“Clinically significant distress” in internet gaming disorder: An individual participant meta-analysis

Although the validity of internet gaming disorder (IGD) in DSM-5 hinges on a relationship between 5 or more IGD symptoms and “clinically significant impairment and/or distress”, to date most studies have focused statistical significance. To address this, we conduct an individual participant meta-analysis comprised primary data from 15 (n = 38,851). Study 1 finds that meeting DSM-5's proposed 5/9 diagnostic threshold is associated with d .65 greater distress across 21 well-being constructs, which exceeds conservative anchor for clinical However, also find classifying participants above below has little power reject threshold: 2/9 cut-off predicts similarly large differences. 2 shows dimensional (continuous) modelling scores offers severe test threshold. Finally, study 3 reveals three criteria—preoccupation, tolerance, loss control—are roughly half as predictive withdrawal escapism, highlighting limitations present suggesting need modify remove these. In sum, do not evidence invalidating proposed, but identify issues threshold-based categorization, inadequate differentiation significance, inclusion potentially flawed criteria. We argue these are possible negative consequences premature switch confirmatory research IGD.