Neurophysiological correlates of resilience in patients with Internet gaming disorder: A resting-state EEG study

Abstract

Internet gaming disorder (IGD) has been defined as persistent and excessive use of the Internet, to participate in games, which results in psychological impairment or distress. Resilience, an important protective factor against IGD, is the ability to recover from negative emotional experiences and constitutes a flexible adaptation to stress. Despite the importance of resilience in predicting IGD, little is known about the relationships between resilience and the neurophysiological features of IGD patients.

Thus, the present study investigated these relationships in 71 males using resting-state electroencephalography (EEG), by comparing IGD patients (n = 35) to healthy controls (HC

n = 36). To identify the EEG features related to resilience, the IGD patients were divided into two groups based on the 50th percentile score on the Connor-Davidson Resilience Scale (CD-RISC): IGD with low resilience (LowRe-IGD

n = 16) and IGD with high resilience (HighRe-IGD

n = 19). First, generalized estimating equations (GEEs) were used to analyze differences in EEG absolute power in terms of resilience (LowRe-IGD, HighRe-IGD, HC), brain region (frontal, central, posterior), and hemisphere (left, right) for each fast frequency band (alpha, beta, and gamma). Second, EEG coherence analyses were conducted to compare functional brain connectivity among the LowRe-IGD, HighRe-IGD, and HC groups. Finally, moderated mediation analyses were performed to examine the conditional indirect effects of resilience on the relationships between IGD and specific EEG features through clinical symptoms (depressive symptoms and stress level).

IGD patients with low resilience had lower alpha absolute power than HC, and higher alpha coherence in the right hemisphere than the HighRe-IGD and HC groups. Among all subjects, only alpha coherence in the right hemisphere had a negative correlation with resilience and positive correlations with depressive symptoms and stress level. In particular, indirect effects of IGD on alpha coherence in the right hemisphere through depressive symptoms and stress level were moderated by resilience. i.e., IGD with lower resilience had more severe depressive symptoms and higher stress level, which it was related with increased alpha coherence in the right hemisphere.

These novel neurophysiological findings regarding the mechanisms underlying resilience may provide a new perspective for understanding IGD and help to establish effective preventive measures against, and treatments for, this disorder.