Introduction

People use digital games for many reasons: relaxation, challenge, social interaction, and recreation [1]. For most, gaming is an enjoyable activity that can improve social and cognitive skills [2] and is also helpful in teaching [3]. Although gaming has some benefits [4], gaming without limits can be addicting [5] and cause negative consequences [6]. As a result, Internet Gaming Disorder (IGD) was added to Section III of the DSM-5 as a diagnosis that needs further research in 2013 [7]. IGD consists of nine criteria that apply to online gaming or gaming on any electronic device: (1) preoccupation with gaming, (2) withdrawal when not playing, (3) tolerance, (4) unsuccessful attempts to reduce or stop gaming, (5) giving up other activities, (6) continued gaming despite problems, (7) deception or covering up gaming, (8) gaming to escape negative moods, and (9) risking or losing relationships or career opportunities as a result of excessive gaming [8].

In addition, Gaming Disorder (GD) was added to the 11th version of the International Classification of Diseases (ICD-11) by the World Health Organization in early 2019. The following three criteria must be present to diagnose GD: a consistent and recurrent pattern of gaming activity (digital or video games) offline or online; (1) inability to control the game, (2) prioritization of the game above other activities, and (3) continuation or escalation of the game despite negative consequences [9].

The criteria for this disorder are different in ICD-11 and DSM-5 [10, 11]. The ICD-11 framework, for example, highlights the functional impairment part of GD, which means GD Clinical symptoms should be severe enough to affect personal, family, social, educational, occupational, and/or other aspects of life [10]. While these negative consequences are merely one of the nine DSM criteria, they are not necessary for diagnosis. Moreover, the DSM-5 framework, on the other hand, includes an extensive range of cognitive and behavioral symptoms of the disorder [7]. Furthermore, The WHO has set exclusion criteria for diagnosing GD in the ICD-11. These include hazardous gaming, bipolar type I, and bipolar type II [9].

On the other hand, children and adolescents are more susceptible to GD due to immaturity and limited cognitive capacity [12,38] two-factor model. These results are congruent with Nazari et al. [41], who also discovered a two-factor structure for this instrument.

Items 1, 2, 4, and 5 are part of the first factor, referred to as cognitive-behavioral symptoms. These questions reflect an inability to control the amount of time spent playing despite the negative consequences. Research literature shows GD can cause a drop in school grades, jeopardize family, friendly and emotional relationships, and affect leisure activities [6, 55,56,57,58]. These adverse outcomes assessed in second-factor negative consequences are identified in items 3, 6, 7, 8, and 9. The scale’s final item assesses the frequency and severity of problems caused by gaming for the individual. These items are based on the ICD-11 criteria and cover all of them.

According to the Table. 1, the prevalence of GD in this research was 4.2 percent. These results are consistent with prior studies on Iranian primary school students, which discovered a 5.9 percent prevalence rate of IGD [32]. The ICD-11 has a higher diagnostic threshold for GD than the DSM-5 [59]. The similarity of the prevalence rates in these two studies is explained by the fact that the current research was conducted during the pandemic and school closure. These factors may increase the time spent playing video games [60] and the prevalence of GD among adolescents [61].

Using a large number of samples per question was one of the study’s strengths. The current research had some limitations, most notably participation and data collection. According to sampling, the convenience sample approach and the absence of female individuals limited the range of comparators for validity. There are possible cultural biases in the translating process. For example, the phrase "poor reference" in item 9 has been removed since such a reference is uncommon for admission to the university and the job market in Iran. The research was carried out during the COVID-19 pandemic and school closure, and data was collected online rather than in person. Data were acquired using self-report tools, which are prone to methodological flaws. The stressful pandemic condition may have worsened the individuals’ mental health difficulties and everyday psychological life suffering [62].

Future research should examine samples of adolescent girls because this area lacks significant research [63]. In addition, there is a major paucity of epidemiological research on GD or IGD in Iran. The current study’s standardized scale can be used in future epidemiological studies.

Conclusion

Eventually, The gaming disorder scale for adolescents in Persian has a two-factor structure and is appropriate for use in Iran.