A comparative interventional study on the effectiveness of acceptance and commitment therapy, emotion-focused therapy, and attachment-based therapy in improving emotion regulation among adolescents with digital game addiction

Background: Digital game addiction is a rapidly developing social and mental health concern that is closely related to emotion regulation difficulties. The present study aimed to compare the effectiveness of acceptance and commitment therapy (ACT), emotion-focused therapy (EFT), and attachment-based therapy (ABT) in improving emotion regulation among adolescents with digital game addiction. Methods: The present study was an interventional study employing a pretest–posttest design and a control group. The sample included 100 adolescents aged 13–18 years who were diagnosed with gaming disorder according to the 11th Revision of the International Classification of Diseases (ICD-11) criteria. Participants were selected using purposive sampling and were assigned to four groups of 25 individuals each, including three experimental groups and one wait-list control group. The 7-item Digital Game Addiction Scale (DGAS-7) and the Regulation of Emotions Questionnaire among Adolescents (REQ-A) were used to gather data. ACT and EFT were administered in eight sessions, whereas ABT was delivered in 10 sessions. Data were analyzed using repeated measures ANOVA in SPSS. Results: It was found that the three therapeutic strategies produced a significant increase in functional emotion regulation scores (internal and external) and a significant decrease in dysfunctional emotion regulation scores compared to the control group (p < 0.001). However, the effect sizes for the ACT and EFT groups were very large compared to the ABT group. There was no significant difference between ACT and EFT; nevertheless, both interventions were significantly more effective compared to ABT at both the posttest and follow-up stages. Conclusion: ACT and EFT are more effective interventions for improving emotion regulation among adolescents with digital game addiction because of their emphasis on psychological flexibility and emotionally profound processing. Although ABT was found to be moderately effective, it can be used as an adjunctive therapy, particularly in cases involving relational problems.