Combined reality therapy and mindfulness meditation decrease intertemporal decisional impulsivity in young adults with Internet gaming disorder

Decisional impulsivity represents an important phenotype and a therapeutic target in Internet gaming disorder (IGD). Reality therapy and mindfulness meditation were two approaches to reduce impulsivity. This study aimed to evaluate the efficacy of a group behavioral intervention combining reality therapy and mindfulness meditation in reducing decisional impulsivity and IGD severity. Twenty-five IGD and 21 healthy comparison (HC) young adults participated in baseline tests on the delay discounting and balloon analog risk tasks to measure intertemporal and risky decision-making respectively. Among them, 18 IGD subjects participated in the intervention and were tested again at the end of intervention, and 19 HC subjects without intervention were also tested twice within a similar time period. Results indicate that: (1) at baseline, IGD subjects showed greater intertemporal and risky decisional impulsivity than HC subjects; (2) After intervention, IGD subjects were decreased in delay discounting rate and IGD severity, but did not perform differently on decisional impulsivity in risky choices, as compared with baseline. These findings suggest that decisional impulsivity is a multifaceted behavioral construct and may serve as a possible therapeutic target for IGD. In addition, these results highlight the need for further research into the roles of different forms of decisional impulsivity in the shaping, maintenance, and remission of IGD.