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      Development and validation of a nine-item short screening test for ICD-11 gaming disorder (GAMES test) and estimation of the prevalence in the general young population


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          Background and Aims

          A definition of gaming disorder (GD) was introduced in ICD-11. The purpose of this study was to develop a short screening test for GD, utilizing a reference GD group. It also sought to estimate the prevalence of GD among individuals, representative of the general young population in Japan.


          Two hundred eighty one men and women selected from the general population, aged between 10 and 29 years, and 44 treatment seekers at our center completed a self-reported questionnaire comprising candidate questions for the screening test. The reference group with ICD-11 GD was established, based on face-to-face interviews with behavioral addiction experts, using a diagnostic interview instrument. The questions in the screening test were selected to best differentiate those who had GD from those who did not, and the cutoff value was determined using the Youden index.


          A nine-item screening test (GAMES test) was developed. The sensitivity and specificity of the test were both 98% and the positive predictive value in the study sample was 91%. The GAMES test comprised two factors, showed high internal consistency and was highly reproducible. The estimated prevalence of GD among the general young population was 7.6% (95% confidence interval; 6.6–8.7%) for males and 2.5% (1.9–3.2%) for females, with a combined prevalence of 5.1% (4.5–5.8%).

          Discussion and Conclusion

          The GAMES test shows high validity and reliability for screening of ICD-11 GD. The estimated prevalence of 5.1% among the general young population was comparable to the pooled estimates of young people globally.

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          Most cited references40

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          Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research

          Background Behavioral addiction research has been particularly flourishing over the last two decades. However, recent publications have suggested that nearly all daily life activities might lead to a genuine addiction. Methods and aim In this article, we discuss how the use of atheoretical and confirmatory research approaches may result in the identification of an unlimited list of “new” behavioral addictions. Results Both methodological and theoretical shortcomings of these studies were discussed. Conclusions We suggested that studies overpathologizing daily life activities are likely to prompt a dismissive appraisal of behavioral addiction research. Consequently, we proposed several roadmaps for future research in the field, centrally highlighting the need for longer tenable behavioral addiction research that shifts from a mere criteria-based approach toward an approach focusing on the psychological processes involved.
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            Cross-sectional and longitudinal epidemiological studies of Internet gaming disorder: A systematic review of the literature.

            The diagnostic criteria of Internet gaming disorder (IGD) have been included in section III of DSM-5. This study aims to systematically review both cross-sectional and longitudinal epidemiological studies of IGD.
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              A review of solutions for diagnostic accuracy studies with an imperfect or missing reference standard.

              In diagnostic accuracy studies, the reference standard may be imperfect or not available in all patients. We systematically reviewed the proposed solutions for these situations and generated methodological guidance. Review of methodological articles. We categorized the solutions into four main groups. The first group includes methods that impute or adjust for missing data on the reference standard. The second group consists of methods that correct estimates of accuracy obtained with an imperfect reference standard. In the third group a reference standard is constructed by combining multiple test results through a predefined rule, based on a consensus procedure, or through statistical modeling. In the fourth group, the diagnostic accuracy paradigm is abandoned in favor of validation studies that relate index test results to relevant clinical data, such as history, future clinical events, and response to therapy. Most of the methods try to impute, adjust, or construct a reference standard. In situations that deviate only marginally from the classical diagnostic accuracy paradigm, these are valuable methods. In cases where an acceptable reference standard does not exist, the concept of clinical test validation may provide an alternative paradigm to evaluate a diagnostic test.

                Author and article information

                J Behav Addict
                J Behav Addict
                Journal of Behavioral Addictions
                Akadémiai Kiadó (Budapest )
                6 July 2021
                July 2021
                July 2021
                : 10
                : 2
                : 263-280
                [1 ]National Hospital Organization Kurihama Medical and Addiction Center , Yokosuka, Kanagawa, Japan
                [2 ]Tottori University, Faculty of Medicine , Yonago, Tottori, Japan
                [3 ]Asahiyama Hospital , Sapporo, Hokkaido, Japan
                [4 ]University of Lübeck , Lübeck, Germany
                [5 ]National Centre for Youth Substance Use Research, The University of Queensland , Brisbane, Queensland, Australia
                Author notes
                [* ]Corresponding author. E-mail: h-susumu@ 123456db3.so-net.ne.jp
                © 2021 The Author(s)

                Open Access. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                Page count
                Figures: 1, Tables: 5, Equations: 0, References: 41, Pages: 18
                Funded by: Ministry of Health, Labour and Welfare of Japan

                icd-11,gaming disorder,internet gaming disorder,screening test,validity,prevalence


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