A Cognitive Behavioral Therapy Intervention for Internet Gaming Disorder

Not Applicable

• Conditions: Internet Gaming Disorder
• Interventions: Behavioral: Cognitive behavioral therapy; Other: Education material about IGD; Other: Education material about CBT

• Registration Number: NCT04257890
• Lead Sponsor: Chinese University of Hong Kong

Brief Summary

This RCT study develops a brief group-based CBT intervention. The primary objective is to evaluate the efficacy of the CBT in reducing IGD, compare to a wait-list control group.

Detailed Description

Introduction Cognitive behavioral therapy (CBT) is potentially useful as it is effective in treating mental/behavioral disorders, restructuring cognitions and cultivating positive coping. A gap exists as the only two existing clinic-based small randomized controlled trials (RCT) yielded mixed findings on CBT's treatment effect for adolescent IGD.

Objectives This RCT study develops a brief group-based CBT intervention. The primary objective is to evaluate the efficacy of the CBT in reducing IGD, compare to a wait-list control group.

Subjects and methods The study design is two-armed RCT. The participants are Secondary 1-4 students (n=226) with IGD (DSM-5 classification) identified in a school-based screening. Evaluation involves surveys at baseline, end of CBT intervention, and 6 months afterwards. In addition to information received by the wait-list control group, the intervention group receives a carefully designed brief 8-week group-based CBT. The control group will receive CBT after the 6-month follow-up. Trained social workers of a collaborating NGO that serves secondary school students will conduct the CBT.

Outcomes and measures The primary outcome is IGD (a validated DSM-5 IGD classification tool). Secondary outcomes include time spent on Internet/Internet games and the intention to reduce IGD. Measures of potential mediators (maladaptive beliefs and coping) include: Internet Gaming Cognition Scale, Generalized Problematic Internet Use Scale, Emotion Regulation Questionnaire, and Coping Scale for Children and Youth.

Data analysis Intention-to-treat analysis is performed. The primary outcome is assessed by absolute and relative risk reduction. Generalized Linear Mixed Models and Structural Equation Models are used to test secondary outcomes and mediation effects.

Implications The findings may lead to an evidence-based treatment for adolescent IGD, a newly defined disease, which has been rarely reported in literature. Understanding its mechanism contributes to theoretical development of IGD and related treatment.

Study Timeline

• Study First Submitted: 2019-12-27
• Study First Submitted QC: 2020-02-05
• Study First Posted: 2020-02-06
• Study Start: 2021-03-19
• Status Verified: 2021-07
• Last Update Submitted: 2021-07-29
• Last Update Posted: 2021-08-02
• Primary Completion: 2022-11-30
• Study Completion: 2022-12-31

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 226

Inclusion Criteria

• secondary 1-4 students (grade 7-10),
• positive screening results (i.e. IGD cases) according to a validated questionnaire (the 5 DSM-5 criteria for IGD),
• students' and parental consent,
• Chinese speaking.

Exclusion Criteria

• self-reported history of any psychiatric or neurological illness,
• current use of any psychotropic medication.

We do not include Secondary 5-6 students due to their preparation for public examinations and practical difficulty in follow-up after their graduation.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Wait-list control group	Cognitive behavioral therapy	Members will receive printed education material about IGD but not CBT during the treatment period.
CBT intervention group	Cognitive behavioral therapy	In addition to the information about IGD of the control group, the intervention group will receive eight weekly group-based 90-minute CBT sessions.
CBT intervention group	Education material about CBT	In addition to the information about IGD of the control group, the intervention group will receive eight weekly group-based 90-minute CBT sessions.
CBT intervention group	Education material about IGD	In addition to the information about IGD of the control group, the intervention group will receive eight weekly group-based 90-minute CBT sessions.
Wait-list control group	Education material about IGD	Members will receive printed education material about IGD but not CBT during the treatment period.
Wait-list control group	Education material about CBT	Members will receive printed education material about IGD but not CBT during the treatment period.

Primary Outcome Measures

Name	Time	Method
Change from baseline Internet gaming disorder (IGD) at 6 months	six months after the interventions	The DSM-5 classification of IGD: The 9-item IGD checklist is a short, user-friendly, self-report measure for assessing the DSM-5 classification of IGD. Symptoms to be assessed include preoccupation, tolerance, withdrawal, unsuccessful attempts to limit gaming, deception or lies about gaming, loss of interest in other activities, use despite knowledge of harm, use for escape or relief of negative mood, and harm in the past 12 months. Response options are no (0) and yes (1). As per the DSM-5 recommendation, those with \>=5 'yes' responses are considered IGD cases. The Chinese version has been validated with high internal consistency.
Change from baseline Internet gaming disorder (IGD) immediately after the interventions	immediately after the interventions	The DSM-5 classification of IGD: The 9-item IGD checklist is a short, user-friendly, self-report measure for assessing the DSM-5 classification of IGD. Symptoms to be assessed include preoccupation, tolerance, withdrawal, unsuccessful attempts to limit gaming, deception or lies about gaming, loss of interest in other activities, use despite knowledge of harm, use for escape or relief of negative mood, and harm in the past 12 months. Response options are no (0) and yes (1). As per the DSM-5 recommendation, those with \>=5 'yes' responses are considered IGD cases. The Chinese version has been validated with high internal consistency.

Trial Locations

Locations (6)

HKMLC Queen Maud Secondary School; 🇨🇳 Hong Kong, Hong Kong, China

Po Kok Secondary School; 🇭🇰 Hong Kong, Hong Kong

Po Leung Kuk Lee Shing Pik College; 🇭🇰 Hong Kong, Hong Kong

Henrietta Secondary School; 🇭🇰 Hong Kong, Hong Kong

S.T.F.A. Lee Shau Kee College; 🇭🇰 Hong Kong, Hong Kong

Shun Tak Fraternal Association Leung Kau Kui College; 🇭🇰 Hong Kong, Hong Kong