The relationship between loot box buying, gambling, internet gaming, and mental health: Investigating the moderating effect of impulsivity, depression, anxiety, and stress

There has been much debate on whether loot box (LB) buying can be considered gambling. The relationship between LB buying, gambling, and mental health has already been examined, reporting inconclusive results. Therefore, the main aim of the present study was to examine the associations between LB buying, gambling, online gaming, and other relevant constructs of mental health. In addition, moderation analyses were conducted to study the relationship between LB buying and gambling/online gaming. Analysing a relatively large sample of adults (N = 1416), the results showed positive relationship between LB buying, problem gambling, and problematic video game use. A positive relationship was found between risky LB buying and depression, anxiety, stress, and impulsivity. Moderation analyses showed that anxiety and impulsivity were associated with significant strengthening of relationships between risky LB buying and gambling symptoms. Likewise, the relationship between risky LB buying and internet gaming symptoms was also strengthened when participants had higher depression scores. Moreover, this relationship appeared to be (i) reinforced when participants engaged in higher risky LB buying while showing higher levels of impulsivity, and (ii) weakened when participants engaged in higher risky LB buying while showing higher levels of depression. Overall, the results suggest that, at least to some extent, LB buying shares similar mental health risk factors with other behavioural addictions. Furthermore, while stress did not moderate this relationship, impulsivity and anxious and/or depressive symptomatology moderated, and in most cases, strengthened the relationship between risky loot box buying and problem gambling/online gaming.