JMIR Publications

ABSTRACT

Background:

Adolescent gaming addiction has been linked to a range of adverse health outcomes. However, whether the health risks associated with gaming addiction differ across game genres remains poorly understood. Moreover, most prior research has adopted a narrow, pathology-focused view of health. It remains unclear whether addiction to different game genres relates differently to adolescents’ health when adopting a broader health framework.

Objective:

Guided by VanderWeele’s multidimensional flourishing framework, this cross-sectional study aimed to explore the genre-specific associations between gaming addiction and flourishing among adolescents.

Methods:

Middle school students (N = 2194, mean age = 14.53 ± 0.76 years) recruited from a private tutoring center in a northwestern city in China participated in the study. Participants listed up to three video games played in the past month and rated their addiction to each. Games were classified into eight genres: action & adventure (AA), sandbox & simulation (SS), multiplayer online battle arena (MOBA), shooting, strategy, casual, sports, and role-playing. Flourishing was assessed using the Human Flourishing Index across five domains: happiness and life satisfaction, mental and physical health, meaning and purpose, character and virtue, and close social relationships. Robust linear regressions estimated the associations between genre-specific addiction and flourishing outcomes.

Results:

Higher AA addiction was inversely associated with overall flourishing (b = −3.11, 95% CI = [−4.34, −1.88], q < .001) and all its subdomains (happiness and life satisfaction: b = −0.46, 95% CI = [−0.75, −0.17], q = .009; mental and physical health: b = −0.61, 95% CI = [−0.88, −0.34], q < .001; meaning and purpose: b = −0.55, 95% CI = [−0.82, −0.27], q = .001; character and virtue: b = −0.74, 95% CI = [−1.06, −0.43], q < .001; close social relationships: b = −0.62, 95% CI = [−0.92, −0.32], q < .001). Higher MOBA addiction was associated with lower overall flourishing (b = −1.33, 95% CI = [−2.34, −0.32], q = .03), lower character and virtue (b = −0.34, 95% CI = [−0.59, −0.08], q = .03), and lower meaning and purpose (b = −0.34, 95% CI = [−0.56, −0.11], q = .02). Higher SS addiction was associated with lower overall flourishing (b = −3.42, 95% CI = [−5.80, −1.04], q = .02), poorer close social relationships (b = −0.86, 95% CI = [−1.46, −0.27], q = .02), and worse mental and physical health (b = −1.09, 95% CI = [−1.60, −0.58], q < .001). No significant associations were observed for addiction to shooting, sports, casual, strategy, or role-playing games.

Conclusions:

This study demonstrates that the association between gaming addiction and adolescent flourishing is genre-dependent. Prevention, education, and policy should prioritize higher-risk genres, particularly AA, MOBA, and SS, to promote adolescents’ health.