Evaluating the quality of evidence for gaming disorder: A summary of systematic reviews of associations between gaming disorder and depression or anxiety

Abstract

Gaming disorder has been described as an urgent public health problem and has garnered many systematic reviews of its associations with other health conditions. However, review methodology can contribute to bias in the conclusions, leading to research, policy, and patient care that are not truly evidence-based. This study followed a pre-registered protocol (PROSPERO 2018 CRD42018090651) with the objective of identifying reliable and methodologically-rigorous systematic reviews that examine the associations between gaming disorder and depression or anxiety in any population. We searched PubMed and PsycInfo for published systematic reviews and the gray literature for unpublished systematic reviews as of June 24, 2020. Reviews were classified as reliable according to several quality criteria, such as whether they conducted a risk of bias assessment of studies and whether they clearly described how outcomes from each study were selected. We assessed possible selective outcome reporting among the reviews. Seven reviews that included a total of 196 studies met inclusion criteria. The overall number of participants was not calculable because not all reviews reported these data. All reviews specified eligibility criteria for studies, but not for outcomes within studies. Only one review assessed risk of bias. Evidence of selective outcome reporting was found in all reviews—only one review incorporated any of the null findings from studies it included. Thus, none were classified as reliable according to prespecified quality criteria. Systematic reviews related to gaming disorder do not meet methodological standards. As clinical and policy decisions are heavily reliant on reliable, accurate, and unbiased evidence synthesis; researchers, clinicians, and policymakers should consider the implications of selective outcome reporting. Limitations of the current summary include using counts of associations and restricting to systematic reviews published in English. Systematic reviewers should follow established guidelines for review conduct and transparent reporting to ensure evidence about technology use disorders is reliable.

Video game play is positively correlated with well-being

“…Given this, it is critical to understand that the quality of the evidence underlying possible classifications of video game play as potentially psychopathological has been criticized strongly. Many experts have argued that there is insufficient evidence that gaming disorder definitions and diagnostic tools meet clinical standards [15,[17][18][19][20][21][22]. Excessive use has been flagged as a key criterion for many gaming disorder definitions, yet researchers exclusively operationalize excessive use by way of selfreported estimates.…”

“…Work by Elson & Przybylski [35] showed that this issue arises regularly in research focused on the effects of technology, including in video games research. Carras et al [19] summarized systematic reviews on gaming disorder and found a high degree of selective reporting in the literature. To increase public trust in their findings, scientists have an obligation to work as transparently as possible, particularly when they collaborate with industry [36].…”

“…Carras et al . [ 19 ] summarized systematic reviews on gaming disorder and found a high degree of selective reporting in the literature. To increase public trust in their findings, scientists have an obligation to work as transparently as possible, particularly when they collaborate with industry [ 36 ].…”

Video game play is positively correlated with well-being

“…Given this, it is critical to understand that the quality of the evidence underlying possible classifications of video game play as potentially psychopathological has been criticised strongly. Many experts have argued that there is insufficient evidence that gaming disorder definitions and diagnostic tools meet clinical standards (Aarseth et al, 2016;Abendroth et al, 2020;Bean et al, 2017;Carras et al, 2020;Kardefelt-Winther et al, 2017;Zastrow, 2017). Excessive use has been flagged as a key criterion for many gaming disorder definitions, yet researchers exclusively operationalise excessive use by way of self-reported estimates.…”

Measuring Internet Gaming Disorder and Gaming Disorder: Qualitative Content Validity Analysis of Validated Scales

“…In the addictive gaming behaviors literature, perhaps the most systematic finding of systematic reviews (e.g., Costa & Kuss, 2019;Colder Carras et al, 2020;King et al, 2020b) is that the field operates with a great range of heterogeneous and inconsistent survey instruments. As this "diagnostic confusion" ) strongly characterized the field already at the time of the DSM-5's release (King et al, 2013b), the descriptions provided by the DSM-5 and the ICD-11 were important as an opportunity to make the field more consistent and coherent, in terms of operationalized criteria at least.…”