July 28, 2021
A Spanish team of researchers recently completed a comprehensive review of studies looking for links between compulsive video gaming (both online and offline) and a variety of psychological disorders, including anxiety, depression, social phobia, and ADHD. The focus was on behavior "of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning."
The team identified 24 studies, of which eight with a combined total of 16,786 participants looked for associations with either ADHD or its hyperactivity component. Participants included children, adolescents, and adults. One large longitudinal study, with 3,034 participants, found no association. Another study with 1,095 participants found a small effect. Two more, with a combined total of 11,868 found medium effect sizes. Four studies found large associations, but their combined total number of participants, was789, comprising less than a twentieth of the combined participants.
The authors concluded, "The relationship between Internet Gaming Disorder and ADHD and hyperactivity symptoms were analyzed in eight studies. Seven of them reported full association, with four finding large, two finding small, and one reporting moderate, effect sizes. The studies comprised two case-control, five cross-sectional and one longitudinal design; they later found no association between the two variables."[1]They also emphasized that 87 percent "of the studies describe significant correlations ... with ADHD or hyperactivity symptoms."[2]
Yet they did not note that all the studies with large effect sizes were comparatively small. And while they presented funnel charts evaluating publication bias for anxiety and depression, they did not do so for ADHD, where the small studies with very large effect sizes suggest publication bias (i.e., that evidence for association is exaggerated due to the early publication of positive findings).
Leaving out these small studies, the four high-powered studies with 15,997 participants reported effect sizes ranging from none to medium. Overall, that suggests that there is an association between ADHD and video gaming, though not a particularly strong one. Moreover, due to the nature of the study designs, this work cannot conclude that the small effect observed is due to playing video games being a risk factor for ADHD or to the possibility that ADHD youth are more attracted to video games than others.
Vega GonzaÌlez-Bueso, Juan JoseÌSantamariÌa, Daniel FernaÌndez, Laura Merino, Elena Montero, and Joan Ribas, "Association between Internet Gaming Disorder or Pathological Video-Game Use and ComorbidPsychopathology: A Comprehensive Review," International Journal of environmental Research and Public Health, vol. 15, 668(2018).