be more prevalent in GD than offline games, likely because they provide safe environments for players to fulfil their social needs while remaining anonymous. Game genres such as massively multiplayer online role-playing games (MMORPGs), first-person/third person shooter (FPS/TPS) games, real-time strategy (RTS) games, and multiplayer online battle arena (MOBA) games have higher addictive potential than others. Individual factors such as personality traits, depression and depressive symptoms, and gaming motivations have also been found to influence GD. Environmental factors such as parental monitoring and peer influences can either protect or increase the risk of developing GD.

Czakó, A., Király, O., Koncz, P., Yu, S. M., Mangat, H. S., Glynn, J. A., Romero, P., Griffiths, M. D., Rumpf, H.-J., & Demetrovics, Z. (2023). Safer esports for players, spectators, and bettors: Issues, challenges, and policy recommendations. Journal of Behavioral Addictions. https://doi.org/10.1556/2006.2023.00012

This paper provides an overview of the possible risks, harms, and challenges that might arise with the development of esports and the threats posed to professional esports players, spectators, bettors, and video game players, including underage players. Alongside the positive aspects of esports, there are several possible challenges, which should be considered, including negative consequences of a sedentary lifestyle, sleep disturbances, the risk of development of problematic gaming, exposure to age-inappropriate content, and esports-related gambling. The paper discusses possible responses and suggestions regarding how to address and mitigate these negative consequences. The need for cooperation and collaboration between various stakeholders such as researchers, policymakers, regulators, the gaming industry, esports organizations, healthcare and treatment providers, and educational institutes is emphasized.

Koncz, P., Demetrovics, Z., Griffiths, M. D., & Király, O. (2023). The Potential Harm of Gambling Streams to Minors. Journal of the American Academy of Child & Adolescent Psychiatry, S0890856723000825. https://doi.org/10.1016/j.jaac.2023.01.020

The article discusses the convergence between video games and gambling and the risks that arise from it. The use of gambling-like elements in video games, as well as the financial benefits of gaming, are making it more similar to gambling. This convergence can put vulnerable individuals at risk, especially those who are impulsive and susceptible to persuasive design elements that are used in both gaming and gambling services. The article also highlights the growing popularity of gambling streams on platforms like Twitch and the potential for these streams to influence minors. Age restriction of access to gambling services is prevalent across Europe, with most countries setting the legal age for gambling at 18 years for land-based gambling activities. However, there are no such restrictions on gambling streams, making it easier for minors to access them. The article suggests the need for future research and policy making to explore this area and protect young consumers.

Demetrovics, Z., & Horváth, Z. (2023). Innovative methods needed to understand links between gambling and self-harm. The Lancet Public Health, 8(3), e168–e169. https://doi.org/10.1016/S2468-2667(23)00034-8

The article discusses the association between problem gambling and self-harm, including non-suicidal self-injury and suicidal ideation and attempts. While some studies have examined the relationship between the two, few have focused on how changes in the levels of these constructs over time might affect each other. The article recommends adopting a more extensive longitudinal design, which would allow researchers to determine the bidirectional relationships more precisely and analyse the relationships between linear and non-linear change trajectories. The article also stresses the importance of considering and controlling for confounding variables that might influence the association between problem gambling and self-harm.

Gavriel-Fried, B., Serry, M., Katz, D., Hidvégi, D., Demetrovics, Z., & Király, O. (2023). The concept of recovery in gaming disorder: A scoping review. Journal of Behavioral Addictions, 12(1), 26–52. https://doi.org/10.1556/2006.2023.00002

This review maps literature on recovery from gaming disorder (GD) (i.e., disordered use of video games), a recently identified mental disorder marked by uncontrollable and harmful gaming behaviours. GD is associated with younger males of lower socio-economic status and psychiatric conditions like depression, anxiety, and ADHD. Various treatments have been adapted from substance use disorder treatments, but the effectiveness and trajectory of these remain unclear. Recovery from GD is understood via two paradigms: the ‘deficit-based’ approach, focusing on symptom reduction, and the ‘strengths-based’ approach, emphasizing personal growth and overall well-being. The review suggests that an integrative approach combining these paradigms is more effective. However, the concept of recovery in relation to GD remains under-studied, likely due to the relative novelty of the disorder and ongoing debates about the nature of GD, its course, and risk factors. Future research should include a greater representation of female participants, given that women may experience more severe psychological manifestations of GD. More qualitative methods and self-defined cases of recovery should also be considered. Despite the limitations, this review provides valuable insights into GD recovery that can inform therapists, researchers, and policy makers.

Kim, H. S., Leslie, R. D., Stewart, S. H., King, D. L., Demetrovics, Z., Andrade, A. L. M., Choi, J.-S., Tavares, H., Almeida, B., & Hodgins, D. C. (2023). A scoping review of the association between loot boxes, esports, skin betting, and token wagering with gambling and video gaming behaviors. Journal of Behavioral Addictions. https://doi.org/10.1556/2006.2023.00013

This review synthesizes empirical research on gambling-like activities (GLAs), such as loot boxes, esports betting, and skin betting, with the aim to identify their associations with gambling and video gaming behaviours. The study, which reviewed 38 articles, found positive associations between participation in GLAs, gambling, and video gaming. Engagement in GLAs was also associated with mental distress and impulsivity. However, a need for more research in areas such as skin betting and token wagering, diversity in research methods, and representation of diverse populations was identified. The review also highlighted potential regulatory responses and the need for further research into the impacts of GLAs. The authors recommend more longitudinal and experimental studies with representative samples, as well as research focused on ethnically, culturally, and regionally diverse populations to better understand the relationship between GLAs, gambling, and gaming behaviours.

Schlossarek, S., Schmidt, H., Bischof, A., Bischof, G., Brandt, D., Borgwardt, S., Browne, D. T., Christakis, D., Hurst-Della Pietra, P., Demetrovics, Z., & Rumpf, H.-J. (2023). Psychometric Properties of Screening Instruments for Social Network Use Disorder in Children and Adolescents: A Systematic Review. JAMA Pediatrics, 177(4), 419. https://doi.org/10.1001/jamapediatrics.2022.5741

This review explores various screening tools assessing Social Network Use Disorder (SNUD) in children and adolescents, with results suggesting that the Social Media Disorder Scale (SMDS) and Bergen Social Media Addiction Scale–Short Form (BSMAS-SF) are the most appropriate instruments for such assessment. It analysed the psychometric properties of 19 screening tools based on 29 empirical studies. Despite this, no single tool emerged as superior due to varying strengths and weaknesses among them. While the SMDS-SF and BSMAS-SF ranked highest in terms of quality, each scale had some shortcomings concerning their psychometric properties. This review acknowledges that the field is relatively new and encourages further research to refine and optimize existing screening tools, establish clear cut-off scores, and improve research in SNUD, especially considering the potential behavioural addiction implications of extensive social media use among young people.

Horváth, Z., Paksi, B., Fernández-Aranda, F., Jiménez-Murcia, S., & Demetrovics, Z. (2023). The Predictive Role of Tolerance and Health Problems in Problem Gambling: A Cross-Sectional and Cross-Lagged Network Analyses. Journal of Gambling Studies. https://doi.org/10.1007/s10899-023-10191-5

Gambling Disorder (GD) is identified as an addictive behaviour, characterized by a set of symptoms, leading to significant impairment in personal, financial, and social spheres, as defined by DSM-5. The network approach to mental disorders views these disorders as systems of causally interrelated symptoms, providing insight into critical symptoms in the progression of disorders such as GD.
In this study, it was found that around 90% of gamblers did not experience problem gambling symptoms, with a slight uptick in symptom scores for females across different survey waves. However, the evidence for the replicability of cross-sectional symptom networks depicting the interconnectedness of symptoms was limited to changing importance of symptoms over time. On a longitudinal scale, “tolerance” and “health problems” from the initial survey wave were seen as predictive of the emergence of other symptoms in the subsequent wave. Yet, these findings were marked by low stability and inconsistent reproducibility, indicating a need for cautious interpretation. Thus, while cross-sectional networks provide some insights, their limitations necessitate exploring longitudinal symptom networks, though these too require careful interpretation due to external sensitivity and limited reproducibility.

Anyanwu, M. U., Demetrovics, Z., Griffiths, M. D., Horváth, Z., Czakó, A., Bajunirwe, F., & Tamwesigire, I. (2023). Problem Gambling Among Adolescents in Uganda: A Cross-sectional Survey Study. Journal of Gambling Studies. https://doi.org/10.1007/s10899-023-10205-2

A study conducted in Uganda, where over 60% of the population is under 24, found a high prevalence of problem gambling among 905 surveyed school-aged adolescents. Despite rapid industry growth and over 1,000 gambling outlets existing since 2014, effective regulation is lacking, notably in enforcing laws prohibiting minors under 25 from gambling. The research revealed a 17.7% rate of problem gambling with male students, those non-religious or of another religion, those engaged in paid work or part-time jobs, living less than one kilometre from a gambling centre, those exposed to peer or parental gambling, and those with psychoactive substance use, risky sexual behaviour, or severe psychological distress being most at risk. While these results cannot be generalized to all Ugandan adolescents, they highlight the urgent need for regulatory measures to combat problem gambling and improve adolescent health and welfare.

Servidio, R., Griffiths, M. D., Boca, S., & Demetrovics, Z. (2023). The serial mediation effects of body image-coping strategies and avatar-identification in the relationship between self-concept clarity and gaming disorder: A pilot study. Addictive Behaviors Reports, 17, 100482. https://doi.org/10.1016/j.abrep.2023.100482

A study of 214 Italian online gamers found a negative relationship between self-concept clarity (SCC) and Gaming Disorder (GD), and a positive correlation between body coping strategies, avatar identification, and GD. Self-concept clarity (SCC) refers to the degree to which an individual’s sense of self is consistent, specific, and internally congruent. This plays a crucial role in digital interactions, particularly in online gaming where users may form strong connections with their digital avatars. When individuals have lower SCC or are dissatisfied with their body image, they might use idealized avatars as a coping mechanism, potentially increasing their risk of gaming disorder (GD), a behavioural addiction. The study discovered a significant negative correlation between SCC and GD, indicating that those with a less defined self-concept might use gaming to establish temporary identity, control, and stability. The study revealed that the relationship between SCC and GD was fully mediated by avoidance and by appearance-fixing and avatar identification. This suggests that those with lower SCC might modify their in-game avatars to improve their self-image, increasing their identification with their avatar and, in turn, their risk of GD. Despite participants not exhibiting high GD levels, these findings emphasize the crucial role of body image-coping strategies and avatar identification in the relationship between SCC and GD, providing a basis for future investigations.

Kun, B., Fetahu, D., Mervó, B., Magi, A., Eisinger, A., Paksi, B., & Demetrovics, Z. (2023). Work Addiction and Stimulant Use: Latent Profile Analysis in a Representative Population Study. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-023-01076-0

This study examines the prevalence of psychostimulant use among individuals with work addiction in a sample of 3076 participants. Results suggest a higher rate of stimulant use, such as smoking, energy drinks, amphetamines, NPS, and cocaine, among work-addicted individuals compared to non-addicted peers. Furthermore, these individuals exhibited more psychopathological symptoms, pointing to a potential vulnerability to risky stimulant use. It’s theorized that these workers use stimulants to manage their stressful lifestyle and boost their self-esteem. The study calls for future research into motivations behind substance use in this group, including the role of “smart drugs” or “nootropics” and the impact of socio-demographic and work-related factors. Practical implications suggest that workplaces should address work addiction in mental health programs to aid employees in managing stress and avoiding task overload.

Zhang, M. X., Yu, S. M., Demetrovics, Z., & Wu, A. M. S. (2023). Metacognitive beliefs and anxiety symptoms could serve as mediators between fear of missing out and gaming disorder in adolescents. Addictive Behaviors, 145, 107775. https://doi.org/10.1016/j.addbeh.2023.107775

This study illuminated how fear of missing out (FoMO) may fuel internet gaming disorder (IGD) in adolescents by investigating the mediating roles of maladaptive metacognitive beliefs and anxiety. The research surveyed 283 Chinese high school students and found that FoMO had a direct positive relationship with IGD, while 3 specific metacognitive beliefs (negative beliefs about worry, confidence, and need for control) along with anxiety mediated such linkage. The results suggest that dysfunctional metacognitions and anxiety are risk-enhancing factors in the FoMO-IGD relationship among youth. Targeting negative metacognitive beliefs through therapy could help to treat IGD among adolescents struggling with high level of FoMO.

Koncz, P., Demetrovics, Z., Takacs, Z. K., Griffiths, M. D., Nagy, T., & Király, O. (2023). The emerging evidence on the association between symptoms of ADHD and gaming disorder: A systematic review and meta-analysis. Clinical Psychology Review, 106, 102343. https://doi.org/10.1016/j.cpr.2023.102343

While the co-existence of gaming disorder (GD) with other mental health problems has been widely reported, no quantitative synthesis has been performed before concerning the comorbidity of GD with attention-deficit/hyperactivity disorder (ADHD). The results of this meta-analysis published in Clinical Psychology Review indicate a moderate association between symptom severity of GD and ADHD: individuals with ADHD tend to have more severe gaming disorder symptoms, and those with gaming disorder have more severe ADHD symptoms. The findings suggest that screening and treatment for both conditions would be beneficial to those who are affected.

These results suggest that screening and treatment for ADHD among individuals with gaming disorder is necessary, and individuals with ADHD should be made aware of their higher susceptibility to gaming disorder.

Ko, C.-H., Király, O., Demetrovics, Z., Griffiths, M. D., Kato, T. A., Tateno, M., & Yen, J.-Y. (2023). Heterogeneity of gaming disorder: A clinically-based typology for developing personalized interventions. Journal of Behavioral Addictions. https://doi.org/10.1556/2006.2023.00059

The present paper proposes a clinical typology of patients with gaming disorder (GD) based on clinical symptoms and comorbidity characteristics of 400 GD patients. The three common types of GD patients are: (1) impulsive adolescent boys with ADHD, (2) dysphoria patients with poor coping skills, and (3) socially isolated patients with anxiety. The study suggests that in order to fit individual needs, psychological and pharmacological treatments should be tailored to each type.

This study provides insight into the heterogeneity of gaming disorder patients, which can inform targeted and effective preventive and interventive measures.

Czakó, A., Király, O., Koncz, P., Yu, S. M., Mangat, H. S., Glynn, J. A., Romero, P., Griffiths, M. D., Rumpf, H. J., & Demetrovics, Z. (2023). Safer esports for players, spectators, and bettors: Issues, challenges, and policy recommendations. Journal of Behavioral Addictions 12(1) 1–8. https://doi.org/10.1556/2006.2023.00012

Mangat, H. S., Griffiths, M. D., Yu, S. M., Felvinczi, K., Ngetich, R. K., Demetrovics, Z., & Czakó, A. (2023). Understanding esports-related betting and gambling: A systematic review of the literature. Journal of Gambling Studies, 40, 893-914. https://doi.org/10.1007/s10899-023-10256-5