Assessing Internet Gaming Disorder: A Systematic Review of Diagnostic Criteria and Measurement Instruments

Background and Purpose: Video gaming has become a major entertainment activity worldwide. Although most gamers play for recreation only, some develop problem video gaming behaviors and exhibit symptoms that are similar to those of substance use and gambling disorders. Both ICD-11 and DSM-5 have proposed the inclusion of Internet Gaming Disorder (IGD) as a non-substance addictive disorder. In response, researchers have proposed a number of measurement instruments that purport to assess IGD in both research and clinical settings. The purpose of this study was to synthesize the empirical evidence of assessment tools for IGD and to investigate the overlap, which can ultimately be used to compare the discrete criteria to similar measures in the field of substance use and gambling studies.

Methods: Comprehensive searches were conducted in PubMed, PsycInfo, Web of Science, Scopus, and Academic Search Premier February 2018 using a search string of “video gaming” OR “computer gaming” OR “online gaming” OR “Internet gaming”) AND (patholog* OR problem* OR addict* OR compulsive OR dependen* OR disorder) AND (measure* OR scale* OR criteri* OR instrument* OR questionnaire* OR test* OR survey.” Search yielded 840 articles potentially relevant for review. The researchers selected 36 studies that were published in English, developed measurement instruments for IGD, and investigated psychometric properties of the IGD measures, were included for review. All selected studies were read in their entirety and followed by extraction of study findings. For each study, we extracted data on wording of measurement items, as well as theoretical constructs of IGD assessed by, and psychometric diagnostic validities of these measures.

Results: Nineteen addiction-related constructs were assessed by the identified IGD measures. Constructs assessed by a majority of measures include preoccupation, withdrawal, tolerance, impaired control, giving up other activities due to gaming, continued gaming despite problems, lying about the amount of gaming, using games to escape from negative mood, and adverse effects of gaming on psychosocial functioning. Other constructs assessed include salience, craving, interpersonal conflicts due to gaming, immersion, and social isolation. Almost all studies reported the construct validity and internal consistency reliability of the IGD measures in different populations. Concurrent and criterion validities were established for most of the IGD measures. Eight studies examined diagnostic cut-off for IGD, and diagnostic sensitivity and specificity.

Conclusions and Implications: The identified measures are purported to assess a variety of addiction-related theoretical constructs underlying IGD. However, after carefully reviewing the expressions used in the measurement items, we found that there is a conflict across the measures regarding how these constructs are assessed. Further, it is debatable whether these constructs are adequately assessed by current IGD measures. Although studies reported validity data for most of the measures, the total variance explained by the IGD items was relatively low (M = 49.9%). Finally, only a minority of the studies examined diagnostic cut-off that may be used in clinical setting to assess IGD. Future research that establishes a unified approach to assess IGD will benefit both research and clinical practice. Implications for research and clinical practice will be discussed.