Stephen V. Faraone, PhDA Spanish team of researchers recently completed a comprehensive review of studies looking for links between compulsive video gaming (both online and offline) and a variety of psychological disorders, including anxiety, depression, social phobia, and ADHD. The focus was on behavior “of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning.”

The team identified 24 studies, of which eight with a combined total of 16,786 participants looked for associations with either ADHD or its hyperactivity component. Participants included children, adolescents, and adults. One large longitudinal study, with 3,034 participants, found no association. Another study with 1,095 participants found a small effect. Two more, with a combined total of 11,868 found medium effect sizes. Four studies found large associations, but their combined total number of participants was 789, comprising less than a twentieth of the combined participants.

The authors concluded, “The relationship between Internet Gaming Disorder and ADHD and hyperactivity symptoms were analyzed in eight studies. Seven of them reported full association, with four finding large, two finding small, and one reporting moderate, effect sizes. The studies comprised two case-control, five cross-sectional and one longitudinal design; the latter found no association between the two variables.”[1] They also emphasized that 87 percent “of the studies describe significant correlations … with ADHD or hyperactivity symptoms.”[2]

Yet they did not note that all of the studies with large effect sizes were comparatively small. And while they presented funnel charts evaluating publication bias for anxiety and depression, they did not do so for ADHD, where the small studies with very large effect sizes suggest publication bias (i.e., that that evidence for association is exaggerated due to the early publication of positive findings).

Leaving out these small studies, the four high-powered studies with 15,997 participants reported effect sizes ranging from none to medium. Overall that suggests that there is an association between ADHD and videogaming, though not a particularly strong one. Moreover, due to the nature of the study designs, this work cannot conclude that the small effect observed is due to the playing video games being a risk factor for ADHD or to the possibility that ADHD youth are more attracted to video games than others.

REFERENCES
Vega González-Bueso, Juan José Santamaría, Daniel Fernández, Laura Merino, Elena Montero and Joan Ribas, “Association between Internet Gaming Disorder or Pathological Video-Game Use and Comorbid Psychopathology: A Comprehensive Review,” International Journal of Environmental Research and Public Health, vol. 15, 668 (2018).

[1] One effect size was mischaracterized as small when in fact it was medium (OR = 2.43).

[2] In the abstract this was misleadingly worded, “The significant correlations reported comprised: 92% between IGD and anxiety, 89% with depression, 85% with symptoms of attention deficit hyperactivity disorder (ADHD),” suggesting a very strong correlation rather than an association of greatly varying effect size in seven of eight studies.

 

Stephen V. Faraone, PhD

About Stephen V. Faraone, PhD

Dr. Faraone is the Principal ADHD Expert for ADHD in Adults. He is Distinguished Professor of Psychiatry, SUNY Upstate Medical University, and is a member of the Board of APSARD, the American Professional Society of ADHD and Related Disorders. He is the Principal Investigator for ADHD in Adults.com and serves on the Advisory Board.