Attention, Externalizing and Internalizing Problems Mediated Differently on Internet Gaming Disorder Among Children and Adolescents With a Family History of Addiction As an Adverse Childhood Experience

Background: This study aimed to examine the factors associated with internet gaming disorder (IGD) and the mediating role of pediatric symptoms (attention, externalizing problems and internalizing problems) in children and adolescents with a family history of addiction as an adverse childhood experience (ACE).

Methods: A total of 2,586 children and adolescents (mean age = 14.04 ± 2.34; age range = 11-19 years; 50.5% boys) completed the Internet Game Use-Elicited Symptom Screen and the Pediatric Symptom Checklist-17. IBM SPSS Statistics 21 was used to calculate descriptive statistics and Pearson correlation coefficients and to conduct multiple regression analyses. Mediation analysis was performed using the Sobel test and the SPSS PROCESS macro. Serial multiple mediation analysis was performed using bootstrapping with 5,000 replications.

Results: The higher levels of Attention problems (β = -0.228, < 0.001) and externalizing problems (β = -0.213, < 0.001) were associated with IGD. Furthermore, the indirect effect of the independent variable on the dependent variable through the mediators was significant (Sobel's T: Z = -5.006, < 0.001). These findings suggest that attention and externalizing problems mediate the effect of family history of addiction on IGD.

Conclusion: This study demonstrated the associations among the family history of addiction, IGD, and pediatric symptoms (attention, externalizing problems, and internalizing problems) among Korean children and adolescents. Therefore, we need to pay attention to pediatric symptoms and develop systematic alternatives to improve mental health among Korean children and adolescents with a family history of addiction as ACEs.