The Reciprocal Relationships Among Impulsivity, Self-Control, Gaming Time, and Internet Gaming Disorder Among Adolescents: Prospective Longitudinal Cohort Study.

Background: Gaming time, impulsivity, and self-control are known determinants of internet gaming disorder (IGD). However, their reciprocity has not been empirically tested. Objective: This study investigated the reciprocal relationships among gaming time, impulsivity, self-control, and IGD simultaneously within a single cross-lagged panel model among Chinese adolescents, hypothesizing that all 4 variables would be prospectively associated with each other. Methods: This 1-year, 2-wave prospective longitudinal cohort (observational) study recruited grade 7 and grade 8 students from a convenience sample of 6 junior high schools in Chengdu and Guangzhou, China. Students completed an identical self-administered questionnaire in classrooms (using paper and pencil, without teachers present) in December 2018 (wave 1 [W1]) and December 2019 (wave 2 [W2]). Impulsivity, self-control, gaming time, and IGD were assessed using validated scales. The 2238 students (mean age 12.60, SD 0.63 years, 95% CI 12.58-12.63; male: n=1102, 49.24%, 95% CI 47.27%-51.21%) who completed the W1 survey were included in the final data analysis, with multiple imputations addressing missing data from dropouts and unmatched assessments across the 2 study waves. Results: Adjusting for background characteristics, autoregressive correlations, and concurrent correlations, the cross-lagged panel model showed that (1) the prospective association between gaming time at W1 and IGD at W2 was statistically nonsignificant (β=0.02, 95% CI -0.04 to 0.08), but IGD at W1 was prospectively and positively associated with gaming time at W2 (β=0.08, 95% CI 0.01-0.16; Conclusions: This prospective longitudinal cohort study is the first to disentangle the reciprocal prospective associations among gaming time, impulsivity, self-control, and IGD simultaneously within a single cross-lagged panel model. Unlike prior studies, which examined these variables separately and largely cross-sectionally, this design clarified their bidirectionality and relative longitudinal importance. The findings revealed novel differential associations among the 4 variables, findings that promise to reorient the field from gaming time toward the cognitive and motivational processes regulating gaming behaviors. Practically, if replicated in studies with more robust designs, prevention and control programs for IGD should prioritize strengthening adolescents' self-control rather than merely restricting their gaming time.