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Title:Long term effects of video and computer game heavy use on health, mental health and education outcomes among adolescents in the U.S.
Author(s):Liu, Chennan
Director of Research:Smith, Douglas C.
Doctoral Committee Chair(s):Liechty, Janet M.; Smith, Douglas C.
Doctoral Committee Member(s):Robinson-Cimpian, Joseph P.; Ostler, Teresa A.; Ackerson, Barry J.; Zhang, Saijun
Department / Program:School of Social Work
Discipline:Social Work
Degree Granting Institution:University of Illinois at Urbana-Champaign
Degree:Ph.D.
Genre:Dissertation
Subject(s):Internet addiction
gaming addiction
heavy gaming
Internet gaming disorder
video and computer use
Adolescents
physical health
Body Mass Index (BMI)
Obesity
general health
mental health
depression
substance use
conduct disorder
education outcomes
high school drop out
total years of education
longitudinal design
propensity score matching
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
Add Health
Abstract:Video and computer gaming addiction, also called gaming disorder and pathological gaming, is an emerging behavioral problem for adolescents. Previous studies have investigated the associated negative outcomes of this putative mental health problem, such as academic failure, physical and mental health problems, but findings have been inconsistent and have methodological weaknesses. Most studies have been cross-sectional, which could not establish temporal order. Furthermore, the limited longitudinal studies found in this field failed to control for baseline health, mental health, academic achievement, gaming frequency and other confounding variables. Therefore, it is not known whether gaming addiction itself can cause long term negative consequences or whether gaming addiction is just associated with other problems. One of the main symptoms of gaming addiction is heavy gaming, defined by persistent and recurrent engagement in gaming for many hours. Even though some studies have investigated the association between heavy gaming and gaming addiction, there is no study focusing on how different cut-off points of heavy gaming predict long-term health, mental health and education outcomes differently. Therefore, it is unclear what cut points (i.e., number of hours of play) should be used to define heavy gaming. This study addresses the above gap by using a longitudinal design that tracked video and computer gaming from adolescence into young adulthood. Data analysis was performed using three waves of the National Longitudinal Study of Adolescent Health (1994-1995, 1996, 2001-2002), a nationally representative panel study. Heavy video and computer gaming was defined as at least 21 hours/week usage on video or computer gaming, with additional usage cut-off points recorded at >35, 42 and 56 hours. A propensity score matching (PSM) method, adding school fixed effect and sampling weight components, was used to create two equivalent groups using different cut-off points in Wave 2 based on 29 matching variables in Wave 1. Matching variables included: demographics, personal characteristics, parenting style, peer relationship, school attachment, community characteristics, as well as baseline conditions of health, mental health and education outcome variables. Then multiple regressions were used to predict Wave 3 (W3) health, mental health and education outcomes based on two equivalent groups created by PSM. Matched adolescent peers below each gaming usage cut-off point were compared to heavy users on W3 outcomes. All 29 matching variables were also included as controls. Conservative Bonferroni test were used in the above regression analysis. Results of fully adjusted multivariate analyses suggested that playing video and computer games 21 hours or more per week during adolescence was longitudinally associated with less likelihood of high school completion five years later (coef. =-.074, p<.001, effect size = -.206), higher likelihood of better self-reported health (coef. =.143, p<.01, effect size = .191), and less likelihood of obesity (coef. = -.084, p<.001, effect size =-.029). Playing video and computer games 35 hours or more per week was longitudinally associated with higher likelihood of better self-reported health five years later (coef. =.319, p<.001, effect size =.464), less likelihood of obesity (coef.=-.173, p<.001, effect size =-.454), less likelihood of marijuana use (coef.=-.222, p<.001, effect size = -.591), and more total years of education (coef.=.319, p<.001, effect size =.229). Playing video and computer games 42 hours or more per week was longitudinally associated with higher likelihood of better self-reported health five years later (coef.=.284, p<.001, effect size =.482), higher likelihood of depression (coef.=.227, p<.001, effect size =.731), less likelihood of conduct disorder (coef.=-.038, p<.001, effect size =-.427), and less likelihood of marijuana use (coef.=-.147, p<.001, effect size =-.468). Based on these findings, it is not possible to provide one single cut-off for heavy gaming which serves as a risk indicator for long term negative consequences. Instead, this study provides a mixed picture: heavy gaming has both negative and positive effects on health, mental health and education outcomes. Overall, findings showed that adolescents’ heavy video and computer gaming use, based on gaming behavior measured in 1996, was longitudinally associated with long term negative outcomes, such as less high school completion and higher likelihood of depression five years later. However, heavy gaming actually predicted less marijuana use after five years, which is different from previous studies. Furthermore, heavy gaming was associated with better health outcomes, which is also different from previous studies. Therefore, based on this study, heavy gaming is not merely a symptom of underlying mental health problems like depression; in the absence of baseline depression during adolescence, heavy gaming predicted depression in young adulthood. Moreover, the mixed findings, whereby heavy gaming induced both negative and positive outcomes, suggest that gaming addiction is not yet understood well enough to be a new category in the DSM-5. More research is needed to determine the exact nature and consequences of video game addiction, and because of the mixed results it is unclear at this time whether more or less video and computer game use should be recommended. Even though there appear to be some positive health outcomes associated with video game use, at least based on gaming options circa 1996, this study suggests that limiting gaming use to less than 3 hours per day may be beneficial during the formative years of adolescence, to reduce the risk of long term negative outcomes such as high school dropout and depression.
Issue Date:2014-09-16
URI:http://hdl.handle.net/2142/50742
Rights Information:Copyright 2014 Chennan Liu
Date Available in IDEALS:2014-09-16
Date Deposited:2014-08


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