In an era where internet gaming disorder (IGD) is emerging as a significant public health concern, a groundbreaking study from China sheds new light on the psychological underpinnings that may influence this condition among young adults. Medical undergraduate students, a group traditionally under intense stress, were the focus of this extensive multi-center survey, unveiling a fascinating relationship between one’s mindset toward stress and the occurrence of problematic gaming behaviors. The research, recently published in BMC Psychiatry, is poised to reshape how mental health professionals approach IGD prevention and intervention.
The investigation centered around the concept of a "stress-is-enhancing" mindset—a cognitive appraisal that views stress as an opportunity for growth and enhanced performance rather than a debilitating force. This perspective contrasts sharply with the more common "stress-is-debilitating" outlook and has been linked in earlier studies to better physical and psychological outcomes. However, until now, its connection to behavioral addictions such as IGD had not been rigorously explored.
Researchers carefully designed a cross-sectional survey involving 8,552 medical undergraduates from seven diverse cities in China, including Baotou, Qiqihar, and Harbin, ensuring a wide demographic representation. Data collection took place over a three-month window from December 2023 to February 2024, employing validated instruments such as the DSM-5 IGD Checklist and the Stress Mindset Measure-General. These tools enabled the team to quantify gaming disorder prevalence and accurately assess individual stress mindsets.
The study’s results revealed that the overall prevalence of IGD within this population was 7.5%, with a stark gender disparity: males exhibited nearly double the rate compared to females, registering at 14.7% versus 7.4%, respectively. This finding mirrors global IGD trends but also underscores the critical need for gender-sensitive approaches in tackling gaming-related problems.
Delving deeper into the psychological mechanisms at play, the researchers identified behavioral disengagement—a coping strategy characterized by withdrawal and avoidance behaviors—as a key mediator between stress mindset and IGD risk. Specifically, individuals embracing a stress-is-enhancing mindset were less likely to engage in behavioral disengagement, which in turn reduced their susceptibility to developing IGD. Conversely, those prone to behavioral disengagement faced heightened vulnerability.
By applying sophisticated path analysis techniques, the team demonstrated that behavioral disengagement fully mediated the relationship between a positive stress mindset and IGD. This mediation suggests a complex interplay wherein adaptive stress perceptions diminish maladaptive coping behaviors, ultimately lowering the risk of gaming addiction. Interestingly, the study found no evidence that gender moderated these associations, indicating that the observed processes function similarly across male and female students.
From a theoretical standpoint, these findings enrich existing stress-coping models by incorporating mindset as a pivotal cognitive appraisal influencing behavioral outcomes. Traditional frameworks often emphasize the stressor-coping dynamic, but this research adds nuance by highlighting how internalized beliefs about stress shape coping strategies and subsequent mental health challenges.
Given that medical students operate under sustained academic pressures, understanding the protective role of a stress-is-enhancing mindset offers practical implications. Cultivating such mindsets could buffer against IGD, which itself can exacerbate academic difficulties and psychological distress. Thus, interventions focusing on mindset training and adaptive coping skills may hold significant promise.
The implications extend beyond medical education, as internet gaming disorder increasingly affects diverse populations worldwide. This study propels forward the conversation on preventive strategies by suggesting that psychological resilience be fostered not just through reducing stressors but also by reshaping perceptions about stress itself.
Looking ahead, the authors call for longitudinal and interventional research to corroborate their findings and evaluate effective methods for promoting stress-is-enhancing mindsets. Such studies could pioneer innovative mental health programs harnessing cognitive reframing techniques to combat behavioral addictions.
Technically, the use of robust multivariate logistic regression bolstered the validity of the associations by controlling for confounding variables. Furthermore, the large sample size and multi-site design enhance the generalizability of the conclusions across a broad spectrum of the young adult population in China.
The integration of stress mindset measures into the cognitive evaluation processes central to coping theories marks a novel methodological advancement. This approach allows for a more nuanced understanding of how internal psychological factors modulate external behaviors such as gaming.
Importantly, while the study confirms the protective effect of a positive stress mindset, it also underscores the detrimental impact of behavioral disengagement—a coping style often overlooked but evidently critical in fostering maladaptive addictive behavior. Targeting such maladaptive behaviors in prevention programs could therefore amplify their effectiveness.
In sum, this multi-center investigation not only quantifies the prevalence of IGD among a high-stress demographic but also uncovers a vital psychological pathway that bridges mindset and behavior. As the digital landscape continues to evolve, research like this equips clinicians, educators, and policymakers with deeper insights needed to design targeted interventions that protect young adults’ mental health in an increasingly connected world.
Subject of Research: The relationship between stress mindset and internet gaming disorder mediated by behavioral disengagement among medical undergraduate students.
Article Title: The association between a stress-is-enhancing mindset and internet gaming disorder was mediated by behavioral disengagement among medical undergraduate students: a multi-center survey in China.
Article References:
Xiang, H., Liu, L., Su, X. et al. The association between a stress-is-enhancing mindset and internet gaming disorder was mediated by behavioral disengagement among medical undergraduate students: a multi-center survey in China. BMC Psychiatry 25, 472 (2025). https://doi.org/10.1186/s12888-025-06910-4
Image Credits: AI Generated
