Internet Gaming Disorder (IGD) is considered a recently developed issue regarding behavioral health concerns internationally, especially among young adults who become more involved in internet gaming activities. Even though there is a vast number of studies conducted internationally, data from Palestine remain limited. The present study was therefore designed to investigate the prevalence rate of IGD in Palestinian adults and its relationship with psychological distress, including depression, anxiety, and stress. A cross-sectional study was conducted between March and May 2026 using a structured questionnaire distributed through social media platforms. The study included adults aged 18 years and older residing in Palestine who provided informed consent. Individuals outside the specified age range or with incomplete questionnaire responses were excluded. Internet Gaming Disorder (IGD) and psychological distress were assessed using the validated Arabic versions of the DSM-5 IGD Scale and the Depression Anxiety Stress Scale-21 (DASS-21). A total of 611 participants were included. Data were analyzed using descriptive statistics, bivariate tests, Spearman correlations, multivariable logistic regression to identify predictors of probable IGD, and multiple linear regression to examine associations between IGD score and DASS-21 subscale scores. The final analysis included 611 participants recruited using convenience sampling through social media and online platforms. Probable Internet Gaming Disorder (IGD) was identified in 23.5% of online gamers. Probable IGD was significantly associated with increased gaming frequency and duration, multiplayer gaming, spending money on games, attempts to reduce gaming time, and negative effects on academic/work performance, social relationships, and sleep (p < 0.05). Significant positive correlations were observed between IGD scores and depression, anxiety, and stress scores (p < 0.001). In multiple linear regression analyses, IGD score remained an independent predictor of higher depression (β = 0.348, p < 0.001), anxiety (β = 0.311, p < 0.001), and stress scores (β = 0.346, p < 0.001). In multivariable logistic regression, playing online with other players most of the time was independently associated with probable IGD (adjusted OR = 3.51, 95% CI: 1.08-11.46, p = 0.037), as were moderate and high perceived negative impacts of gaming on academic/work performance (adjusted OR = 4.38, 95% CI: 1.78-10.80, p = 0.001; and adjusted OR = 4.88, 95% CI: 1.61-14.81, p = 0.005, respectively). Higher IGD scores also independently predicted higher depression, anxiety, and stress scores in adjusted linear regression models. This study highlights probable IGD as an emerging behavioral health concern among Palestinian adult online gamers, particularly when gaming is linked to functional impairment and use as a coping strategy for stress or negative emotions. The findings suggest that assessment should move beyond gaming duration alone and consider gaming-related consequences, psychological distress, and coping motives. Future research should use longitudinal and clinically assessed designs to clarify temporal relationships between IGD and psychological distress. Prevention and intervention efforts should focus on healthy coping skills, early screening, and accessible support for individuals whose gaming is associated with distress or impairment. Not applicable.
This cross-sectional survey study examines associations between demographic characteristics, gaming patterns, and six psychological dimensions of digital gaming addiction among adults. Data were collected from 391 adults (aged 18+) engaging in digital gaming using the Digital Game Addiction Scale for Adults (DGAS-A). The scale measured Attachment (reverse-coded; higher scores indicate lower attachment), Shame, Coping, Sad Withdrawal, Angry Withdrawal, Loss of Control, and Negative Consequences. Non-parametric analyses revealed the highest scores on Coping (M = 3.22), while the Attachment subscale mean (M = 3.28, reverse-coded) indicates relatively low gaming attachment in this sample. Spearman's correlation analysis confirmed significant positive associations among all six subdimensions (p < .01), with Loss of Control demonstrating the strongest inter-subscale relationships, underscoring the scale's multidimensional coherence. Males had significantly higher scores on Angry Withdrawal (p = .038); the Attachment finding (p = .037) indicates that males scored higher on this reverse-coded subscale, meaning males reported lower emotional attachment to gaming than females, not higher. Young adults (18-24) demonstrated elevated scores across subdimensions. Digital/creative sector workers showed higher addiction-related scores (p < .001) than traditional sector workers. Married participants reported greater Shame (p = .032), Coping (p = .039), and Angry Withdrawal (p < .001). Multi-platform users and Action/FPS/RPG players exhibited higher addiction-related scores than single-platform and casual gamers. Daily screen time exceeding 7 h was associated with elevated addiction scores. The findings are consistent with the possibility that gaming addiction-related patterns among adults may be shaped by occupational, demographic, and life stage factors, suggesting the phenomenon is not confined to adolescence. The results also raise exploratory questions about whether industry practices that optimise engagement metrics may be associated with addiction-related indicators. All findings are associational and should not be interpreted causally, given the cross-sectional design.
Gaming disorder is a prevalent behavioral disorder among adolescents, exerting a negative impact on their social development. Parental rejection has been suggested as a core risk factor for gaming disorder symptoms. However, longitudinal research on the direction of this association and the underlying psychological mechanisms remains limited, with most studies failing to disentangle between-person and within-person effects. To address this gap, this study conducted a three-wave longitudinal survey over one year with 1,987 adolescents (56.1% male, Mage = 12.32). Using the Random Intercept Cross-Lagged Panel Model, we examined the bidirectional relationship between parental rejection and gaming disorder symptoms, and the mediating role of school engagement. At the within-person level, parental rejection directly predicted gaming disorder symptoms, whereas gaming disorder symptoms indirectly predicted parental rejection through the mediating effect of school engagement. These findings not only enhance our understanding of the longitudinal relationships among parental rejection, school engagement, and gaming disorder symptoms, but also underscore the complex interplay between changes in family and school environments and the development of gaming disorder in adolescents.
Previous research suggests that loot box engagement is associated with gambling problems and gaming disorder symptoms, but population-based evidence from Central and Eastern Europe is limited. The present research aimed to examine sociodemographic characteristics of loot box engagement in Poland and to investigate its association with gambling problems and gaming disorder symptoms. Study 1 used a representative sample of Polish Internet users with 643 active gamers (319 female; M = 40.02 years; SD = 15.33; age range: 18-79). Study 2 included 1012 gamers (547 female; M = 33.86 years; SD = 10.05; age range: 16-72) who made payments in free electronic games. Study 3 involved 2021 gamers (1027 females; M = 34.88 years; SD = 10.70; age range: 18-75) who played games with loot boxes. We assessed loot box engagement, sociodemographic variables, and indicators of gambling problems and gaming disorder symptoms. In Study 1, playing games with loot boxes was more common among males, younger individuals, students, those with less education, and single participants. In Studies 2 and 3, opening loot boxes was associated with greater GP and higher GD symptoms. Paying for loot boxes was associated with higher gambling frequency, GP, and GD symptoms in Study 3. Stronger correlations between GP and GD symptoms were observed among gamers who paid for loot boxes. Loot box engagement, particularly paid use, is associated with gambling and gaming-related problems in Polish adults. Greater engagement with loot boxes may blur the boundary between gaming and gambling.
A man in his 20s was admitted after a serious suicide attempt (hypnotic overdose) following months of severe depression and social withdrawal. In the preceding 2 weeks, after a 2-day forced break from gaming due to a brief, mild, self-limited illness during which COVID-19 testing was not performed and loss of in-game status, he developed derealisation and paranoid ideas that others were 'non-playable characters'. His history revealed compulsive online gaming (approximately 10 hours/day) and chronic cannabis use, and urine toxicology was positive for cannabis. He was treated with antipsychotics and antidepressants, a short course of benzodiazepines, psychoeducation and family work, with plans for cannabis abstinence and gaming restriction. Psychotic symptoms and suicidality remitted over 4 weeks. At follow-up, up to 3 months, clinical stability was maintained, urine toxicology was negative for cannabis and symptom measures improved. This case illustrates a clinically important temporal and phenomenological association between severe depression, problematic gaming, cannabis use and psychotic decompensation while emphasising that causality cannot be inferred from a single case.
The transition from late adolescence to emerging adulthood is a critical period of psychological and neurobiological change. Gaming disorder (GD), depression, and anxiety often co-occur, yet little is known about how their comorbidity structures reorganize across developmental stages. A two-wave longitudinal study was conducted with 663 Chinese adolescents assessed during late adolescence (T₀, mean age = 17.52) and 620 participants reassessed three years later in emerging adulthood (T₁, mean age = 20.53). Validated self-report scales measured symptoms of GD, depression, and anxiety. Symptom networks were estimated separately at each wave using regularized Gaussian graphical models. Expected influence (EI) and bridge expected influence (BEI) were computed to assess central and bridging symptoms, network stability was evaluated using bootstrap procedures, and Network Comparison Tests were conducted to compare global strength and network structure between waves. From T₀ to T₁, network sparsity decreased from 0.80 to 0.75, density increased from 0.20 to 0.25, and global strength increased from 19.55 to 22.50. At T₀, the highest EI nodes were GAD1 (nervousness, 1.23) and GD6 (persistent gaming, 1.11), and the highest BEI nodes were GAD1 (0.50) and PHQ6 (worthlessness, 0.41). At T₁, the highest EI nodes were GAD5 (restlessness, 1.22) and GAD3 (excessive worry, 1.19), and the highest BEI nodes were GAD5 (0.64) and PHQ9 (suicidal thoughts, 0.62). Network Comparison Tests indicated that global EI increased by 1.28 (p = 0.02). Centrality invariance testing revealed significant EI increases for GAD3 (0.58, p < 0.01) and GAD5 (0.57, p < 0.01). For BEI, GAD7 (catastrophizing, 0.42, p = 0.02) and GAD3 (0.40, p < 0.01) showed significant increases. The longitudinal network analysis showed that the comorbidity of GD, depression, and anxiety reorganized from late adolescence to emerging adulthood. Cognitive-affective symptoms became central and bridging, whereas gaming-related emotional and behavioral links weakened, reflecting a possible developmental shift from reactive, behavior-based coping in adolescence to internally sustained, cognitively driven symptom networks in emerging adulthood. Interventions should focus on strengthening adaptive coping and targeting core cognitive-affective symptoms to reduce long-term psychopathological risk. Not applicable.
BackgroundActivity microbreaks may help reduce the affective and cognitive burden of sedentary work, but immersive exergaming microbreaks remain underexplored.ObjectiveThis study examined the effects of virtual reality (VR) and mixed reality (MR) exergaming microbreaks on positive affect, inhibitory control, and acute physiological responses in desk-based employees.MethodsIn a randomized crossover trial, 28 desk-based employees completed 5-min VR, MR, and passive-rest conditions. Positive affect (PANAS-PA) and the Victoria Stroop Color-Word interference score (C-W) were assessed before and after each session. Heart rate (HR) was monitored continuously; rating of perceived exertion (RPE) and intention to continue (ITC) were also recorded. Baseline-adjusted linear mixed-effects models included condition and period as fixed effects and participant as a random intercept.ResultsBoth immersive conditions improved PANAS-PA relative to rest (VR vs. rest: 7.80, 95% CI [5.10, 10.50], p < 0.001; MR vs. rest: 6.62, 95% CI [3.91, 9.32], p < 0.001), with no clear VR-MR difference. The C-W score did not show a significant condition effect (omnibus p = 0.11) and adjusted pairwise comparisons were non-significant. HR was substantially higher during VR and MR than during rest (p < 0.001), whereas VR and MR did not significantly differ (p = 0.19). RPE was higher after VR than MR (p = 0.004), and ITC was similar across immersive conditions (p = 0.22).ConclusionsVR and MR exergaming microbreaks may support acute improvements in positive affect and physiological activation in the workplace; however, they did not improve inhibitory control in the present study.Trial registrationThis trial was prospectively registered at ClinicalTrials.gov (Identifier: NCT06889597).
This study investigated the immediate effects of three sitting positions, including chair sitting with and without a backrest and cross-legged sitting on the floor, on cervical and trunk postures, musculoskeletal discomfort, and ergonomic risk during smartphone gaming among young adults. A randomized within-subject study was conducted in 41 healthy participants (mean age 20.4 ± 1.1 years). Each participant played Realm of Valor (ROV) on their personal smartphone for 20 minutes in three randomly assigned sitting positions. Cervical and trunk angles were measured using two-dimensional photogrammetry at baseline and at 5, 10, 15, and 20 minutes. Ergonomic risk was assessed using the Rapid Upper Limb Assessment (RULA), with the maximum score used for analysis. After each session, participants reported perceived musculoskeletal discomfort using a visual analog scale. A significant interaction between time and sitting position was found for both neck flexion (F(3.87, 232.27) = 5.31, p < 0.001, partial η² = 0.081) and trunk angles (F(8,480) = 2.73, p = 0.006, partial η² = 0.044). Perceived neck discomfort was the most common symptom, with the cross-legged position showing the highest prevalence (51.2%, Cochran's Q = 8.67, p = 0.013, Kendall's W = 0.106). However, symptom intensity did not differ significantly among positions. RULA scores also differed across sitting positions (χ²(2) = 27.0, p < 0.001, Kendall's W = 0.329), with the cross-legged position showing the highest score. Sitting posture significantly affected cervical and trunk alignment, perceived discomfort, and ergonomic risk during smartphone gaming. Cross-legged sitting induced the greatest neck and trunk flexion, which may contribute to increased musculoskeletal strain over time. These findings emphasize the importance of promoting ergonomic awareness and healthy digital habits to maintain spinal alignment and reduce posture-related musculoskeletal strain; however, longitudinal studies are needed to confirm long-term effects.
Little is known about whether specific types of maladaptive cognitions consistently relate to both internet gaming disorder (IGD) and problematic social media use (PSMU), or whether these cognitions can explain gender differences in IGD and PSMU. Drawing on gender socialization perspectives and cognition-based models, this study aims to compare the mediating effects of various types of maladaptive cognitions related to internet gaming and social media. A sample of 942 junior high school students in China participated in a two-wave survey. Logistic regression analysis revealed that specific types of maladaptive cognition did not serve as common predictors of IGD and PSMU at T2. Mediation analysis demonstrated distinct mediating effects for different maladaptive cognitions. The association between gender and IGD at T2 was mediated by perceived urges to play internet games and perceived unwillingness to stop playing internet games at T1. The specific indirect effect indicated that only the perceived unwillingness to stop using social media at T1 mediated the association between gender and PSMU at T2. The findings provide stronger support for the cognitive-behavioral model than for the interaction of person-affect-cognition-execution model concerning the effects of maladaptive cognitions. Providing counseling for adolescents experiencing thoughts of unwillingness to stop may help protect them from developing IGD and PSMU.
Internet gaming disorder (IGD) and insomnia are highly prevalent and comorbid public health issues among college students. While physical activity (PA) is a recognized protective factor, the longitudinal dynamic interactive mechanisms among PA, IGD, and insomnia remain unclear. This study investigated the longitudinal bidirectional relationships among these variables, focusing on the mediating role of IGD between PA and insomnia. A three-wave longitudinal study (3-month intervals) was conducted with 475 Chinese college students (aged 18.43 ± 1.71). Assessments included the Physical Activity Rating Scale-3, the Internet Gaming Disorder Checklist, and the Athens Insomnia Scale. A cross-lagged panel model (CLPM) was constructed, and mediation was tested using the bias-corrected Bootstrap method. CLPM analysis revealed that: (1) PA was significantly and negatively correlated with subsequent IGD (T1→T2: β = -0.113, p < 0.001; T2→T3: β = -0.081, p = 0.029) and insomnia (T1→T2: β = -0.098, p = 0.003; T2→T3: β = -0.089, p = 0.003), whereas later-stage IGD was significantly and inversely correlated with subsequent PA (T2→T3: β = -0.123, p = 0.003), but the earlier-stage correlation was not significant (T1→T2: β= -0.052, p=0.175); (2) IGD was consistently and positively correlated with subsequent insomnia (T1→T2: β = 0.131, p=0.010; T2→T3: β = 0.137, p = 0.005), whereas insomnia was positively correlated with subsequent IGD only in the early stage (T1→T2: β = 0.132, p = 0.001), with the later-stage correlation being non-significant (T2→T3: β = 0.103, p = 0.055); (3) insomnia was not significantly correlated with subsequent PA (T1→T2: β = -0.030, p = 0.408; T2→T3: β = -0.065, p = 0.151); (4) T1 PA predicted lower T3 insomnia both directly and indirectly via lower T2 IGD (indirect effect = -0.005, 95% CI [-0.010, -0.002]). longitudinal associations exist among PA, IGD, and insomnia. PA emerges as a key prospective protective factor, and IGD plays a significant longitudinal mediating role in the association between PA and sleep, providing practical insights for preventing IGD and insomnia through increased physical activity.
Internet gaming disorder (IGD) has emerged as a significant behavioral addiction and public health concern. However, its underlying neurobiological mechanisms remain unclear. This study aimed to develop a machine learning approach to evaluate IGD based on multimodal neurophysiological signals. Forty-seven male university students with IGD and 42 recreational game users (RGUs) participated in the study. Event-related potential (ERP) and functional near-infrared spectroscopy (fNIRS) signals were simultaneously recorded during a game-related dot-probe paradigm to evaluate attentional bias and cue-reactivity. The extracted features included general linear model (GLM) beta values representing changes in cortical oxygenation from fNIRS, along with the latency and amplitude of ERP components. Compared to RGUs, IGD participants exhibited altered P100, N200, and P300 responses that were modulated by stimulus duration. Additionally, they showed reduced prefrontal hemodynamic activity, particularly in the dorsolateral prefrontal cortex. Several machine learning algorithms were evaluated for classification, including baseline classifiers, ensemble methods, and a hybrid model, with the KNN algorithm yielding the highest classification performance. Classification accuracy increased from 79.95% using ERP features alone to 85.4% when combining ERP and fNIRS features. The findings suggest that IGD and RGU can be objectively distinguished using neurophysiological data, offering a potential tool to support clinical diagnosis. Reduced activation in the dorsolateral prefrontal cortex may serve as a potential neuro-biomarker for IGD. In addition, altered N200 and P300 responses, which are modulated by cue duration, may also serve as electrophysiological markers of IGD. This is the first study to classify IGD using multimodal neural responses during the dot-probe task. This comprehensive approach, combining electrophysiological and hemodynamic data within a cue-reactivity framework, highlights the potential of multimodal imaging to enhance our understanding and detection of IGD.
Motivational orientation and immersive tendency describe complementary questionnaire-based dimensions of player characterization. Motivation instruments capture why players report engaging with games, whereas immersive-tendency instruments describe individual predispositions toward absorption, involvement, and attention focusing in mediated environments. To support reuse in questionnaire-based player modelling, we created an open, item-level, single-cohort survey dataset linking Bartle Test responses, ITQ-18 responses, demographics, and self-reported gaming preferences among IT students and teachers. The dataset contains a single comma-separated values (CSV) file (one record per participant), with n = 175 and 64 variables. It includes: demographics (age, gender); self-reported weekly gaming time (total and excluding mobile); preferred mode (single-player or multiplayer); binary genre indicators with the most popular genre; item-level responses from the 30-item Bartle Test of Gamer Psychology with response options Achiever, Socializer, Explorer, Killer; and 18 items from the Immersive Tendencies Questionnaire rated on a seven-point Likert scale. The dataset is fully anonymized, contains no free-text fields, and uses categorical codes to facilitate reuse.
Early childhood is a sensitive developmental period for the acquisition of cognitive and socio-emotional skills that are strongly associated with later mental health, academic achievement, and social functioning. Children growing up in socioeconomically disadvantaged contexts are at increased risk for early emotional and behavioral difficulties, highlighting the need for accessible, scalable, and developmentally appropriate preventive interventions. Japi 2.0 is a tablet-based gaming platform designed to stimulate six interrelated cognitive and socio-emotional skills-working memory, inhibitory control, emotion recognition, social competence, empathy, and cognitive planning-through structured play in preschool settings. We conducted a pilot cluster randomized controlled trial in low-income preschools in Santiago, Chile. Schools were randomized to either the Japi 2.0 intervention or treatment as usual. The intervention consisted of 24 individual sessions delivered over 12 weeks during regular class hours. Primary outcomes were acceptability (perceived by children, early years educators, and parents) and feasibility (recruitment, retention, attendance, intervention delivery, and data completeness). Secondary outcomes explored preliminary changes in cognitive, socio-emotional, and behavioral functioning using standardized assessments and parent- and teacher-reported measures. Exploratory analyses were conducted using multilevel models adjusted for baseline scores and clustering, based on available outcome data from randomized participants. Japi 2.0 showed high acceptability across stakeholders. Educators and parents reported that the game and the accompanying web-based dashboard were engaging, age-appropriate, easy to use, and pedagogically relevant. Children reported high levels of enjoyment and positive emotional experiences during gameplay. Feasibility indicators were satisfactory: most planned sessions were delivered as scheduled, attendance was high, and outcome data completeness was adequate. Exploratory analyses indicated improvements over time in both groups across most outcomes. Preliminary exploratory signals favoring the intervention were observed for empathy and parent-reported emotional and behavioral difficulties; however, these findings should be interpreted cautiously given the small number of clusters and exploratory nature of the analyses. This pilot trial demonstrates that Japi 2.0 is a feasible and highly acceptable digital intervention for preschool children in low-income educational settings. Although efficacy findings are preliminary, results support progression to a fully powered randomized controlled trial to evaluate effectiveness and longer-term impacts on cognitive, socio-emotional, and behavioral development. Trial registration Clinical Trials NCT06420544, May 20th, 2024. https://www. gov/study/ NCT06420544.
Hikikomori, first recognised and defined in Japan as a culture-bound syndrome of prolonged social withdrawal, is increasingly reported worldwide. There is now a broad consensus that hikikomori is not confined to Japan. Its relevance to the UK context is raised by the presence of approximately one million young adults not in education, employment or training (NEET). To examine the occurrence of hikikomori and hikikomori-like behaviours among UK university students and to explore the association between mental health difficulties, neurodevelopmental traits and gaming disorder in its development. A cross-sectional online survey was conducted, with a final sample of 105 students completing validated measures of social withdrawal, psychological distress, functional impairment and associated psychiatric traits. One in five students (21.0%) reported some form of hikikomori behaviour; 14.3% met criteria for pathological hikikomori, although no cases of severe hikikomori (home confinement >6 months) were identified. Hikikomori tendencies correlated strongly with psychological distress (r = 0.73, p < 0.001), autism-related traits (r = 0.72 p < 0.001) and internet gaming disorder (r = 0.70, p < 0.001). Moderate positive associations were found with depression and anxiety, while weaker negative associations emerged with psychotic-like experiences, agreeableness and conscientiousness. Gaming disorder, underlying mental health difficulties and autistic traits emerged as strong predictors of hikikomori behaviours. Hikikomori-like behaviour may be more prevalent in the UK student population than previously recognised. The findings underline the importance of screening for social withdrawal in young adults, with particular attention to gaming behaviours, mental health problems and autistic traits. Furthermore, identifying and addressing pre-hikikomori cases (social withdrawal lasting less than three months) may be crucial for early intervention and prevention.
Digitalisation and rapid technological advancements have intensified socio-cultural pressures surrounding body ideals and performance, contributing to the increased use of Image and Performance Enhancing Drugs (IPED). Body dissatisfaction, muscularity-oriented concerns, and distorted self-perception represent key drivers of this phenomenon and are further amplified by digital media, which increasingly promote IPED use. Although IPED use has been consistently associated with body image disturbances and eating-related psychopathology, its relationship with behavioural addictions remains largely underexplored. This represents a critical knowledge gap, given that IPEDs are often used to shape the body, regulate mood, sustain productivity, sharpen cognition, and intensify sexual experiences, all of which may contribute to compulsive patterns of behaviour. This narrative review synthesises existing literature examining IPED use in relation to behavioural addictions, including exercise addiction, eating disorders, work addiction, gaming disorder, gambling disorder, and compulsive sexual behaviour disorder. Moving beyond traditional doping frameworks, it examines how IPED use is shaped by appearance-related disorders, compulsive behaviours, and social validation pressures. Particular attention is given to the role of digital environments and online fora in facilitating access to IPEDs, normalising their use, and interacting with reinforcement processes in these conditions. By integrating previously fragmented lines of research, the review proposes a novel framework that conceptualises IPED use as recurring across diverse behavioural addictions rather than an isolated phenomenon confined to sport. Understanding the mechanisms linking IPED use, behavioural addictions, and digital contexts is crucial for informing targeted public health strategies and the development of effective prevention and intervention approaches.
Internet addiction among university students has become a growing concern, yet effective interventions that reduce it without conflicting with academic demands remain limited. This quasi-experimental study examined the effects of a digital game-based psychological intervention on producing behavioral and cognitive gains, specifically reducing internet addiction and enhancing English reading, writing, and translation proficiency, among at-risk Chinese university EFL learners with internet addiction. A total of 67 participants from two intact classes were randomly designated into either an experimental group (n = 34) or a control group (n = 33). The experimental group engaged with a digital game-based psychological intervention, whereas the control group received conventional instruction without game-based elements. Behavioral and cognitive gains, specifically improvements in English reading, writing, and translation proficiency, were assessed at the 17th week (post-test) and the 42nd week (delayed post-test) using self-developed English examination papers. In addition, changes in internet addiction were measured using the Gaming Disorder Screening Scale at the same time points. Independent samples t-tests and 2 × 3 mixed-design ANOVAs were used for data analysis. Results revealed that, compared with the control group, the experimental group achieved significantly higher gains in terms of English reading, writing, and translation skills, as well as a marked reduction in internet addiction levels. These findings suggest that a digital game-based psychological intervention may be effective in yielding dual benefits, alleviating internet addiction while enhancing English reading, writing, and translation proficiency, among at-risk Chinese university EFL learners. Practical recommendations include selecting language-rich games, regulating gameplay time, and integrating structured tasks for educators, as well as allocating resources for program development and teacher training for policymakers.
Active, pixel-level addressability is central to the realization of metadevices with programmable wavefront control. However, two-dimensional operation at visible wavelengths remains challenging, as reducing metasurface pixel dimensions imposes increasing constraints on electrical interconnect design and local tunability. Here, we demonstrate interactively addressable organic metadevices, in which ultrathin polyaniline is conformally integrated with plasmonic nanoantennas to yield individually switchable metasurface pixels with localized electrochemical modulation. Using a planar fan-out architecture, we realize two-dimensional metasurface arrays, in which each pixel is electronically isolated and driven at sub-volt voltages, enabling millisecond-scale switching dynamics. Embedded within a user-driven electronic control loop, the platform converts user inputs into pixel-level voltage patterns to generate reconfigurable holographic projections, supporting functionalities ranging from alphanumeric character rendering to interactive gaming. Pixel-resolved measurements reveal uniform electrochemical behaviour, negligible electrical crosstalk, and stable operation across dynamically evolving holographic scenes. Our results establish organic metasurfaces as a promising route toward user-programmable and interactively addressable photonic systems.
Esports participation is expanding rapidly, yet evidence on players' health and health-related behaviors remains limited and inconsistent. This study examined health indicators and health-related behaviors in esports players and explored differences by weekly playtime and nationality. A cross-sectional online survey was completed by 413 esports players from 48 nationalities. Measures included body mass index (BMI), physical activity, smoking, alcohol use, sleep behavior, depressive symptoms, health-related quality of life (HRQoL), and perceived social support. Overall, the sample showed a heterogeneous but not uniformly adverse health profile. Mean BMI was within the normal-weight range, smoking and alcohol consumption were generally low, depressive symptoms were predominantly minimal to mild, and average sleep duration was approximately 8.2 h per night. However, 38.3% of participants were categorized as insufficiently physically active. Weekly playtime was largely unrelated to health indicators. The only significant difference was smoking frequency, with players reporting more than 10 h of weekly playtime smoking slightly more often than those playing 0-10 h. In contrast, nationality was associated with differences in BMI, smoking frequency, drinking frequency, physical activity, and selected HRQoL domains, while no nationality differences were observed for sleep parameters, depressive symptoms, or perceived social support. These findings challenge simplified assumptions that esports players exhibit uniformly poor health and suggest that health-related differences may be better explained by subgroup characteristics and sociocultural context than by gaming volume alone. Future longitudinal and intervention-based research is needed to better understand and promote healthy participation in esports.
This study aimed to cross-culturally adapt the Problem Gambling Severity Index (PGSI) into Brazilian Portuguese and to conduct a preliminary assessment of its content and face validity. The adaptation process followed internationally recognized guidelines and included several stages: initial translation, translation synthesis, back-translation, review by a committee of experts, evaluation by an expert panel of 11 specialists, pre-test with participants from the general population, and final revision. The Content Validity Index (CVI), Clarity Index (CI), and Content Validity Ratio (CVR) were calculated based on the experts' evaluations. As a first step, establishing semantic and content validity is essential before broader psychometric testing can be meaningfully conducted in the target population. The adapted PGSI demonstrated strong content validity, with all items reaching a CVI of 0.90 or higher and an overall mean of 0.98. The CI ranged from 2.63 to 2.90, and the CVR indicated high agreement regarding the essentiality of the items. Face validity testing with 33 participants from the general population revealed that all items were rated as understandable or entirely understandable by most participants (84.9% to 100%). Expert feedback was also used to refine the wording of items, particularly to distinguish between "gaming" and "gambling" in the Brazilian context. The Brazilian Portuguese version of the PGSI presented robust preliminary evidence of semantic, conceptual, and cultural adequacy. This version fills a critical methodological gap and provides a culturally appropriate screening and monitoring tool for use in clinical and research settings in Brazil, supporting prevention and public health monitoring of gambling-related harms, including financial impacts. Future studies will evaluate additional psychometric properties further to consolidate its use in clinical and epidemiological contexts.
Globally, access to menstrual cycle and hygiene information is limited, especially for women who are largely hearing impaired. Interactive games offer a promising approach as they increase knowledge about menstrual health. This study was conducted to determine the effect of an interactive game played with women of reproductive age with hearing disabilities on their perception of the menstrual cycle and hygiene. This quasi-experimental pre-test-post-test study was conducted between May 30 and August 31, 2025, with 82 women with hearing disabilities (40 control, 42 intervention). In the intervention group, the interactive game was played once, and the post-test was administered four weeks later. No intervention was applied to the control group. Data were collected using a questionnaire including demographic information and sections on menstrual cycle and hygiene perception. Analyses were performed using the Independent Sample T-Test, ANOVA, Paired T-Test, and Mixed ANOVA. The mean post-test scores of menstrual cycle and hygiene perceptions were statistically significantly higher in the intervention group compared to the control group (F: 126.197, p < 0.001, ηp²: 0.612). It was also determined that all women in the intervention group (100%) were satisfied with the interactive game. This study found that the interactive game had a significant effect on the menstrual cycle and hygiene perception of women with hearing disabilities. Therefore, it is recommended that health professionals use the interactive game-based training model when providing menstrual cycle education and counselling, to support the knowledge levels of women with hearing disabilities. Statement of SignificanceProblemThe menstrual cycle and hygiene perceptions of hearing-impaired women of reproductive age have not been previously determined. And no interactive application has been developed on this subject.Current KnowledgeWomen of reproductive age with disabilities obtain information about menstrual cycles and hygiene from their mothers. However, the level of knowledge is insufficient.Contribution of This ArticleThis study measured the level of awareness of menstrual cycles and hygiene among hearing-impaired women of reproductive age. It also found that interactive games have a strong impact on awareness of menstrual cycles and hygiene.