Internet gaming disorder and psychological distress among Palestinian adult online gamers

Internet Gaming Disorder (IGD) is considered a recently developed issue regarding behavioral health concerns internationally, especially among young adults who become more involved in internet gaming activities. Even though there is a vast number of studies conducted internationally, data from Palestine remain limited. The present study was therefore designed to investigate the prevalence rate of IGD in Palestinian adults and its relationship with psychological distress, including depression, anxiety, and stress. A cross-sectional study was conducted between March and May 2026 using a structured questionnaire distributed through social media platforms. The study included adults aged 18 years and older residing in Palestine who provided informed consent. Individuals outside the specified age range or with incomplete questionnaire responses were excluded. Internet Gaming Disorder (IGD) and psychological distress were assessed using the validated Arabic versions of the DSM-5 IGD Scale and the Depression Anxiety Stress Scale-21 (DASS-21). A total of 611 participants were included. Data were analyzed using descriptive statistics, bivariate tests, Spearman correlations, multivariable logistic regression to identify predictors of probable IGD, and multiple linear regression to examine associations between IGD score and DASS-21 subscale scores. The final analysis included 611 participants recruited using convenience sampling through social media and online platforms. Probable Internet Gaming Disorder (IGD) was identified in 23.5% of online gamers. Probable IGD was significantly associated with increased gaming frequency and duration, multiplayer gaming, spending money on games, attempts to reduce gaming time, and negative effects on academic/work performance, social relationships, and sleep ( p < 0.05). Significant positive correlations were observed between IGD scores and depression, anxiety, and stress scores ( p < 0.001). In multiple linear regression analyses, IGD score remained an independent predictor of higher depression (β = 0.348, p < 0.001), anxiety (β = 0.311, p < 0.001), and stress scores (β = 0.346, p < 0.001). In multivariable logistic regression, playing online with other players most of the time was independently associated with probable IGD (adjusted OR = 3.51, 95% CI: 1.08–11.46, p = 0.037), as were moderate and high perceived negative impacts of gaming on academic/work performance (adjusted OR = 4.38, 95% CI: 1.78–10.80, p = 0.001; and adjusted OR = 4.88, 95% CI: 1.61–14.81, p = 0.005, respectively). Higher IGD scores also independently predicted higher depression, anxiety, and stress scores in adjusted linear regression models. This study highlights probable IGD as an emerging behavioral health concern among Palestinian adult online gamers, particularly when gaming is linked to functional impairment and use as a coping strategy for stress or negative emotions. The findings suggest that assessment should move beyond gaming duration alone and consider gaming-related consequences, psychological distress, and coping motives. Future research should use longitudinal and clinically assessed designs to clarify temporal relationships between IGD and psychological distress. Prevention and intervention efforts should focus on healthy coping skills, early screening, and accessible support for individuals whose gaming is associated with distress or impairment. Not applicable.