Internet Gaming Disorder (IGD) in children: case studies and clinical treatment insights

Objective: Although the formalisation of Internet Gaming Disorder (IGD) and Gaming Disorder (GD) as psychiatric disorders has allowed a once divided field more clarity in working towards common treatment goals, there is still a paucity of detailed information about the causes, presentation and treatment of these disorders, particularly in children under 14. The aim of the current study was to conduct a series of case studies to provide an in-depth account of six paediatric cases aged between 11-13 years old, representing the youngest cohort to date in the IGD/GD case study literature, and the associated risk factors and impacts on development in each case. A further aim was to compare presenting symptoms with published IGD and GD diagnostic criteria and to evaluate a multi-modal parent/child treatment approach. Methods: Case files from six children at the Internet Addiction Clinic @ Kidspace (Sydney) were analysed for evidence of a range of factors including: amount of daily screen use, risk factors for developing IGD and GD, impact on development, symptoms relevant to IGD and GD diagnostic criteria and treatment outcomes. Results: Risk factors for developing IGD and GD, including social isolation, self-control difficulties, impulsivity, family conflict, lack of warmth in the family, bullying and low self-esteem were prominent, with all six cases displaying evidence of at least four risk factors. Social isolation was present only in the older sample (13-year-olds). Social, behavioural, educational and health domains were found to be impacted in multiple areas for all 6 children; however, the two younger children (aged 11 and 12 years) displayed less impact on development than the 13-year-old cases. Five cases met criteria for IGD, and four cases met criteria for GD. The study found evidence that the multi-modal parent/child treatment approach used facilitated positive outcomes, including better family communication and relationships, reduced aggression and impulsivity, improvements in school refusal and goal setting, improved social and peer connections, and improved sleep hygiene. Conclusions: The multi-model parent/child treatment approach used may be an effective means to address risk factors and increase protective factors in the development of IGD/GD, forming a “circuit breaker” for developmental impacts and functioning and reducing symptoms of IGD in children. Results suggest that early intervention strategies for problematic screen use and IGD should focus on primary school aged children before the pivotal transition to high school where developmental impacts can compound in a more chronic or comorbid course.