In collaboration with Payame Noor University and Iranian Health Psychology

Document Type : research


1 Department of Clinical Psychology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Psychology and Educational Sciences, Arak University, Arak, Iran

3 Department of Psychology and Educational Sciences, University of Tehran, Tehran, Iran


Objective: The present study aimed to examine whether the treatment of Internet Gaming Disorder (IGD) in adolescents via Attentional Bias Modification (ABM) improves their health-related quality of life.
Method: 34 adolescents with IGD who were 12-17 years old were randomly assigned to experimental (n = 16) and control (n = 18) groups. The experimental group received ABM, while no interventions were delivered to the control group. Attentional bias, IGD severity, and health-related quality of life were assessed using Modified Stroop Task, Internet Gaming Disorder-20 (IGD-20), and KIDSCREEN-52 questionnaires, respectively. Data from pre-test, post-test, and two months follow-up measurements were analyzed using two-way mixed measures ANOVA and Fisher's least significant difference (LSD) via SPSS software.
Results: ABM successfully reduced attentional bias and IGD severity and improved health-related quality of life in adolescents of the experimental group (p < 0.05). These significant changes were observed at post-test and two months follow-up. Meanwhile, no significant change occurred in the control group (p > 0.05).
Conclusion: It could be concluded that ABM not only reduces the severity of IGD in adolescents, but also improves their health-related quality of life, although further research is required for the understanding of its mechanisms of effects


Article Title [Persian]

ارتقاء کیفیت زندگی مربوط به سلامت در نوجوانان مبتلا به اختلال بازی اینترنتی

Authors [Persian]

  • سعید نصیری 1
  • زهرا ابراهیمی 2
  • آرش منجم 3

1 گروه روانشناسی بالینی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

2 گروه روانشناسی و علوم تربیتی، دانشگاه اراک، اراک، ایران

3 گروه روانشناسی و علوم تربیتی، دانشگاه تهران، تهران، ایران

Abstract [Persian]

هدف: پژوهش حاضر با هدف بررسی امکان ارتقاء کیفیت زندگی مربوط به سلامت نوجوانان مبتلا به اختلال بازی اینترنتی (IGD)، از طریق درمان این اختلال به وسیله‌ی اصلاح سوگیری توجه (ABM) انجام شد.
روش: ۳۴ نوجوان مبتلا به IGD که ۱۲-۱۷ سال سن داشتند به صورت تصادفی در گروه آزمایش (۱۶ = n) و کنترل (۱۸ = n) گماشته شدند. گروه آزمایش ABM را دریافت کرد، در حالی که هیچ مداخله‌ای به گروه کنترل ارائه نشد. سوگیری توجه، شدت IGD و کیفیت زندگی مربوط به سلامت به ترتیب با استفاده از آزمون استروپ تغییریافته و پرسشنامه‌های اختلال بازی اینترنتی-۲۰ (IGD-20) و KIDSCREEN-52 سنجیده شدند. داده‌های اندازه‌گیری‌های پیش‌آزمون، پس‌آزمون و پیگیری ۲ ماهه با استفاده از آزمون تحلیل واریانس دوطرفه با اندازه‌گیری‌های مکرر و آزمون حداقل اختلاف معنادار فیشر (LSD)، از طریق نرم‌افزار SPSS تحلیل شدند.
نتایج: ABM به صورت موفقیت‌آمیز سوگیری توجه و شدت IGD را در گروه آزمایش کاهش و کیفیت زندگی مربوط به سلامت را در آن‌ها ارتقاء داد (۰/۰۵ > p). این تغییرات معنادار در پس‌آزمون و پیگیری ۲ ماهه مشاهده شدند. در عین حال، هیچ تغییر معناداری در گروه کنترل رخ نداد (۰/۰۵ < p).
نتیجه‌گیری: می‌توان نتیجه گرفت که ABM نه تنها شدت IGD را در نوجوانان کاهش داده، بلکه کیفیت زندگی مربوط به سلامت آن‌ها را نیز ارتقاء می‌دهد، هرچند پژوهش‌های بیشتر برای فهم مکانیزم‌های اثرات آن ضروری است.

Keywords [Persian]

  • اختلال بازی اینترنتی
  • کیفیت زندگی
  • ارتقاء سلامت
  • اصلاح سوگیری توجه
  • نوجوانان
Aghayousefi, A., Zare, H., & Mohammadi, R. (2018). The Effect of Cognitive Computer-based Training Program on Attention and Memory Function of the Students with Diabetes. Quarterly Journal of Health Psychology, 6(24), 162-179.
Argyriou, E., Davison, C. B., & Lee, T. T. (2017). Response inhibition and internet gaming disorder: a meta-analysis. Addictive behaviors, 71, 54-60.
Arsanjani, M., Zargham hajebi, M., & Mirzahosseini, H. (2020). The Effect of Cognitive Bias Modification in the Attention Bias of Students With Test Anxiety. Bimonthly of Education Strategies in Medical Sciences, 13(4), 325-334.
Azarmehr, R., & Ahmadi, E. (2020). The role of anxiety sensitivity and attentional control in predicting the tendency toward addiction in youth. Iranian Journal of Health Psychology, 2(2), 45-50. doi:10.30473/ijohp.2020.47685.1054
Brown, H. M., Eley, T. C., Broeren, S., MacLeod, C., Rinck, M., Hadwin, J. A., & Lester, K. J. (2014). Psychometric properties of reaction time based experimental paradigms measuring anxiety-related information-processing biases in children. Journal of Anxiety Disorders, 28(1), 97-107. doi:j.janxdis.2013.11.004
Browning, M., Holmes, E. A., & Harmer, C. J. (2010). The modification of attentional bias to emotional information: A review of the techniques, mechanisms, and relevance to emotional disorders. Cognitive, Affective, & Behavioral Neuroscience, 10(1), 8-20. doi:10.3758/CABN.10.1.8
Chia, D. X., & Zhang, M. W. (2020). A Scoping Review of Cognitive Bias in Internet Addiction and Internet Gaming Disorders. International Journal of Environmental Research and Public Health, 17(1), 373. doi:10.3390/ijerph17010373
Cox, W. M., Fadardi, J. S., & Pothos, E. M. (2006). The addiction-stroop test: Theoretical considerations and procedural recommendations. Psychological bulletin, 132(3), 443. doi:10.1037/0033-2909.132.3.443
Denissen, J. J., Neumann, L., & Van Zalk, M. (2010). How the internet is changing the implementation of traditional research methods, people’s daily lives, and the way in which developmental scientists conduct research. International Journal of Behavioral Development, 34(6), 564-575. doi:10.1177/0165025410383746
Dietel, F. A., Zache, C., Bürkner, P. C., Schulte, J., Möbius, M., Bischof, A., . . . Buhlmann, U. (2020). Internet-based interpretation bias modification for body dissatisfaction: A three-armed randomized controlled trial. Int J Eat Disord, 53(6), 972-986. doi:10.1002/eat.23280
Fazeli, S., Mohammadi Zeidi, I., Lin, C.-Y., Namdar, P., Griffiths, M. D., Ahorsu, D. K., & Pakpour, A. H. (2020). Depression, anxiety, and stress mediate the associations between internet gaming disorder, insomnia, and quality of life during the COVID-19 outbreak. Addictive Behaviors Reports, 12, 100307. doi:10.1016/j.abrep.2020.100307
Field, M., & Cox, W. M. (2008). Attentional bias in addictive behaviors: a review of its development, causes, and consequences. Drug and alcohol dependence, 97(1-2), 1-20. doi:10.1016/j.drugalcdep.2008.03.030
Fuster, H., Carbonell, X., Pontes, H. M., & Griffiths, M. D. (2016). Spanish validation of the internet gaming disorder-20 (IGD-20) test. Computers in Human Behavior, 56, 215-224. doi:10.1016/j.chb.2015.11.050
Gentile, D. (2009). Pathological video-game use among youth ages 8 to 18: A national study. Psychological science, 20(5), 594-602. doi:10.1111/j.1467-9280.2009.02340.x
Heitmann, J., Bennik, E. C., van Hemel-Ruiter, M. E., & de Jong, P. J. (2018). The effectiveness of attentional bias modification for substance use disorder symptoms in adults: a systematic review. Systematic reviews, 7(1), 160.
Hønsi, A., Mentzoni, R. A., Molde, H., & Pallesen, S. (2013). Attentional bias in problem gambling: A systematic review. Journal of Gambling Studies, 29(3), 359-375. doi:10.1007/s10899-012-9315-z
J Kuss, D., D Griffiths, M., Karila, L., & Billieux, J. (2014). Internet addiction: A systematic review of epidemiological research for the last decade. Current pharmaceutical design, 20(25), 4026-4052.
Jeromin, F., Nyenhuis, N., & Barke, A. (2016). Attentional bias in excessive Internet gamers: Experimental investigations using an addiction Stroop and a visual probe. Journal of Behavioral Addictions, 5(1), 32-40. doi:10.1556/2006.5.2016.012
Jeromin, F., Rief, W., & Barke, A. (2016). Using two web-based addiction Stroops to measure the attentional bias in adults with Internet Gaming Disorder. Journal of Behavioral Addictions, 5(4), 666-673. doi:10.1556/2006.5.2016.075
Khodadadi, M., Feyzi Daryati, M. R., Movahedi, Y., & Ahmadi, I. (2014). Assessment of attention bias in the cognitive processing of neutral and emotional words Using semantic Strop test. Shenakht Journal of Psychology and Psychiatry, 1(1), 23-30.
Kuss, D. J., & Griffiths, M. D. (2012). Internet gaming addiction: A systematic review of empirical research. International Journal of Mental Health and Addiction, 10(2), 278-296. doi:10.1007/s11469-011-9318-5
Lam, L. T. (2014). Internet gaming addiction, problematic use of the internet, and sleep problems: a systematic review. Current psychiatry reports, 16(4), 444. doi:10.1007/s11920-014-0444-1
Lim, J. A., Lee, J. Y., Jung, H. Y., Sohn, B. K., Choi, S. W., Kim, Y. J., . . . Choi, J. S. (2016). Changes of quality of life and cognitive function in individuals with Internet gaming disorder: A 6-month follow-up. Medicine (Baltimore), 95(50), e5695. doi:10.1097/md.0000000000005695
MacLeod, C., & Clarke, P. J. (2015). The attentional bias modification approach to anxiety intervention. Clinical Psychological Science, 3(1), 58-78. doi:10.1177/2167702614560749
MacLeod, C., Rutherford, E., Campbell, L., Ebsworthy, G., & Holker, L. (2002). Selective attention and emotional vulnerability: assessing the causal basis of their association through the experimental manipulation of attentional bias. Journal of abnormal psychology, 111(1), 107.
Metcalf, O., & Pammer, K. (2011). Attentional bias in excessive massively multiplayer online role-playing gamers using a modified Stroop task. Computers in Human Behavior, 27(5), 1942-1947. doi:10.1016/j.chb.2011.05.001
Nik, A. A., Naenian, M. R., & Shairi, M. R. (2014). Validity and reliability of the health related Quality of Life Questionnaire (Kidscreen-52) in a sample of Iranian Students. Journal of Community Health Research, 3(3), 210-224.
Pontes, H. M., & Griffiths, M. D. (2015). Internet gaming disorder and its associated cognitions and cognitive-related impairments: A systematic review using PRISMA guidelines. Revista Argentina de Ciencias del Comportamiento, 7(3), 102-118.
Pontes, H. M., Kiraly, O., Demetrovics, Z., & Griffiths, M. D. (2014). The conceptualisation and measurement of DSM-5 Internet Gaming Disorder: The development of the IGD-20 Test. PloS one, 9(10), e110137. doi:10.1371/journal.pone.0110137
Rabinovitz, S., & Nagar, M. (2015). Possible end to an endless quest? Cognitive bias modification for excessive multiplayer online gamers. Cyberpsychology, Behavior, and Social Networking, 18(10), 581-587. doi:10.1089/cyber.2015.0173
Rasti, A., & Taghavi, M. (2006). Implicit Memory Bias for Negative Information in Patients With Generalized Anxiety Disorder and Major Depressive Disorder and Normal Individuals. Advances in Cognitive Sciences, 8(3), 25-32.
Ravens-Sieberer, U., Gosch, A., Rajmil, L., Erhart, M., Bruil, J., Power, M., . . . Czemy, L. (2008). The KIDSCREEN-52 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Value in health, 11(4), 645-658. doi:10.1111/j.1524-4733.2007.00291.xs
Shu M, Y., Ivan Jacob, A. P., Meng Xuan, Z., & Anise MS, W. (2019). Psychometric validation of the Internet Gaming Disorder-20 Test among Chinese middle school and university students. Journal of Behavioral Addictions, 8(2), 295-305. doi:10.1556/2006.8.2019.18
Sublette, V. A., & Mullan, B. (2012). Consequences of play: A systematic review of the effects of online gaming. International Journal of Mental Health and Addiction, 10(1), 3-23. doi:10.1007/s11469-010-9304-3
Vahidi, M., Zamanzadeh, V., Musavi, S., Janani, R., & Namdar, A. H. (2019). Validation of the Persian version of the internet gaming disorder-20 Test among the students of Tabriz University of Medical Sciences. Journal of Torbat Heydariyeh University of Medical Sciences, 7(1), 15-26.
van Holst, R. J., Lemmens, J. S., Valkenburg, P. M., Peter, J., Veltman, D. J., & Goudriaan, A. E. (2012). Attentional bias and disinhibition toward gaming cues are related to problem gaming in male adolescents. Journal of Adolescent Health, 50(6), 541-546. doi:10.1016/j.jadohealth.2011.07.006
Wartberg, L., Kriston, L., & Kammerl, R. (2017). Associations of Social Support, Friends Only Known Through the Internet, and Health-Related Quality of Life with Internet Gaming Disorder in Adolescence. Cyberpsychol Behav Soc Netw, 20(7), 436-441. doi:10.1089/cyber.2016.0535
Wen, S., Larsen, H., Boffo, M., Grasman, R. P. P. P., Pronk, T., van Wijngaarden, J. B. G., & Wiers, R. W. (2020). Combining Web-Based Attentional Bias Modification and Approach Bias Modification as a Self-Help Smoking Intervention for Adult Smokers Seeking Online Help: Double-Blind Randomized Controlled Trial. JMIR Ment Health, 7(5), e16342. doi:10.2196/16342
Wilms, I. L., Petersen, A., & Vangkilde, S. (2013). Intensive video gaming improves encoding speed to visual short-term memory in young male adults. Acta psychologica, 142(1), 108-118. doi:10.1016/j.actpsy.2012.11.003
Wittekind, C. E., Bierbrodt, J., Lüdecke, D., Feist, A., Hand, I., & Moritz, S. (2019). Cognitive bias modification in problem and pathological gambling using a web-based approach-avoidance task: A pilot trial. Psychiatry research, 272, 171-181. doi:10.1016/j.psychres.2018.12.075
Yau, M. Y. H., & Potenza, M. N. (2015). Gambling disorder and other behavioral addictions: recognition and treatment. Harvard review of psychiatry, 23(2), 134. doi:10.1097/HRP.0000000000000051
Ziaee, S. S., Fadardi, J. S., Cox, W. M., & Yazdi, S. A. A. (2016). Effects of attention control training on drug abusers’ attentional bias and treatment outcome. Journal of Consulting and Clinical Psychology, 84(10), 861. doi:10.1037/a0040290