The associations between loneliness, anxiety, and problematic gaming behavior during the COVID-19 pandemic: The mediating role of mentalization

Maria Ciccarelli, Giovanna Nigro, Francesca D'Olimpio, Mark D. Griffiths, Mariagiulia Sacco, Barbara Pizzini, Marina Cosenza


Background: The COVID-19 pandemic has negatively impacted mental health, contributing to increase the feeling of loneliness, the psychological distress, and the gaming involvement. Despite accumulating data in the field of gaming, the research examining the psychological determinants of gaming severity, especially in the unique circumstances of COVID-19 pandemic, is still in its infancy. The aim of the present study was to examine, for the first time, the role of mentalization in gaming and to clarify the pattern of associations between loneliness, psychological distress, and problematic gaming behavior, as well as the mediating role of mentalizing in this relationship during COVID-19 pandemic in Italy.

 Methods: A total of 466 adults aged 18-29 years completed an online survey including the Internet Gaming Disorder Scale-Short Form, the Reflective Functioning Questionnaire, the UCLA Loneliness Scale, and the Depression Anxiety Stress Scales.

Results: Regression analysis showed that male gender, anxiety, hypermentalizing, and loneliness were good predictors of problematic gaming behavior. The path analysis indicated that gender predicted gaming directly, whereas anxiety and loneliness contributed to gaming both directly and indirectly via hypermentalizing.

Conclusions: The present study is the first to examine the role of mentalizing in gaming during COVID-19 pandemic and provide insight into the interrelationships between mentalization, psychological distress, perceived loneliness, and problematic gaming behavior, demonstrating that an inaccurate mentalization has a key role in contributing to problematic gaming. The study provides a useful contribution for prevention of gaming severity and indicates that specific intervention on mentalizing could be effective in reducing problematic gaming by reducing levels of both anxiety and perceived loneliness.


Problematic gaming behavior; Mentalizing; Hypermentalizing; Loneliness; Anxiety; COVID-19 pandemic.

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