Confusion in gaming disorder measurement

Abstract

Measurement is important for the scientific programmes of addictive behaviours. In the present study, we investigated the measurement of gaming disorder, which recently became the first formal mental disorder owing to technology use (International Classification of Diseases 11). In particular, we tested the gambling hypothesis: whether survey studies on gaming disorder are contaminated by a linguistic conflation of gambling and gaming behaviours. The 500 most cited studies were analysed. Both confirmatory and exploratory analyses supported the gambling hypothesis. Of all 13 studies for which authors shared their survey materials, only one had excluded gambling (95% credible interval (CrI) [1.8%, 33.9%]; Bayes factor (BF) compared to 50% prevalence = 45). Based on an exploratory review of 358 full texts, approximately 30% of the studies had excluded gambling (95% CrI [23.54%, 32.80%]; BF compared to 50% prevalence = 2.8 × 10¹ 4). We further surveyed English (EN; n = 312) and Slovak (SK; n = 319) speakers about their views on gaming and gambling, which revealed terminological confusions in both languages. For instance, about half of the participants (EN = 48.7%/SK = 59.1%) interpreted 'gambling' to be 'gaming' as well. The majority of gaming disorder survey research appears to be contaminated by a systematic measurement error stemming from conceptual confusion. This problem is linguistic and does not concern all languages similarly. To minimize the impact of the error, we recommend researchers clarify survey instructions and seek alternatives to survey data. © 2026 The Authors.