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Reliability and Validity of the Scale for the Assessment of Pathological

Computer-Gaming (CSV-S)

Article  in  PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie · September 2010

DOI: 10.1055/s-0030-1263145 · Source: PubMed

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Reliability and Validity of the Scale for the Assessment of Pathological
Computer-Gaming (AICA- S)

Authors: Klaus Wölfling , Kai W. Müller , Manfred Beutel

Institut: Outpatient Clinic of Computer Game and Internet Addictive Behaviour –

University Medical Center of the Johannes Gutenberg University (CCIA)

Originally published in: Psychotherapie Psychosomatik Medizinische Psychologie

DOI: http://dx.doi.org/10.1055/s-0030-1263145

Growing numbers of young adults are preoccupied with excessive computer gaming.
Nevertheless the scientific sight on classification, diagnostics and prevalence of the so called
computer game addiction isn’t yet clarified. This study was conducted to introduce a validated
instrument (AICA-S) with sound psychometric properties to distinguish between regular and
excessive computer gaming. The AICA-S was applied in two independent samples (N = 1
710) of juveniles aged between 13 and 18 years in order to determine the validity of the
AICA-S in a cross-validation -design. Results emphasize the psychometric quality of the
AICA-S concerning reliability and validity. The AICA-S provides a useful inventory to assess
excessive computer gaming.
With the expansion of broadband internet the amount of people using the internet constantly
increases worldwide. Being proved by monitoring studies, German adolescents are spending
the same amount of time using the internet than watching T.V [1]. Concerning latest studies
50% of males and 17% of females in the age between 12 and 19 years spend their time with
computer gaming every day or at least several times a week. They may be considered as
regular computer gamers [2]. In particular the MMORPGs play a decisive role in the online
behaviour of young people [3].
The augmentation of adolescents and young adults using computer games excessively
occupies clinicians, scientists, addiction counselling centres and public. Excessive or rather
addicted computer gaming is described in epidemiological studies [4-6] as well as in clinical
trials [8] . A basic problem of the present studies seems to be the different conception of the
morbid or rather addicted behavior in computer gaming. Some authors consider this behavior
as developmental disorder others as Obsessive-Compulsive Disorder or Personality Disorder
[9]. The computer game addiction gets more and more empirical validation in the context of
non-substance- related addictions, so called behavioral addictions [10,11]. Persons concerned,
report on a massive mental obsession with gaming behaviour or rather excessive craving for
the game as well as an increase of time spend with gaming (tolerance).
Aversive conditions are being described as tension or depressive episodes in relation to
abstinence of gaming (withdrawal). The gaming behavior will be maintained despite negative
performance-relating consequences (i. e. declining grades), social Problems (Loss of social
contacts, familial conflicts) or psycho -vegetative disorders [12,13]. These symptoms can be
compared phenomenologically with substance related addictions. This character of addiction
is underlined by results of neurobiological trials.
Thalemann et al. [14] indicated that computer addiction is based on the cortical processing of
cue-reactivity the way it exist within alcoholism and other substance-related addictions [15-
17]. Excessive computer gamers and regular computer gamers were confronted with visual
cues of different emotional value from the International Affective Picture System (IAPS,
[18]). The cortical processing was recorded by EEG. Excessive computer gamers process
computer game related impulses with comparable intensity as highly arousing emotional

1
stimuli. The reaction of the computer game related impulses by regular gamers was captured
in the neutral category an d was therefore not associated with a deep emotional processing.
These specific reactions bring close that even excessive computer game behavior indicates
changes in cortical reactions (Sensitization of the mesolimbic dopaminergic reward center and
development of an addiction memory, which is supposed to play a central role [19].
First epidemiological data bring close that addicted computer game behavior is often showed
among adolecents and young adults. Estimations of prevalence range from app. 3 % [20,21] to
19% [22]. Besides biases of the recruitment (for example online-interviews), the wide range
can be explained by the missing of generally accepted definitions, clear clinical criteria and
measurement procedures with good psychometric quality. To register excessive computer
game behaviour different tools with less psychometric quality (for example Virtual Addiction
Scale, [23] or with limited conception have been used (for example Game Addiction Scale,
[24 ]. The questionnaire according to children computer game behaviour (CSVK-
Questionnaire, [25 ]) is oriented on the international accepted criteria of substance-related
addictions (DSM- IV- TR, [26 ] and ICD-10, [27]) and has been validated [25]. In addition to
the scale “Pathologic Computer Gaming” the CSVK-Questionnaire includes 6 other scales
(for example free time and friends, school, self-perception) which are being registered within
237 items.
In the present work the reanalysis of the scale for computer game behaviour concerning its
adaptability for adolescents is shown. The AICA-S is based on the scale for pathologic
computer game behaviour of the CSVK-Questionnaire [25] additionally considering aspects
of regulation of emotion and negative effects of the computer game behaviour [28]. It is an
economic procedure with 16 items being used for clinical and epidemiological research.
The validation was based on hypotheses taking into consideration recent studies. It was shown
in different tests that addiction-like Internet- or Computer Game behaviour can be associated
with diminished self efficacy and increased social insecurity [21,28,29]. In addition to the
validation disturbance of school performance [30], school anxiety [12,28] and somatoform
disorders are considered [31]. It can be assumed that functional coping strategies are less
frequently used by addicted users [32] than media focussed coping strategies [2 8].
The intention of the present study is to test the AICA-S by means of two independent samples
of adolecents with comparable gender and age patterns AICA-Sconcerning the reliability and
validity.
With an easy structured and valid research tool it should be possible to develop consistent
criteria for excessive and addicting computergame behaviour in future and compare results of
different scientists to establish the word computer game addiction in the international
classification system of psychological disorders.

Method

Measurement methods

The items of the AICA-S stem from the detailed questionnaire of computer game behaviour
(CSVK-Fragebogen, [25]. The selection of the items was undertaken carefully, making sure
the content being valid meaning that all established criteria of the addiction are represented
completely. Quantitative and qualitative using patterns were added (i. e. item 1:”How many
hours do you play on an usual weekday?” and empirically described [9,33 ] aspects of
emotional regulation of computer game behaviour (item 11: “ How often do you play to avoid
negative feelings such as boredom and grief?”). The items are in a 5-step-likert-scale or in an
open answering pattern.

2
To verify different levels of the computer game behaviour, a reanalysis was conducted with
the aid of an older data set (consisting of 221 pupils, aged between 13 and 16 years using the
CSV-K) from Woelfling et al. [6]
First the items of the subscale „pathological computer game behaviour” were tested in a
separate analysis. All items with a definition of more than 0,55 were weighted by factor 2.
Out of the 14 relevant items of the AICA-S a main score between 0 and 27 points was
computed to classify the computer game behaviour in the categories unsuspicious, excessive
and add icted users. (see appendix 1)
With consideration of these scorings 221 attendants showed an average of 1,5 (SD=2,71) in
AICA-S. Considering that a difference of two standard deviation of th is average means a
significant deviance of the regular population, a value of 7,0 points has been defined as a cut-
off for addicted game behaviour. Attendants who score one standard deviation above average
are assigned to the group of excessive users. (cutoff 4, 0 points)

Scale of general self efficacy (SWE; [34])

The SWE covers the common optimistic self belief respectively authority expectation with a
sum score between 10 and 40. The average of representative samples is 29 points (SD=4,00).
The internal consistency is good (0,80-0,90), as well as the factorial and the criterion validity
[36 ].

Eating Disorder Inventory ( EDI-2, Subscala “social insecurity”; [35])

The scale „social insecurity“ of the EDI-2 covers with 8 items the stability and reliability of
social relationships. The retest- reliability lies between 0,73 and 0,93. For the testing there are
comparative values of 288 healthy controls [37].
Further variables focus on school performance (for example “How many times have you
ditched school in order to play computer games ?”), school anxiety (for example “ Are you
scared of school?”), physical problems (for example “Do you often suffer from headache?”)
and coping behavior (for example “ What do you do if you are angry or sad?”). 9 items on 4-
step likert scales cover functional, dysfunctional and media focused coping. The time of
gaming during the week-end (in hours), the increase of gaming time since the first contact
with computer games (in hours), the frequency of usage of MMORPGs and the amount of
available multimedia equipment was evaluated as well.
The project leaders (psychologists) carried out the investigation with two people and in
presence of a teacher during class, assuring anonymity. Before answering the questionnaire
the attendants got instructions how to fill it out. If there were any questions or problems with
understanding the professionals could be asked at any time.

Participants

Data of two independent samples were raised. Before the surveys started the authorization by
the Stadtschulrat Wien respectively the Schulamt NRW was obtained as well as the agreement
of the attendants.The survey s fulfilled the criteria of the declaration of Helsinki. 1068
adolecents of Vienna aged between 13 and 18 years (M=14,3, SD= 0,82) took part in the first
assessment, which was carried out in cooperation with the Sigmund -Freud-Privatuniversität
Vienna. In the second sample 642 pupils of Nordrhein -Westfalen participated. The age pattern
(M=14,9, SD=1,25) and the gender distribution were similar. Sociodemographic
characteristics are figured in Tab. 1.

3
Data analysis

As a measure of reliability the internal consistency (Cronbachs a) was computed . Further

calculations to examine and select the items considered the homogeneity of the scale (rii ) and
the determination of the coefficient discriminatory power. (rit ).
For the factorial construct validation the expected single-factor structure of the questionaire
the first sample was examined by the aid of a principal component analysis. The eigen value
was taken as extraction criterion by taking into consideration the Kaiser -Guttmann-Criterion
[38] and the Scree- Test [39]. The determined factorial structure was examined by the aid of a
second factorial analysis testing the second sample. The realized calculations refer to he
numeric raw scores of the single items.
For a subgroup comparison of the three research groups (unsuspicious, excessive and addicted
users) the Kruskal-Wallis-Test was used because of the inhomogeneity of the sample
dimensions.
Further analysis of the mean deviation were calculated with the Mann -Whitney-U-Test.
As as measure of coherence the point biserial correlation coefficient was used. Calculations
were made with the statistic program SPSS 17.0.

Tab. 1 Sociodemographic characteristics of the reviewed samples

First sample: Overall Girls (N=487; Boys (N=581; 55,4

Vienna (N=1068) 45,6%) %)
Age (in years) M = 14,3 M = 14,3 M = 14,3
(SD = 0,82) (SD = 0,81) (SD = 0,82)
Siblings (%, n) 82,9% 82,1% 83,4%
(n=885) (n=399) (n=483)
Number of siblings M = 1,8 M = 1,8 M = 1,8
SD = 1,19 SD = 1,12 SD = 1,16
Second sample: Overall Girls (N=303; Boys (N=339; 52,8
North Rhine Westphalia (N=642) 47,2%) %)
Age (in years) M = 14,9 M = 14,9 M = 14,9
(SD = 1,25) (SD = 1,30) (SD = 1,24)
Siblings (%, n) 91,4% 92,7% 90,1%
(n = 587) (n = 281) (n = 306)
Number of siblings M = 1,9 M = 1,9 M = 1,9
(SD = 1,30) (SD = 1,33) (SD = 1,28)
Explanatory notes: M = mean; SD = standard deviation; Age range: 13-18 years

Results

Classification of usage

In the first sample 12,3% (131) and 8,4% (54) in the second sample were classified as
addicted players. In addition, 7,5 % (80) in the first sample and 21,5% (138) in the second
sample were classified as excessive players. The remaining 80,2% (857) and 70,1% (450) can
be classified as unsuspicious users. The average time spent playing over all subjects amounts
to 2,5 hours in the first sample (SD = 1,98) and 3,4 hours per weekday in the second sample
(SD = 3,88). Addict ion-like users play 5,1 hours (SD = 3,20; first sample) or 6,1 hours per
weekday (SD = 3,31; second sample), excessive users play 4,1 hours (SD = 1,88; first
sample) or 5,5 hours per weekday (SD = 4,26; second sample). In comparison, unsuspicious

4
users play 2,1 hours (SD = 1,76; first sample) or 2,1 hours per weekday (SD = 2,95). As
expected, the raw scores of the AICA-SAICA-S have their peak on the left side of the
distribution in both samples. An Overview of the cumulated percentages can be found in
appendix 2.

Results of reliability

Means, standard deviations and corrected coefficients of discriminatory power can be found
in Tab 2. The items of the AICA-S form a homogenous scale (rii = 0,32) with good internal
consistency ( ). The coefficients of discriminatory power vary between rit = 0,23 and
rit = 0,76. With one exception (Item 12), all items have a discriminatory power of rit = 30
(Tab. 2) and therefore lie in an acceptable or good range [40-42]. The second sample shows a
good intern consistency (( and homogeneity (rii = 0,25) as well. The coefficients of
discriminatory power are comparable to those in the first sample (rit = 0,17 to rit = 0,69).

Tab. 2 Descriptive statistics for the total scale and the single items of the AICA-S

M SD Discrimi
natory
power
1) How many hours do you spend on the internet on an N1 2,52 1,98 0,48
average weekday (Monday to Friday)? N2 3,40 3,88 0,36
2) How many hours do you spend on the internet on a day of N1 2,53 2,09
Entfällt
the weekend? N2 3,05 3,27
N1 2,49 1,48 0,53
3) How often do you play computer games?
N2 2,66 1,57 0,69
N1 2,17 0,94 0,56
4) How long do you play usually?
N2 1,91 0,99 0,59
5) How strongly are you mentally preoccupied with playing N1 1,03 1,22 0,69
computer games? N2 0,79 0,98 0,65
6) How frequently do you play despite that you had planned N1 0,92 0,77 0,53
not to play? N2 0,73 0,98 0,60
N1 0,58 1,08 0,63
7) Do you feel moody if you can’t be play computer games?
N2 0,34 0,83 0,52
8) Did you recognize that you have to play more often or for a N1 0,53 0,71 0,52
longer time to feel good or relaxed again? N2 0,34 0,83 0,58
9) How intense is your desire for playing computer games on N1 0,87 1,12 0,77
the average? N2 0,80 0,95 0,69
10) How often does the urge to play computer games seem to N1 0,42 0,57 0,63
be overwhelming? N2 0,39 0,79 0,61
11) How frequently do you avoid negative feelings by playing N1 0,72 1,06 0,61
computer games? N2 0,63 0,98 0,56
N1 0,77 0,91 0,28
12.1) How often did you try quitting to play computer games?
N2 0,49 0,86 0,21
N1 0,69 0,46 0,17
12.2) …if you have tried to quit or restrict, did you succeed?
N2 0,65 0,48 0,14
13) How frequently did you forget something important (e.g. N1 0,69 0,77 0,52
homeworks, chores) because you played computer games all N2 0,63 0,94 0,51

5
the time?
14) How often did you have the feeling of playing too often N1 0,97 0,72 0,36
or playing for too many hours? N2 0,81 1,00 0,44
15) Did you face problems or negative consequences because N1 0,96 1,15 0,44
of your gaming habits? N2 0,62 1,09 0,47
N1 2,82 3,22
AICA-S (total scale) Entfällt
N2 2,12 3,02
Explanatory notes: first sample: N = 1068; second sample: N2 = 642; M = mean; SD =
standard deviation; Item 1 and 2 are in an open response format. All remaining items use a 5-
stage likert scale.

Factorial validity

To test the scale structure, explorative factor analysis were conducted with both samples for
the 14 items relevant for the classification of the computer gaming behaviour. . The calculated
measure of the sample suitability with the Kaiser- Meyer-Olkin coefficient lies with 0,91 and
0,92 well above the minimum requirement for the factor analytic analyzability of the sample
[43]. Referring to the Bartlett-Test of sphericity with α2 (78) = 3755,01, p < 0,001 and
accordingly α2 (91) = 3201,25 p < 0,001, the correlation matrix differs significantly from a
random unit matrix [42]. Table 3 shows an overview over the extracted factor loadings.
Considering the results of the Scree-Test, the 14 items of the AICA-S relevant for the
diagnosis, can be factoranalyticaly reduced to one single shared factor. This factor can be
interpreted as “addiction -like computer gaming”. The factor explains 39,15% (first sample)
and accordingly 43,05% (second sample) of the total variance. Item 9 exhibits the highest
factor loading with 0,81.

Tab. 3 Factor loadings of the items of the AICA-S in both examined samples

Item Factor Factor

loading in loading in
first sample second
(N = 1068) sample (N
= 642)
1) How many hours do you spend on the internet on an 0,58 0,53
average weekday (Monday to Friday)?
3) How often do you play computer games? 0,61 0,71
4) How long do you play usually? 0,63 0,69
5) How strongly are you mentally preoccupied with playing 0,75 0,79
computer games?
6) How frequently do you play despite that you had planned 0,64 0,74
not to play?
7) Do you feel moody if you can’t be play computer games? 0,70 0,65
8) Did you recognize that you have to play more often or for 0,61 0,69
a longer time to feel good or relaxed again?
9) How intense is your desire for playing computer games on 0,81 0,82
the average?
10) How often does the urge to play computer games seem to 0,71 0,73
be overwhelming?

6
 11) How frequently do you avoid negative feelings by 0,68 0,67
playing computer games?
12) How often did you try quitting to play computer games? 0,35 0,31
13) How frequently did you forget something important (e.g. 0,62 0,62
homeworks, chores) because you played computer games all
the time?
14) How often did you have the feeling of playing too often 0,46 0,57
or playing for too many hours?
15) Did you face problems or negative consequences because 0,56 0,54
of your gaming habits?
Explanatory notes: Factor loadings of the principal component analysis; Explained
variance: first sample: 39,15%; second sample: 43,05%

Criterion and construct validity in the three classified groups

There are significant differences between excessive and addiction -like players regarding the
criterion and convergent validity (Tab. 4). Addiction-like players have significant more
playing time on the weekend and use significantly more MMORPGs than excessive players.
We found no significant group differences considering the amount of available multimedia
devices. There are substantial correlations between the increase in playing time since the first
contact with the medium computer game and the survey date between the three groups (p <
0,001) as well as between the addicted and excessive players (p < 0,001). Present findings
showed significant group differences regarding psychosocial noticeable problems (Tab. 5):
Absenteeism in the school, felt mark pressure, concentration problems, school anxiety and
physical complaints. All group differences were confirmed in the separate comparison
between excessive and addicted computer players as well.
In order to quantify possible relations between the AICA-S and established psychological
constructs, which are connected with addiction -like computer usage [28], the mean
differences of the study groups were calculated in the subscale “Soziale Unsicherheit” of the
Eating Disorder Inventory (EDI -2, [35]) and the “Skala zur Allgemeinen
Selbstwirksamkeitserwartung” (SWE, [34]) (Tab. 6). We found statistically significant
differences between the three stu dy groups in the expected way. The separate consideration of
group differences between the excessive and the addicted computer players shows statistic
significance in the SWE as well as regarding the “Soziale Unsicherheit” scale. Furthermore,
the AICA-S correlates with EDI -2 (r = 0,24; p < 0,01) and SWE (r = -0.27; p < 0,01)
significantly.
The three study groups differ likewise concerning the measured coping strategies, the
functional coping and the media focused coping. Comparing the excessive and addiction-like
computer players, the addiction-like players have significantly higher results regarding the
media focused coping. In contradiction, the functional coping shows no significant mean
difference (Tab. 6).

7
Tab. 4 Use pattern in dependency of the computer gaming behaviour

Overall Overall1 A: B: C: A vs. B² B vs. C³

(N=642) inconspicous user excessive user addicted user
(N=450) (N=138) (N=54)

M SD X² M SD M SD M SD U U
Possession of multimedia devices 4,3 1,48 51,99*** 4,0 1,51 4,9 1,18 5,0 1,21 35370.00*** -
Usage of MMORPG’s 0,8 1,16 45,62*** 0,5 0,86 1,1 1,28 1,7 1,71 28710,50*** 2966,00*
Playing time on the weekend 3,1 3,41 175,81*** 1,9 2,52 5,4 3,23 7,2 4,56 13888,00*** 2273,50*
Control of playing time 0,6 2,22 259,29*** -0,2 2,03 0,8 1,97 1,8 3,04 21168,00** 23049,50***

Explanatory notes: The data refers to the second sample (N2 =642);
1
Overall comparison with Kruskal-Wallis-Test (df = 2); ² Post-hoc-comparison inconspicuous vs. excessive users (Mann -Whitney-Test); ³ Post-hoc-
comparison excessive vs. addicted users (Mann-Whitney-Test); * p < 0,05 ** p < 0,01 *** p < 0,001

Tab. 5 Psychologic and psychosocial noticeable problems in dependency of the gaming behaviour

Overall Overall1 A: B: C: A vs. B²

(N=1068) inconspicous user excessive user addicted user
(N=857) (N=90) (N=131)

M SD X² M SD M SD M SD U
Absenteeism in school 0,1 0,29 108 ,62*** 0,1 0,11 0,1 0,27 0,3 0,47 31066,50*
Marking pressure 1,1 0,95 17,78*** 1,1 0,95 1,1 0,92 1,5 1,02 32461,50*
Concentration problems 1,0 0,72 24,29*** 0,9 0,67 1,0 0,72 1,3 0,79 32145,00***
School anxiety 0,3 0,64 18,24*** 0,3 0,59 0,3 0,58 0,6 0,94 33562,0*
Psychovegetative liability 0,9 0,72 14,76*** 1,0 0,70 0,9 0,69 1,2 0,81 33764,50*

Explanatory notes: The data refers to the first sample (N1 = 1068);
1
Overall comparison with Kruskal-Wallis-Test (df = 2); ² Post-hoc-comparison excessive vs. addicted users (Mann -Whitney-Test); * p < 0,05 ** p <
0,01 *** p < 0,001

8
Tab. 6 “Allgemeine Kompetenzerwartung” (SWE), “Soziale Unsicherheit” (EDI -2) and coping styles in dependency of the computer gaming
behaviour

Overall Overall1 A: B: C: A vs. B²

(N=642) inconspicous user excessive user addicted user
(N=450) (N=138) (N=54)

M SD X² M SD M SD M SD U
SWE 28,3 5,82 80,97*** 29,1 5,62 27,6 6,12 22,9 2,87 1425,50***
EDI -2 (“Soziale Unsicherheit”) 20,9 6,39 21,49*** 20,2 6,03 21,7 6,54 24,8 6,39 12499,00 **
Functional coping 1,9 0,86 25,03*** 2,0 0,86 1,6 0,82 1,4 0,83 -
Media focused coping 1,1 0,90 92,89*** 0,9 0,78 1,5 0,85 2,0 0,90 2501,50***

Explanatory notes: The data refers to the second sample (N2 =642);
1
Overall comparison with Kruskal-Wallis-Test (df = 2); ² Post-hoc-comparison excessive vs. addicted users (Mann-Whitney-Test); ** p < 0,01 ***
p < 0,001

9
Discussion

The presented study confirms the reliability and validity of the scale for computer gam ing
behavior. All extracted items loaded on one factor which can be interpreted as “addicted
computer game behavior”. The items of the scale show good characteristic values concerning
their homogeneity and internal consistency and the coefficients of discriminatory power lie
within an acceptable to very good range. An exception is the combined item “unsuccessfull
abstinence efficiency” which quality of discriminatory power is located in the lower range.
This is explained through the symptomatic characteristic of computer game addiction. As
with other (substance related) addictions the problem lies in the lacking degree of insight of
the affected persons. For instance a gamer may have never tought of changing his game
playing behaviour autonomously up to the point of the survey A clinical unsuspicious gamer
on the other hand should not see a reason to regulate his computer game behavior or has been
successful controlling it. One can also imagine that the remote discriminatory power results of
evaluating two combined questions in one item.
In contrast to other inventories, which are used in studies of pathological online- respectively
computer game behavior, the AICA-S focuses, regard ing its contents, on the established
criteria of substance-related addiction and on pathological gambling, which shows a
reasonable operationalisation of the construct. Thus addicted computer gaming behavior is not
empirically quantified with the aid of pure time spent gaming, which is considered an
important but not sufficient criteria, but rather by means of further criteria such as craving,
continued consumption and tolerance. The latter could be verified as essential component of
addiction-like gaming behaviour within this examination of time spent playing computer.
The findings referring to the validity seem to be auspicious: Next to significant adverse
effects in psychosocial and performance-related parameters, addiction -like players show in
comparison to excessive players a distinctive social insecurity as well as significantly lowered
outcome expectancy. In delineation to mere descriptive-symptom -related scales [5], those
parallel measured variables of the AICA-S give an adequate anchorage to convergent
psychological constructs. Furthermore, addiction-like users employ computer games
significantly more often dysfunctional for coping with stress (media focused coping). Those
findings support the presumptions of ätiopathologic models for computer gaming addiction
[28]. They give evidence to the fulfillment of the requirements of construct validity through
the AICA-S.
Alongside expected differences concerning objectively assessed external criteria can be
discovered using the classification with the aid of the AICA-S. Addiction -like computer
gamers differ from excessive users with regard to the playing time on the weekend
significantly. Addiction -like users make disproportionately more use of MMORPG’s, which
have an exceedingly higher addictive potential from a clinical point of view [44]. The current
discussion concerning the DSM-V supports the opinion, that addiction -like computer gaming
behaviour can be operationalized with criteria of the addiction -disorder. In the present study
the computer gamers classified as addiction -like meet the criteria for excessive gaming
behaviour as well as those for addiction. The fact that no clinical assessment as an external
criterion could be established, limits the previous statements. There are significant references
for the clinical validity of the taken group classifications (Wölfling et al., in press) concerning
the practice in the Outpatient Clinic of Computer Game and Internet Addictive Behaviour –
University Medical Center of the Johannes Gutenberg University.
Further statistic validity analysis are necessary in future studies for example concerning the
methodology of the Multitrait-Multimethod -Method. In addition, children and youths have to
be examined in further studies. At last, it is necessary to proof if the AICA-S can be applied to
adults under guarantee of the psychometric quality.

10
In summary the AICA-S is an economical, reliable and valid instrument for diagnosing
computer game addiction. It is advised to utilize the AICA-S comprehensively to gain further
insight into the as yet scarcely investigated field of computer game addiction.

Conclusion for the praxis

By the development of a clinical and diagnostic tool for the assessment of addiction-like
Computer game playing (AICA-S), as well as the successful statistical examination of its
psychometric quality clinicians and researchers have recourse to a reliable and valid
instrument which allows the differentiated assessment of phenomenological, epidemiological
and clinical aspects of addiction -like computer gaming behaviour.

Appendix 1

Instruction part and weighted scoring for the computer gaming behaviour scale (AICA-S).

Item-Nr. Response category Weighting

1 From statement “4 hours” 1
3 “every day” 2
4 “4-6 hours” 2
“more than 6 hours” 1
5 4 – “very strong” 2
3 – “strong” 1
6 4 – “very often” 2
3 – “often” 1
7 4 – “very often 2
3 – “often” 1
2 – “sometimes” 1
8 4 – “very often” 2
3 – “often 1
9 4 – “very strong” 2
3 – “strong” 1
10 4 – “very often” 1
11 4 – “very often” 2
3 – “often” 1
12 4 – “very often”
3 – “often” 2
and “never”
13 4 – “very often” 2
3 – “often” 1
14 4 – “very often” 2
3 – “often” 1
15 Overall 6 entries. Per 0,5
occurred negative
consequence
Explanatory notes: Response categories: Item 2: open response format; Item 3: 1 = less than
once per month, 2 = Once per month, 3 = Once per week, 4 = 2-3 times a week, 5 = every
day; Item 4: 1 = less than an hour, 2 = 1-2 hours, 3 = 2-4 hours, 4 = 4-6 hours, 5 = more than
6 hours; Items 5 and 9: 0 = not at all, 1 = moderately, 2 = considerably, 3 = strong, 4 = very
strong; Items 6,7,8,10,11,12,13 and 14: 0 = never, 1 = seldom, 2 = sometimes, 3 = often, 4 =
very often; Item 15: 0 = no, 1 = yes

11
Instructions:
The following questions are related to your internet behaviour. Please answer to all of them
truthfully and completely. Please mind that there are no “right” or “false” answers. So just fill
in the answer that you consider as the most apt one.
Please note that all the questions are related to the way you use the internet in your leisure
time and not for school-related issues.

Appendix 2

Cumulated percentages according to the raw value of the AICA-S

Raw values Percentages( cumulated)

AICA-S
Total (%) Male (%) Female (%)
0,0 29 20 37
0,5 40 29 51
1,0 51 39 63
1,5 60 49 72
2,0 71 61 80
2,5 77 68 85
3,0 79 71 88
3,5 81 73 89
4,0 83 76 91
4,5 85 78 91
5,0 86 80 92
5,5 87 81 94
6,0 88 83 94
6,5 89 84 94
7,0 90 86 95
7,5 91 87 95
8,0 93 89 96
8,5 94 90 97
9,0 95 91 98
9,5 95 92 98
10,0 96 93 98
10,5 96 94 99
11,0 97 94 99
11,5 97 95 99
12,0 97 95 99
12,5 97 96 99
13,0 98 96 99
13,5 98 97 100
14,0 99 97 100
14,5 99 98 100
15,0 99 98 100
15,5 99 98 100
16,0 99 98 100
16,5 99 98 100
17,0 99 99 100
17,5 99 99 100

12
18,0 99 99 100
18,5 100 99 100
19,0 100 99 100
from 19,5 100 100 100

13
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