ORIGINAL RESEARCH

published: 19 February 2019

doi: 10.3389/fpsyg.2019.00310

Comparison of the Video Game

Functional Assessment-Revised
(VGFA-R) and Internet Gaming
Disorder Test (IGD-20)
Matthew Evan Sprong 1* , Mark D. Griffiths 2 , Daniel Perry Lloyd 3 , Erina Paul 4 and
Frank D. Buono 3
1
School of Interdisciplinary Health Professions, Northern Illinois University, DeKalb, IL, United States, 2 Psychology,
Nottingham Trent University, Nottingham, United Kingdom, 3 Department of Psychiatry, School of Medicine, Yale University,
New Haven, CT, United States, 4 Center for Molecular Medicine and Genetics, Wayne State University School of Medicine,
Detroit, MI, United States

Initially labeled as internet addiction in the mid-1990s (e.g., Griffiths, 1996; Young,
1996), researchers have since focused on how specific online activities result in negative
consequences for those who overuse and have problems with online applications such
as online gambling and online sex (Griffiths, 2000; Potenza, 2017). More recently, this
has been applied to online problematic video game play, often used synonymously
with terms such as online video game addiction, online gaming addiction, and Internet
Edited by: gaming disorder (IGD). With the publication of the fifth edition of the Diagnostic and
Frosso Motti,
National and Kapodistrian University Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA],
of Athens, Greece 2013), IGD was identified by the APA as warranting further study. The current proposed
Reviewed by: diagnostic criterion in the DSM-5 requires the presence of five of nine symptoms over
Alastair Andrew Anderson,
a 12-month period. These include: (a) preoccupation or obsession with Internet games,
Cairnmillar Institute, Australia
Valeria de Palo, (b) withdrawal symptoms when not playing Internet games, (c) an increasing need
University of Foggia, Italy over time to spend more and more time playing video games, (d) failed attempts to
*Correspondence: stop or curb Internet gaming, (e) loss of interest in other activities such as hobbies, (f)
Matthew Evan Sprong
[email protected] continued overuse of Internet games even with knowledge of the impact of overuse
on their life, (g) lying about extent of Internet game usage, (h) uses Internet games
Specialty section: to relieve anxiety or guilt, and (i) has lost or put at risk an opportunity or relationship
This article was submitted to
Quantitative Psychology because of Internet games (American Psychiatric Association [APA], 2013). However, it
and Measurement, is unclear if the disorder represents addiction to the internet or if IGD evaluates specific
a section of the journal
Frontiers in Psychology
behaviors occurring within the context of the video gaming (Starcevic and Billieux, 2017;
Received: 25 July 2018
Young and Brand, 2017).
Accepted: 31 January 2019
Keywords: internet gaming disorder, video game addiction, DSM-5, video game functional assessment, internet
Published: 19 February 2019 gaming addiction, internet gaming addiction (IGA)
Citation:
Sprong ME, Griffiths MD,
Lloyd DP, Paul E and Buono FD INTRODUCTION
(2019) Comparison of the Video
Game Functional To evaluate the diagnostic utility of the prosed DSM-5 criteria Pontes and Griffiths (2014)
Assessment-Revised (VGFA-R)
developed the 20-item Internet Gaming Disorder Test (IGD-20), a brief questionnaire based
and Internet Gaming Disorder Test
(IGD-20). Front. Psychol. 10:310.
on an addiction components model (Griffiths, 2005). Griffiths stated that addiction must be
doi: 10.3389/fpsyg.2019.00310 understood in terms of core characteristics that occur in both problematic use of substances and

Frontiers in Psychology | www.frontiersin.org 1 February 2019 | Volume 10 | Article 310

Sprong et al. Video Game Functional Assessment – Revised

behaviors (salience, mood modification, tolerance, withdrawal, criteria of the IGD-20 with the primary reinforcing behavioral
conflict, and relapse). Pontes et al. compared these sub-factors functions evaluated by the VGFA-R. More specifically, the
in a large sample of gamers to the DSM-5 criteria of IGD study compares the component factors outlined in the IGD-
and found the entire assessment to have good reliability and 20 (salience, mood modification, tolerance, withdrawal, conflict,
validity. Moreover, the IGD assessment was shown to correspond and relapse) and the subscales of the VGFA-R (social attention,
within criterion established for the DSM-5 definition of IGD tangible/intangible rewards, escape/avoidance of demands, and
[i.e., Salience – Criterion (a), Mood Modification – Criterion (h), sensory stimulation) by conducting a confirmatory factor analysis
Tolerance – Criterion (c), Withdrawal – Criterion (b), Conflict – (CFA) of video game players at a midwestern university in
Criteria (e, f, g, i), Relapse – Criterion (d)]. However, the utility the United States. By embedding the VGFA-R more firmly
of the assessment is limited beyond providing generalized, non- with the current proposed DSM-5 criteria for IGD, the
specific treatment recommendations or alerting the individual present study provides an examination of the potential overlap
that their gaming behavior puts them in the danger of developing between behavioral motivation and the formal diagnosis of
an addiction. Furthermore, the IGD-20 does not inform the IGD. Furthermore, we were interested in observing if a direct
individual at what point gaming becomes problematic and lacks relationship exists between minutes played in a gaming session
the ability to assist researchers in addressing and reducing the and each scale.
motivation to engage in problematic play.
The field of applied behavior analysis has evaluated
the motivation underlying maladaptive behaviors such as MATERIALS AND METHODS
pathological gambling, sexual addiction, or problematic video
gaming (Cooper et al., 2007; Vollmer et al., 2015). This research Participants
asserts motivation is typically maintained by providing the A total of 320 participants showed initial interest in completing
individuals with at least one of the following functions: (i) social the survey. Of the total number of participants, 304 completed
attention, (ii) tangible/intangible rewards, (iii) escape/avoidance the entire study and had a mean age of 29.82 years (SD = 9.82).
of demands or pain, and (iv) sensory stimulation. Through A total of 178 participants indicated they were female (58.55%)
functional analysis of the antecedents and consequences of a with 126 reporting as male (41.45%). Most of the study
given behavior, it becomes possible to assess the motivation participants reported being White Non-Hispanic (n = 190,
and isolate the main function of a maladaptive, isolating, 62.50%). A total of 37 participants reported being Black or
or undesirable behavior. These are ‘paper-and-pencil’ tasks African American (12.17%), 23 participants reported being Asian
where individuals rank targeted behaviors via clear, simplistic (7.57%), and 30 participants reported being Hispanic or Latino
structured sentences. The Video Game Functional Assessment- (9.87%). Participants played an average of 13.78 h per week
Revised (VGFA-R; Buono et al., 2016) was designed and is (SD = 11.79), and an average of 175.75 min (2.93 h) each time
the only assessment to evaluate the reinforcing behavioral the participant engaged in a gaming session. The average age of
motivation of video game players by assessing the function when study participants first started gaming was 10.94 years of
of their video game play. More recently, Buono et al. (2017) age (SD = 7.54). See Table 1 for other demographic information.
found individuals reporting “high” levels of play (e.g., 24 h For both the Qualtrics’ community engagement tool and
of gaming per week and above) were largely motivated by recruitment at the United States midwestern school, the identical
the escape/avoidance or social attention functions. While inclusion and exclusion criteria were utilized. In which, inclusion
effective at evaluating an individual’s motivation for gameplay, for the study was active video game players who self-reported
further work on the VGFA-R is required to determine if playing video games for at least an hour per week, and individuals
high levels of play meet the criteria of IGD as outlined in who were 18 years or older at the time of the study. Exclusion
the DSM-5. criteria were individuals who did not have access to internet-
The diagnostic criteria of IGD encompass those used in based computer, tablet, or phone to complete the survey.
potentially addictive gameplay, as well as allied behaviors
such as smartphone addiction and problematic internet use Materials
(Lopez-Fernandez et al., 2018). Additionally, the criteria The VGFA-R is a 24-item Likert-style scale was designed to
share characteristics with other behavioral addictions such assess four functions (i.e., attention, escape, tangible, sensory
as pathological gambling and problematic social media use stimulation) that maintain video game play (Buono et al., 2016).
(Wood et al., 2007; Oggins and Sammis, 2010; Pontes and Participants were presented with a question (e.g., I choose to play
Griffiths, 2014; Kuss and Griffiths, 2017; Potenza, 2017). video games when I am nervous or anxious) and were asked
Although several treatment modalities based upon the principle to select one of seven responses (1 = Never, 2 = Almost Never,
of cognitive behavioral therapy are showing initial promise 3 = Seldom, 4 = Half of the time, 5 = Usually, 6 = Almost
(Torres-Rodriguez et al., 2017a,b; Young and Brand, 2017), there Always, 7 = Always). Each behavioral function has six questions
remains a need for rigorous, empirically validated treatments associated with it, and the scores for each question are combined
for IGD. It is thus crucial to provide accurate diagnosis and may range between 7 and 42, with total scores ranging
and effective, empirically validated treatment of individuals between 7 and 168. Higher scores indicate the behavioral function
struggling with video game addiction. Therefore, the focus of is a strong indicator of the motivation for continued video
the present study is to compare the DSM-5 validated assessment game play. The VGFA-R had strong overall internal consistency

Frontiers in Psychology | www.frontiersin.org 2 February 2019 | Volume 10 | Article 310

Sprong et al. Video Game Functional Assessment – Revised

TABLE 1 | Demographic information of video gaming participants (N = 304). the community-engaged recruitment feature was utilized for
the study. The service was requested by entering information
N % of Population
about the study (e.g., characteristics of the study participants we
Hours played/week were targeting), the recruitment script and providing the IRB
0 to 5 88 28.95 approval form. Participants were provided a recruitment email
6 to 11 83 27.30 that disclosed the purpose of the study, the approximate time
12 to 17 57 18.75 that it would take to complete the study, participant inclusion
18 to 23 32 10.53 information (e.g., above the age of 18 years), information related
24+ 44 14.47 to discontinuation of the survey, and that they would be
Relationship status reimbursed for their participation.
Married/domestic 103 33.88 Additionally, a mass-email was approved by the midwestern
partnership university’s IRB to be utilized for recruitment. The identical
In a relationship 24 7.89 recruitment script was distributed twice through email by the
Single 153 50.33 assistant director of information technology to all actively
Divorced/separated 8 2.63 enrolled college students in the academic year of 2017–2018 in
Type of games
the course of a month. Participants that agreed to participate in
played
the study were instructed to click on the link at the bottom of
Role-playing 191 34.12
the recruitment email. The link redirected the study participants
First-person shooter 194 34.19
to the study materials within Qualtrics. The VGFA-R was
Real-time strategy 131 22.47
administered to study participants, followed by demographic
Turn-base 99 24.37
information, and concluding with IGD assessment. The materials
Simulation 187 24.26
were administered in this manner because to provide a break
Sports 117 15.23
between answering questions that have some similarity in
Facebook 154 15.26
phrases. Once participants completed all of the study materials,
a debriefing statement was provided and Qualtrics paid them
directly for their participation.
(α = 0.927) and across the four functions: attention (α = 0.911),
escape (α = 0.796), tangible (α = 0.835), sensory (α = 0.795)
(Buono et al., 2016).
Data Analysis
The IGD Test is a 20-item Likert-style scale was developed A CFA was performed to assess the relationship between the
to assess six components of addictive behavior (e.g., salience, four functions of the VGFA-R and the six factors of the IGD
mood modification, tolerance, withdrawal symptoms, conflict, scales. Previous literature (e.g., Buono et al., 2016, Buono et al.,
and relapse) associated with the DSM-5 criteria for IGD diagnosis 2017) has already established the functions of the VGFA-R, and
(Pontes and Griffiths, 2014). Each component comprises of three Pontes and Griffiths (2014) have cited previous studies that have
to five questions per domain: salience (3), mood modification established the factors of the IGD scale. Holtzman and Vezzu
(3), tolerance (3), withdrawal symptoms (3), conflict (5), and (2011) suggested that once an initial model is established, it is
relapse (3). Participants were presented with a question (e.g., I important to perform CFA to confirm that the hypothesized
often lose sleep because of long gaming sessions) and were asked model provides a good fit to the data. If outcome data are
to choose one of five responses (1 = strongly agree, 2 = agree, collected, such as grades, structural equation modeling (SEM)
3 = neither agree nor disagree, 4 = disagree, 5 = strongly disagree). should also be employed to investigate how well the assessment
All items were reversed scored with the exception of items 2 and predicts these measures. It is important to note that the CFA is a
19, so that a score of 5 was converted to 1, 4 was converted part of the SEM. Whether the factor structure of a non-cognitive
to 2, 2 was converted to 4, and 1 was converted to 5. The instrument is determined using psychological theory or empirical
IGD had strong overall internal consistency (α = 0.925), and research, it is important to perform CFA, which is a special case
each subscale had good internal consistency, including salience of what is known as SEM. SEM typically refers to models where
(α = 0.796), mood modification (α = 0.880), tolerance (α = 0.844), causal relationships are investigated between latent variables.
withdrawal symptoms (α = 0.921), conflict (α = 0.821), and
relapse (α = 0.701).
RESULTS
Procedure Given the Exploratory Factor Analysis findings that were
Approval from the primary author’s institutional review board reported in several other studies evaluating the VGFA-R (i.e.,
(IRB) was requested prior to recruiting participants for the Buono et al., 2016, 2017) indicating a four-factor solution, a CFA
study. Once granted (protocol approval code HS17-0060), was performed to confirm the hypothesized model was a good fit
study materials were developed within the Qualtrics online of data compared to the IGD-20 test. Therefore, we developed
software program. Qualtrics is a password-protected online four a priori factors (i.e., attention, escape, tangible, sensory)
software program that allows a researcher to administer surveys for the VGFA-R. Additionally, we developed six a priori factors
electronically. As a part of other services offered by Qualtrics, for the IGD-20 (e.g., salience, mood modification, tolerance,

Frontiers in Psychology | www.frontiersin.org 3 February 2019 | Volume 10 | Article 310

Sprong et al. Video Game Functional Assessment – Revised

FIGURE 1 | The unstandardized solution for the VGFA-R and IGD-20.

Frontiers in Psychology | www.frontiersin.org 4 February 2019 | Volume 10 | Article 310

Sprong et al. Video Game Functional Assessment – Revised

withdrawal symptoms, conflict, and relapse) given previous TABLE 3 | Structural equation model linear equations.
studies that found six factors (e.g., Pontes and Griffiths, 2014).
Variable Linear equation

Time played during gaming = 0.258 × VGFA-R + 0.4088

Confirmatory Factor Analysis session (minutes) × IGD-20 + error
The CFA for the VGFA-R was estimated with maximum VGFA-R
likelihood (ML) estimation. Chi-square statistic goodness-of- Attention = 5.6623 × VGFA-R + error
fit test, χ2 (34, N = 304) = 271.64, p < 0.0001; χ2 /df = 7.99; Escape = 6.6762 × VGFA-R + error
CFI = 0.88; RMSEA = 0.15 (90% confidence interval [CI]; Tangible = 5.3162 × VGFA-R + error
0.14, 0.17). All factor loadings were significant (ranging from Sensory = 6.4199 × VGFA-R + error
5.30 to 6.63), and there was no evidence of cross-loading for IGD-20
any indicator. Since the Chi-square statistic is not close to Salience = 2.6818 × IGD-20 + error
zero and significant, the data would appear to be a weak fit Mood modification = 1.5341 × IGD-20 + error
(Holtzman and Vezzu, 2011). However, Chi-square indicators are Tolerance = 2.4581 × IGD-20 + error
highly dependent on sample size, thus suggesting that other fit Withdrawal = 2.6567 × IGD-20 + error
indices be examined. Therefore, other indices were exampled and Conflict = 3.1425 × IGD-20 + error
reported above (e.g., CFI, RMSEA). The unstandardized solution Relapse = 2.5031 × IGD-20 + error
produced a score of 0.68, which indicates a moderate to good
relationship between the two scales (see Figure 1). Examination
of the residual correlations, which are the differences between VGFA-R and Minutes Played Each
the observed and model-implied correlations, did not reveal any Gaming Session and Hours Played per
problem related to the indicators of the latent variables (Weston
and Gore, 2006). The results suggest that the VGFA-R model Week
approached acceptable levels (CFI = 0.88, where 0.90 is needed for Several multiple linear regression analyses were performed to
acceptable fit), indicating other fit indices needing to be explored. determine if each function of the VGFA-R could be predicted
Correlations among the latent variables and factor loadings of the from the minutes played in each gaming session and the
measurement model are presented in Table 2. estimated number of hours played each week. The null hypothesis
tested was the regression coefficient (i.e., slope) as equal to
zero. The data were screened for missingness and violation
Structural Model of assumptions prior to analysis. There were no missing data.
In order to fully examine the behavioral functions of the VGFA- Results of the regression analysis suggested that all of the
R, we used SEM to test the relationships among the VGFA-R functions were significantly predicted by minutes played during
constructs and the IGD-20. This was performed using PROC each gaming session, including attention [F(2,311) = 19.47,
CALIS in SAS. Even though previous studies have provided p < 0.001, r2 = 0.41], escape [F(2,311) = 28.765, p < 0.001,
empirical evidence for the application of the VGFA-R in r2 = 0.67], tangible [F(2,311) = 21.957, p < 0.001, r2 = 0.54], and
understanding the function that maintains video game play, there sensory [F(2,311) = 22.412, p < 0.001, r2 = 0.69]. The individual
is limited research connecting the behavioral function and factors predictors were examined further for attention and indicated that
of the IGD-20 that established items consistent with DSM-5 minutes played each gaming session (t = 2.44, p = 0.015) and
criteria for IGD diagnosis. The VGFA-R demonstrated acceptable hours played each week (t = 4.02, p = 0.015) were significant
fit to the data, χ2 (42, N = 304) = 304.57, p < 0.0001; χ2 /df = 7.25; predictors in the model. The individual predictors were examined
CFI = 0.88; RMSEA = 0.14 (90% confidence interval [CI]; 0.13, further for the escape function and indicated that minutes played
0.16). The structural relationships among the VGFA-R and IGD- each gaming session (t = 2.68, p = 0.008) and hours played
20 are depicted in Figure 1. The corresponding linear equations each week (t = 6.16, p < 0.001) were significant predictors in
are presented in Table 3. the model. The individual predictors were examined further for
the tangible function and indicated that minutes played each
gaming session (t = 0.132, p = 0.03) and hours played each week
(t = 5.51, p < 0.001) were significant predictors in the model.
TABLE 2 | Correlation coefficients between levels of the VGFA-R and IGD-20 test. The individual predictors were examined further for the sensory
VGFA-revised
function and indicated that minutes played each gaming session
(t = 3.58, p < 0.001) and hours played each week (t = 4.54,
Attention Escape Tangible Sensory p < 0.001) were significant predictors in the model.
IGD-20 Test Salience 0.370 0.589 0.412 0.438
Mood 0.106 0.606 0.298 0.246
Tolerance 0.343 0.613 0.493 0.517 DISCUSSION
Withdrawal 0.278 0.595 0.368 0.406
Conflict 0.337 0.550 0.282 0.401 The present study compared the DSM-5 criteria of the 20-item
Relapse 0.320 0.538 0.279 0.397 IGD Test (IGD-20) with the behavioral functions evaluated

Frontiers in Psychology | www.frontiersin.org 5 February 2019 | Volume 10 | Article 310

Sprong et al. Video Game Functional Assessment – Revised

by the 24-item VGFA-R. More specifically, it compared desirability and memory recall). However, these are present
the component factors of the IGD-20 (salience, mood in all studies using self-report data and readers are advised
modification, tolerance, withdrawal, conflict, and relapse) with to take this into account when interpreting the data. The
the VGFA-R subscales (social attention, tangible/intangible sample size was modest (although acceptable for the kinds of
rewards, escape/avoidance of demands, sensory stimulation) analysis carried out). Future studies should replicate the present
by conducting a CFA of 304 United States student video game study with larger and more representative samples (especially
players. Findings indicated a significant relationship between the those who are representative of the gaming community
two instruments. Given that the two instruments were designed rather than a particular country, although cultural differences
in completely different ways for potentially different purposes, are likely).
and the fact that they are so highly correlated suggests that the The present study demonstrates that high scores on
VGFA-R could be used by clinicians and practitioners as an VGFA-R and the IGD-20 are significantly correlated with
adjunct to the IGD-20 and provide extra information relating each other and each scale provides evidence of construct
to the motivations underlying the problematic gaming among validity for the other that they are assessing what they are
their clients. supposed to be assessing. Motivations play an important role
Looking at the individual correlations in Table 2, it is in the development of problematic gaming and the present
evident that the motivation most correlated with the six IGD- study appears to show that escape is the most important
20 criteria is that of escape (all six correlations above 0.53). motivational factor in repeat playing. We found that all four
This confirms previous research showing that escape is often motivations in the VGFA-R (i.e., escape, attention, sensory,
one of the key motivating factors among those experiencing tangible) were strong predictors of the duration of time a
problematic video gaming, especially when used as a coping gamer will play in a single gaming session (measured by
strategy to forget about other negative experiences in the gamer’s minutes played each gaming session). Given the findings
life (e.g., Sattar and Ramaswamy, 2004; Wan and Chiou, 2006a,b; from previous research and findings from the current study,
Wood et al., 2007; Hussain and Griffiths, 2009; Griffiths, 2010). the VGFA-R may be a useful tool in the development of
The escape motivation was also a significant predictor of the clinical interventions and further research that investigates
amount of time spent gaming both within-session and across methods of reducing undesired play when video gaming
the whole week (i.e., the more the motivation was to escape, becomes problematic.
the greater amount of time spent gaming within-session and
weekly). Although the exact reasoning as to why the duration
of video gaming increased for participants scoring high in the ETHICS STATEMENT
escape function category, previous studies (e.g., Kim et al.,
2017) have found that individuals that could be classified as Ethics Committee: Jeanette Gommel (Research Compliance
having internet game addiction were attempting to escape from Coordinator), Office of Research Compliance, Integrity and
negative emotions such as major depressive disorder, dysthymia, Safety, Division of Research and Innovation Partnerships. The
and depressive disorders. Previous research has identified that consent procedure was discussed within the manuscript but
video gaming behavior is due to one of the four behavioral participants were recruited in two ways (students at a Midwestern
functions as measured by the VGFA-R. For example, Fuster University – a mass email system sent out our recruitment
et al. (2013) found that socialization (equivalent to attention email discussing the study methodologies and their rights
function from the VGFA-R), achievement (equivalent to the to participate, and Qualtrics community engaged recruitment
tangible function from the VGFA-R), and escapism and/or stress program). Participants were allowed to click on the link if
relief (equivalent to the escape function from the VGFA-R) they wished to participate or close their browsers if they did
were all components related to why people are motivated to not want to participate. After receiving the recruitment email,
play video games. Other studies, such as Hilgard et al. (2013) they were taken to a consent page where they were again told
explored the risk factors associated with pathological game their rights to participate and discontinue at any time without
use (defined as excessively frequent or prolonged use) and penalization. We did not know who participated so all data was
found three primary factors related to pathological game usage, anonymous. No vulnerable populations participated (we do not
including (1) the use of games to escape daily life, (2) the use know if our participants had disabilities or not because we did
of games as a social outlet, and (3) positive attitudes toward not ask).
the steady accumulation of in-game rewards (perhaps building
a desired character to represent what the gamer wishes their
real-life was). AUTHOR CONTRIBUTIONS
The present study is not without its limitations. The
data were self-report and the participants were recruited via MS and FB designed the study and wrote the methods
convenience sampling that is unlikely to be representative section. MG assisted with introduction and wrote discussion
of the United States population or the gamer population. section. EP and MS analyzed the data. MS wrote up the
The use of self-report data is known to have a number results section. DL wrote the introduction and conducted
of well-known biases (most notably biases concerning social literature review.

Frontiers in Psychology | www.frontiersin.org 6 February 2019 | Volume 10 | Article 310

Sprong et al. Video Game Functional Assessment – Revised

REFERENCES Pontes, H. M., and Griffiths, M. D. (2014). Assessment of internet gaming disorder
in clinical research: past and present perspectives. Clin. Res. Regul. Aff. 31,
American Psychiatric Association [APA] (2013). Diagnostic and Statistical Manual 35–48. doi: 10.3109/10601333.2014.962748
of Mental Disorders, 5th Edn. Washington, DC: American Psychiatric Potenza, M. N. (2017). Clinical neuropsychiatric considerations regarding
Association. doi: 10.1176/appi.books.9780890425596 nonsubstance or behavioral addictions. Dialogues Clin. Neurosci. 19, 281–291.
Buono, F. D., Sprong, M. E., Lloyd, D. P., Cutter, C., Printz, D. M. B., Sullivan, Sattar, P., and Ramaswamy, S. (2004). Internet gaming addiction. Can. J. Psychiatry
R. M., et al. (2017). Delay discounting of video game players: comparison of 49, 871–872. doi: 10.1177/070674370404901225
time duration among gamers. Cyberpsychol. Behav. Soc. Netw. 20, 104–108. Starcevic, V., and Billieux, J. (2017). Does the construct of internet addiction
doi: 10.1089/cyber.2016.0451 reflect a single entity or a spectrum of disorders? Clin. Neuropsychiatry
Buono, F. D., Upton, T. D., Griffiths, M. D., Sprong, M. E., and Bordieri, J. (2016). 14, 5–10.
Demonstrating the validity of the video game functional assessment-revised Torres-Rodriguez, A., Griffiths, M. D., and Carbonell, X. (2017a). The treatment
(VGFA-R). Comput. Hum. Behav. 54, 501–510. doi: 10.1016/j.chb.2015.08.037 of internet gaming disorder: a brief overview of the PIPATIC program.
Cooper, J. O., Heron, T. E., and Heward, W. L. (2007). Applied Behavior Analysis, Int. J. Ment. Health Addict. doi: 10.1007/s11469-017-9825-0 [Epub ahead
2nd Edn. Columbus, OH: Merrill Prentice Hall. of print].
Fuster, H., Carbonell, X., Charmarro, A., and Oberst, U. (2013). Interaction Torres-Rodriguez, A., Griffiths, M. D., Carbonell, X., Farriols-Hernando, N., and
with the game and motivation among players of massively multiplayer online Torres-Jimenez, E. (2017b). Internet gaming disorder treatment: a case study
role-playing games. Span. J. Psychol. 16:E43. doi: 10.1017/sjp.2013.54 evaluation of four adolescent problematic gamers. Int. J. Ment. Health Addict.
Griffiths, M. D. (1996). Internet addiction: an issue for clinical psychology? Clin. doi: 10.1007/s11469-017-9845-9 [Epub ahead of print].
Psychol. Forum 97, 32–36. Vollmer, T. R., Peters, K. P., and Slocum, S. (2015). “Treatment of severe behavior
Griffiths, M. D. (2000). Internet addiction-time to be taken seriously? Addict. Res. disorders,” in Clinical and Organizational Applications of Behavior Analysis, eds
8, 413–418. doi: 10.3109/16066350009005587 H. S. Roane, J. E. Ringdahl, and T. S. Falcomata (Waltham, MA: Elsevier),
Griffiths, M. D. (2005). A components model of addiction within a biopsychosocial 47–68. doi: 10.1016/B978-0-12-420249-8.00003-4
framework. J. Subst. Use 10, 191–197. doi: 10.1080/14659890500114359 Wan, C. S., and Chiou, W. B. (2006a). Psychological motives and online games
Griffiths, M. D. (2010). The role of context in online gaming excess and addiction: addiction: a test of flow theory and humanistic needs theory for Taiwanese
some case study evidence. Int. J. Ment. Health Addict. 8, 119–125. doi: 10.1007/ adolescents. Cyberpsychol. Behav. 9, 317–324. doi: 10.1089/cpb.2006.9.317
s11469-009-9229-x Wan, C. S., and Chiou, W. B. (2006b). Why are adolescents addicted to online
Hilgard, J., Engelhardt, C. R., and Bartholow, B. D. (2013). Individual differences gaming? an interview study in Taiwan. Cyberpsychol. Behav. 9, 762–766. doi:
in motives, preference, and pathology in video games: the gaming attitudes, 10.1089/cpb.2006.9.762
motives, and experiences scales (GAMES). Front. Psychol. 4:608. doi: 10.3389/ Weston, R., and Gore, P. A. Jr. (2006). A brief guide to structural equation
fpsyg.2013.00608 modeling. Couns. Psychol. 34, 719–751. doi: 10.1177/0011000006286345
Holtzman, S., and Vezzu, S. (2011). Confirmatory Factor Analysis and Structural Wood, R. T. A., Griffiths, M. D., and Parke, A. (2007). Experiences of time loss
Equation Modeling of Noncognitive Assessments Using PROC CALIS. Princeton, among videogame players: an empirical study. Cyberpsychol. Behav. 10, 45–56.
NJ: Educational Testing Services. doi: 10.1089/cpb.2006.9994
Hussain, Z., and Griffiths, M. D. (2009). The attitudes, feelings, and experiences Young, K. (1996). Psychology of computer use: XL. Addictive use of the internet:
of online gamers: a qualitative analysis. Cyberpsychol. Behav. 12, 747–753. doi: a case that breaks the stereotype. Psychol. Rep. 79, 899–902. doi: 10.2466/pr0.
10.1089/cpb.2009.0059 1996.79.3.899
Kim, D. J., Kim, K., Lee, H. W., Hong, J. P., Cho, M. J., Fava, M., et al. (2017). Young, K. S., and Brand, M. (2017). Merging theoretical models and therapy
Internet game addiction, depression, and escape from negative emotions in approaches in the context of internet gaming disorder: a personal perspective.
adulthood: a nationwide community sample of Korea. J. Nerv. Ment. Dis. 205, Front. Psychol. 8:1853. doi: 10.3389/fpsyg.2017.01853
568–573. doi: 10.1097/NMD.0000000000000698
Kuss, D. J., and Griffiths, M. D. (2017). Social networking sites and addiction: Conflict of Interest Statement: The authors declare that the research was
ten lessons learned. Int. J. Environ. Res. Public Health 14:E311. doi: 10.3390/ conducted in the absence of any commercial or financial relationships that could
ijerph14030311 be construed as a potential conflict of interest.
Lopez-Fernandez, O., Männikkö, N., Kääriäinen, M., Griffiths, M. D., and Kuss,
D. J. (2018). Mobile gaming does not predict smartphone dependence: a cross- Copyright © 2019 Sprong, Griffiths, Lloyd, Paul and Buono. This is an open-access
cultural study between Belgium and Finland. J. Behav. Addict. 7, 88–99. doi: article distributed under the terms of the Creative Commons Attribution License
10.1556/2006.6.2017.080 (CC BY). The use, distribution or reproduction in other forums is permitted, provided
Oggins, J., and Sammis, J. (2010). Notions of video game addiction and their the original author(s) and the copyright owner(s) are credited and that the original
relation to self-reported addiction among players of World of Warcraft. Int. J. publication in this journal is cited, in accordance with accepted academic practice. No
Ment. Health Addict. 10, 210–230. doi: 10.1007/s11469-010-9309-y use, distribution or reproduction is permitted which does not comply with these terms.

Frontiers in Psychology | www.frontiersin.org 7 February 2019 | Volume 10 | Article 310