Prevalence and Association of Primary Caregivers' Parenting Styles with Gaming Addiction in Adolescents with ADHD at King Chulalongkorn Memorial Hospital: A Mediation Analysis of Self-Esteem and Self-Control
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Abstract
Objective: This study aimed to investigates the prevalence of game addiction and examine the correlation between caregiver's parenting styles and game addiction in adolescents with ADHD outpatient treatment at King Chulalongkorn Memorial Hospital, with self-esteem and self-control posited as mediating variables.
Methods: This cross-sectional correlational study recruited 130 dyads of adolescents with ADHD aged 12 – 15 years and their primary caregivers from outpatient department of Child and Adolescent Psychiatry at King Chulalongkorn Memorial Hospital from August to October 2025. Data were collected using validated questionnaires; the Alabama Parenting Questionnaire (APQ), Rosenberg Self-Esteem Scale (RSES), Brief Self-Control Scale (BSCS), Game Addiction Screening Test (GAST), and Swanson, Nolan, and Pelham-IV (SNAP-IV). Data were analyzed using bootstrapping with bias-corrected confidence intervals via the SPSS version 29.0 PROCESS Macro.
Results: The prevalence of game addiction in this group was 11%, with an additional 34% classified as being at high risk for addiction. The findings indicate that neither positive nor negative parenting styles had a significant direct or indirect relationship with game addiction (Direct: (β = -0.101, 95% CI = [-0.290, 0.087]; β = -0.022, 95% CI = [-0.207, 0.164] respectively) Indirect: (β = -0.046, 95% CI = [-0.173, 0.066]; β = -0.023, 95% CI = [-0.163, 0.090] respectively). However, both self-control and self-esteem were found independently to have a highly significant negative correlation with the level of gaming addiction.
Conclusion: The findings demonstrate that increased self-esteem and self-control are critical factors significantly associated with a reduced level of gaming addiction in adolescents with ADHD. This evidence underscores the importance of focusing on these internal protective mechanisms. Therefore, the study strongly suggests that clinicians and healthcare professionals utilize this information to develop intervention programs aimed at fostering self-control and self-esteem, critically by promoting parental awareness and involvement. Such a strategy represents a potent approach for the prevention and mitigation of gaming addiction risk in this population.
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References
Ma M, Sui T. Internet Gaming Disorder in Adolescence: A Literature Review. International Journal of Education and Humanities 2023;8:153-8.
Taechoyotin P, Tongrod P, Thaweerungruangkul T, Towattananon N, Teekapakvisit P, Aksornpusitpong C, et al. Prevalence and associated factors of internet gaming disorder among secondary school students in rural community, Thailand: a cross-sectional study. BMC Res Notes 2020;13:11.
Schneider LA, King DL, Delfabbro PH. Family factors in adolescent problematic Internet gaming: A systematic review. J Behav Addict 2017;6:321-33.
Gui H, Zhao Q, Mao Y. Parenting styles and internet addiction in college students: self-esteem and self-control as mediators. Front Psychol 2025;16:1555900.
Lukavská K. Parenting styles and their relation to videogame addiction. International Journal of Psychology and Behavioral Sciences 2017;11:1461-6.
Jeong H, Yim HW, Lee SY, Lee HK, Potenza MN, Jo SJ, et al. Low self-control and aggression exert serial mediation between inattention/hyperactivity problems and severity of internet gaming disorder features longitudinally among adolescents. J Behav Addict 2020;9:401-9.
Tang-arai-arun D, Pornnoppadol C, Hosiri T. Prevalence, associated factors, and functional impairment of gaming addiction among children and adolescents with attention-deficit/hyperactivity disorder. Journal of Mental Health of Thailand. 2021;29:93-104.
Boonsithi W. Attention-deficit/hyperactivity disorder: diagnosis and treatment. Journal of the Psychiatric Association of Thailand. 2012;57:373-386.
Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007;164:942-8.
Kumsiri P, Leknoi A. Attention deficit hyperactivity disorder (ADHD) and public stigma. Journal of Preventive Medicine Association of Thailand 2018;7:302-311.
Mazzone L, Postorino V, Reale L, Guarnera M, Mannino V, Armando M, et al. Self-esteem evaluation in children and adolescents suffering from ADHD. Clin Pract Epidemiol Ment Health 2013;9:96-102.
Ellis B, Nigg J. Parenting Practices and Attention-Deficit/Hyperactivity Disorder: New Findings Suggest Partial Specificity of Effects. Journal of the American Academy of Child & Adolescent Psychiatry 2009;48:146-54.
Jinan N, Yusof N, Vellasamy V, Ahmad A, Rahman M, Motevalli S. Review of Parenting Styles and Their Impact on The Adolescents’ Self-Esteem. International Journal of Academic Research in Progressive Education and Development 2022;11: 31–47.
Lerdpaisanskul M, Boonchooduang N, Charnsil C, Louthrenoo O. Self-esteem in children with attention-deficit/hyperactivity disorder. Chiang Mai Medical Journal 2017;56:1-7.
Gul F, Abbas K, Saeed S, Haider T, Qayyum SN, Noori S. The relationship between parenting styles and self-esteem of medical students with age and gender as moderators. Ann Med Surg (Lond) 2024;86:5145-51.
Coopersmith S. Self-esteem inventories. Consulting Psychologists Press 1981, 1987.
Kou S. The Relationship between Parenting Style and Self-Esteem in Adolescents. Journal of Education, Humanities and Social Sciences 2022;5:307-12.
Liu S. The Influences of Parenting Style on Child Self-regulation. Lecture Notes in Education Psychology and Public Media 2023;24:77-82.
Li JB, Willems YE, Stok FM, Deković M, Bartels M, Finkenauer C. Parenting and Self-Control Across Early to Late Adolescence: A Three-Level Meta-Analysis. Perspect Psychol Sci 2019;14:967-1005.
Zhang W, Wang Z. Parenting Styles and Adolescents' Problem Behaviors: The Mediating Effect of Adolescents' Self-Control. Psychol Rep 2023;126:2979-99.
Phanubol P, Hosiri T, Apinanthavech S. The relationship between self-esteem and parenting styles in adolescents with attention-deficit/hyperactivity disorder. Journal of Psychiatry. 2022;15(2):123-135.
Kavanagh M, Brett C, Brignell C. What is the reported relationship between self-esteem and gaming disorder? A systematic review and meta-analysis. Computers in Human Behavior 2023;145:107776.
Kavanagh M, Brett C, Brignell C. The role of self-esteem in triggering and maintaining gaming for people with gaming disorder cut-off scores and above average gaming disorder scores: A quasi-experimental study. Computers in Human Behavior 2024;152:108051.
Safarina N, Halimah L. Self-control and online game addiction in early adult gamers. Journal of Physics: Conference Series 2019;1375:012094.
Hu Y, Chen S, Qi D, Zhu S. Problematic Gaming and Self-Control Among Adolescents and Emerging Adults: A Systematic Review and Meta-Analysis. Cyberpsychol Behav Soc Netw 2025;28:301-17.
Cochran WG. Sampling techniques. 3rd ed. New York: John Wiley & Sons; 1977.
Lohr SL. Sampling: Design and analysis. 2nd ed. Boston, MA: Brooks/Cole; 2010.
Phithayaratstian N, Buranasukskul T, Jungsirikulwit D, Benyakorn T. Psychometric properties of the Thai version of the Swanson, Nolan, and Pelham IV Scale (SNAP-IV) and the Strengths and Difficulties Questionnaire ADHD subscale (SDQ-ADHD). Journal of the Psychiatric Association of Thailand. 2014;59:101-118.
Kham-on E, Srisurapanont M, Suradom C. Development and validation of the Thai version of the Alabama Parenting Questionnaire (APQ). Journal of Mental Health of Thailand. 2019;27(2):107-120.
Wongpakaran T, Wongpakaran N. Confirmatory factor analysis of the Rosenberg Self-Esteem Scale: a study in Thai students. Journal of the Psychiatric Association of Thailand. 2009;56:59-70.
Pornnoppadol C, Sornpaisarn B, Khamklieng K, Pattana-amorn S. The development of game addiction screening test (GAST). Journal of the Psychiatric Association of Thailand 2014;59:3-14.
Tangney JP, Baumeister RF, Boone AL. High self-control predicts good adjustment, less pathology, better grades, and interpersonal success. Journal of Personality 2004;72:271-324.
Wang JL, Yin XQ, Wang HZ, King DL, Rost DH. The longitudinal associations between internet addiction and ADHD symptoms among adolescents. J Behav Addict 2024;13:191-204.
Barkley RA. Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull 1997;121:65-94.
Niu X, Li J-y, King D, Rost D, Wang H-Z, Wang J-L. The relationship between parenting styles and adolescent problematic Internet use: A three-level meta-analysis. Journal of Behavioral Addictions 2023;12:652-69.
P V S, Srivastava A. Impact of parenting style and self-control on internet gaming disorder among adolescents. International Journal of Health Sciences 2022:10733-41.
Chen I-H, Lee Z-H, Dong X-Y, Gamble JH, Feng H-W. The Influence of Parenting Style and Time Management Tendency on Internet Gaming Disorder among Adolescents. International Journal of Environmental Research and Public Health 2020;17:9120.
Koning IM, van den Eijnden RJJM, Verdurmen JEE, Engels RCME. Explaining the relationship between ADHD and gaming addiction: The role of self-control and parental monitoring. Journal of Behavioral Addictions 2018;7:120-8.
Chou WJ, Liu TL, Yang P, Yen CF, Hu HF. Attention-deficit/hyperactivity disorder symptoms and internet addiction in children and adolescents. Journal of Behavioral Addictions 2015;4:165-73.
Bandura A. Social cognitive theory of self-regulation. Organizational Behavior and Human Decision Processes 1991;50:248-87.
Yen CF, Yang P, Ko YC, Chou WJ. The effects of self-esteem and social support on internet addiction in adolescents with attention-deficit/hyperactivity disorder. Journal of Adolescence 2014;37:1271-80.
Orth U, Robins RW. The development of self-esteem. Current directions in psychological science 2014;23:381-7.
Chen IH, Lee ZH, Dong XY, Gamble JH, Feng HW. The Influence of Parenting Style and Time Management Tendency on Internet Gaming Disorder among Adolescents. Int J Environ Res Public Health 2020;17.
Kolubinski DC, Frings D, Nikčević AV, Lawrence JA, Spada MM. A systematic review and meta-analysis of CBT interventions based on the Fennell model of low self-esteem. Psychiatry Research 2018;267:296-305.
Thakur PC, Sharma MK, Mohan V, Kommu JVS, Anand N, Marimuthu P. Gaming among female adolescents: profiling and psychopathological characteristics in the Indian context. Frontiers in Psychiatry 2023;14:2023.
