Video game use predicts increase in ADHD symptoms

Recent studies have linked screen time – including video game play – to concerning outcomes in children, including low self-esteem, low life satisfaction, and depressive symptoms. Screen time has also been found to be correlated with symptoms of ADHD in children and adolescents, even when earlier attention difficulties are taken into account.

These findings suggest that excessive video game play may be a risk factor for the development of ADHD symptoms. Other research suggests the possibility of reverse causation, i.e., that ADHD symptoms predict the development of excessive video game play.

Determining whether causal links exist between ADHD symptoms and video game play requires a longitudinal study in which ADHD symptoms and video game play are measured at 2 points in time.

With this design, researchers can test whether video game use at Time 1 predicts an increase in ADHD symptoms at Time 2, after controlling for ADHD symptoms at Time 1., i.e., more video game play leads to more ADHD symptoms.

Similarly, one can test whether ADHD symptoms at Time 1 predicts higher video game use at Time 2, controlling for video game use at Time 1., i.e., more ADHD symptoms leads to more video game play.

This design was employed in a study published recently in the Journal of Attention Disorders [Tiraboschi et al., (2022). Associations between video game engagement and ADHD symptoms in early adolescence. Journal of Attention Disorders, DOI: 10.177/10870547211073473].

Participants were over 1400 youth (roughly 50% female) from a representative sample drawn from the province of Quebec. As part of a larger longitudinal study, these youth self-reported their weekly hours of video game as well as their ADHD symptoms at age 12, and again one year later. Video game engagement was rated on a scale from zero hours per week to more than 20 hours per week. ADHD symptoms were rated on a 3-point scale from ‘Never true’ to ‘Often or very true’.

Results – After controlling for sex, socioeconomic status, and ADHD symptoms at age 12, the weekly amount video game play reported at age 12 predicted higher levels of self-reported ADHD symptoms at age 13; this was true for both inattentive and hyperactive impulsive symptoms. The magnitude of the effect was not large, but it was statistically significant.

In contrast, higher levels of ADHD symptoms at age 12 did not predict an increase in video game play one year later. Although being male and of lower socioeconomic status was linked to higher ADHD symptoms and more video game play at age 12, these factors did not predict an increase in either ADHD symptoms or video game play over time.

Summary and implications – Results from this study provide evidence that youth who engage in more video game play are at risk for an increase in ADHD symptoms over time. Because this result was obtained with a representative community sample of youth, and was not restricted to youth diagnosed with ADHD, it suggests that video game play may be a general risk factor for ADHD symptoms.

The authors note several important study limitations, including the fact that both ADHD symptoms and video game play were self-reported. There was also not information collected on the type of video game play; this is especially important in that the FDA recently approved a video game (Endeavor RX) as a treatment for ADHD based on favorable results in a clinical trial.

Because attention problems need not be elevated to a level typically seen in youth with ADHD can still adversely affect academic achievement, these findings are potentially concerning. However, it should be emphasized that the impact of video game play on increasing ADHD symptoms, although statistically significant, was modest. The clinical implications of these findings thus remain unclear.

It is also not clear whether video game play may need to be above a certain threshold level before it may contribute to an increase in ADHD symptoms while lower levels of engagement are not associated with any risk.

The above considerations highlight that while excessive use of some types of video games may lead to an increase in ADHD symptoms over time, it is premature to conclude that any type of video game play has this effect. Developing a better understanding of this issue will hopefully emerge over time.

Copyright © 2022 by David Rabiner

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