Narita Zui C, DeVylder Jordan, Knowles Gemma, Ando Shuntaro, Yamasaki Syudo, Miyashita Mitsuhiro, Stanyon Daniel, Yamaguchi Satoshi, Furukawa Toshiaki A, Kasai Kiyoto, Nishida Atsushi
National Center of Neurology and Psychiatry, Tokyo, Japan.
New York University, New York, NY, USA.
Commun Psychol. 2025 Aug 4;3(1):117. doi: 10.1038/s44271-025-00296-5.
Theoretical models suggest that attention-deficit/hyperactivity and problematic online gaming could contribute to negative mental health outcomes, yet evidence on their interplay remains limited. Using data from 3171 adolescents in the Tokyo Teen Cohort, the present study examined the interplay of attention-deficit/hyperactivity at age 12 and problematic online gaming at age 14 associated with mental health issues at age 16. The sample consisted of 1487 girls (46.9%) and 1684 boys (53.1%). Doubly robust estimation revealed that a high degree of problematic online gaming consistently elevated the absolute and relative risks of mental health issues. The fully adjusted risk difference and risk ratio (95% confidence intervals (CIs)) were: incident depression, 7.8% (3.0%-13.1%) and 1.62 (1.25-2.05); incident anxiety, 5.7% (2.7%-8.7%) and 1.98 (1.45-2.67); incident psychotic experiences, 5.9% (2.3%-10.8%) and 1.72 (1.30-2.47); diminished well-being, 9.6% (5.1%-14.3%) and 1.54 (1.27-1.84). Higher attention-deficit/hyperactivity scores were associated with a greater degree of problematic online gaming (adjusted β per 1 SD: 0.18, 95% CI: 0.12-0.24). Causal mediation analysis-ensuring temporal plausibility, carefully adjusting for confounders, and accounting for exposure-mediator interaction-showed that problematic online gaming partially mediated the association between attention-deficit/hyperactivity and mental health issues: depressive symptoms (29.2%), anxiety (12.3%), psychotic experiences (20.6%), and diminished well-being (22.1%). The findings highlight the interplay of psychopathology, diminished inhibitory control, and addictive behaviors associated with negative consequences. Problematic online gaming may represent a modifiable mediator, warranting further intervention research to examine its potential as a treatment target.
理论模型表明，注意力缺陷多动障碍和有问题的网络游戏可能会导致负面心理健康结果，但关于它们之间相互作用的证据仍然有限。本研究利用东京青少年队列中3171名青少年的数据，考察了12岁时的注意力缺陷多动障碍与14岁时的有问题的网络游戏之间的相互作用，以及它们与16岁时心理健康问题的关联。样本包括1487名女孩（46.9%）和1684名男孩（53.1%）。双重稳健估计显示，高度有问题的网络游戏持续提高了心理健康问题的绝对风险和相对风险。完全调整后的风险差异和风险比（95%置信区间）分别为：新发抑郁症，7.8%（3.0%-13.1%）和1.62（1.25-2.05）；新发焦虑症，5.7%（2.7%-8.7%）和1.98（1.45-2.67）；新发精神病体验，5.9%（2.3%-10.8%）和1.72（1.30-2.47）；幸福感降低，9.6%（5.1%-14.3%）和1.54（1.27-1.84）。较高的注意力缺陷多动障碍得分与更高程度的有问题的网络游戏相关（每标准差调整后的β值：0.18，95%置信区间：0.12-0.24）。因果中介分析——确保时间上的合理性、仔细调整混杂因素并考虑暴露-中介相互作用——表明，有问题的网络游戏部分介导了注意力缺陷多动障碍与心理健康问题之间的关联：抑郁症状（29.2%）、焦虑（12.3%）、精神病体验（20.6%）和幸福感降低（22.1%）。研究结果突出了精神病理学、抑制控制能力下降和成瘾行为之间的相互作用及其带来的负面后果。有问题的网络游戏可能是一个可改变的中介因素，值得进一步开展干预研究，以考察其作为治疗靶点的潜力。
