Genre-Specific Gaming Addiction and Flourishing in Adolescents: Cross-Sectional Survey Study

Adolescent gaming addiction (GA) has been linked to a range of adverse health outcomes. However, whether the associated health risks differ across game genres remains poorly understood.

Guided by VanderWeele's multidimensional flourishing framework, this study aims to examine genre-specific associations between GA and flourishing among adolescents.

This study used a cross-sectional observational design. A total of 2194 middle school students were recruited via convenience sampling from a private tutoring center in a northwestern city in China. Eligibility criteria were (1) enrollment in participating classes at the tutoring center, (2) provision of both student and parental consent, and (3) presence during questionnaire administration. The mean age of participants was 14.53 (SD 0.76) years; 985 (44.90%) were boys and 1174 (53.51%) were girls. During class time, students completed paper-based questionnaires that assessed their demographics, gaming addiction, and flourishing. Participants listed up to 3 video games played in the past month and rated their addiction to each. Games were classified into 8 genres: action and adventure (AA), sandbox and simulation (SS), multiplayer online battle arena (MOBA), shooting, strategy, casual, sports, and role-playing. Flourishing was assessed using the Human Flourishing Index across 5 domains: happiness and life satisfaction, mental and physical health, meaning and purpose, character and virtue, and close social relationships.

Robust linear regression analyses (α=.05) showed that AA addiction was associated with lower overall flourishing (b=-3.11, 95% CI -4.34 to -1.88) and all 5 subdomains (happiness and life satisfaction: b=-0.46, 95% CI -0.75 to -0.17; mental and physical health: b=-0.61, 95% CI -0.88 to -0.34; meaning and purpose: b=-0.55, 95% CI -0.82 to -0.27; character and virtue: b=-0.74, 95% CI -1.06 to -0.43; and close social relationships: b=-0.62, 95% CI -0.92 to -0.32). MOBA addiction was associated with lower overall flourishing (b=-1.33, 95% CI -2.34 to -0.32), character and virtue (b=-0.34, 95% CI -0.59 to -0.08), and meaning and purpose (b=-0.34, 95% CI -0.56 to -0.11). SS addiction was associated with lower overall flourishing (b=-3.42, 95% CI -5.80 to -1.04), close social relationships (b=-0.86, 95% CI -1.46 to -0.27), and mental and physical health (b=-1.09, 95% CI -1.60 to -0.58).

This study provides novel evidence that the association between GA and adolescent flourishing is genre dependent. In contrast to prior research that conceptualizes health narrowly or unidimensionally, a multidimensional perspective provides a more nuanced understanding of the health risks associated with GA. The findings advance the field by showing that addiction to AA, MOBA, and SS games is associated with greater health risks than addiction to other genres. Accordingly, prevention, education, and policy efforts should prioritize higher-risk genres to promote adolescent health.