Accepted for/Published in: JMIR Serious Games
Date Submitted: Jul 30, 2025
Date Accepted: Jan 15, 2026
Conceptualization and Measurement of Withdrawal Symptoms in Gaming Disorder: Development and Psychometric Validation of the Gaming Withdrawal Symptoms Questionnaire – A Cross-Sectional Study
ABSTRACT
Background:
Gaming Disorder (GD) is an emerging issue that leads to significant impairment, yet existing tools for measuring withdrawal symptoms in GD are limited and often fail to capture its multidimensional nature. Most current measures rely on single-item assessments or adapt tools from substance use disorders, overlooking cognitive, behavioral, and physiological components. A comprehensive, multidimensional questionnaire is needed to more accurately assess withdrawal in GD, aiding in early detection and intervention.
Objective:
The objective of this study was to develop and psychometric validate of a comprehensive measurement tool, the Gaming Withdrawal Symptoms Questionnaire (GWSQ) that captures the multidimensional nature of withdrawal symptoms in GD, encompassing affective, cognitive, behavioral, and physiological components.
Methods:
A multi-stage psychometric approach was used, starting with item generation from a scoping literature review. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to refine the questionnaire. Reliability and validity were assessed using two cross-sectional online studies. Participants (Study 1: 480 adults, mean age 23; Study 2: 565 adults, mean age 25) were recruited from gaming-related platforms and social media (e.g., Discord, Reddit, Facebook).
Results:
EFA revealed a three-factor model of withdrawal symptoms: (1) Motivational and Cognitive Symptoms, (2) Affective Symptoms, and (3) Physical Symptoms, explaining 54% of the variance. CFA confirmed good model fit (χ²(227) = 887.88, p < .001; CFI = 0.91; TLI = 0.90; RMSEA = 0.072). The GWSQ demonstrated high internal consistency (α = 0.89–0.90). Correlations with related constructs (IGDS9-SF, PHQ-9, GAD-7) ranged from moderate (r = 0.42–0.48), and normative data (Sten scores) were established.
Conclusions:
The GWSQ is the first validated, multidimensional tool specifically designed to assess withdrawal symptoms in Gaming Disorder. It addresses critical gaps in GD diagnosis and research by capturing a broader spectrum of symptoms beyond affective distress, supporting clinical and research utility for early detection, diagnosis, and intervention planning.
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