Internet Gaming Disorder Associated With Decision-Making Deficits in Reward-Related Behaviors

Young man sitting at his PC, playing computer games
The study authors sought to examine the aggregated effect sizes of reward-related decision-making deficits in internet gaming disorder and to explore potential moderators on the variability of effect sizes across studies.

Reward-related decision-making deficits were associated with internet gaming disorder (IGD) during a systematic review and meta-analysis, which was published in the journal Addiction.

Publication databases were searched from January 1995 through June of 2020 for studies of internet gaming and decision-related behaviors or disorders. A total of 20 independent samples from 24 studies comprising 604 participants with IGD and 641 controls were included.

Studies assessed participants under differing decision-making situations (risky: n=18, ambiguous: n=10, intertemporal: n=7) by behavioral experiments (n=15) or imaging assessment (n=9).

Overall, effect sizes were negative (g, -0.45; 95% CI, -0.57 to -0.32; P <.01) with significant heterogeneity (Q[34], 70.87; P <.01). A leave-1-out approach found effect sizes ranging from -0.42 to -0.47 (Z, -2.78; P <.01).

Effect sizes were similar among ambiguous (g, -0.46; 95% CI, -0.70 to -0.22; P <.01), risky (g, -0.39; 95% CI, -0.56 to -0.23; P <.01), and intertemporal (g, -0.58; 95% CI, -0.86 to -0.30; P <.01) decision-making situations (log-likelihood ratio [LLR], 1.28; degrees of freedom [DF] difference, 2; P =.53).

Larger aggregates of effect sizes were observed among gain-related (g, -0.46; 95% CI, -0.63 to -0.29; P <.01) and mixed (g, -0.57; 95% CI, -0.74 to -0.39; P <.01) decision-making situations compared with loss-related (g, -0.16; 95% CI, -0.40 to 0.08; P =.20; LLR, 6.36; DF difference, 2; P =.04).

No differences were observed between behavioral (g, -0.45; 95% CI, -0.60 to -0.30; P <.01) and imaging (g, -0.45; 95% CI, -0.67 to -0.22; P <.01) studies (LLR, <0.01; DF difference, 1; P =.98) nor between studies of clinical (g, -0.54; 95% CI, -0.76 to -0.31; P <.01) or community (g, -0.41; 95% CI, -0.56 to -0.26; P<.01) samples (LLR, 0.83; DF difference, 1; P =.36).

This analysis was likely biased by the significant heterogeneity detected among the underlying studies.

The study authors concluded individuals with IGD, in general, seek to gain and attempt to avoid losses, reacting similarly across decision-making tasks.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Yao YW, Zhang JT, Fang XY, Liu L, Potenza MN. Reward-related decision-making deficits in internet gaming disorder: A systematic review and meta-analysis.Addiction. Published online April 16, 2021. doi:10.1111/add.15518