title: Stress vulnerability in male youth with Internet Gaming Disorder.
abstract: Internet Gaming Disorder [IGD] was introduced as new behavioral addiction in DSM-5 Section 3. Vulnerability to stress is a potential predisposing factor for IGD. Given a lack of preexisting empirical data, the study investigated differences in the psychological and neurobiological response to acute stress in patients with IGD. 24 young men (mean age 18.38 years; range 13-25 years) fulfilling DSM-5 criteria for IGD and 25 matched controls underwent the Trier Social Stress Test [TSST]. Participants provided hair samples for the analysis of basal hypothalamic-pituitary-adrenal [HPA] axis activity and clinical interviews were conducted to assess psychopathology. During the experiment, participants reported on their subjective stress experience and momentary affect, provided samples of salivary cortisol and their heart rate was continuously recorded. Patients with IGD reported greater everyday and chronic stress, as well as psychopathological comorbidity. No differences were found on measures of hair cortisol. Compared to controls, IGD patients showed an attenuated cortisol response (χ2(7)=25.75, p<0.001) and greater negative affect (χ2(7)=17.25, p=0.016) in response to acute stress. Heart rate (χ2(1)=5.49, p=0.019), negative affect (χ2(1)=5.60, p=0.018) and subjective stress (χ2(1)=5.55, p=0.019) were transiently increased in IGD patients. After adjusting for sportive activities, IGD patients showed transiently decreased cortisol (χ2(1)=5.20, p=0.022), potentially indicating general HPA-axis dysfunction beyond altered reactivity. Stress reactivity showed correlations with IGD symptom severity. Findings illustrate differences in acute psychological and neurobiological stress reactivity in patients with IGD. Alterations of the stress response system may be involved in the development and maintenance of IGD.
authors.affiliation: Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany. Electronic address: michael.kaess@med.uni-heidelberg.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Kaess
authors.affiliation: Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Parzer
authors.affiliation: Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Mehl
authors.affiliation: Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Luisa
authors.initials: L
authors.lastname: Weil
authors.affiliation: Department of Child and Adolescent Psychiatry, University Hospital Münster, Germany.
authors.forename: Esther
authors.initials: E
authors.lastname: Strittmatter
authors.affiliation: Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Franz
authors.initials: F
authors.lastname: Resch
authors.affiliation: Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Koenig
mesh_terms: D000293:Adolescent; D000328:Adult; D016739:Behavior, Addictive / Q000503:physiopathology* / Q000523:psychology; D006197:Hair / Q000737:chemistry; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D020407:Internet; D008297:Male; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012463:Saliva / Q000737:chemistry; D013315:Stress, Psychological / Q000503:physiopathology* / Q000523:psychology; D018910:Video Games / Q000523:psychology*; D055815:Young Adult
chemical_list: D006854:Hydrocortisone
keywords: Behavioral addiction; Cortisol; Heart rate; Internet Gaming Disorder; Stress; Trier social stress test