Hostname: page-component-848d4c4894-tn8tq Total loading time: 0 Render date: 2024-06-13T21:46:09.010Z Has data issue: false hasContentIssue false

Online Self-Help Acceptance and Commitment Therapy Module for College Students with Higher Gaming Disorder During COVID-19: A Pilot Study

Published online by Cambridge University Press:  28 September 2023

Dongyan Ding
Affiliation:
Bengbu Medical College, Bengbu, China
Mengdie Pan*
Affiliation:
Bengbu Medical College, Bengbu, China
Wenjuan Wang*
Affiliation:
Bengbu Medical College, Bengbu, China
Xiucheng Wang
Affiliation:
Bengbu Medical College, Bengbu, China
Simin Ma
Affiliation:
Bengbu Medical College, Bengbu, China
Yuqing Yang
Affiliation:
Bengbu Medical College, Bengbu, China
Yonghui Huang
Affiliation:
Bengbu Medical College, Bengbu, China
Menghui Guo
Affiliation:
Bengbu Medical College, Bengbu, China
Yizhen Wu
Affiliation:
Bengbu Medical College, Bengbu, China
*
Corresponding authors: Mengdie Pan, Email: 330310117@qq.com; Wenjuan Wang, Email: wwj.wen@163.com
Corresponding authors: Mengdie Pan, Email: 330310117@qq.com; Wenjuan Wang, Email: wwj.wen@163.com
Get access

Abstract

During the COVID-19 pandemic, there was an increase in online gaming behaviour among college students. This study aimed to examine the impact of online self-help interventions consisting of different components within the Acceptance and Commitment Therapy (ACT) framework on college students’ gaming disorder and gaming frequency. Additionally, it evaluated the effectiveness of both interventions in addressing psychological distress among college students during the COVID-19 pandemic. One intervention was a full ACT program, which consists of six core components, while the other intervention focused on the engaged components of ACT (specifically targeting value-based actions). The study employed a 2 conditions (Full ACT vs. Engaged ACT) × 3 times (pre-, mid- and post-program) design to examine the effectiveness of these interventions. Each intervention consisted of 10 sessions, delivered at a frequency of five sessions per week over a 2-week period for both groups. The participants in this study were enrolled in two online classes. Participants with gaming disorder scores in the top 20% were selected and assigned to either the Full group (N = 49) or the Engaged group (N = 41) for the interventions. The study assessed outcome variables, including gaming disorder, psychological flexibility, daily gaming hours, weekly gaming days and psychological distress, at pre-intervention, mid-intervention, post-intervention and one-month follow-up for both groups. No significant differences were observed between the two groups on these outcomes at the pre-intervention stage. The findings of this study indicate that both interventions effectively reduced gaming disorder and weekly gaming frequency, while enhancing psychological flexibility. Nonetheless, the Engaged group exhibited a significant reduction in daily gaming hours. There was no substantial change in psychological distress in either group during and after the intervention. The implications and limitations of this study were also reported.

Type
Standard Paper
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Australian Association for Cognitive and Behaviour Therapy

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Dongyan Ding, Mengdie Pan and Wenjuan Wang are the co-first authors; they have contributed equally to this work.

References

Amstadter, AB, Broman-Fulks, J, Zinzow, H, Ruggiero, KJ and Cercone, J (2009). Internet-based interventions for traumatic stress-related mental health problems: A review and suggestion for future research. Clinical Psychology Review, 29, 410420. https://doi.org/10.1016/j.cpr.2009.04.001.CrossRefGoogle ScholarPubMed
A-Tjak, JGL, Davis, ML, Morina, N, Powers, MB, Smits, JAJ and Emmelkamp, PMG (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84, 3036. https://doi.org/10.1159/000365764.CrossRefGoogle ScholarPubMed
Brooke, J (1996). SUS: A quick and dirty usability scale.Google Scholar
Brunborg, GS, Mentzoni, RA and Frøyland, LR (2014). Is video gaming, or video game addiction, associated with depression, academic achievement, heavy episodic drinking, or conduct problems? Journal of Behavioral Addictions, 3, 2732. https://doi.org/10.1556/JBA.3.2014.002.CrossRefGoogle ScholarPubMed
Cao, J, Ji, Y and Zhu, Z (2013). Reliability and validity of the Chinese version of the Acceptance and Action Questionnaire-Second Edition (AAQ-II) in college students. Chinese Mental Health Journal, 27, 873877. https://doi.org/10.3969/j.issn.1000-6729.2013.11.014.Google Scholar
Cheng, L, Liu, Q and Tong, J (2020). Prevalence of gaming disorder and the influencing factors among adolescents in Jianaxi province. Journal of International Psychiatry, 47, 11571160+1165. https://doi.org/10.13479/j.cnki.jip.2020.06.019.Google Scholar
Chew, B-H, Fernandez, A and Shariff-Ghazali, S (2018). Psychological interventions for behavioral adjustments in diabetes care—A value-based approach to disease control. Psychology Research and Behavior Management, 11, 145–155. https://doi.org/10.2147/PRBM.S117224.CrossRefGoogle ScholarPubMed
Chia, DXY, Ng, CWL, Kandasami, G, Seow, MYL, Choo, CC, Chew, PKH, … Zhang, MWB (2020). Prevalence of internet addiction and gaming disorders in Southeast Asia: A meta-analysis. International Journal of Environmental Research and Public Health, 17, 2582. https://www.mdpi.com/1660-4601/17/7/2582 10.3390/ijerph17072582CrossRefGoogle ScholarPubMed
Chorpita, BF, Rotheram-Borus, MJ, Daleiden, EL, Bernstein, A, Cromley, T, Swendeman, D and Regan, J (2011). The old solutions are the new problem: How do we better use what we already know about reducing the burden of mental illness? Perspectives on Psychological Science, 6, 493497. https://doi.org/10.1177/1745691611418240.CrossRefGoogle ScholarPubMed
Conn, VS and Chan, KC (2016). How much, how often, how long? Addressing dosage in intervention studies. Western Journal of Nursing Research, 38, 34. https://doi.org/10.1177/0193945915605067.CrossRefGoogle ScholarPubMed
Ding, D and Wang, W (2022). Psychological flexibility and job performance among IT staff: A chained mediation model of workplace ostracism and perceived stress. Psychologia, 64, 4052. https://doi.org/10.2117/psysoc.2021-A154.CrossRefGoogle Scholar
Ding, D and Zheng, M (2022). Associations between six core processes of psychological flexibility and functioning for chronic pain patients: A three-level meta-analysis. Frontiers in Psychiatry, 13, 893150. https://doi.org/10.3389/fpsyt.2022.893150.CrossRefGoogle ScholarPubMed
Fam, JY (2018). Prevalence of internet gaming disorder in adolescents: A meta-analysis across three decades. Scandinavian Journal of Psychology, 59, 524531. https://doi.org/10.1111/sjop.12459.CrossRefGoogle ScholarPubMed
Fang, S and Ding, D (2020a). The efficacy of group-based acceptance and commitment therapy on psychological capital and school engagement: A pilot study among Chinese adolescents. Journal of Contextual Behavioral Science, 16, 134143. https://doi.org/10.1016/j.jcbs.2020.04.005.CrossRefGoogle Scholar
Fang, S and Ding, D (2020b). A meta-analysis of the efficacy of acceptance and commitment therapy for children. Journal of Contextual Behavioral Science, 15, 225234. https://doi.org/10.1016/j.jcbs.2020.01.007.CrossRefGoogle Scholar
Flynn, MK and Hebert, ER (2022). Values matter in approach behaviors: A replication using contamination anxiety behavioral approach tasks. Journal of Contextual Behavioral Science, 23, 4852. https://doi.org/10.1016/j.jcbs.2021.11.005.CrossRefGoogle Scholar
French, K, Golijani-Moghaddam, N and Schroder, T (2017). What is the evidence for the efficacy of self-help acceptance and commitment therapy? A systematic review and meta-analysis. Journal of Contextual Behavioral Science, 6, 360374. https://doi.org/10.1016/j.jcbs.2017.08.002.CrossRefGoogle Scholar
Gloster, AT, Lamnisos, D, Lubenko, J, Presti, G, Squatrito, V, Constantinou, M, … Karekla, M (2020). Impact of COVID-19 pandemic on mental health: An international study. PLoS One, 15, e0244809. https://doi.org/10.1371/journal.pone.0244809.CrossRefGoogle ScholarPubMed
Gong, X, Xie, X-y, Rui, X and Yue-jia, L (2010). Psychometric properties of the Chinese versions of DASS-21 in Chinese college students. Chinese Journal of Clinical Psychology, 18, 443447. https://doi.org/10.16128/j.cnki.1005-3611.2010.04.020.Google Scholar
Graham, CD, Gouick, J, Krahe, C and Gillanders, D (2016). A systematic review of the use of Acceptance and Commitment Therapy (ACT) in chronic disease and long-term conditions. Clinical Psychology Review, 46, 4658. https://doi.org/10.1016/j.cpr.2016.04.009.CrossRefGoogle ScholarPubMed
Harris, R (2009). ACT made simple: An easy-to-read primer on acceptance and commitment therapy. Oakland, CA: New Harbinger Publications.Google Scholar
Hayes, SC (2016). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies – republished article. Behavior Therapy, 47, 869885. https://doi.org/10.1016/j.beth.2016.11.006.CrossRefGoogle ScholarPubMed
Hayes, SC, Luoma, JB, Bond, FW, Masuda, A and Lillis, J (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44, 125. https://doi.org/10.1016/j.brat.2005.06.006.CrossRefGoogle ScholarPubMed
Hayes, SC, Pistorello, J and Levin, ME (2012). Acceptance and commitment therapy as a unified model of behavior change. The Counseling Psychologist, 40, 9761002. https://doi.org/10.1177/0011000012460836.CrossRefGoogle Scholar
Heffner, JL, McClure, JB, Mull, KE, Anthenelli, RM and Bricker, JB (2015). Acceptance and Commitment Therapy and nicotine patch for smokers with bipolar disorder: Preliminary evaluation of in-person and telephone-delivered treatment. Bipolar Disorder, 17, 560566. https://doi.org/10.1111/bdi.12300.CrossRefGoogle ScholarPubMed
Hofmann, SG and Hayes, SC (2018). Modern CBT: Moving toward process-based therapies. Revista Brasileira de Terapias Cognitivas, 14, 77–84. https://doi.org/10.5935/1808-5687.20180012.CrossRefGoogle Scholar
Hofmann, SG and Hayes, SC (2019). The future of intervention science: Process-based therapy. Clinical Psychological Science, 7, 3750. https://doi.org/10.1177/2167702618772296.CrossRefGoogle ScholarPubMed
Hong, YN, Hwang, H, Starcevic, V, Choi, TY, Kim, TH and Han, DH (2023). Which is more stable and specific: DSM-5 internet gaming disorder or ICD-11 gaming disorder? A longitudinal study. Psychiatry and Clinical Neurosciences, 77, 213222. https://doi.org/10.1111/pcn.13522.CrossRefGoogle ScholarPubMed
Juarascio, A, Shaw, J, Forman, E, Timko, CA, Herbert, J, Butryn, M, … Lowe, M (2013). Acceptance and commitment therapy as a novel treatment for eating disorders: An initial test of efficacy and mediation. Behavior Modification, 37, 459489. https://doi.org/10.1177/0145445513478633.CrossRefGoogle ScholarPubMed
Kass, AE, Trockel, M, Safer, DL, Sinton, MM, Cunning, D, Rizk, MT, … Taylor, CB (2014). Internet-based preventive intervention for reducing eating disorder risk: A randomized controlled trial comparing guided with unguided self-help. Behaviour Research and Therapy, 63, 9098. https://doi.org/10.1016/j.brat.2014.09.010.CrossRefGoogle Scholar
Kim, SM, Han, DH, Lee, YS and Renshaw, PF (2012). Combined cognitive behavioral therapy and bupropion for the treatment of problematic on-line game play in adolescents with major depressive disorder. Computers in Human Behavior, 28, 19541959. https://doi.org/10.1016/j.chb.2012.05.015.CrossRefGoogle Scholar
Kim, BM, Lee, J, Choi, AR, Chung, SJ, Park, M, Koo, JW, … Choi, JS (2021). Event-related brain response to visual cues in individuals with Internet gaming disorder: Relevance to attentional bias and decision-making. Translational Psychiatry, 11, 258. https://doi.org/10.1038/s41398-021-01375-x.CrossRefGoogle ScholarPubMed
Kim, HS, Son, G, Roh, EB, Ahn, WY, Kim, J, Shin, SH, … Choi, KH (2022). Prevalence of gaming disorder: A meta-analysis. Addictive Behaviors, 126, 107183. https://doi.org/10.1016/j.addbeh.2021.107183.CrossRefGoogle ScholarPubMed
King, DL, Delfabbro, PH, Wu, AMS, Doh, YY, Kuss, DJ, Pallesen, S, … Sakuma, H (2017). Treatment of internet gaming disorder: An international systematic review and CONSORT evaluation. Clinical Psychology Review, 54, 123133. https://doi.org/10.1016/j.cpr.2017.04.002.CrossRefGoogle ScholarPubMed
Lee, J (2020). Mental health effects of school closures during COVID-19. The Lancet Child & Adolescent Health, 4, 421. https://doi.org/10.1016/s2352-4642(20)30109-7.CrossRefGoogle ScholarPubMed
Levin, ME, Hayes, SC, Pistorello, J and Seeley, JR (2016). Web-based self-help for preventing mental health problems in universities: Comparing acceptance and commitment training to mental health education. Journal of Clinical Psychology, 72, 207225. https://doi.org/10.1002/jclp.22254.CrossRefGoogle ScholarPubMed
Levin, ME, Krafft, J, Hicks, ET, Pierce, B and Twohig, MP (2020). A randomized dismantling trial of the open and engaged components of acceptance and commitment therapy in an online intervention for distressed college students. Behaviour Research and Therapy, 126, 103557. https://doi.org/10.1016/j.brat.2020.103557.CrossRefGoogle Scholar
Liao, Z, Huang, Q, Huang, S, Tan, L, Shao, T, Fang, T, … Shen, H (2020). Prevalence of internet gaming disorder and its association with personality traits and gaming characteristics among Chinese adolescent gamers. Frontiers in Psychiatry, 11, 598585. https://doi.org/10.3389/fpsyt.2020.598585.CrossRefGoogle ScholarPubMed
Lovibond, PF and Lovibond, SH (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335343. https://doi.org/10.1016/0005-7967(94)00075-U.CrossRefGoogle ScholarPubMed
Milani, L, La Torre, G, Fiore, M, Grumi, S, Gentile, DA, Ferrante, M, … Di Blasio, P (2017). Internet gaming addiction in adolescence: Risk factors and maladjustment correlates. International Journal of Mental Health and Addiction, 16, 888904. https://doi.org/10.1007/s11469-017-9750-2.CrossRefGoogle Scholar
Petersen, JM, Krafft, J, Twohig, MP and Levin, ME (2021). Evaluating the open and engaged components of acceptance and commitment therapy in an online self-guided website: Results from a pilot trial. Behavior Modification, 45, 480501. Article 0145445519878668. https://doi.org/10.1177/0145445519878668CrossRefGoogle Scholar
Petry, NM, Rehbein, F, Gentile, DA, Lemmens, JS, Rumpf, HJ, Mossle, T, … O'Brien, CP (2014). An international consensus for assessing internet gaming disorder using the new DSM-5 approach. Addiction, 109, 13991406. https://doi.org/10.1111/add.12457.CrossRefGoogle ScholarPubMed
Pocai, B (2019). The ICD-11 has been adopted by the World Health Assembly. World Psychiatry, 18, 371372. https://doi.org/10.1002/wps.20689.CrossRefGoogle ScholarPubMed
Pontes, HM, Kiraly, O, Demetrovics, Z and Griffiths, MD (2014). The conceptualisation and measurement of DSM-5 Internet Gaming Disorder: The development of the IGD-20 Test. PLoS ONE, 9, e110137. https://doi.org/10.1371/journal.pone.0110137.CrossRefGoogle ScholarPubMed
Powers, MB, Vording, MBZVS and Emmelkamp, PMG (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and Psychosomatics, 78, 7380. https://doi.org/10.1159/000190790.CrossRefGoogle ScholarPubMed
Qin, L-x, Liu, Q-s, & Luo, T (2020). Reliability and validity of 20-item Internet Gaming Disorder Test for Chinese college students. Chinese Journal of Clinical Psychology, 28, 3336. https://doi.org/10.16128/j.cnki.1005-3611.2020.01.008.Google Scholar
R Core Team (2016). R: A language and environment for statistical computing. https://www.r-project.org/Google Scholar
Statista (2021). Online gaming market size worldwide by region. https://www.statista.com/outlook/dmo/digital-media/video-games/online-games/Google Scholar
Stevens, MWR, King, DL, Dorstyn, D and Delfabbro, PH (2019). Cognitive-behavioral therapy for internet gaming disorder: A systematic review and meta-analysis. Clinical Psychology & Psychotherapy, 26, 191203. https://doi.org/10.1002/cpp.2341.CrossRefGoogle ScholarPubMed
Stevens, SB and Morris, TL (2007). College dating and social anxiety: Using the Internet as a means of connecting to others. Cyberpsychology Behavior, 10, 680688. https://doi.org/10.1089/cpb.2007.9970.CrossRefGoogle ScholarPubMed
Sudhir, PM (2018). Cognitive behavioural interventions in addictive disorders. Indian Journal of Psychiatry, 60, S479S484. https://doi.org/10.4103/psychiatry.indianjpsychiatry_15_18.CrossRefGoogle ScholarPubMed
Taechoyotin, P, Tongrod, P, Thaweerungruangkul, T, Towattananon, N, Teekapakvisit, P, Aksornpusitpong, C, … Piyaraj, P (2020). Prevalence and associated factors of internet gaming disorder among secondary school students in rural community, Thailand: A cross-sectional study. BMC Research Notes, 13, 11. https://doi.org/10.1186/s13104-019-4862-3.CrossRefGoogle ScholarPubMed
Teng, Z, Pontes, HM, Nie, Q, Griffiths, MD and 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, 169180. https://doi.org/10.1556/2006.2021.00016.CrossRefGoogle ScholarPubMed
Tian, F and Wang, L (2022). Research on the use and impact of online games on minors. Youth Exploration, 05, 6574. https://doi.org/10.13583/j.cnki.issn1004-3780.2022.05.006.Google Scholar
Tuo, HA, Weidong, MA, Hong, GO, Yanchao, HU, Zhang, Y, Zhang, C, … Congxia, WA (2021). Investigation and analysis of negative emotion among university students during home quarantine of COVID-19. Journal of Xi'an Jiaotong University (Medical Science), 42, 132136. https://kns.cnki.net/kcms/detail/61.1399.R.20200426.0824.002.htmlGoogle Scholar
Twohig, MP (2009). The application of acceptance and commitment therapy to obsessive-compulsive disorder. Cognitive and Behavioral Practice, 16, 1828. https://doi.org/10.1016/j.cbpra.2008.02.008.CrossRefGoogle Scholar
Velotti, P, Rogier, G, Beomonte Zobel, S and Billieux, J (2021). Association between gambling disorder and emotion (dys)regulation: A systematic review and meta-analysis. Clinical Psychology Review, 87, 102037. https://doi.org/10.1016/j.cpr.2021.102037.CrossRefGoogle ScholarPubMed
Villatte, JL, Vilardaga, R, Villatte, M, Plumb Vilardaga, JC, Atkins, DC and Hayes, SC (2016). Acceptance and Commitment Therapy modules: Differential impact on treatment processes and outcomes. Behaviour Research and Therapy, 77, 5261. https://doi.org/10.1016/j.brat.2015.12.001.CrossRefGoogle ScholarPubMed
Wang, Y, Liu, B, Zhang, L and Zhang, P (2022). Anxiety, depression, and stress are associated with internet gaming disorder during COVID-19: Fear of missing out as a mediator. Frontiers in Psychiatry, 13, 827519. https://doi.org/10.3389/fpsyt.2022.827519.CrossRefGoogle ScholarPubMed
Xiang, YT, Jin, Y, Zhang, L, Li, L, Ungvari, GS, Ng, CH, … Hao, W (2020). An overview of the expert consensus on the prevention and treatment of gaming disorder in China (2019 edition). Neuroscience Bulletin, 36, 825828. https://doi.org/10.1007/s12264-020-00475-w.CrossRefGoogle Scholar
Zhao, W, Wei, T, Zhou, R, Wang, Y, Wang, Y, Ren, Z, … Jiao, D (2021). The influence of online game behaviors on the emotional state and executive function of college students in China. Frontiers in Psychiatry, 12, 713364. https://doi.org/10.3389/fpsyt.2021.713364.CrossRefGoogle ScholarPubMed