Autism May Boost Risk for 'Addictive' Gaming Behavior

Deborah Brauser

July 31, 2013

Children with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) may be at increased risk for "problematic" video and computer game use, new research suggests.

A study of 141 adolescent boys showed that although those with ASD spent the most time playing video games, both those with ASD and those with ADHD were at significantly greater risk for addictive and aggressive game use than were their typically developing (TD) peers.

In addition, symptoms of inattention in both the ASD and ADHD groups were strongly linked to increased risk for problematic game use, as was a preference for role-playing games in those with ASD.

"Even after controlling for the relationship between total video game exposure and problematic game play, we found that diagnostic group was a strong predictor for problem video behaviors," coinvestigator Christopher R. Engelhardt, PhD, from the Thompson Center for Autism and Neurodevelopmental Disorders in Columbia, Missouri, told Medscape Medical News.

"And the strongest predictor was between those with autism and those who were typically developing," said Dr. Engelhardt. "The number 1 take-away is that people with autism are at greater risk for developing problematic video game play. And if these symptoms become apparent, parents may want to pay attention to potential consequences."

The study was published online July 29 in Pediatrics.

First Study of Its Kind

According to Dr. Engelhardt, individuals with ASD and with ADHD tend to be exposed to more media than the general population.

"So we were curious about the relationship between developmental disorders and propensity to develop video game problem behaviors/addiction," he said.

Dr. Christopher Engelhardt

"This was particularly exciting for us because no study looking at this had ever compared people with ADHD, people with ASD, and typical people all in the same study."

The investigators enrolled 141 boys between the ages of 8 and 18 years (mean age, 11.7 years) who were clinically diagnosed with ASD (n = 56) or ADHD (n = 44), or who were deemed TD (n = 41).

"Due to the significant gender differences in ASD and ADHD prevalence and phenotypes..., the current study examined video game use among boys only," report the investigators.

Parents of all of the participants were given questionnaires that asked about daily use of video/computer games, in-room access, and genre of games played.

They were also asked about symptoms of inattention and hyperactivity/impulsivity on the Vanderbilt ADHD Parenting Rating Scale and about ASD symptoms on the Social Communication Questionnaire–Current.

In addition, the parents filled out the 19-item Problem Video Game Playing Test. Dr. Engelhardt reported that examples of problematic game use included becoming angry or aggressive during play "or items that indicate that video games disrupted daily activities or interfered with their health or relationships."

Poor Impulse Control

Results showed that the group with ASD averaged significantly more daily video game use than the TD group (2.1 hours vs 1.2 hours, P = .01). Use by those with ADHD did not differ significantly from use by either of the other 2 groups.

However, both the ASD and ADHD groups were at significantly greater risk for problematic video game use (P = .001 and P = .03, respectively) compared with the TD group.

The ASD and ADHD groups also had greater in-room access to video games (P = .001 and P = .002, respectively).

In both of these groups, inattention was a strong adjusted predictor of problematic game use (P = .01 and P = .04, respectively). However, a link between a preference for role-playing games and problematic game use was found only in the boys with ASD (P = .03).

Hyperactivity was not a significant predictor in either group.

"These results shed light into potential associated features of problematic game use," write the investigators.

"Children with ASD and those with ADHD experience difficulties with impulse control and response inhibition, and these problems appear to be closely related to video game preoccupation," they add.

Future studies should assess whether maladaptive video game use leads to attention problems in boys with ASD or if attention problems can cause problematic game use — "and whether there are bidirectional influences," note the researchers.

"It's unclear from our study what causes what at this point. For example, it could be that people with problematic gaming behaviors just prefer role playing games. So it's a little difficult to say what the order of causality is," said Dr. Engelhardt.

"We do know that there are associations, at least. But why or what the causal mechanism is is still a little unclear at this point."

The study was funded by a grant from the University of Missouri Research Board. The study authors have disclosed no relevant financial relationships.

Pediatrics. Published online July 29, 2013. Full article


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