CIN: Computers, Informatics, Nursing
& Vol. 30, No. 12, 640–646 & Copyright B 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
C O N T I N U I N G
E D U C A T I O N
Emotional Competence
and Online Game Use
in Adolescents
MIA SEO, PhD, RN
HEE SUN KANG, PhD, RN
SUN-MI CHAE, PhD, RN, CPNP
Playing online games has become the most common leisure activity among adolescents worldwide. The prevalence
of online game addiction or excessive gaming in adolescents varies across countries, at 3% in the Netherlands,1
8.2% in central Greece,2 and 9% in Singapore.3 Compared
with these countries, Korea has reported an even higher
rate of game addiction in adolescents, occurring at 14.6%.4
Online game-playing provides adolescents with opportunities to feel achievement from winning the games, to
make friends and interact with them in virtual reality, to
experience a sense of belonging, and to find relief from
stress.5 However, excessive game use has been found to
interfere with healthy growth and development of adolescents,6 thus leading to behavioral and social maladjustment.7 Emotional problems including depression, loneliness,
anxiety, and aggression have also been identified as outcomes of online game overuse in adolescents.8,9
Emotions make significant contributions to our rational thoughts and behaviors.10 Emotional competence
is the ability to be aware of and express one’s emotions
based on one’s emotional intelligence (EI).11 Unlike negative emotion, positive emotion improves mental health
and, furthermore, helps reduce the effects of negative
emotions, resulting in psychological resilience.12 People
with experiences of positive emotions are more likely to be
socially integrated and healthy.13 Therefore, emotionally
competent people can acknowledge and express their
emotions in an appropriate manner by tapping their EI
in order to adjust to the challenges of life. However, the
literature on the topic of online game has been generally
focusing on associations of negative emotions and excessive online game use,14 and little has been known
about the relationship between online game use in adolescents and emotional competence, including positive
640
The purpose of this study was to explore the relations between emotional competence and online
game use in adolescents. This study is a crosssectional descriptive survey using a convenience
sample. The participants were 2199 adolescents
in South Korea. Online game use and emotional
competence including positive emotion, emotional
expression, and emotional intelligence were measured. The study results indicated that emotional
competence was negatively correlated with excessive online game use. All variables of emotional
competence were significantly lower in high-risk
users compared with general users. In addition,
female adolescents were rated significantly higher
in emotional competence among general users,
but there were no significant gender differences
among high-risk users. The results of our study
imply that high-risk game users have lower levels
of emotional intelligence than general users do.
The results of this study suggest that emotion is
an important factor to which practitioners in psychomedical fields and nursing should pay attention. Therefore, nurses in schools and communities
should regularly screen the emotions of adolescents who habitually play online games and
develop a program to enhance emotional competence associated with online games.
KEY WORDS
Adolescents & Emotional competence & Online game
emotion, emotional expression, and EI. Therefore, this
study was carried out to investigate emotional competence of adolescents who play online games. The results
Author Affiliations: Department of Family Counseling, Graduate
School of Administration and Law, Dankook University, Gyeonggi-do
(Dr Seo); Department of Nursing, Red Cross College of Nursing,
Chung-Ang University (Dr Kang); and College of Nursing, Seoul
National University (Dr Chae), Seoul, Korea.
The present research was conducted by the research fund of
Dankook University in 2010.
The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.
Corresponding author: Mia Seo, PhD, RN, Department of Family
Counseling, Graduate School of Administration and Law, Dankook
University, 126 Jukjeon-dong, Suji-gu, Yongin-city, Gyeonggi-do, 448-701,
Korea ([email protected]).
DOI: 10.1097/NXN.0b013e318261f1a6
CIN: Computers, Informatics, Nursing & December 2012
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of this study will provide insight on the role of emotional
competence in adolescents playing online games and
ultimately offer foundations for the establishment of
strategies to enhance the emotional competence of those
adolescents.
Objectives
This study examined the relations between emotional competence such as positive emotion, emotional expression,
and EI and online game use in adolescents. The specific
aims of this study were as follows:
To examine the level of emotional competence
and online game use
To explore the relations between emotional
competence and online game use
To compare the difference in the emotional
competence between general game users and
excessive game users
To identify the difference of emotional competence
depending on the gender of general game users
and excessive game users
ONLINE GAME USE
The scale used in this study was the Korean version of
the Internet game addiction self-test scale developed by
the Korea Agency for Digital Opportunity & Promotion
(KADO).15 The questionnaire is composed of 20 items
and consists of four subscales: daily life (four items), withdrawal (seven items), tolerance and loss of self-control (five
items), and pursuing virtual relationships (four items). A
four-point Likert scale was used for the scoring system,
with 1 representing ‘‘not at all’’ and 4 representing
‘‘always.’’ The total score ranges from 20 to 80, with
a higher score indicating a higher possibility of online
game addiction. According to the guidelines presented
by KADO, a person with a total score of 38 or above
was classified as a high-risk user. In addition, a person
with a total score of 20 to 37 was classified as a general
user. Cronbach’s ! was used to establish the internal
consistency of the instrument. Cronbach’s ! was .93 in
the KADO study and .93 in this study.
EMOTIONAL COMPETENCE
Emotional competence was measured by assessing positive emotion, emotional expression, and EI of the participants in this study.
POSITIVE EMOTION
METHODS
Study Design and Sample
This study used a cross-sectional descriptive survey with a
convenience sample of 2199 adolescents. Before starting
the study, 16 schools in Seoul and Kyunggi Province of
South Korea were selected through a snowball sampling
method. All the headmasters of the schools received letters from the research team explaining the purpose of the
study and asking for participation. A total of 10 school
headmasters agreed to participate in the study. The questionnaires and procedures of this study were examined by
school officials and were approved by them before conducting the surveys, which indicates there were no contraindications relating to the proposed human subject
procedures. The participants of this study were 2199 students attending elementary, middle, and high schools. We
obtained written, informed consent from the participants.
Parental consent may be omitted for anonymous surveys
in Korea. The Ethical Committee of Dankook University
Hospital approved the study.
Instruments
The questionnaire included the following components:
(1) demographics, (2) online game use, and (3) emotional
competence.
Positive emotion was measured using the Korean version of the Intensity and Time Affect Survey originally
developed by Diener et al,16 which was translated and
revised by Lee.17 This measure is composed of a total
of eight different kinds of positive emotions (satisfaction, affection, pleasure, etc). A seven-point Likert scale,
ranging from 0 (not at all) to 7 (always feel), was used.
The total score was in the range of 8 to 56, where
higher scores represented more positive emotions.
Cronbach’s ! was .77 in original studies and .90 for the
current study.
EMOTIONAL EXPRESSION
Emotional expression is the expression of internal emotional experience, expression of positive emotions, and
expression of negative emotions.18 Emotional expression
was measured using the Korean version of the emotional
expressiveness scale,19 originally developed by Kring
et al.20 The scale measures each individual’s tendency to
express his/her emotions, one’s perception of emotional
expression, and other’s perception of emotional expressions using 17 questions.
A five-point Likert scale ranging from ‘‘not at all’’ (0)
to ‘‘always’’ (4) was used. The total score was in the
range of 0 to 85, where higher scores represented more
emotional expression. Cronbach’s ! was .90 at the time
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641
of the development of this instrument and .82 in the
current study.
expression, and EI. Cronbach’s ! coefficient was used to
determine the reliability of instruments. A significance
level of .05 was considered acceptable.
EMOTIONAL INTELLIGENCE
Emotional intelligence is the ability to perceive and express emotion accurately, as well as to assess the emotions of others correctly and regulate emotions in self
and others.21 The present study based its foundation on
the EI model in which Mayer and Salovey21 produced
and used the Emotional Intelligence Questionnaire for
adolescents and in Moon’s22 study, adapted with permission. This scale includes 40 questions based on five
different scales, namely, perception and appraisal of
emotion, reflection of emotion, emotional facilitation
of thinking, using emotional knowledge, and emotional regulation. A five-point Likert scale ranging from
‘‘not at all’’ (1) to ‘‘always’’ (5) was used. The total
score was in the range of 40 to 200, and a higher score
represented more EI. Cronbach’s ! was .81 at the time
of the development of this instrument and .88 in the
current study.
Data Collection
Data were collected from April 11 to June 17, 2011. After
receiving approval for the study from the headmasters,
the purpose of the study was explained to the students in
the classroom by the researchers. Students were assured
that their participation was voluntary and anonymous.
The structured questionnaires were administered only to
the students who verbally agreed to participate in the
study, and completed questionnaires were then returned
to the researcher. Completion of the questionnaire took
approximately 20 minutes. The sample size is produced
z2 pð1pÞN
a=2
based on the following equation: n ¼ z d2 ðN1Þþz
2
a=2
pð1pÞ
(where n is the sample size; d, sampling error; N, population) and can be calculated as 1536 considering
5 375 000 adolescent samples23 with a 95% confidence
interval and 2.5% (sampling error). A total of 2199 questionnaires (94.6%) were collected, excluding invalid questionnaires among 2324 returned questionnaires.
RESULTS
General Characteristics and Online
Game Use–Related Characteristics
of Participants
Table 1 shows the demographic and online game use–
related characteristics. Among the participants, there
were 1293 male students (58.8%) and 906 female students (41.2%). The average age of the participants was
13.37 years. Most of the students were living with
parents (86.5%), and the average number of siblings
was 2.47. More than half of the participants (59.8%)
had started playing online games after age 10, and the
average age at first online game play was 9.11 years.
Participants who play online games more than 3 days
per week totaled 65.9%, and the average days playing
online games was reported at 3.24 days per week. During the weekdays, 73.2% of participants responded
that they played online games for more than 4 hours a
day, and the mean hours of playing online games were
2.73 hours a day. During the weekends, 76.6% of participants reported playing online games more than 4 hours
per day, and the average play time was 3.03 hours daily.
T a b l e 1
General Characteristics and Online Game
Use–Related Characteristics of Participants
(n = 2199)
Characteristics
Gender
Age, y
Living with
Siblings
Data Analysis
Age at first gaming, y
Data were analyzed using SPSS-PC (version 18.0 for
Windows; SPSS, Chicago, IL). Descriptive analysis was
used to describe students’ demographic characteristics,
the level of online game use, and all study variables.
Pearson correlation coefficients were used to measure
the correlation between variables. Independent t tests
were used to compare differences in the mean scores
among the two groups for positive emotion, emotional
642
Gaming days during
the week, d
Gaming hours during
the week, h
Gaming hours during
weekends, h
Category
Male
Female
9–13
14–19
Both parents
Single parent
Other
None
92
910
e10
Q3
G3
94
e4
94
e4
No. (%)
1293
906
1253
946
1903
116
180
529
1670
1316
883
1449
750
1609
590
1684
515
(58.8)
(41.2)
(57.0)
(43.0)
(86.5)
(5.3)
(8.2)
(24.1)
(75.9)
(59.8)
(40.2)
(65.9)
(34.1)
(73.2)
(26.8)
(76.6)
(23.4)
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Mean (SD)
13.37 (2.09)
2.47 (1.82)
9.11 (2.14)
3.24 (2.87)
2.73 (3.37)
3.03 (2.84)
Mean and SD of Variables
The average mean (SD) score for positive emotion was
30.26 (10.75). The mean scores for emotional expression
and EI were 47.52 (11.12) and 123.59 (32.56), respectively. According to the KADO, a person with a total
score of 38 or above was classified as a high-risk user.
The mean scores for online game use showed 26.87 (8.84).
Correlations Among the Research Variables
The correlation matrix is listed in Table 2. Positive emotion had positive correlation with emotional expression
(r = 0.31, P G .001) and EI (r = 0.30, P G .001). Emotional expression had weak but positive correlation with
EI (r = 0.10, P G .001). There were statistically significant negative correlations between online game use and
positive emotion (r = j0.16, P G .001), emotional expression (r = j0.21, P G .001), and EI (r = j0.14, P G .001).
Differences of Variables by Online Game Use
The mean and SD scores for online game use by groups
are presented in Table 3. Among the participants, 1947
students (88.54%) were identified as general users, and
252 students (11.46%) were high-risk users. The mean
(SD) scores of positive emotion were 30.73 (10.83) for
general users and 26.64 (9.35) for high-risk users. The
mean (SD) scores for emotional expression and EI
were 48.22 (11.01) and 124.24 (19.05), respectively, for
general users, and 42.14 (10.54) and 118.52 (17.41),
respectively, for high-risk users. There were significant
differences in positive emotion (t = 6.40, P G .001), emotional expression (t = 8.57, P G .001), and EI (t = 4.85,
P G .001) between the two groups.
Gender Differences in the Variables
In general users, there were statistically significant differences in the average scores for male adolescents’ and
T a b l e 2
Correlation Coefficients Among Variables
(n = 2199)
Positive
Emotion,
r (P )
Emotional
Expression,
r (P )
EI, r (P )
Positive emotion 1.00
Emotional
0.31 (G.001) 1.00
expression
EI
0.30 (G.001)
0.10 (G.001) 1.00
Online game use j0.16 (G.001) j0.21 (G.001) j0.14 (G.001)
female adolescents’ positive emotion (t = j2.95, P = .004),
emotional expression (t = j4.94, P G .001), and EI (t =
j6.83, P G .001). In high-risk users, there were no
statistically significant differences in the variables by
gender (Table 4).
DISCUSSION
To the best of our knowledge, this is the first study to
examine the relation of emotional competence and playing online game in adolescents. Our findings demonstrate that high-risk users of online games showed lower
emotional competence, that is, lower positive emotion,
emotional expression, and EI, than general users. This
implies that adolescents who use online games excessively
could be more negatively affected in terms of their emotional competence compared with those practicing moderate use of online games. The correlations between online
game use and emotional competence were statistically
significant but relatively low. Other studies also reported
fairly low correlations between the use of Internet and
emotion, such as anxiety14 and depression.24 Despite the
weak correlation, emotional competence associated with
online game use should not be disregarded because the
relations were significant.
The high-risk users of online games in this study displayed lower levels of positive emotion than did the
general users. This result was consistent with previous
studies, which showed higher levels of negative emotions such as depression and loneliness, anger, hostility,
phobic anxiety, paranoid ideation, and psychoticism in
high-risk game users.25,26 Positive emotion does not merely
reflect particular momentary happiness and satisfaction
but functions to expand a person’s attention and cognition. It includes confidence, optimism, and self-efficacy27;
facilitates creative and flexible thinking; and derives effective problem solving and coping skills.28 In addition,
positive emotions buffer the deleterious effects of negative emotions in order to allow for the attainment
of psychological resilience.29 Therefore, healthcare providers should develop a strategy to enhance positive
emotion of high-risk users and help them to be able to
recognize and use their positive emotions to manage
negative circumstances.
The results of this study also demonstrate that highrisk users express their emotions less than do general
users. In this study, emotional expression was measured
by assessing how the participants expressed their emotions to others through verbal or nonverbal channels.
Meanwhile, gamers who felt socially awkward, isolated,
and insecure in real life can transform themselves into
someone who feels socially confident and connected to
others within the game. As they immerse in the game, they
feel themselves more accomplished and more accepted,
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643
Ta b l e 3
Differences of Variables by Online Game Use (n = 2199)
Positive emotion
Emotional expression
EI
Total
General Users (n = 1947),
Mean (SD)
High-Risk Users (n = 252),
Mean (SD)
t
P
30.26
47.52
123.59
30.73 (10.83)
48.22 (11.01)
124.24 (19.05)
26.64 (9.35)
42.14 (10.54)
118.52 (17.41)
6.40
8.57
4.85
G.001
G.001
G.001
which may not be the case in the real world. Inability to
express emotions is associated with difficulties in interpersonal relations, hostility, social avoidance, depression,
and somatization.30,31
Hence, adolescents who play online games excessively
should be encouraged to engage in reality and express
their emotions. Also, it should be emphasized that balance between the online world and real world needs to
be sought, as they are no longer mutually exclusive, and
building a positive online presence is becoming increasingly more important for adolescents. The results of a
very recent study on the positive effects of video games
stated that prosocial video games that promote positive
social behaviors increased the accessibility of socially
positive thoughts.32 This is because gamers help and support each other in nonviolent ways in prosocial games.
The researchers reported that exposure to prosocial video
games increased the accessibility of prosocial thoughts
and promoted prosocial behaviors. ‘‘Chibi Robo,’’
‘‘Super Mario Sunshine,’’ and the Zurich prosocial game
are few examples of prosocial video games.33,34 Even
though there are some criticisms about dichotomizing
video games into prosocial and violent categories because
prosocial themes are common in many violent games,35
guiding adolescents to play video games with positive
effects on prosocial behavior rather than violent games
is important. Therefore, utilization of online games designed for emotional expression could be useful in adolescents needing encouragement to express their emotions.
Emotional intelligence is the ability to identify, understand, use, and regulate emotions in order to promote
greater emotional and personal growth and to achieve
one’s goals using one’s emotions. It has been found to
be positively correlated with psychosocial well-being
and life satisfaction,36 whereas it has negative relations
with problematic behaviors, generalized anxiety disorder, depression, substance use, and cigarette smoking
intensity.37–39 The levels of EI in the high-risk users of
online games were lower than those in the general users
in the present study. Emotional intelligence was found
as a strong predictor of addiction-related behaviors such
as gaming, Internet overuse, and online gambling.40 Siu’s37
study reported that lower levels of EI were related to
higher levels of internalizing behaviors such as depression, anxiety, and externalizing behaviors including aggression and delinquency. Therefore, the high-risk users
of online games need to be supported to acknowledge
and control their emotions through EI training. An EI
training program was reported to be effective to enhance self-awareness, self-motivation, mood regulation,
and getting along with peers.41 In addition, online game
users could be aware of and manage their emotions and
eventually regulate their game hours if schools or community organizations were to provide a simple, userfriendly self-screening tool for emotion and online game
use regulation through personal e-mails or pop-up messages on school Web sites.
Our study results revealed gender differences in emotional competence among the general users of online
games. Female adolescents had higher levels of positive
emotion, emotional expression, and EI than male adolescents, which is consistent with the findings of previous
studies.42,43 But the gender differences in emotional competence did not remain significant in high-risk users of
online games, which may indicate that female adolescents lose their ability to control their emotions once
they are involved in excessive use of online games. Hence,
female high-risk game users should be included in the
Ta b l e 4
Gender Differences in the Variables (n = 2199)
General Users (n = 1947)
Male (n = 1093), Female (n = 854),
Mean (SD)
Mean (SD)
Positive emotion
Emotional expression
EI
644
30.08 (10.78)
47.12 (10.38)
121.67 (19.12)
31.53 (10.84)
49.59 (11.65)
127.54 (18.46)
High-Risk Users (n = 252)
t (P )
Male (n = 200), Female (n = 52),
Mean (SD)
Mean (SD)
j2.95 (.004)
26.91 (9.71)
j4.94 (G.001) 42.28 (10.77)
j6.83 (G.001) 118.00 (17.30)
25.62 (7.80)
41.62 (9.68)
120.54 (17.89)
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t (P )
0.89 (.450)
0.40 (.509)
j0.94 (.350)
development of programs to improve emotional competence for online game users because they experience a
decrease in emotional competence similar to male adolescents when they are addicted to online games.
We believe this study will help build awareness so that
healthcare providers can monitor and plan to enhance
emotional competence for adolescents playing online
games. Early detection and intervention for adolescents
at risk of online game overuse can be accomplished in
schools by nurses. Screening services could be offered by
school nurses along with an annual physical examination
or nutritional assessment because poor nutrition is related
to Internet overuse.44 School programs requiring students
to receive instruction and learn potential health hazards
from online game play may help students build emotional
and social skills to prevent online game addiction.
Nursing interventions such as EI training for safe control of their own or others’ emotions, self-understanding,
and emotional regulation programs, refusal and resistance
techniques against risky behaviors, peer counseling programs, and the Jump Up Internet Rescue School, a camp
designed by the Korean government, would be beneficial.45–47 Education and counseling interventions could
be offered not only to students who come for help, but
also to at-risk students identified through screening, as
a group or private service, based on students’ preferences, and perhaps through online and offline services.
School nurses must contact the parents, report online
game overuse, and educate and involve the parents in
monitoring and intervening with their children. Information on the prevalence of online game overuse and
behaviors that might indicate the presence of a problem
such as depression, anxiety, social phobias, and lower
school performance48 can be disseminated through school
newspapers or text messages. School nurses can also teach
students how they might help in preventing and identifying problem behaviors among peers. Continuing education about online game addiction should be offered to
school nurses who may be unprepared to deal with the
phenomenon.
The relationship between emotional competence and
online game use has not been investigated so there are
currently no targeted interventions to improve emotional
competence for online game users. The results of this study
should build awareness of the need to monitor and develop emotional competence for adolescents playing online games.
Limitations
This study has several limitations. First, the data collection method used in this study, a self-report questionnaire, might result in a social desirability bias and limit
interpretation of the average tendency. Second, the samples in this study were limited to adolescents residing in
urban areas. This limits generalization of the results.
Lastly, we did not measure the degree of characteristics
of online games the participants were involved in. For
example, violent games could affect the emotions of users
more than other types of games. Future studies may need
to include characteristics of games when assessing emotions of the users. Despite these limitations, this study is
the first study investigating the relations of emotional
competence and online game use among adolescents.
CONCLUSION
Our study results imply that adolescents’ usage of online
games and their emotional competence are closely correlated. High-risk game users have relatively low levels of
positive emotion, emotional expression, and EI. Therefore,
anticipatory guidance should be given to online game users
and their parents to help them understand that excessive
game use could have a negative impact on emotions.
Furthermore, self-awareness in adolescents should be
promoted to prevent excessive online game use and to
allow for intervention at an earlier stage.
Additionally, there seems to be no difference in emotional competence between genders among excessive game
users. Thus, female adolescents at high risk should not
be overlooked for the possibility of game addiction. Healthcare providers should screen high-risk users of online
games with low emotional competence in schools or in
the community and support them to enhance their emotional competence.
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