The cross-cultural expression of internet gaming distress in North America, Europe, and China

Abstract

We compare the forms online gaming-related distress takes cross-culturally, and examine how much such distress resembles the World Health Organization's (WHO) “Gaming disorder,” understood to be an “addiction.” Our preliminary exploratory factor analysis (EFA) in North America (n = 2025), Europe (n = 1198), and China (n = 841) revealed a constant four-factor structure across the three regions, with classic “addiction” symptoms always clustering together on the first and most important factor, though with some variability in regional factors' exact item composition. In the present study, we use second-order confirmatory factor analysis (CFA) to further examine this factor structure and the cultural similarities and differences. Specifically, we focus on confirming the regional structure and composition of an ethnographically developed 21-item gaming distress scale, which contains a wider symptoms pool than typical gaming disorder scales, and thus allows us to better separate generalized gaming distress's “addictive” from other culturally-influenced “problem” experiences and behaviors in each regional case. We use propensity score matching to separate the impact on gaming-related distress of regional culture from demographic variables (North America/Europe: n = 1043 pairs; North America/China: n = 535 pairs). Although our results support current WHO formulations of gaming-related distress as an addictive disorder, we show how cultural forces can shape how “addictive” and “problem” gaming are experienced and thus psychiatrically presented in different parts of the world. In particular, generalized gaming distress's addictive and problematic dimensions seem to be shaped by culture-specific expressions of achievement motivations, social connection and disconnection, and unique psychosomatic experiences.

Highlights

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  Second-order CFA shows similarities and differences between online gaming distress in North America, Europe, and China.

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  Our 21-item distress scale allows us to separate “addictive” from “problem” experiences and behaviors in each regional case.

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  Propensity score matching helps us separate the impact on gaming distress of regional culture from demographic variables.

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  Generalized gaming distress consists of four dimensions, with three closely related to addiction experiences and behaviors.

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  Our results support current WHO and APA formulations of gaming-related distress as an addictive disorder.

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  Culture also shapes how “addictive” and “problem” gaming are experienced in different parts of the world.