Psychological Therapy for Gaming Disorder

Study Overview
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Brief Summary
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Gaming is a common leisure activity, both for children and adult, and while it is generally a positive experience for most, it can lead to problems for some individuals. There is currently a lack of knowledge of when video gaming becomes a problem and why, and there is a lack of evidence-based interventions for treating Gaming disorder. This pilot study aims to evaluate a new treatment manual for Gaming Disorder, which consists of modules based on cognitive behavioral therapy and family therapy. The therapy can be provided as individual therapy to the patient, to relatives, or as family therapy involving both the patient and their relatives. This study is an effectiveness trials and will follow all-patients at the clinic who will be offered the treatment. The hypothesis is that the manual-based psychotherapy for Gaming Disorder will result in a reduction of Gaming Disorder symptoms and psychological distress, as well as an improvement in daily functioning.

Detailed Description
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This study is a part of the clinical work at Gamingprojektet Maria Malmö, which is an outpatient clinic for patients with problematic gaming or Gaming Disorder. The clinic is focused on young people over 13 years of age and adults with problematic gaming or who meet the diagnosis of Gaming Disorder. The study will aim to evaluate a new treatment that has been developed and are offered at Gamingprojektet Maria Malmö for patients with a problematic gaming behavior or Gaming Disorder. Before starting the treatment, they will undergo a semi-structured interview about their gaming habits, motivation for playing, demographic information, gambling, social habits, family climate, physical health, and psychiatric comorbidity. This is combined with self-assessment questionnaires on mental health, social media habits, alcohol use, drug use, gambling, emotion regulation, and everyday functioning. They will be offered a psychological treatment that combines Cognitive behavioral therapy (CBT) and Family therapy (FT). At each session, they will answer short questions about their well-being, how much they have played in the past week, and how much their well-being is related to their gaming. After completing the treatment, the patients will undergo the same semi-structured interview and questionnaires as pre-treatment. Three months after the treatment has ended, they will be called for a follow-up, where they will complete questioners about symptoms of Gaming disorder and psychological wellbeing. The study is conducted fully integrated into regular clinical practice, which allows for the feasibility and possibilities for implementation to be studied directly in connection with the study and in relation to treatment outcomes.

Official Title
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To Evaluate the Effect of a Psychological Treatment for Patients With Gaming Disorder or Hazardous Gaming.

Conditions
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Gaming Disorder, Internet Gaming Disorder

Intervention / Treatment
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* Behavioral: Psychological treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Can read and speak Swedish fluidly. ≥ 13 years of age Are treatment seeking for problematic gaming or Gaming disorder Exclusion Criteria: - Somatic or psychiatric disease that is contraindicating or severely complicates the implementation of the intervention (e.g., ongoing psychotic, manic or hypomanic episode or neuropsychiatric condition with severe disability)

Ages Eligible for Study
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Minimum Age: 13 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Psychological therapy for Gaming Disorder<br>They will be offered a module-based psychological treatment that combines Cognitive behavioral therapy (CBT) and Family therapy (FT). | Behavioral: Psychological treatment<br>* The treatment is module-based, and the clinician are supposed to choose a small number of modules to work with depending on the patients need. The individual CBT modules are: 1) Behavioral activation, 2) Accepting thought, 3) Emotion regulation, 4) Impulse control, 5) Procrastination, 6) Relationships, 7) Problem-solving skills, 8) Structuring everyday-life, 9) Diet-Exercise-Sleep, and 10) Social anxiety. The family therapy modules are: 1) Psychoeducation about gaming, 2) Encourage other activities, 3) Positive time together, 4) Expectations and the patients abilities, 5) Making agreements in the family, 6) Emotional validation, and 7) Conflict management.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Gaming Disorder Test (GDT) | Change in symptoms of Gaming Disorder Min: 4 Max: 20 A higher outcome means worse gaming problems | At baseline (Timepoint (T) 0); Post treatment: an average of 9 months from baseline (T2); At follow up: 3 months after post treatment (T3) | 
| Internet Gaming Disorder Scale-Short-Form (IGDS9-SF) | Change in symptoms of Internet Gaming Disorder. Min: 9 Max: 45 A higher outcome means worse gaming problems | At baseline (Timepoint (T) 0); Post treatment: an average of 9 months from baseline (T2); At follow up: 3 months after post treatment (T3) | 
| Time spent on gaming in the last week | Change in time spent on gaming per week | At baseline (Timepoint (T) 0); Post assessment: an average of 4 weeks from baseline (T1); Post treatment: an average of 9 months from baseline (T2); At follow up: 3 months after post treatment (T3) | 
| Time spent on gaming in the last week during the treatment | Change in time spent on gaming per week during the treatment | Once a week during the treatment period: (Post-assessment to Post-treatment) an average of 25 weeks | 
| Clinical Outcomes in Routine Evaluation - Outcome Measure 34 (Core-OM 34) | Change in self-report measure of psychological distress (for the the patients 16 years and older) Min: 0 Max: 136 A higher outcome means higher psychological distress | At baseline (Timepoint (T) 0); Post assessment: an average of 4 weeks from baseline (T1); Post treatment: an average of 9 months from baseline (T2); At follow up: 3 months after post treatment (T3) | 
| The Revised Child Anxiety and Depression Scale (RCADS) Youth | Change in self-report measure of psychological distress (For children) a 47-item self-report questionnaire with subscales including: separation anxiety disorder, social phobia, generalized anxiety disorder, panic disorder, obsessive compulsive disorder, and low mood. Min: 0 Max: 141 A higher outcome means higher psychological distress | At baseline (Timepoint (T) 0); Post assessment: an average of 4 weeks from baseline (T1); Post treatment: an average of 9 months from baseline (T2); At follow up: 3 months after post treatment (T3) | 
| The Revised Child Anxiety and Depression Scale (RCADS) Parent | Change in self-report measure of psychological distress (For children) a parent 47-item questionnaire about their children with subscales including: separation anxiety disorder, social phobia, generalized anxiety disorder, panic disorder, obsessive compulsive disorder, and low mood. Min: 0 Max: 141 A higher outcome means higher psychological distress | At baseline (Timepoint (T) 0); Post assessment: an average of 4 weeks from baseline (T1); Post treatment: an average of 9 months from baseline (T2); At follow up: 3 months after post treatment (T3) | 
| The Gaming Addiction Identification Test (GAIT) | Change in a parent report measure of problematic gaming in adolescents (For children) Min: 0 Max: 35 A higher outcome means worse gaming problems | At baseline (Timepoint (T) 0); Post treatment: an average of 9 months from baseline (T2); At follow up: 3 months after post treatment (T3) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mini International Neuropsychiatric Interview (MINI) | Change in if the patients meet criteria for common psychiatric diagnoses. The instrument is a brief structured diagnostic interview for the major psychiatric disorders in DSM-5. The children will be administered MINI-KID | At baseline (Timepoint (T) 0); Post treatment: an average of 9 months from baseline (T2); | 
| The Global Assessment of Functioning (GAF) | Change in functioning. The instrument is a numeric scale used by clinicians to rate subjectively the functioning of an patient Min: 0 Max: 100 A higher outcome means higher functioning | At baseline (Timepoint (T) 0); Post treatment: an average of 9 months from baseline (T2); | 
| Working Alliance Inventory 12 (WAI) | self-report questionnaire for measuring the quality of the working alliance after the treatment Min: 12 Max: 84 A higher outcome means higher working alliance | Post treatment: an average of 9 months from baseline (T2); | 
| Difficulties in Emotion Regulation Scale - 16 item (Ders-16) | Change in difficulties in emotion regulation Min: 16 Max: 80 A higher outcome means more problems with emotion regulation | At baseline (Timepoint (T) 0); Post treatment: an average of 9 months from baseline (T2); | 
| Bergen Social Media Addiction Scale | Change in symptom of social media disorder, Min: 6 Max: 30 A higher outcome means worse social media problems | At baseline (Timepoint (T) 0); Post treatment: an average of 9 months from baseline (T2); | 
| Motives for Online Gaming Questionnaire (MOGQ) | Change in motives for gaming. The motives are: Escape, Coping, Fantasy, Skill Development, Recreation, Competition, and Social Min: 27 Max: 135. A higher outcome indicate that the patient recognizes himself/herself to a greater extent in the various motives. | At baseline (Timepoint (T) 0); Post treatment: an average of 9 months from baseline (T2); | 
| National Opinion Research Center DSM-IV Screen for Gambling: Preoccupation + Escape + Risked Relationships + Chasing (NODS-PERC) | Change in symptoms of gambling disorder Min: 0 Max: 4 A higher outcome means worse gambling problems | At baseline (Timepoint (T) 0); Post treatment: an average of 9 months from baseline (T2); | 
| The Alcohol Use Disorders Identification Test (Audit) | Change in alcohol use Min: 0 Max: 12 A higher outcome means more problems with alcohol use | At baseline (Timepoint (T) 0); Post treatment: an average of 9 months from baseline (T2); | 
| Drug Use identification list | Change in drug use. By a list to identify use of common substances and frequency of use. Min: 0 Max: 45. A higher outcome means more problems with drug use | At baseline (Timepoint (T) 0); Post treatment: an average of 9 months from baseline (T2); | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Gaming