Longitudinal associations among posttraumatic stress symptoms, intolerance of uncertainty and internet gaming disorder symptoms among disaster-exposed adolescents.

Disaster-exposed adolescents face elevated risks for developing posttraumatic stress symptoms (PTSS) and maladaptive coping behaviors, including internet gaming disorder (IGD). However, the longitudinal mechanisms underlying these relationships remain unclear, particularly the role of intolerance of uncertainty (IU) as a potential transdiagnostic vulnerability factor. This longitudinal study examined 403 disaster-exposed adolescents (Mage = 13.33, SD = 0.52; 49.6% girls) across three waves. PTSS, IU, and IGD symptoms were assessed at three time points, with a six-month interval between each assessment. We employed latent variable cross-lagged panel models to examine the temporal directionality of these relationships and tested a complete longitudinal mediation model. Cross-lagged analyses indicated that PTSS consistently predicted subsequent increases in IGD symptoms over time, but not vice versa. The longitudinal mediation model revealed two significant indirect pathways: (1) early PTSS predicted later IGD symptoms through the mediating effect of increased IU, and (2) early IU predicted later IGD symptoms through the mediating effect of increased PTSS. Our findings reveal complex longitudinal pathways linking trauma-related distress, cognitive vulnerability, and problematic gaming. Intolerance of uncertainty emerges as a key mechanism that both results from trauma and contributes to the development of IGD. These results underscore the importance of screening for and treating IU in trauma-informed interventions for disaster-exposed adolescents to prevent the onset or exacerbation of secondary complications like IGD.