Do teenagers who struggle with video gaming also use more drugs and have worse mental health?

What is it about?

This large-scale survey study examined the links between problematic video gaming (PVG), substance use, and psychosocial wellbeing among adolescents in the Netherlands. Three classroom-based survey samples were pooled to create a dataset of 8,478 young people. Participants completed measures of gaming behaviour and game type, the Video game Addiction Test, depressive mood, loneliness, social anxiety, negative self-esteem, school performance, and use of alcohol, cannabis and nicotine. Problematic gaming was most common among those who played multiplayer online games. Boys were far more likely to be gamers and to show problematic gaming patterns than girls. Adolescents scoring high on problematic gaming showed elevated rates of depression, loneliness, social anxiety and negative self-esteem, lower academic performance, and higher rates of alcohol, cannabis and nicotine use compared with non-problematic gamers, suggesting that problematic gaming co-occurs with a broader cluster of psychosocial difficulties and substance use rather than appearing in isolation.

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Why is it important?

Published in the same year that Internet Gaming Disorder first appeared in the DSM-5 appendix as a condition requiring further research, this study contributed timely population-level evidence to a field grappling with whether problematic gaming constitutes a clinically meaningful construct. Drawing on one of the largest adolescent samples in the gaming research literature at the time, the findings show that problematic gaming is not simply a matter of spending too much time playing, but clusters with mental health difficulties and substance use in ways that point to shared vulnerability factors and heightened clinical need. The gender pattern, with boys disproportionately affected, has remained a consistent and important finding in the field. The study supported the case for integrating gaming behaviour screening into broader adolescent mental health and substance use assessments, and contributed to the evidence base used in subsequent debates about the formal classification of gaming disorder by the WHO and DSM working groups.