Serious Games and Gamification: Health Care Workers' Experience, Attitudes, and Knowledge.

OBJECTIVE: With the rapid advancement of digital technology due to COVID-19, the health care field is embracing the use of digital technologies for learning, which presents an opportunity for teaching methods such as serious games to be developed and improved. Technology offers more options for these educational approaches. The goal of this study was to assess health care workers' experiences, attitudes, and knowledge regarding serious games in training. METHODS: The convenience sample consisted of 223 participants from the specialties of internal medicine and psychiatry who responded to questions regarding sociodemographic data, experience, attitudes, and knowledge regarding serious games. This study used an ordinal regression model to analyze the relationship between knowledge, attitudes, and experiences and the idea or wish to implement serious games. RESULTS: The majority of healthcare workers were not familiar with serious games or gamification. The results show gender and age differences regarding familiarity and willingness to use serious games. With increasing age, the respondents preferred conventional and traditional learning methods to playful teaching elements; younger generations were significantly more motivated than older generations when envisioning using elements of serious games in the future. CONCLUSIONS: The COVID-19 pandemic has encouraged the use of new technologies and digitalization. This study describes positive attitudes toward serious games, mainly in younger people working in health care. Serious games present an opportunity to develop new approaches for postgraduate medical teachings and continuing medical education.

Subjective attitudes moderate the social connectedness in esports gaming during COVID-19 pandemic: A cross-sectional study.

Background: Electronic sports (esports) has become a practical intervention for young people craving social connections since the COVID-19 pandemic. Past studies have shown an equivocal role of esports participation in boosting social ties or social connectedness. It is unclear if their relationship is affected by subjective attitudes of gamers. Moreover, the present COVID-19 pandemic may further modify this relationship to a greater extent. Objective: This study primarily aimed to investigate the moderating effect of participants' subjective attitudes toward esports gaming on the relationship between in-game interaction during esports participation and participants' anticipated social connectedness among Chinese young adults during the COVID-19 lockdown periods in China. Methods: We conducted a nationwide online questionnaire survey through the Credamo platform among 550 Chinese young adults in the present study. The Social Connectedness Scale-Revised was used to assess participants' social connectedness levels. Results: Four hundred and fifty-three participants were included in the final analysis. The effective response rate was 82.4%. Our results showed that the esports participation measured by in-game communication frequency among participants, as an independent factor, was negatively associated with participants' social connectedness scores (ß = -0.13, p < 0.05). However, when the moderating effect of subjective attitudes toward esports gaming was considered, the association between communication frequency and social connectedness scores was turned into the opposite direction with a larger effect size (ß = 0.35, p < 0.001). Conclusion: Our primary finding revealed that a positive mindset in esports gaming is indispensable in boosting social connectedness. Overall, our study provided supporting evidence for the benefits of esports on individuals' social connectedness. In future circumstances similar to the COVID-19 era, playing esports games is strongly encouraged in an attempt to maintain social connections and relieve psychological stress. In the meantime, we believe that having a positive esports experience, often associated with a positive mindset during gaming, can better promote social connectedness. Nevertheless, the amount of time spent on gaming per day should be of great concern, as esports games can be addictive, especially for teenagers and college students.

Relationships between psychological flexibility and internet gaming disorder among adolescents: Mediation effects of depression and maladaptive cognitions.

Psychological flexibility may reduce addictive behaviours by adaptive and flexible emotional and cognitive processes. This study tested a mediation model of internet gaming disorder (IGD) in which psychological flexibility would reduce depression and maladaptive cognitions related to internet gaming and in turn lower the risk of IGD. A cross-sectional study surveyed 2102 secondary 1-4 students from seven schools during March to November 2021 in Hong Kong, China. The results showed that 12.7% and 52.2% of the students were classified as having probable IGD and depression, respectively. The proposed mediation model fitted the data well: χ2/df = 8.00, CFI = .99, NNFI = .99, RMSEA = .01. Psychological inflexibility was directly and positively associated with IGD (B = .01, ß = .07, p = .003) and indirectly and positively associated with IGD via depressive symptoms (B = .01, ß = .07, p = .001, PM = 23.7%) and maladaptive cognitions (B = .03, ß = .15, p = .001, PM = 50.8%). Multi-group analyses showed that gender significantly moderated the associations between psychological inflexibility and maladaptive cognitions (Δχ2/Δdf = 8.69/1, p < .05), between maladaptive cognitions and IGD (Δχ2/Δdf = 4.33/1, p < .05), and between psychological inflexibility and IGD (Δχ2/Δdf = 5.46/1, p < .05). Depression and maladaptive cognitions may be significant mediators that could explain the relationship between psychological flexibility and IGD. Also, gender difference may exist. Based on the findings, intervention strategies for IGD reduction are discussed.

Risk and protective factors for (internet) gaming disorder: A meta-analysis of pre-COVID studies.

This large-scale meta-analysis aimed to provide the most comprehensive synthesis to date of the available evidence from the pre-COVID period on risk and protective factors for (internet) gaming disorder (as defined in the DSM-5 or ICD-11) across all studied populations. The risk/protective factors included demographic characteristics, psychological, psychopathological, social, and gaming-related factors. In total, we have included 1,586 effects from 253 different studies, summarizing data from 210,557 participants. Apart from estimating these predictive associations and relevant moderating effects, we implemented state-of-the-art adjustments for publication bias, psychometric artifacts, and other forms of bias arising from the publication process. Additionally, we carried out an in-depth assessment of the quality of underlying evidence by examining indications of selective reporting, statistical inconsistencies, the typical power of utilized study designs to detect theoretically relevant effects, and performed various sensitivity analyses. The available evidence suggests the existence of numerous moderately strong and highly heterogeneous risk factors (e.g., male gender, depression, impulsivity, anxiety, stress, gaming time, escape motivation, or excessive use of social networks) but only a few empirically robust protective factors (self-esteem, intelligence, life satisfaction, and education; all having markedly smaller effect sizes). We discuss the theoretical implications of our results for prominent theoretical models of gaming disorder and for the existing and future prevention strategies. The impact of various examined biasing factors on the available evidence seemed to be modest, yet we identified shortcomings in the measurement and reporting practices.

Escapism and Excessive Online Behaviors: A Three-Wave Longitudinal Study in Finland during the COVID-19 Pandemic.

Excessive online behaviors refer to harmful or disproportionate use of digital network applications. Such behaviors are likely to be associated with escapist motives. Our aim was to analyze whether escapism predicts excessive gambling, excessive gaming, and excessive internet use over time. A longitudinal sample of Finnish residents aged 18-75 years (n = 1022, 51.27% male) was surveyed at three time points during the COVID-19 pandemic in 6-month intervals: April 2021 (Time 1), October-November 2021 (Time 2), and April-May 2022 (Time 3). Of the original Time 1 respondents, 66.80% took part in the surveys at both Time 2 and Time 3. All surveys included measures for excessive gambling (Problem Gambling Severity Index), excessive gaming (Internet Gaming Disorder Test), and excessive internet use (Compulsive Internet Use Scale). Three escapism-specific questions were used to construct a dedicated escapism variable. Socio-demographic variables, alcohol consumption, and psychological distress were used as controls. The study was conducted with multilevel regression analyses using hybrid models. Our research showed that escapism had strong within-person effects on excessive gambling, B = 0.18, p = 0.003; excessive gaming, B = 0.50, p < 0.001; and excessive internet use, B = 0.77, p < 0.001 over time. The between-person effect of escapism was demonstrated on excessive gaming B = 0.91, p < 0.001, and excessive internet use B = 0.61, p = 0.036. Adverse societal events and uncertain times can manifest in excessive online behaviors motivated by escapism, highlighting a need to focus prevention efforts on healthy coping methods.

The Relationship between Depressive Symptoms, Loneliness, Self-Control, and Gaming Disorder among Polish Male and Female Gamers: The Indirect Effects of Gaming Motives.

The present study analyzed the relationship between gaming disorder (GD), motives for gaming, and psychological problems in daily life (i.e., depression, loneliness, and self-control deficits) among Polish gamers. More specifically, the purpose of the present study was to analyze the indirect effects between GD and psychological problems in daily life via motives for gaming among male and female gamers. Additionally, the present study examined gender differences in motives for gaming and the relationship between the analyzed variables. The sample comprised 652 gamers (233 females; M = 28.77 years; SD = 7.18; age range: 18-48 years). The nine-item Internet Gaming Disorder Scale-Short Version (IGDS9-SF) was used to assess GD. The motives for gaming were assessed using the Motives for Online Gaming Questionnaire (MOGQ). The nine-item Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms, and the Brief Self-Control Scale (BSCS) was used to assess self-control. Loneliness was assessed using the De Jong Gierveld Loneliness Scale. In order to examine the relationship between the study variables, path analysis and indirect effects analysis were performed among both male and female gamers. The present study showed that depressive symptoms and self-control exerted a significant indirect effect on GD via escape and fantasy motives for gaming. Additionally, there was an indirect effect between depressive symptoms and GD via social motives for gaming. However, these indirect effects were found among male gamers only. The present study also showed gender differences in all analyzed gaming motives except escape (males scoring higher on all of them) and in the relationship between depressive symptoms and escape. These findings contribute to a better understanding of GD development mechanisms, which are associated with psychological problems in daily life.

Impact of increased digital use and internet gaming on nursing students' empathy: A cross-sectional study.

BACKGROUND: The COVID-19 restrictions and quarantines had led to increased dependence and usage of digital devices for various human activities and internet gaming to the extent of risking vulnerable individuals to develop addiction towards it. Little is known on such risks among populations of nursing students and its impact on their empathy skills or trait. OBJECTIVE: Determining the impact of digital use and internet gaming on empathy of nursing students undergoing remote learning during closure of learning institutions nationwide. DESIGN: Cross-sectional online survey was conducted from October to December 2020. SETTINGS: Two established public institutions located in Malaysia. PARTICIPANTS: A total of 345 nursing students pursuing diploma and bachelor nursing programs. METHODS: Toronto Empathy Questionnaire (TEQ), Digital Addiction Scale (DAS) and Internet Gaming Disorder Scale-Short form (IGDS9-SF) were self-administered via Google Form™. Following principal component analysis of TEQ using IBM-SPSS™ (V-27), path analyses was performed using SmartPLS™ (V-3). RESULTS: Despite the increased time spent on digital devices (∆ 2.8 h/day) and internet gaming (∆ 1 h/week) before and during the pandemic, the proportion of high digital users (1.4 %) and gamers (20.9 %) were low; and sizable ≈75 % had higher-than-normal empathy. Digital-related emotions and overuse of them were associated with lower empathy (ß = -0.111, -0.192; p values < 0.05) and higher callousness (ß = 0.181, 0.131; p values < 0.05); internet gaming addiction predicted callousness (ß = 0.265, p < 0.001) but digital dependence correlated with higher empathy (ß = 0.172, p = 0.009). CONCLUSIONS: Digital and internet gaming addiction potentially impact empathy. The negative impact of digital dependence can be attenuated by "digital empathy" - an emerging phenomenon becoming increasingly vital in digital health and communication.

Resource-Strengthening Training for Parents of Adolescents with Problematic Gaming (Res@t-P): A Clinical Pilot Study.

Background: Problematic gaming (PG) has become an increasing mental health issue among adolescents during the preceding years. The role of parents and the family environment in the development of PG has been repeatedly emphasized. However, the structured involvement of parents in the therapy is still largely insufficient. Resource-strengthening training for parents of adolescents with PG (Res@t-P) is a new parent-centered 8-week group intervention to fill this substantial gap. The present pilot study aimed to collect first information on its potential effectiveness in improving parental and family factors. Methods: The study was conducted in a clinical setting with N = 43 parents of adolescents with PG, applying a pre- and post-follow-up design. Standardized questionnaires on psychological stress perception, family communication, family functioning, media rules, and adolescent PG symptoms were applied at three measurement points (before, at the end of, and 6 weeks after the training). Conditional growth models were estimated. Results: Over time, an improvement in parental and family aspects as well as a reduction in adolescent PG symptoms could be observed. Conclusions: The results of the present pilot study on the effectiveness of Res@t-P are promising. No causal inferences can be drawn at this stage. A randomized-controlled intervention study is highly warranted.

Internet Gaming Disorder and Aggression among Students on School Closure during COVID-19 Pandemic.

BACKGROUND: The Corona Virus Disease (COVID-19) pandemic has significantly disrupted the regular school-going activities of the students, predominantly increasing internet gaming activities to endure significant stress. Excessive involvement in internet gaming brings deviant behaviour, especially aggression among the students. Hence, this study aimed to assess the internet gaming disorder and aggression among the students on school closure during COVID-19 pandemic in Chitwan, Nepal. METHODS: A web-based cross-sectional survey was conducted among 417 students from secondary and higher secondary level who studied in two private schools of Chitwan district. Sample were selected using simple random sampling technique and structured questionnaire, i.e. Internet gaming disorder scale- short form (IGDS9-SF) and Aggression questionnaire (Buss and Perry, 1992) were used to collect the data via web-based through Google Form. Obtained data were analysed using descriptive and inferential statistics. RESULTS: Out of 417 students, the mean age was 17 (±1.411) years, 278 (66.7%) were male and 150 (36.0%) were studying in twelve standard. Majority of students 405 (97.1%) were non-disordered gamers whereas only 12 (2.9%) students were disordered gamers. Students' overall aggression score was 57.79% where the verbal aggression score was higher (66.33%) followed by hostility (61.41%) and anger (56.80%). Further significant positive relationship was found between scores on online gaming disorders and aggression (r=0.239). CONCLUSIONS: Internet gaming disorder and aggression are common among the students during COVID-19 pandemic. Therefore, educational institutions and concern authorities need to organize awareness programs and effective psychosocial intervention approaches for students to enhance the knowledge regarding harmful use of internet game, IGD, to cope with stress and aggression as well as to enhance the adoptive behaviour.

Novel 3-D action video game mechanics reveal differentiable cognitive constructs in young players, but not in old.

Video game research predominantly uses a "one game-one function" approach-researchers deploy a constellation of task-like minigames to span multiple domains or consider a complex video game to essentially represent one cognitive construct. To profile cognitive functioning in a more ecologically valid setting, we developed a novel 3-D action shooter video game explicitly designed to engage multiple cognitive domains. We compared gameplay data with results from a web-based cognitive battery (WebCNP) for 158 participants (aged 18-74). There were significant negative main effects on game performance from age and gender, even when controlling for prior video game exposure. Among younger players, game mechanics displayed significant and unique correlations to cognitive constructs such as aim accuracy with attention and stealth with abstract thinking within the same session. Among older players the relation between game components and cognitive domains was unclear. Findings suggest that while game mechanics within a single game can be deconstructed to correspond to existing cognitive metrics, how game mechanics are understood and utilized likely differs between the young and old. We argue that while complex games can be utilized to measure distinct cognitive functions, the translation scheme of gameplay to cognitive function should not be one-size-fits-all across all demographics.

Internet gaming disorder in an adolescent during the COVID-19 pandemic: a case report.

The internet has become an indispensable tool in people´s daily lives during the COVID-19 pandemic. Internet and video game use are experiencing rapid growth in the youth and adult populations as a major source of entertainment. However, excessive gaming may cause addiction and negatively impact mental health, entailing low psychosocial well-being, poor social skills, and decreased academic achievement. We report the case of a 16-year-old student with a "typical" pattern of internet gaming disorder (IGD) developed during the pandemic, which improved after weeks of treatment with pharmacotherapy and psychosocial interventions. This case highlights that it is essential for the mental health professionals to know the psychopathology of IGD and multimodal approaches to treat it.

Disordered gaming in esports: Comparing professional and non-professional gamers.

INTRODUCTION: The American Psychiatric Association (APA) proposed 'Internet Gaming Disorder' (IGD) as a tentative disorder (APA framework) in 2013 and in 2019 the World Health Organization (WHO) has fully recognized 'Gaming Disorder' (GD) as a mental health disorder (WHO framework). These two frameworks have not yet been jointly investigated in the context of esports. The present study aims to investigate the feasibility of the APA and WHO frameworks for disordered gaming among professional and non-professional gamers and to ascertain the suitability of existing psychometric tools for use in esports. METHODS: A sample of 5,734 gamers (Mage = 21.47 years, SD = 6.69 years; 6.94% female) recruited through an online survey prior to the COVID-19 pandemic that included an age and gender matched group of professional (n = 2,867) and non-professional gamers (n = 2,867) was investigated. Pairwise comparisons, measurement invariance (MI), and latent mean difference tests were conducted to distinguish the two groups of gamers. RESULTS: Overall, professional gamers showed greater time spent gaming and prevalence of disordered gaming than non-professional gamers. Additionally, MI was supported and both disordered gaming levels and latent means were significantly higher among professional gamers when compared to non-professional gamers across both APA and WHO frameworks. CONCLUSIONS: Esports is cross-sectionally associated with greater disordered gaming vulnerability through increased time spent gaming and disordered gaming prevalence rates. Furthermore, the APA and WHO frameworks are viable in the context of esports gaming with existing assessment tools being effective in the assessment of disordered gaming in esports. The results and implications are further discussed in light of the extant literature.

The Comparative Efficacy of Treatments for Children and Young Adults with Internet Addiction/Internet Gaming Disorder: An Updated Meta-Analysis.

Internet gaming disorder (IGD) is a formal mental disorder leading to bad outcomes for children and adolescents. This study comprehensively compared the estimated effect of various pharmacotherapy and psychosocial interventions for IGD from randomized controlled trials (RCT) through updated meta-analysis, using meta-regression. A search of PubMed/MEDLINE, Cochrane Library, and Airiti Library between 2000 and 2017 was conducted for various IA/IGD intervention modalities. A total of 124 studies from 29 selected papers involving 5601 children and young adults with IA/IGD were found. Meta-analyzing the pooled standardized mean difference (SMD) revealed a preliminary random effect of 1.399 with a 95% confidence interval of 1.272-1.527, suggesting highly effective treatment of IA/IGD. After adjusting for the confounding risks of age, publication year, type of subjects, and type of study, this study revealed that combining pharmacotherapy with cognitive behavioral therapy (CBT) or multi-level counseling (MLC) was the most effective treatment option. Using a scale of time spent online or a severity of IA symptoms scale was a more effective measurement, with p-values = 0.006 and 0.002, respectively. IA/IGD patients with comorbid depression showed worse outcomes than youth with another comorbidity. The corresponding model goodness-of-fit indices were τ2 = 1.188; I2-Residual = 89.74%; and Adjusted-R2 = 16.10%. This systematic review indicates that pharmacotherapy combined with CBT or MLC might be an effective therapeutic strategy for youth with gaming disorder.

A data-driven approach for examining the demand for relaxation games on Steam during the COVID-19 pandemic.

The COVID-19 pandemic has been a major source of stress for a majority of people that might have negative long-term effects on mental health and well-being. In recent years, video games and their potential positive effects on stress relief have been researched and "relaxation" has been an important keyword in marketing a certain kind of video game. In a quasi-experimental design, this study investigated the increase of average daily player peak (ADPPs) for the COVID period compared to the pre-COVID period and if this increase was significantly larger for relaxing games in contrast to non-relaxing games. Results showed a medium-sized increase of ADPPs over all types of games but no difference between relaxing games and non-relaxing games. These results are discussed in regards to their potential of presenting gaps between the current theoretical models of the influence of video games on mental health and actual observed player behaviour.

Depression and anxiety symptoms associated with internet gaming disorder before and during the COVID-19 pandemic: A longitudinal study.

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic has profoundly impacted aspects of human life globally. Playing videogames has been encouraged by several organizations to help individuals cope with the COVID-19 pandemic and associated restrictive measures. This longitudinal study was the first to examine gaming in the context of the pandemic and its association with depressive and anxiety symptoms. METHODS: The sample comprised 1,778 children and adolescents (50.7% male) who were part of the Project of School Mental Health in Southwest China. Data were collected at two-time intervals: before the COVID-19 pandemic (October to November 2019 - [T1]) and during the COVID-19 pandemic (April to May 2020 - [T2]). Data were collected on perceived COVID-19 impacts, videogame use, Internet Gaming Disorder (IGD), and depressive and anxiety symptoms. Cross-lagged panel models were computed to examine longitudinal relationships. RESULTS: The results indicated that both videogame use and IGD increased significantly for adolescents at T2. The cross-lagged panel model results suggested that depressive and anxiety symptoms at T1 positively predicted IGD and videogame use at T2 (especially for boys), but not inversely. Perceived COVID-19 impacts mediated the relationship between depressive and anxiety symptoms at T1 and IGD at T2. CONCLUSION: Children and adolescents both increased videogame use at T2, but only adolescents significantly increased IGD severity at T2. The findings supported the compensatory hypothesis, and are consistent with the Interaction of Person-Affect-Cognition-Execution model as individual responses to COVID-19 may function as a mediator between personal predisposing variables and IGD.

COVID-19 as 'Game Changer' for the Physical Activity and Mental Well-Being of Augmented Reality Game Players During the Pandemic: Mixed Methods Survey Study.

BACKGROUND: Location-based augmented reality (AR) games, such as Pokémon GO and Harry Potter: Wizards Unite, have been shown to have a beneficial impact on the physical activity, social connectedness, and mental health of their players. In March 2020, global social distancing measures related to the COVID-19 pandemic prompted the AR games developer Niantic Inc to implement several changes to ensure continued player engagement with Pokémon GO and Harry Potter: Wizards Unite. We sought to examine how the physical and mental well-being of players of these games were affected during the unprecedented COVID-19 restriction period as well as how their video game engagement was affected. OBJECTIVE: The aims of this study were to examine the impact of COVID-19-related social restrictions on the physical and mental well-being of AR game players; to examine the impact of COVID-19-related social restrictions on the use of video games and motivations for their use; and to explore the potential role of AR games (and video games in general) in supporting well-being during COVID-19-related social restrictions. METHODS: A mixed methods web-based self-reported survey was conducted in May 2020, during which COVID-19-related social restrictions were enforced in many countries. Participants were recruited on the web via four subreddits dedicated to Pokémon GO or Harry Potter: Wizards Unite. Data collected included quantitative data on demographics, time spent playing video games, physical activity, and mental health; qualitative data included motivations to play and the impact of video games on mental health during COVID-19 lockdown. RESULTS: We report results for 2004 participants (1153/1960 male, 58.8%, average age 30.5 years). Self-reported physical activity during COVID-19-related social restrictions significantly decreased from 7.50 hours per week on average (SD 11.12) to 6.50 hours (SD 7.81) (P<.001). More than half of the participants reported poor mental health (925/1766, 52.4%; raw World Health Organization-5 Well-Being Index score <13). Female gender, younger age, and reduced exercise were significant predictors of poor mental health. Participants reported a significant increase in video game play time from 16.38 hours per week on average (SD 19.12) to 20.82 hours (SD 17.49) (P<.001). Approximately three quarters of the participants (n=1102/1427, 77.2%) reported that playing video games had been beneficial to their mental health. The changes made to Pokémon GO and Harry Potter: Wizards Unite were very well received by players, and the players continued to use these games while exercising and to maintain social connection. In addition to seeking an escape during the pandemic and as a form of entertainment, participants reported that they used video games for emotional coping and to lower stress, relax, and alleviate mental health conditions. CONCLUSIONS: AR games have the potential to promote physical and mental health during the COVID-19 pandemic. Used by populations under isolation and distress, these games can improve physical and mental health by providing virtual socialization, sustained exercise, temporal routine, and mental structure. Further research is needed to explore the potential of AR games as digital behavioral interventions to maintain human well-being in the wider population.

Impact of COVID-19 on gaming disorder: Monitoring and prevention.

The global coronavirus disease 2019 (COVID-19) outbreak has necessitated physical distancing, lockdown, contact tracing, and self-quarantine so as to prevent the spread of the disease. Amid the outbreak, gaming data usage has reportedly increased in the United States, and game download volume has reached a record high in Europe. Because gaming can be used to cope with the psychological stress from the outbreak, therefore mental health professionals should be aware of how increased gaming during the pandemic may contribute to risk of gaming disorder, especially if the pandemic persists. Mental health professionals should thus formulate safe social interaction alternatives for people, particularly adolescents, who have gaming disorder risk.

Exergames as Coping Strategies for Anxiety Disorders During the COVID-19 Quarantine Period.

The COVID-19 outbreak has led to wide-scale self-isolation, as a result of the quarantine period recommended by the World Health Organization. Consequently, people's mental health, including their anxiety levels, may be becoming impaired. To cope with the situation, the exergame appears to be an enjoyable easy-to-use tool for reducing social isolation, as well as an interesting mode of home-based exercise for tackling anxiety disorders and sedentary behavior. This article critically appraises the opportunities and challenges exergames present for the prevention and treatment of anxiety disorders in a home-based environment during the COVID-19 quarantine period.

Problematic online gaming and the COVID-19 pandemic.

Stay-at-home mandates and quarantines related to the coronavirus (COVID-19) pandemic have led to greatly increased participation in online gaming. Initiatives such as #PlayApartTogether that promote gaming for socializing and stress reduction may achieve positive outcomes. Although gaming can be a healthy coping strategy for the majority, it can also pose risks to some vulnerable individuals. Protracted periods of social isolation and technology-based activity pose the danger of solidifying unhealthy lifestyle patterns, leading to difficulties to readaptation when the COVID-19 crisis has passed. Balanced and effective approaches to gaming during the COVID-19 pandemic are needed to support physical and psychological wellbeing.