The study was led by Professor Anderson Sungmin Yoon and Minah Kim of Sungkyunkwan University under the supervision of Willem Kuyken, director of the Oxford Mindfulness Centre. Their work focuses on internet gaming disorder, a condition characterized by persistent and excessive gaming that interferes with education, employment, relationships, sleep, and other areas of daily life. Although gaming is a common form of entertainment, the disorder involves a loss of behavioral control, increasing priority given to gaming, and continued play despite harmful consequences.

College students may be particularly vulnerable to problematic gaming. The transition to university often brings academic pressure, uncertainty about future careers, social challenges, and newfound independence from family supervision. For some students, gaming becomes an immediately accessible way to regulate stress or escape difficult emotions. Over time, however, this coping strategy can reinforce a cycle in which distress triggers gaming, gaming disrupts daily responsibilities, and those disruptions generate additional distress.

MBCT-G adapts Mindfulness-Based Cognitive Therapy, an established psychological treatment originally developed to prevent depressive relapse. The new program applies the same core principles to the thoughts, emotions, and impulses associated with gaming. Participants learn to observe an urge to play as a temporary mental and physical event rather than an instruction that must be followed. This process, often described in clinical psychology as decentering, creates psychological distance between an individual and the impulse to act.

The intervention also incorporates cognitive therapy techniques. Rather than attempting to suppress gaming-related thoughts, participants examine the assumptions and emotional reactions that accompany them. A student might learn to identify thoughts such as “gaming is the only thing that will make me feel better” or “I cannot tolerate this stress without playing,” and then evaluate whether those thoughts are accurate or useful. Mindfulness practice supports this process by training attention and emotional awareness, while cognitive restructuring encourages more flexible responses.

Forty-six college students considered to be at high risk for internet gaming disorder took part in the research. During the eight-week program, participants practiced mindfulness meditation, social skills, and self-care strategies. They were also encouraged to plan and complete alternative pleasurable activities, including exercise, social and recreational activities, and creative hobbies. This behavioral component was important because the program did not simply ask students to reduce gaming; it aimed to help them rebuild a more varied and rewarding daily routine.

According to the research team, students who completed MBCT-G experienced a meaningful reduction in symptoms associated with gaming addiction. They also reported lower levels of stress and anxiety. These findings suggest that the program may work through several connected pathways: improving awareness of automatic impulses, strengthening emotional regulation, reducing reliance on gaming as a coping mechanism, and increasing access to satisfying activities outside the gaming environment.

The most notable outcome was an improvement in self-control, defined in the study as the ability to resist or manage the urge to play without relying entirely on external restrictions. The effect remained visible one month after the intervention ended, indicating that the program may have produced skills that continued to influence behavior after the structured sessions were over. Sustained improvement is particularly important in behavioral treatments, where short-term reductions can disappear when formal support is withdrawn.

Professor Yoon said the findings provide promising evidence for a psychological intervention that could help college students and adolescents interrupt the cycle of impulsive gaming during challenging developmental periods. He also noted that MBCT-G could be suitable for college counseling centers and gaming addiction prevention services because its group-based format may allow clinicians to support multiple participants with fewer resources than one-to-one treatment. However, the researchers’ results should be interpreted as early evidence rather than definitive proof. The study involved a relatively small sample, and further research will be needed to determine how well the intervention performs in larger, more diverse populations and in controlled comparisons with other treatments.

The research was supported by the Ministry of Culture, Sports and Tourism and the Korea Creative Content Agency as part of efforts to develop game-based digital therapeutics technology. Published in the journal Mindfulness, the study adds to a rapidly expanding field examining how psychological science can respond to technology-related behavioral problems. As gaming becomes increasingly embedded in social life, competition, and digital entertainment, interventions such as MBCT-G may offer a way to address harmful use while recognizing that the goal is not to eliminate gaming, but to restore balance, choice, and control.

Subject of Research: Mindfulness-Based Cognitive Therapy for Internet Gaming Disorder among college students.

Web References: https://doi.org/10.1007/s12671-026-02855-1

References: Yoon, Anderson Sungmin, Kim, Minah, and colleagues. Study published in Mindfulness. DOI: 10.1007/s12671-026-02855-1.

Keywords: Internet gaming disorder, gaming addiction, mindfulness-based cognitive therapy, MBCT-G, college students, behavioral addiction, self-control, stress, anxiety, cognitive therapy, digital therapeutics, mental health, mindfulness meditation

A rigorous investigation spearheaded by a research team at Penn State College of Medicine has delved into the complexities of treating co-occurring ADHD and SUD among youth aged 15 to 25. Their work uncovers a conspicuous treatment gap, particularly concerning the prescription of central nervous system (CNS) stimulants, widely regarded as the frontline pharmacotherapy for ADHD symptom management. These findings were substantiated through an expansive retrospective data and statistical analysis of over 1.2 million de-identified health records, thereby providing one of the most comprehensive assessments of treatment patterns and clinical outcomes in this vulnerable population.

Despite clinical guidelines advocating CNS stimulants—such as methylphenidate and amphetamine derivatives—for their robust efficacy in alleviating core ADHD symptoms, the research illuminates a reluctance among healthcare providers to initiate or continue stimulant therapy once an SUD diagnosis enters the clinical picture. This hesitancy stems from prevailing apprehensions about medication misuse and potential exacerbation of substance-related pathology, compounded by regulatory constraints including Food and Drug Administration warnings that underscore abuse potential. Consequently, adolescents and young adults with co-occurring ADHD and SUD represent a demographic wherein evidence-based ADHD treatment is often underutilized, potentially undermining therapeutic outcomes.

The study demonstrated that individuals receiving any form of ADHD pharmacotherapy—encompassing both stimulant and non-stimulant modalities—exhibited significantly improved health outcomes relative to their untreated counterparts. Notably, treatment was associated with reductions in hospitalizations, emergency department utilization, and accidental overdoses, alongside diminished incidences of suicidal ideation and suicide attempts. These clinical gains were further translated into tangible survival benefits; over a longitudinal five-year period, ADHD treatment conferred an approximate 30% reduction in mortality risk among these patients, underscoring the life-saving potential of appropriate intervention.

Intriguingly, the cohort treated with CNS stimulants experienced even more pronounced benefits, including a 4% decrement in both suicidal thoughts and suicide attempts compared to those prescribed non-stimulant alternatives. This suggests that stimulants retain a favorable risk-benefit profile even in the context of concurrent substance use disorders. The neuropharmacological rationale for these findings may lie in the stimulants’ efficacy in enhancing executive function and impulse control, potentially mitigating behaviors that contribute to both ADHD symptomatology and substances misuse.

However, the analysis revealed a disconcerting pattern: the probability of initiating or maintaining stimulant therapy decreased substantially following an SUD diagnosis. Specifically, ongoing stimulant prescriptions declined by roughly 15%, while initial prescriptions plummeted by over 17% post-SUD diagnosis. Such data indicate systemic barriers or clinician biases against stimulant pharmacotherapy that may inadvertently exacerbate adverse outcomes through therapeutic nihilism or overcautious prescribing.

These findings highlight the imperative need for clinicians to reconcile concerns about stimulant misuse with emerging evidence affirming the safety and utility of ADHD pharmacological treatment in substance-affected populations. Rigorous clinical monitoring, integrated behavioral therapies, and judicious prescribing practices should be emphasized to maximize benefits while minimizing risks. This nuanced approach is essential in light of epidemiological data showing up to half of all individuals with ADHD eventually develop a substance use disorder, a confluence that compounds risks for hospitalization, suicidality, and mortality beyond the impact of either condition alone.

Furthermore, this body of work opens new investigative avenues, as the research team has initiated broader analyses encompassing a wider age range—16 to 65 years—and incorporating demographic variables such as sex, race, and type of substance use disorder. These forthcoming studies aim to unravel the multifactorial determinants influencing ADHD treatment accessibility and outcomes in diverse clinical and sociodemographic contexts, thereby informing more equitable and effective health care strategies.

The implications extend into the domain of health policy and clinical education, where there is an urgent call to update guidelines and training to reflect evidence-based practices affirming the role of stimulant medications amidst complex comorbidities. Empowering clinicians with data-backed protocols promises to bridge extant treatment gaps, optimize functional recovery, and ultimately, preserve lives among youth grappling with the dual challenges of ADHD and substance misuse.

This landmark research was disseminated through the Journal of the American Academy of Child and Adolescent Psychiatry and supported by funding from the National Center for Advancing Translational Sciences of the NIH, underscoring the interplay between foundational scientific inquiry and translational impact on public health. It exemplifies the critical role of large-scale data analytics in illuminating treatment disparities and guiding clinical innovation at the nexus of neurodevelopmental disorders and addiction medicine.

By casting new light on the complex interplay between ADHD pharmacotherapy and substance use comorbidity, this work challenges prevailing stigmas and paves the way for optimized care paradigms. In an era where mental health and substance use disorders increasingly intersect within young populations, harnessing the full potential of evidence-based treatments is vital to altering life trajectories and enhancing societal well-being. The Penn State team’s research thus represents a pivotal stride toward integrated, patient-centered approaches that can transform outcomes for tens of thousands of adolescents and young adults nationwide.

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Subject of Research: People
Article Title: Attention-Deficit/Hyperactivity Disorder Treatment Patterns and Association With Clinical Outcomes in Adolescents and Young Adults with Co-occurring Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder: A Retrospective Analysis
News Publication Date: 18-Dec-2025
Web References: http://dx.doi.org/10.1016/j.jaac.2025.12.003
Keywords: Attention deficit hyperactivity disorder, Substance related disorders, Young people, Substance abuse, Suicide, Human behavior