Impact of video game addiction on social interaction: An observational review examining loneliness, social anxiety, and social activity

Table 1 Characteristics of included observational studies on gaming addiction and social interaction outcomes (2000-2025)

Ref.	Country	Design and sample	Age (years)	Male (%)	Gaming addiction measure	Social outcome measure	Analysis
Limone et al[1], 2023	South Korea	Cross-sectional; n = 1008 high school students	About 16 (adolescents)	50%	Game Addiction Scale (Korean, self-report)	Perceived Social Support Scale	SEM (mediation model)
Tse et al[2], 2025	South Korea	Cross-sectional; n = 930 middle school boys	13-15 (teens)	100%	Online Game Addiction Scale (obsessive vs harmonious passion)	Social Anxiety Scale; Social Skills and Hostility Scales	SEM (path analysis)
Gentile et al[3], 2011	Singapore	Longitudinal (2-year); n = 3034 schoolchildren	8-12 (at baseline)	75%	DSM-IV/APA-based Pathological Gaming Criteria	Social Phobia symptoms (self-report); academic and other outcomes	Logistic and longitudinal regression
Mentzoni et al[4], 2011	Norway	Cross-sectional (national survey); n = 816 adults	16-40 (mixed adults)	56%	PVP	Life Satisfaction Rating; Anxiety and Depression Scales	Correlation; group comparison
Wei et al[5], 2012	Taiwan	Cross-sectional (online survey); n = 722 online gamers	21.8 ± 4.9	83%	CIAS - gaming use subset	SPIN; DSSS	Pearson correlation; linear regression
Kök Eren and Örsal[6], 2018	Turkey	Cross-sectional; n = 205 4th grade children	9-10 (children)	49%	Computer Game Addiction Scale for Children (21-item)	UCLA Loneliness Scale	Spearman correlation (r)
Adams et al[7], 2019	Australia	Cross-sectional (pilot); n = 125 emergent adults	About 19-25 (young adults)	50%	IGDS	Family cohesion (moderator); social anxiety	Pearson correlation
Tham et al[8], 2020	United States	Cross-sectional; n = 361 university students (including gamers)	Mean about 20 (young adults)	71%	Gaming Disorder Test (WHO-based) - “Problematic Gaming”	Multidimensional social support: Real-world vs in-game support	Path analysis (structural)
Jeong and Kim[9], 2020	South Korea	Cross-sectional; about 300 adolescents	About 15-17	50%	K-IGA	Peer relationship quality; social anxiety	Regression, moderation
Guo et al[10], 2024	China	Cross-sectional; n = 479 university students	Mean about 19.5	46%	DSM-5 IGD Scale (9-item)	Social Isolation Subscale (Self-Compassion Scale)	Pearson correlation; mediation (PROCESS)
Ko et al[11], 2024	South Korea	Cross-sectional (national survey); n = 2764 adults (18-49)	18-49 (adult gamers)	67%	Structured Clinical Interview for IGD (DSM-5)	Perceived Loneliness and Social Isolation (single-item)	Logistic regression
Prince et al[12], 2023	India	Cross-sectional; n = 200 undergraduates (1st year)	Mean about 18-19	84%	Self-reported Gaming Addiction Questionnaire	Time spent with family/friends (self-report); perceived social isolation while gaming (single-item)	Descriptive stats (%, χ²)
Lo et al[13], 2005	Taiwan	Cross-sectional; n = 174 MMORPG players	Mean about 17 (teens)	69%	Online gaming use (hours/week) - not diagnostic	Social anxiety (Chinese Social Anxiety Scale); offline vs online friends count	t-tests, correlation
Colwell and Payne[14], 2000	United Kingdom	Cross-sectional; n = 204 adolescents	12-14 (school)	52%	Gaming frequency and preference (no formal tool)	Self-esteem Scale; Social Isolation Concerns (questionnaire)	Pearson correlation

SEM: Structural equation modeling; DSM-IV: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; APA: American Psychiatric Association; PVP: Problem Video Game Playing Scale; CIAS: Chen Internet Addiction Scale; SPIN: Social Phobia Inventory; DSSS: Depression and Somatic Symptoms Scale; UCLA: University of California, Los Angeles Loneliness Scale; IGDS: Internet Gaming Disorder Scale; WHO: World Health Organization; K-IGA: Korean Internet Gaming Addiction Scale; DSM-5: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; IGD: Internet gaming disorder; PROCESS: PROCESS macro for mediation, moderation, and conditional process analysis; MMORPG: Massively multiplayer online role-playing game.

Table 2 Results of quality assessment: Newcastle-Ottawa Scale

Ref.	Selection (0-4 points)	Comparability (0-2 points)	Outcome (0-3 points)	Total score (0–9 points)	Quality rating
Limone et al[1], 2023	3	2	2	7	Good
Tse et al[2], 2025	3	2	2	7	Good
Gentile et al[3], 2011	4	2	3	9	Good
Mentzoni et al[4], 2011	3	1	2	6	Fair
Wei et al[5], 2012	3	1	2	6	Fair
Kök Eren and Örsal[6], 2018	3	1	2	6	Fair
Adams et al[7], 2019	3	1	2	6	Fair
Tham et al[8], 2020	3	2	2	7	Good
Jeong and Kim[9], 2020	3	2	2	7	Good