Ji Yinan, Wong Daniel Fu Keung
Department of Social Work, Hong Kong Baptist University, Hong Kong, China.
Addiction. 2023 Nov;118(11):2093-2104. doi: 10.1111/add.16292. Epub 2023 Jul 12.
AIMS, DESIGN AND SETTING: The aim of this study was to test the efficacy of the integrated cognitive-behavioral therapy with a strength-based motivational approach [integrated cognitive-behavioral therapy (ICBT)] intervention to change gaming disorder (GD) symptoms and other outcomes and to study the therapeutic mechanism. A two-arm parallel randomized waiting-list controlled trial with 3- and 6-month follow-ups were conducted in a secondary vocational school in mainland China.
Participants comprised 77 Chinese adolescents with GD symptoms with a mean age of 16.36 years [standard deviation (SD) = 0.93]; 88.3% were male INTERVENTIONS: Participants were randomized into an ICBT group (n = 38) and a waiting-list control (WLC, n = 39) group. ICBT intervention comprised eight weekly sessions to encourage participants to identify their interests and strengths and set goals for developing personally meaningful real-life activities.
The outcomes were measured at pre-treatment (t ), post-treatment (t ), 3-month (t ) and 6-month (t ) follow-ups. The primary outcome was GD symptoms at t3. Secondary outcomes included GD symptoms at t and t , and gaming motivation, maladaptive gaming cognition, depression and anxiety symptoms at t , t and t . With the intention-to-treat principle, the GD scores at t were significantly different between the CBT and WLC groups [mean difference 62.08 (SD = 10.48) versus 73.64 (SD = 11.70); Hedges' g = 1.15, 95% confidence interval = 0.67-1.62]. Linear mixed-effects modeling showed significant group × time interaction for the secondary outcomes (P < 0.01), with a moderate to strong between-group effect size in the reduction in depression symptoms (g = 0.67-0.84) and anxiety symptoms (g = 0.6-0.64). Path analysis shows ICBT leads to GD reduction through reducing gaming motivation and maladaptive gaming cognition.
An integrated cognitive-behavioral therapy with strength-based motivational approach intervention reduced gaming disorder symptoms and time spent gaming over a 6-month period by decreasing maladaptive gaming motivation and cognition.
目的、设计与背景：本研究旨在测试采用基于优势的动机性方法的综合认知行为疗法（ICBT）干预对改变游戏障碍（GD）症状及其他结果的疗效，并研究其治疗机制。在中国大陆的一所中等职业学校进行了一项双臂平行随机等待列表对照试验，并进行3个月和6个月的随访。
参与者包括77名有GD症状的中国青少年，平均年龄为16.36岁[标准差（SD）=0.93]；88.3%为男性。干预措施：参与者被随机分为ICBT组（n=38）和等待列表对照组（WLC，n=39）。ICBT干预包括每周一次的八次课程，鼓励参与者识别自己的兴趣和优势，并为开展个人有意义的现实生活活动设定目标。
在治疗前（t₁）、治疗后（t₂）、3个月（t₃）和6个月（t₄）随访时测量结果。主要结果是t₃时的GD症状。次要结果包括t₁和t₂时的GD症状，以及t₁、t₂和t₄时的游戏动机、适应不良的游戏认知、抑郁和焦虑症状。根据意向性分析原则，CBT组和WLC组在t₃时的GD得分有显著差异[平均差异62.08（SD=10.48）对73.64（SD=11.70）；Hedges'g=1.15，95%置信区间=0.67-1.62]。线性混合效应模型显示次要结果存在显著的组×时间交互作用（P<0.01），在抑郁症状减轻（g=0.67-0.84）和焦虑症状减轻（g=0.6-0.64）方面，组间效应大小为中度至强。路径分析表明，ICBT通过降低游戏动机和适应不良的游戏认知导致GD减少。
采用基于优势的动机性方法的综合认知行为疗法干预，通过减少适应不良的游戏动机和认知，在6个月内减轻了游戏障碍症状和游戏时间。
