The Association Between Causality Orientation and Internet Gaming Disorder, and the Role of Sensation Seeking, Anxiety, and Depression

Yanjie Peng; Yuxiang Wang; Zhenlei Peng; Xiaoyuan Liao; Ke Gong; Cheng Qin; Mingyuan Tian; Xiaotong Cheng; Xinyi Zhou; Juan Deng; Yuwen Chen; Shuang Feng; Maomao Zhang; Kezhi Liu; Bo Xiang; Wei Lei; Jing Chen

doi:10.30773/pi.2024.0122

Psychiatry Investig > Volume 21(11); 2024 > Article

Peng, Wang, Peng, Liao, Gong, Qin, Tian, Cheng, Zhou, Deng, Chen, Feng, Zhang, Liu, Xiang, Lei, and Chen: The Association Between Causality Orientation and Internet Gaming Disorder, and the Role of Sensation Seeking, Anxiety, and Depression

Original Article

Psychiatry Investigation 2024;21(11):1268-1278.

Published online: November 18, 2024

DOI: https://doi.org/10.30773/pi.2024.0122

The Association Between Causality Orientation and Internet Gaming Disorder, and the Role of Sensation Seeking, Anxiety, and Depression

Yanjie Peng^1,^2,³

, Yuxiang Wang^1,^2,³

, Zhenlei Peng⁴

, Xiaoyuan Liao^1,^2,³

, Ke Gong^1,^2,³

, Cheng Qin^1,^2,³

, Mingyuan Tian¹

, Xiaotong Cheng¹

, Xinyi Zhou¹

, Juan Deng¹

, Yuwen Chen^1,^2,³

, Shuang Feng^1,^2,³

, Maomao Zhang^1,^2,³

, Kezhi Liu¹

, Bo Xiang^1,^2,³

, Wei Lei^1,^2,³

, Jing Chen^1,^2,³

¹Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Luzhou, China

²Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China

³School of Clinical Medicine, Southwest Medical University, Luzhou, China

⁴Xinjiang Clinical Research Center for Mental (Psychological) Disorders, The Psychological Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

Correspondence: Wei Lei, MD Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiang Yang District, 646000 Luzhou, China Tel: +86-0830-3165019, E-mail: leiwei_fy@swmu.edu.cn

Correspondence: Jing Chen, PhD Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiang Yang District, 646000 Luzhou, China Tel: +86-0830-3165019, E-mail: chengjing_fy@swmu.edu.cn

Received April 8, 2024 Revised August 11, 2024 Accepted September 19, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

Self-determination theory (SDT) deems that people have three causality orientations: autonomy orientation, control orientation, and impersonal orientation. Previous studies suggested that lower autonomy orientation or higher control and impersonal orientations may be associated with more addictive behaviors. Our study aimed to investigate if these associations exist in Internet gaming disorder (IGD), and if sensation seeking, anxiety, and depression could influence the associations between causality orientations and IGD symptoms.

Methods

A total of 1,400 college students completed the Internet Gaming Disorder Scale, General Causality Orientation Scale, Brief Sensation Seeking Scale, Generalized Anxiety Disorder Scale, and Patient Health Questionnaire. Correlation, multiple linear regressions, structural equation model (SEM) analyses, and moderation analyses were conducted to explore the associations.

Results

The control and impersonal orientations were positively associated with IGD symptoms, while the autonomy orientation was negatively associated with them. Moreover, SEM analyses showed that the autonomy-IGD relationship was totally mediated by anxiety and depression, the impersonal-IGD relationship was partially mediated by anxiety, and the control-IGD relationship was partially mediated by depression. Finally, the effects of causality orientations on IGD were moderated by sensation seeking.

Conclusion

Overall, autonomy orientation is linked to fewer gaming problems, whereas control and impersonal orientations are associated with more gaming problems. Moreover, the relationships between causality orientations and IGD symptoms are mediated by anxiety and depression and moderated by sensation seeking. Our findings inform theory on the motivations of gaming behaviors and may shed light on the prevention and intervention of IGD from the perspective of SDT.

Keywords: Internet gaming disorder, Self-determination theory, General causality orientations, Anxiety, Depression, Sensation seeking

INTRODUCTION

Internet games have become a popular kind of leisure nowadays. Up to June 2023, the scale of China’s online game users reached 550 million, accounting for 51% of the overall Internet users [1]. Internet gaming disorder (IGD), a type of behavioral addiction characterized by repeated and excessive use of games, hence has received increasing attention [2]. IGD was associated with substantial psychological (e.g., depression, anxiety, suicidal ideation) and physical impairments (e.g., substance use, self-injury, sleep deprivation), which likely stem from sustained and problematic patterns of Internet game engagement [3-11]. Gaming behaviors can be motivated by many things. However, an open question is what are the common characteristics that exist under various game motivations? According to the self-determination theory (SDT), motivation is determined by two things: environmental factors (e.g., external reward) and causality orientations [12]. The causality orientations of gamers thus could bear vital information on the drive of gaming behaviors.

According to SDT, causality orientations are the tendentious trait of motivation that characterizes the source of initiation and regulation of their behavior [13]. SDT defined three different causality orientations existing in all persons [14]: the autonomy orientation (the extent to which a person is oriented toward aspects of the environment that stimulate intrinsic motivation, e.g., aspects that are optimally challenging and providing informational feedback), the control orientation (the extent to which a person is oriented toward being controlled by rewards, deadlines, structures, punishments, and other people’s directives), and the impersonal orientation (the extent to which a person believes that attaining desired outcomes is beyond his/her control and that achievement is largely a matter of luck or fate). These causality orientations have been associated with the mental health of individuals. Particularly, the autonomy orientation is positively associated with better mental health such as self-actualization, private self-consciousness, ego development, interest, and self-esteem [13], while the control orientation is associated with difficulties in regulating emotions, higher levels of stress, hostility, poorer coping, and defensive reactions in interpersonal situations [13,15-17]. Finally, individuals who are impersonal-oriented may lose their senses of volition, intentionality and engagement, and feel that they are ineffective and unable to attain desired outcomes [13,14,18].

Causality orientations have been linked to various addictive disorders (e.g., alcoholism, gambling) in previous studies. Generally, higher control and impersonal orientations were associated with more addiction-related problems (such as drinking more alcohol and spending more money on gambling), while autonomy orientation was associated with fewer of these problems [19,20]. For instance, a study examined causality orientations along with self-reported measurements on alcohol consumption and alcohol-related negative consequences in 560 (347 women) college students and found that students with lower autonomy orientation (and male students with higher control orientation) tended to hold more positive expectancies about alcohol, consume more alcohol products, and show more alcohol-related problems [19]. Similarly, another study showed that college students who had higher scores on control orientation gambled more frequently, spent more money on gambling, had more negative gambling consequences, and were more likely to meet the criteria of disordered gambling even after accounting for other risk factors [21]. Contrary to the autonomy orientation, the impersonal orientation appeared to partially overlapping effects on health behaviors with the control orientation, potentially because “both are lacking a sense of personal endorsement and volition” [22]. A recent meta-analysis found that not only impersonal and control orientations were positively correlated with each other, both orientations were positively correlated with controlled forms of motivations as well [18]. Yet, differences between the impersonal and control orientations have been observed at times. For instance, while all three orientations positively correlated with alcohol use, only the impersonal orientation significantly predicted the alcohol use in a community sample [23]. Additionally, only the impersonal orientation, but not control, showed a significant positive correlation with symptoms of mobile phone addiction [24]. As we know, no previous study has assessed the association between causality orientations and IGD symptoms severity. Mills et al. [25,26] have found positive associations between extrinsic gaming motivations (measured using the Gaming Motivation Scale [27], which revealed scores on various gaming motivations, named extrinsic motivation, intrinsic motivation, and amotivation) and problematic video gaming symptoms in two studies. These findings were similar to previous literature on control/autonomy orientation and pathologic gambling symptoms [21], suggesting that similar associations may exist between IGD symptoms and causality orientations. However, note that the construct of “intrinsic/extrinsic motivations” is different from “causality orientations.” While the former represents a fundamental distinction of various motivations (the reasons or goals that give rise to a specific activity), the latter indicates the general tendency of motives that are assumed to exist in all activities [12]. According to SDT, motivation is determined by environmental factors and causality orientations [12]. The causality orientations thus are supposed to underlie specific motivations. For example, a study showed that high autonomy orientation and positive competence-enhancing feedback can enhance intrinsic motivation (indicated by time spent on puzzles) in college students [28].

The exact mechanisms of how causality orientations relate to addiction-related problems are currently unclear. The self-determination health behavior model proposes that the individual differences in personality regarding autonomy (i.e., causality orientations) are key predictors of psychological needs satisfaction (i.e., the needs for autonomy, competence, and relatedness), which in turn predict better behavioral regulation, and finally, better mental health (e.g., less depression and anxiety) and more health-conducive behaviors (e.g., abstinence smoking and exercise) [29]. In line with this model, a recent study found that autonomy orientation facilitated the satisfaction of psychological needs and decreased self-derogation strategies of self-presentation, while impersonal orientation decreased self-enhancement strategies and increased self-derogation strategies through psychological needs frustration [30]. The self-determination health behavior model provides a rough framework for the association between causality orientations and healthy behaviors, but in the specific cases of IGD, the mechanisms may become more complex. For example, the SDT motivational model for game engagement proposed that game-play exemplified intrinsically motivated behaviors, which were autonomy-oriented [31]. From this perspective, an autonomy-oriented individual could engage in an excessive amount of gameplay (and thus have an increasing risk of IGD) when he/she finds it is fun. Therefore, more researches are needed to understand the relationship between causality orientations and gaming behaviors.

By definition, causality orientations are traits of motivation but not motivation per se. Particular mediators hence are required to realize the effect of causality orientations on gaming behaviors. According to previous studies, two potential mediators have consistently been linked to IGD: anxiety and depression. Firstly, there was consistent evidence that anxiety and depression were predictors of gaming engagement or IGD symptoms. Longitudinal studies showed that the level of depressive and anxiety symptoms at baseline positively predicted the severity of IGD symptoms at the follow-up tests [32,33]. On the other hand, excessive gaming engagement may also give rise to negative emotional states, such as anxiety and depression [34]. Secondly, causality orientations can predict anxiety and depression as well. A longitudinal study with five assessment waves over nine years found that a more external locus of control (wherein one views their behavior as driven by external rewards, like control orientation, as measured using the Mastery Scale [35]) predicted symptoms of severe anxiety and depression [36]. Moreover, another longitudinal study showed that autonomy support from teachers in the seventh grade boosted basic psychological needs satisfaction, and decreased anxiety and depression in the eighth grade [37]. Likewise, a recent study showed that extrinsic motivation and amotivation predicted test anxiety in students [38]. Similarly, being extrinsically oriented could also predict higher depression [39]. In sum, previous studies indicated that anxiety and depression could mediate the relationship between causality orientations and IGD symptoms.

In addition to the mediation effects of anxiety and depression, the relationship between causality orientations and IGD symptoms could further be moderated by sensation seeking. Sensation seeking describes the willingness to take risks to attain varied, novel, and complex experiences [40]. Sensation seeking is a personality trait that is consistently linked to drug abuse and behavioral addiction, such as IGD. There was accumulated evidence on the associations between sensation seeking and excessive gaming behaviors [41-46]. For example, a longitudinal study found that sensation seeking predicted gaming addiction in adolescents [43]. Moreover, existing research evidence suggested sensation seeking could be linked to causality orientations as well. For instance, Zuckerman [47] found that external locus of control (one views his/her behavior as driven by external rewards, as control orientation) was correlated with higher sensation seeking in drug users. Another study showed that being control-oriented increased the propensity to take recreational risks (like sensation seeking) [48]. From a physiological perspective, individual differences in sensation seeking have been linked to the dopaminergic systems, particularly at D2-like receptors, which are also implicated in addiction and intrinsic motivation [49-52]. Therefore, sensation seeking could moderate the relationship between causality orientations and IGD symptoms.

Building on findings from past investigations, the present study was aimed at assessing the associations between causality orientations and gaming problems (IGD symptoms, weekly gaming time (WGT), and craving for gaming), and if sensation seeking, anxiety, and depression could influence the associations between causality orientations and IGD symptoms. According to previous research, it was hypothesized that autonomy orientation was associated with fewer IGD symptoms, while both control and impersonal orientations were associated with more IGD symptoms (hypothesis 1 [H1]). Second, the relationship between causality orientations and IGD symptoms was mediated by anxiety and depression (hypothesis 2 [H2]). Finally, the relationship between causality orientations and IGD symptoms was moderated by sensation seeking (hypothesis 3 [H3]). Figure 1 presented a proposed model with the effects of causality orientations on IGD symptoms mediated by anxiety and depression, and moderated by sensation seeking.

METHODS

Participants and procedure

The questionnaires were given to 1,465 college and graduate students. All responses were made through an online survey platform (https://www.wjx.cn/). As a result, 1,419 participants completed the questionnaires. Data of 19 respondents were excluded due to indiscriminate filling or incomplete response, resulting in 1,400 valid participants (mean age=23.19± 6.16, range: 17-28, 787 women, response rate=95.6%). All participants provided informed consent and were compensated with course credits for their participation. This study was carried out in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board of Southwest Medical University (Ethics number: KY2022081).

Measures

The Chinese version Internet Gaming Disorder Scale (IGDS) was used to assess IGD behaviors during the last 12-month period [53,54]. The scale has nine items, each item is scored by “yes” or “no,” where “yes” scored 1 point and “no” scored 0 points. A higher total score indicates more severe IGD symptoms. Cronbach’s α of IGDS was 0.93 in the current study. Additional information on gaming behaviors, such as WGT in the past year, and craving for gaming (via a visual analog scale from 0=not at all to 10=extremely) was also collected.

The Chinese version General Causality Orientation Scale for Clinical Populations (GCOS-CP) was used to assess the causality orientations of participants [55,56]. The scale includes 8 scenarios each with an event and three potential ways of response, one for each causality orientation, resulting in 24 items. Each item was rated on a Likert scale from 1 (very unlikely) to 7 (very likely). GCOS-CP provides measures of three causality orientations: 1) autonomy orientation, 2) control orientation, and 3) impersonal orientation. The higher the corresponding score of each causality orientation, the stronger the causality orientation. Cronbach’s α of GCOS-CP subscales were α_Autonomy=0.816, α_Control=0.829, and α_Impersonal=0.790 in the current study. The GCOS-CP was originally designed for clinical purposes, but has also been used in multiple studies to assess causality orientations in non-clinical populations, and demonstrated good reliability and validity in healthy samples [56-58]. In the current study, we calculated the correlations of 7-item version Generalized Anxiety Disorder Scale (GAD) and causality orientations. The results showed that GAD scores were positively correlated with control (r=0.11, p<0.001) and impersonal orientations (r=0.16, p<0.001) but negatively correlated with autonomy orientation (r=-0.26, p<0.001). These results were consistent with previous studies on the relationship between anxiety and causality orientations, and aligned with the predictions of SDT [59]. This suggests that the GCOS-CP measure can be applied to assess causality orientations in healthy populations.

The Chinese version Brief Sensation Seeking Scale (BSSS) was used to assess sensation seeking of participants [60,61]. The scale includes 8 items rated on a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). A higher total score indicates a stronger sensation seeking trait. Cronbach’s α of BSSS was 0.89 in the current study.

The Chinese version GAD was used to assess anxiety symptoms in the past 2 weeks [62,63]. The scale includes 7 items rated on a Likert scale ranging from 0 (not a day) to 3 (almost every day). The total score ranges from 0 to 21. A higher total score indicates worse anxiety. Cronbach’s α of GAD was 0.93 in the current study.

The Chinese version 9-item version Patient Health Questionnaire (PHQ) was used to assess the severity of depressive symptoms in the past 2 weeks [64,65]. The scale includes 9 items rated on a Likert scale ranging from 0 (not a day) to 3 (almost every day). A higher total score indicates more depression. Cronbach’s α of PHQ was 0.92 in the current study.

Statistical analysis

Data were analyzed using SPSS version 23.0 (IBM Corp., Armonk, NY, USA) and R version 4.1.0 (R Core Team, https://www.r-project.org). Firstly, we explored the correlation between these variables using Spearman correlations. Secondly, multiple linear regression was used to further explore the independent contribution of causality orientations to IGDS, WGT, and craving for gaming while controlling the effects of the other causality orientations. Statistical tests were threshold at p<0.05 Bonferroni corrected. Together, the correlation and regressions were carried out to test H1.

Thirdly, according to H2, we constructed a structural equation model (SEM) with causality orientations contributing to IGD symptoms through partial mediation effects of anxiety and depression. The SEM was performed using the Lavaan package Version 0.6-7 in R [66]. The parameter estimation was carried out using the maximum likelihood estimation method. The following parameters were used to appraise model fit: χ²/df ratio (≤5), the root means a square error of approximation (RMSEA; ≤0.08), comparative fit index (CFI; ≥0.95), Tucker-Lewis Index (TLI; ≥0.95), and Standardized Root Mean Square Residual (SRMS; <0.08) [67]. The mediating tests were performed using Lavaan, with 5,000 bootstrap samples [68]. In bootstrapping tests, 95% confidence intervals (CIs) for the indirect effect that does not include zero indicate a significant indirect effect at p<0.05. According to the recommendations of Mehmetoglu and Jakobsen [69], standardization coefficients of ≤0.09, 0.1-0.2, and ≥0.2 correspond to small, moderate, and large effects, respectively. SEM and mediating effect tests were performed to test H2. Finally, SPSS and Model 1 of Hayes’ PROCESS macro [70] were used to assess whether the causality orientations-IGD relationship was moderated by sensation seeking to test H3. We used the bootstrapping method, with 5,000 samples, to test the significance of the effects in order to obtain robust standard errors for parameter estimation [70].

RESULTS

Results pertaining to H1

IGDS scores were significantly and positively associated with all three causality orientations. IGDS scores were also positively correlated with sensation seeking and anxiety, but not depression (r=0.03, p=0.225) (Table 1). Similar correlations were also revealed between WGT, craving for gaming, and causality orientations.

The multiple linear regression model showed that the three causality orientations explained 38% of the variance in IGDS (F=288.69, p<0.001) (Table 2). Specifically, the control (β=0.48, p<0.001) and impersonal orientations (β=0.21, p<0.001) were positively predictive of IGDS scores, while autonomy orientation (β=-0.11, p<0.001) was negatively predictive of IGDS scores. Similarly, the three causality orientations explained 33% of the variance in WGT (F=225.49, p<0.001), and 34% of the variance in craving (F=242.08, p<0.001) (Table 2). Again, control and impersonal orientations were positively predictive of WGT and craving, while autonomy orientation was negatively predictive of these two variables. The assumptions of independence and multicollinearity were met in all linear regression models (Durbin-Watson=1; max variance inflation factor=1.91).

Results pertaining to H2

We removed the insignificant paths and obtained a final model with a good fit (χ²=4.311; df=3.000; χ²/df=1.437; p=0.230; RMSEA=0.018; CFI=1.000; TLI=0.998; SRMR=0.012). As shown in Figure 2, the control orientation was associated with IGD through partial mediation effects of depression, the impersonal orientation was associated with IGD through partial mediation effects of anxiety, and the effect of autonomy orientation on IGD was totally mediated by anxiety and depression. The autonomy-anxiety-IGD, autonomy-depression, control-IGD, and impersonal-IGD paths showed a large effect size, while the depression-IGD and control-depression paths showed a moderate effect size, and the impersonal-anxiety path showed a small effect size (standardization coefficients ≤0.09).

The mediating effect tests further supported the partial mediating effects shown in the final model, but in the “Impersonal → Anxiety → IGD” path, the indirect effect was not significant (b=-0.004, p=0.234) (Table 3). Together with SEM results, our analyses confirmed H2.

Results pertaining to H3

As shown in Table 4, the moderation analyses revealed a significant moderating effect of sensation seeking on the relationships between the IGDS scores and all three causality orientations. The interaction terms for autonomy (β=0.02), control (β=0.02), and impersonal orientations (β=0.02) were all significant, with 95% CIs did not include zero. The simple slope plots are shown in Figure 3.

DISCUSSION

This study was aimed at examining the associations between causality orientations and gaming problems and exploring if sensation seeking, anxiety, and depression would influence these associations. We found that: 1) the control and impersonal orientations were positively associated with IGD symptoms, WGT, and craving for gaming, while the autonomy orientation was negatively associated with these variables. 2) SEM analyses showed that anxiety and depression mediated the associations between causality orientations and IGD symptoms. Particularly, the autonomy-IGD relationship was totally mediated by anxiety and depression, the control-IGD relationship was partially mediated by depression, and the impersonal-IGD relationship was partially mediated by anxiety. 3) The effects of all three causality orientations on IGD were moderated by sensation seeking.

The regression analyses showed that, when the effects of the other two orientations were controlled, the control and impersonal orientations were positively associated with IGD symptoms, WGT, and craving for gaming, while the autonomy orientation was negatively associated with these variables. Our results were in line with previous findings that control orientation was positively associated with addiction-related problems and that autonomy orientation was negatively associated with addiction-related problems [19-21,71-73]. These results suggested that highly autonomy-oriented individuals, who tend to act on his/her interests, exhibited less enthusiasm for games (IGDS), spent less time on games (WGT), and showed less desire to play (craving for gaming). On the contrary, individuals with high control orientation who tend to act for reward or avoid punishment would have more of these gaming problems. Our analyses also revealed a positive association between impersonal orientation and gaming problems, suggesting that individuals with high impersonal orientation could engage in more games playing as well. Together, our results revealed a pattern of associations between causality orientations and IGD, which was similar to other forms of addictions, indicating common psychopathology of addiction-related problems. Our findings were also in line with SDT, suggesting that autonomy orientation may be a protective factor that could prevent individuals from adopting maladaptive behavioral patterns (excessive gaming), while the other two orientations were more susceptible to maladaptive behaviors [29]. Note that, we do not consider that the negative associations between the autonomy orientation and gaming problems contradicted the SDT motivational model for game, which proposed that video games have the potential to satisfy the basic psychological needs and hence facilitate the appeal of video games [31]. Instead, our results suggest that being autonomy-oriented is a protective factor against excessive engagement in gaming, as it facilitates the enjoyment of gaming, while also promoting better control over gaming behaviors [25]. The lack of correlations between depression and IGDS is surprising. One possible explanation is that the relationship between depression and IGD could be more complicated than expected. For example, although depression affects 32% of IGD individuals, the rate of the exact comorbidity event varies considerably (from 0% to 75%) [74]. Moreover, a longitudinal study found that while excessive gaming predicted increases in depressive symptoms, depressive symptoms predicted decreases in gaming over time, which also highlighted the complexity of the depression-IGD correlations [75].

The SEM analyses showed that anxiety and depression mediated the associations between causality orientations and IGD symptoms. These results were in line with our hypothesis, suggesting that causality orientations could be linked to gaming behaviors through depression and anxiety. This is partly in agreement with the prediction of SDT [29] and the stress response hypothesis [76], suggesting that causality orientations are linked to different levels of anxiety and depression, and game-play may be adopted as a way to cope with these aversive feelings. Firstly, the SEM analyses showed the relationship between control orientation and IGD symptoms was partially mediated by depression, with a moderate effect size in the control-depression-IGD path. Our results thus suggest a mild mediating effect of depression on the control-IGD connection. For this path, the primary impact on IGD came from the direct effect, suggesting that being control-orientated (with an external locus of causality) could prompt IGD symptoms. This path was negatively mediated by depression with moderate effect sizes. The symptoms of depression often include a lack of interest in one’s surroundings [77]. This negative path hence suggests that being depressed could lead to a loss of interest in playing games. However, as our data was collected from healthy students who had very low levels of anxiety (mean GAD score=2.31±3.41) and depression (mean PHQ score= 3.21±4.32), it remained possible that depression may play a more influential role in subjects with higher levels of anxiety or depression, such as those with depressive disorders. Secondly, the effect of autonomy orientation on IGD was totally mediated by anxiety and depression. This contrasts with the control and impersonal orientations, suggesting that the autonomy orientation impacts IGD symptoms by mitigating the experience of negative emotions, such as anxiety and depression. These results were also in line with SDT, suggesting that autonomy-oriented individuals may be better able to cope with life stress and hence experience less anxiety and depression [13]. Finally, the SEM indicated a positive mediation effect of anxiety on the impersonal-IGD association. Like the control orientation, the primary effect of the impersonal-anxiety-IGD path drives from the direct effect, suggesting that being impersonal-orientated could prompt IGD symptoms. Impersonal orientated individuals may experience higher levels of anxiety due to difficulties in regulating their emotions and a low perceived sense of competence, while the later could lead to increased gaming behaviors [13]. However, the effect size of this path was very small and did not survive the mediating effect test. Consequently, our results suggest that the impersonal orientation affects IGD symptoms primarily through direct rather than indirect effects.

This study found that the relationships between causality orientations and IGD were significantly moderated by sensation seeking. Particularly, all three causality orientations appear to be associated with more severe IGD symptoms when sensation seeking is high. These results were consistent with previous findings of the positive association between sensation seeking and IGD [41-43]. This study found a positive moderating effect of sensation seeking on the control-IGD path. That is, when an individual with a high control orientation is also a sensation-seeker, they are at a high risk of IGD. This result is in line with previous findings of sensation seeking correlated with an external locus of control [47], indicating an association between sensation seeking and control orientation. Additionally, sensation seeking is closely linked to risk-taking, for sensation seekers “the rewards of the sensation outweigh any possible punishments from engaging in the activity and there is a willingness to take risks for the sake of the experience”, which could provide a basis for compulsivity in addictions [78]. Unexpectedly, sensation seeking positively moderates the effect of autonomy orientation on IGD as well, suggesting autonomy-oriented individuals could be at high risk of gaming addiction if they are sensation seekers at the same time. This result suggests that, at least in extreme cases, high sensation seeking could overshadow the protective effect of autonomy orientation on IGD. This is in line with the SDT motivational model for game engagement in which game-play exemplifies intrinsically motivated behaviors, which expects autonomy-oriented individuals could engage in game-play when they find it is fun, and that video games are ways to satisfy basic psychological needs for gamers [31]. The significant moderating effect of sensation seeking on the impersonal-IGD path suggests that for highly impersonal-oriented individuals, games could be a means to compensate for the difficulty in experiencing sensations. Indeed, although depressed subjects generally have lower scores of sensation seeking than normal subjects, in men with depression disorders, the more the subjects are anhedonia and globally effectively indifferent, the higher they score on sensation seeking [79].

This study has some limitations. Firstly, both control and impersonal orientations have a direct effect on IGD, indicating that other variables (other than the ones tested in the current study) may also mediate the effect of causality orientations. Secondly, some upstream variables, such as basic psychological needs [80], may be important to motivate gaming behaviors. Further studies are needed to expand the model outlined in this study. Next, our sample was restricted to college and graduate students which limited the generalizability of our conclusions. Future research on a sample of other age groups (e.g., adolescents) is needed. Lastly, the cross-sectional design of the current study limited our ability to infer causal relationships between causality orientations and symptoms of IGD. Further longitudinal studies are needed to investigate this matter.

Conclusions

Notes

Availability of Data and Material

The datasets generated or analyzed during the current study are available in the OSF repository, https://osf.io/mfqge/.

Conflicts of Interest

The authors have no potential conflicts of interest to disclose.

Author Contributions

Conceptualization: Wei Lei, Jing Chen. Data curation: Yanjie Peng, Zhenlei Peng, Xiaoyuan Liao. Formal analysis: Yanjie Peng, Yuxiang Wang, Zhenlei Peng, Xiaoyuan Liao. Funding acquisition: Wei Lei, Jing Chen. Investigation: Yanjie Peng, Yuxiang Wang, Zhenlei Peng, Xiaoyuan Liao, Cheng Qin, Mingyuan Tian, Xiaotong Cheng, Xinyi Zhou, Juan Deng, Yuwen Chen, Shuang Feng, Maomao Zhang. Methodology: Yanjie Peng. Resources: Kezhi Liu. Software: Yanjie Peng, Wei Lei. Supervision: Kezhi Liu, Ke Gong, Bo Xiang, Wei Lei, Jing Chen. Validation: Wei Lei, Yanjie Peng. Visualization: Yanjie Peng. Writing—original draft: Yanjie Peng. Writing—review & editing: Wei Lei, Yanjie Peng, Jing Chen.

Funding Statement

The joint project of Luzhou Science and Technology Bureau & Southwest Medical University (grant number 2019LZXNYDJ39); the Sichuan Education Department Research Project (grant number 18ZB0634); the joint project of Hejiang People’s Hospital & Southwest Medical University (grant number 2021HJXNYD16, 2022HJXNYD13); Social Science Federation of Southwest Medical University (grant number SMUSS202220); and Sichuan Applied Psychology Research Center (grant number CSXL-212A17).

ACKNOWLEDGEMENTS

We are grateful to the study participants for dedicating their time to take part in this study.

Figure 1.

Proposed models based on evidence from the literature and self-determination theory. IGD, Internet gaming disorder.

Figure 2.

The final model depicts the associations among causality orientations, anxiety, depression, and IGD. *p<0.05; **p<0.001. IGD, Internet gaming disorder.

Figure 3.

Moderating effects of sensation seeking on the relationship between causality orientations and IGDS. A: Autonomy orientation. B: Control orientation. C: Impersonal orientation. High sensation seeking: individuals with BSSS score of above mean+SD. Low sensation seeking: individuals with BSSS score of below mean-SD. IGDS, Internet Gaming Disorder Scale; BSSS, Brief Sensation Seeking Scale; SD, standard deviation.

Table 1.

Correlations among the main variables

	IGDS	WGT	Craving	Autonomy	Control	Impersonal	BSSS	GAD
WGT	0.70^*	1
Craving	0.64^*	0.76^*	1
Autonomy	0.09^*	0.08^*	0.08^*	1
Control	0.39^*	0.39^*	0.44^*	0.18^*	1
Impersonal	0.42^*	0.32^*	0.37^*	0.09^*	0.58^*	1
BSSS	0.42^*	0.37^*	0.40^*	0.12^*	0.46^*	0.42^*	1
GAD	0.18^*	0.07^*	0.07^*	-0.26^*	0.11^*	0.16^*	0.20^*	1
PHQ	0.03	-0.06	-0.08^*	-0.29^*	-0.12^*	-0.01	0.01	0.66^*
Mean±SD	2.09±3.01	9.52±13.24	3.01±2.95	42.10±6.62	31.58±8.28	34.45±7.42	20.26±7.31	2.31±3.41

^* Bonferroni corrected p<0.05 (0.05/8=0.006).

IGDS, Internet Gaming Disorder Scale; WGT, weekly gaming time; BSSS, Brief Sensation Seeking Scale; GAD, 7-item version Generalized Anxiety Disorder; PHQ, 9-item version Patient Health Questionnaire; SD, standard deviation

Table 2.

Multiple linear regressions among causality orientations

Dependent variable	Adjusted R²	F	p	Independent variable	β
IGDS	0.38	288.69	<0.001	Autonomy	-0.11^*
				Control	0.48^*
				Impersonal	0.21^*
WGT	0.33	225.49	<0.001	Autonomy	-0.09^*
				Control	0.49^*
				Impersonal	0.13^*
Craving	0.34	242.08	<0.001	Autonomy	-0.07^*
				Control	0.48^*
				Impersonal	0.16^*

^* Bonferroni corrected p<0.05 (0.05/3=0.017).

IGDS, Internet Gaming Disorder Scale; WGT, weekly gaming time

Table 3.

Significance test of the mediating effect

Model pathways	Effects	b	p	95% CI
Control → Depression → IGD	Indirect	0.008	0.012	0.002 to 0.014
Autonomy → Depression → IGD	Indirect	0.076	<0.001	0.054 to 0.099
Autonomy → Anxiety → IGD	Indirect	-0.105	<0.001	-0.138 to -0.075
Impersonal → Anxiety → IGD	Indirect	-0.004	0.234	-0.013 to 0.001

CI, confidence interval; IGD, Internet gaming disorder

Table 4.

Regression analysis of the moderating effect of sensation seeking

Regression equation	Fit index			Significance of regression coefficients
Independent variable	R	R²	F	β	Lower limit	Upper limit	t
Autonomy	0.69	0.47	411.92^*	0.04	0.02	0.06	4.04^*
SS				0.23	0.21	0.24	26.65^*
Autonomy×SS				0.02	0.016	0.02	14.00^*
Control	0.79	0.63	797.27^*	0.09	0.07	0.10	11.25^*
SS				0.09	0.08	0.11	10.41^*
Control×SS				0.02	0.018	0.02	25.12^*
Impersonal	0.78	0.61	724.51^*	0.10	0.09	0.12	12.90^*
SS				0.12	0.10	0.13	12.97^*
Impersonal×SS				0.02	0.02	0.023	24.67^*

^* p<0.05.

SS, sensation seeking

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