Maladaptive emotion regulation strategies as mediators in the relationship between gaming disorder and psychological pain, depression, and anxiety

Video game use disorder, classified in the ICD-11 as a behavioral addiction (code: 6C51), is characterized by impaired control over gaming, prioritization of gaming over other activities, and continuation despite negative consequences. Affecting an estimated 3.3% of the global population and 3.7% in Poland, it has been linked to symptoms of depression, anxiety, and psychological distress. Individuals struggling with this disorder often exhibit difficulties in emotion regulation, which may lead to the adoption of maladaptive coping strategies such as rumination, self-blame, or catastrophizing. These strategies not only reinforce problematic gaming behaviors as a means of escaping negative emotional states but may also intensify symptoms of mental health issues. The aim of this study was to examine the role of maladaptive emotion regulation strategies in the relationship between video game use disorder and psychological pain, anxiety, and depression. Methods: The study included 201 Polish computer game players who completed five standardized self-report measures: the IGD-20 (symptoms of Internet Gaming Disorder), HADS (symptoms of anxiety and depression), PAS (psychological pain), and the Cognitive Emotion Regulation Questionnaire (KPRE; emotion regulation strategies). Mediation models were analyzed in R (version 4.5.1) using the lavaan package with bootstrap confidence interval estimation (5000 samples, 95% CI). Results: Mediation analysis showed that catastrophizing mediated the relationship between Internet Gaming Disorder and all psychopathological variables. Rumination was a significant mediator only for anxiety, while self-blame mediated the relationship with psychological pain. Blaming others did not serve as a significant mediator. Conclusions: The findings confirmed the mediating role of maladaptive self-blame, rumination, and catastrophizing strategies in the relationship between computer game use disorder and depression, anxiety, and psychological pain. A stronger mediating effect was observed in the case of psychological pain, suggesting the particular importance of maladaptive emotion regulation in the context of intense emotional suffering. These results highlight the need to address self-blame, rumination, and catastrophizing strategies in the treatment of IGD, as well as in the diagnosis and assessment of co-occurring emotional symptoms and suicide risk among gamers. Further exploration of the identified issue is needed.