Prevalence and Risk Factors for Internet Gaming Disorder (IGD) in a sample of 5,979 Italian Online Gamers

Laura Ferraro, Chiara Avanzato, Giuseppe Maniaci, Crocettarachele Sartorio, Marco Daino, Fabio Seminerio, Giada Tripoli, Diego Quattrone, Rosa Lo Baido, Daniele La Barbera, Caterina La Cascia


Background: The prevalence of Internet Gaming Disorder (IGD) in the Italian population of gamers is unknown. Several risk factors, including time spent playing (TSP), are proposed as an epiphenomenon of emotional dysregulation.

Methods: The study estimated the prevalence of IGD in at-risk Italian online gamers, and the interplay between alexithymia and other risk factors.

5,979 responders were surveyed. IGDS-SF9 estimated pathological gaming. TAS-20 measured Difficult in Identifying (DIF) and Describing Feelings (DDF), and Externally Oriented Thinking (EOT). 

Results: 43% of participants had pathological IGD scores. Male gender (OR=1.2, 95% C.I.=1, 1.5, p=0.019), TSP (OR=7.6, 95% C.I.=5.5, 10.6, p<0.001), DIF (OR=1.5, 95% C.I.=1.1, 2.1, p=0.003), boredom/loneliness feelings (OR=1.8, 95% C.I.=1.5, 2, p<0.001), recent negative events (OR=1.1, 95% C.I.=1, 1.3, p=0.026), and a behavioral addiction (OR=2.1, 95% C.I.=1.2, 3.9, p=0.009) independently increased its risk. 

Conclusions: Almost one on two players joining online communities presented IGD. Some risk factors were crucial, including TSP, independently from emotional dysregulation.


Internet Gaming Disorder (IGD); Videogames; Risk-factors; Adolescence; Alexithymia; Playing-time.

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AESVI. (2018a). I videogiochi in biblioteca. In (Vol. 6, Issue 3).

AESVI. (2018b). I videogiochi In Italia nel 2018. In ISFE.

American Psychiatric Association. (2013). The Diagnostic and Statistical Manual of Mental Disorders (5th Edition). American Psychiatric Publishing, Inc.

Bagby, R. M., Ayearst, L. E., Morariu, R. A., Watters, C., & Taylor, G. J. (2014). The internet administration version of the 20-item Toronto Alexithymia Scale. Psychological Assessment, 26(1), 16–22.

Billieux, J., Deleuze, J., Griffiths, M. D., & Kuss, D. J. (2015). Textbook of Addiction Treatment: International Perspectives. Textbook of Addiction Treatment: International Perspectives, 1515–1525.

Billieux, J., Van Der Linden, M., Achab, S., Khazaal, Y., Paraskevopoulos, L., Zullino, D., & Thorens, G. (2013). Why do you play World of Warcraft? An in-depth exploration of self-reported motivations to play online and in-game behaviours in the virtual world of Azeroth. Computers in Human Behavior, 29(1), 103–109.

Bonnaire, C., & Baptista, D. (2019). Internet gaming disorder in male and female young adults: The role of alexithymia, depression, anxiety and gaming type. Psychiatry Research, 272, 521–530.

Bowditch, L., Naweed, A., & Chapman, J. (2019). Escaping into a Simulated Environment: A Preliminary Investigation into How MMORPGs Are Used to Cope with Real Life Stressors. Communications in Computer and Information Science, 46–57.

Brand, M., Young, K. S., Laier, C., Wölfling, K., & Potenza, M. N. (2016). Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) model. Neuroscience and Biobehavioral Reviews, 71, 252–266.

Braun, B., Stopfer, J. M., Müller, K. W., Beutel, M. E., & Egloff, B. (2016). Personality and video gaming: Comparing regular gamers, non-gamers, and gaming addicts and differentiating between game genres. Computers in Human Behavior, 55, 406–412.

Bressi, C., Taylor, G., Parker, J., Bressi, S., Brambilla, V., Aguglia, E., Allegranti, I., Bongiorno, A., Giberti, F., Bucca, M., Todarello, O., Callegari, C., Vender, S., Gala, C., & Invernizzi, G. (1996). Cross validation of the factor structure of the 20-item Toronto Alexithymia Scale: an Italian multicenter study. Journal of Psychosomatic Research, 41(6), 551–559.

Canale, N., Marino, C., Griffiths, M. D., Scacchi, L., Monaci, M. G., & Vieno, A. (2019). The association between problematic online gaming and perceived stress: The moderating effect of psychological resilience. Journal of Behavioral Addictions, 8(1), 174–180.

Cerniglia, L., Guicciardi, M., Sinatra, M., Monacis, L., Simonelli, A., & Cimino, S. (2019). The Use of Digital Technologies, Impulsivity and Psychopathological Symptoms in Adolescence. Behavioral Sciences, 9(8), 82.

Coëffec, A., Romo, L., Cheze, N., Riazuelo, H., Plantey, S., Kotbagi, G., & Kern, L. (2015). Early substance consumption and problematic use of video games in adolescence. Frontiers in Psychology, 6(APR), 1–8.

Cortina, J. M. (1993). What Is Coefficient Alpha? An Examination of Theory and Applications. Journal of Applied Psychology, 78(1), 98–104.

Dang, D. L., Zhang, M. X., Leong, K. K. H., & Anise, M. S. W. (2019). The predictive value of emotional intelligence for internet gaming disorder: A 1-year longitudinal study. International Journal of Environmental Research and Public Health, 16(15), 12–15.

Deleuze, J., Nuyens, F., Rochat, L., Rothen, S., Maurage, P., & Billieux, J. (2017). Established risk factors for addiction fail to discriminate between healthy gamers and gamers endorsing DSM-5 Internet gaming disorder. Journal of Behavioral Addictions, 6(4), 516–524.

Di Blasi, M., Giardina, A., Giordano, C., Lo Coco, G., Tosto, C., Billieux, J., & Schimmenti, A. (2019). Problematic video game use as an emotional coping strategy: Evidence from a sample of MMORPG gamers. Journal of Behavioral Addictions, 8(1), 1–10.

Drummond, A., & Sauer, J. D. (2018). Video game loot boxes are psychologically akin to gambling. Nature Human Behaviour, 2(8), 530–532.

Dullur, P., & Starcevic, V. (2018). Internet gaming disorder does not qualify as a mental disorder. Australian & New Zealand Journal of Psychiatry, 52(2), 110–111.

Emory Woodard, B. H., & Natalia Gridina, W. (2000). THE ANNENBERG PUBLIC POLICY CENTER OF THE UNIVERISTY OF PENNSYLVANIA Media in the Home The Fifth Annual Survey of Parents and Children. 7.

ESA. (2019). Essential facts about computer and video game industry. In Media.

Fauth-Bühler, M., & Mann, K. (2017). Neurobiological correlates of internet gaming disorder: Similarities to pathological gambling. Addictive Behaviors, 64, 349–356.

Frisone, F., Settineri, S., Sicari, F., & Merlo, E. M. (2020). Gambling in adolescence: a narrative review of the last 20 years. Journal of Addictive Diseases, 1–20.

Gaetan, S., Bréjard, V., & Bonnet, A. (2016). Video games in adolescence and emotional functioning: Emotion regulation, emotion intensity, emotion expression, and alexithymia. Computers in Human Behavior, 61, 344–349.

Gao, G., & Shih, P. C. (2018). Does Platform Matter? A Game Design Analysis of Female Engagement in MOBA Games. DiGRA 2018, 1–16.

Griffiths, M. D. (2010). The role of context in online gaming excess and addiction: Some case study evidence. International Journal of Mental Health and Addiction, 8(1), 119–125.

Griffiths, M. D. (2012). The use of online methodologies in studying paraphilias — A review. Journal of Behavioral Addictions, 1(4), 143–150.

Griffiths, M. D., & Parke, J. (2010). Adolescent gambling on the Internet: A review. International Journal of Adolescent Medicine and Health, 22, 59–75.

Grosso, W. (2016). The Science & Craft of Designing Daily Rewards -- and Why FTP Games Need Them.

Iacolino, C., Lombardo, E. M. C., Cervellione, B., Mannino, G., & Micieli, S. (2019). Internet Addiction Disorder: Internet Gaming Disorder in a Nonclinical Sample Of Moba And Mmorpg Videoplayers. World Futures, 0(0), 1–27.

IBM. (2018). IBM SPSS Software | IBM Analytics. IBM.

Ipsos Connect. (2017). The new faces of gaming.

Jeromin, F., Rief, W., & Barke, A. (2016). Validation of the Internet Gaming Disorder Questionnaire in a Sample of Adult German-Speaking Internet Gamers. Cyberpsychology, Behavior, and Social Networking, 19(7), 453–459.

Kaptsis, D., King, D. L., Delfabbro, P. H., & Gradisar, M. (2016). Withdrawal symptoms in internet gaming disorder: A systematic review. In Clinical Psychology Review (Vol. 43, pp. 58–66). Elsevier Inc.

Kardaras, N. (2016). It’s “digital heroin”: How screens turn kids into psychotic junkies. Nypost.Com.

King, D. L., Delfabbro, P. H., Potenza, M. N., Demetrovics, Z., Billieux, J., & Brand, M. (2018, July 27). Internet gaming disorder should qualify as a mental disorder. Australian and New Zealand Journal of Psychiatry, 52(7), 615–617.

Kokkonen, P., Karvonen, J. T., Veijola, J., Läksy, K., & Jokelainen, J. (2001). Perceived and sociodemographics correlates of alexithymia in a population sample of young adults. Comprehensive Psychiatry, 42(6), 471–476.

Kuss, D. J., & Griffiths, M. D. (2012a). Online gaming addiction in children and adolescents: A review of empirical research. Journal of Behavioral Addictions, 1(1), 3–22.

Kuss, D. J., & Griffiths, M. D. (2012b). Internet Gaming Addiction: A Systematic Review of Empirical Research. International Journal of Mental Health and Addiction, 10(2), 278–296.

Leménager, T., Dieter, J., Hill, H., Koopmann, A., Reinhard, I., Sell, M., Kiefer, F., Vollstädt-Klein, S., & Mann, K. (2014). Neurobiological correlates of physical self-concept and self-identification with avatars in addicted players of Massively Multiplayer Online Role-Playing Games (MMORPGs). Addictive Behaviors, 39(12), 1789–1797.

Lemmens, J. S., & Hendriks, S. J. F. (2016). Addictive Online Games: Examining the Relationship Between Game Genres and Internet Gaming Disorder. Cyberpsychology, Behavior, and Social Networking, 19(4), 270–276.

Lemmens, J. S., Valkenburg, P. M., & Peter, J. (2011). Psychosocial causes and consequences of pathological gaming. Computers in Human Behavior, 27(1), 144–152.

Li, W., Mills, D., & Nower, L. (2019). The relationship of loot box purchases to problem video gaming and problem gambling. Addictive Behaviors, 97(April), 27–34.

Maganuco, N. R., Costanzo, A., & Schimmenti, A. (2019). Impulsivity and alexithymia in virtual worlds : A study on players of World of Warcraft. Clinical Neuropsychiatry, 16(July), 127–134.

Messner, S., & (2019). League of Legends draws 8 million concurrent players, making it the most popular game on PC.

Milani, L., La Torre, G., Fiore, M., Grumi, S., Gentile, D. A., Ferrante, M., Miccoli, S., & Di Blasio, P. (2017). Internet Gaming Addiction in Adolescence: Risk Factors and Maladjustment Correlates. International Journal of Mental Health and Addiction, 16(4), 888–904.

Monacis, L., Palo, V. de, Griffiths, M. D., & Sinatra, M. (2016). Validation of the Internet Gaming Disorder Scale - Short-Form (IGDS9-SF) in an Italian-speaking sample. Journal of Behavioral Addictions, 5(4), 683–690.

Myrseth, H., Notelaers, G., Strand, L. Å., Borud, E. K., & Olsen, O. K. (2017). Introduction of a new instrument to measure motivation for gaming: the electronic gaming motives questionnaire. Addiction, 112(9), 1658–1668.

Newman, M. Z. (2017). Atari Age. The emergence of video games in America.

Paulus, F. W., Ohmann, S., von Gontard, A., & Popow, C. (2018). Internet gaming disorder in children and adolescents: a systematic review. Developmental Medicine and Child Neurology, 60(7), 645–659.

Pontes, H. M., & Griffiths, M. D. (2015). Measuring DSM-5 internet gaming disorder: Development and validation of a short psychometric scale. Computers in Human Behavior, 45, 137–143.

Rehbein, F., Staudt, A., Hanslmaier, M., & Kliem, S. (2016). Video game playing in the general adult population of Germany: Can higher gaming time of males be explained by gender specific genre preferences? Computers in Human Behavior, 55, 729–735.

Rho, M. J., Lee, H., Lee, T. H., Cho, H., Jung, D. J., Kim, D. J., & Choi, I. Y. (2017). Risk factors for internet gaming disorder: Psychological factors and internet gaming characteristics. International Journal of Environmental Research and Public Health, 15(1), 1–11.

Roberts, D. F., Foehr, U. G., Rideout, V. J., & Brodie, M. (1999). Kids and media @ the new millennium. In Kaiser Family Foundation.

Şalvarlı, Ş. İ., & Griffiths, M. D. (2019). Internet Gaming Disorder and Its Associated Personality Traits: A Systematic Review Using PRISMA Guidelines. International Journal of Mental Health and Addiction.

Saunders, J. B., Hao, W., Long, J., King, D. L., Mann, K., Fauth-Bühler, M., Rumpf, H.-J., Bowden-Jones, H., Rahimi-Movaghar, A., Chung, T., Chan, E., Bahar, N., Achab, S., Lee, H. K., Potenza, M., Petry, N., Spritzer, D., Ambekar, A., Derevensky, J., … Poznyak, V. (2017). Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention. Journal of Behavioral Addictions, 6(3), 271–279.

Schneider, L. A., King, D. L., & Delfabbro, P. H. (2017). Maladaptive Coping Styles in Adolescents with Internet Gaming Disorder Symptoms. International Journal of Mental Health and Addiction, 16(4), 905–916.

Seay, A. F., & Kraut, R. E. (2007). Project massive: Self-regulation and problematic use of online gaming. Conference on Human Factors in Computing Systems - Proceedings, April 2007, 829–838.

Shi, J., Renwick, R., Turner, N. E., & Kirsh, B. (2019). Understanding the lives of problem gamers: The meaning, purpose, and influences of video gaming. Computers in Human Behavior, 97(March), 291–303.

Sirola, A., Savela, N., Savolainen, I., Kaakinen, M., & Oksanen, A. (2020). The Role of Virtual Communities in Gambling and Gaming Behaviors: A Systematic Review. In Journal of Gambling Studies (pp. 1–23). Springer.

Snodgrass, J. G., Lacy, M. G., Dengah, F., Eisenhauer, S., Batchelder, G., & Cookson, R. J. (2014). A vacation from your mind: Problematic online gaming is a stress response. Computers in Human Behavior, 38(October 2017), 248–260.

Spekman, M. L. C., Konijn, E. A., Roelofsma, P. H. M. P., & Griffiths, M. D. (2013). Gaming addiction, definition and measurement: A large-scale empirical study. Computers in Human Behavior, 29(6), 2150–2155.

Starcevic, V., & Aboujaoude, E. (2017). Internet Gaming Disorder, Obsessive-Compulsive Disorder, and Addiction. Current Addiction Reports, 4(3), 317–322.

Statista, & Gough, C. (2019). U.S. gamers - Statistics & Facts.

Statista research department. (2019). Estimated number of World of Warcraft subscribers 2015-2023.

Stavropoulos, V., Kuss, D. J., Griffiths, M. D., Wilson, P., & Motti-Stefanidi, F. (2017). MMORPG gaming and hostility predict Internet Addiction symptoms in adolescents: An empirical multilevel longitudinal study. Addictive Behaviors, 64, 294–300.

Steam. (2019). Steam - statistiche di gioco.

Taylor, G. J. (1984). Alexithymia: Concept, measurement, and implications for treatment. American Journal of Psychiatry, 141(6), 725–732.

The European House, A. (2018). Meridiano sanità, le coordinate della salute - rapporto 2018.

Torres-Rodríguez, A., Griffiths, M. D., Carbonell, X., Farriols-Hernando, N., & Torres-Jimenez, E. (2019). Internet Gaming Disorder Treatment: A Case Study Evaluation of Four Different Types of Adolescent Problematic Gamers. International Journal of Mental Health and Addiction, 17(1), 1–12.

Triberti, S., & Argenton, L. (2013). Psicologia dei videogiochi. Come i mondi virtuali influenzano mente e comportamento. Apogeo Education.

Triberti, S., Milani, L., Villani, D., Grumi, S., Peracchia, S., Curcio, G., & Riva, G. (2018). What matters is when you play: Investigating the relationship between online video games addiction and time spent playing over specific day phases. Addictive Behaviors Reports, 8, 185–188.

Vasiliadis, S. D., Jackson, A. C., Christensen, D., & Francis, K. (2013). Physical accessibility of gaming opportunity and its relationship to gaming involvement and problem gambling: A systematic review. In Journal of Gambling Issues (Issue 28).

Wartberg, L., Kriston, L., Zieglmeier, M., Lincoln, T., & Kammerl, R. (2017). A longitudinal study on psychosocial causes and consequences of Internet gaming disorder in adolescence. Psychological Medicine, 49(2), 287–294.

Wichstrøm, L., Stenseng, F., Belsky, J., von Soest, T., & Hygen, B. W. (2019). Symptoms of Internet Gaming Disorder in Youth: Predictors and Comorbidity. Journal of Abnormal Child Psychology, 47(1), 71–83.

Williams, D., Yee, N., & Caplan, S. E. (2008). Who plays, how much, and why? Debunking the stereotypical gamer profile. Journal of Computer-Mediated Communication, 13(4), 993–1018.

Wood, R. T. A. (2008). Problems with the concept of video game “addiction”: Some case study examples. International Journal of Mental Health and Addiction, 6(2), 169–178.

Yen, J. Y., Lin, H. C., Chou, W. P., Liu, T. L., & Ko, C. H. (2019). Associations among resilience, stress, depression, and internet gaming disorder in young adults. International Journal of Environmental Research and Public Health, 16(17).



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