Purpose in life, social support, and internet gaming disorder among Chinese university students: A 1-year follow-up study

Addictive Behaviors 99 (2019) 106070

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Purpose in life, social support, and internet gaming disorder among Chinese university students: A 1-year follow-up study

T

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Meng Xuan Zhang1, Xinrui Wang1, Shu M. Yu, Anise M.S. Wu

Department of Psychology, Faculty of Social Sciences, University of Macau, Avenida da Universidade, Taipa, Macao, China

H I GH L IG H T S

prevalence of probable IGD was high among Chinese university students. • The in life and social support were negatively related to IGD symptoms in both waves. • Purpose in life was an effective factor to protect university students against IGD. • Purpose support at baseline did not predict IGD symptoms at follow-up. • Social • Purpose in life and social support presented a reciprocal relationship across time.

A R T I C LE I N FO

A B S T R A C T

Keywords: Internet gaming disorder Protective factors Purpose in life Social support Chinese university students

Aims: Given the high prevalence of Internet gaming disorder (IGD) among university students and the beneficial effects of positive psychological factors on mental illness, the present longitudinal research aimed to investigate whether purpose in life and social support yields long-term results in protecting university students from IGD. Methods: We recruited 469 Chinese university students to voluntarily fill out an anonymous questionnaire at baseline, and 283 of them were followed up and given similar measures after one year. Results: The prevalence of probable IGD at the baseline and follow-up surveys was 14.8% and 9.9% respectively. Purpose in life and social support were negatively correlated with IGD symptoms in both surveys (p < .05). The results of a cross-lagged analysis showed that purpose in life, but not social support, assessed at baseline predicted fewer IGD symptoms at follow-up (p < .001). In addition, social support and purpose in life predicted one another across time. Conclusions: The prevalence of probable IGD was high among Chinese university students. Purpose in life was shown to be an effective significant protective factor against IGD, while the effect of social support might be indirect. Positive psychology interventions, which promote the search for and attainment life purpose, may be incorporated in school-based program for IGD prevention.

1. Introduction Increasing attention has been given to the problematic use of the Internet, especially gaming, which has been argued to be the most attractive and addictive part of Internet use (Faust & Prochaska, 2018; Wan & Chiou, 2006). In 2018, gaming disorder, including both offline and online types, was included as an addictive disorder in the International Classification of Diseases 11th Revision, which listed its major symptoms as impaired control over gaming, increasing priority given to gaming, and continued gaming despite of negative consequences (World Health Organization [WHO], 2018). These descriptions are

consistent with the criteria of Internet Gaming Disorder (IGD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). According to the China Internet Network Information Center (CNNIC), by the end of 2017, the number of Internet users in China reached 772 million, 30% of whom were young adults (aged 20–29) and 57.2% were online gamers ((China Internet Network Information Center, 2018)). The number of Internet gamers has been rapidly increasing ((China Internet Network Information Center, n.d., 2018)). IGD induces various negative outcomes such as decline in academic performance, social dysfunction, and dysfunction of brain regions

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Corresponding author. E-mail address: [email protected] (A.M.S. Wu). 1 Co-first author. https://doi.org/10.1016/j.addbeh.2019.106070 Received 27 March 2019; Received in revised form 24 July 2019; Accepted 31 July 2019 Available online 01 August 2019 0306-4603/ © 2019 Elsevier Ltd. All rights reserved.

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drug use, unsafe sex, and Internet addiction (Brassai, Piko, & Steger, 2011; Minehan, Newcomb, & Galaif, 2000; Zhang et al., 2015; Zhang, Mou, Tong, & Wu, 2018). With regard to gaming disorder, PIL has been found to be negatively associated with problematic video game playing among Chinese young adults (Wu et al., 2013). However, the negative correlation between PIL and IGD tendency was not replicated in a sample of community dwelling adults in Macao, China (Wu et al., 2018). Since PIL is deemed particularly important for emerging adults (Bronk, 2013); Glanzer, Hill, & Robinson, 2018, it might have a more salient effect on IGD in university students. We, therefore, hypothesized that higher level of PIL at baseline would predict fewer IGD symptoms at the follow-up among Chinese university students (H1).

related to self-regulation, even at university level (Jiang, 2014; Meng, Deng, Wang, Guo, & Li, 2015; Wang et al., 2017; Whang, Lee, & Chang, 2003). Research has also shown a high prevalence of IGD among Chinese university students, which ranges from 3.7% to 17.0% (Zhou & Li, 2009; Long et al., 2018). This study therefore aimed to investigate the protective influence of purpose in life (PIL) and social support on IGD, as well as their shielding effects over time using a two-wave crosslagged panel study. 1.1. Protective factors against IGD Risk factors of IGD have been well documented. For examples, male gender, psychosocial dysfunction (e.g., higher social anxiety) and adverse environment (e.g., family disharmony) were associated with IGD among Chinese university gamers (Lo, Wang, & Fang, 2005; Zhou & Li, 2009). In addition to reducing risks, nurturing protective resources against IGD is also necessary for effectively combating young people's IGD. Positive psychological interventions (PPIs; e.g., valuing close relationships, strengthening healthy social bonds and finding meaning in life) have been shown to not only increase happiness, but they also offer solutions to stress and mental illness (Bolier et al., 2013; Diener & Seligman, 2002; Steger, Kashdan, & Oishi, 2008). Empirical research has also shown a negative association between positive psychological factors (e.g., frustration tolerance, mindfulness, basic need satisfaction, and self-esteem) and IGD or problematic game playing in both Western and Chinese gamers (Beard, Haas, Wickham, & Stavropoulos, 2017; Scerri, Anderson, Stavropoulos, & Hu, 2018; Wu, Lei, & Ku, 2013; Yu, Mao, & Wu, 2018). However, these studies suffer from the limitations of their cross-sectional design. No existing research, except for Weinstein, Przybylski, and Murayama's (2017) six-month follow-up study on the influence of psychological need satisfaction, has used a longitudinal design in investigating the protective effects of positive psychology factors on IGD. Both an individual's predisposition and interpersonal context explain and predict his/her vulnerability to behavioral addiction including IGD (Burleigh, Stavropoulos, Liew, Adams, & Griffiths, 2018; Griffiths, 2005). In a similar manner, PPIs emphasize the positive effects on mental health of both finding purpose or goal in daily life and building positive interpersonal relationships (Diener & Seligman, 2002; Steger et al., 2008). In particular, PIL and social support are two major kinds of developmental assets for university students who are in emerging adulthood (Pashak, Handal, & Scales, 2018). Clear life purpose and sufficient social support are essential for adolescents' successful transitions to adulthood and dealing with developmental tasks in this period (e.g., identity explorations, educational pursuits, and post-graduation life planning; Bundick, 2011; Dezutter et al., 2014; Lane, 2014; Pettit, Roberts, Lewinsohn, Seeley, & Yaroslavsky, 2011; Shulman, Kalnitzki, & Shahar, 2009). These two factors, hence, are expected to protect university students from the development of mental problems like IGD; however, empirical evidence is warranted. To address the current research gap, the present study investigated the effects of two protective factors, PIL and social support against IGD, in a oneyear longitudinal study.

1.3. Social support as a protective factor against IGD Social support is a robust indicator of one's available interpersonal resources, and refers to emotional, informational and practical assistance from one's social environment, particularly parents, friends, and other significant others (Thoits, 2010). Social support is the perception or feeling that one is cared for and tends to generate a sense of relatedness and belonging (Inguglia, Ingoglia, Liga, Coco, & Cricchio, 2015; Legault, Green-Demers, & Pelletier, 2006; Tian, Tian, & Huebner, 2016), which is a basic psychological need and contributes to an individual's wellbeing (Deci & Ryan, 2008). It is not surprising that social support is consistently and negatively associated with university students' problematic behaviors (e.g., problematic Internet use) and mental distress in the literature (Lamis, Ballard, May, & Dvorak, 2016; Rankin, Paisley, Mulla, & Tomeny, 2018; Tan, 2018; Wang, Koenig, Ma, & Al Shohaib, 2016; Zhang et al., 2018). Regarding gaming disorder, one previous study reported that social support in a school context was negatively associated with German adolescents' vulnerability to IGD (Rehbein & Baier, 2013). Cross-sectional studies also found that social support/relatedness was negatively associated with gaming addiction symptoms in Chinese children and/or adolescents (Wei et al., 2014; Yu, Sun, Zhang, & Huang, 2009), and adults (Wu et al., 2013; Yu, Mao, & Wu, 2018). To our knowledge, the effect of social support on IGD has not been examined longitudinally. This study hypothesized that social support would predict fewer IGD symptoms of Chinese university students over time (H2). 1.4. The interplay between PIL and social support Positive psychology theories posit multiple dimensions of wellbeing which are intertwined with each other (Ryff, 1995). Both PIL and positive social relations have been identified as salient dimensions of wellbeing across age groups and have been found to be mildly but significantly associated (Ryff & Keyes, 1995; Ulmer, Range, & Smith, 1991). House, Umberson, and Landis (1988) propose that social connection such as intimacy, parenthood, friendship may promote overall well-being by providing a sense of meaning and PIL. Supportive social relationships offer not only practical and emotional assistance, but they also create a caring environment for individuals to explore their purpose and meaning in life (Feeney & Collins, 2015). Krause's (2007) longitudinal study provided support to this claim, reporting that the emotional support older adults received from family members and close friends was associated with a deeper sense of meaning in life over time. Along the same lines, Martelal, Ryan, and Steger (2017) found that satisfaction of relatedness (e.g., high social connection and support) predicted higher meaning in life in daily life with a sample of adults online. Compared to the positive influences of social support on an individual's sense of PIL, it is less empirically clear whether PIL promotes social connection and support. To our knowledge, no published study examined such a possibility. However, one experimental study has shown that a strong sense of life meaning made people more

1.2. PIL as a protective factor against IGD Purpose or meaning in life is defined as individuals' perception of or desire for significance in their lives, which includes purposes, missions, or aspirational aims they wish to accomplish (Steger, 2009; Zhang et al., 2016). Such purpose is considered to provide guidance and direction in one's life (McKnight & Kashdan, 2009). Behaving in accordance with this guidance would benefit individuals' health and wellbeing, while experiencing frustration of one's PIL might cause an existential vacuum, which could lead to various mental and behavioral disorders (DeWitz, Woolsey, & Walsh, 2009). For examples, PIL appears to play a protective role against psychosomatic symptoms, depression, 2

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(e.g., “My life is_____”, 1 = empty/desperate to 5 = exciting). A higher mean score indicated a stronger sense of life purpose.

interpersonally appealing, which might imply that people with a stronger sense of meaning in life would develop more abundant interpersonal relationships (Stillman, Lambert, Fincham, & Baumeister, 2011). The present study aimed to fill this research gap and test the potential bidirectional relationship between social support and PIL (H3) among Chinese university students.

3.3. Social support Participants responded to the 12-item Multidimensional Scale of Perceived Social Support (Zimet, Dahlem, Zimet, & Farley, 1988) on a 5-point Likert scale (1 = Strongly disagree to 5 = Strongly agree) to rate their perceived support from parents, friends and important others (e.g., “There is a special person who is around when I am in need.”). Higher mean scores represented higher social support.

2. Methods 2.1. Participants and procedures For the baseline study, participants with gaming experience (N = 469, 41.6% male, age = 18 to 27 years, M = 19.29, SD = 1.10) were conveniently recruited at a public university in Macao, China, after the end of classes in the university's general education program in April 2016 (Wave 1 [W1]). After they finished the questionnaire for the baseline study, they were asked to provide their phone number and/or email address on a separated sheet if they were interested in taking part in the follow-up study (i.e., Wave 2 [W2]). Among those participants who voluntarily left their contact (n = 434), 283 participants (39.6% male, M = 20.47, SD = 1.15) were successfully reached and completed the follow-up questionnaire one year later (W2). For both waves of the study, participants provided their written consent to participate and then completed an anonymous questionnaire. A personal code (Date of birth-Birth order-Family name of mother) was created by each participant for matching his/her data of two waves. Participants received a supermarket coupon of 100 MOP (about 12.5 USD) for participating in the surveys at W1 and W2, respectively. Ethics approval was obtained from the Ethics Committee of the corresponding author's university.

Attrition analyses and preliminary analyses were conducted in SPSS 24. Given only one person with missing data in IGD symptoms (W1), we used full information maximum likelihood estimation (Enders & Bandalos, 2001). A cross-lagged panel model (Rogosa, 1980) was tested in AMOS24. We used chi-square test (χ2), comparative fit index (CFI), Tucker-Lewis index (TLI), and the root mean square error of approximation (RMSEA) as indexes of model fitness (McDonald & Ho, 2002), and all variables (except for gender and age) were standardized with standardized coefficients reported. Statistical significance was accepted at p ≤ .05 in all analyses.

3. Measures

4. Results

3.1. IGD symptoms

4.1. Attrition analyses

IGD symptoms were assessed by the nine diagnostic criteria (i.e., preoccupation, tolerance, withdrawal symptoms, unsuccessful attempts to stop or reduce gaming, loss of interest in other activities, continuing to game despite problems, deceive or cover up the game time, mood modification, and risk or lose relationships and/or job/educational/ career opportunities) proposed in DSM-5 (APA, 2013). Participants reported whether they experienced each symptom in the past 12 months (Yes[1]/No[0]). A higher summation score indicated a greater degree of IGD symptoms. Participants who scored ≥5 were classified as probable IGD (Ko et al., 2014).

Attrition analyses showed that there was no significant differences between participants who dropped out (39.66%) and those who participated in the follow-up survey in all baseline variables: gender, χ2 = 0.10, p = .75; age, t(369.28) = 0.85, p = .39; GPA, t (344.04) = 0.84, p = .40; IGD symptoms, t(467) = 0.33, p = .74; social support, t(352.72) = 0.62, p = .54; and PIL, t(466) = 0.88, p = .38).

3.4. Demographic information Participants were asked to provide their gender (Male = 1 and Female = 2), age (years), and academic performance (Grade Point Average [GPA]). 3.5. Data analysis

4.2. Preliminary analyses (N = 283) The descriptive statistics of the major variables and their correlation coefficients were showed in Table 1. The prevalence of probable IGD was 14.84% (n = 42) at W1 and 9.89% (n = 28) at W2 respectively, with 30.41% (W1) and 16.96% (W2) among male students and 8.03% (W1) and 5.26% (W2) among female students. IGD symptoms were negatively correlated with GPA at both W1 and W2. However, IGD

3.2. PIL Participants answered the six-item Purpose in Life Test (Crumbaugh & Maholick, 1964; McKenna & West, 2007) on a 5-point Likert scale Table 1 Descriptive statistics and inter-correlations among major variables (n = 283).

1. IGD symptoms (W1) 2. IGD symptoms (W2) 3. Social support (W1) 4. Social support (W2) 5. Purpose in life (W1) 6. Purpose in life (W2) 7. GPA (W1) 8. GPA (W2) 9. Gender (W1) 10. Age (W1)

M

SD

1

2

3

4

5

6

7

8

9

10

1.794 1.445 3.887 3.993 3.289 3.216 2.773 2.808 1.590 19.272

2.407 1.968 0.569 0.615 0.676 0.611 0.554 0.540 0.493 1.136

(0.86) 0.465⁎⁎⁎ −0.187⁎⁎ −0.178⁎⁎ −0.209⁎⁎⁎ −0.201⁎⁎ −0.227⁎⁎⁎ −0.209⁎⁎⁎ −0.404⁎⁎⁎ 0.094

(0.80) −0.213⁎⁎⁎ −0.197⁎⁎ −0.278⁎⁎⁎ −0.289⁎⁎⁎ −0.195⁎⁎ −0.184⁎⁎ −0.338⁎⁎⁎ 0.131⁎

(0.91) 0.523⁎⁎⁎ 0.415⁎⁎⁎ 0.344⁎⁎⁎ 0.250⁎⁎⁎ 0.215⁎⁎⁎ 0.307⁎⁎⁎ −0.065

(0.92) 0.328⁎⁎⁎ 0.416⁎⁎⁎ 0.153⁎ 0.189⁎⁎ 0.229⁎⁎⁎ −0.009

(0.81) 0.631⁎⁎⁎ 0.243⁎⁎⁎ 0.199⁎⁎ 0.172⁎⁎ −0.030

(0.78) 0.229⁎⁎⁎ 0.240⁎⁎⁎ 0.166⁎⁎ −0.050

– 0.787⁎⁎⁎ 0.335⁎⁎⁎ −0.266⁎⁎⁎

– 0.323⁎⁎⁎ −0.306⁎⁎⁎

– −0.256⁎⁎⁎

–

Note: ⁎p < .05, ⁎⁎p < .01, *** p < .001, W1 = assessed at baseline, W2 = assessed at follow-up, GPA = Grade Point Average. Cronbach's alpha of each measure is provided in the parentheses. 3

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Social Support (W1)

.415***

-.180**

Purpose in life (W1)

.467***

.134**

e1

.263***

.099*

.590***

Purpose in life (W2)

e2

IGD symptoms (W2)

e3

-.173***

-.210***

IGD symptoms (W1)

Social Support (W2)

.365***

Fig. 1. Cross-lagged panel analysis. Note: * p = .05, ** p < .05, *** p < .001, W1 = assessed at baseline, W2 = assessed at follow-up.

more vulnerable to IGD than adults. Moreover, we also found IGD symptoms were negatively correlated with GPA at W1 and W2, and such findings support the potential adverse influence of problematic gaming patterns on academic performance (Jiang, 2014). Effective interventions for IGD at universities are warranted. The present research is the first longitudinal study that tested the protective effects of PIL and social support against IGD among Chinese people. Consistent with the finding of previous cross-sectional studies (Chen, Tong, Wu, Lau, & Zhang, 2018; Wu et al., 2013; Yu, Mao, & Wu, 2018), these two positive psychology variables were negatively correlated with IGD symptoms at both baseline and follow-up surveys. However, over time, PIL, but not social support, was showed to be a salient predictor for fewer IGD symptoms. Our finding thus demonstrated the long-term effect of PIL in alleviating university student's IGD vulnerability. The results also provided evidence of the potential efficacy of meaning-oriented interventions, which have shown to successfully promote PIL in various samples, especially for emerging adults (Henry et al., 2010; Lee, Cohen, Edgar, Laizner, & Gagnon, 2006; Mok, Lau, Lai, & Ching, 2012), on IGD prevention. In this developmental transition period, university students face challenges and pressure in multiple life changes, which makes them more vulnerable to mental disorders such as IGD compared to other age groups (Ibrahim, Kelly, Adams, & Glazebrook, 2013). Identifying PIL would decrease their vulnerability to IGD and facilitate them to solve the development tasks in this period. Therefore, interventions that aims to increase university students' passionate pursuits and goal-directed thinking may be useful in IGD prevention programs. Via school-based programs, university students could also be equipped with simple techniques such as setting a small goal in daily life and making efforts to achieve it, which have been shown to help cultivate meaning in life and facilitate coping with distress (Grant, 2008). Social support and PIL demonstrated a reciprocal relationship in our sample, supporting our hypothesis that social support helps individuals find their PIL, whereas a sense of PIL can also facilitate individuals' building their positive social relations. These findings support the reciprocal effects of the different dimensions of wellbeing and the way they interact with each other. Previous longitudinal studies have only provided evidence for the positive influence of social support in contributing to individuals' sense of PIL (Krause, 2007; Martela, Ryan, & Steger, 2018); this study is the first of its kind that tested and showed not only such enhancement effects, but also the positive influence of PIL in building social support. Stillman et al. (2011) proposed that a strong sense of PIL promotes one's interpersonal attractiveness. It is also possible that PIL could increase the subjective well-being (i.e., life satisfaction and positive affections; Sumner, Burrow, & Hill, 2015), and in this way contribute to relationship satisfaction and sense of relatedness (Tian, Chen, & Huebner, 2014). Other plausible mechanisms may also

symptoms at W1 did not significantly predict GPA at W2 after controlling gender, age, and GPA at W1 (β = −0.01, p = .73). 4.3. Cross-lagged analysis The cross-lagged panel model with gender and age as control variables was tested first and results showed that the model had poor fit, χ2(1) = 18.34, p < .001, CFI = 0.965, TLI = 0.015, GFI = 0.984, RMSEA = 0.248, 90%CI [0.157,0.354], SRMR = 0.051. There were three non-significant paths (i.e., social support [W1] ➔ IGD [W2], IGD [W1] ➔ social support [W2], and IGD [W1] ➔ PIL [W2]) and two nonsignificant residual covariances (i.e., between the residual of social support [W2] and the residual of IGD [W2], and between the residual of PIL [W2] and the residual of IGD [W2]) in the model. Moreover, none of the paths between age and other variables was significant. The paths between gender and social support [W2] as well as PIL [W2] were also non-significant. After removing age, the two non-significant residual covariances, and those non-significant paths mentioned above, the final model (Fig. 1) showed good model fit, χ2(7) = 1.11, p = .342, CFI = 0.998, TLI = 0.994, GFI = 0.992, RMSEA = 0.021, 90%CI [0.000,0.078], SRMR = 0.036. In this final model, with the effect of gender adjusted for all variables, social support, PIL and IGD symptoms at W1 significantly predicted their corresponding variables assessed at W2. IGD symptoms (W2) were also predicted by PIL (W1), β = −0.173, p < .001, which supported H1. Social support (W1) did not significantly predict IGD symptoms (W2), offering no support for H2. Social support (W1) was a significant predictor to PIL (W2; β = 0.099, p = .050), while PIL (W1) significantly predicted social support (W2), β = 0.173, p = .015. These results supported H3. 5. Discussion The prevalence of probable IGD was 14.8% (W1) and 9.9% (W2) in our Chinese university student sample. Using the same cut-off point of 4/5 (Ko et al., 2014), this prevalence was much higher than that among Chinese community-dwelling adult population in the same region (2%, Wu, Chen, Tong, Yu, & Lau, 2018), indicating the high vulnerability to IGD among university students; this was in keeping with the prevalence (i.e., 8.77% to 9.88%) reported in a recent study among university student samples in six Asian country/regions, using Problematic Online Gaming Questionnaire Short-Form to assess IGD (Tang et al., 2018). University students who are emerging adults experience specific challenges unique to this life stage, such as becoming more independent, living on campus, having a less structured class schedule, and wider choices of extra-curricular activities. The challenges and stress that accompanies higher autonomy and freedom of lifestyle may make them 4

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References

be further explored in future research. Social support, however, did not significantly predict IGD symptoms in our cross-lagged model. One possible reason is that the effect of social support on IGD symptoms was in fact mediated by PIL. A similar argument has been proposed by Wu et al. (2013), who found PIL plays a mediating role between relatedness dissatisfaction and gaming addiction tendency in the cross-sectional study. A longitudinal study with three or more waves should be further implemented to examine such mediating effect of PIL over time. Another possible reason is that some individuals may develop online relationships via gaming and receive/ perceive support from their online friends, and such social reward in turn may exacerbate IGD tendencies (King & Delfabbro, 2014). The present study did not assess online and offline social support separately and the potentially distinct effect of these two types of support on IGD should be considered and analyzed in future multi-wave longitudinal studies. Moreover, its model was not involved contextual-level factors (e.g., family environment and mass media); future studies may also investigate the interplay of contextual-level factors and individual-level factors on the development of addictive behaviors (Cleveland, Collins, Lanza, Greenberg, & Feinberg, 2010; Li, Garland, & Howard, 2014; Wu et al., 2018). Other limitations of this study should also be noted. First, the attrition was high, although no difference was found in primary variables between the dropped-out and followed-up participants. Second, the sample was recruited by convenient sampling and therefore the extent to which the findings can be generalized to both student and nonstudent populations, particularly in rural regions, is unknown. Furthermore, IGD symptoms were measured by a self-report measure, instead of a clinical diagnosis. The cross-lagged panel model also suffers from the shortcomings, such as the confounding problem of the between-person and within-person associations and the problem of timeinterval dependency. These shortcomings can only be addressed by other methodologies, such as a random intercepts cross-lagged panel model (with three or more waves; Hamaker, Kuiper, & Grasman, 2015) and continuous-time model (Kuiper & Ryan, 2018). Studies with three or more waves are also required to test the mediating effect of PIL on the relationship between social support and IGD. Despite its constraints, this study was the first attempt to longitudinally test not only the reciprocity between PIL (a positive internal quality) and social support (a positive external attribute), but also the relative predictive value of these two positive psychology factors to IGD development. The findings have practical implications that PPIs, particularly those aiming to nurture one's sense of life purpose and meaning (e.g., Steger et al., 2008), are potentially effective in combating IGD at school settings. Future research should examine the effectiveness of such kind of PPIs against IGD with randomized controlled trials.

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6. Conclusions Our findings suggest that the prevalence of probable IGD is potentially high in Chinese university students, and probable IGD students suffer from poor academic performance. PIL served as a salient factor to protect students against IGD, while social support and PIL promoted each other over time among university students. Intervention strategies that foster the search for and attainment of a sense of PIL may be considered in school-based programs for IGD prevention in university students. Declaration of Competing Interest All authors declare that they have no conflicts of interest. Acknowledgement The research was supported by the research grants of the University of Macau (Ref #: MYRG2015-00213-FSS and MYRG2016-00162-FSS). 5

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