Gaming addiction in high school students: anxiety, gender, and contextual differences

Background

Problematic gaming in adolescence is often framed as excessive screen exposure, but this view may overlook mental health and contextual vulnerability among students who play games. This study aimed to identify factors independently associated with computer game addiction (CGA) among game-playing high school students.

Methods

Data came from an online survey of 1,031 students aged 15–19 years in Małopolskie Voivodeship, southern Poland. CGA was assessed with the Gaming Addiction Scale-Brief Version. Health literacy (HL) was measured with the Health Literacy for School-Aged Children scale, and anxiety symptoms with the Generalized Anxiety Disorder-7 scale. Students reporting no computer gaming were excluded. Multivariable linear regression was performed.

Results

The analysis included 559 students who reported computer gaming, representing 54.2% of the full sample. Mean CGA score was 14.63 (SD = 5.62). The model was significant (F(29,529)=3.43, p < 0.001) and explained 15.8% of CGA variance (adjusted R²=0.112). Higher anxiety symptoms were associated with higher CGA score (B = 0.20, 95%CI: 0.11 to 0.29). Compared with males, females students had lower scores (B=-2.66, 95%CI: -3.71 to -1.61), while students reporting other gender did not differ significantly. Higher scores were also observed among students from the larger urban residence category compared with rural residence (B = 1.63, 95%CI: 0.20 to 3.06) and among third-year versus fourth-year students (B = 1.91, 95%CI: 0.55 to 3.27). HL was not independently associated with CGA score (B=-0.06, 95%CI: -0.16 to 0.03).

Conclusions

Among game-playing students, CGA was more closely linked with anxiety symptoms and school or residential context than with HL. Problematic gaming should be addressed not only as a digital behavior issue but also as part of adolescent well-being. School-based prevention may combine responsible gaming guidance with anxiety-sensitive support and context-aware risk recognition.

Key messages

• Among game-playing students, problematic gaming was linked with anxiety symptoms and contextual differences, not with general health literacy after adjustment.

• School-based prevention should move beyond screen-time warnings and combine responsible gaming guidance with anxiety-sensitive support.