For example, both the Interaction of Person–Affect–Cognition–Execution (I-PACE) and tripartite neurocognitive models propose that the imbalance of the impulsive (or affect) and reflective (or cognitive) systems lead to poor decision-making in IGD. Most theories of IGD also highlight its role in the development and maintenance of this condition. Reward-related decision-making dysfunction was included in the Research Domain Criteria (RDoC) framework as an important transdiagnosic construct. Indeed, substance use disorders (SUDs) and gambling disorder have been frequently associated with impaired reward-related decision-making, a pervasive process when individuals need to make a choice from several options based on subjective values. Individuals with IGD are characterized by persistent gaming despite potential negative consequences , which may be attributed to impaired risk evaluation and reward processing during decision-making. Despite much effort, the psychopathology of IGD remains to be elucidated.
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Considering the large number of affected individuals and its negative impact on both personal life and social productivity, IGD has been included in both the 11th revision of the International Classification of Diseases (ICD-11 ) and the appendix of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a world-wide condition warranting further study. IGD may lead to a variety of dysfunctions related to physical health, work performance and social interactions. There were more than 930 million active internet gamers around the world in 2020 ( ) and the prevalence of IGD was approximately 4.6%, according to a recent meta-analysis of 16 survey studies. Internet gaming disorder (IGD) has received much attention with the rapid expansion of on-line gaming use during the last two decades. Internet gaming disorder appears to be consistently associated with reward-related decision-making deficits. Decision-making alterations were not closely associated with IGD severity or self-reported impulsivity differences at the study level. No significant difference between behavioral studies and those with extra measurements was observed. Studies based on clinical and community samples showed similar effects. Larger aggregate ESs were identified for pure-gain and mixed compared with pure-loss decision-making. The effects were comparable across risky, ambiguous and inter-temporal decision-making. The overall ES for decision-making deficits in IGD was small ( g = −0.45, P < 0.01). Reward-related decision-making differences between IGD and control groups. Twenty-four studies (20 independent samples) were included in the meta-analysis, resulting in 604 IGD and 641 control participants and 35 ESs. The effects of decision-making situation, valence, sample type, testing environment, IGD severity and self-reported impulsivity on decision-making differences were examined by moderator analyses. Random-effects modeling was conducted using Hedge‘s g as the effect size (ES). Review of peer-reviewed studies comparing reward-related decision-making performance between IGD and control participants identified via PubMed, Web of Science and ProQuest databases. To estimate the aggregated effect sizes of reward-related decision-making deficits in internet gaming disorder (IGD) and to explore potential moderators on the variability of effect sizes across studies.
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