To identify potential subtypes of attention deficit hyperactivity disorder (ADHD) symptoms among middle school students and further explore the association between these subtypes and internet gaming addiction.

A stratified random sampling method was used to select 2 100 students from six middle schools in Bijie City, Guizhou Province. The Internet Gaming Disorder Scale (IGDS) and the Barkley Current Symptom Scale (BCSS) were administered for assessment. Latent Profile Analysis (LPA) was employed to determine the latent classifications of ADHD symptoms, followed by the application of a robust three-step approach to analyze the relationship between these classifications and internet gaming addiction. To assess the relationship between ADHD symptom classifications and the risk of internet gaming addiction, binary Logistic regression analysis was conducted, controlling for demographic variables such as gender and age, to clarify the predictive effect of ADHD symptoms on the risk of internet gaming addiction.

The prevalence rate of internet gaming addiction among middle school students was found to be 4.57% (n=96). Latent profile analysis identified three potential subtypes of ADHD symptoms: low symptom subtype (n=1 058, 50.4%), moderate symptom subtype (n=829, 39.5%), and high symptom subtype (n=213, 10.1%). Further analysis indicated statistically significant differences in internet gaming addiction scores among the ADHD symptom subtypes (χ²=547.438, P<0.001), with the high symptom subtype scoring the highest, followed by the moderate symptom subtype, and the low symptom subtype(scores were 26.79±0.54, 19.47±0.26, 14.75±0.19, respectively). After adjusting for demographic variables such as gender and ethnicity and conducting multiple comparisons, the association between moderate and high levels of ADHD symptoms and the risk of internet gaming addiction remained significant (OR values respectively were (1.25, 95% CI:1.58-1.35) and (1.14, 95% CI:1.08-1.20)), while the impact of the low symptom level was not significant.

There is significant heterogeneity in ADHD symptoms among middle school students and different latent subtypes of ADHD symptoms are significantly associated with internet gaming addiction. Students with higher levels of ADHD symptoms are more likely to have higher internet gaming addiction scores. Schools and families should pay more attention to middle school students exhibiting more severe ADHD symptoms to promote mental health development.