Review manuscript: Emotional regulation in Gaming Disorder: A systematic review.

Background and objectives: Problematic video game use is a source of concern. In addictions, difficulties with emotional regulation have become an important variable of interest. However, their study in relation to problematic video game use remains insufficient.

Methods: A systematic review was conducted following PRISMA 2020 guidelines; 322 studies were screened, resulting in a final sample of k = 18 studies. The methodological quality of these studies was rated as moderate according to the McMaster Critical Review Form for Quantitative studies (CRF-Q).

Results: There is evidence of relationship between different facets of emotional regulation and the presence of problematic video game use. Particularly, video games serve as escape strategy for suppressing emotional expression. There is no consensus regarding the nature of the relationship between emotional regulation, psychopathology, and problematic video game use, with various proposals suggesting moderation and mediation. There is also no consensus regarding the mediation of gender in the relationship between emotional dysregulation and problematic video game use. The level of certainty regarding the validity of the results was moderate.

Discussion and conclusions: Emotional dysregulation plays a role in problematic video game use, especially through strategies as emotional suppression, and lack of abilities to understand and control emotions. It is important to consider emotional regulation as a potential target for research and intervention in clinical populations.

Scientific significance: We review the largest sample of papers on problem gaming and emotion regulation to date. Our results highlight the importance of emotion regulation and, specially, emotional suppression, or negative escapism, on problematic video game use.