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Eur Psychiatry. 2017 Jul;44:30-38. doi: 10.1016/j.eurpsy.2017.03.004. Epub 2017 Mar 30.

Cognitive control and reward/loss processing in Internet gaming disorder: Results from a comparison with recreational Internet game-users.

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Department of Psychology, Zhejiang Normal University, 321004 Jinhua, Zhejiang Province, PR China; Institute of Psychological and Brain Sciences, Zhejiang Normal University, 321004 Jinhua, Zhejiang Province, PR China. Electronic address:
Department of Psychology, Zhejiang Normal University, 321004 Jinhua, Zhejiang Province, PR China.
Department of Psychiatry, Department of Neurobiology, Child Study Center, and National Center on Addiction and Substance Abuse, Yale University School of Medicine, 06519 New Haven, CT, USA; Connecticut Mental Health Center, 06519 New Haven, CT, USA. Electronic address:


Although playing of Internet games may lead to Internet gaming disorder (IGD), most game-users do not develop problems and only a relatively small subset experiences IGD. Game playing may have positive health associations, whereas IGD has been repeatedly associated with negative health measures, and it is thus important to understand differences between individuals with IGD, recreational (non-problematic) game use (RGU) and non-/low-frequency game use (NLFGU). Individuals with IGD have shown differences in neural activations from non-gamers, yet few studies have examined neural differences between individuals with IGD, RGU and NLFGU. Eighteen individuals with IGD, 21 with RGU and 19 with NFLGU performed a color-word Stroop task and a guessing task assessing reward/loss processing. Behavioral and functional imaging data were collected and compared between groups. RGU and NLFGU subjects showed lower Stroop effects as compared with those with IGD. RGU subjects as compared to those with IGD demonstrated less frontal cortical activation brain activation during Stroop performance. During the guessing task, RGU subjects showed greater cortico-striatal activations than IGD subjects during processing of winning outcomes and greater frontal brain during processing of losing outcomes. Findings suggest that RGU as compared with IGD subjects show greater executive control and greater activations of brain regions implicated in motivational processes during reward processing and greater cortical activations during loss processing. These findings suggest neural and behavioral features distinguishing RGU from IGD and mechanisms by which RGU may be motivated to play online games frequently yet avoid developing IGD.


Executive control; Internet gaming disorder; Recreational Internet game use; Reward/punishment sensitivity

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