Emotion Regulation and Internet Gaming Disorder

The authors of this research article correlated emotional regulation with Internet gaming activity. Students from a large, Midwestern research and teaching university were sampled. Respondents self-reported their emotion regulation behavior as well as their Internet gaming behavior. Two emotion regulation strategies (reappraisal and suppression) were evaluated for their relation to Internet Gaming Disorder (IGD). Introduction Internet gaming is one of the most popular indoor activities, especially among the youth. Internet use for playing games is generally not considered harmful, however, a large number of individuals engage in uncontrolled gaming behavior (Grant, Potenza, Weinstein, & Gorelick, 2010; Gentile, 2009) and some research suggests (Mandryk & Birk, 2017) excessive gaming behavior is correlated to depression. This uncontrolled Internet use can take the form of excessive preoccupation with Internet gaming behavior, with withdrawal symptoms, tolerance, loss of interest for other activities, and a risk for jeopardizing social relationships and employment (American Psychiatric Association [APA], 2013; Pontes & Griffiths, 2015). The maladaptive use of the Internet can take the form of Internet Gaming Disorder, characterized by persistent and recurrent use of the Internet playing games. In this research project, the authors investigated any correlation between emotion regulation and uncontrolled Internet gaming. The purpose of the current study is to assess how generally adaptive and maladaptive strategies of emotion regulation are linked to a greater tendency to demonstrate IGD symptomatology. To this end, two widely researched emotion regulation strategies, reappraisal (mostly related to adaptive emotion regulation) and suppression (mostly related to maladaptive emotion regulation) were investigated as predictors of IGD. The moderating role of gender and age was also assessed. Literature Review IGD is likely to be related to emotion dysregulation. Consulted literature reveals that every form of psychopathology, both internalizing and externalizing, include emotion dysregulation problems as a central characteristic (Yen, Yeh, Wang, Liu, Chen & Ko, 2018; Gross & Thompson, 2007). For example, disturbances of varying types in emotion regulation have been implicated in depression and anxiety disorders (Campbell-Sills & Barlow, 2007; Mennin, Holaway, Fresco, Moore, & Heimberg, 2007; Nolen-Hoeksema, 2008) as well as in alcohol abuse and addiction (Tice, Bratslavsky, & Baumeister, 2001). Revealing a positive association between IGD and the maladaptive use of emotion regulation strategies could provide evidence for the legitimacy of IGD as disorder. Internet Gaming Disorder Individuals suffering from IGD are preoccupied with Internet gaming and their Internet use for this purpose is persistent and recurrent (APA, 2013). This preoccupation with Internet gaming results in clinically significant impairment or distress (APA, 2013). Although Internet addiction was studied in the literature for about a decade, IGD, focusing specifically in addictive behaviors related to gaming, was introduced in the DSM-5 for the first time in 2013 as a disorder warranting additional study (APA, 2013; Petry & O'Brien, 2013). IGD is specifically limited to gaming and is one of the “main types of Internet disorders” (Billieux, Deleuze, & Griffiths, 2017, p. 1515). While the term Internet is used and most often involved a specific online game, the DSM-5 does allow for non-Internet electronic games as well. IGD does not include other Internet utilization such as chat, gambling, or pornographic websites. Nine criteria were generated for this disorder (APA, 2013). These are the following: 1. Preoccupation thinking about gaming during times of non-play. 2. Tolerance – increasing gaming time to achieve desired effects. 3. Withdrawal – unpleasant feelings when gaming is not occurring. 4. Persistence – inability to stop or reduce game play. 5. Escape – utilizing gaming to escape from negative mood or other problems. 6. Problems – gaming that creates negative life consequences for the gamer. 7. Deception – lying about gaming behavior. 8. Displacement – gaming dominates other activities. 9. Conflict – substantial problems with relationships or employment. A limited number of studies have used the DSM diagnostic construct to study IGD (Dong & Potenza, 2014; Lemmens, Valkenburg, & Gentile, 2015). In the DSM-5, IGD is classified as a behavioral addiction, although several researchers have argued that it should be classified as an impulse control disorder (Dong & Potenza, 2014). The debate for the most appropriate classification of IGD as either an impulse control disorder or a behavioral addiction has not been resolved yet. Additionally, there are some neurobiological studies that have shown many similarities between IGD and other addictions. From a neurobiological perspective, a recent meta-analysis conducted by Meng, Deng, Wand, Guo, and Li (2015) demonstrated the importance of the dysfunctional prefrontal lobe in the neuropathological mechanism of IGD. Impairments in this brain region have been implicated in dysfunctions of the reward and self-regulatory system, which are thought to play an important role in substance use disorders (Meng et al., 2015). Dong, DeVito, Huang, and Du (2012) have found and studied cerebral cortex abnormalities in Internet gaming addicts as well. Relatedly, Chun et al. (2017), in their research on smartphone users and altered brain activity, found certain brain regions experienced neural deactivation in excessive smartphone users Dong and Potenza (2014), adopting a behavioral addiction conceptualization of IGD, propose a cognitive-behavioral model for IGD. According to these researchers, IGD involves deficits in three main domains in correspondence with other addictions (Dong & Potenza, 2014). The first domain involves motives driven from reward-seeking and stress reduction. Specifically, individuals with IGD have been found to demonstrate increase reward sensitivity and decreased loss sensitivity in winning and losing tasks (Dong, Huang, & Du, 2011; Dong, DeVito, Huang, & Du, 2012), which may be related to heightened need to gaming (Dong, & Potenza, 2014). The second domain involves decision-making, with IGD individuals presenting difficulties in weighing pros and cons for engaging in the desired behaviors. The last domain involves deficits in executive control related to difficulties in resisting cravings and limit excessive Internet gaming. The last two domains are related to the maladaptive use of the different emotion regulation strategies (Cohen, Daches, Mor, & Henik, 2014; Sheppes et al., 2014). Emotion and emotion regulation Emotions are thought to have been developed through human evolution to prepare for action in response to environmental stimuli (Kring, 2008). They are generated through stages, including attending to a situation, giving a valenced meaning, and responding experientially, behaviorally, and physiologically (Berenbaum, Raghavan, Le, Vernon, & Gomez, 2003; Sheppes, Suri, & Gross, 2015). Emotions generally are adaptive in nature and enable different interand intra-personal functions (Kring, 2008). However, emotional valence, emotional intensity, and disconnection disturbances can make them maladaptive. Nevertheless, that can be adjusted through emotion regulation processes (Berenbaum, et al., 2003). Gross (1998) defined emotion regulation as the “processes by which individuals influence which emotions they have, when they have them, and how they experience and express these emotions” (p. 275). The role of emotion regulation in the development of psychopathology has been emphasized in the literature, with previous studies focusing attention on the use of regulatory strategies by individuals with psychopathology (Sheppes, Suri, & Gross, 2015). Over the years, different theoretical models have highlighted different specific strategies as adaptive or maladaptive (Aldao, Nolen-Hoeksema, & Schweizer, 2010). A number of theories suggest that psychopathology can result from the inability to downregulate negative emotions through strategies such as reappraisal (i.e. finding benign or positive attributions or interpretations of an event to prevent or reduce negative mood about the event), acceptance, problem-solving, or attentional redeployment (i.e. diverting one’s attention to positive or benign stimuli to change one’s mood; Nolen-Hoeksema, 2012). Thus, inability to use adaptive strategies to down-regulate negative emotions is thought to lead in negative emotionality. Moreover, the use of maladaptive strategies that involve engagement in processes that exacerbate and prolong negative emotions is thought to be related to more negative emotions, which are uncontrollable, severe, and chronic, likely developing into psychopathology (Campbell-Sills & Barlow 2007; Nolen-Hoeksema, 2012).