Cognitive Mechanisms Between Psychosocial Resources and the Behavioral Intention of Professional Help-Seeking for Internet Gaming Disorder Among Chinese Adolescent Gamers: Cross-Sectional Mediation Study

Abstract Background Internet gaming disorder (IGD) is a global public health concern for adolescents due to its potential severe negative consequences. Professional help-seeking is important for early screening, diagnosis, and treatment of IGD. However, research on the factors associated with professional help-seeking for IGD as well as relevant mediation mechanisms among adolescents is limited. Objective Based on the stress coping theory, the conservation of resource theory, and behavioral change theories, this study investigated the prevalence and factors influencing the behavioral intention of professional help-seeking for internet gaming disorder (BI-PHSIGD). The research also explored the underlying mechanisms, including psychosocial resources like resilience and social support, perceived resource loss due to reduced gaming time, and self-efficacy, in professional help-seeking among adolescent internet gamers. Methods A cross-sectional survey was conducted among secondary school students who were internet gamers in 2 Chinese cities from October 2019 to January 2020. Data from the full sample (N=1526) and a subsample of 256 IGD cases (according to the 9-item DSM-5 [ Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ] IGD Checklist) were analyzed. Multivariate logistic regression analysis was conducted to examine the factors of BI-PHSIGD, while structural equation modeling was performed to test the proposed mediation mechanisms. Results The prevalence of BI-PHSIGD was 54.3% (829/1526) in the full sample and 40.6% (104/256) in the IGD subsample (vs 708/1239, 57.1% among non-IGD cases). In the full sample, psychosocial resources of resilience (adjusted odds ratio [aOR] 1.03, 95% CI 1.02-1.05) and social support (aOR 1.03, 95% CI 1.02-1.04) as well as self-efficacy in professional help-seeking (aOR 1.64, 95% CI 1.49-1.81) were positively associated with BI-PHSIGD, while perceived resource loss due to reduced gaming time was negatively associated with BI-PHSIGD (aOR 0.97, 95% CI 0.96-0.98); the positive association between psychosocial resources and BI-PHSIGD was fully mediated via 2 single-mediator indirect paths (via self-efficacy in professional help-seeking alone: effect size=53.4%; indirect effect/total effect=0.10/0.19 and via perceived resource loss due to reduced gaming time alone: effect size=17.8%; indirect effect/total effect=0.03/0.19) and one 2-mediator serial indirect path (first via perceived resource loss due to reduced gaming time then via self-efficacy in professional help-seeking: effect size=4.7%; indirect effect/total effect=0.009/0.19). In the IGD subgroup, a full mediation via self-efficacy in professional help-seeking alone but not the other 2 indirect paths was statistically significant. Conclusions Many adolescent internet gamers, especially those with IGD, were unwilling to seek professional help; as a result, early treatment is often difficult to achieve. To increase BI-PHSIGD, enhancing psychosocial resources such as resilience and social support, perceived resource loss due to reduced gaming time, and self-efficacy in professional help-seeking may be effective. Future longitudinal and intervention studies are needed to confirm and extend the findings.