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Open Access

Peer-reviewed

Research Article

Loot box engagement: A scoping review of principal studies on prevalence and clan with problematic gaming and gambling

• Irene Montiel,
• Aránzazu Basterra-González,
• Juan M. Machimbarrena,
• Jéssica Ortega-Barón,
• Joaquín González-Cabrera

x

• Published: January 27, 2022
• https://doi.org/ten.1371/periodical.pone.0263177

Figures

Abstruse

Background

Boodle boxes are an increasingly mutual blazon of random microtransaction in videogames. There is some business organization about their expansion and entailed risks, especially amid adolescents. The actual prevalence of engagement with loot boxes amidst child and adult population is uncertain, and there is still controversy over the nature of their relationship with problematic gaming and gambling.

Objectives

The aims of this scoping review are to summarize the characteristics and findings of published master empirical studies about the prevalence of engagement with loot boxes and/or their relationship with problematic gaming and gambling, taking in business relationship the blazon of sample, fourth dimension frame and measured variables.

Methods

This study follows the Joanna Briggs Found'southward "Guidance for conducting systematic scoping reviews" and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Iii academic databases provided 299 articles.

Results

Sixteen chief empirical studies met the inclusion criteria for this review. All studies used cantankerous-sectional designs, and most used convenience samples. Twelve study samples were comprised exclusively of gamers, and 2 were comprised of gamers and/or gamblers. Just vi studies included adolescents. The annual prevalence rate of loot box purchases was higher for adult gamers than for adolescents (22.7%–44.2% and xx%–33.nine%, respectively), simply in studies with full general population samples, the opposite was true (24.9% for players aged xiii–14 versus 7.8% for adults). In general, the studies suggested a significant positive relationship between engagement with loot boxes and problematic gaming and gambling, just this may be related to the type of engagement (open up/purchase/sell), and the characteristics of the report participants (male person/female, adolescents/adults, gamers/gamers-gamblers/full general population).

Conclusions

This scoping review summarizes the results of recent empirical studies on engagement with loot boxes and discusses how methodological issues may touch their results and estimation. Recommendations for time to come research are also provided.

Commendation: Montiel I, Basterra-González A, Machimbarrena JM, Ortega-Barón J, González-Cabrera J (2022) Loot box engagement: A scoping review of primary studies on prevalence and association with problematic gaming and gambling. PLoS One 17(1): e0263177. https://doi.org/10.1371/periodical.pone.0263177

Editor: Marc Potenza, Yale University, UNITED STATES

Received: May 24, 2021; Accepted: January 13, 2022; Published: January 27, 2022

Copyright: © 2022 Montiel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in whatever medium, provided the original writer and source are credited.

Data Availability: All relevant data are inside the manuscript and its Supporting information files.

Funding: This enquiry was funded past the Spanish Ministry of Economic system, Industry and Competitiveness, RTI2018-094212-B-I00: (CIBER-AACC), and by the International University of La Rioja, Project "Cyberpsychology" (2017-2020) and Project "DOMIN-The states" (2020-2022). There was no additional external funding received for this study. The funders had no part in written report pattern, data collection and analysis, conclusion to publish, or grooming of the manuscript.

Competing interests: The authors have declared that no competing interests be.

Introduction

Nigh 40% of the earth'due south population plays videogames [1]. The number of gamers has increased by an average of 6% per twelvemonth over the by five years, reaching 2.7 billion users by 2020. Acquirement in the videogame manufacture reached $120.1 billion in 2019 and approximately $159.iii billion in 2020, an annual increment of more than 9% [1]. An important source of revenue—and i component of this industry's success—lies in the incorporation of in-game purchases [2, 3].

Within a videogame, there are several objects (ordinarily different in each videogame) that allow players to gain in-game improvements and advantages and quickly attain the game's objectives. Graphic elements that modify the external appearance of the characters by changing their aesthetics, their clothes, or their weapons (then-called skins) are besides mutual. These advantages are normally purchased through microtransactions (i.e., a player pays a stipulated price for a specific and known reward or skin) [iv]. Loot boxes, too called crates, gachas, cases, or chests, are one specific type of microtransaction in which a random virtual item is purchased [5, 6]. Loot boxes can exist purchased using existent or virtual in-game money, with the most desired items appearing less frequently [seven, viii].

The most established games in the world (e.grand., Overwatch, FIFA, Battlefield, Phone call of Duty, Fortnite, and League of Legends) include loot boxes within their mechanics. The presence of loot boxes in desktop videogames increased 67% between 2010 and 2019 [9], and more than 58% of Google Play and iPhone games contain loot boxes [ten]. Among gamers, 78% of adults take purchased at least one boodle box [eleven], and forty.five% of adolescents between the ages of sixteen and 18 have purchased i within the by month [12]. 1 of the most worrisome aspects is that 56% of mobile games containing boodle boxes are considered suitable for children aged 7 years or older, and 93% are considered suitable for children at to the lowest degree twelve years of historic period [10]. There is some testify well-nigh the increasing apply of boodle boxes, just the real extent of the phenomenon is still uncertain, as are the risks it might entail for both adults and adolescents.

Some authors claim that loot boxes introduce gambling elements into gaming and argue that they may human action every bit a gateway to problematic gambling or that they could aggravate gambling or gaming-related harm [five–7, thirteen]. Whether the excessive use of loot boxes is best conceptualized under the theoretical framework of problem gambling or problem/excessive gaming is also under debate [4, 13, xiv]. A recent meta-assay found a small but potentially clinically relevant relationship betwixt gambling symptomatology and boodle box spending. Information technology was besides shown that this association was at least as big as that plant between excessive gaming symptoms and boodle box spending, suggesting the need for further research [xiv]. Some longitudinal studies have also pointed out that problematic gaming appears to be an entry behavior to problematic gambling [xv]. Still, a recent review found piffling disarming evidence in back up of this "gateway hypothesis," suggesting that farther longitudinal research is needed to meliorate understand the links between video gaming and gambling [thirteen].

In light of the above and with the primary purpose of protecting children and adolescents, a legislative argue has been initiated well-nigh whether engaging with loot boxes should be considered "gambling." Some authors emphasize its virtual, uncertain, and random nature, pointing to a relationship with the advantage systems nowadays in gambling [16, 17]. Others merits that loot boxes are a clear hybrid between slot machines and collectible card packs [18] and but have similarities with gambling behaviors [xix]. Nielsen and Grabarczyk [xx] argue that loot boxes are a specific application of a more than general miracle called the random reinforcement mechanism, which has been implemented in videogames for decades [17]. These reward mechanisms are too nowadays in slot machines, and their components are a condition of eligibility (a requirement that the player must run across to actuate the reward, such as reaching a sure number of points), randomness (eastward.grand., shuffling or throwing die), and reward (e.yard., a new weapon) [xx]. These authors argue that only those that are embedded in the broader economy (i.east., those that offer randomized rewards that can be both sold and purchased) tin be considered structurally similar to gambling. However, as demonstrated past Drummond et al. [21], virtual items accept real-world monetary value to users, irrespective of whether they tin be cashed out; therefore, they could exist regulated nether existing gambling legislation. The human relationship betwixt loot boxes and random advantage mechanisms raises concerns for adolescents and young people, as these populations are more vulnerable to developing emotional, cognitive, and behavioral problems related to traditional and online gambling [22–25]. Furthermore, these populations may not fully empathise the associated underlying mechanisms and advantage systems [2, 26]. This makes the issue of boodle boxes and their potential similarities to gambling of particular involvement when information technology comes to protecting children and young people, for the same reason that these populations are prohibited from gambling.

The discrepancies in the scientific literature mentioned above can be reflected in the unlike stances that countries accept regarding loot box regulation. For case, Belgium and the Netherlands consider loot boxes to exist an illegal form of gambling [27]. In the Usa there is no uniform legislation regarding this topic [28] and the U.k. have prohibited the use of boodle boxes merely if their contents can exist sold exterior of the videogame itself [29]. Other countries, such as People's republic of china and Southward Korea, require game developers to disclose the odds of winning the prize [30]. Nippon only prohibits some types of loot boxes, such as the "kompu gacha" (boxes with rare rewards that can only exist unlocked afterwards purchasing a drove of other boodle box items) [31]. Conspicuously, information technology is necessary to accelerate and homogenize scientific/technical criteria to assist policymakers standardize such important political and legal guidelines.

Due to the emerging nature of this field, a scoping review is the nigh appropriate methodological approach for assessing and understanding our enquiry questions. Scoping reviews are especially useful when a body of literature has not yet been comprehensively reviewed or exhibits a complex or heterogeneous nature [32]. Moreover, scoping reviews allow us to identify farther areas for subsequent research and clarify whether a systematic review may exist conducted to address more specific questions [33]. Two systematic reviews about boodle boxes have recently been published [14, 34], only they focused exclusively on the relationship between loot-box-related spending and trouble gaming and/or gambling. These reviews did not summarize the prevalence of appointment with boodle boxes or provide separate data for adolescents versus adults. Additionally, many empirical studies that did non appear in these works have recently been published in peer-reviewed journals.

Therefore, we conducted a scoping review of the primary empirical studies on engagement with loot boxes published to date in peer-reviewed journals. Our initial research questions were every bit follows: 1) How did these primary empirical studies measure engagement with boodle boxes? 2) What is the prevalence of engagement with loot boxes among adults and adolescents? 3) Is there a clear positive relationship between engagement with loot boxes and problematic gaming and/or gambling, or does this depend on the study characteristics? We and so used this data to offer suggestions regarding measurement problems and advise ideas for meaningful future research.

Methods

The research and reporting methods of this scoping review are consistent with the Preferred Reporting Items for Systematic reviews and Meta-Assay extension for Scoping Reviews (PRISMA-ScR) [35], as outlined in the S1 Table. In addition, the present report follows the Joanna Briggs Found's "Guidance for conducting systematic scoping reviews" [32, 36], based on earlier piece of work past Arksey and O'Malley [37] and Levac et al. [38], to improve the utility and robustness of the results [32]. The objectives, inclusion criteria, and methods of analysis for this review were specified in accelerate and documented in a protocol adapted from the protocol template of the International prospective register of systematic reviews (PROSPERO) [39] which is available upon request from the corresponding author.

Identification of relevant studies

A systematic and comprehensive search was carried out from June 22, 2020 to July 22, 2020 (inclusive of both dates) using the following electronic databases: Google Scholar, Web of Science, and Scopus. The search terms used were "loot boxes" and "loot box." Considering of the scarcity of relevant published literature and the emerging nature of this topic, no limits were placed on the publication dates of the articles. Bibliographic references from qualitative or review studies were reviewed to identify research manufactures non captured by the electronic search. An additional search was later carried out in the last week of April 2021 to detect new publications.

Inclusion and exclusion criteria

The inclusion criteria arose from the formulation of the review questions in the PCC (population, concept, context) format [32]. To exist included in the scoping review, studies had to meet three eligibility criteria: i) primary empirical studies with samples of adults and/or adolescents providing data on the prevalence of engagement with loot boxes in videogames and/or data on the relationship between engagement with boodle boxes and problematic gaming and/or problematic gambling; 2) published in English language or Spanish; and 3) published in peer-reviewed journals. Qualitative studies, theses, reports non published in bookish journals, systematic reviews, and meta-analyses were excluded. However, their reference lists were reviewed to locate potentially eligible studies. In cases of pre-prints, authors were contacted to check the status of the studies. 1 of them provided the published study, which was included in the final selection [sixteen].

Selection of the studies

Fig ane shows the pick procedure of studies for this review. In the initial search, 292 manuscripts were identified from the iii databases consulted. Seven manuscripts identified through other sources (due east.g., reference lists and original authors contacted past email) were added. All references (due north = 297) were then imported into the Zotero bibliographic manager. Through the bibliographic manager the authors ordered the references and reviewed the titles, abstracts, and digital object identifiers to detect duplicates. Duplicates were eliminated, and a total of 220 items were transferred to the screening phase. To reduce potential bias at this stage of the review, 2 independent researchers (X.X. and Y.Y.) evaluated all titles and abstracts to pre-select articles that could potentially come across the three eligibility criteria. If an abstract did not allow assessment of report eligibility, the total text was scanned. At this stage, 188 items were removed, leaving a total of 33 pre-selected items. Kappa'southward coefficient for agreement between the two researchers in the screening and pre-choice phase was 0.852. After an in-depth reading of the pre-selected manufactures, 17 were discarded because they did not meet all eligibility criteria. The 2d researcher reviewed the final selection, and potential disagreements almost a study's final inclusion were solved by a bulk consensus amongst all team researchers. From the concluding search conducted in Apr 2021, two manufactures were added. Finally, sixteen studies/articles were included in the qualitative synthesis of this scoping review. Notably, two of the studies [40, 41] included 2 different samples, equally demonstrated in Table 1. This is specified in the narrative synthesis of the results.

Data extraction

Table ane provides a summary of all information extracted from the 16 studies included in the concluding review. A standardized extraction sheet (Microsoft Excel) containing the post-obit variables was adult: authors and publication twelvemonth, country and year of data drove, sample size and age and sex of participants, design and recruitment, objectives, measurement instruments, and outcomes of the studies relevant to the aims of this scoping review (i.e., charge per unit of date with boodle boxes and results apropos the presence or absence of a statistically significant human relationship between engagement with loot boxes and problematic gaming/gambling). Table 2 shows the studies' loot box engagement rates by age group (adolescents versus adults), time frame, and behavior assessed (open up/purchase/sell). Afterwards piloting the extraction sheet within the review team, data extraction was performed by one squad researcher and cross-checked by another team member for accuracy.

Results

Characteristics of the studies

Of the xvi selected studies (Table 1), nine were carried out with samples from a single place of origin. Four of these studies used samples limited to Europe (ii from the United Kingdom [42, 43], ane from Denmark [two], and one from Frg [16]. Three studies were conducted using samples from the USA [six, 40, 41], and 2 were conducted using samples from Asia [44, 45]. For two studies, samples were nerveless through the Net, and the origin of the participants was unknown [iii, 46]. The other five studies obtained samples from several countries [5, 11, 12, 47, 48]. The written report by Macey et al. [48] is noteworthy for its multifariousness, as information technology included a sample from 61 countries. All studies were carried out betwixt 2017 and 2019 with a cross-exclusive design and were published in peer-reviewed journals between 2018 and 2021.

The sample sizes were heterogeneous, ranging from 113 participants [twoscore] to xiii,042 [41]. The ages of study participants ranged from 12 years [ii] to 58 and older [43]. Of the 16 studies selected, only iv had samples made up exclusively of adolescents between 12 and xviii years of age [ii, 12, 41, 45], and ten had samples fabricated up of merely adults over xviii years of historic period [iii, five, 6, eleven, 16, 40, 43, 44, 46, 47]. The remaining two studies had mixed samples composed of both adolescents and adults [42, 48].

Five samples were obtained from the data of iv larger national studies [2, 16, 41, 45] conducted through population-based sampling: one representative sample of the adolescent population from Denmark [2], two from Delaware [41], i from Tokyo [45], and 1 representative sample of the German language population of adult Cyberspace users [16]. Additionally, one study used participants recruited from an online survey past quota sampling to represent the UK adult population [43]. Another written report used an online panel survey in which data were weighted to reflect the age, sexual activity, and regional profile of the population between xvi and 24 years quondam in Uk [42]. Of these seven samples, four included gamers, non-gamers, gamblers, and not-gamblers and similar proportions of male and female respondents (general population samples)—ii samples of Delawarean adolescents [41], one of British adults [43], and one of British youth betwixt xvi and 24 years one-time [42]. The other three samples required fulfillment of some inclusion criteria (e.g., existence video gamers [2, 45] or being gamblers or Pay2Win users [16]).

10 studies used convenience sampling procedures in which participants were recruited through various online platforms, such as Reddit [11, 12, 48], Amazon Mechanical Turk [half dozen, xl, 46], Findparticipants.com [three], or gaming forums [3, 44, 47]. In four of these 10 studies, participants received an economic or academic reward [40, 43, 44, 48]. Two of the studies blinded the aims of the research and did not mention loot boxes in their recruitment letters [6, 46]. All of these study samples required fulfillment of some inclusion criteria, such equally being video gamers [3, v, 11, 12, xl, 44, 46]; video gamers who had watched eSports, bet, or bought loot boxes [48]; or gamers of specific videogames [half-dozen], such as Fortnite [47].

In summary, twelve studies in this scoping review used samples composed exclusively of gamers [two, 3, v, six, xi, 12, 40, 44–47]. Two were equanimous of gamers and/or gamblers [sixteen, 48]. In most of these samples, at that place was a higher proportion of male respondents than females [6, xi, 12, 40, 44–48]. However, one sample had a college proportion of female person respondents [v]), and iii others had similar proportions of males and females [2, xvi, 40]. Furthermore, of the studies involving gamer samples, two included a high proportion of people with gaming problems [3, 45] and 4 included a high proportion of people who presented gambling problems [3, 5, 46, 48].

Operationalization and measurement of loot box appointment.

All included studies provided homogeneous definitions with regard to the characteristics of the construct in question such as virtuality, randomness, and monetary payment. Some authors nuanced the definitions, supplementing them with terms such every bit "digital advantage," "bet," "uncertain value," or "in-game or real-earth currency" [three, 5, 16, 42, 43, 48]. Only two studies provided a specific definition of boodle boxes before asking about their use [twoscore, 43].

Regarding the operationalization of the utilize of boodle boxes, not all studies asked about the aforementioned behaviors or types of engagement. Xiii evaluated the purchase of loot boxes [2, 3, 11, 12, xvi, 40–46, 48], two evaluated the sale or "greenbacks-out" [2, 46], and two also measured the opening of a loot box in general, with or without payment [2, 40]. For this purpose, sociodemographic questions designed ad hoc (such every bit "Have yous bought a loot box in the concluding year?" [2]) were used. In 11 of the studies, the questions prompted a dichotomic response of "yes" or "no" [2, 11, 12, 16, 40, 42, 43, 46, 48]; one asked for the number of loot boxes purchased [41]; and another calculated overall engagement from different variables, such as frequency of purchasing or time spent [48]. Half-dozen of the sixteen selected studies asked participants virtually their expenditure on loot boxes [3, 5, 6, 12, 46, 47]; five of these studies used an open-answer format to indicate the corporeality spent [5, 6, 12, 46, 47], and the other one used a closed-respond spending bracket format (ranging from < $1 to > $300 in the past calendar month) [xi].

Regarding the time frames analyzed in the studies, two asked about the participants' lifetimes [11, twoscore], nine focused on the by year [ii, 3, 16, 41–44, 48], iv examined the past month [5, 6, 12, 46], one asked almost unlike fourth dimension frames (daily, weekly, monthly, and yearly) [47], and one did not specify a time frame [45].

Brooks and Clark [twoscore] designed an musical instrument to evaluate risky behaviors surrounding the use of loot boxes that may become problematic. Their "Risky Loot Box Alphabetize" (RLI) consists of five items associated with 3 dimensions: cognitive concern nearly the use of loot boxes, impulsive utilize, and chasing losses. This instrument has demonstrated adequate reliability (α = .864), although its internal validity is limited.

Prevalence of loot boxes.

There was great heterogeneity among the data regarding loot box engagement prevalence from the 16 selected studies. These information were presented in terms of whether or not boodle boxes were purchased, obtained/opened (without specifying payment), or sold; the type of sample evaluated (adolescents or adults over 18 years of historic period); and the time frame analyzed (lifetime, almanac, or monthly) (Tabular array 2). Notably, analysis of the behaviors surrounding boodle box purchases revealed that none of the studies differentiated betwixt directly purchases with real money (legal tender) and purchases using virtual in-game/ecosystem currency (which must accept been previously purchased with legal tender). All studies took a general approach to the purchase of loot boxes without qualifying this aspect.

In adolescents. Of the xvi studies analyzed, four exclusively studied adolescents (12 to 18 years of age) [2, 12, 41, 45]. The first written report used two different representative samples of Delawarean adolescents (8^th form and 11^th course) to analyze the annual prevalence of loot box purchases. This rate ranged from 17% for ages xvi–17 (n = ii,329) to 24.9% for ages thirteen–14 (n = 2,126) (28.3% and 33.nine%, respectively, in the gamer samples) [41]. The second report, with a representative sample of 1137 Danish adolescents between 12 and 17 years of age, revealed that the annual prevalence rate of loot box purchasing amongst gamers (n = 995) was 20% [two]. The third study analyzed the monthly prevalence of loot box purchases amidst 1155 boyish gamers (anile sixteen to eighteen years) and reported it to be twoscore.v% [12]. The fourth study revealed a buy prevalence of 3.5% in a sample of 1615 adolescent Japanese gamers (xiv years sometime), just this study did not specify the time frame analyzed [45].

Simply one written report on adolescents analyzed data regarding other forms of appointment with boodle boxes. Among gamers from a representative sample of Danish adolescents between 12 and 17 years, in that location was a higher annual rate of obtaining a loot box (with or without paying, 40.7%) than of purchasing one (paying, 20.5%) [ii].

In adults. 10 of the 16 studies used developed samples [3, five, half-dozen, eleven, 16, 40, 43, 44, 46, 47]. Of these studies, six reported an annual prevalence charge per unit of loot box purchases. The rates ranged from 7.8% (in a representative sample of adults from the Uk [43]) to 9.eight% (in a representative sample of High german developed Cyberspace users [16]) to 44.2% (in a sample of gamers) and 66.1% (in a sample of gamers who also gambled [3]). Furthermore, in a sample comprised of gamers, one study determined that the monthly prevalence of loot box purchases was 62.4% [46]. Two studies examined this prevalence throughout participants' lifetimes, revealing rates of 49.iii% [xl] and 78% [xi]. One report included 2 different convenience samples of adult gamers [40]. It addressed the lifetime prevalence of dissimilar loot-box-related behaviors, such every bit one) participating in games containing a loot box, 2) opening a loot box, 3) buying a boodle box, and 4) selling a loot box. The prevalence charge per unit of opening a loot box was 88.9% in the first sample (northward = 144) and 94.8% in the 2nd sample (n = 113). In the example of loot box purchases, the rates were 49.3% in the beginning sample and threescore.3% in the second sample. In the example of selling loot boxes, the rates were 27.8% in the commencement sample and 39.7% in the 2nd sample. The remainder of the studies involving adults (n = iii) did not provide data on the prevalence of engagement with loot boxes; they only measured loot box expenditure [v, 6, 47].

In mixed samples of adults and adolescents. 2 studies examined mixed samples of adults and adolescents [42, 48]. One used a convenience sample and determined that 46.2% of gamers who also gambled or watched eSports (north = 582) had bought a boodle box in the prior year [48]. The other study demonstrated an annual loot box buy prevalence of 12.one% using an online panel survey of three,549 British participants between 16 and 24 years, with younger people existence the biggest purchasers (38.9% were betwixt sixteen and 18 years of historic period) [42].

Association between engagement with loot boxes and problematic gaming and gambling.

Eight of the xvi studies analyzed the relationship between engagement with boodle boxes and problematic gaming. Seven analyzed adult samples [3, 5, 16, 40, 43, 44, 47]. One sample was representative of the High german adult population of Internet users [sixteen], and some other used quota sampling to correspond the U.k. developed population in terms of sex, age, and ethnicity [43]. One of the viii studies used a sample of boyish gamers from a population-based birth accomplice report in Nihon [45]. Half-dozen of the 8 studies revealed a positive, statistically significant relationship between the two constructs [3, 5, 40, 43–45]. However, i study did not find this human relationship [47], and another showed mixed results [16]. Of those half dozen studies, five reported a positive relationship between loot box purchases and problematic gaming as measured by the Internet Gaming Disorder Scale (IGDS [43, 49]), the Net Gaming Disorder Scale–Short Course (IGDS9-SF; [44, 50]), and the DSM-five Internet Gaming Disorder criteria (IGD; [3, 23, 43, 45]). Two studies reported a positive relationship betwixt RLI score and higher scores for problematic gaming as measured past the IGDS [5, 40]. A study by von Meduna et al. [16] indicated that 68.nine% of loot boxes purchasers were problem gamers according to an adapted Trouble Gambling Severity Alphabetize (PGSI) score for Pay2Win gaming, merely this report highlighted mixed results in the regression models; namely, the authors observed that having bug with Pay2Win gaming was significantly associated with boodle box purchasing (yes/no) in all three tested models only had no meaning effect on the frequency of boodle box purchasing. Drummond et al. [5] observed a positive correlation betwixt loot box spending and college scores for disordered gaming every bit measured by the IGDS. Only one report, carried out in a sample of adult Fortnite gamers, did non discover a positive relationship between loot box expenditure (yeah/no and amount) and IGD symptomatology as measured past the DSM-5 criteria [47]. Notably, some studies found the clan between loot box engagement and problem gaming to be associated with personal variables, such every bit the participants' sex. For case, Ide et al. [45] observed in a sample of Japanese adolescents aged 14 that the likelihood of presenting problem online gaming was significantly higher in boyish female person gamers who purchased loot boxes (OR 6.73, 95% CI 2.42–18.72) than in male person gamers who purchased loot boxes (OR two.88, 95% CI one.51–5.51).

Furthermore, 12 of the 16 selected studies analyzed the relationship between engagement with boodle boxes and problematic gambling. They all indicated a positive clan betwixt the two constructs [ii, 3, 5, vi, xi, 12, 16, twoscore, 42, 43, 46, 48]. Two of these 12 studies were carried out using adolescent samples [2, 12], two with mixed samples of adolescents and adults [42, 48], and the remaining viii with adult samples. Only iv of these 12 studies used representative samples of their populations of involvement: one used a representative sample of the German adult population of Internet users [xvi]; one used quota sampling to stand for the United kingdom adult population in terms of sex activity, age, and ethnicity [43]; ane used a representative sample of 1137 Danish adolescents between 12 and 17 years of age [2]; and ane used an online panel survey of 3,549 British youth between the ages of xvi and 24 [42]. Seven of these 12 studies reported a positive human relationship between the buy of loot boxes and problematic gambling equally measured by the PGSI [51] in adults [3, 16, 42, 43, 46, 48] and the South Oaks Gambling Screen–Revised for Adolescents (SOGS-RA; [2, 52]) in adolescents. 2 studies found a positive relationship between RLI score and higher scores for problematic gambling as measured past the PGSI [v, 40]. Five studies found a positive correlation between loot box expenditure and higher scores for problem gambling as measured by the PGSI in adults [5, 6, 11, 46] and the Canadian Adolescent Gambling Inventory (CAGI; [53]) in adolescents [12]. The study past von Meduna et al. [16] indicated that 45.9% of boodle box purchasers were problem gamblers according to the PGSI, just this written report highlighted mixed results in the regression models. Namely, the authors observed that beingness a problem gambler yields a meaning positive effect on loot box purchasing (yeah/no) and loot box purchasing frequency in some of the regression models but not in others.

Some studies plant that the association betwixt engagement with loot boxes and trouble gambling was associated with variables such as sex, age, and type and level of loot box date. For instance, Kristiansen & Severin [two] plant, in a representative sample of Danish adolescents, that this human relationship was markedly stronger for females than for males (females: local γ = 0.777, p = 0.043; males: local γ = 0.541, p < 0.01) and for the two older groups (12–13 yrs.: local γ = 0.294, p = 0.322; 14–15 yrs.: local γ = 0.779, p < 0.01; 16–17 yrs.: local γ = 0.565, p < 0.1). They besides found that this link was dependent upon the level of appointment. They institute that the proportions of at-risk and problem gamblers were college among those who had purchased or sold items from a loot box than among those who had obtained a free boodle box. Similarly, Zendle et al. [46] observed that the positive association between engagement with boodle boxes and PGSI scores in a convenience sample of adult gamers was higher when participants paid for the boodle boxes than when they did not.

Discussion

To date, numerous studies about loot boxes have been published. Yet, to our knowledge, no piece of work has summarized the prevalence rates of dissimilar forms of engagement among adolescents and adults or synthesized the most recent empirical results about the relationships betwixt these forms of engagement with loot boxes and problematic gaming and problematic gambling, taking into account methodological aspects of the existing studies. The present scoping review aimed to meantime examine these aspects of the existing literature.

With regard to methods of measuring engagement with boodle boxes in the existing master empirical studies, we observed stiff agreement apropos the characteristics of loot boxes, such as the virtuality of the objects, randomness, and monetary payment (with real currency or in-game currency earned through gaming time). Notwithstanding, very few studies were sufficiently consequent in their methods to let comparison of their results. Each study measured different aspects of boodle boxes, such equally the opening, purchase (yep/no), frequency, number of loot boxes and/or loot box expenditure, and utilize across diverse time frames, making it difficult and inappropriate to compare results between studies. Additionally, as far as we know, in that location is merely one validated instrument that evaluates risky behaviors surrounding the use of loot boxes—the Risky Loot Box Alphabetize [twoscore]. However, it would be advisable to carry out more robust analyses of this tool's psychometric properties.

The heterogeneity of the methods used prevent us from truly understanding the magnitude of the phenomenon. Taking all data extracted from the studies without differentiating among time frames or loot box behaviors (purchase, opening, etc.), prevalence rates amidst adolescents varied betwixt 3.5% [45] and 44.three% [2], and those among adults varied betwixt vii.8% [43] and 94.viii% [twoscore]; however, these information are incomparable among them. The annual purchase prevalence among boyish gamers varied between 20% [2] and 33.ix% [41]. Amid adult gamers over the age of 18, the annual purchase prevalence varied betwixt 22.7% [44] and 44.2% [48], merely the range was greater among gamers who too gambled (46.ii%–66%) [3, 48]. As nosotros can see, amid gamers, annual boodle box purchase prevalence was higher in adults than in adolescents. This makes sense considering that minors are subjected to parental control, enjoy less liberty, and have less purchasing power. Nonetheless, in studies that used general population samples, the average annual purchase prevalence amidst adolescents aged 13–xiv years was higher than that among participants aged 16–24 years and that among adults (24.nine%, 12.1%, and 7.8%, respectively) [41–43]. This suggests that loot box usage is prevalent amongst adolescents, regardless of whether they recognized themselves every bit gamers or not. In add-on, these results are in line with those of other works suggesting that age is negatively correlated with this behavior [11, 16, 48, 54], as younger people, in general, are more tech savvy and open up to trying something new. However, once an individual comes into contact with a loot box, age is not a moderating variable that reduces the frequency of loot box usage [sixteen]. In any instance, it is expected that engagement with loot boxes amidst adolescents will proceed growing in the absence of relevant interventions or legal measures.

Additionally, the differences in results across the existing studies may exist associated with cultural and legal variables specific to each land. For case, the 3.v% loot box purchase rate in Tokyo [45] and the 7.8% rate in the UK [43] are far from the 38.ix% rate in Germany [16]. This could be a result of differences in the legal status of loot boxes in these countries. In Germany, there are legal barriers to regulating loot boxes as gambling [19], whilst in the United kingdom of great britain and northern ireland, loot boxes are covered by the gambling legislation, and in Japan, some types of loot boxes are prohibited [31].

Concerning the last of our research questions, there appears to be a positive human relationship between loot boxes and problematic gaming and gambling. However, further research is needed, and sampling bias must be considered when interpreting the results of the existing studies. It is worth mentioning that only eight of the studies analyzed the human relationship betwixt boodle boxes and problematic gaming, and only one of them used an adolescent sample, despite the facts that 1) admission to loot boxes occurs exclusively through videogames and 2) adolescents are heavy videogame users [55]. In general, a positive association between the constructs was observed [three, 5, 16, xl, 43–45, 47]. However, this was primarily truthful for adult samples and, in some cases, for an overrepresentation of participants classified as trouble gamers [3, 5, 45, 47]. The merely study that did non find an association between boodle boxes and gaming disorder symptoms was based exclusively on Fortnite [47], which may take influenced its results.

In addition, the differentiated result of opening free loot boxes (versus paid loot boxes) should be considered. The increment in gaming time required to obtain loot boxes might suggest a possible link with the development of problematic gaming, but none of the studies reviewed addressed this. Notwithstanding, some studies in our scoping review examined a similar line of research, pointing out that paid loot boxes are more than strongly associated with problem gambling than unpaid loot boxes. For example, Kristiansen and Severin [2] stressed that there was simply a relationship betwixt loot boxes and problem gambling when it came to buying or selling boodle boxes, not when they were obtained for free. Furthermore, Zendle et al. [48] observed a stronger association betwixt loot boxes and trouble gambling when a price was paid than when they were obtained for complimentary.

As far equally the human relationship with gambling is concerned, it seems reasonable to infer that the gambling nuance fastened to loot boxes favors the relationship between boodle box purchases and problematic gambling [3, 16]. This has been corroborated past the existing studies to date in both adult and adolescent samples and in a recent secondary analysis of loot box expenditure data [34]. However, caution is necessary when interpreting such results. The scientific literature is notwithstanding deficient, and an overrepresentation of adults and people with gambling issues [3, 5, 46, 48] was observed in the samples of some studies included in this scoping review. This is also true for the aforementioned secondary assay by Close et al. [34]. Such a limitation may influence the results and limits generalization. On the other hand, although few studies have simultaneously analyzed the relationship between loot boxes, problematic gaming, and problematic gambling [e.thou., three, v, xiv, 38, 41], their results indicate to a statistically pregnant human relationship between buy of (or expenditure toward) loot boxes and the 2 problems, in line with the results of a meta-analysis by Garea et al. [fourteen]. In brusk, it can exist concluded that boodle boxes are linked with problems related to both to gaming and gambling; all the same, to larn more nigh these relationships, longitudinal studies and representative samples are necessary. All studies in the present review were cantankerous-exclusive in nature, and most of them were of limited representativeness. Therefore, they do non permit establishment of causal furnishings between variables or extrapolation of their results to the general population.

Recommendations for research

In view of the results obtained in this scoping review, some recommendations can be made for further research. First, future studies should standardize measurements of appointment with loot boxes to allow for comparisons between studies. This will too favor overall comprehension of the construct and facilitate understanding of the real magnitude of this phenomenon. For example, providing report participants with an established definition of boodle boxes (perhaps with some examples and pictures) before asking questions about usage habits might be a adept practice. A potential starting betoken for a definition that includes all necessary elements of a loot box as proposed by different authors [xvi–20] might be the post-obit: "a loot box is a virtual object (such as a breast, a key, envelope, etc.) within a videogame that offers random contents (such as equipment, weapons, characters, etc.) within the game itself in commutation for an corporeality of money (either existent money paid straight or real coin that has been transformed into a virtual currency within the videogame or game ecosystem)."

Secondly, regarding the time frame, we recommend including several factors that can be valuable. Currently, most existing literature has evaluated loot box appointment during the prior year and whilst continue doing so, would facilitate comparison with the electric current literature, it might also be of interest to know whether this beliefs has taken place in the last twelvemonth (aye/no), frequency which with it happens, (rarely, in one case or twice, oft, or many times in the last year) and the boilerplate number of boodle boxes purchased/opened/sold or boilerplate expenditure. All the same, when using continuous measures, it will be desirable to ask nigh shorter periods (east.g., the previous month), since participants' responses regarding the annual or lifetime timeframe may comprise more biases [56].

Thirdly, it will also be relevant to carry out investigations in which at that place is a clear distinction betwixt the opening of costless boodle boxes and the opening of paid boodle boxes. This will allow analysis of their differing effects on problematic gaming and/or gambling. It may also be relevant to perform analysis every bit a office of the videogames in which loot boxes are used or of the type of boodle box (e.g., purely cosmetic or key to the game). In add-on, it should be asked whether these purchases are made direct with real money or with virtual currency through a game/platform ecosystem (afterwards payment with real money).

Furthermore, facilitators of future population-based studies should include like proportions of males and females also as wider age ranges, provide aggregated and disaggregated data for each subsample, discuss their results with similar subsamples from other studies, and have steps to avoid limitations to interpretation and generalization. Additionally, in view of the existing data [57–59], it may be noteworthy to increase the proportions of girls in studies most loot box engagement. It would also be advisable to differentiate between analyses with clinical and non-clinical samples and to use clinical and specific instruments for the online context, such as the Online Gambling Disorder Questionnaire [60]. Alternatively, when using the PGSI, information technology might be advisable to explicitly land that the study is not assessing a clinical problem but rather its more social aspects [61]. Finally, additional instrumental studies are needed to assess the construct of problematic boodle box usage as it relates to gaming and gambling problems, both in general and clinical populations.

The present scoping review does take some limitations that should exist mentioned. Outset, the review included a small number of studies, which may be due to the novelty of the subject affair and the inclusion criteria chosen. For example, relevant studies not published in peer-reviewed journals (e.yard., theses, unpublished dissertations, reports) were left out of this review. Secondly, the heterogeneity and express representativeness of some of the samples hindered the procedure of comparison between studies, which may lead to biases in their interpretation, and their results cannot be extrapolated to the general population. For this reason, we presented the historic period of the study sample, the fourth dimension frame, and the behavior assessed in each study as carve up factors. Thirdly, all studies included in this review were cross-sectional, which must be considered when interpreting results on the human relationship between loot boxes and problematic gaming and/or gambling. Finally, caution is advised because the scientific literature is all the same scarce and very few studies differentiated betwixt types of engagement (opening, purchasing, or selling) in their analyses.

Conclusion

In summary, this study contributes to a better agreement of engagement with loot boxes in videogames. First, this study confirms that the utilise of loot boxes is prevalent amongst both adults and adolescents. The results too propose that the purchase of loot boxes is a frequent practice among minors. However, data on this prevalence are heterogeneous, primarily due to methodological differences (e.g., the operationalization of engagement with loot boxes, the samples' characteristics, and diverse cultural or legal contexts). This makes the results incomparable across studies and countries. Second, available data suggest a significant relationship between engagement with loot boxes and gambling and gaming problems. Finally, it is necessary for future studies to be conducted in a fashion that allows comparability—for case, using common definitions, like fourth dimension frames, and similar cess instruments (particularly to assess the relationship with problematic gaming and gambling). Effective policies for preventing problematic gaming and/or gambling must be based on scientific evidence; thus, a valid and thorough understanding of the magnitude of this phenomenon is essential.

Supporting information

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