Decreased Specific Pavlovian-to-Instrumental Transfer Effect in Internet Gaming Disorder Following Short-Term Abstinence from Gaming.

BACKGROUND AND AIMS Enhanced game-related specific Pavlovian-to-instrumental transfer (SPIT) has been observed in Internet Gaming Disorder (IGD). However, it remains unclear whether this effect is malleable. This study examined whether short-term abstinence from gaming modulates game-related SPIT effect in this population.

METHODS Sixty young adults with IGD were recruited and assigned to two groups. The abstinence group (n = 29) refrained from gaming for seven days, with compliance verified through daily mobile screenshots and self-reports; the control group (n = 31) maintained their usual gaming routines. Game-related specific PIT (SPIT) was measured before (D0) and after (D7) the abstinence period, and social-reward general PIT (GPIT) was assessed as a comparison. During the Pavlovian phase, three abstract patterns (conditioned stimuli, CSs) were each paired with game-, social-, or shopping-related rewards. In the instrumental phase, two keys (G and F) were paired separately with game- and shopping-related rewards. Game, and pleasure- and arousal-matched shopping and social-reward images were used as rewards in training. Finally, the influence of the CSs on instrumental responses (PIT effects) were tested in the transfer phase. Linear mixed models were applied to assess the change of SPIT and GPIT effects.

RESULTS 1) We observed a significant three-way CS × time × group interaction in the choice rate (CR) for game related-rewards, the abstinence group demonstrated a significant declined G-key choices from D0 to D7 (b = -1.413, z = -3.521, p < 0.001, OR = 0.243), whereas the control group remained stable, indicting a selective attenuation of SPIT effect following abstinence. 2) There was a significant time × group interaction for IGDS scores (F1,58 = 8.008, p = 0.006, ɳp² = 0.121), where the abstinence group showed more reduction in IGDS scores over time than controls. 3) Within the abstinence group, the magnitude of the SPIT reduction was significantly correlated with the decrease in IGDS scores (r = 0.395, p = 0.046). 4) No significant changes of social-reward-related GPIT effect were observed in either group.

DISCUSSION AND CONCLUSIONS Our findings demonstrate a declined game-related SPIT effect in young adults with IGD after a brief period of gaming abstinence.This points to a reversible incentive sensitization process in IGD, where heightened motivational salience attributed to gaming cues may diminish following abstinence, supporting the potential clinical value of integrating short-term, supervised abstinence within therapeutic interventions for IGD.