Problematic online gaming mediates the association between attention-deficit/hyperactivity and subsequent mental health issues in adolescents
Abstract Theoretical models suggest that attention-deficit/hyperactivity and problematic online gaming could contribute to negative mental health outcomes, yet evidence on their interplay remains limited. Using data from 3171 adolescents in the Tokyo Teen Cohort, the present study examined the inter...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2025-08-01
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| Series: | Communications Psychology |
| Online Access: | https://doi.org/10.1038/s44271-025-00296-5 |
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| _version_ | 1849343267772039168 |
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| author | Zui C. Narita Jordan DeVylder Gemma Knowles Shuntaro Ando Syudo Yamasaki Mitsuhiro Miyashita Daniel Stanyon Satoshi Yamaguchi Toshiaki A. Furukawa Kiyoto Kasai Atsushi Nishida |
| author_facet | Zui C. Narita Jordan DeVylder Gemma Knowles Shuntaro Ando Syudo Yamasaki Mitsuhiro Miyashita Daniel Stanyon Satoshi Yamaguchi Toshiaki A. Furukawa Kiyoto Kasai Atsushi Nishida |
| author_sort | Zui C. Narita |
| collection | DOAJ |
| description | Abstract Theoretical models suggest that attention-deficit/hyperactivity and problematic online gaming could contribute to negative mental health outcomes, yet evidence on their interplay remains limited. Using data from 3171 adolescents in the Tokyo Teen Cohort, the present study examined the interplay of attention-deficit/hyperactivity at age 12 and problematic online gaming at age 14 associated with mental health issues at age 16. The sample consisted of 1487 girls (46.9%) and 1684 boys (53.1%). Doubly robust estimation revealed that a high degree of problematic online gaming consistently elevated the absolute and relative risks of mental health issues. The fully adjusted risk difference and risk ratio (95% confidence intervals (CIs)) were: incident depression, 7.8% (3.0%–13.1%) and 1.62 (1.25–2.05); incident anxiety, 5.7% (2.7%–8.7%) and 1.98 (1.45–2.67); incident psychotic experiences, 5.9% (2.3%–10.8%) and 1.72 (1.30–2.47); diminished well-being, 9.6% (5.1%–14.3%) and 1.54 (1.27–1.84). Higher attention-deficit/hyperactivity scores were associated with a greater degree of problematic online gaming (adjusted β per 1 SD: 0.18, 95% CI: 0.12–0.24). Causal mediation analysis—ensuring temporal plausibility, carefully adjusting for confounders, and accounting for exposure–mediator interaction—showed that problematic online gaming partially mediated the association between attention-deficit/hyperactivity and mental health issues: depressive symptoms (29.2%), anxiety (12.3%), psychotic experiences (20.6%), and diminished well-being (22.1%). The findings highlight the interplay of psychopathology, diminished inhibitory control, and addictive behaviors associated with negative consequences. Problematic online gaming may represent a modifiable mediator, warranting further intervention research to examine its potential as a treatment target. |
| format | Article |
| id | doaj-art-e02dbffd8f754832a3cd7941b39af722 |
| institution | Kabale University |
| issn | 2731-9121 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Communications Psychology |
| spelling | doaj-art-e02dbffd8f754832a3cd7941b39af7222025-08-20T03:43:02ZengNature PortfolioCommunications Psychology2731-91212025-08-013111010.1038/s44271-025-00296-5Problematic online gaming mediates the association between attention-deficit/hyperactivity and subsequent mental health issues in adolescentsZui C. Narita0Jordan DeVylder1Gemma Knowles2Shuntaro Ando3Syudo Yamasaki4Mitsuhiro Miyashita5Daniel Stanyon6Satoshi Yamaguchi7Toshiaki A. Furukawa8Kiyoto Kasai9Atsushi Nishida10National Center of Neurology and PsychiatryNew York UniversityKing’s College LondonThe University of TokyoTokyo Metropolitan Institute of Medical ScienceTokyo Metropolitan Institute of Medical ScienceKing’s College LondonTokyo Metropolitan Institute of Medical ScienceKyoto UniversityThe University of TokyoTokyo Metropolitan Institute of Medical ScienceAbstract Theoretical models suggest that attention-deficit/hyperactivity and problematic online gaming could contribute to negative mental health outcomes, yet evidence on their interplay remains limited. Using data from 3171 adolescents in the Tokyo Teen Cohort, the present study examined the interplay of attention-deficit/hyperactivity at age 12 and problematic online gaming at age 14 associated with mental health issues at age 16. The sample consisted of 1487 girls (46.9%) and 1684 boys (53.1%). Doubly robust estimation revealed that a high degree of problematic online gaming consistently elevated the absolute and relative risks of mental health issues. The fully adjusted risk difference and risk ratio (95% confidence intervals (CIs)) were: incident depression, 7.8% (3.0%–13.1%) and 1.62 (1.25–2.05); incident anxiety, 5.7% (2.7%–8.7%) and 1.98 (1.45–2.67); incident psychotic experiences, 5.9% (2.3%–10.8%) and 1.72 (1.30–2.47); diminished well-being, 9.6% (5.1%–14.3%) and 1.54 (1.27–1.84). Higher attention-deficit/hyperactivity scores were associated with a greater degree of problematic online gaming (adjusted β per 1 SD: 0.18, 95% CI: 0.12–0.24). Causal mediation analysis—ensuring temporal plausibility, carefully adjusting for confounders, and accounting for exposure–mediator interaction—showed that problematic online gaming partially mediated the association between attention-deficit/hyperactivity and mental health issues: depressive symptoms (29.2%), anxiety (12.3%), psychotic experiences (20.6%), and diminished well-being (22.1%). The findings highlight the interplay of psychopathology, diminished inhibitory control, and addictive behaviors associated with negative consequences. Problematic online gaming may represent a modifiable mediator, warranting further intervention research to examine its potential as a treatment target.https://doi.org/10.1038/s44271-025-00296-5 |
| spellingShingle | Zui C. Narita Jordan DeVylder Gemma Knowles Shuntaro Ando Syudo Yamasaki Mitsuhiro Miyashita Daniel Stanyon Satoshi Yamaguchi Toshiaki A. Furukawa Kiyoto Kasai Atsushi Nishida Problematic online gaming mediates the association between attention-deficit/hyperactivity and subsequent mental health issues in adolescents Communications Psychology |
| title | Problematic online gaming mediates the association between attention-deficit/hyperactivity and subsequent mental health issues in adolescents |
| title_full | Problematic online gaming mediates the association between attention-deficit/hyperactivity and subsequent mental health issues in adolescents |
| title_fullStr | Problematic online gaming mediates the association between attention-deficit/hyperactivity and subsequent mental health issues in adolescents |
| title_full_unstemmed | Problematic online gaming mediates the association between attention-deficit/hyperactivity and subsequent mental health issues in adolescents |
| title_short | Problematic online gaming mediates the association between attention-deficit/hyperactivity and subsequent mental health issues in adolescents |
| title_sort | problematic online gaming mediates the association between attention deficit hyperactivity and subsequent mental health issues in adolescents |
| url | https://doi.org/10.1038/s44271-025-00296-5 |
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