Trauma and problematic gaming: A scoping review of psychological mechanisms and clinical applications

Abstract Background A substantial body of research indicates that PTSD is associated with elevated risk of addiction. Despite these established patterns in substance use disorders and addictive behaviours, few studies have examined whether comparable mechanisms apply to problematic gaming. This scoping review examined literature on the relationship between PTSD, trauma, and gaming. Methods A systematic literature search was conducted in PubMed, Scopus, EMBASE, Medline, CINAHL, Communication & Mass Media Complete, and PsycInfo. Seventy-two studies met inclusion criteria. Results Five themes emerged: trauma exposure is associated with problematic gaming behaviours, gaming is used as a coping strategy, multiple mechanisms shape the trauma-gaming relationship, games and virtual reality may support trauma-focused interventions, and the literature remains mixed due to heterogeneity in definitions of trauma, measures, participant samples, and study designs. Discussion Findings indicate a predominantly positive association between trauma-related symptoms and gaming-related behaviours. Gaming was frequently described as a coping strategy in the context of trauma, although some studies did not support coping-motivated play. Studies evaluating game-based or virtual reality interventions for trauma commonly reported benefit for at least some trauma-related outcomes, while others found unclear effects or no advantage over comparison conditions. Conclusions Existing research underscores a complex interplay between trauma, psychological processes, and gaming behaviours, with gaming producing highly variable functional and psychological outcomes depending on motives, emotion regulation, and individual vulnerability. Furthermore, mechanisms linking childhood trauma, PTSD, and problematic gaming remain insufficiently understood.