Effectiveness of non-invasive interventions for internet gaming disorder: A meta-analysis of randomized controlled trials

Abstract

BACKGROUND

Internet gaming disorder (IGD) is a growing concern among adolescents and adults, necessitating effective treatment strategies beyond pharmacological interventions.

AIM

To evaluated the effectiveness of non-invasive interventions for treating IGD among adolescents and adults.

METHODS

A total of 11 randomized controlled trials published between 2020 and 2025 were included in this meta-analysis, encompassing 1208 participants from diverse geographic and cultural contexts. The interventions examined included cognitive behavioral therapy (CBT), internet-based CBT, neurofeedback, virtual reality therapy, abstinence-based programs, and school-based prevention. The primary outcomes assessed were reductions in gaming time and IGD severity. Secondary outcomes included improvements in mood, anxiety, and psychosocial functioning (e.g., stronger peer relationships, better academic or work performance, and healthier daily-life role fulfillment).

RESULTS

The pooled standardized mean difference for IGD symptom reduction significantly favored non-invasive interventions (Hedges’ g = 0.56, 95%CI: 0.38-0.74, P < 0.001), with moderate heterogeneity observed (I² = 47%). Subgroup analyses indicated that CBT-based programs, both in-person and online, yielded the strongest effects, particularly when caregiver involvement or self-monitoring was incorporated. Funnel plot asymmetry was minimal, suggesting a low risk of publication bias.

CONCLUSION

These findings support the efficacy of scalable, low-risk non-invasive interventions as first-line treatment options for IGD, particularly in youth populations. Future studies should prioritize investigating long-term outcomes, comparing the effectiveness of different non-invasive modalities, and developing culturally adaptive delivery methods.

Keywords: Internet gaming disorder; Cognitive behavioral therapy; Virtual reality; Non-invasive intervention; Meta-analysis; Digital addiction

Core Tip: This meta-analysis of 11 randomized controlled trials involving 1208 adolescents and adults reveals that non-invasive interventions effectively reduce internet gaming disorder (IGD) symptoms. Cognitive behavioral therapy (CBT), both in-person and internet-based CBT, showed the most significant positive impact. Incorporating caregiver involvement or self-monitoring further enhanced the effectiveness of CBT-based programs. Overall, the findings support the use of these low-risk, scalable interventions as initial treatment options for IGD, especially in young people. Future research should explore long-term effects, compare different intervention types, and adapt delivery methods for various cultures.