The effectiveness of an online acceptance and commitment therapy self-help course in reducing excessive gaming behavior through inhibitory control: A pilot randomized controlled trial

Background and aims Internet Gaming Disorder (IGD) has emerged as a significant mental health concern. However, a substantial number of young people exhibit excessive gaming behavior (EGB) without meeting the full criteria for IGD. Compared to IGD, studies on EGB are limited. On the basis of innovative design acceptance and commitment therapy (ACT) online self-help course, this study explored the mechanism of ACT self-help course improving inhibitory control ability and alleviating EGB.

Methods This study focused on college students with Internet Gaming Disorder-20 Test (IGD-20) scores between 55 and 70 and more than 21 h of weekly gaming time, representing individuals in the EGB stage who had not yet reached IGD. A total of 58 individuals with EGB (mean age = 20.5 ± 1.2 years) underwent an ACT self-help course (n = 30) or a routine education intervention (n = 28). The IGD-20, Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), and Acceptance and Action Questionnaire (AAQ-II) were used to assess participants before and after the intervention. GO/NOGO tasks and electroencephalogram activities (N200, P300) were also recorded.

Results Compared to the control group, the ACT group exhibited significantly lower game addictive behaviors (IGD-20 score), reduced game time, and improved executive function (BRIEF-A) and cognitive flexibility (AAQ-II). Additionally, the ACT group demonstrated significantly improved NOGO task accuracy, increased N200 amplitude, and shortened P300 latency. Furthermore, correlation analyses and regression model identified that reduced gaming time, alongside improvements in executive function, psychological flexibility, and N200 amplitude, were significant predictors of treatment success.

Conclusions The online ACT self-help course effectively reduced excessive gaming (EGB) and enhanced Inhibitory control. Its efficacy appears driven by simultaneous improvements in psychological and neurocognitive processes, highlighting its clinical potential for treating EGB and IGD.