Loot boxes: A scoping review on primary studies of prevalence and association with problematic gaming and gambling

Abstract

Background: Loot boxes are a type of random microtransactions that are increasingly common in videogames, so there is some concern about its true extent and entailed risks. Although many papers have been published recently about this topic, the actual prevalence of loot boxes use is uncertain and there is still controversy over the nature of its relationship with problematic gaming and gambling. Objectives: The aims of this scoping review are to summarize the characteristics and findings of published primary research studies about the prevalence of loot boxes and/or its relationship with problematic gaming and gambling, taking into account the operationalization of loot boxes use in these studies. Methods: The Joanna Briggs Institute Guidance for conducting a systematic scoping reviews and the systematic reviews and meta-analysis extension for scoping reviews (PRISMA-ScR) are followed. Searches in three academic databases provided 299 articles. Results: Sixteen primary studies met the inclusion criteria for this review. All the studies were cross-sectional, only four used samples of adolescents and males were overrepresented in ten of the samples. The annual purchase prevalence rate in gamers is higher in adults than in adolescents (22.7 - 44.2% and 20 - 33.9%, respectively), but in general samples (gamers and non-gamers) it is just the opposite (from 24.9% among 13-14 to 7.8% in adults). Prevalence rates are also higher in the samples made up of gamers and gamblers and in studies that measured monthly or lifetime prevalence. In general, studies suggest a positive and significant relationship between loot boxes and problematic gaming and gambling. Conclusions: The overrepresentation of male adults with gaming and/or gambling problems in study samples do not allow to generalize their results. An enhanced standardization in measurements and methods for future research in this field is recommended. Also, further longitudinal research is needed to improve the understanding of these problems.