A Cross-Lagged Study of Developmental Trajectories of Video Game Engagement, Addiction, and Mental Health

Elfrid Krossbakken, Ståle Pallesen, Rune Aune Mentzoni, Daniel Luke King, Helge Molde, Turi Reiten Finserås, Torbjørn Torsheim

Research output: Contribution to journalArticlepeer-review

60 Citations (Scopus)


Objectives: Video game addiction has been associated with an array of mental health variables. There is a paucity of longitudinal studies investigating such associations, and studies differentiating addicted gaming from problem and engaged (i.e., frequent but non-problem) gaming. The current explorative study investigate the natural course of gaming behavior in three sub-studies. The aim of study 1 was to investigate antecedents and consequences of video game addiction measured as a unidimensional construct (pathological gaming). Aim of study 2 was to investigate the same associations in terms of typologies of gamers ("engaged," "problem," "addicted"). Furthermore, study 3 aimed to investigate the estimated stability and transitions occurring between the aforementioned typologies, and a non-pathological gaming group. Methods: A nationally representative sample of 3,000 adolescents aged 17.5 years was drawn from the population registry of Norway in 2012 and invited to participate in annual surveys spanning 3 years (NT1 = 2,059, NT2 = 1,334, NT3 = 1,277). The respondents completed measures of video game addiction, depression, anxiety, loneliness, aggression, and alcohol use disorder. Statistical analysis comprised cross-lagged path modeling, Satorra-Bentler chi square test (study 1), regression analyses (study 2), hidden Markov model of transition probabilities (study 3). Results: Findings in study 1 showed that depression and loneliness were reciprocally associated with pathological gaming. Physical aggression was identified as an antecedent, and anxiety was a consequence of pathological gaming. Investigation of the three typologies of gamers (study 2) identified loneliness and physical aggression as antecedents, and depression as a consequence of all typologies. Depression was found to be an antecedent of problem and engaged gamers. Loneliness was found as a consequence of problem gamers, and anxiety was a consequence of addicted gamers. High alcohol consumption was found antecedent to addicted gamers, and low alcohol consumption was found antecedent to problem gamers. The estimated stability of video game addiction was 35%. Conclusion: A reciprocal relationship between pathological gaming and measures of mental health problems seems to exist. The stability of video game addiction indicates a condition that for a substantial number of people does not resolve spontaneously over the course of 2 years.

Original languageEnglish
Article number2239
JournalFrontiers in Psychology
Issue numberNOV
Publication statusPublished - 21 Nov 2018
Externally publishedYes

Bibliographical note

Copyright © 2018 Krossbakken, Pallesen, Mentzoni, King, Molde, Finserås and
Torsheim. This is an open-access article distributed under the terms of the Creative
Commons Attribution License (CC BY). The use, distribution or reproduction in
other forums is permitted, provided the original author(s) and the copyright owner(s)
are credited and that the original publication in this journal is cited, in accordance
with accepted academic practice. No use, distribution or reproduction is permitted
which does not comply with these terms.


  • Adolescents
  • Gaming disorder
  • Internet gaming disorder
  • Longitudinal study
  • Mental health


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