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Early identification of high-risk gaming behaviors (HRGB) is crucial for prevention, yet research using wearable data for detection remains limited. This study analyzed the temporal dynamics of gaming behavior and health indicators using 28-day summary statistics derived from longitudinal data in young adults with HRGB, thereby providing a basis for gaming disorder prevention and intervention.Methods:This 28-day longitudinal study employed a self-designed system implemented on the Huawei Research Platform for participant recruitment and data collection. Participants completed daily mobile app questionnaires between 18:00 and 23:00 assessing gaming time, mood, and sleep, while a smart band continuously collected physiological and activity data. Emotional states were assessed weekly using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7. Machine learning models were applied to compare the predictive performance of active (self-report), passive (wearable), and combined data in identifying HRGB, and to determine key predictive factors relevant for intervention.Results:The final sample comprised 37 participants in the HRGB group and 23 in the non-HRGB group. Significant between-group differences were observed across multiple indicators. Combined data yielded the highest area under the receiver operating characteristic curve (AUROC) in five of six models (logistic regression: 0.86 vs 0.81). Wearable-derived data enhanced early classification of HRGB, with depression severity (PHQ-9), heart rate, and sleep metrics emerging as potential markers. A one-standard-deviation increase in PHQ-9 scores was associated with a 3.51-point increase in Gaming Disorder Screening Scale (GDSS) scores (89% credible interval [CrI], 1.85\u20135.20), while a higher heart rate index was associated with a 1.36-point increase in GDSS scores (89% CrI, 0.13\u20132.60). The population attributable fraction was 15.51% for PHQ-9.Conclusions:Wearable data enhances early HRGB classification. PHQ-9, heart rate, and sleep metrics are key predictors, showing clinical utility.<\/jats:p>","DOI":"10.31083\/ap48256","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T12:42:51Z","timestamp":1783428171000},"source":"Crossref","is-referenced-by-count":0,"title":["Digital Phenotyping of High-Risk Gaming Behavior Using Wearable Devices"],"prefix":"10.31083","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0031-4483","authenticated-orcid":true,"given":"Yijie","family":"Song","sequence":"first","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4611-9888","authenticated-orcid":true,"given":"Yawen","family":"Shi","sequence":"additional","affiliation":[{"name":"Shanghai Changning Mental Health Center, Affiliated Mental Health Center of East China Normal University, 200335 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7552-4165","authenticated-orcid":true,"given":"Yiqun","family":"Tu","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1229-0039","authenticated-orcid":true,"given":"Haidi","family":"Shan","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9619-9824","authenticated-orcid":true,"given":"Chuanning","family":"Huang","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2052-8554","authenticated-orcid":true,"given":"Yue","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8929-4102","authenticated-orcid":true,"given":"Shuo","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8067-6557","authenticated-orcid":true,"given":"Zhekai","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5730-2259","authenticated-orcid":true,"given":"Hang","family":"Su","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4656-2936","authenticated-orcid":true,"given":"Na","family":"Zhong","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6105-8749","authenticated-orcid":true,"given":"Tianzhen","family":"Chen","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8382-3050","authenticated-orcid":true,"given":"Min","family":"Zhao","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"},{"name":"Shanghai Key Laboratory of Psychotic Disorders, 200030 Shanghai, China"},{"name":"CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, 200031 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3644-4581","authenticated-orcid":true,"given":"Jiang","family":"Du","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Limone P, Ragni B, Toto GA. The epidemiology and effects of video game addiction: A systematic review and meta-analysis. Acta Psychologica. 2023; 241: 104047.","DOI":"10.1016\/j.actpsy.2023.104047"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Macur M, Pontes HM. Internet Gaming Disorder in adolescence: investigating profiles and associated risk factors. BMC Public Health. 2021; 21: 1547.","DOI":"10.1186\/s12889-021-11394-4"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Ko CH, Lin HC, Lin PC, Yen JY. Validity, functional impairment and complications related to Internet gaming disorder in the DSM-5 and gaming disorder in the ICD-11. The Australian and New Zealand Journal of Psychiatry. 2020; 54: 707\u2013718.","DOI":"10.1177\/0004867419881499"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Wong HY, Mo HY, Potenza MN, Chan MNM, Lau WM, Chui TK, et al. Relationships between Severity of Internet Gaming Disorder, Severity of Problematic Social Media Use, Sleep Quality and Psychological Distress. International Journal of Environmental Research and Public Health. 2020; 17: 1879.","DOI":"10.3390\/ijerph17061879"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Billieux J, Stein DJ, Castro-Calvo J, Higushi S, King DL. Rationale for and usefulness of the inclusion of gaming disorder in the ICD-11. World Psychiatry: Official Journal of the World Psychiatric Association (WPA). 2021; 20: 198\u2013199.","DOI":"10.1002\/wps.20848"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Long J, Bhad R, Potenza MN, Orsolini L, Phan V, Kanabar M, et al. Public health approaches and policy changes after the inclusion of gaming disorder in ICD-11: global needs. 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NPJ Digital Medicine. 2023; 6: 238.","DOI":"10.1038\/s41746-023-00977-7"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Liu Y, Peng S, Wu X, Liu Z, Lian Z, Fan H, et al. Neural, cognitive and psychopathological signatures of a prosocial or delinquent peer environment during early adolescence. Developmental Cognitive Neuroscience. 2025; 73: 101566.","DOI":"10.1016\/j.dcn.2025.101566"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Yu G, Wu X, Liu Z, Shi M, Fan H, Liu Y, et al. Genetic influence and neural pathways underlying the dose-response relationships between wearable-measured physical activity and mental health in adolescence. Psychiatry Research. 2025; 349: 116503.","DOI":"10.1016\/j.psychres.2025.116503"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Choi J, Gutierrez-Osuna R. Using heart rate monitors to detect mental stress. 2009 Sixth International Workshop on Wearable and Implantable Body Sensor Networks. 2009; 219\u2013223.","DOI":"10.1109\/BSN.2009.13"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Park SM, Lee JY, Choi AR, Kim BM, Chung SJ, Park M, et al. Maladaptive neurovisceral interactions in patients with Internet gaming disorder: A study of heart rate variability and functional neural connectivity using the graph theory approach. Addiction Biology. 2020; 25: e12805.","DOI":"10.1111\/adb.12805"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Tang F, Ishwaran H. Random Forest Missing Data Algorithms. Statistical Analysis and Data Mining. 2017; 10: 363\u2013377.","DOI":"10.1002\/sam.11348"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"B\u00fcrkner PC. brms: An R package for Bayesian multilevel models using Stan. Journal of Statistical Software. 2017; 80: 1\u201328.","DOI":"10.18637\/jss.v080.i01"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Lemoine NP. Moving beyond noninformative priors: why and how to choose weakly informative priors in Bayesian analyses. Oikos. 2019; 128: 912\u2013928.","DOI":"10.1111\/oik.05985"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Iqbal SMA, Mahgoub I, Du E, Leavitt MA, Asghar W. Advances in healthcare wearable devices. NPJ Flexible Electronics. 2021; 5: 9.","DOI":"10.1038\/s41528-021-00107-x"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Liu Y, Gong R, Yu Y, Xu C, Yu X, Chang R, et al. Longitudinal predictors for incidence of internet gaming disorder among adolescents: The roles of time spent on gaming and depressive symptoms. Journal of Adolescence. 2021; 92: 1\u20139.","DOI":"10.1016\/j.adolescence.2021.06.008"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Zhang M, Nie Q, Ye W, Wang Y, Yang Z, Teng Z. Longitudinal Dynamic Relationships Between Videogame Use and Symptoms of Gaming Disorder and Depression Among Chinese Children and Adolescents. Journal of Youth and Adolescence. 2025; 54: 426\u2013438.","DOI":"10.1007\/s10964-024-02068-6"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"Munakata M, Imai Y, Hashimoto J, Sakuma H, Sekino H, Abe K, et al. The influence of antihypertensive agents on circadian rhythms of blood pressure and heart rate in patients with essential hypertension. The Tohoku Journal of Experimental Medicine. 1992; 166: 217\u2013227.","DOI":"10.1620\/tjem.166.217"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"Anderson C, Forte G, Hu W, Zhang H, Boyett MR, D'Souza A. Non-canonical role of the sympathetic nervous system in the day-night rhythm in heart rate. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences. 2023; 378: 20220179.","DOI":"10.1098\/rstb.2022.0179"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"Li P, Kim JK. Circadian regulation of sinoatrial nodal cell pacemaking function: Dissecting the roles of autonomic control, body temperature, and local circadian rhythmicity. PLoS Computational Biology. 2024; 20: e1011907.","DOI":"10.1371\/journal.pcbi.1011907"},{"key":"ref32","doi-asserted-by":"publisher","unstructured":"Ramesh A, Nayak T, Beestrum M, Quer G, Pandit JA. Heart Rate Variability in Psychiatric Disorders: A Systematic Review. Neuropsychiatric Disease and Treatment. 2023; 19: 2217\u20132239.","DOI":"10.2147\/NDT.S429592"},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"Fan H, Wang H, Lian Z, Yu Q, Wu X, Kuang N, et al. Dynamic Interactions Between Hemispheres Reveal a Compensatory Pathway for Motor Recovery in Moderate-to-Severe Subcortical Stroke. Journal of Stroke. 2026; 28: 97\u2013114.","DOI":"10.5853\/jos.2025.01725"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"Zheng H, Wang M, Zheng Y, Dong GH. How sleep disturbances affect internet gaming disorder: The mediating effect of hippocampal functional connectivity. Journal of Affective Disorders. 2022; 300: 84\u201390.","DOI":"10.1016\/j.jad.2021.12.085"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"Kristensen JH, Pallesen S, King DL, Hysing M, Erevik EK. Problematic Gaming and Sleep: A Systematic Review and Meta-Analysis. 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