A ‘components’ model of addiction within a biopsychosocial framework

Addiction beyond pharmacological effects: The role of environment complexity and bounded rationality

Several decision-making vulnerabilities have been identified as underlying causes for addictive behaviours, or the repeated execution of stereotyped actions despite their adverse consequences. These vulnerabilities are mostly associated with brain alterations caused by the consumption of substances of abuse. However, addiction can also happen in the absence of a pharmacological component, such as seen in pathological gambling and videogaming. We use a new reinforcement learning model to highlight a previously neglected vulnerability that we suggest interacts with those already identified, whilst playing a prominent role in non-pharmacological forms of addiction. Specifically, we show that a dual-learning system (i.e. combining model-based and model-free) can be vulnerable to highly rewarding, but suboptimal actions, that are followed by a complex ramification of stochastic adverse effects. This phenomenon is caused by the overload of the capabilities of an agent, as time and cognitive resources required for exploration, deliberation, situation recognition, and habit formation, all increase as a function of the depth and richness of detail of an environment. Furthermore, the cognitive overload can be aggravated due to alterations (e.g. caused by stress) in the bounded rationality, i.e. the limited amount of resources available for the model-based component, in turn increasing the agent's chances to develop or maintain addictive behaviours. Our study demonstrates that, independent of drug consumption, addictive behaviours can arise in the interaction between the environmental complexity and the biologically finite resources available to explore and represent it.

Parent and peer attachment as predictors of facebook addiction symptoms in different developmental stages (early adolescents and adolescents)

Facebook Addiction (FA) is a problem that concerns minors all over the world. The attachment bond with peers and parents has been proven to be a risk factor for the onset of FA. However, the family and peer group can have a different importance depending on the developmental period of the minor. This study examined the influence of peer and parental attachment on the symptoms of FA in early adolescents and adolescents to verify whether attachment to peers and parents predicts FA symptoms in both categories respectively. The sample was composed of 598 participants (142 early adolescents) between the ages of 11 and 17 years (M age = 14.82, SD = 1.52) recruited in the school setting. Multivariate multiple regressions were performed. For early adolescents the relationships with their parents influenced the levels of FA the most (such as withdrawal, conflict, and relapse), whereas peer relationships (such as, peer alienation) were the most relevant for adolescents. Our study provides support to the role of attachment to peers and parents as a risk factor for symptoms of FA. In line with developmental theories, parents and peers acquire a different weight in predicting the relationship between attachment and FA for early adolescents and adolescents respectively. Clinical implications and future research directions are discussed.

The Use of Digital Technologies, Impulsivity and Psychopathological Symptoms in Adolescence

Background and aims: Past research on the associations between psychopathological symptoms and technological-based addictions, i.e., Internet Gaming Disorder (IGD) and Social Media Addiction (SMA), showed contradictory results in adolescents and adult populations. The present study investigated correlations between adolescents’ psychopathological risks and impulsivity, IGD and SMA. Methods: A sample of 656 participants (338 males; M_age = 16.32 years) was divided into three age groups (early, mid-, and late adolescence) and completed a battery of scales comprising the (i) Internet Gaming Disorder Scale–Short Form, (ii) Bergen Social Media Addiction Scale, (iii) Barratt Impulsiveness Scale for Adolescents, and (iv) Symptom Checklist-90-R. Results: The significance of the correlations was not corroborated in the basic tables. Significant associations appeared only in the adolescent subgroups, sometimes for bivariate and sometimes for partial correlations and with different patterns of associations between males and females. Moreover, both technological addictions were correlated with impulsiveness in bivariate and partial correlations. Discussion and conclusions: Following a developmentally-oriented approach to determine the patterns of associations between technological behavioral addictions and psychopathology in the specific sub-phases of early-, mid- and late-adolescence, this exploratory research showed how these associations might change depending on the developmental phase and gender of the individual. Future research is needed to provide empirical evidence of specific emotional–psychopathological correlations.

Role of Personality Characteristics and Sexual Orientation in the Risk for Sexual Addiction Among Israeli Men: Validation of a Hebrew Sex Addiction Scale

Men having sex with men are known to exhibit heightened sexual activity. This raises the conjecture that different sexual orientations exhibit different levels of sex addiction risk, which is also affected by personality. The present study examined the prevalence of the sex addiction risk within the context of sexual orientation and personality in Israeli men while also validating the Hebrew Bergen-Yale Sex Addiction Scale (HBYSAS). Results based on 177 participants showed that the HBYSAS is appropriate for assessing the risk for sex addiction in Israeli men. Furthermore, results showed that sex addiction risk varied with individuals’ sexual orientation while being modestly associated with higher neuroticism and lower conscientiousness.

Temperament profile and its association with the vulnerability to smartphone addiction of medical students in Indonesia

Two dimensions of temperament, namely, (high levels of) novelty seeking and (low levels of) harm avoidance are related to substance addictions. However, their implications for smartphone addiction remain unexplored. Medical students are heavy smartphone users. Accordingly, screening for the risk of smartphone addiction based on individual differences in temperament can facilitate the identification of the best possible prevention strategy. Therefore, the present study aimed to examine the relationship between temperament and the vulnerability to smartphone addiction among medical students in Jakarta, Indonesia. The research study adopted a cross-sectional research design and used a simple random sampling technique. The Indonesian versions of the Temperament and Character Inventory and the Smartphone Addiction Scale were used to measure the study variables. Logistic regression analysis was conducted to examine the relationships between demographic factors, patterns of smartphone use, temperament, and vulnerability to smartphone addiction. A majority of the 185 participants were found to have the following temperament profile: low levels of novelty seeking and high levels of reward dependence and harm avoidance. The average duration of daily smartphone use was 7.83 hours (SD = 4.03) and the age at first smartphone use was 7.62 years (SD = 2.60). The respondents used smartphone to communicate with other people and access social media. A high level of harm avoidance was significantly associated with the risk of smartphone addiction (Odds Ratio [OR] = 2.04, 95% Confidence Interval [CI] = 1.12, 3.70). The findings suggest that smartphone addiction is comparable to other addictive behaviors. Further, harm avoidance increases the risk of smartphone addiction. Therefore, the risk of smartphone addiction among medical students must be ascertained based on their temperament profiles.

A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health

The opioid crisis has reached epidemic proportions in the United States with rising overdose death rates. Identifying the underlying factors that contribute to addiction vulnerability may lead to more effective prevention strategies. Supply side environmental factors are a major contributing component. Psychosocial factors such as stress, trauma, and adverse childhood experiences have been linked to emotional pain leading to self-medication. Genetic and epigenetic factors associated with brain reward pathways and impulsivity are known predictors of addiction vulnerability. This review attempts to present a biopsychosocial approach that connects various social and biological theories related to the addiction crisis. The emerging role of nutrition therapy with an emphasis on gastrointestinal health in the treatment of opioid use disorder is presented. The biopsychosocial model integrates concepts from several disciplines, emphasizing multicausality rather than a reductionist approach. Potential solutions at multiple levels are presented, considering individual as well as population health. This single cohesive framework is based on the interdependency of the entire system, identifying risk and protective factors that may influence substance-seeking behavior. Nutrition should be included as one facet of a multidisciplinary approach toward improved recovery outcomes. Cross-disciplinary collaborative efforts, new ideas, and fiscal resources will be critical to address the epidemic.

Psychometric Instruments for Problematic Pornography Use: A Systematic Review

Despite a lack of consensus in the field about how best to conceptualize problematic pornography use, psychometric instruments have nonetheless been developed to assess the construct. The present systematic review aimed to (i) identify psychometric tools that have been developed to assess problematic pornography use; (ii) summarize key characteristics, psychometric properties, and strengths and limitations of instruments for problematic pornography use; (iii) compare the instruments' theoretical conceptualizations of problematic pornography use; and (iv) evaluate each instrument on their ability to assess various core components of addiction. In this article, 22 instruments assessing problematic pornography use were reviewed. Results indicated that while the instruments had different conceptualizations of problematic pornography use, addiction still emerged as the most common theoretical framework used by the instruments. Five of the most commonly assessed addiction components across the different instruments were (1) impaired control, (2) salience, (3) mood modification, (4) interpersonal conflict, and (5) general life conflict. Contextual factors that may potentially affect the assessment of problematic pornography use and recommendations for researchers and clinicians are discussed.

Neurobiological Risk Factors for the Development of Internet Addiction in Adolescents

The sudden appearance and spread of Internet addiction in adolescent populations, in association with the rapid escalation of consumed Internet content and the broad availability of smartphones and tablets with Internet access, is posing a new challenge for classical addictology which requires urgent solutions. Like the majority of other psychopathological conditions, pathological Internet addiction depends upon a group of multifactor polygenic conditions. For each specific case, there is a unique combination of inherited characteristics (nervous tissue structure, secretion, degradation, and reception of neuromediators), and many are extra-environment factors (family-related, social, and ethnic-cultural). One of the main challenges in the development of the bio-psychosocial model of Internet addiction is to determine which genes and neuromediators are responsible for increased addiction susceptibility. This information will herald the start of a search for new therapeutic targets and the development of early prevention strategies, including the assessment of genetic risk levels. This review summarizes the literature and currently available knowledge related to neurobiological risk factors regarding Internet addiction in adolescents. Genetic, neurochemical and neuroimaging data are presented with links to actual pathogenetic hypotheses according to the bio-psychosocial model of IA forming.

S. W. Psychometric validation of the Internet Gaming Disorder-20 Test among Chinese middle school and university students

BACKGROUND AND AIMS

Internet gaming disorder (IGD) was proposed in Diagnostic and Statistical Manual of Mental Disorders of American Psychiatric Association as an area warranting more research attention. High prevalence of excessive Internet game use and related addictions has been reported in China, especially among youth; however, there is a lack of psychometrically and theoretically sound instruments for assessing IGD in the Chinese language.

METHODS

This study aimed to examine the psychometric properties of a Chinese version of the Internet Gaming Disorder Test (IGD-20 Test) among Chinese middle school (n = 569; Mage = 13.34; 46.2% females) and university students (n = 523; Mage = 20.12; 48.4% females) samples in Beijing, China. All participants voluntarily completed an anonymous questionnaire.

RESULTS

Confirmatory factor analysis results showed that the Chinese version of the IGD-20 Test had five factors (i.e., salience-tolerance, mood modification, withdrawal, conflict, and relapse). Measurement invariance was confirmed across the two samples. The test score was positively associated with the modified Young's Internet Addiction Test for gaming addiction. Concurrent validation was further demonstrated by the IGD-20 Test's positive correlation with weekly gameplay and depression symptoms. The latent profile analysis showed four different gamer classes (i.e., regular gamers, low-risk engaged gamers, high-risk engaged gamers, and probable disordered gamers), with the estimated prevalence of 2.1% of the last group.

DISCUSSION AND CONCLUSION

The IGD-20 Test was applicable to Chinese youth and its Chinese version generally demonstrated good psychometric properties.

Need fulfilment and internet gaming disorder: A preliminary integrative model

BACKGROUND

The need for a better understanding of the risk factors underpinning disordered gaming has been consistently emphasized. Although, gaming may offer a simple and straightforward means of alleviating distress, relying on gaming to address one's unmet psychological needs could invite problematic usage. Self-determination theory highlights the significance of three universally inherent psychological needs for relatedness, competency, and autonomy. A motivation to engage in gaming may be to address unmet needs and may become problematic.

OBJECTIVE

This study aimed to assess whether experienced levels of loneliness, depression and self-esteem mediate the association between Internet Gaming Disorder (IGD) behaviours and Need-Fulfilment deficits.

METHOD

The participants comprised of 149 adults (83 males, 66 females), aged between 18 and 62 years. A series of self-reported questionaries assessing their levels of IGD behaviours, depression, loneliness, self-esteem and need-fulfilment were completed.

RESULTS

Need-fulfilment deficits were linked to higher IGD behaviours. Interestingly, this association was mediated by the reported levels of self-esteem and depression and not loneliness.

CONCLUSIONS

The findings lend further empirical support for the mediating role of psychological distress between need fulfilment deficits and IGD behaviours.

Associations between attention deficit hyperactivity and internet gaming disorder symptoms: Is there consistency across types of symptoms, gender and countries?

BACKGROUND

Videogame addiction has been suggested as a tentative disorder in 2013 by the American Psychiatric Association (APA) and was recently officially recognized as a mental health disorder by the World Health Organization (WHO). Although a few studies have identified attention deficit and hyperactivity disorder (ADHD) as a key risk factor for Internet Gaming Disorder (IGD), the interplay between ADHD and IGD symptoms with gender differences across cultures remains to be further examined.

OBJECTIVE

This study examined the moderating effects of gender in the association between ADHD and IGD across two nations.

METHOD

A cross-sectional online survey was developed to recruit 164 Australian (Mage = 23.01, SD = 3.35, Minage = 18, Maxage = 31, Males n = 121, 73.80%) and 457 U.S.-North American (Mage = 25.25 years, SD = 2.76, Minage = 18 years, Maxage = 29 years, Males = 265, 57.98%) Massively Multiplayer Online (MMO) players aged between 18 and 29 years.

RESULTS

The hierarchical linear regression, moderation and moderated moderation analyses revealed that participants presenting greater inattention and hyperactivity symptoms exhibited higher levels of IGD-related behaviors in the two samples. Moreover, these associations differed across genders between the two countries. Specifically, more hyperactive-impulsive, as well as inattentive males in the USA presented higher levels of disordered gaming.

CONCLUSION

The results highlight the need for more cross-cultural and symptom-focused research in the broader IGD field.

The relationship between daily stress, social support and Facebook Addiction Disorder

The present study investigated the links between daily stress, social support, Facebook use, and Facebook Addiction Disorder (FAD). Two varieties of social support were considered, according to the communication channel: offline and online. In a sample of 309 Facebook users (age: M(SD) = 23.76(4.06), range: 18-56), daily stress was positively related to the intensity of Facebook use and to tendencies towards Facebook addiction. The link between daily stress and intensity of Facebook use was negatively moderated by perceived offline social support, indicating that individuals who received low levels of support offline were particularly likely to increase their Facebook use at higher levels of daily stress. Perceived online social support partly mediated the positive relationship between Facebook use intensity and tendencies towards FAD. It is remarkable that Facebook use intensity is systematically related to both positive (i.e., receiving online social support) and negative (i.e., building up FAD) consequences. Thereby, individuals who receive high levels of social support online tend to be at risk for tendencies towards FAD. Thus, while offline social support might protect mental health, online support might influence it negatively. This should be considered when assessing individuals at risk for obsessive Facebook use and when planning interventions to deal with FAD.

Are Video Games a Gateway to Gambling? A Longitudinal Study Based on a Representative Norwegian Sample

The scope and variety of video games and monetary gambling opportunities are expanding rapidly. In many ways, these forms of entertainment are converging on digital and online video games and gambling sites. However, little is known about the relationship between video gaming and gambling. The present study explored the possibility of a directional relationship between measures of problem gaming and problem gambling, while also controlling for the influence of sex and age. In contrast to most previous investigations which are based on cross-sectional designs and non-representative samples, the present study utilized a longitudinal design conducted over 2 years (2013, 2015) and comprising 4601 participants (males 47.2%, age range 16-74) drawn from a random sample from the general population. Video gaming and gambling were assessed using the Gaming Addiction Scale for Adolescents and the Canadian Problem Gambling Index, respectively. Using an autoregressive cross-lagged structural equation model, we found a positive relationship between scores on problematic gaming and later scores on problematic gambling, whereas we found no evidence of the reverse relationship. Hence, video gaming problems appear to be a gateway behavior to problematic gambling behavior. In future research, one should continue to monitor the possible reciprocal behavioral influences between gambling and video gaming.

Analysis of Problematic Smartphone Use Across Different Age Groups within the ‘Components Model of Addiction’

Smartphones have rapidly become indispensable in modern life. The wide spectrum of activities and virtual interaction possibilities with the mobile device render some individuals prone to exaggerated use exhibiting core symptoms akin to substance addiction. The core common symptoms of addictions can be framed within the ‘components model of addiction.’ Based on the different pattern of smartphone use in various age groups, the symptoms and the risk of smartphone addiction may differ during various life stages. Some age groups may be more at risk of smartphone addiction than others. This hypothesis was tested utilizing data from six surveys comprising 1603 individuals representing various age groups. Results obtained through two recommended age-group analyses both confirmed that preschool children and young adults are at highest risk for smartphone-related addictive behavior. Furthermore, the various components of addiction also differed between the age groups. These results suggest that preventive measures should be primarily targeted to the two most vulnerable age groups represented by preschool children and emerging adults. The results of the present study help identify the dominant addiction symptoms in the various age groups that could pinpoint aspects which should be targeted in implementation of various measures aimed at the prevention of dysfunctional smartphone use.

Test-Retest Measurement Invariance of the Nine-Item Internet Gaming Disorder Scale in Two Countries: A Preliminary Longitudinal Study

The reliable longitudinal assessment of Internet Gaming Disorder (IGD) behaviors is viewed by many as a pivotal clinical and research priority. The present study is the first to examine the test-retest measurement invariance of IGD ratings, as assessed using the short-form nine-item Internet Gaming Disorder Scale (IGDS9-SF) over an approximate period of 3 months, across two normative national samples. Differences referring to the mode of the data collection (face-to-face [FtF] vs. online) were also considered. Two sequences of successive multiple group confirmatory factor analyses (CFAs) were calculated to longitudinally assess the psychometric properties of the IGDS9-SF using emergent adults, gamers from (i) the United States of America (USA; N = 120, 18–29 years, Meanage = 22.35, 51.6% male) assessed online and; and (ii) Australia (N = 61, 18–31 years, Meanage = 23.02, 75.4% male) assessed FtF. Configural invariance was established across both samples, and metric and scalar invariances were supported for the USA sample. Interestingly, only partial metric (factor loadings for Items 2 and 3 non-invariant) and partial scalar invariance (i.e., all thresholds of Items 1 and 2, and thresholds 1, 3, for Items 4, 6, 8, and 9 non-invariant) were established for the Australian sample. Findings are discussed in the light of using IGDS9-SF to assess and monitor IGD behaviors over time in both in clinical and non-clinical settings.

Likes and Problematic Instagram Use: The Moderating Role of Self-Esteem

Mobile devices have contributed to fuel Internet use and in particular social network sites. Instagram has now become one of the most popular social network sites. Along with this growth, concerns arise about problematic use. "Likes" are one of the main factors catching people's attention due to their rewarding power. Particularly, during adolescence, likes are considered a sign of social approval. Surprisingly, the study of likes relationship to problematic use is scarce. In contrast, the direct effect of variables such as self-esteem on problematic use has been widely analyzed, but moderation studies to underscore the dynamics with other variables are scarce. The aim of this study is to expand current literature by analyzing the influence of likes and self-esteem on Instagram problematic use and the moderating role of self-esteem in the relationship between likes and problematic use. Participants were 244 teenagers. Regression analysis with Process macro for SPSS evidence the impact of likes on problematic use and the moderating role of self-esteem, serving as a protective factor, so that the impact of likes increase on problematic use is lower in participants with higher self-esteem compared to those with lower self-esteem. Results open the door for future research as well as for intervention efforts to benefit from social network use, while reducing teen's problematic use.

The Love Addiction Inventory: Preliminary Findings of the Development Process and Psychometric Characteristics

Although the existence of dysfunctional love relationships is well known and the term “love addiction” dates back to the 1970s, empirical studies on this topic are still limited. The biggest problem is arguably is the lack of a clear definition of the love addiction construct and the lack of psychometric instruments for the assessment of its symptoms. The aim of the present study was to develop and examine the psychometric characteristics of a self-report scale assessing love addiction using the components model of behavioral addiction. Two studies based on the splitting of a total sample of 663 participants involved in an intimate relationship (for at least for 6 months) were recruited to examine the psychometric characteristics of the newly developed love addiction scale and its six-item short-form. In the first study, an exploratory factor analysis (EFA) was conducted with a sample of 329 participants. In the second study, a confirmatory factor analysis (CFA) approach was used with a sample of 334 participants engaged in a romantic relationship. In both studies, reliability and concurrent validity were also examined. Results suggested that the factor structure of the Love Addiction Inventory and its six-item short-form is in line with the theoretical framework and showed good reliability and concurrent validity. The LAI in both short and longer forms are psychometrically robust and can be used to assess love addiction in future studies.

Attachment and behavioral addictions in adolescents: The mediating and moderating role of coping strategies

Gambling, video gaming, and Internet use are typically included as everyday activities that could potentially become behavioral addictions. There is growing evidence that views non-substance related addictions as coping mechanisms, and considers that attachment styles are likely to play a pivotal role on the development of such addictions, especially on young people. Therefore, the present study aimed to: (1) explore the association between attachment, coping, and behavioral addictions (i.e., gambling disorder, video game addiction, and problematic Internet use); and (2) to analyze the mediating/moderating effect that coping has in the relationship of attachment and these behavioral addictions. A sample consisting of 472 students from secondary education (Mean age = 15.6; SD = 1.33; 51.6% females) was recruited. The findings showed a negative association between attachment and behavioral addictions. Most coping strategies were found to be associated with attachment styles, except for self-critique and emotional avoidance. In particular, problem avoidance was significantly correlated to all behavioral addictions. In addition, self-blame and problem solving were significantly correlated to video game addiction and problematic Internet use. Finally, coping was found to act as a mediator and moderator between attachment and video game addiction and problematic Internet use.

Relationships of Internet addiction and Internet gaming disorder symptom severities with probable attention deficit/hyperactivity disorder, aggression and negative affect among university students

The aim of the present study was to evaluate relationships of Internet addiction (IA) and Internet gaming disorder (IGD) symptom severities with probable attention deficit/hyperactivity disorder (ADHD) and aggression among university students, while controlling the effects of anxiety and depressive symptoms. The study was conducted with online survey among 1509 volunteered university students in Ankara who regularly use the Internet, among whom we conducted analyses related with IA. Among these students, 987 of them, who play video games, were included in the analyses related with IGD. Correlation analyses revealed that the severities of the scale scores were mildly correlated with each other both among students who regularly use the Internet and students who play video games. Probable ADHD was associated with the severity of IA symptoms, together with depression and aggression, particularly physical aggression and hostility, in ANCOVA analyses. Similarly probable ADHD was also associated with the severity of IGD symptoms, together with depression and aggression, particularly physical aggression, anger and hostility, in ANCOVA analyses. These findings suggest that the presence of probable ADHD is related with both severity of IA and IGD symptoms, together with aggression and depression.

Psychopathological Consequences Related to Problematic Instagram Use Among Adolescents: The Mediating Role of Body Image Dissatisfaction and Moderating Role of Gender

In a minority of cases, problematic use of technology can negatively impact on adolescents and impair some aspects of their social, emotional, and psychological development. The purpose of the present study was to examine the direct and indirect effects of problematic Instagram use (PIU) on different psychopathological outcomes including loneliness, depression, anxiety, and social anxiety via body image dissatisfaction (BID). Additionally, moderating role of gender on the relationships among variables was investigated. A total of 491 adolescents (Mage = 15.92 years, SDage = 1.07; range = 14 to 19 years) were recruited for the study to complete a questionnaire that included the relevant assessment tools for the aforementioned variables. Mediation and moderation analyses showed that among male adolescents, PIU was directly associated with loneliness, depression, general anxiety, and social anxiety and BID partially mediated these associations. Among females, PIU was directly associated with depression and indirectly with general anxiety and social anxiety via BID. Gender significantly moderated the direct relationships of PIU with loneliness, general anxiety, and social anxiety. PIU was directly associated with loneliness, general anxiety, and social anxiety among males only, whereas among females, PIU was indirectly associated with general and social anxiety via BID but was not related to loneliness. Results of this study indicate that PIU has different negative psychological effects on male and female adolescents and that BID appears to be one explanatory factor for these impairments especially among females.

Examination of the Psychometric Characteristics of the Italian Version of the Game Addiction Scale for Adolescents

In the last years, the interest in Internet Gaming Disorder has grown considerably, which has necessitated the development of valid and reliable tools in different cultural contexts. Although, in the scientific literature, there are several measures that evaluate the Internet Gaming Disorder, the Game Addiction Scale has shown to be a valid questionnaire specifically designed for adolescents and based on the Griffiths' theory of components model of behavioral addiction. For this reason, the aim of this study is to verify the psychometric characteristics of the Italian translation of the full and short form of the Game Addiction Scale in a sample of 452 Italian adolescents (190 males and 262 females), aged between 13 and 17 years (M = 14.75; SD = 1.21). A series of confirmatory factor analyses was used to assess the Game Addiction Scale factorial structure, and the comparison of the models showed that the best fitting model was the Bifactor Model for the full form, while the unidimensional structure showed good fit for the short form of the Game Addiction Scale. Furthermore, both versions showed good reliability and correlations with Internet Addiction and hours of gaming. In sum, the Game Addiction Scale can be considered a relevant instrument for investigating Internet Gaming Disorder in Italian adolescents.

The emergence of Exercise Addiction, Body Dysmorphic Disorder, and other image-related psychopathological correlates in fitness settings: A cross sectional study

INTRODUCTION

In a society that perpetuates the strive for a perfect appearance, a fit body has become synonymous with success, but simultaneously hard to achieve. This represents a fertile ground for the development of Exercise Addiction (EA) alongside other disorders, such as Body Dysmorphic Disorder (BDD). This study aims to explore the diffusion of EA in fitness settings in the United Kingdom, Italy, Netherlands, Hungary and the previously unexplored association with appearance anxiety, BDD, self-esteem and the use of fitness supplements.

METHODS

A large cross-sectional sample (N = 1711) was surveyed in fitness settings using the Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI) and Rosenberg's Self Esteem Scale (RSE) in addition to questions surrounding the use of fitness supplements.

RESULTS

Compulsive exercise, appearance anxiety and low self-esteem were present in this sample according to the psychometric measures used (EAI, AAI, RSE). 11.7% scored over the cut off for EA, with alarming peaks in the Netherlands (20.9%) and the United Kingdom (16.1%). 38.5% were found at risk of BDD, mainly female (47.2%). 39.8% used fitness enhancing supplements without medical consultation (95.5%). This cohort of supplement users scored higher in both EAI and AAI. The logistic regression model revealed a strong association between the consumption of sport products and the level of EA across the sample with an odds ratio (OR) of 3.03. Other co-variable factors among female were appearance anxiety (AAI; OR 1.59) and to a lesser extent self-esteem (RSE) (OR 1.08).

CONCLUSIONS

This study identified a high risk of EA, appearance anxiety and BDD amongst a cohort of gym users internationally. The previously-unexplored association between these disorders and the unsupervised use of a variety of fitness products, including illicit drugs, highlights the need for informed and integrated responses targeting such vulnerable individuals.

Duality of self-promotion on social networking sites

Purpose

Self-promotion on social networking sites (SNSs) is a controversial issue as it has been attributed to various positive and negative consequences. To better understand the reasons for the mixed consequences and the nature of self-promotion on SNSs, the purpose of this paper is to theorize and empirically investigate the duality of SNS self-promotion and its underlying socio-psychological mechanisms.

Design/methodology/approach

By drawing on the motivational affordance lens and self-determination theory, this study develops a theoretical account of the duality of self-promotion on SNSs. The author places subjective vitality and SNS addiction as the positive and negative consequences of self-promotion. The model was tested using partial least squares technique with data collected from 289 Finnish Facebook users using a survey.

Findings

The results show that self-promotion contributes to both subjective vitality and to SNS addiction. Importantly, exhibitionism attenuates the effect of self-promotion on subjective vitality and amplifies the effect of self-promotion on SNS addiction. The feature-level analysis shows that status updates, adding photos, commenting in others’ posts and profile completeness are the main determinants of self-promotion. Status updates, adding photos and check-ins, in turn, have high exhibitionistic appeal.

Originality/value

To date, the empirical attempts to investigate the duality of SNS use have been rare. In particular, prior research is largely silent in explaining what tilt the outcomes of self-promotion either toward positive or negative direction. The paper fills this theoretical and empirical gap and thus contributes to literature on dualities of SNS use.

Current diagnostic procedures and interventions for Gaming Disorders: A Systematic Review

Background: Despite the growth in the number of studies on Gaming Disorders (GD), assessing the characteristics of clinical subjects is still limited. Driven by the need to overcome this limitation, a broad systematic review is essential to cover the studies that have already assessed the clinical characteristics of individuals diagnosed with GD.

Objectives: The aim of this systematic review is to provide a broad cross-cultural picture of the current diagnostic procedures and interventions used for GDs in clinical practice.

Methods: A total of 28 studies met the inclusion criteria, and data were synthesized in these categories: (1) the cultural background of the country where the research took place; (2) the instruments used to measure GD; (3) the diagnostic criteria for GD; (4) the diagnostic procedures used; and (5) the treatment protocol applied.

Results: Results of this systematic review suggest that in GD clinical practice, there is a great deal of heterogeneity in the choice of instruments, the diagnostic and intervention processes for GD.

Conclusions: This systematic review indicates that a validation process of standard procedures in clinical populations with GD is necessary to create clear shared guidelines for practitioners.

Prevalence and Psychiatric Risk Factors of Excessive Internet Use among Northern Bangladeshi Job-Seeking Graduate Students: A Pilot Study

Although internet addiction (IA) has been the subject of research in many countries, it is poorly studied in Bangladesh, and previous studies in the country have not examined potential mental health risk factors in relation to the development of IA. The present pilot study attempted to assess the prevalence and associated risk factors of IA among a convenience sample of recently graduated university students actively looking for a job (N = 284) from July to October 2018 in Rajshahi (a city in Bangladesh). The measures included socio-demographic and behavioral variables, the Internet Addiction Test (IAT), and the Depression, Anxiety, and Stress Scale. Surprisingly, no cases of IA were identified in the sample (i.e., the prevalence rate of IA was 0%) which may have been a consequence of the specific population sampled. A total of 3.9% of the participants (n = 11) were classified as excessive users (≥ 60 in IAT). Using regression analysis, the risk factors for excessive internet use were spending more time online (> 5 h daily) and experiencing psychiatric conditions (i.e., depression, stress). It is hoped the present pilot study will facilitate further study in Bangladesh with a more in-depth focus on the socio-demographic and psychiatric morbidities in excessive and problematic internet use. It is also speculated that job-seeking may be a situational protective risk factor for developing IA.

Assessing Online Flow Across Cultures: A Two-Fold Measurement Invariance Study

The association between online Flow and Internet Gaming Disorder (IGD) has attracted significant attention. Despite the consensus that online Flow plays a pivotal role in the development of IGD and other Internet addictive behaviors, there has been a lack of consistency in measurement scales used to assess online Flow. Even widely used measures of online Flow have not been psychometrically assessed across culturally diverse populations of gamers. Such an assessment would enhance the accuracy of cross-cultural comparisons. Attending to this need, the present study assessed the psychometric properties of the binary coded (i.e., Yes, No) Online Flow Questionnaire (OFQ), while concurrently taking into consideration country, age, language, and mode of data collection (online or face-to-face) differences. Two sequences of successive multiple group confirmatory factor analyses were used to assess the psychometric properties of the OFQ, between: (a) emergent adults from the United States of America (N = 482, Mage = 25.23, SD = 2.746) and Australia (N = 168, Mage = 23.55, SD = 3.37) and (b) adolescents from Greece (N = 1579, Mage = 16.12, SD = 0.849) and Cyprus (N = 1372, Mage = 15.54, SD = 0.656). Configural and partial metric invariance were confirmed between the United States and Australian samples. For the Greek and Cypriot samples, results indicated full configural and metric invariance. These results provide initial information to researchers and clinicians of the extent to which the OFQ maintains its consistency when used across cultures and invite for further cross-cultural studies in the field. Implications, as well as limitations, are discussed.

Modeling of variables related to problematic social media usage: Social desirability tendency example

Social media usage has been popular for the last decade. Individuals use their social media environments for various reasons such as to socialize, play games, have fun and share posts. Overuse of these environments may lead to negative psychological and behavioral consequences for individuals. Additionally, it increases the worries about potential addicted/problematic use of social media. In this study, it is aimed to determine the level of problematic social media usage of participants who are active social media users and to analyze the relationships between problematic social media usage and various personal characteristics and social variables. Study in relational screening model is carried out with the participation of 580 volunteers. Partial least squares (PLS) structural equation modeling is used to analyze the data obtained through various scale according to the research model. The structural equation modeling analysis shows that there is a significant relationship between problematic social media usage and the daily time of social media usage, the use of frequency of social media for recognition, publicity, communication/interaction and education, loneliness, and social anxiety. The variable which shows higher correlation between problematic social media usage is social anxiety.

The role of family and personality traits in Internet gaming disorder: A mediation model combining cognitive and attachment perspectives

BACKGROUND AND AIMS

Gaming disorder was recently recognized as a mental health disorder by the World Health Organization and included in the International Classification of Diseases. Extensive research has been conducted with regard to psychosocial correlates and comorbidity, less so for the developmental mechanisms and the processes leading to the disorder. The association between family factors, personality traits, and gaming has been studied independently but not in combination. To fill this gap in knowledge, this study examined (a) the association between parental acceptance-rejection theory and Internet gaming disorder (IGD) and (b) the mediating and moderating effect of core self-evaluations (CSE), a personality construct, on the aforementioned variables.

METHODS

The study was quantitative and involved young adults members of online gaming communities (N = 225).

RESULTS

The results showed that parental rejection is associated with the occurrence of IGD, only through the mediating effect of CSE. The moderation model was not confirmed.

DISCUSSION

Findings bridge early emotional deficits with CSE personality traits and IGD, based on two widely acknowledged theoretical frameworks. In addition, they highlight the importance of the father's role in upbringing.

CONCLUSIONS

These frameworks combine cognitive and attachment perspectives and a process-oriented approach to the development and maintenance of IGD. The implications of these findings are discussed in relation to (a) the mechanisms leading to the disorder and (b) providing an evidence base for therapeutic interventions for IGD to go beyond abstinence and include self-esteem enhancement and efficacy contingencies. Directions for future research are also provided in this study.

Beyond the myths about work addiction: Toward a consensus on definition and trajectories for future studies on problematic overworking

In an unprecedented collaborative effort to integrate the existing knowledge on work addiction and delineate trajectories for future studies, several papers from work addiction researchers (including some of the most prolific experts in the field) have contributed to the debate on the misconceptions/myths about this problematic behavior. On the basis of the overview of the presented arguments, the most commonly proposed recommendations were that there should be: (a) a general definition of work addiction, (b) the need for more transdisciplinary and integrative approach to research, and (c) propositions regarding more high-quality research. These three aspects are summarized in the present paper. There is a general agreement among work addiction researchers that work addiction is a problematic behavior that merits more systematic studies, which require input and expertise from a wide range of fields due to its complex nature.

Problematic video game use as an emotional coping strategy: Evidence from a sample of MMORPG gamers

BACKGROUND

A positive relationship between problematic gaming and escapism motivation to play video games has been well established, suggesting that problematic gaming may result from attempts to deal with negative emotions. However, to date, no study has examined how emotion dysregulation affects both escapism motives and problematic gaming patterns.

METHODS

Difficulties in emotion regulation, escapism, and problematic involvement with video games were assessed in a sample of 390 World of Warcraft players. A structural equation modeling framework was used to test the hypothesis that escapism mediates the relationship between emotion dysregulation and problematic gaming.

RESULTS

Statistical analyses showed that difficulties in emotion regulation predicted both escapism motives and problematic gaming, and that escapism partially mediated this relationship.

CONCLUSION

Our findings support the view that problematic players are likely to escape in online games as a maladaptive coping strategy for dealing with adverse emotional experiences.

G, Rita K, Zsolt D. The psychometric evaluation of the Revised Exercise Addiction Inventory: Improved psychometric properties by changing item response rating

BACKGROUND

The Exercise Addiction Inventory (EAI) is a short, valid, and reliable instrument used to assess the risk for exercise addiction, and has already been used in numerous published studies. The EAI contains six items, rated on a 5-point scale (strongly agree to strongly disagree), which are based on the components model of addiction. The middle of the original scale (scoring 3 out of 5) reflects neither agreement nor disagreement, which conveys neutrality. However, the present authors believe that individual who provides a neutral opinion on each item (i.e., scoring 3) is a conceptual dilemma because it artificially increases the total score obtainable on the scale without yielding agreement or disagreement with a particular item. Indeed, the six items of the EAI are phrased in such way that respondents can either agree or disagree in the slightly to strongly range.

METHODS

This study modified the EAI from a 5-point rating scale to a 6-point one, so that it eliminated a middle neutral response. A total of 277 exercising participants completed the Revised Exercise Addiction Inventory (EAI-R) and Exercise Dependence Scale.

RESULTS

All psychometric properties of the EAI-R were superior to the originally published scale.

CONCLUSION

Considering these findings, it is recommended that scholars now use the EAI-R in the future research if they need to assess the risk of exercise addiction.

Prefrontal cortex response to drug cues, craving, and current depressive symptoms are associated with treatment outcomes in methadone-maintained patients

Methadone maintenance is an effective treatment for opioid use disorder, yet many methadone-maintained patients (MMPs) continue to struggle with chronic relapse. The current study evaluated whether functional near-infrared spectroscopy (fNIRS) could identify prefrontal cortex (PFC) markers of ongoing opioid use in MMPs, and whether clinical measures of depression and self-report measures of craving would also be associated with opioid use. MMPs (n = 29) underwent a drug cue reactivity paradigm during fNIRS measurements of PFC reactivity. Self-reported opioid craving (measured by a visual analog scale; 0-100) was collected before and after drug cue reactivity, and depressive symptoms were assessed via the 17-item Hamilton Depression Rating Scale (HAM-D). Hierarchical regression and partial correlations were used to evaluate associations between weekly urine drug screens over a 90-day follow-up period and fNIRS, craving, and HAM-D assessments. Neural response to drug cues in the left lateral PFC, controlling for age, sex, and days in treatment was significantly associated with percent opioid-negative urine screens during follow-up (∆F1, 24 = 13.19, p = 0.001, ∆R2 = 0.30), and correctly classified 86% of MMPs as either using opioids, or abstaining from opioids (χ2(4) = 16.28, p = 0.003). Baseline craving (p < 0.001) and HAM-D assessment (p < 0.01) were also associated with percent opioid-negative urine screens. Combining fNIRS results, baseline craving scores, and HAM-D scores created a robust predictive model (∆F3, 22 = 16.75, p < 0.001, ∆R2 = 0.59). These data provide preliminary evidence that the fNIRS technology may have value as an objective measure of treatment outcomes within outpatient methadone clinics. Depressive symptoms and drug craving were also correlated with opioid use in MMPs.

The Development of the Turkish Social Media Craving Scale (SMCS): a Validation Study

Over the past decade, the use of social media applications have increased worldwide. In parallel with this, abuse of social media has also increased. In recent years, many disorders related to social media use have been conceptualized. One of the common consequences of these disorders is the intense desire (i.e., craving) to use social media. The aim of the present study was to develop the Social Media Craving Scale (SMCS) by adapting the Penn Alcohol Craving Scale (PACS). The study comprised 423 university students (242 females and 181 males) across five different samples. The psychometric instruments used included the Social Media Craving Scale, Social Media Disorder Scale, Brief Self-Control Scale, and Personal Information Form. In the present study, structural validity and reliability of the SMCS were investigated. The structural validity of SMCS was investigated with Exploratory Factor Analysis (EFA), confirmatory factor analysis (CFA), and criterion validity. The reliability of SMCS was evaluated using Cronbach α internal consistency reliability coefficient, corrected item total correlation coefficients, and test-retest method. As a result of EFA, the SMCS was found to be unidimensional scale. This unidimensional structure explained approximately half of the total variance. The unidimensional structure of SMCS was tested in two different samples with CFA. As a result of CFA, SMCS models were found to have acceptable fit values. The criterion validity of the SMCS was evaluated by assessing social media disorder, self-discipline, impulsiveness, daily social media use duration, social media usage history, frequency of checking social media accounts during the day, number of social media accounts, and number of daily shares. Analysis demonstrated that the SMCS was associated with all these variables in the expected direction. According to the reliability analysis (Cronbach’s α internal consistency coefficients, corrected item total correlation coefficients, and test-retest method), the SMCS was found to be a reliable scale. When validity and reliability analyses of the SMCS are considered as a whole, it is concluded that the SMCS is a valid and reliable scale in assessing social media craving.

Comparison of the Video Game Functional Assessment-Revised (VGFA-R) and Internet Gaming Disorder Test (IGD-20)

Initially labeled as internet addiction in the mid-1990s (e.g., Griffiths, 1996; Young, 1996), researchers have since focused on how specific online activities result in negative consequences for those who overuse and have problems with online applications such as online gambling and online sex (Griffiths, 2000; Potenza, 2017). More recently, this has been applied to online problematic video game play, often used synonymously with terms such as online video game addiction, online gaming addiction, and Internet gaming disorder (IGD). With the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013), IGD was identified by the APA as warranting further study. The current proposed diagnostic criterion in the DSM-5 requires the presence of five of nine symptoms over a 12-month period. These include: (a) preoccupation or obsession with Internet games, (b) withdrawal symptoms when not playing Internet games, (c) an increasing need over time to spend more and more time playing video games, (d) failed attempts to stop or curb Internet gaming, (e) loss of interest in other activities such as hobbies, (f) continued overuse of Internet games even with knowledge of the impact of overuse on their life, (g) lying about extent of Internet game usage, (h) uses Internet games to relieve anxiety or guilt, and (i) has lost or put at risk an opportunity or relationship because of Internet games (American Psychiatric Association [APA], 2013). However, it is unclear if the disorder represents addiction to the internet or if IGD evaluates specific behaviors occurring within the context of the video gaming (Starcevic and Billieux, 2017; Young and Brand, 2017).

Using Eye Tracking to Explore Facebook Use and Associations with Facebook Addiction, Mental Well-being, and Personality

Social networking sites (SNSs) have become ubiquitous in our everyday lives, and for all its communicative benefits, excessive SNS use has been associated with a range of negative health implications. In the present study, the authors use eye-tracking methodology to explore the relationship between individual differences in personality, mental well-being, SNS usage, and the focus of Facebook users’ visual attention. Participants (n = 69, mean age = 23.09, SD = 7.54) completed questionnaire measures for personality and to examine changes in depression, anxiety, stress, and self-esteem. They then engaged in a Facebook session while their eye movements and fixations were recorded. These fixations were coded as being directed to social and update areas of interest (AOI) of the Facebook interface. An exploratory analysis of personality factors revealed a negative correlation between openness to experience and inspection times for the updates AOI and an unexpected negative relationship between extraversion and inspection times for social AOI. There were correlations between changes in depression score and inspection of updates AOI, with reduced depression scores associated with increased inspection of updates. Finally, self-reported duration of participants’ typical Facebook sessions did not correlate with eye-tracking measures but were associated with increased Facebook addiction scores and greater increases in depression scores. These initial findings indicate that there are differences in the outcomes of interacting with Facebook which can vary based on Facebook addiction, personality variables, and the Facebook features that individuals interact with.

Evaluating the Psychometric Properties of the 7-Item Persian Game Addiction Scale for Iranian Adolescents

The 7-item Gaming Addiction Scale (GAS) is a brief instrument based on DSM criteria to assess gaming addiction. Although the psychometric properties of the GAS have been tested using classical test theory, its psychometric properties have never been tested using modern test theory (e.g., Rasch analysis). The present study used a large adolescent sample in Iran to test the psychometric properties of the Persian GAS through both classical test and modern test theories. Adolescents (n = 4442; mean age = 15.3 years; 50.3% males) were recruited from Qazvin, Iran. In addition to the GAS, all of them completed the following instruments: the nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), and a generic quality of life instrument. Two weeks later, all participants completed the GAS again. Confirmatory factor analysis (CFA) and Rasch analysis were used to test the unidimensionality of the GAS. Pearson correlation coefficients were used to test the test-retest reliability, and a regression model was used to test the criterion-related validity of the GAS. Both CFA and Rasch analysis supported the unidimensionality of the GAS. Pearson correlations coefficients showed satisfactory test-retest reliability of the GAS (r = 0.78 to 0.86), and the regression model demonstrated the criterion-related validity of the GAS (β = 0.31 with IGDS-SF9; 0.41 with PSQI). Based on the results, the Persian GAS is a reliable and valid instrument for healthcare providers to assess the level of gaming addiction among Persian-speaking adolescents.