Meta-analysis of the relationship between problem gambling, excessive gaming and loot box spending

Loot boxes are purchasable randomised rewards contained in some video games. Concerns have been raised that these share psychological and structural features with traditional forms of gambling, and that they may exacerbate excessive video gameplay. Here, we quantitatively summarise two specific research areas regarding loot box spending using meta-analyses. We examined the relationships between loot box spending and (1) problem gambling (15 studies), and (2) excessive gaming (7 studies). We found significant small-to-moderate positive correlations between loot box spending and gambling symptomology, r = 0.26 (r = 0.37 using Trim and Fill), and excessive gaming, r = 0.25. Our results suggest a small, but replicable and potentially clinically relevant, relationship between gambling symptomology and loot box spending that is at least as large as the relationship between excessive gaming symptoms and loot box spending. Further research should examine the potential for statistical interactions between these constructs.