Prevalence of internet gaming disorder and its association with Chronotype among Chinese children and adolescents: A network analysis

Although sleep problems are closely related to internet gaming disorder (IGD) in children and adolescents, the role of chronotype has received relatively limited attention, and whether its association with IGD differs across developmental stages remains unclear. This cross-sectional study included 30,669 children and adolescents recruited using cluster random sampling. IGD symptoms were assessed using the Internet Gaming Disorder Scale-Short Form, and chronotype was measured with the reduced Morningness-Eveningness Questionnaire. Descriptive statistics, chi-square tests, and binary logistic regression were conducted, followed by network analysis to explore symptom-level associations. The overall proportion of participants screening positive for probable IGD was 5.1%, with the highest proportion observed among evening-type individuals (11.8%). After adjusting for sex and school stage, chronotype remained significantly associated with probable IGD. Network analysis identified tolerance, loss of other interests, and loss of control as symptoms with relatively high bridge expected influence between IGD and chronotype-related communities. These symptom-level association patterns varied across school stages. These findings highlight the importance of considering chronotype and symptom-level patterns when understanding IGD among children and adolescents.