236 - Partnering with Caregivers to Create a Screening Tool for Internet Gaming Disorder

Publication Number: 4232.236

Emily Wassmer, Children’s Hospital of Philadelphia, Drexel Hill, PA, United States; Alex Holdaway, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Thomas Power, Childrens Hospital of Philadelphia, Philadelphia, PA, United States

Background: The Diagnostic and Statistical Manual, 5th Edition (DSM-5) includes provisional criteria for Internet Gaming Disorder (IGD) as a condition requiring further research. More than 80% of American children play video games, and there has been growing concern in recent decades about the impact of gaming on the physical and mental health of young children.

Objective: Existing screening tools based on IGD criteria are self-report measures for adolescents. To our knowledge, there are few, if any, parent-report measures and tools available for children younger than age 13. Our multidisciplinary team aimed to create a parent-report screening tool based on DSM-5 IGD criteria with modifications that incorporated caregiver feedback.

Design/Methods: IGD DSM-5 criteria were adapted into survey questions by a team including professionals in DBP and psychology. We conducted cognitive interviewing in groups with caregivers of children with various medical conditions, along with one-on-one contexts with mothers of children with ADHD age 6-11.

Results: Interviews resulted in changes to the survey including: anchors for scaled response options, inclusion of concrete details to aide with descriptions of symptoms, adaptations to ensure developmental appropriateness of questions, and separation of questions that incorporated multiple concepts into individual questions. The original measure was 10 items, each with a yes/no response. After caregiver interviews, the adapted measure is 15 items, each with 4 response options on a Likert-type scale.

Conclusion(s): Gaming Disorder will be the first of the Addiction Disorders that will be broadly applied to young children, so these age groups must be considered when codifying the diagnostic criteria and creating associated standardized tools. Incorporating input of caregivers is an important step to ensure that a tool is socially valid.

Concern from one mother of a 6-year-old highlights this importance - is a 5 or 6-year-old child's gaming increasing over a one-year period due to addiction, or are they allowed more screen time now that they are one year older?

Next steps for our IGD questionnaire include validating the measure in a large sample of respondents.

Flowchart of survey evolution
Left column: DSM-5 criteria for Internet Gaming Disorder

Middle column: preliminary screening questions modeled after existing screening tools created for IGD or Internet Addiction

Right column: final iteration of IGD screening tool with changes made based on multiple rounds of caregiver input