{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:20:50Z","timestamp":1783034450061,"version":"3.54.6"},"reference-count":50,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T00:00:00Z","timestamp":1653782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: Internet gaming disorder (IGD) in youths likely leads to disruptive mood dysregulation, especially among those with attention-deficit\/hyperactivity disorder (ADHD). Whether IGD mediates the pathways leading ADHD to disruptive emotional dysfunction remains unclear. This study aims to elucidate the direct or indirect influence of IGD on ADHD; (2) Method: The Swanson, Nolan, and Pelham Version IV questionnaire was used to evaluate symptoms of ADHD and oppositional defiant disorder, and the Chen gaming disorder scale was used to measure IGD. A psychiatrist diagnosed ADHD, IGD, and disruptive mood dysregulation disorder (DMDD)-like symptoms. Structural equation modeling was applied to evaluate the role of IGD in mediating ADHD progression to disruptive mood dysregulation; (3) Results: Among a total of 102 ADHD youths, 53 (52%) of them with IGD were significantly more likely to have poor interpersonal relationships (p &lt; 0.01) and DMDD-like symptoms (p &lt; 0.01) than ADHD youths without IGD. IGD played a mediating role in increasing the risk of disruptive mood dysregulation in ADHD youths; (4) Conclusions: The findings suggest that IGD mediates ADHD\u2019s progression to disruptive mood dysregulation. Intensive biopsychosocial interventions are warranted for ADHD youths with IGD. More children and adolescents became mood-dysregulated after excessive gaming during the COVID-19 pandemic; this study\u2019s results suggest that child mental health experts develop earlier detection and prevention strategies for children and adolescents hidden behind internet addiction.<\/jats:p>","DOI":"10.3390\/ijerph19116648","type":"journal-article","created":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T23:43:03Z","timestamp":1653867783000},"page":"6648","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Structural Equation Modeling (SEM): Gaming Disorder Leading Untreated Attention-Deficit\/Hyperactivity Disorder to Disruptive Mood Dysregulation"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9527-6306","authenticated-orcid":false,"given":"Ruu-Fen","family":"Tzang","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Mackay Memorial Hospital, Taipei 10449, Taiwan"},{"name":"Department of Childhood Care and Education, Mackay Junior College of Medicine, Nursing and Management, Taipei 11260, Taiwan"},{"name":"Department of Audiology and Speech-Language Pathology, Mackay Medical College, New Taipei City 25245, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan-Hsin","family":"Chang","sequence":"additional","affiliation":[{"name":"Agricultural Biotechnology Research Center, Academia Sinica, Taipei 11529, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0224-1268","authenticated-orcid":false,"given":"Yue-Cune","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Mathematics, Tamkang University, Taipei 251301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1556\/2006.2020.00016","article-title":"Problematic online gaming and the COVID-19 pandemic","volume":"9","author":"King","year":"2020","journal-title":"J. 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