Attentional bias and disinhibition toward gaming cues are related to problem gaming in male adolescents

The role of attentional control in moderating attentional bias towards game-related stimuli in individuals with a high tendency for internet gaming addiction

Background

The aim of this study was to elucidate individual difference factors that modulate the attentional processing of game stimuli to explain the heterogeneity of extant findings. The current study examined whether individual differences in components of attentional control (AC-shifting and AC-focusing) moderated the link between internet gaming addiction symptom and attentional engagement to and disengagement biases from game-relevant cues.

Methods

A total of 75 male undergraduate students who have played League of Legend (LOL) for more than 2 years completed well-established self-report questionnaires of internet gaming disorder symptoms and attentional control. The attentional bias toward game stimuli was measured for attentional engagement and disengagement using the attentional response to the distal vs. proximal emotional information (ARDPEI) task.

Results

The results revealed that attentional control was a significant moderator of the relationship between internet game addiction symptoms and attentional disengagement bias. Further analyses revealed a positive relationship between internet game addiction symptoms and attentional disengagement bias only among those with low levels of AC-shifting ability. Contrary to our expectations, AC-shifting also moderated the relationship between internet gaming disorder and attentional engagement bias. The positive relationship between internet game addiction symptoms and attentional engagement bias only appeared among those with low levels of AC-shifting ability. Individual differences in AC-focusing did not moderate the relationship between internet gaming disorder and any attentional bias.

Conclusion

This study confirmed that the greater the symptoms of game addiction, the stronger the attentional bias, especially in individuals with low AC-shifting ability. Therefore, it is necessary to examine sub-factors of AC in understanding the nature of attentional bias mechanisms in the development of internet game addiction and consider it as a psychological intervention to improve attentional bias.

Noradrenergic regulation of cue-guided decision making and impulsivity is doubly dissociable across frontal brain regions

RATIONALE

Win-paired stimuli can promote risk taking in experimental gambling paradigms in both rats and humans. We previously demonstrated that atomoxetine, a noradrenaline reuptake inhibitor, and guanfacine, a selective α2A adrenergic receptor agonist, reduced risk taking on the cued rat gambling task (crGT), a rodent assay of risky choice in which wins are accompanied by salient cues. Both compounds also decreased impulsive premature responding.

OBJECTIVE

The key neural loci mediating these effects were unknown. The lateral orbitofrontal cortex (lOFC) and the medial prefrontal cortex (mPFC), which are highly implicated in risk assessment, action selection, and impulse control, receive dense noradrenergic innervation. We therefore infused atomoxetine and guanfacine directly into either the lOFC or prelimbic (PrL) mPFC prior to task performance.

RESULTS

When infused into the lOFC, atomoxetine improved decision making score and adaptive lose-shift behaviour in males, but not in females, without altering motor impulsivity. Conversely, intra-PrL atomoxetine improved impulse control in risk preferring animals of both sexes, but did not alter decision making. Guanfacine administered into the PrL, but not lOFC, also altered motor impulsivity in all subjects, though in the opposite direction to atomoxetine.

CONCLUSIONS

These data highlight a double dissociation between the behavioural effects of noradrenergic signaling across frontal regions with respect to risky choice and impulsive action. Given that the influence of noradrenergic manipulations on motor impulsivity could depend on baseline risk preference, these data also suggest that the noradrenaline system may function differently in subjects that are susceptible to the risk-promoting lure of win-associated cues.

Psychological Effects of FIFA, PES, and Clash of Clans Games on Young Men at Risk of Developing Internet Gaming Disorder

BACKGROUND

The present study aimed to investigate the psychological effects of FIFA, PES, and Clash of Clans games on young men at risk of developing internet gaming disorder (IGD).

METHODS

The sample consisted of 150 young men, 50 of whom were in the FIFA and PES group, 50 in the Clash of Clans group, and 50 in the control group. Two groups of young men at risk of developing IGD were compared with a control group. The participants completed the General Health Questionnaire (GHQ), Quality of Relationships Inventory (QRI), Game Addiction Scale, and Behavior Rating Inventory of Executive Function (BRIEF).

FINDINGS

The results of the study showed that the scores of mental health problems, conflict with friends, and executive function problems in the Clash of Clans group were significantly higher than those of the FIFA, PES, and control groups. Concerning conflict with parents, the FIFA group had a higher score than the Clash of Clans and control groups. In addition, the results indicated that gaming addiction affects mental health by affecting executive functions.

CONCLUSION

The Clash of Clans game has more negative effects on psychological functions.

Attentional biases and daily game craving dynamics: An ecological momentary assessment study

BACKGROUND AND AIMS

Theories posit that the combination of external (e.g. cue exposure) and internal (e.g. attention biases) factors contributes to the development of game craving. Nevertheless, whether different components of attentional biases (namely, engagement bias and disengagement bias) play separate roles on game craving has not been fully elucidated. We aimed to examine the associations between two facets of attentional biases and game craving dynamics under a daily life setting.

METHODS

Participants (110 regular internet game players) accomplished the modified attentional assessment task in the laboratory, after which they entered a 10-day ecological momentary assessment (EMA) to collect data on their momentary game craving and occurrence of game-related events at five different time points per day.

RESULTS

We found that occurrence of game-related events was significantly associated with increased game craving. Moreover, attentional disengagement bias, instead of engagement bias, bore on the occasional level variations of game craving as moderating variables. Specifically, attentional disengagement bias, not engagement bias, was associated with a greater increase in game craving immediately after encountering a game-related event; however, neither attentional engagement bias nor disengagement bias was associated with the craving maintenance after a relatively long period.

DISCUSSION AND CONCLUSIONS

The present study highlights the specific attentional processes involved in game craving dynamics, which could be crucial for designing interventions for attentional bias modification (ABM) in Internet Gaming Disorder (IGD) populations.

The roles of implicit approach motivation and explicit reward in excessive and problematic use of social networking sites

Despite growing concerns about the addictive potential of social networking sites (SNSs), little is known about the precise neural, cognitive, and emotional processes underpinning compulsive SNS behaviours, such as excessive checking of SNSs. Recent evidence points to the important role of reward in SNS behaviours and one avenue to examine reward processes related to SNSs is the use of behavioural paradigms that allow for the measurement of implicit motivational responses, such as the approach avoidance task (AAT). The AAT has been successfully utilised to capture changes in unconscious reward processes in substance use disorders and other behavioural addictions, with faster approach reactions to addiction-related stimuli reflecting increased wanting/urges to have/consume the reward. In the present study 411 young adults completed an online Visual Approach/Avoidance by the Self Task (VAAST) with social media and control logos as well as other subjective (explicit) measures of reward experience related to SNSs. Our results showed that across participants SNS logos elicited strong approach reactions (compared to control stimuli) and that stronger SNS approach tendencies predicted more frequent SNS checking. Importantly, increased approach motivation was not associated with more problematic use. However, both checking frequency and problematic use were related to alterations of explicit reward processing, including the subjective experience of SNS urges or wanting. We conclude that changes in automatic approach motivation towards SNS stimuli are common in most SNS users, which suggests that implicit imbuement of social media with reward has become pervasive among young adults. Problematic SNS use however may be more reliably indicated by changes in explicit reward processing, such as subjective wanting.

Investigating Adolescents' Video Gaming and Gambling Activities, and Their Relationship With Behavioral, Emotional, and Social Difficulties: Protocol for a Multi-Informant Study

Background

Growing empirical evidence suggests that adolescents have a relatively greater propensity to develop problematic video gaming or gambling habits.

Objective

The main objectives of this study are to estimate the prevalence of potential pathological gambling and video game use among adolescent students and to evaluate their risk factors.

Methods

This is a cross-sectional multi-informant study based on an online survey. It will include a sample of adolescents attending secondary schools located in Brescia, northern Italy, their schoolteachers, and parents. The survey includes extensive data on adolescents’ (1) demographic, social, economic, and environmental characteristics; (2) behavioral, emotional, and social problems and adaptive functioning; (3) emotional and social loneliness; (4) perception of the reasons to use social networks; (5) video game habits and pathological use of video gaming; and (6) gambling behaviors.

Results

This protocol was approved by the Institutional Ethics Board of the Spedali Civili of Brescia (Italy). We expect to collect data from 793 or more adolescent students, as determined by our sample size calculation.

Conclusions

This multisite project will make a substantial contribution to (1) the implementation of a system for identifying pathological gambling and pathological video game use among adolescents, allowing for interventions aimed at improving adolescents’ financial, emotional, and social well-being; and (2) the identification of distinct profiles of gamblers and pathological video gamers that will contribute to setting up effective targeted prevention measures. Understanding the causes and impact of gambling and pathological video gaming on adolescents is a public health issue.

International Registered Report Identifier (IRRID)

DERR1-10.2196/33376

Neural substrates of deficient cognitive control in individuals with severe internet gaming disorder

BACKGROUND AND AIMS

Internet gaming disorder (IGD) is rapidly becoming a worldwide health concern. The prefrontal-subcortical model of self-regulation emphasizes that an impaired prefrontal cognitive control system and an overwhelming subcortical reward-seeking system are both crucial factors in health problems, including addiction. This study focused on the cognitive control system of IGD, aiming to investigate whether cognitive control is altered and the underlying neural correlates in college students with IGD.

METHODS

Thirty college students with IGD and twenty-five matched healthy controls were asked to complete a stop-signal task that measures cognitive control while being monitored by functional magnetic resonance imaging (fMRI).

RESULTS

Compared to the controls, only the college students with severe IGD, rather than those with mild IGD, had deficient brain activity involved in inhibitory control and response execution (specifically, the inferior frontal gyrus, anterior cingulate cortex and primary motor cortex); this result implies that cognitive control deficits are closely linked to addiction severity in individuals with IGD. Regarding performance monitoring function, college students with IGD exhibited unabated behavioral and brain activity, as did the control group.

CONCLUSIONS

Combined with our previous finding that the subcortical reward system was enhanced in individuals with IGD, the present findings extend the prefrontal-subcortical model of self-regulation from the perspective of IGD in a college student population and thus provide useful insight for the effective prevention and treatment of IGD.

Social media 'addiction': The absence of an attentional bias to social media stimuli

BACKGROUND AND AIMS

Social media use has become a ubiquitous part of society, with 3.8 billion users worldwide. While research has shown that there are positive aspects to social media engagement (e.g. feelings of social connectedness and wellbeing), much of the focus has been on the negative mental health outcomes which are associated with excessive use (e.g. higher levels of depression/anxiety). While the evidence to support such negative associations is mixed, there is a growing debate within the literature as to whether excessive levels of social media use should become a clinically defined addictive behaviour.

METHODS

Here we assess whether one hallmark of addiction, the priority processing of addiction related stimuli known as an 'attentional bias', is evident in a group of social media users (N = 100). Using mock iPhone displays, we test whether social media stimuli preferentially capture users' attention and whether the level of bias can be predicted by platform use (self-report, objective smartphone usage data), and whether it is associated with scores on established measures of social media engagement (SMES) and social media 'addiction' severity scales (BSNAS, SMAQ).

RESULTS

Our findings do not provide support for a social media specific attentional bias. While there was a large range of individual differences in our measures of use, engagement, and 'addictive' severity, these were not predictive of, or associated with, individual differences in the magnitude of attentional capture by social media stimuli.

CONCLUSIONS

More research is required before social media use can be definitively placed within an addiction framework.

Incentive sensitization in binge behaviors: A mini review on electrophysiological evidence

Introduction

Binge behavior not only refers to the consumption of substances such as alcohol or food, but is also used in relation to gaming, watching and gambling. Dependent on context it makes for a widespread, benign recreational activity or can pose a serious mental health problem with deleterious consequences. Incentive sensitization theory describes the attribution of salience towards stimuli strongly associated with dopamine-mediated reward as a result of repeated consumption. The sensitized neural networks cause cue-triggered craving and excessive desire, but thus, this mechanism may also be applicable to stimulus-induced behaviors not associated with classical withdrawal symptoms. Event-related potentials (ERP) are a useful method of examining motivated attention towards incentive stimuli. This mini review aims to synthesize ERP findings from different types of binge behaviors in order to compare cue-reactivity to incentive stimuli.

Methods

Studies investigating binge drinking, binge eating as well as binge watching, gaming and gambling were screened. To limit the influence of concurrent task demands, ERP studies applying picture viewing paradigms with incentive stimuli were selected.

Results

Across binge behaviors, evidence on altered mid-latency ERPs has been mixed. However, studies investigating later stages of attentional processes more consistently find enlarged P300 and late positive potentials (LPP) amplitudes to relevant cues.

Conclusion

An altered attentional processing of incentive stimuli reflecting motivated attention is in line with incentive sensitization theory. Considering the limited number of studies, especially regarding binge behaviors not involving substances, more research is needed to attain a more thorough understanding of incentive sensitization across binge behaviors.

Behavioral modification decreases approach bias in young adults with internet gaming disorder

BACKGROUND

One of the key symptoms of Internet gaming disorder is the impulsive pursuit of Internet games, which causes individuals with this disorder to have a tendency to approach gaming cues. Dual processing theory states that this approach bias is caused by the suppression of reflective processing and the hyperactivity of impulsive processing. Therefore, reverse modification training for approach bias can suppress impulsive processing, thereby reducing or treating the disorder.

METHOD

In this study, 48 individuals with Internet gaming disorder were selected and randomly assigned to the following two groups: the experimental group and the control group. The 24 participants in the experimental group received a 4-day stimulus-response compatibility (SRC) approach bias modification treatment, whereas the 24 participants in the control group received a corresponding SRC pseudomodification training.

RESULTS

The approach response time of both groups to the gaming cues was significantly shorter than that to the neutral cues at baseline. After the modification, the response time of the experimental group to the gaming cues significantly increased, whereas the scores for Internet gaming disorder severity, anxiety level and craving significantly decreased. However, the control group subjects did not show these effects.

CONCLUSION

The current results imply that individuals with Internet gaming disorder show approach bias toward Internet gaming cues, and SRC reverse modification training can significantly correct this bias and therefore have therapeutic effects to some extent.

Impaired disengagement of attention from computer-related stimuli in Internet Gaming Disorder: Behavioral and electrophysiological evidence

BACKGROUND AND AIMS

Attentional biases contribute to the maintenance of addictive behaviors. For the problematic use of online gaming - recognized as Internet Gaming Disorder (IGD) - first evidence points to a bias towards in-game stimuli. This study aimed to provide behavioral and electrophysiological evidence for a generalized bias towards computer-related stimuli, and to identify the specific attentional processes contributing to this bias: facilitated attention deployment, impaired disengagement or failed suppression.

METHOD

Twenty participants with IGD and 23 casual gamers performed a visual search task with photographs of real-world objects. Either the target or a to-be-ignored distractor was addiction-relevant (computer-related), whereas all other items were addiction-irrelevant (related to cars or sport). Event-related potential components associated with facilitated attentional deployment to the target (NT), its post-selection processing (SPCN), and suppression of irrelevant information (PD) were analyzed.

RESULTS

Unlike casual gamers, gamers with IGD exhibited prolonged reaction times and increased SPCN amplitudes for computer-related stimuli, reflecting their continued attentional processing. At the individual level, larger SPCN amplitudes were associated with longer delays in reaction time.

DISCUSSION AND CONCLUSIONS

This pattern of results indicates that the disengagement of attention from computer-related stimuli is impaired in IGD. More generally, our findings demonstrate that conditioning processes occur in IGD, and thus open up new avenues for treatment.

Identifying individuals in need of help for their uncontrolled gaming: A narrative review of concerns and comments regarding gaming disorder diagnostic criteria

OBJECTIVE

In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) included the diagnostic criteria of Internet gaming disorder (IGD). Then, in 2019, the 11th Revision of the International Classification of Diseases (ICD-11) categorized gaming disorder (GD) as an addictive disorder. This review aimed to review the raised concerns, debate, and research of IGD or GD criteria and provide suggestions to resolve them.

METHODS

A narrative review was conducted, and PubMed was searched for articles mentioning concerns and research on the DSM-5 criteria for IGD, ICD-11 criteria for GD, or criteria for other synonyms, such as problematic gaming or gaming addiction. A total of 107 articles were identified.

RESULTS

Concerns were organized into three categories: conceptual framework, moral panic, and diagnostic validity. Most argumentations supported the proposition that GD and other substance use disorders have similar presentations. A clear definition of GD and adequate public education could prevent rather than exacerbate moral panic. Several researchers reported concerns regarding the nosology, diagnostic validity, and wording of each criterion. However, the threshold, five of the nine criteria with impaired function, demonstrated adequate validity in interview studies.

CONCLUSION

The current findings support the addiction framework, functional impairment, and validity of the GD criteria. However, further prospective, experimental, and clinical studies validating these findings are warranted. Moreover, an integrative review or debate conference could contribute to the organization of the available results and concept development. Aggregating adequate scientific information could allay or resolve concerns related to the diagnosis of GD.

The Potential Interaction Between Time Perception and Gaming: A Narrative Review

Compromised time control is a variable of interest among disordered gamers because time spent on videogames can directly affect individuals’ lives. Although time perception appears to be closely associated with this phenomenon, previous studies have not systematically found a relationship between time perception and gaming. Therefore, the purpose of this narrative review is to explore how gaming disorder may be associated with time perception. It has been found that gamers exhibit a stronger attentional focus as well as an improved working memory compared with non-gamers. However, gamers (and especially disordered gamers) exhibit a stronger reaction to gaming cues which—coupled with an altered emotion regulation observed among disordered gamers—could directly affect their time perception. Finally, “'flow states”' direct most of the attentional resources to the ongoing activity, leading to a lack of resources allocated to the time perception. Therefore, entering a flow state will result in an altered time perception, most likely an underestimation of duration. The paper concludes that the time loss effect observed among disordered gamers can be explained via enhanced emotional reactivity (facilitated by impaired emotion regulation).

Cognitive Correlates in Gaming Disorder and Social Networks Use Disorder: a Comparison

Purpose of Review

This overview aims at summarizing studies, which investigated cognitive correlates of gaming disorder and of a problematic use of social networks by using behavioral experimental paradigms and brain imaging techniques.

Recent Findings

Based on theoretical models, inhibition/inhibitory control, attentional bias, executive functions, decision-making, and working memory capabilities have been identified as cognitive components, which are assumed to play a crucial role in the development and maintenance of an addictive behavior. A systematic search shows that various studies have already examined the involvement of different cognitive components in both types of potential addictive behaviors. However, the number of studies addressing cognitive correlates of social networks use disorder is very much lower compared with gaming disorder, even if there is a positive trend in terms of new publications in recent years.

Summary

Cognitive correlates have been frequently investigated in gaming disorder, as in many other disorders due to substance use or addictive behaviors. Studies on cognitive aspects involved in a problematic social networks use are still rare, but they are needed in order to further show if this phenomenon may also deserve a classification as addictive disorder. Interactions between different cognitive and affective processes are still understudied in both gaming disorder and problematic social networks use.

Implicit memory associations and video gaming

BACKGROUND AND OBJECTIVES

The aim of this study was to develop measures to assess implicit memory associations for video gaming and to examine the relationship between implicit memory associations, video gaming involvement, and problem video gaming.

METHODS

A survey of online panelists from across Canada was conducted that included 166 problem video gamers who were recruited for participation in a larger study examining the relationship between gambling, video gaming, and collectible card play. Memory associations were assessed using a 10-item measures of word associations and behaviour associations. Video gaming involvement was assessed via self-report of time and frequency of play, and problem video gaming was assessed using the Behavioral Addiction Measure for Video Gaming (BAM-VG).

RESULTS

Significant Kendall tau-b correlations ranging from 0.297 to 0.405 were found between measures of memory associations and both level of video gaming involvement and problem video gaming.

CONCLUSIONS

There is a robust relationship between memory associations for video gaming with level of video gaming involvement and problem video gaming. The results suggest that implicit associations may have utility in the assessment of problem video gaming.

Real-world social support but not in-game social support is related to reduced depression and anxiety associated with problematic gaming

Playing video games can become problematic, interfering with gamers' daily functioning. This problematic gaming is associated with negative mental health outcomes, such as depression and anxiety. Social support, provided in the real-world, can protect against mental health disorders such as depression and anxiety. However, previous research on gaming has found that real-world social support for gamers often decreases, while within-game social support increases. Importantly, it is currently unknown whether in-game social support can replace real-world social support in protecting problematic gamers from symptoms of depression and anxiety. To address this, we conducted an online survey (n = 361), recruiting participants from both a general university population and an online campus gaming (E-sports) group. We collected measures of problematic gaming, depression, anxiety, and both real-world and in-game social support, and then conducted a path analysis. In line with previous research, problematic gaming was significantly associated with decreased real-world social support and increased in-game social support. However, only real-world social support was then associated with reduced depression and anxiety, while in-game social support was unrelated to both. Problematic gaming also retained a significant direct effect on depression and anxiety. Maintaining real-world social support should be encouraged in the face of problematic gaming behaviors.

Disordered gambling and attentional bias: The mediating role of risk-taking

BACKGROUND

Previous research has emphasized the importance of attentional bias in the maintenance of both adult and adolescent disordered gambling. There is a substantial body of empirical evidence demonstrating facilitated attention and difficulty in disengagement from gambling stimuli among disordered gamblers, but no study has ever experimentally investigated the association between attentional bias and risk-taking behavior in gambling. The aim of the present study was to examine the interrelationship between attentional bias for gambling stimuli, risk-taking attitude, and severity of gambling involvement.

METHODS

The present study recruited 70 male adults from gambling venues to participate in the experiment. Gambling severity, attentional bias, and risk-taking were assessed utilizing the South Oaks Gambling Screen, the Modified Posner Task, and the Balloon Analogue Risk Task, respectively.

RESULTS

Disordered gamblers showed greater readiness to detect gambling stimuli and took more risks than non-disordered gamblers. Regression analysis showed that being of a young age, automatic facilitated attention for gambling cues, and risk-proneness significantly predicted problem gambling. Additionally, a path analysis was performed to test if automatic facilitated attention towards gambling was on the path from risk-taking to gambling severity, or if risk-taking mediated the impact of facilitation biases on gambling severity. The results indicated that attentional bias predicted gambling severity both directly and indirectly via risk-taking.

LIMITATIONS

The modest sample size and the absence of female gamblers limited the generalizability of the results.

CONCLUSIONS

The present findings are compatible with the view that an automatic detection of gambling stimuli is responsible for greater riskiness that, in turn, fosters gambling problems.

From sign-tracking to attentional bias: Implications for gambling and substance use disorders

Sign-tracking behavior in Pavlovian autoshaping is known to be a relevant index of the incentive salience attributed to reward-related cues. Evidence has accumulated to suggest that animals that exhibit a sign-tracker phenotype are especially vulnerable to addiction and relapse due to their proneness to attribute incentive salience to drug cues, and their relatively weak cognitive and attentional control over their behavior. Interestingly, sign-tracking is also influenced by reward uncertainty in a way that may promote gambling disorder. Research indicates that reward uncertainty sensitizes sign-tracking responses and favors the development of a sign-tracker phenotype, compatible with the conditioned attractiveness of lights and sounds in casinos for problem gamblers. The study of attentional biases in humans (an effect akin to sign-tracking in animals) leads to similar observations, notably that the propensity to develop attraction for conditioned stimuli (CSs) is predictive of addictive behavior. Here we review the literature on drug addiction and gambling disorder, highlighting the similarities between studies of sign-tracking and attentional biases.

Inhibitory control and problematic Internet-pornography use - The important balancing role of the insula

BACKGROUND AND AIMS

Diminished control over a specific behavior is a core characteristic in addictive behaviors such as problematic Internet-pornography (IP) use. First studies suggest that a hyperactivity of the impulsive system is one reason for impulsive behaviors in the context of problematic IP use. The tripartite-process theory of addiction explains neurocognitive mechanisms beyond common dual-process theories in addictive behaviors. However, the role of the reflective and interoceptive system is still unresolved.

METHODS

The study comprised a stop-signal task (SST) including neutral and pornographic images during fMRI and questionnaires to investigate associations between symptoms of problematic IP use, craving, and neural activity of the impulsive, reflective, and interoceptive system. We examined 28 heterosexual males with varying symptom severity of problematic IP use.

RESULTS

Data indicates that individuals with more symptoms of problematic IP use showed better performance in the SST which was linked to decreased insula and inferior frontal gyrus activity during pornographic image processing. An increase in craving was associated with lower activity of the ventral striatum during pornographic image processing. The interoceptive system showed varying effects. Increased insula activity during inhibitory control and decreased activity during pornographic image processing were associated with higher inhibitory control performance.

DISCUSSION AND CONCLUSION

Effects of tolerance and motivational aspects may explain the better inhibitory control performance in individuals with higher symptom severity which was associated with differential activity of the interoceptive and reflective system. Diminished control over IP use presumably results from the interaction between the impulsive, reflective, and interoceptive systems.

Automatic detection advantage of problematic Internet users for Wi-Fi signal cues and the moderating effect of negative affect: An event-related potential study

Cognitive bias toward Internet-related cues is an important factor of the formation and maintenance of the addictive behavior of problematic Internet users (PIUs). The development of fiber-optic communication and smartphones has ushered human society into the era of wireless networks. The Wi-Fi signal, the symbol of wireless network connection, represents not only network access but also a channel for communication with others anywhere at any time. Therefore, the Wi-Fi signal cues should be an effective inducer of the addictive behaviors of PIUs. We used images of Wi-Fi signal as Internet-related cues to explore the automatic detection advantage of PIUs for these cues and to determine whether negative affect, another predisposing factor for addiction, can enhance this advantage. We utilized an intergroup design in this study. The PIU and control groups each comprised 30 participants and were randomly assigned to negative or neutral affect priming group. Mismatch negativity (MMN) was induced through the deviant-standard reverse oddball paradigm. Wi-Fi signal cues and neutral cues were used as standard and deviant stimuli, respectively. Results show that the MMN induced by Wi-Fi signal cues in the PIU group was larger than that in the control group. Meanwhile, the MMN induced by Wi-Fi signal cues was considerably enhanced in the PIU group under negative affect priming relative to that in the PIU group under neutral affect priming. Overall, PIUs have an automatic detection advantage for Wi-Fi signal cues, and negative affect can enhance this advantage. Our results suggest that the MMN elicited by Wi-Fi signal cues function as a sensitive neurobiological marker tracing the change of addiction motivation for PIUs.

Video Game Addiction and Emotional States: Possible Confusion Between Pleasure and Happiness?

Internet gaming disorder is characterized by a severely reduced control over gaming, resulting in an increasing gaming time and leading to negative consequences in many aspects of the individual life: personal, family, social, occupational and other relevant areas of functioning (World Health Organization). In the last years, the significant boom in using video games has been raising health issues that remain insufficiently understood. The extent of this phenomenon (the estimated prevalence is between 1.7 and 10% of the general population) has led the mentioned Organization to include gaming disorders in the list of mental health conditions (2018). Several studies show converging findings that highlight the common brain activities between substance use disorders and behavioral addictions (i.e., gaming disorders). Addiction specialists observed that addict subjects tend to confuse pleasure with happiness when linking emotional states to their addictive activities. As far as we know, beyond the mentioned observations, distinguishing the perception of these two emotional states in the frame of an addiction has not been yet the object of formal research. This study aims at examining the possible confusion between pleasure and happiness within the addiction sphere. Video game addiction has been chosen to explore the possible occurrence of this perceptional distortion. A mixed design lab-based study was carried out to compare between video games addicts and non-addicts (between-subjects), and video games-related activities and neutral activities (within-subject). Emotional reactions were gauged by self-reported scales and physiological data acquired through a range of biosensors: Relaxation and Hearth Rate. From a therapeutic standpoint, this research intends to explore alternatives to deal with this sort of disorders. More specifically, at the cognitive level, the idea is elaborating guidelines to develop patients' insights into these emotional states and thus increasing their ability to handle them. Overall, several indices resulting from this study constitute a bundle of arguments that argue in favor of the confusion between pleasure and happiness made by addict users when associating their affective states to video gaming. Furthermore, this approach illustrates how reappraising emotions may contribute to reducing the perceptional distortion of these emotional states.

A Scoping Review of Cognitive Bias in Internet Addiction and Internet Gaming Disorders

Internet addiction and Internet gaming disorders are increasingly prevalent. Whilst there has been much focus on the use of conventional psychological approaches in the treatment of individuals with these addictive disorders, there has also been ongoing research exploring the potential of cognitive bias modification amongst individuals with Internet and gaming addiction. Some studies have documented the presence of cognitive biases and the effectiveness of bias modification for Internet addiction and gaming disorders. However, there have not been any reviews that have synthesized the findings related to cognitive biases for Internet addiction and Internet gaming disorders. It is important for us to undertake a scoping review as an attempt to map out the literature for cognitive biases in Internet addiction and gaming disorders. A scoping review was undertaken, and articles were identified using a search through the following databases: PubMed, MEDLINE, and PsycINFO. Six articles were identified. There were differences in the methods of ascertaining whether an individual has an underlying Internet or gaming addiction, as several different instruments have been used. With regards to the characteristics of the cognitive bias assessment task utilized, the most common task used was that of the Stroop task. Of the six identified studies, five have provided evidence documenting the presence of cognitive biases in these disorders. Only one study has examined cognitive bias modification and provided support for its effectiveness. Whilst several studies have provided preliminary findings documenting the presence of cognitive biases in these disorders, there remains a need for further research evaluating the effectiveness of bias modification, as well as the standardization of the diagnostic tools and the task paradigms used in the assessment.

Attentional bias in Internet users with problematic use of social networking sites

BACKGROUND AND AIMS

Evidence from the field of addictive disorders suggests that attentional bias for stimuli related to a substance or activity of abuse (e.g., gambling) exacerbates the addictive behavior. However, evidence regarding attentional bias in PIU is sparse. This study aims to investigate whether individuals who express problematic tendencies toward social networking sites (SNS), a subtype of PIU, show attentional bias for stimuli associated with social media.

METHODS

Sixty-five participants performed Visual Dot-Probe and Pleasantness Rating Tasks containing SNS-related and matched control images during eye movements were recorded, providing a direct measure of attention. Participants were assessed on their levels of SNS Internet use (ranging from problematic to non-problematic) and their levels of urges to be online (high vs. low).

RESULTS

Problematic SNS users and, in particular, a subgroup expressing higher levels of urges to be online showed an attentional bias for SNS-related images compared to control images.

CONCLUSION

These results suggest that attentional bias is a common mechanism associated with problematic Internet use as well as other addictive disorders.

Meta-analyses of the functional neural alterations in subjects with Internet gaming disorder: Similarities and differences across different paradigms

Internet gaming disorder (IGD) has become a global public health concern due to its increasing prevalence and potential negative consequences. Researchers have sought to identify which brain regions are associated with this disorder. However, inconsistent results have been reported among studies due to the heterogeneity of paradigms and subjects. The present research aimed to combine the results of individual studies to provide a more coherent and powerful explanation. By selecting 40 studies utilizing a qualified whole-brain analysis, we performed a comprehensive series of meta-analyses that employed seed-based d mapping. We divided the existing experimental paradigms into 3 categories: game-related cue-reactivity, executive control, and risk-reward-related decision-making tasks. We divided all studies into three subgroups according to their paradigms. In cue-reactivity tasks, patients with IGD exhibited significant hyperactivation in the bilateral precuneus and bilateral cingulate and significant hypoactivation in the insula, but there were no differences in the striatum. In executive control tasks, patients with IGD displayed significant hyperactivation in the right superior temporal gyrus, bilateral precuneus, bilateral cingulate, and insula and hypoactivation in the left inferior frontal gyrus. In risky decision-making paradigms, IGD patients exhibited significant hyperactivation in the left striatum, right inferior frontal gyrus, and insula and hypoactivation in the left superior frontal gyrus, left inferior frontal gyrus, and right precentral gyrus. Our study aimed to discover the similarities among all studies and to explore the uniqueness of the different paradigms. This study further confirmed the critical role of reward circuitry and executive control circuitry in IGD but not under all conditions.

Automatic detection advantage of problematic Internet users for Wi-Fi signal cues and the moderating effect of negative affect: An event-related potential study

Cognitive bias toward Internet-related cues is an important factor of the formation and maintenance of the addictive behavior of problematic Internet users (PIUs). The development of fiber-optic communication and smartphones has ushered human society into the era of wireless networks. The Wi-Fi signal, the symbol of wireless network connection, represents not only network access but also a channel for communication with others anywhere at any time. Therefore, the Wi-Fi signal cues should be an effective inducer of the addictive behaviors of PIUs. We used images of Wi-Fi signal as Internet-related cues to explore the automatic detection advantage of PIUs for these cues and to determine whether negative affect, another predisposing factor for addiction, can enhance this advantage. We utilized an intergroup design in this study. The PIU and control groups each comprised 30 participants and were randomly assigned to negative or neutral affect priming group. Mismatch negativity (MMN) was induced through the deviant-standard reverse oddball paradigm. Wi-Fi signal cues and neutral cues were used as standard and deviant stimuli, respectively. Results show that the MMN induced by Wi-Fi signal cues in the PIU group was larger than that in the control group. Meanwhile, the MMN induced by Wi-Fi signal cues was considerably enhanced in the PIU group under negative affect priming relative to that in the PIU group under neutral affect priming. Overall, PIUs have an automatic detection advantage for Wi-Fi signal cues, and negative affect can enhance this advantage. Our results suggest that the MMN elicited by Wi-Fi signal cues function as a sensitive neurobiological marker tracing the change of addiction motivation for PIUs.

Attenuated brain activity during error processing and punishment anticipation in procrastination - a monetary Go/No-go fMRI study

Procrastination is a self-regulatory failure in which people voluntarily but irrationally delay important tasks. Trait procrastination is estimated to affect 15-20% of the total population and leads to a significant decrease in performance, satisfaction with achievements, and quality of life. Procrastination is related to impulsivity and reduced executive control, especially in the domain of inhibition. Moreover, procrastinatory tendencies seem to increase with negative affect, suggesting impaired emotion regulation. The aim of this study was to investigate the neuronal mechanisms of inhibition, error processing, and behavioral control under pressure of punishment in procrastinators. Non-student subjects recruited to low (LP) and high procrastination (HP) groups performed an fMRI monetary Go/No-go task. HP showed significantly lower error-related activity in ACC than LP. There was also a significant group by condition interaction in the ACC and right DLPFC suggesting increase of control during the punishment condition in LP but not HP group. These results suggest that procrastinators have impaired error processing mechanisms which may add to the persistence of procrastination through difficulties in correction of faulty behaviors. Procrastination also seems to be related to a decreased ability to intensify self-control in more demanding situations and/or impaired coping in the context of negative situations.

Increased motor impulsivity in a rat gambling task during chronic ropinirole treatment: potentiation by win-paired audiovisual cues

RATIONALE

Chronic administration of D_2/3 receptor agonists ropinirole or pramipexole can increase the choice of uncertain rewards in rats, theoretically approximating iatrogenic gambling disorder (iGD).

OBJECTIVES

We aimed to assess the effect of chronic ropinirole in animal models that attempt to capture critical aspects of commercial gambling, including the risk of losing rather than failing to gain, and the use of win-paired sensory stimuli heavily featured in electronic gambling machines (EGMs).

METHODS

Male Long-Evans rats learned the rat gambling task (rGT; n = 24), in which animals sample between four options that differ in the magnitude and probability of rewards and time-out punishments. In the cued rGT (n = 40), reward-concurrent audiovisual cues were added that scaled in complexity with win size. Rats were then implanted with an osmotic pump delivering ropinirole (5 mg/kg/day) or saline for 28 days.

RESULTS

Chronic ropinirole did not unequivocally increase preference for more uncertain outcomes in either the cued or uncued rGT. Ropinirole transiently increased premature responses, a measure of motor impulsivity, and this change was larger and more long-lasting in the cued task.

CONCLUSIONS

These data suggest that explicitly signaling loss prevents the increase in preference for uncertain rewards caused by D_2/3 receptor agonists observed previously. The ability of win-paired cues to amplify ropinirole-induced increases in motor impulsivity may explain why compulsive use of EGMs is particularly common in iGD. These data offer valuable insight into the cognitive-behavioral mechanisms through which chronic dopamine agonist treatments may induce iGD and related impulse control disorders.

Cued for risk: Evidence for an incentive sensitization framework to explain the interplay between stress and anxiety, substance abuse, and reward uncertainty in disordered gambling behavior

Gambling disorder is an impairing condition confounded by psychiatric co-morbidity, particularly with substance use and anxiety disorders. Yet, our knowledge of the mechanisms that cause these disorders to coalesce remains limited. The Incentive Sensitization Theory suggests that sensitization of neural "wanting" pathways, which attribute incentive salience to rewards and their cues, is responsible for the excessive desire for drugs and cue-triggered craving. The resulting hyper-reactivity of the "wanting' system is believed to heavily influence compulsive drug use and relapse. Notably, evidence for sensitization of the mesolimbic dopamine pathway has been seen across gambling and substance use, as well as anxiety and stress-related pathology, with stress playing a major role in relapse. Together, this evidence highlights a phenomenon known as cross-sensitization, whereby sensitization to stress, drugs, or gambling behaviors enhance the sensitivity and dopaminergic response to any of those stimuli. Here, we review the literature on how cue attraction and reward uncertainty may underlie gambling pathology, and examine how this framework may advance our understanding of co-mordidity with substance-use disorders (e.g., alcohol, nicotine) and anxiety disorders. We argue that reward uncertainty, as seen in slot machines and games of chance, increases dopaminergic activity in the mesolimbic pathway and enhances the incentive value of reward cues. We propose that incentive sensitization by reward uncertainty may interact with and predispose individuals to drug abuse and stress, creating a mechanism through which co-mordidity of these disorders may emerge.

Changes over time in Lithuanian schoolchildren's attitudes toward addictive behaviors: Promoting and preventing factors

Background

Concern is growing about the high prevalence of traditional and new forms of addictive behaviors among young people due to the health risks and a better understanding of the factors causing these behaviors is needed.

Aim

To evaluate tendencies in the attitudes of Lithuanian schoolchildren toward addictive behaviors over a three year period and to ascertain the promoting and preventing factors of such behaviors.

Methods

The researchers developed a survey which was conducted twice over a three year period. The sample consisted of pupils in the 5^th, 9^th and 12^th grades (N = 1590, age range 11–19 years) from both urban and rural areas.

Results

Both the recognition of and involvement in addictive behaviors significantly increased with age. Motivation to abstain due to internal factors decreased with age and increased among pupils already involved in addictive behaviors. Time- and age-related differences were found regarding substance abuse and behavioral addictions. Whilst betting adverts were increasingly noticed over time, smoking adverts were decreasingly noticed over the three year period and it was concomitant with inconsistent changes in self-reported involvement in these behaviors.

Conclusions

Most significant changes in the attitudes of Lithuanian pupils toward addictive behaviors occur between the ages of 11 and 15 years. However, age-related changes differ for the pupils’ attitudes toward substance abuse and behavioral addictions. Increasing awareness of the potential risk of addictive behaviors does not prevent their increasing prevalence with age. Increased risk of involvement in addictive behavior correlates with decreased internal motivation to abstain from addictive behavior and decreased recognition of its potential risks. No clear correlation was found between significant changes in noticing adverts and involvement in addictive behaviors.

Group independent component analysis reveals alternation of right executive control network in Internet gaming disorder

OBJECTIVE

Previous studies have demonstrated that individuals with Internet gaming disorder (IGD) showed attentional bias toward gaming-related cues and exhibited impaired executive functions. The purpose of this study was to explore the alternations in related functional brain networks underlying attentional bias in IGD subjects.

METHODS

Eighteen IGD subjects and 19 healthy controls (HC) were scanned with functional magnetic resonance imaging while they were performing an addiction Stroop task. Networks of functional connectivity were identified using group independent component analysis (ICA).

RESULTS

ICA identified 4 functional networks that showed differences between the 2 groups, which were related to the right executive control network and visual related networks in our study. Within the right executive control network, in contrast to controls, IGD subjects showed increased functional connectivity in the temporal gyrus and frontal gyrus, and reduced functional connectivity in the posterior cingulate cortex, temporal gyrus, and frontal gyrus.

CONCLUSION

These findings suggest that IGD is related to abnormal functional connectivity of the right executive control network, and may be described as addiction-related abnormally increased cognitive control processing and diminished response inhibition during an addiction Stroop task. The results suggest that IGD subjects show increased susceptibility towards gaming-related cues but weakened strength of inhibitory control.

Component Model of Addiction Treatment: A Pragmatic Transdiagnostic Treatment Model of Behavioral and Substance Addictions

Behavioral addictions such as gambling, video games, sex, and shopping share many clinical features with substance use addictions including etiology, course, and neurobiology. Yet, the treatment of behavioral and substance use addictions tends to be separated. However, we argue that a more effective and efficient treatment approach is to conceptualize behavioral and substance use addictions as different expressions of a common underlying disorder and, in treatment, to address the underlying mechanisms common to both. To this end, the article presents a developing transdiagnostic treatment model of addictions that targets underlying similarities between behavioral and substance use addictions, called the component model of addiction treatment (CMAT). The CMAT is transdiagnostic in that it can be used in the treatment of both behavioral and substance use addictions. It is pragmatic in that it targets component vulnerabilities, which are enduring, yet malleable, individual psychological, cognitive, and neurobiological characteristics that are common to all addictive disorders and have been demonstrated to be modifiable. A working model of CMAT is presented, including proposed component vulnerabilities: lack of motivation, urgency, maladaptive expectancies, deficits in self-control, deficits in social support, and compulsivity, as well as their potential intervention possibilities. Future directions and potential implications of the CMAT are discussed.

Automatic detection advantage of network information among Internet addicts: behavioral and ERP evidence

Converging evidence has proved the attentional bias of Internet addicts (IAs) on network information. However, previous studies have neither explained how characteristics of network information are detected by IAs with priority nor proved whether this advantage is in line with the unconscious and automatic process. To answer the two questions, this study aims to investigate whether IAs prioritize automatic detection of network information from the behavior and cognitive neuroscience aspects. 15 severe IAs and 15 matching healthy controls were selected using Internet Addiction Test (IAT). Dot-probe task with mask was used in the behavioral experiment, while deviant-standard reverse oddball paradigm was used in the event-related potential (ERP) experiment to induce mismatch negativity (MMN). In the dot-probe task, when the probe location appeared on the Internet-related picture's position, the IAs had significantly shorter reaction time than do the controls; in the ERP experiment, when Internet-related picture appeared, MMN was significantly induced in the IAs relative to the controls. Both experiments show that IAs can automatically detect network information.

Problematic Video Gaming in a Young Spanish Population: Association with Psychosocial Health

Problematic video gaming (PVG) is a concern for psychologists attending children and adolescents. Uniform diagnostic criteria are lacking, and risk factors are poorly understood. Internet gaming disorder (IGD) was included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and scales derived from its diagnostic criteria may be helpful to assess PVG. A multicenter study was conducted in secondary schools using an IGD-derived scale (dichotomous Nine-Item Internet Gaming Disorder Scale [IGD-9]), analyzing PVG-related variables. Seven hundred eight students (55.8 percent male) with mean age 15.6 ± 2.7 years were included. Seventy-three percent were gamers and 22 percent heavy gamers (HGs). Forty-five percent reported online gaming and 6.6 percent massive multiplayer online role-playing games (MMORPGs). Fifty-nine students (8.3 percent) scored 5 or more in IGD-9 and were classified as IGD+. HG and IGD+ subjects were more frequently male and online and MMORPG gamers (p < 0.01). However, IGD+ subjects had significantly worse psychosocial scores than IGD- (p < 0.001), while HGs did not significantly differ from casual gamers (p > 0.01). The multivariate analysis showed that IGD+ scores were significantly associated with worse psychosocial health and adjustment (p < 0.001), while the other variables (male sex, online and MMORPG gaming, and HG) were not significantly associated (p > 0.01). The IGD-9 scale scored positive in 8.3 percent of our sample. Unlike gaming time, this scale was associated with psychosocial disturbances, making it potentially useful as a screening method to detect candidates for clinical intervention.

Internet and Video Game Addictions: Diagnosis, Epidemiology, and Neurobiology

In the past 2 decades, there has been substantial increase in availability and use of digital technologies, including the Internet, computer games, smart phones, and social media. Behavioral addiction to use of technologies spawned a body of related research. The recent inclusion of Internet gaming disorder as a condition for further study in the DSM-V invigorated a new wave of researchers, thereby expanding our understanding of these conditions. This article reviews current research, theory, and practice regarding the diagnosis, epidemiology, and neurobiology of Internet and video game addictions.

Trait and state impulsivity in males with tendency towards Internet-pornography-use disorder

INTRODUCTION

Impulsivity has been identified to be involved in the development and maintenance of specific Internet-use disorders (IUD). It can be differentiated between relatively stable trait impulsivity and state impulsivity which is dependent on environmental and affective factors such as craving. Following the I-PACE (Interaction of Person-Affect-Cognition-Execution) model, both trait and state impulsivity may play an interactive role in IUD. The present study aimed to investigate the relationship between trait and state impulsivity and symptom severity of Internet-pornography-use disorder (IPD) as one form of IUD.

METHODS

Fifty heterosexual males participated in this study. State impulsivity was measured with reaction times in a modified stop-signal task. Each participant conducted two blocks of this task which included neutral and pornographic pictures. Moreover, current subjective craving, trait impulsivity, and symptom severity of IPD were assessed using several questionnaires.

RESULTS

Results indicate that trait impulsivity was associated with higher symptom severity of IPD. Especially those males with higher trait impulsivity and state impulsivity in the pornographic condition of the stop-signal task as well as those with high craving reactions showed severe symptoms of IPD.

CONCLUSION

The results indicate that both trait and state impulsivity play a crucial role in the development of IPD. In accordance with dual-process models of addiction, the results may be indicative of an imbalance between the impulsive and reflective systems which might be triggered by pornographic material. This may result in loss of control over the Internet-pornography use albeit experiencing negative consequences.

Development and Validation of Videogame Addiction Scale for Children (VASC)

The aim of the present study was to develop a valid and reliable Videogame Addiction Scale for Children (VASC). The data were derived from 780 children who completed the Videogame Addiction Scale (405 girls and 375 boys; 48.1% ranging in age from 9 to 12 years). The sample was randomly split into two different sub-samples (sample 1, n = 400; sample 2, n = 380). Sample 1 was used to perform exploratory factor analysis (EFA) to define the factorial structure of VASC. As a result of EFA, a four-factor structure comprising 21 items was obtained and explained 55% of the total variance (the four factors being “self-control,” “reward/reinforcement,” “problems,” and “involvement”). The internal consistency reliability of VASC has found 0.89. Confirmatory factor analysis (CFA) was performed to confirm the factorial structure obtained by EFA in the remaining half of sample (n = 390). The obtained fit indices from the CFA confirmed the structure of the EFA. The 21-item VASC has good psychometric properties that can be used among Turkish schoolchildren populations.

Using two web-based addiction Stroops to measure the attentional bias in adults with Internet Gaming Disorder

Background and aims People with substance abuse and pathological gamblers show an attentional bias. In a laboratory setting, we found an attentional bias using an addiction Stroop in adults with Internet Gaming Disorder (IGD). We aimed at investigating this effect using two web-based experiments. Methods Study 1: Gamers with IGD, casual gamers, and non-gamers (N = 81, 28.1 ± 7.8 years) completed a web-based addiction Stroop with a fully randomized word order. They saw computer-related and neutral words in four colors and indicated the word color via keypress. Study 2: Gamers with IGD, casual gamers, and non-gamers (N = 87, 23.4 ± 5.1 years) completed a web-based addiction Stroop and a classical Stroop (incongruent color and neutral words), which both had a block design. We expected that in both studies, only the gamers with IGD would react more slowly to computer-related words in the addiction Stroop. All groups were expected to react more slowly to incongruent color words in the classical Stroop. Results In neither study did the gamers with IGD differ in their reaction times to computer-related words compared to neutral words. In Study 2, all groups reacted more slowly to incongruent color words than to neutral words confirming the validity of the online reaction time assessment. Discussion Gamers with IGD did not show a significant attentional bias. IGD may differ from substance abuse and pathological gambling in this respect; alternatively experimenting on the Internet may have introduced error variance that made it harder to detect a bias.

Cue-induced craving for Internet among Internet addicts

Intense craving is a core feature of addictive disorder, and cue-induced craving is believed to be a key factor in the maintenance and relapse of addictive behaviors. With the rapid development of the Internet, Internet addiction has become a widespread behavioral problem accompanied by many negative effects. This study used the cue-reactivity paradigm to examine cue-induced craving for the Internet among Internet addicts and non-addicts. Participants were exposed to Internet-related words, and asked to report their craving for the Internet. Results indicated that Internet-related words aroused cue-induced craving for the Internet among both Internet addicts and non-addicts; however, the craving was more intense among Internet addicts. These results suggest that craving may not be a unipolar, all or none state found only in addicts, but may also be present among non-addicts. They indicate that Internet-related words may be able to induce craving for the Internet, and that Internet addiction and other addictions may share similar underlying mechanisms. This finding has important implications for designing interventions for Internet addiction.

Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) model

Within the last two decades, many studies have addressed the clinical phenomenon of Internet-use disorders, with a particular focus on Internet-gaming disorder. Based on previous theoretical considerations and empirical findings, we suggest an Interaction of Person-Affect-Cognition-Execution (I-PACE) model of specific Internet-use disorders. The I-PACE model is a theoretical framework for the processes underlying the development and maintenance of an addictive use of certain Internet applications or sites promoting gaming, gambling, pornography viewing, shopping, or communication. The model is composed as a process model. Specific Internet-use disorders are considered to be the consequence of interactions between predisposing factors, such as neurobiological and psychological constitutions, moderators, such as coping styles and Internet-related cognitive biases, and mediators, such as affective and cognitive responses to situational triggers in combination with reduced executive functioning. Conditioning processes may strengthen these associations within an addiction process. Although the hypotheses regarding the mechanisms underlying the development and maintenance of specific Internet-use disorders, summarized in the I-PACE model, must be further tested empirically, implications for treatment interventions are suggested.

Attentional biases in problem and non-problem gamblers

BACKGROUND

From a cognitive perspective, attentional biases are deemed as factors responsible in the onset and development of gambling disorder. However, knowledge relating to attentional processes in gambling is scarce and studies to date have reported contrasting results. Moreover, no study has ever examined which component and what type of bias are involved in attentional bias in gambling.

METHODS

In the present study, 108 Italian participants, equally divided into problem and non-problem gamblers, were administered a modified Posner Task, an attentional paradigm in which - through the manipulation of stimuli presentation time - it is possible to measure both initial orienting and maintenance of attention. In addition to the experimental task, participants completed self-report measures involving (i) craving (Gambling Craving Scale), (ii) depression, anxiety and stress (Depression Anxiety Stress Scale) and (iii) emotional dysregulation (Difficulties in Emotion Regulation Scale).

RESULTS

Analyses revealed facilitation in detecting gambling-related stimuli at the encoding level in problem gamblers but not in non-problem gamblers. Compared to non-problem gamblers, problem gamblers also reported higher levels of craving, emotional dysregulation, and negative mood states. Furthermore, all measures correlated with the gambling severity.

LIMITATIONS

The use of indirect measure of attentional bias could be less accurate compared to direct measures.

CONCLUSIONS

The facilitation in detecting gambling-related stimuli in problem gamblers and the correlation between subjective craving and facilitation bias suggests that attentional bias could not be due to a conditioning process but that motivational factors such as craving could induce addicted-related seeking-behaviors.