Video games are one of the most popular entertainment media worldwide, particularly among adolescents, who use them as a form of leisure and socialization that impacts their values and behaviors (Limone et al., 2023; Rodríguez and Padilla, 2021; Guzmán-Brand and Gelvez-Garcia, 2022).

While playing video games can have positive effects on adolescents (Raith et al., 2021; Liao et al., 2023; Portillo Peñuelas et al., 2023), problematic use or addiction may lead to violent behavior, family conflicts, and emotional, academic, and social difficulties (Luo et al., 2022; Chen et al., 2025; Wang et al., 2020; Estrada-Araoz et al., 2023; González Moreno and Molero Jurado, 2022; Hou et al., 2022; Jadallah et al., 2023; Limone et al., 2023; Mbarki et al., 2023).

Video game addiction involves compulsive dependence on gaming, characterized by a lack of control over its use, prioritizing gaming over relationships, responsibilities, or personal goals (Estrada-Araoz et al., 2023; Raney et al., 2023; Mohamed et al., 2023).

Globally, an increasing trend of adolescents showing risk criteria associated with problematic video game use has been observed (Long et al., 2018; Colasante et al., 2022; Mohamed et al., 2023; Raney et al., 2023; Chen et al., 2025). In Peru, studies such as Király et al. (2019) reported high levels of this problem, findings corroborated by Estrada-Araoz et al. (2023).

The classification of video game disorder is relatively recent. The inclusion of “video game addiction” in the DSM-5 marked its formal recognition as a behavioral addiction (American Psychiatric Association, 2013; Luo et al., 2022). The ICD-11 also recognized this disorder, providing specific diagnostic criteria (Costa and Kuss, 2019; Dong et al., 2019; Luo et al., 2022). Although there appears to be consensus on the harmful effects of this addiction, the need for further research persists (American Psychiatric Association, 2013; Costa and Kuss, 2019) to deepen the understanding of this phenomenon, particularly the processes contributing to its development (Dong et al., 2019; Von der Heiden et al., 2019; Brand et al., 2020).

For adolescents, behavioral adaptation is crucial for development, enabling them to adjust to environmental demands. This process includes identifying resources, interpreting norms, and adapting expectations and behaviors to social dynamics (Bandzeladze et al., 2019; Silvers, 2022; Li et al., 2023; Choe et al., 2024).

Inadequate adaptation can hinder the management of interpersonal relationships, academic demands, and family conflicts, which could increase an individual’s vulnerability to problematic behaviors (Artuch-Garde et al., 2017; Ruiz and Yabut, 2024), such as video game addiction (Wang and Cheng, 2022; Lin et al., 2024; Chen et al., 2025).

Table 1, indicates relationships between the model variables and video game addiction. Overall, results show that mean levels of behavioral adaptation (M = 60.68, SD = 17.61), state anxiety (M = 32.79, SD = 5.22), and trait anxiety (M = 33.57, SD = 5.86) are relatively low. Similarly, the average score for video game dependency (M = 22.67, SD = 20.17) suggests mild rather than severe dependency. Correlations confirm these relationships: behavioral adaptation negatively correlates with state anxiety (r = −0.311) and trait anxiety (r = −0.218), while both types of anxiety positively correlate with video game dependency (r = 0.252 for state anxiety, r = 0.221 for trait anxiety).

Figure 2, the structural model presented, confirms the proposed hypotheses (H1, H2, H3, and H4), showing that behavioral adaptation and anxiety influence video game addiction, including both direct and indirect effects mediated by anxiety, in adolescents from urban and rural areas. The model fit indices are adequate, with satisfactory values (χ²/df = 4.836; TLI = 0.945; CFI = 0.964; GFI = 0.950; RMSEA = 0.080, 90% CI [0.068, 0.092]). It is observed that the standardized coefficients predicting the structural model of video game addiction are as follows: (a) The variable X (Behavioral Adaptation) must have a significant effect on the mediator (Anxiety): X → M (β = −0.55; p < 0.001), (b) The variable X (Behavioral Adaptation) must have a significant effect on the variable Y (Video Game Addiction): X → Y (β = −0.12; p < 0.024), and (c) The variable M (Anxiety) must have a significant effect on Y (Video Game Addiction): M → Y (β = 0.33; p < 0.001).

If the aforementioned conditions (a, b, c) are met, it must also be satisfied that the direct effect (β = −0.12) of the independent variable X (Behavioral Adaptation) on the dependent variable Y (Video Game Addiction) is smaller than the indirect effect (β = 0.33), which is observed in the model.

Figure 3, shows a mediation model evaluating the effects of state and trait anxiety on the relationship between behavioral adaptation and video game addiction. The results confirm hypothesis H5, demonstrating that state anxiety has a more significant and negative mediating effect than trait anxiety. Specifically, lower behavioral adaptation is associated with an increase in state anxiety (β = −0.31), which, in turn, leads to higher levels of video game addiction (β = 0.20). Similarly, lower behavioral adaptation is also linked to an increase in trait anxiety (β = −0.22), and higher levels of trait anxiety contribute positively to video game addiction (β = 0.16). These findings highlight the differential mediating role of both types of anxiety, with state anxiety being the most influential mediating factor in the relationship between behavioral adaptation and video game addiction.

Moreover, behavioral adaptation is associated with the area (β = −0.76). Applying the Student’s t-test for independent samples [t₍₆₀₄₎ = 17.804; p < 0.001; d = 1.493] shows that students from rural areas (M = 47.4; SD = 12.0) exhibit lower behavioral adaptation compared to their urban counterparts (M = 68.7; SD = 15.5). Similarly, results for state anxiety [t₍₆₀₄₎ = 3.610; p < 0.001; d = −0.303] and trait anxiety [t₍₆₀₄₎ = 3.341; p < 0.001; d = −0.280] also indicate that adolescents from rural areas (state anxiety: M = 33.8; SD = 5.3; trait anxiety: M = 34.6; SD = 5.4) present higher levels of anxiety than adolescents from urban areas (state anxiety: M = 32.2; SD = 5.1; trait anxiety: M = 32.9; SD = 6.1).

The results obtained confirmed the consistency of the proposed structural model, with satisfactory goodness-of-fit indices (χ²/df = 4.836; TLI = 0.945; CFI = 0.964; GFI = 0.950; RMSEA = 0.080, 90% CI [0.068, 0.092]). These values support the validity of the model and its capacity to explain the relationships between behavioral adaptation, anxiety, and video game addiction among Peruvian adolescents from urban and rural areas. Based on this foundation, the findings validated the first four hypotheses proposed. Behavioral adaptation showed a significant effect on anxiety (β = −0.55, p < 0.001), the relationship between behavioral adaptation and video game addiction was confirmed (β = −0.12, p < 0.024), and the relationship between anxiety and video game addiction was verified (β = 0.33, p < 0.001), reinforcing its mediating role. Additionally, state anxiety was found to have a greater effect than trait anxiety, highlighting the impact of immediate emotional responses on problematic video game use.

Regarding the sample results, it was observed that the general levels of behavioral adaptation were low, as were the levels of trait anxiety, state anxiety, and video game addiction. Among the dimensions of behavioral adaptation, personal adaptation had the most significant weight (λ = 0.93), followed by school adaptation (λ = 0.84). Finally, adolescents from rural areas presented lower levels of behavioral adaptation compared to urban adolescents [t₍₆₀₄₎ = 17.804; p < 0.001; d = 1.493].

In evaluating the hypotheses, the study confirmed a significant negative relationship between behavioral adaptation and anxiety (β = −0.55, H1). This finding suggests that as adolescents’ capacity to adjust to social, emotional, and academic demands improves, anxiety levels decrease. This relationship is consistent with previous research indicating that adaptive difficulties increase anxiety levels, creating emotional vulnerability. Studies such as Li et al. (2023) and Lanfredi et al. (2021) emphasize that adaptive problems amplify psychological distress and hinder stress management. Similarly, Tariq et al. (2021) identified that problematic adaptive schemas exacerbate stress, while Wang et al. (2020) noted that maladaptation contributes to a perpetuating cycle of anxiety and emotional difficulties. These results are particularly relevant during adolescence, a stage characterized by significant adaptive challenges.

Regarding H2, behavioral adaptation showed a direct but low effect on video game addiction (β = −0.12), confirming a significant but limited relationship when considered in isolation. This result aligns with the theoretical I-PACE model and various authors such as Dong et al. (2019), Brand (2017), and Király et al. (2023), who emphasize the interaction of multiple factors in the development of addictive behaviors. Although specific research in this context is lacking, prior studies suggest that biopsychological changes during adolescence increase emotional sensitivity and hinder efficient resolution of daily problems (Lin et al., 2024). This may intensify negative thoughts and emotions, motivating adolescents to resort to immediate avoidance strategies such as excessive video game use (Von der Heiden et al., 2019; Estévez et al., 2021; Lin et al., 2024).

Anxiety demonstrated a significant correlation with video game addiction (β = 0.33), reinforcing its role as a critical factor in the formation of addictive behaviors and confirming H3. This finding is consistent with previous studies identifying anxiety as a key predictor of problematic video game use as an emotional regulation strategy (Li et al., 2023). Wang et al. (2020) found a positive relationship between social anxiety and video game addiction, while Qin et al. (2023) also reported a positive correlation between these variables, although this was not the primary focus of their analysis.

Regarding H4, the analysis confirmed that anxiety acts as an indirect mediating effect in the relationship between behavioral adaptation and video game addiction, amplifying the impact of adaptive difficulties on the development of addictive behaviors. This finding supports the idea that video game addiction depends on a complex interaction of multiple factors, as highlighted in studies by Dong et al. (2019) and Király et al. (2023).

Anxiety in general this relationship by manifesting at different levels during addiction formation. As a personal factor, trait anxiety reflects a stable predisposition toward negative emotions, increasing the likelihood that adolescents use video games as a coping strategy (Von der Heiden et al., 2019; Fujihara et al., 2023). From an affective and cognitive perspective, anxiety intensifies threat perception and hampers emotional regulation, promoting avoidance patterns that contribute to problematic video game use (Wang et al., 2020; Qin et al., 2023). Additionally, elevated anxiety states can interfere with executive functions, affecting key skills such as attention, cognitive flexibility, and decision-making (Neo et al., 2011; Moran, 2016; Hubbard et al., 2020; Dolz-del-Castellar and Oliver, 2021). These limitations hinder the evaluation of long-term consequences, reinforcing compulsive behaviors that perpetuate dependence (Von der Heiden et al., 2019; Huang et al., 2022).

In terms of the difference between anxiety types, the results align with the final hypothesis (H5), demonstrating that state anxiety has a stronger mediating effect than trait anxiety.

It could be that the reason why state anxiety has a more significant effect as a mediator in video game addiction is related to how each type of anxiety behaves and the effects it produces at the brain level (Wiers and Wiers, 2016; Billieux et al., 2017; Yang et al., 2018). Thus, the first key difference found lies in the motivation that triggers anxiety (Eysenck et al., 2007; Zhou and Siu, 2015; Wiers and Wiers, 2016). While trait anxiety is related to a permanent perception of threats in the environment, state anxiety is associated with a specific threat that could even be the reason for its emergence (Dolz-del-Castellar and Oliver, 2021; Fujihara et al., 2023; Portela-Pino and Dominguez Rodriguez, 2023).

To better understand it, it is necessary to understand fear, a variable closely associated with anxiety that imparts a negative emotional intensity (Gawda and Szepietowska, 2016; Yang et al., 2018; Toh and Yang, et al., 2020). Thus, trait anxiety is linked to a diffuse fear (Öhman, 2008); in this type of anxiety, individuals experience a sense of insecurity caused by an unspecified fear or several minor fears (Fujihara et al., 2023; Portela-Pino and Dominguez Rodriguez, 2023). Conversely, state anxiety is directed toward a specific situation or problem (Dolz-del-Castellar and Oliver, 2021; Fujihara et al., 2023; Portela-Pino and Dominguez Rodriguez, 2023). Although negative emotions are present in both forms of anxiety, they differ: in trait anxiety, these emotions are less intense but more enduring, while in state anxiety, they are temporary but intense (Pacheco-Unguetti et al., 2010; Torrano et al., 2020). This intensity could represent one of the keys to the development of addiction.

Additionally, another important difference for the study could be the inhibition process (Neo et al., 2011; Martin-Ramos et al., 2015; Yang et al., 2018; Toh and Yang, 2020). Although both types of anxiety affect inhibition, the way they do so might be related to the results of this study. Trait anxiety, being persistent, appears to generate brain-level modifications that induce a constant focus on threats, inhibiting other attentional processes (Finucane, 2011; Martin-Ramos et al., 2015; Toh and Yang, 2020). In this context, trait anxiety is associated with sustained activation of brain structures involved in emotional regulation, such as the amygdala and prefrontal cortex, which promotes continuous alertness to perceived dangerous stimuli, with difficulty in modulating this response (Bishop, 2009; Neo et al., 2011; Yang et al., 2018; Toh and Yang, 2020).

On the other hand, state anxiety, in its initial phase, affects proactive cognitive control, which can lead to indecision or difficulty initiating an action, similar to trait anxiety at this stage (Yang et al., 2018). However, individuals with state anxiety, although they may have difficulties in inhibiting attention before confronting the situation or problem, can focus their attention better when directly facing anxiety, neutralizing distractions and concentrating on the perceived threat (Finucane, 2011; Pacheco-Unguetti et al., 2010; Yang et al., 2018; Toh and Yang, 2020). This process is related to reactive cognitive control, which proves to be more effective in this context (Yang et al., 2018).

Therefore, it could be postulated that during a state anxiety episode, the individual has the biological capacity to concentrate on a single focus of attention, which, in an appropriate adaptation process, would be the specific problem (Eysenck et al., 2007; Yang et al., 2018). In contrast, individuals with trait anxiety have difficulty focusing on a single stimulus, as their hypersensitivity to emotional and cognitive stimuli prevents them from concentrating their attention, favoring the spread of attention to multiple sources of distraction, both positive and negative (Pacheco-Unguetti et al., 2010; Yang et al., 2018; Toh et al., 2020).

In relation to this study, it is relevant to consider how each type of anxiety acts as a means of escape, taking into account both emotion and inhibition (Carbonell et al., 2017; Billieux et al., 2017; Chen et al., 2023). State anxiety could be more influential, as adolescents with adaptation problems, amplified by anxiety, would not use their problem-solving skills to focus on the situation but instead shift their attention to symbolic situations, such as video games, which offer a problem-solving experience (Von der Heiden et al., 2019). Some studies support this idea through their neural analyses related to video game use (Gray and McNaughton, 2000; Roy et al., 2021; Chen et al., 2023).

Considering the importance of dopamine-generating emotionality and how it has a key impact on addictive memory (Zhou and Siu, 2015; Wiers and Wiers, 2016; Chen et al., 2023; Xu et al., 2024), it is essential to understand the brain processes involved. State anxiety would have a greater impact on video games due to its pronounced intensity (Zhou and Siu, 2015), as it would more strongly activate brain areas involved in reward and motivation, such as the dopaminergic system (Wiers and Wiers, 2016; Palaus et al., 2017; Reynolds and Flores, 2021). Unlike trait anxiety, which is less intense but more frequent, generating consistency in gaming behavior and potentially facilitating the formation of addiction. However, as proposed by Brand (2017), no single variable predicts addiction; rather, it is a combination of factors. This study, with its limitations, does not aim to offer a definitive conclusion but seeks to move closer to a broader understanding of this phenomenon.

Additionally, these assumptions are supported by prior research, such as Mehroof and Griffiths (2010), who suggest that this could be due to the intensity of emotions involved. Other studies also provide relevant evidence (Huerta et al., 2020; De Pasquale et al., 2021; Dolz-del-Castellar and Oliver, 2021; Fujihara et al., 2023; Mishu et al., 2023). However, more specific studies are suggested, as most current research focuses on anxiety in general without specifying differences between its types.

The low levels of behavioral adaptation observed in the sample may reflect a context in which adolescents lack effective skills to manage their environment, contributing to greater dependence on video games. The strength of the coefficients found in adaptation dimensions (personal adaptation: λ = 0.93; school adaptation: λ = 0.84) highlights the importance of individual skills and the school environment as key determinants of behavioral and emotional adjustment (Wang et al., 2020; Méndez et al., 2021; Lin et al., 2024).

In this regard, Méndez et al. (2021) indicate that, within the adaptation process, family adaptation is one of the most important as it provides the foundation for other adaptations. However, in the context of adolescents, school adaptation may acquire special relevance (Choe et al., 2024; Alvarez and Castelló, 2020), considering that recognition from teachers and peers constitutes an important means of validation (Alvarez and Castelló, 2020; Gutiérrez et al., 2021). On the other hand, authors such as Santander et al. (2022) and Maya et al. (2023) point out that adaptation is closely related to social support in a bidirectional relationship, suggesting that low levels of adaptation could negatively impact adolescents’ perception of support (Gutiérrez et al., 2021), generating adverse effects on their well-being (Lin et al., 2024; Ruiz and Yabut, 2024). Méndez et al. (2021) also highlight that personal adaptation results from prior adaptations such as family, social, and academic adaptations. Thus, in the analyzed sample, results indicating low adaptation suggest the need for interventions in school and personal domains.

Finally, the differences observed between adolescents from rural and urban areas underscore the influence of context on behavioral adaptation (Choe et al., 2024). Rural adolescents, presenting lower levels of adaptation, may face greater challenges in accessing educational and social resources, increasing their vulnerability to problematic behaviors such as video game addiction. In this regard, Sánchez-Castro et al. (2024) and Choe et al. (2024) indicate that socioeconomic and opportunity differences significantly influence the proper development of children and adolescents, as the stress factors associated with contextual deficiencies hinder the optimal development of their skills (Choe et al., 2024). This may be related to the results of this study, considering that the rural population in Peru is vulnerable both economically and geographically (UNICEF, 2021; Cavagnoud, 2023).

From a theoretical perspective, the results of this study provide significant evidence about the underlying dynamics in the relationship between behavioral adaptation, anxiety, and video game addiction in adolescents. The findings highlight the central role of anxiety as a key mediator, reinforcing theories emphasizing the interaction between emotional and behavioral factors in the formation of problematic behaviors. Additionally, the identification of state anxiety as a more influential mediating factor than trait anxiety offers a new perspective for understanding how emotional and situational responses, rather than stable emotional predispositions, can intensify addictive behaviors in specific contexts. These contributions enrich the existing theoretical body by demonstrating the importance of addressing both adaptive difficulties and fluctuating emotional states in the development of behavioral addictions during adolescence, especially in vulnerable socio-educational contexts.

From a practical perspective, the results of this study underscore the importance of interventions aimed at preventing video game addiction in adolescents, especially those from rural areas where lower levels of behavioral adaptation were found. This finding reinforces the need for strategies that strengthen individual competencies and school dynamics in contexts with limited access to educational and social resources, as low behavioral adaptation is a predisposing factor for problematic behaviors. Although trait and state anxiety levels were moderately low in the sample, their mediating role in the relationship between behavioral adaptation and video game addiction highlights the importance of addressing emotional distress that can act as a trigger for problematic video game use. Additionally, the low levels of video game addiction observed in the sample offer a favorable framework for implementing preventive programs that consolidate socio-emotional skills, preventing adolescents from resorting to this form of entertainment as an avoidance strategy. These practical implications suggest that interventions should focus not only on improving behavioral adaptation but also on addressing the emotional and contextual factors that increase vulnerability to video game addiction.

Although this study provides a comprehensive perspective on the relationship between behavioral adaptation, anxiety, and video game addiction among Peruvian adolescents, it presents some limitations that should be considered. First, the cross-sectional design limits the ability to establish definitive causal relationships between the variables studied. While the SEM model allows exploring direct and indirect relationships, the data obtained represent a specific moment in time, preventing observation of how these interactions might evolve longitudinally.

Second, the use of non-probabilistic convenience sampling could limit the generalization of the findings to other adolescent populations, particularly in different cultural or socioeconomic contexts. Although the sample included adolescents from urban and rural areas, differences in access to educational and social resources between these contexts could influence the interpretation of the results.

Additionally, although the structural model’s fit indices were satisfactory, the moderate correlations observed between the variables suggest the need to include other relevant factors, such as family dynamics or the school environment, to obtain a more complete view of the factors contributing to video game addiction. Finally, although the instruments used showed acceptable validity and reliability in this sample, future research could consider broader validation of these instruments in similar contexts to ensure robustness.

These limitations underscore the importance of conducting future research with longitudinal designs and more representative samples, as well as including additional variables that allow for a deeper analysis of the factors affecting video game addiction in adolescents.