Online Gaming Addiction and Emotional Disorders Among Adolescents: A Cross-Sectional Study in a Public Junior Secondary School
DOI:
https://doi.org/10.62255/mjhp.v4i1.242Abstract
The rapid global expansion of online gaming has raised increasing concerns regarding gaming addiction and its psychological consequences among adolescents, particularly in low- and middle-income countries where evidence remains limited. This study aimed to examine the association between online gaming addiction and emotional disorders among adolescents attending a public junior secondary school in East Java, Indonesia. A cross-sectional study with stratified random sampling was conducted among 142 students (mean age 13.1 years; 61.3% male). Data were collected using the Internet Gaming Disorder Scale-20 (IGDS9-SF) and the Strengths and Difficulties Questionnaire (SDQ), then analysed using Spearman’s rank correlation and multivariate ordinal regression. Most respondents demonstrated moderate gaming addiction (55.6%), while 2.1% met criteria for high addiction. Emotional disorders were identified in 51.4% of participants, consisting primarily of behavioural disorders (42.5%), depression (34.3%), and anxiety (23.2%). Spearman’s analysis revealed a significant positive correlation between gaming addiction and emotional disorders (r = 0.41, p = 0.001). Multivariate analysis further showed that gaming addiction independently predicted emotional disorders after adjustment for age and sex (adjusted OR = 3.12; 95% CI: 1.68–5.79; p < 0.001). Behavioural disturbance emerged as the most prominent emotional manifestation. These findings highlight the importance of integrating school-based mental health screening and preventive interventions into adolescent health policies in Indonesia.
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Keywords:
online gaming addiction, emotional disorders, adolescents, internet gaming disorder, mental health, Indonesia, school-based health, SDQ, cross-sectional study, LMICReferences
Ahmed, G., Abdalla, A.-A., Mohamed, A., Mohamed, L., & Shamaa, H. (2022). Relation between internet gaming addiction and comorbid psychiatric disorders and emotion avoidance among adolescents: A cross-sectional study. Psychiatry Research, 312, 114584. https://doi.org/10.1016/j.psychres.2022.114584
Alhamoud, M., Alkhalifah, A., Althunyan, A., Mustafa, T., Alqahtani, H., & Awad, F. (2022). Internet gaming disorder: Its prevalence and associated gaming behavior, anxiety, and depression among high school male students, Dammam, Saudi Arabia. Journal of Family & Community Medicine, 29, 93–101. https://doi.org/10.4103/jfcm.jfcm_48_22
Bumozah, H., Al-Quwaidhi, A., & Al-Ghadeeb, R. (2023). Prevalence and Risk Factors of Internet Gaming Disorder Among Female Secondary School Students in Al-Ahsa, Kingdom of Saudi Arabia. Cureus, 15. https://doi.org/10.7759/cureus.40375
Chang, C. I., Sit, H. F., Chao, T., Chen, C., Shen, J., Cao, B., Montag, C., Elhai, J., & Hall, B. (2022). Exploring subtypes and correlates of internet gaming disorder severity among adolescents during COVID-19 in China: A latent class analysis. Current Psychology (New Brunswick, N.J.), 1–12. https://doi.org/10.1007/s12144-022-03133-8
Chen, Z., Ren, S., He, R., Liang, Y., Tan, Y., Liu, Y., Wang, F., Shao, X., Chen, S., Liao, Y., He, Y., Li, J., Chen, X., & Tang, J. (2023). Prevalence and associated factors of depressive and anxiety symptoms among Chinese secondary school students. BMC Psychiatry, 23. https://doi.org/10.1186/s12888-023-05068-1
Coutelle, R., Balzer, J., Rolling, J., & Lalanne, L. (2024). Problematic gaming, psychiatric comorbidities, and adolescence: A systematic review of the literature. Addictive Behaviors, 157, 108091. https://doi.org/10.1016/j.addbeh.2024.108091
Dang, L., Yang, H., Spada, M., & Wu, A. (2024). A three-wave longitudinal study on the underlying metacognitive mechanism between depression and Internet gaming disorder. Journal of Behavioral Addictions, 13, 215–225. https://doi.org/10.1556/2006.2023.00072
De Pasquale, C., Sciacca, F., Martinelli, V., Chiappedi, M., Dinaro, C., & Hichy, Z. (2020). Relationship of Internet Gaming Disorder with Psychopathology and Social Adaptation in Italian Young Adults. International Journal of Environmental Research and Public Health, 17. https://doi.org/10.3390/ijerph17218201
Demianowska, A., Ost?p, J., Ry?, M., & Kucharska, K. (2025). Maladaptive emotion regulation strategies as mediators in the relationship between gaming disorder and psychological pain, depression, and anxiety. Kwartalnik Naukowy Fides et Ratio. https://doi.org/10.34766/0wsqte15
Deng, X., Hu, Y.-B., Liu, C.-Y., Li, Q., Yang, N., Zhang, Q.-Y., Liu, L., Qiu, J., Xu, H.-B., Xue, L., Shi, Y.-W., Wang, X.-G., & Zhao, H. (2023). Psychological distress and aggression among adolescents with internet gaming disorder symptoms. Psychiatry Research, 331, 115624. https://doi.org/10.1016/j.psychres.2023.115624
Falcione, K., & Weber, R. (2025). Psychopathology and Gaming Disorder in Adolescents. JAMA Network Open, 8. https://doi.org/10.1001/jamanetworkopen.2025.28532
Fernández-Catalán, G., Modrego-Alarcón, M., Sánchez-Pérez, N., & Alcaraz-Iborra, M. (2025). The Mediation Role of Emotional Symptoms Between Impulsivity Traits and Problematic Gaming Behavior in Adolescents. Journal of Adolescence, 97, 1991–2000. https://doi.org/10.1002/jad.70018
Gao, T., Chen, Y., Gai, Q., D’Arcy, C., & Su, Y. (2024). The co-occurrence between symptoms of internet gaming disorder, depression, and anxiety in middle and late adolescence: A cross-lagged panel network analysis. Addictive Behaviors, 161, 108215. https://doi.org/10.1016/j.addbeh.2024.108215
Gao, Y., Wang, J., & Dong, G. (2022). The prevalence and possible risk factors of internet gaming disorder among adolescents and young adults: Systematic reviews and meta-analyses. Journal of Psychiatric Research, 154, 35–43. https://doi.org/10.1016/j.jpsychires.2022.06.049
Hygen, B., Skalická, V., Stenseng, F., Belsky, J., Steinsbekk, S., & Wichstrøm, L. (2020). The co-occurrence between symptoms of internet gaming disorder and psychiatric disorders in childhood and adolescence: prospective relations or common causes? Journal of Child Psychology and Psychiatry, and Allied Disciplines. https://doi.org/10.1111/jcpp.13289
Kakul, F., & Javed, S. (2023). Internet Gaming Disorder: An Interplay of Cognitive Psychopathology. Asian Journal of Social Health and Behavior, 6, 36–45. https://doi.org/10.4103/shb.shb_209_22
Krossbakken, E., Pallesen, S., Mentzoni, R., King, D., Molde, H., Finserås, T., & Torsheim, T. (2018). A Cross-Lagged Study of Developmental Trajectories of Video Game Engagement, Addiction, and Mental Health. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.02239
Li, W., Zhao, Y., Yang, C., Wu, W., Li, J., & Li, X. (2025). Longitudinal Network Associations Between Symptoms of Problematic Gaming and Generalized and Social Anxiety Among Adolescents. Research on Child and Adolescent Psychopathology, 53, 1263–1279. https://doi.org/10.1007/s10802-025-01335-9
Li, Y.-Y., Hu, A.-Q., Yi, L., Mao, Z., Lü, Q.-Y., Wang, J., Wei, W., Huang, Y., Huang, S., Dai, W.-J., Qiao, M.-X., Xu, J.-J., Wang, Q., Li, X.-J., Luo, F.-G., Deng, W., Hu, Y., Li, T., & Guo, W.-J. (2025). Comparing the Associations of Internet Addiction and Internet Gaming Disorder With Psychopathological Symptoms: Cross-Sectional Study of Three Independent Adolescent Samples. Journal of Medical Internet Research, 28. https://doi.org/10.2196/82414
Liu, L., Yao, Y.-W., Li, C., Zhang, J.-T., Xia, C.-C., Lan, J., Shanshan, Zhou, N., & Fang, X. (2018). The Comorbidity Between Internet Gaming Disorder and Depression: Interrelationship and Neural Mechanisms. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00154
Liu, Y., Gong, R., Yu, Y., Xu, C., Yu, X., Chang, R., Wang, H., Wang, S., Wang, Q., & Cai, Y. (2021). Longitudinal predictors for incidence of internet gaming disorder among adolescents: The roles of time spent on gaming and depressive symptoms. Journal of Adolescence, 92, 1–9. https://doi.org/10.1016/j.adolescence.2021.06.008
Macur, M., & Pontes, H. (2021). Internet Gaming Disorder in adolescence: investigating profiles and associated risk factors. BMC Public Health, 21. https://doi.org/10.1186/s12889-021-11394-4
Meng, Y., Shi, X., Cai, D., Ran, M., Ye, A., & Qiu, C. (2024). Prevalence, predictive factors, and impacts of internet gaming disorder among adolescents: A population-based longitudinal study. Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2024.06.020
Mohamed, N., Manan, N. A. A., Chan, M. F. M. F., Rahmatullah, B., Wahab, R. A., Baharudin, S. N. A., Govindasamy, P., & Abdulla, K. (2023). The prevalence of internet gaming disorders and the associated psychosocial risk factors among adolescents in Malaysian secondary schools. Clinical Child Psychology and Psychiatry, 28, 1420–1434. https://doi.org/10.1177/13591045231164870
Mohamed, N., Ting, T. J., Manan, N. A., Senari, I. F. M., Chan, M. F. M. F., Rahmatullah, B., Govindasamy, P., & Abdulla, K. (2024). Prevalence and predictors of social anxiety disorders among Malaysian secondary school students during the COVID-19 pandemic: Exploring the influence of internet gaming disorder and impulsivity. Clinical Child Psychology and Psychiatry, 31, 69–83. https://doi.org/10.1177/13591045231206967
Narita, Z., DeVylder, J., Knowles, G., Ando, S., Yamasaki, S., Miyashita, M., Stanyon, D., Yamaguchi, S., Furukawa, T., Kasai, K., & Nishida, A. (2025). Problematic online gaming mediates the association between attention-deficit/hyperactivity and subsequent mental health issues in adolescents. Communications Psychology, 3. https://doi.org/10.1038/s44271-025-00296-5
Peng, P., Chen, Z., Ren, S., He, Y., Li, J., Liao, A., Zhao, L., Shao, X., Chen, S., He, R., Liang, Y., Tan, Y., Chen, X., Tang, J., & Liao, Y. (2025). Trajectory of internet gaming disorder among Chinese adolescents: Course, predictors, and long-term mental health outcomes. Journal of Behavioral Addictions, 14, 846–860. https://doi.org/10.1556/2006.2025.00054
Purwaningsih, E., & Nurmala, I. (2021). The Impact of Online Game Addiction on Adolescent Mental Health: A Systematic Review and Meta-analysis. Open Access Macedonian Journal of Medical Sciences. https://doi.org/10.3889/oamjms.2021.6234
Putra, P. Y., Fithriyah, I., & Zahra, Z. (2023). Internet Addiction and Online Gaming Disorder in Children and Adolescents During COVID-19 Pandemic: A Systematic Review. Psychiatry Investigation, 20, 196–204. https://doi.org/10.30773/pi.2021.0311
Rahul, R., R, T., M, S., Kareem, S. A., Gowda, K., & Sajna, S. (2025). Impact of internet gaming disorder on mental well-being: prevalence and psychological distress among adolescents and young adults. Psychiatry Research, 349, 116512. https://doi.org/10.1016/j.psychres.2025.116512
Rajan, R., Gunasekaran, S., Duraisamy, V., Mathew, B., Vinolia, T., & Gainneos, P. (2024). Internet gaming disorder: The prevalence and associated gaming behavior, anxiety, and depression among 8-12-year-old children of private schools in Salem city, India. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 42 2, 98–103. https://doi.org/10.4103/jisppd.jisppd_27_24
She, R., Lin, J., Wong, K., & Yang, X. (2024). Cognitive-behavioral statuses in depression and internet gaming disorder of adolescents: A transdiagnostic approach. PLOS ONE, 19. https://doi.org/10.1371/journal.pone.0304715
She, R., Zhang, Y., & Yang, X. (2022). Parental Factors Associated With Internet Gaming Disorder Among First-Year High School Students: Longitudinal Study. JMIR Serious Games, 10. https://doi.org/10.2196/33806
Siste, K., Hanafi, E., Sen, L., Damayanti, R., Beatrice, E., & Ismail, R. (2022). Psychometric properties of the Indonesian Ten-item Internet Gaming Disorder Test and a latent class analysis of gamer population among youths. PLoS ONE, 17. https://doi.org/10.1371/journal.pone.0269528
Sugaya, N., Shirasaka, T., Takahashi, K., & Kanda, H. (2019). Bio-psychosocial factors of children and adolescents with internet gaming disorder: a systematic review. Biopsychosocial Medicine, 13. https://doi.org/10.1186/s13030-019-0144-5
Teng, Z., Pontes, H., Nie, Q., Griffiths, M., & Guo, C. (2021). Depression and anxiety symptoms associated with internet gaming disorder before and during the COVID-19 pandemic: A longitudinal study. Journal of Behavioral Addictions, 10, 169–180. https://doi.org/10.1556/2006.2021.00016
Thakur, P., Sharma, M., Mohan, V., Kommu, J., Anand, N., & Marimuthu, P. (2023). Gaming among female adolescents: profiling and psychopathological characteristics in the Indian context. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1081764
Todorovic, L., Bozhar, H., De Rooij, S., Bogaerts, A., Boyer, B., & Larsen, H. (2025). Bidirectional associations of problematic social media use and problematic gaming with mental health difficulties and strengths in adolescents: Sex and social support as potential moderators. Journal of Research on Adolescence, 35. https://doi.org/10.1111/jora.70076
Tsui, Y., & Cheng, C. (2021). Internet Gaming Disorder, Risky Online Behaviour, and Mental Health in Hong Kong Adolescents: The Beneficial Role of Psychological Resilience. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.722353
Yin, M., Huang, S., & Yu, C. (2023). Depression and Internet Gaming Disorder among Chinese Adolescents: A Longitudinal Moderated Mediation Model. International Journal of Environmental Research and Public Health, 20. https://doi.org/10.3390/ijerph20043633
Zheng, P., Tao, Z., Fang, L., Yao, T., Zhou, L., Wang, Y., & Lin, Y.-N. (2026). Longitudinal Association Between Internet Gaming Disorder and School Refusal Among Adolescents Using a Random Intercept Cross-Lagged Panel Model: Three-Wave Prospective Cohort Study. JMIR Serious Games, 14. https://doi.org/10.2196/89619
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