A ‘components’ model of addiction within a biopsychosocial framework

The Assessment of Problematic Internet Pornography Use: A Comparison of Three Scales with Mixed Methods

The primary aim of this study was to compare different screening tools for problematic internet pornography use (IPU) and identify the most accurate measure. The reliability and validity of three scales, namely, the Problematic Pornography Consumption Scale (PPCS), Problematic Pornography Use Scale (PPUS), and Short Internet Addiction Test Adapted to Online Sexual Activities(s-IAT-sex), were examined using three homogeneous groups, respectively. A total of 972 adults (mean age = 24.8) from 28 provinces/regions in China participated in the quantitative part (QUAN). The Brief Pornography Screener served as the reference standard. The PPCS demonstrated stronger reliability and validity, including criterion validity, as well as greater sensitivity and acceptable specificity; therefore, it was considered to be the more accurate screening instrument. In the qualitative part (QUAL), we interviewed 22 volunteers and 11 therapists (who had worked with individuals with problematic IPU) to examine their perspectives on the core features of problematic IPU and dimensions of the PPCS. Almost all the interviewees endorsed the structure of the PPCS. These findings encourage the use of the PPCS in future research studies and underscore its screening applications because of its ability to classify IPU as problematic or nonproblematic.

Does Smartphone Addiction Fall on a Continuum of Addictive Behaviors?

Due to the high accessibility and mobility of smartphones, widespread and pervasive smartphone use has become the social norm, exposing users to various health and other risk factors. There is, however, a debate on whether addiction to smartphone use is a valid behavioral addiction that is distinct from similar conditions, such as Internet and gaming addiction. The goal of this review is to gather and integrate up-to-date research on measures of smartphone addiction (SA) and problematic smartphone use (PSU) to better understand (a) if they are distinct from other addictions that merely use the smartphone as a medium, and (b) how the disorder(s) may fall on a continuum of addictive behaviors that at some point could be considered an addiction. A systematic literature search adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was conducted to find all relevant articles on SA and PSU published between 2017 and 2019. A total of 108 articles were included in the current review. Most studies neither distinguished SA from other technological addictions nor clarified whether SA was an addiction to the actual smartphone device or to the features that the device offers. Most studies also did not directly base their research on a theory to explain the etiologic origins or causal pathways of SA and its associations. Suggestions are made regarding how to address SA as an emerging behavioral addiction.

Design and Measurement Properties of the Online Gambling Disorder Questionnaire (OGD-Q) in Spanish Adolescents

Gambling disorder is of great clinical and social relevance since it seriously affects people who suffer from it. More recently, the Internet has exacerbated the problem with online casinos, poker, and sports betting. However, there is little evidence of this problem, and we know of no diagnostic questionnaire. The main objectives of this study were to develop the Online Gambling Disorder Questionnaire (OGD-Q) for adolescents, evaluate its main psychometric properties, and establish diagnostic criteria to differentiate pathological from non-pathological online gamblers. We conducted a study in 16 schools across seven regions of Spain, sampling 2691 adolescents, 883 of whom had reported some online gambling experience. Of those, 602 were boys (68.2%) and 281 were girls (31.8%) Sampling was non-probabilistic and incidental. Mean age and standard deviation were 14.25 ± 1.55 (11-19 years). Confirmatory factor analysis yielded a one-dimensional model with a good fit. The reliability indicators were satisfactory (>0.94). The scores on the OGD-Q were related to other constructs, such as Internet gaming disorder, problematic Internet use, and nomophobia. Participants classified as having problems or being at risk of online gambling disorder presented significantly more stress, anxiety, and depression. Participants categorized as having online gambling disorder comprised 0.89% (n = 24) of the total sample and 2.71% of those who have gambled at some time. We discuss these findings and their practical implications in this article and propose future lines of research.

An Analysis of Problematic Media Use and Technology Use Addiction Scales – What Are They Actually Assessing?

Increasingly, research attention is being afforded to various forms of problematic media use. Despite ongoing conceptual, theoretical, and empirical debates, a large number of retrospective self-report scales have been produced to ostensibly measure various classes of such behaviour. These scales are typically based on a variety of theoretical and diagnostic frameworks. Given current conceptual ambiguities, building on previous studies, we evaluated the dimensional structure of 50 scales targeting the assessment of supposedly problematic behaviours in relation to four technologies: Internet, smartphones, video games, and social network sites. We find that two dimensions (‘compulsive use’ and ‘negative outcomes’) account for over 50% of all scale-items analysed. With a median of five dimensions, on average, scales have considered fewer dimensions than various proposed diagnostic criteria and models. No relationships were found between the number of items in a scale and the number of dimensions, or the technology category and the dimensional structure. The findings indicate, firstly, that a majority of scales place an inordinate emphasis on some dimensions over others and, secondly, that despite differences in the items presented, at a dimensional level, there exists a high degree of similarity between scales. These findings highlight shortcomings in existing scales and underscore the need to develop more sophisticated conceptions and empirical tools to understand possible problematic interactions with various digital technologies.

Self-Reported Screen Time on Social Networking Sites Associated With Problematic Smartphone Use in Chinese Adults: A Population-Based Study

Background: Problematic smartphone use (PSU) has been associated with screen time in general, but little is known about the effect of different screen-based activities. We examined the associations of self-reported time spent on overall and specific screen-based activities with PSU and its addictive symptoms in Hong Kong Chinese adults. Methods: We analyzed data from 562 smartphone owners (56.5% female; 82.1% aged 25-64 years) in a population-based telephone survey in 2017. PSU was measured using Smartphone Addiction Scale-Short Version (range 10-60) which includes symptoms of daily-life disturbance, withdrawal, cyberspace-oriented relationship, overuse, and tolerance. Screen time was self-reported as average hours per day spent on the internet, online book/newspaper/magazine, online video, and social networking sites (SNS). Multivariable linear regression analyzed the associations of self-reported screen time with PSU severity and symptoms. Interaction effects of sex, age group, educational attainment, and monthly household income were examined. Results: Self-reported time spent on overall screen-based activities was associated with PSU severity (β = 1.35, 95% CI 0.15, 2.55) and withdrawal and overuse symptoms, after adjusting for sociodemographic and health-related variables. Independent association was observed for self-reported SNS time with PSU severity (β = 1.42, 95% CI 0.35, 2.49) and symptoms of withdrawal and cyberspace-oriented relationship, after mutually adjusting for time on other activities. The strongest association between self-reported SNS time and PSU severity was observed in younger than older adults (β = 4.36, 95% CI 2.58, 6.13; P for interaction = 0.004). Conclusions: The independent association of self-reported SNS time with PSU and core addictive symptoms highlighted the addiction potential of SNS use, particularly in younger users.

Prevalence of Internet Gaming Disorder and Its Association With Personality Traits and Gaming Characteristics Among Chinese Adolescent Gamers

Background: Internet gaming is extremely popular in China. However, some players overuse it, with negative outcomes. Knowing the prevalence rate and specific risk factors can provide a better understanding of the etiology of Internet Gaming Disorder (IGD). This study aimed to estimate the prevalence of IGD among Chinese adolescents and its association with their personality traits and Internet gaming characteristics. Methods: A cross-sectional study design was utilized in this study. Participants were recruited from 34 provincial administrative districts in China and consisted of 6,379 adolescent game players aged 15-25 (males/females = 3,701/2,678, mean age: 19.35 ± 1.61). A self-report structured questionnaire containing questions regarding demographic information and Internet gaming use characteristics, the Video Gaming Dependency Scale, and the Chinese Big Five Inventory-brief version, was used in the study. Results: The prevalence of IGD among Chinese adolescent game players was 17.0%. All participants were divided into the IGD group (males/females = 751/333, mean age: 19.74 ± 1.85) or the non-IGD group (males/females = 2,950/2,345, mean age: 19.27 ± 1.54). Specifically, twelve factors were significantly associated with IGD (p < 0.001), including neuroticism (β = 0.17), conscientiousness (β = -0.14), Internet gaming time per day (Hour) (β = 0.21), Internet gaming charge per month (Yuan) (β = 0.21), motive: escaping (β = 0.15), motive: sensation seeking (β = 0.13), motive: maintaining (β = 0.08), motive: coping (β = 0.06), having one or two long-term game partners (β = 0.06), male (β = 0.12), undergraduate and above (β = 0.04), and relationship status of couple (β = 0.04). Conclusion: Our findings offer evidence with respect to the prevalence of IGD and its relationships with specific personality traits and Internet gaming characteristics in China. It is necessary for Chinese parents, teachers, and social workers to pay more attention to adolescents' personality traits of high neuroticism and low conscientiousness, long time and high expense they spend on game, as well as their motives.

The Therapeutic Community: A Unique Social Psychological Approach to the Treatment of Addictions and Related Disorders

The evolution of the contemporary Therapeutic Community (TC) for addictions over the past 50 years may be characterized as a movement from the marginal to the mainstream of substance abuse treatment and human services. TCs currently serve a wide array of clients and their diverse problems; through advances in research in treatment outcomes, the composition of staff has been reshaped, the duration of residential treatment has been reduced, the treatment goals have been reset and, to a considerable extent, the approach of therapy itself has been modified. An overview of the TC as a distinct social-psychological method for treating addiction and related disorders is provided by this paper. Included in this is a focus on the multifaceted psychological wounds that consistently show a strong association with addiction and thereby require initiating a recovery process characterized by life-style and identity changes.

Latent profiles of family background, personality and mental health factors and their association with behavioural addictions and substance use disorders in young Swiss men

Background:

Recent theories suggest that behavioural addictions and substance use disorders may be the result of the same underlying vulnerability. The present study investigates profiles of family background, personality and mental health factors and their associations with seven behavioural addictions (to the internet, gaming, smartphones, internet sex, gambling, exercise and work) and three substance use disorder scales (for alcohol, cannabis and tobacco).

Methods:

The sample consisted of 5287 young Swiss men (mean age = 25.42) from the Cohort Study on Substance Use Risk Factors (C-SURF). A latent profile analysis was performed on family background, personality and mental health factors. The derived profiles were compared with regards to means and prevalence rates of the behavioural addiction and substance use disorder scales.

Results:

Seven latent profiles were identified, ranging from profiles with a positive family background, favourable personality patterns and low values on mental health scales to profiles with a negative family background, unfavourable personality pattern and high values on mental health scales. Addiction scale means, corresponding prevalence rates and the number of concurrent addictions were highest in profiles with high values on mental health scales and a personality pattern dominated by neuroticism. Overall, behavioural addictions and substance use disorders showed similar patterns across latent profiles.

Conclusion:

Patterns of family background, personality and mental health factors were associated with different levels of vulnerability to addictions. Behavioural addictions and substance use disorders may thus be the result of the same underlying vulnerabilities.

Facebook addiction and personality

This study explored the associations between Facebook addiction and personality factors. A total of 114 participants (age range of participants is 18-30 and males were 68.4% and females were 31.6 %) have participated through an online survey. The results showed that 14.91 % of the participants had reached the critical polythetic cutoff score, and 1.75 % has reached the monothetic cutoff score. The personality traits, such as extraversion, openness to experience, neuroticism, agreeableness, conscientiousness, and narcissism, are not related to Facebook addiction and Facebook intensity. Loneliness was positively related to Facebook addiction, and it significantly predicted Facebook addiction by accounting to 14% of the variation in Facebook addiction. The limitations and suggestions for further research have been discussed.

“A Cancer in the Minds of Youth?” A Qualitative Study of Problematic Smartphone Use among Undergraduate Students

There is empirical evidence to suggest that problematic smartphone use (PSU) is associated with mental health problems including anxiety in educational settings. This qualitative study explored attitudes towards—and self-reported impacts of—smartphone use among British young adult students, as well as perceived causes of PSU. Free-response written accounts were gathered from 265 British undergraduates at an English university. Open-ended questions were asked about their attitudes towards smartphone use, their reasons for using their smartphones, and what they perceived as the consequences of their smartphone use. Narratives were analyzed using framework analysis and a thematic framework was identified. The three main consequences of PSU described by participants were (1) uncontrolled frequent checking of smartphones, (2) using smartphones late at night, and irrelevant use of smartphones in class. The main reported explanations for PSU were fear of missing messages, boredom in class, poor self-regulation, and external reasons (e.g., boring lectures). Smartphone use was reported to have both positive and negative impacts on young adults’ life satisfaction, social relationships, physical health, and study. Many participants reported that they need to develop better self-regulation to address their PSU. Findings suggest that smartphone use can have benefits as well as potentially causing harm among university students. PSU can—in some cases—be understood as reflecting mental well-being issues, poor self-regulation, and social problems.

Do It, Don't Feel It, and Be Invincible: A Prolog of Exercise Addiction in Endurance Sports

The social relevance of endurance sports has increased people's motivation to engage in these particular physical activities, associating their practice with a particular lifestyle (e.g., feeling victorious and a feeling of self-improvement). Therefore, the dark personality traits (not because they are negative but because they are more hidden), understood as a personal and adaptive response to the psychosocial relationships that athletes establish while practicing these sports. Following these arguments, Grit has been used to trace the response of athletes in their quest to improve performance and endurance in the face of common setbacks suffered as a result of long hours of training. Empirical studies should help to discover how these personality traits can pose real challenges to their adaptation, and what the impact of their psychological response may be in a functional or dysfunctional way [e.g., exercise addiction (EA)], in order to classify them as risk or protective factors. Through transversal design, the present study sought to explore the relationship between Grit and Dark Traits of Personality regarding the appearance of EA in a sample (N = 241) of amateur endurance sport athletes (M age = 31.80; SD = 9.87). The results show that men not only score higher for addiction levels but also for narcissism (grandiosity feelings) and psychopathy (coldness) factors. If signs of narcissism and Machiavellianism increase, perseverance efforts grow too, and the likelihood of EA increases considerably. The conclusions drawn on the basis of the results allow us to place consistency of interest as a protective factor for the EA, whereas Dark Traits of personality - especially Machiavellianism - constitute a risk factor.

The Associations between Problematic Social Networking Site Use and Sleep Quality, Attention-Deficit Hyperactivity Disorder, Depression, Anxiety and Stress

Social networking sites (SNSs) are now used by billions of users worldwide and can help facilitate communication and the sharing of information. However, there is evidence that problematic SNS use (PSNSU) can have negative effects on health. The present study examined the associations between PSNSU, sleep quality, attention-deficit/hyperactivity disorder (ADHD), depression, anxiety and stress among SNS users. A total of 638 SNS users (mean age = 32.03 years, SD = 10.08) completed an online survey comprising instruments assessing SNS addiction, sleep quality, ADHD, depression, anxiety and stress. Regression analysis indicated that the factors of age (β = − .24, p < .01), relationship status (i.e., being in a relationship) (β = − .09, p < .05), ADHD (β = .43, p < .01) and anxiety (β = .12, p < .01) explained 23.9% of the variance in problematic SNS use. Bivariate correlations identified moderate positive correlations between PSNSU, poor sleep quality (r = .24, p < .01, R2 = .06), ADHD (r = .47, p < .01, R2 = .22), depression (r = .32, p < .01, R2 = .10), anxiety (r = .38, p < .01, R2 = .14) and stress (r = .34, p < .01, R2 = .12). The study demonstrated that PSNSU was associated with psychopathological and psychiatric disorders symptoms, the findings will help inform future interventions for reducing and tackling PSNSU.

Purpose in life, social support, and internet gaming disorder among Chinese university students: A 1-year follow-up study

AIMS

Given the high prevalence of Internet gaming disorder (IGD) among university students and the beneficial effects of positive psychological factors on mental illness, the present longitudinal research aimed to investigate whether purpose in life and social support yields long-term results in protecting university students from IGD.

METHODS

We recruited 469 Chinese university students to voluntarily fill out an anonymous questionnaire at baseline, and 283 of them were followed up and given similar measures after one year.

RESULTS

The prevalence of probable IGD at the baseline and follow-up surveys was 14.8% and 9.9% respectively. Purpose in life and social support were negatively correlated with IGD symptoms in both surveys (p < .05). The results of a cross-lagged analysis showed that purpose in life, but not social support, assessed at baseline predicted fewer IGD symptoms at follow-up (p < .001). In addition, social support and purpose in life predicted one another across time.

CONCLUSIONS

The prevalence of probable IGD was high among Chinese university students. Purpose in life was shown to be an effective significant protective factor against IGD, while the effect of social support might be indirect. Positive psychology interventions, which promote the search for and attainment life purpose, may be incorporated in school-based program for IGD prevention.

The psychology of "swiping": A cluster analysis of the mobile dating app Tinder

BACKGROUND AND AIMS

The use of the smartphone dating application Tinder is increasingly popular and has received much media attention. However, no empirical study to date has investigated the psychological characteristics driving its adaptive or problematic use. The aim of this study is to determine whether reliable subtypes of users can be identified via a cluster analysis approach.

METHODS

A total of 1,159 Tinder users were recruited. Survey questions investigated user characteristics, including: motives for app use, sexual desire, attachment styles, impulsivity traits, self-esteem, problematic use, depressive mood, and patterns of use.

RESULTS

Four reliable clusters were identified: two with low levels of problematic use ("regulated" and "regulated with low sexual desire"), one with an intermediate level of problematic use ("unregulated-avoidants"), and one with a high level of problematic use ("unregulated-highly motivated"). The clusters differed on gender, marital status, depressive mood, and use patterns.

CONCLUSION

The findings provide insight into the dynamic relationships among key use-related factors and shed light on the mechanisms underlying the self-regulation difficulties that appear to characterize problematic Tinder use.

Smartphone addiction in students: A qualitative examination of the components model of addiction using face-to-face interviews

BACKGROUND AND AIMS

Smartphone use has increased markedly over the past decade and recent research has demonstrated that a small minority of users experience problematic consequences, which in extreme cases have been contextualized as an addiction. To date, most research have been quantitative and survey-based. This study qualitatively examined the components model of addiction for both "addicted" and "non-addicted" users.

METHODS

A screening tool comprising 10 dichotomous items was administered to 40 college students. Of these, six addicted and six non-addicted participants were identified on the basis of their score on the screening tool and were asked to participate in a semi-structured interview. The interview questions were based on the components model of addiction comprising six domains (i.e., salience, withdrawal, conflict, relapse and reinstatement, tolerance, and mood modification). Directed content analysis was used to analyze the transcribed data and subthemes as well as emerging themes for the study as a whole were established.

RESULTS

There was some evidence of demarcation between smartphone addicts on the dimensions of salience, tolerance, withdrawal, and conflict. Mood modification was not much different in either group, and no participant reported relapse.

CONCLUSIONS

The non-addicted group had much greater control over their smartphone usage than the addicted group on four (of six) aforementioned dimensions of behavioral addiction. Consequently, the main findings of this study provided good support for the components model of behavioral addiction.

Digital detox: The effect of smartphone abstinence on mood, anxiety, and craving

Whether behavioural addictions should be conceptualised using a similar framework to substance-related addictions remains a topic of considerable debate. Previous literature has developed criteria, which allows any new behavioural addiction to be considered analogous to substance-related addictions. These imply that abstinence from a related object (e.g., smartphones for heavy smartphone users) would lead to mood fluctuations alongside increased levels of anxiety and craving. In a sample of smartphone users, we measured three variables (mood, anxiety, and craving) on four occasions, which included a 24-hour period of smartphone abstinence. Only craving was affected following a short period of abstinence. The results suggest that heavy smartphone usage does not fulfil the criteria required to be considered an addiction. This may have implications for other behavioural addictions.

Behavioral Addictions: Excessive Gambling, Gaming, Internet, and Smartphone Use Among Children and Adolescents

The introduction of behavioral addictions is a relatively new concept in psychiatry. It was not until 2010 that the term behavioral addictions was added to the official classification of psychiatric diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Gambling, typically thought to be an adult behavior, has become commonplace among adolescents. Although technological advances have made accessing information and communication easier, excessive use of the Internet and smartphones can result in multiple mental and physical health issues. Gambling disorders, gaming disorders, Internet use disorder, and excessive smartphone use often begin during childhood and adolescence.

Relationships between addictive Facebook use, depressiveness, insomnia, and positive mental health in an inpatient sample: A German longitudinal study

BACKGROUND AND AIMS

Individuals with high level of negative mental health often tend to use the social platform Facebook to escape from daily stress. They are at risk to develop an emotional bond to Facebook linked to a need to stay permanently online. The current work investigated addictive use of Facebook and its conceptual framework in clinical context.

METHODS

In a longitudinal study design, duration of daily use of Facebook, addictive Facebook use, depressiveness, insomnia, and positive mental health (PMH) were assessed in a sample of 349 inpatients [M_age (SD_age) = 50.13 (9.41)] of a psychosomatic rehabilitation clinic in Germany over a period of on average 6 weeks.

RESULTS

Regression analyses revealed that duration of daily Facebook use at the first measurement time point (T1) served as significant positive predictor of addictive Facebook use at the second measurement time point (T2). Addictive Facebook use (T1) significantly positively predicted depressiveness and insomnia (T2). Its prediction of PMH (T2) was significantly negative. Mediation analyses showed that PMH (T1) partially mediated the association between addictive Facebook use (T1) and depressiveness (T2), and fully mediated the relationship between addictive Facebook use (T1) and insomnia (T2).

DISCUSSION AND CONCLUSIONS

Current longitudinal results indicate that addictive Facebook use might negatively impact the recovery process of inpatients. Thus, it might be relevant to assess and consider addictive Facebook use in the clinical context. Therapeutic interventions are suggested to focus on the enhancement of inpatients' PMH level, which may buffer the negative effect of problematic Facebook use.

The Digital Addiction Scale for Children: Development and Validation

Researchers worldwide have developed and validated several scales to assess various forms of adults' digital addiction. The urge for some of these scales found support in World Health Organization's inclusion of gaming disorder as a mental health condition in its eleventh revision of the International Classification of Diseases in June 2018. Additionally, several studies have shown that children are starting to use digital devices (DDs) (e.g., tablets and smartphones) at a very young age, including playing video games and engaging in social media. Consequently, the need for early detection of the risk of digital addiction among children is becoming more of a necessity. In the present study, the Digital Addiction Scale for Children (DASC)-a 25-item self-report instrument-was developed and validated to assess the behavior of children 9 to 12 years old in association with DD usage, including video gaming, social media, and texting. The sample comprised 822 participants (54.2 percent males), from grade 4 to grade 7. The DASC showed excellent internal consistency reliability (α = 0.936) and adequate concurrent and criterion-related validities. The results of the confirmatory factor analysis showed that the DASC fitted the data very well. The DASC paves the way to (a) help in early identification of children at risk of problematic use of DDs and/or becoming addicted to DDs and (b) stimulate further research concerning children from different cultural and contextual settings.

Developing a mobile SNS addiction scale utilizing factor analysis and the Rasch model

Purpose

The purpose of this paper is to develop a mobile social networking service (SNS) addiction scale to measure respondents’ addiction levels.

Design/methodology/approach

Drawing on the existing literature on the components model of addiction by Griffiths (2005) and mobile SNS addiction, an initial scale in a five-point Likert-format was developed. It was refined through the pilot study with 100 participants and the main study with 423 participants utilizing factor analysis and Rasch analysis.

Findings

Mobile SNS addiction as a behavioral addiction, demonstrated six addiction symptoms: modification, salience, tolerance, withdrawal, conflict and relapse, which were interrelated with each other. The mobile SNS addiction scale developed in this study was found to be psychometrically robust and unidimensional.

Practical implications

The mobile SNS addiction scale consists of nine items, thus making it easier and more convenient to be applied to academic research and clinical practice.

Originality/value

The combined use of factor analysis and the Rasch model could largely reduce potential negative effects associated with limitations of classical test theory and improve the chance of developing a psychometrically robust instrument. The mobile SNS addiction scale covers a range of types of SNSs, thus being more generic. The items in the scale are unidimensionally loaded on the latent construct of mobile SNS addiction and demonstrate measurement invariance across respondents of different demographics.

Histrionic Personality, Narcissistic Personality, and Problematic Social Media Use: Testing of a New Hypothetical Model

In the present study, a hypothetical model examining the relationships between histrionic personality belief, need for social approval, desire for being liked, social media disorder, and narcissistic personality belief was proposed and tested. The effect of histrionic personality belief on the need for social approval and desire for being liked was tested first. Then the effect of the need for social approval and desire for being liked on social media addiction were tested. Finally, the effect of social media addiction on narcissistic personality belief was tested. The present study comprised 305 adolescents (165 girls and 140 boys) and they were administered the Personality Belief Questionnaire-Short Form, Need for Social Approval Scale, Desire for Being Liked Scale, and Social Media Disorder Scale. Before the proposed hypothetical model was tested, each latent variable was tested with measurement models to determine if it could be used in structural models. Findings demonstrated that histrionic personality belief positively affected the need for social approval and desire for being liked. The need for social approval and desire for being liked positively affected social media addiction. Finally, social media addiction positively affected narcissistic personality belief.

Psychiatric comorbidity and co-occurring opioid misuse: Depression mediates the relationship between post-traumatic stress disorder and opioid misuse in community pharmacy settings

AbstractsBackground: Individuals who misuse opioids frequently have comorbid psychiatric issues, including post-traumatic stress disorder (PTSD) and depression. However, little is known about the mechanisms by which these disorders are associated with opioid misuse and specifically in community pharmacy settings. The current study examined whether depression mediated the relationship between PTSD and opioid misuse in patients filling opioid prescriptions. Methods: We administered a health survey in four community pharmacies among patients filling opioid medications in southwestern Pennsylvania. Univariate statistics were used to assess relationships among demographic and clinical characteristics of PTSD, depression, and opioid misuse behaviors. We then examined whether depression mediated the relationship between PTSD and opioid misuse using ordinary least squares path analysis with bootstrapping. Results: A total of 333 participants completed the health survey. Opioid misuse was reported among 15.9% of all participants, 33.3% among those with a positive PTSD screen, and 29.3% of those who screened positive for depression. Depression significantly mediated the relationship between PTSD and opioid misuse. Specifically, there was a statistically significant indirect effect (ab) of PTSD on opioid misuse through a pathway mediated by depression (ab = .06, SE_ab = .02, 95% CI = .02-.10). The direct effect (c') of PTSD on opioid misuse was also significant (c' = .12, SE_c' = .05, P = .01, 95% CI = .03-.22), suggesting partial mediation. Conclusions: Results suggest an indirect pathway by which clinical intervention may help ameliorate outcomes in patients with PTSD. Further, there is an increased need for screening, assessment, and intervention protocols for this patient population in which community pharmacy is a novel setting to expand future efforts within the patient population.

Laxer Clinical Criteria for Gaming Disorder May Hinder Future Efforts to Devise an Efficient Diagnostic Approach: A Tree-Based Model Study

Internet Gaming Disorder (IGD) has been recognized in May 2013 and can be evaluated using the criteria developed by American Psychiatric Association (APA). The present study investigated the role each IGD criteria plays in diagnosing disordered gaming. A total of 3377 participants (mean age 20 years, SD = 4.3 years) participated in the study. The data collected was scrutinized to detect patterns of IGD using Conditional Inference Tree (Ctree), a sophisticated machine algorithm. Participants provided basic sociodemographic information and completed the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF). The results identified classes of IGD-related symptoms, indicating that endorsing ‘withdrawal’ and ‘loss of control’ increases the probability of disordered gaming by 77.77% while endorsement of ‘withdrawal’, ‘loss of control’ and ‘negative consequences’ increases the probability of disordered gaming by 26.66%. Moreover, lack of endorsement of ‘withdrawal’ and endorsement of ‘preoccupation’ increases the likelihood of disordered gaming by 7.14%. Taken together, the results obtained illustrate that different IGD criteria can present with different clinical weighing as unique diagnostic roles in the development of disordered gaming can be evidenced by each criterion. Moreover, the present findings help inform future revisions of diagnostic manuals and helps enhancing the assessment of IGD in the future. Additional research and clinical implications are discussed.

Does Life Satisfaction Mediate the Association between Socioeconomic Status and Excessive Internet Use?

Excessive Internet use is becoming a rapidly increasing problem in today’s society. Our aim was to assess the association between socioeconomic status (SES) of the family and excessive Internet use (EIU), and whether life satisfaction mediates this association. We analyzed data from a representative sample of 2844 Slovak adolescents (mean age 14.34, 50.5% boys) from the 2014 Health Behavior in School aged Children (HBSC) study, based on self-report questionnaires. We assessed the association of SES, measured by several indicators, such as perceived family wealth, parental education, and (un)employment, and adolescent EIU using linear regression, adding life satisfaction as a mediator. Adolescents whose father was unemployed and whose perceived family wealth was low tended to score higher on EIU. Neither gender nor age affected this relationship. Life satisfaction mediated a part of the association between SES and EIU in the case of low perceived family wealth and father’s (un)employment. Adolescents with a low SES are more likely to become excessive Internet users, and life satisfaction mediates this association. Prevention of EIU among adolescents should be targeted at those with low SES, with life satisfaction being the topic to address.

A Web-Based Intervention for Social Media Addiction Disorder Management in Higher Education: Quantitative Survey Study

Background

Social media addiction disorder has recently become a major concern and has been reported to have negative impacts on postgraduate studies, particularly addiction to Facebook. Although previous studies have investigated the effects of Facebook addiction disorder in learning settings, there still has been a lack of studies investigating the relationship between online intervention features for Facebook addiction focusing on postgraduate studies.

Objective

In an attempt to understand this relationship, this study aimed to carry out an investigation on online intervention features for effective management of Facebook addiction in higher education.

Methods

This study was conducted quantitatively using surveys and partial least square-structural equational modeling. The study involved 200 postgraduates in a Facebook support group for postgraduates. The Bergen Facebook Addiction test was used to assess postgraduates’ Facebook addiction level, whereas online intervention features were used to assess postgraduates’ perceptions of online intervention features for Facebook addiction, which are as follows: (1) self-monitoring features, (2) manual control features, (3) notification features, (4) automatic control features, and (5) reward features.

Results

The study discovered six Facebook addiction factors (relapse, conflict, salience, tolerance, withdrawal, and mood modification) and five intervention features (notification, auto-control, reward, manual control, and self-monitoring) that could be used in the management of Facebook addiction in postgraduate education. The study also revealed that relapse is the most important factor and mood modification is the least important factor. Furthermore, findings indicated that notification was the most important intervention feature, whereas self-monitoring was the least important feature.

Conclusions

The study’s findings (addiction factors and intervention features) could assist future developers and educators in the development of online intervention tools for Facebook addiction management in postgraduate education.

Treatments of internet gaming disorder: a systematic review of the evidence

Introduction: The American Psychiatric Association included Internet gaming disorder (IGD) in the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders, and the World Health Organization included gaming disorder in the 11th revision of the International Classification of Diseases. These recent updates suggest significant concern related to the harms of excessive gaming.Areas covered: This systematic review provides an updated summary of the scientific literature on treatments for IGD. Inclusion criteria were that studies: 1) evaluate the effectiveness of an intervention for IGD or excessive gaming; 2) use an experimental design (i.e. multi-armed [randomized or nonrandomized] or pretest-posttest); 3) include at least 10 participants per group; and 4) include an outcome measure of IGD symptoms or gaming duration. The review identified 22 studies evaluating treatments for IGD: 8 evaluating medication, 7 evaluating cognitive behavioral psychotherapy, and 7 evaluating other interventions and psychosocial treatments.Expert opinion: Even with the recent uptick in publication of such clinical trials, methodological flaws prevent strong conclusions about the efficacy of any treatment for IGD. Additional well-designed clinical trials using common metrics for assessing IGD symptoms are needed to advance the field.

Validation of the Arabic version of the Bergen Facebook Addiction Scale in Tunisian adolescents

Background Facebook is by far the most popular social network. Thus, it is important to use a valid measuring tool. This study aimed to validate an Arabic version of the Bergen Facebook Addiction Scale (BFAS). Methods It was a cross-sectional study conducted among public secondary schools, within the city of Sousse, Eastern Tunisia over 2 months. Students completed self-administrated questionnaires. The revised test-retest version of the scale was given to a sample of ten pilot students in order to check the readability of the translation. Internal consistency was measured using Cronbach's alpha coefficient in order to assess the extent to which the BFAS items were interrelated. Results A total of 1399 participants took part in the study (60.5% females). Among 1353 students who are using Facebook, 71.8% had non-problematic use. The median score of addiction was 13 ranging from 6 to 30. The median time spent each day on Facebook was 3 h. The Cronbach's alpha coefficient was 0.87. Students with higher Facebook addiction scores were significantly more addicted to video games (p = 0.001), and more depressed (p < 0.0001). Conclusion The Arabic-BFAS is consistent as a screening test for Facebook addiction among secondary school students due to having good reliability and validity.

Demographic and psychiatric correlates of compulsive sexual behaviors in gambling disorder

BACKGROUND AND AIMS

Gambling disorder (GD) and compulsive sexual behavior (CSB) may commonly co-occur. Yet, the psychiatric correlates of these co-occurring disorders are an untapped area of empirical scrutiny, limiting our understanding of appropriate treatment modalities for this dual-diagnosed population. This study examined the demographic and clinical correlates of CSB in a sample of treatment-seeking individuals with GD (N = 368) in São Paulo, Brazil.

METHODS

Psychiatrists and psychologists conducted semi-structured clinical interviews to identify rates of CSB and other comorbid psychiatric disorders. The Shorter PROMIS Questionnaire was administered to assess additional addictive behaviors. The TCI and BIS-11 were used to assess facets of personality. Demographic and gambling variables were also assessed.

RESULTS

Of the total sample, 24 (6.5%) met diagnostic criteria for comorbid CSB (GD + CSB). Compared to those without compulsive sexual behaviors (GD - CSB), individuals with GD + CSB were more likely to be younger and male. No differences in gambling involvement emerged. Individuals with GD + CSB tended to have higher rates of psychiatric disorders (depression, post-traumatic stress disorder, and bulimia nervosa) and engage in more addictive behaviors (problematic alcohol use, drug use, and exercise) compared to GD - CSB. Those with GD + CSB evidenced less self-directedness, cooperativeness, self-transcendence, and greater motor impulsivity. Logistic regression showed that the predictors of GD + CSB, which remained in the final model, were being male, a diagnosis of bulimia, greater gambling severity, and less self-transcendence.

DISCUSSION AND CONCLUSION

Given those with GD + CSB evidence greater psychopathology, greater attention should be allocated to this often under studied comorbid condition to ensure adequate treatment opportunities.

Examining the relationship between fitness-related self-conscious emotions, disordered eating symptoms, and morbid exercise behavior: An exploratory study

BACKGROUND AND AIMS

Theoretical models of morbid exercise behavior (MEB) suggest that it may emerge as a result of complex interactions between a range of psychosocial factors. However, in spite of fitness-related self-conscious emotions involving such factors, their relationship with the risk of MEB has never been investigated. Consequently, this study had two objectives. First, to explore the relationship that fitness-related self-conscious emotions have with (a) symptoms reflecting MEB as assessed by the Exercise Addiction Inventory (EAI) and the Exercise Dependence Scale-Revised (EDS-R) and (b) exercise frequency. Second, to examine whether these relationships might vary according to disordered eating symptoms.

METHODS

A sample of 646 undergraduate students (59% males; M_age = 21.25; SD_age = 2.94) completed a self-reported questionnaire.

RESULTS

After controlling for age, sex, and disordered eating symptoms, it was found that shame, hubristic pride, and authentic pride positively explained MEB; for their part, guilt (negatively) and authentic pride (positively) explained exercise frequency. The positive relationships between pride and MEB were weaker (in the case of the hubristic facet) or stronger (in the case of the authentic facet) under higher levels of disordered eating symptoms. The independent variables explained 29% (EAI), 28% (EDS-R), and 27% (exercise frequency) of the variance in dependent variables.

DISCUSSION

Tempering fitness-related emotions of shame, guilt, hubristic pride, and authentic pride may contribute to healthier exercise behavior.

The Craving and Excitement of Social Networking Sites Addicts: Based on Cue-Reactivity

Everyone benefits from social networking as a daily tool, but there are potential addictions. However, little is known about the craving and excitability of social networking sites addiction, and mode of change in psychological craving. The study consisted of two experiments that used a cue-reactivity paradigm to study the cravings and excitement of social networking sites (SNSs) addiction and the changing regulars in cravings. Sixty subjects were divided into a high-score group and a low-score group. In Experiment 1, all subjects evaluated word clues. The results showed that the SNS-related clues only induced the craving and excitability of the high-score group, but not the low-score group, and the craving fluctuated. Furthermore, in Experiment 2, image clues were used. The results showed that the craving induced by an image clue is significantly higher than the craving induced by a word clue, and there is no difference in excitability. Taken together, our findings suggest the SNS-related stimulation, especially image clues, could significantly induce subjects for the craving and excitability of social networks, and the craving fluctuates.

The Development of the Turkish Craving for Internet Gaming Scale (CIGS): A Validation Study

As the use of digital technology has increased, abuse and addiction to technology have been identified among a minority of users. In the mid-1990s, the concept of internet addiction was first used. Today, almost every digital technology use has been claimed to have a minority of disordered users. One key aspect of addictive substance behaviors is craving. Craving is also an important component of behavioral addictions including digital technology disorders such as Internet Gaming Disorder. The aim of the present study was to develop the Turkish version of the Craving for Internet Gaming Scale (CIGS) via an adaptation of the Penn Alcohol Craving Scale (PACS). The present study comprised 368 adolescents from four different samples. The measures used included the Craving for Internet Gaming Scale, Digital Game Addiction Scale, and Brief Self-Control Scale. The structural validity of CIGS was investigated with Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and criterion validity. The reliability of CIGS was evaluated using Cronbach α internal consistency reliability coefficient and corrected item total correlation coefficients. As a result of EFA, it was found that the five-item CIGS had a single-factor structure. The unidimensional CIGS obtained as a result of EFA was tested with CFA. As a result of CFA, the unidimensional structure of CIGS was confirmed in two different samples. Criterion validity of CIGS was assessed via digital gaming addiction, self-discipline, impulsiveness, daily internet gaming duration, and internet gaming history. As a result of criterion analysis, CIGS was associated with these variables in the expected direction. Finally, according to reliability analysis, the CIGS was found to be a reliable scale. When validity and reliability analysis of the CIGS are considered as a whole, it is concluded that the CIGS is a valid and reliable scale that assesses craving for internet gaming.

Problematic internet use in Bangladeshi students: The role of socio-demographic factors, depression, anxiety, and stress

Problematic Internet Use (PIU) has become a concern for public mental health across the globe. However, there are few studies assessing PIU in Bangladesh. The present cross-sectional study estimated the prevalence rate of PIU and its associated risk factors among 405 university students in Bangladesh between June and July 2018. The measures included sociodemographic questions, internet and health-related variables, the Internet Addiction Test (IAT) and the Depression, Anxiety and Stress Scale (DASS-21). The prevalence of PIU was 32.6% among the respondents (cut-off score of ≥50 on the IAT). The prevalence of PIU was higher in males in comparison to females, although the difference was not statistically significant. Internet-related variables and psychiatric comorbidities were positively associated with PIU. From the unadjusted model, more frequent use of the internet and more time spent on the internet were identified as strong predictors of PIU, whereas the adjusted model showed depressive symptoms and stress only as strong predictors of PIU. It is hoped this preliminary study will facilitate further study on PIU along with other psychiatric disorders in Bangladesh.