The Process of Maternal Recognition of and Response to Suspected Gaming Disorder Among Japanese Adolescents Receiving Psychiatric Outpatient Care: A Qualitative Study

Introduction: Gaming disorder (GD) is prevalent among adolescents, and those with neurodevelopmental conditions or symptoms of anxiety and depression may be particularly vulnerable to GD. Family-related factors, including the parent-child relationship, are also linked to adolescent gaming problems.However, less is known about how parents come to notice and respond to a child's gaming-related problems.This study aimed to explore, through mothers' retrospective accounts, how mothers of Japanese adolescents receiving psychiatric outpatient care who screened positive for suspected GD recognized and responded to gaming-related difficulties and associated smartphone use.The interviews also explored mothers' own experiences and the parent-child relationship in the course of responding to these difficulties.Methods: This qualitative study used the Modified Grounded Theory Approach.Eligible participants were parents of a child aged 10 years or older who cohabited with them and engaged in internet gaming.The child was receiving outpatient psychiatric care.Data were collected between February and August 2024.Nine mothers whose children screened positive for suspected GD on the Gaming Disorder Scale for Parents were included in the analysis.Concepts were generated from interview transcripts and compared and refined through constant comparative analysis across cases to form categories. Results: All nine children of participating mothers had at least one developmental or mental health diagnosis, and eight had two or more co-occurring diagnoses.Analysis generated 20 concepts, nine subcategories, and four categories.Mothers' accounts traced a process that began with the "necessity and personal ownership of smartphones," giving way to "uncontrolled game/smartphone use."As household rules went unenforced, mothers came to recognize increasingly serious problems, including "school nonattendance," "mental instability," and "trouble on social media," and mothers confronted these problems largely alone, reflected in "isolated child-rearing for mothers."Mothers also described experiences of "reaching professional support" and, in some families, "changes in parental awareness and behavior."Conclusions: The process of maternal recognition and response involved isolation and fatigue, as mothers confronted problem behaviors, such as school non-attendance and emotional instability, largely on their own.These findings suggest that clinical assessment of families of adolescents with suspected GD may benefit from attending to mothers' own experiences alongside the child's symptoms.