Mindfulness-Oriented Recovery Enhancement for Video Game Addiction in U.S. Emerging Adults: An Early-Stage Randomized Controlled Trial

Background: Video game addiction (VGA) is characterized by signs and symptoms similar to those of substance use and gambling disorders (Petry et al., 2014). A subtype of VGA, Internet Gaming Disorder, is included in Section 3 of DSM-5 (APA, 2013). VGA is increasingly prevalent in emerging adults and is associated with physical and psychosocial impairments (Kuss & Griffiths, 2012). However, no evidence-based treatments for VGA have been identified. Mindfulness-Oriented Recovery Enhancement (MORE) treatment (Garland, 2013) shows positive effects for substance use disorder, and may be a promising intervention for VGA because VGA and substance misuse share similar risk mechanisms that could be addressed by mindfulness treatment. Thus, this study evaluated the effects of MORE for emerging adults with VGA.

 

Methods: A randomized controlled trial was conducted to compare the effects of MORE to a support group (SG) intervention vis-à-vis reducing severity of VGA in emerging adults. Thirty adults (Mage = 25.0, SD = 5.4) who met DSM-5 criteria for VGA were randomized to 8 weekly, two-hour sessions of group-based MORE (n = 15) or SG (n = 15). Outcomes included number of DSM-5 criteria participants met for VGA, intensity of craving for video game playing, video gaming-related maladaptive cognitions, perceived stress, cognitive coping, and mindfulness, and were measured at pre-and posttreatment using standardized self-report instruments. Analysis of covariance (ANCOVA) was used for outcome evaluation.

Results: Twenty-nine participants who completed pre- and posttreatment assessments were included in data analyses. Bivariate tests showed no significant differences in sociodemographic or outcome variables between MORE and SG groups at pretreatment except for participants’ age and age at which they first recognized having a problem with video game playing (p’s < .05). These variables were controlled for in ANCOVA. ANCOVAs revealed that compared to SG, MORE participation was associated with significantly greater reductions in signs and symptoms of VGA (β = -2.91, SE = .87, p = .003), gaming-related maladaptive cognitions (β = -7.11, SE = 2.31, p = .005), intensity of craving for video game playing (β = -1.80, SE = .78, p = .03); and a significantly greater increase in positive cognitive coping (β = 4.32, SE = 1.38, p = .005) at posttreatment. Further, MORE participants showed higher levels of nonreactivity to unwanted thoughts and emotions at posttreatment compared to SG participants (β = 3.27, SE = 1.82, p = .08).

Discussion: MORE was more effective in reducing severity of VGA than the SG and might address mechanisms implicated in automatic and addictive video gaming behaviors. Findings suggested mechanisms by which mindfulness training reduced craving for video game playing by raising participants’ awareness of urges and enhancing their nonreactivity to unwanted urges and thoughts. Moreover, effects of mindfulness practice on enhancements in emotional regulation and positive cognitive coping might lead to a significant decrease in video gaming-related maladaptive cognitions. A decrease in maladaptive cognitions could attenuate participants’ motivations to play video games as a palliative coping strategy for stress and negative affect. These mechanisms should be further evaluated in a larger RCT.