Network Structures of Internet Gaming Disorder and Gaming Disorder: Symptom Operationalization Causes Variation

Objective: From 2022, the International Classification of Diseases, eleventh edition (ICD-11) includes the first mental disorder based on digital technology, "gaming disorder," which was previously suggested as a condition for further examination in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). In this cross-sectional study, we provide the first large-scale network analysis of various symptom structures for these constructs to understand the complex interconnections between their proposed symptoms. Method: Culturally diverse samples of 2,846 digital game players (M = 25.3 years) and 746 esports players (M = 23.5 years) were recruited. A network approach was applied to explore a multiverse of gaming disorder symptom structures, effects of item operationalization, and possible external moderators. Gaming disorder was measured using the Internet Gaming Disorder Scale 9-Short Form (IGDS9-SF), Gaming Disorder Test, and several items borrowed from Chinese Internet Gaming Disorder Scale, Personal Internet Gaming Disorder Evaluation-9, and Clinical Video game Addiction Test 2.0 scales. Results: Two symptoms (loss of control and continued use despite problems) present in both, the DSM-5 and ICD-11, were systematically central to most of the analyzed networks. Alternative operationalizations of single items systematically caused significant network differences. Networks were invariant across groups of play style, age, gender, gaming time, and most of the psychosocial characteristics. Conclusions: Our results caution practitioners and researchers when studying and interpreting gaming disorder symptoms. The data indicate that even minor operational changes in symptoms can lead to significant network-level changes, thus highlighting the need for careful wording.