A ‘components’ model of addiction within a biopsychosocial framework

Revisiting the Role of Impulsivity and Compulsivity in Problematic Sexual Behaviors

Impulsivity and compulsivity are transdiagnostic features associated with clinically relevant aspects of psychiatric disorders, including addictions. However, little research has investigated how impulsivity and compulsivity relate to hypersexuality and problematic pornography use. Thus, the aims of the present study were to investigate (a) self-reported impulsivity and compulsivity with respect to hypersexuality and problematic pornography use and (b) the similarities and possible differences between hypersexuality and problematic pornography use in these domains. Utilizing structural equation modeling (SEM) in a large community sample (N = 13,778 participants; female = 4,151, 30.1%), results indicated that impulsivity (β = .28, β = .26) and compulsivity (β = .23, β = .14) were weakly related to problematic pornography use among men and women, respectively. Impulsivity had a stronger relationship (β = .41, β = .42) with hypersexuality than did compulsivity (β = .21, β = .16) among men and women, respectively. Consequently, impulsivity and compulsivity may not contribute as substantially to problematic pornography use as some scholars have proposed. On the other hand, impulsivity might have a more prominent role in hypersexuality than in problematic pornography use. Future research should examine further social and situational factors associated with problematic pornography use.

Online Porn Addiction: What We Know and What We Don't-A Systematic Review

In the last few years, there has been a wave of articles related to behavioral addictions; some of them have a focus on online pornography addiction. However, despite all efforts, we are still unable to profile when engaging in this behavior becomes pathological. Common problems include: sample bias, the search for diagnostic instrumentals, opposing approximations to the matter, and the fact that this entity may be encompassed inside a greater pathology (i.e., sex addiction) that may present itself with very diverse symptomatology. Behavioral addictions form a largely unexplored field of study, and usually exhibit a problematic consumption model: loss of control, impairment, and risky use. Hypersexual disorder fits this model and may be composed of several sexual behaviors, like problematic use of online pornography (POPU). Online pornography use is on the rise, with a potential for addiction considering the "triple A" influence (accessibility, affordability, anonymity). This problematic use might have adverse effects in sexual development and sexual functioning, especially among the young population. We aim to gather existing knowledge on problematic online pornography use as a pathological entity. Here we try to summarize what we know about this entity and outline some areas worthy of further research.

Work addiction is associated with increased stress and reduced quality of life: Validation of the Bergen Work Addiction Scale in Danish

Addiction to work is defined as a compulsion or an uncontrollable need to work incessantly. Only few measures exist to identify work addiction and the health consequences are sparsely explored. The Bergen Workaholic Scale (BWAS) measures seven core elements of work addiction and has been used in Norway, Hungary, Brazil, Italy, USA and Poland. The aim of this study was to validate the BWAS in a Danish sample and to investigate if high risk of work addiction was associated with stress and reduced quality of life. We conducted an online screening survey with 671 participants aged 16-68 years with the Danish translation of the BWAS. We added the perceived stress scale (PSS) and the quality of life scale EQ-5D-5L. Those with high risk of work addiction reported significantly higher mean PSS scores (20.0 points) compared to those with low risk of addiction (12.5 points) and poorer quality of life (61.9) compared to the low risk group (81.3). Furthermore, work addiction was associated with more weekly working hours (44.0 vs. 35.6 hours/week) and having more leadership responsibility. A preliminary estimate of work addiction prevalence was 6.6%. The BWAS demonstrated good reliability (α = 0.83), and factor analyses pointed at a single factor structure. Work addiction seems to be associated with health problems in terms of stress and poorer quality of life. The BWAS is recommended as a reliable and valid tool to identify work addiction in Danish.

The role of childhood emotional maltreatment and body image dissatisfaction in problematic smartphone use among adolescents

Growing empirical evidence has identified specific psychological and contextual risk factors associated with problematic smartphone use (PSU). However, the potential direct and indirect impact of childhood emotional maltreatment (CEM) on PSU remains largely unexplored, despite the established role of CEM in the onset of other excessive, problematic, and addictive behaviors. Consequently, the purpose of the present study was to test the direct and indirect relationships of emotional abuse and neglect (two facets of CEM) with PSU via specific mediational pathways including body image dissatisfaction (BID), social anxiety, and depression. The sample comprised 443 adolescents who completed a questionnaire that included assessment tools of aforementioned variables. Multiple mediation model results indicated that CEM was directly and indirectly associated with PSU via BID, depression, BID-related depression, and BID-related social anxiety. Results suggested that emotionally traumatic experiences were associated with PSU in adolescents and that this relationship may partially be explained by BID and psychosocial risk factors. The present study draws caution to the amplifying roles of CEM and BID on increased PSU. The results of the study have important clinical and public health implications, but additional research is needed before interventions can be developed and implemented on the basis of present results.

Adição à internet ou uso problemático da internet? Qual dos termos usar?

Resumo O uso da internet tem aumentado exponencialmente a nível mundial. Ainda que ele não seja por si só negativo, já que integra benefícios vários, alguns indivíduos parecem exibir problemas relacionados com o seu uso excessivo, descontrolado e disfuncional. Consequentemente, tem sido crescente, particularmente nas últimas duas décadas, o interesse dos investigadores em explorar este uso, quando excessivo e pouco saudável. Porém, e sendo um tema/constructo tratado por diferentes autores com quadros teóricos também diferentes, são vários os termos usados na literatura para descrever este fenómeno. Neste sentido, este artigo propõe-se a apresentar o trabalho uma revisão de literatura de dois dos conceitos mais usados e espartilhados na literatura científica, ou seja, adição à internet e uso problemático da internet.

How does self-esteem affect mobile phone addiction? The mediating role of social anxiety and interpersonal sensitivity

Low self-esteem is an important factor influencing mobile phone addiction, which has been well documented. However, little research focused on the mechanism underlying the association between self-esteem and mobile phone addiction. We hypothesized that social anxiety and interpersonal sensitivity may mediate the relationship between self-esteem and mobile phone addiction. Six hundred and fifty three (353 girls among them) college students with the mean age of 19.94 (SD = 1.34) were recruited for the study. Participants completed mobile phone addiction scale, Rosenberg self-esteem scale, the social anxiety questionnaire and interpersonal sensitivity subscale of SCL-90. The findings were as follows: 1) interpersonal sensitivity mediated the relation between self-esteem and mobile phone addiction. 2) social anxiety and interpersonal sensitivity sequentially mediated the relation between self-esteem and mobile phone addiction. The result reveals that self-esteem has indirect effect on mobile phone addiction, which is mediated by social anxiety and interpersonal sensitivity.

The association between Facebook addiction and depression: A pilot survey study among Bangladeshi students

Social media addiction has become an area of increasing research interest over the past few years. However, there has been no previous research on social media addiction in Bangladesh. The present pilot study is the first ever in Bangladesh to examine the relationship between one specific form of social media addiction (i.e., 'Facebook addiction') and its associated predictors. This present study comprised 300 students from the University of Dhaka (Bangladesh) who participated in a survey that included questions relating to socio-demographics, health and behavioral measures, and the Bergen Facebook Addiction Scale (BFAS), and the nine-item Patient Health Questionnaire (PHQ9). The prevalence of FA was 39.7% (cutoff score was ≥18 on the BFAS). Using a regression analysis, the risk of being addicted to Facebook was predicted by being single, having less involvement in physical activities, sleep disturbance (more or less than 6 to 7 h of sleep), time spent on Facebook (≥5 h per day), and depression symptoms. Based on the sample in the present study, the risk of Facebook addiction (as assessed using the BFAS) appears to be a significant issue among Bangladeshi students, and depression to be one of the main comorbid factors.

Generalised Versus Specific Internet Use-Related Addiction Problems: A Mixed Methods Study on Internet, Gaming, and Social Networking Behaviours

The field of technological behavioural addictions is moving towards specific problems (i.e., gaming disorder). However, more evidence of generalised versus specific Internet use-related addiction problems (generalised pathological Internet use (GPIU) vs. specific pathological Internet use (SPIU)) is still needed. This mixed methods study aimed to disentangle GPIU from SPIU. A partially mixed sequential equal status study design (QUAN→QUAL) was undertaken. First, through an online survey, which adapted the compulsive Internet use scale (CIUS) for three types of problems (i.e., generalised Internet use, and specific online gaming and social networking). Second, potential problem users’ perceptions of the evolution of these problems (aetiology, development, consequences, and factors) were ascertained, through semi-structured interviews, together with their opinion on present Internet gaming disorder (IGD) criteria adapted to each problem studied. Findings showed the CIUS remains valid and reliable for GPIU and SPIUs examined; a prevalence between 10.8% and 37.4% was estimated for potential at-risk problem gamers and Internet users, respectively, who reported their preference for maintaining their virtual lives. Half of the sample had a risk of a unique or mixed profile of these problems. Moreover, device patterns, gender, and age issues emerged, such as problem gamers being proportionally equal male and female young or middle-aged adults. GPIU was highly associated with problem social networking use, and weakly with problematic gaming, but both SPIUs were independent. Concerning addictive symptoms, salience, deception, and tolerance required redefinition, especially for SPIUs, while better-valued IGD criteria applied to GPIU and SPIUs were: Risk relationships or opportunities, give up other activities, withdrawal, and continue despite problems. Thus, although problems studied are present as risk behaviours, SPIUs seem to cover the addictive symptomatology in those categorised as potential problem users, online gaming being the most severe behavioural addiction problem.

Moving from the terminology debate to a transdisciplinary understanding of the problem

This commentary considers a recent debate paper which presents and counters 10 work addiction myths. I reflect upon the proposal to move the field forward by distinguishing between, work addiction, which denotes a clinical phenomenon; and workaholism, a term used by the occupational psychology literature with little agreement about its defining dimensions beyond working compulsively. Rather than choosing between these two terms, I argue that addiction experts should lead a transdisciplinary integration of findings from studies where participants report both working compulsively and experiencing significant conflict. I also stress the importance of understanding the macro factors underlying this particular addiction.

Ten myths and twenty years: What we know and what we still do not know about work addiction

This commentary addresses a recent article by Griffiths et al. (2018) about myths in work addiction. In response to the narrative review, I reflect on all the myths that the authors highlighted and the argument on how they tried to counter them. In comparison to an earlier overview by Robinson (1998), it is clear which myths about work addiction are persistent and represent the most important issues about this problem. Most of the myths were countered by the authors, but some of them need more evidence to be unequivocally defeated. The commentary focuses on the most important future research directions based on the myths discussed in this paper.

The dark side of internet: Preliminary evidence for the associations of dark personality traits with specific online activities and problematic internet use

BACKGROUND AND AIMS

Research has shown that personality traits play an important role in problematic internet use (PIU). However, the relationship between dark personality traits (i.e., Machiavellianism, psychopathy, narcissism, sadism, and spitefulness) and PIU has yet to be investigated. Consequently, the objectives of this study were to investigate the relationships of dark traits with specific online activities (i.e., social media, gaming, gambling, shopping, and sex) and PIU.

METHODS

A total of 772 university students completed a self-report survey, including the Dark Triad Dirty Dozen Scale, Short Sadistic Impulse Scale, Spitefulness Scale, and an adapted version of the Bergen Facebook Addiction Scale.

RESULTS

Hierarchical regression analysis and a multiple mediation model indicated that being male was positively associated with higher online gaming, online sex, and online gambling, and negatively associated with social media and online shopping. Narcissism was related to higher social media use; Machiavellianism was related to higher online gaming, online sex, and online gambling; sadism was related to online sex; and spitefulness was associated with online sex, online gambling, and online shopping. Finally, Machiavellianism and spitefulness were directly and indirectly associated with PIU via online gambling, online gaming, and online shopping, and narcissism was indirectly associated with PIU through social media use.

DISCUSSION

Findings of this preliminary study show that individuals high in dark personality traits may be more vulnerable in developing problematic online use and that further research is warranted to examine the associations of dark personality traits with specific types of problematic online activities.

Seeing the forest through different trees: A social psychological perspective of work addiction

We live in exciting times for the scientific study of work addiction, given its increased relevance and the diverse perspectives one might take to approach this phenomenon. Simultaneously, this field does not appear to be unified as a result of several misleading myths, which are addressed by the debate paper of Griffiths et al. (2018). In response, we would like to complement this study by proposing that the construct of interest should be more precisely identified in the context of related constructs and that an integrative framework should be applied, which is able to take into account not just the micro-level characteristics (i.e., individual differences), but meso- (i.e., environmental factors) and macro-level (i.e., societal factors) ones as well.

Ten myths about work addiction

BACKGROUND AND AIMS

Research into work addiction has steadily grown over the past decade. However, the literature is far from unified and there has been much debate on many different issues.

AIM AND METHODS

This paper comprises a narrative review and focuses on 10 myths about work addiction that have permeated the psychological literature and beyond. The 10 myths examined are (a) work addiction is a new behavioral addiction, (b) work addiction is similar to other behavioral addictions, (c) there are only psychosocial consequences of work addiction, (d) work addiction and workaholism are the same thing, (e) work addiction exclusively occurs as a consequence of individual personality factors, (f) work addiction only occurs in adulthood, (g) some types of work addiction are positive, (h) work addiction is a transient behavioral pattern related to situational factors, (i) work addiction is a function of the time spent engaging in work, and (j) work addiction is an example of overpathogizing everyday behavior and it will never be classed as a mental disorder in the DSM.

RESULTS

Using the empirical literature to date, it is demonstrated that there is evidence to counter each of the 10 myths.

CONCLUSION

It appears that the field is far from unified and that there are different theoretical constructs underpinning different strands of research.

How to counter the ten myths about work addiction?: Three postulates for future research

BACKGROUND AND AIM

Referring to Ten myths about work addiction reviewed by Griffiths, Demetrovics, and Atroszko in the Journal of Behavioral Addiction, three postulates were proposed to apply in future research on work addiction: (a) the clinical psychology perspective, (b) the systems approach, and (c) diversified and adequate methodologies.

METHODS

In a narrative review, using theoretical assumptions and empirical data, postulates were discussed against myths.

RESULTS

The opportunities offered by the perspectives and new insights related to myths were presented.

CONCLUSION

It appears that the three postulates may contribute to theoretical and methodological progress in future research on work addiction.

Problematic overstudying: Studyholism or study addiction?

This commentary addresses Griffiths et al. (2018)'s sixth myth about work addiction. We agree that work addiction could also be spread in the school context, although we propose that problematic overstudying may be more similar to an obsession than to an addiction toward the study. We refer to the DSM-5 diagnostic criteria related to the obsessive-compulsive disorder (OCD) and the substance-use disorder, presenting some theoretical considerations related to the similarities and differences between problematic overstudying and these two diagnoses. Finally, we focus on the obsessive-compulsive personality disorder. We conclude that problematic overstudying might better be conceptualized as an OCD-related disorder.

Ontological addiction theory: Attachment to me, mine, and I

BACKGROUND

Ontological addiction theory (OAT) is a novel metaphysical model of psychopathology and posits that human beings are prone to forming implausible beliefs concerning the way they think they exist, and that these beliefs can become addictive leading to functional impairments and mental illness. The theoretical underpinnings of OAT derive from the Buddhist philosophical perspective that all phenomena, including the self, do not manifest inherently or independently.

AIMS AND METHODS

This paper outlines the theoretical foundations of OAT along with indicative supportive empirical evidence from studies evaluating meditation awareness training as well as studies investigating non-attachment, emptiness, compassion, and loving-kindness.

RESULTS

OAT provides a novel perspective on addiction, the factors that underlie mental illness, and how beliefs concerning selfhood are shaped and reified.

CONCLUSION

In addition to continuing to test the underlying assumptions of OAT, future empirical research needs to determine how ontological addiction fits with extant theories of self, reality, and suffering, as well with more established models of addiction.

A Latent Class Approach for Classifying the Problem and Disordered Gamers in a Group of Adolescence

Gaming disorder is not yet recognized as a formal psychiatric disorder, and consensus is still lacking in the field concerning the definition of gaming disorder and what methods should be used to measure it. In order to deal with methodological challenges related to previously suggested approaches, the aim of the present study was to develop an alternative assessment procedure for gaming disorder using a latent class cluster approach, and to compare the criterion validity of this procedure with existing assessment procedures. A representative sample of 3,000 adolescents (n = 1,500 female) aged 17.5 years was drawn from the National Registry, and 2,055 participants responded (yielding a response rate of 70.3%). The Gaming Addiction Scale for Adolescents was used to measure gaming disorder and measures of loneliness, anxiety, depression, and aggression were used to test criterion validity. A model with five Latent Class Clusters represented the best fit [BIC(LL) = 21,253,7; L² = 3,881,204; df = 1,978; Class. Err. = 0.1239]. The five different groups were labeled never symptoms (46.2%), rarely symptoms (22.3%), occasionally symptoms (23.5%), problem gamers (6.9%), and disordered gamers (1.2%). The groups displayed different probabilities of responses (never/rarely/sometimes/often/very often) to the seven Gaming Addiction Scale items. Regarding criterion validity, MANOVA revealed a significant overall main effect of latent classes [F_{(20, 6359)} = 13.50, p < 0.001; Wilks Lambda = 0.871]. All dependent variables (loneliness, depression, anxiety, verbal, and physical aggression) reached statistical significance when results from the dependent variables were considered separately. Comparing the present approach with previous suggested classifications of gaming addiction offered by Lemmens et al. and Charlton and Danforth, the present approach showed greater specificity in terms of number of classes identified. We conclude that the Latent Class approach identifying five different groups of gamers offers a more refined view on addiction compared to previous assessment procedures.

Problematic social networking site usage and substance use by young adolescents

Background

Substance use and abuse by young adolescents has become a serious issue for public health services, and several socio-environmental factors can influence how vulnerable a young adolescent may be to their appeal. The present study was devised to examine whether substance use in early adolescence is associated with problematic social networking site usage (PSNSU).

Methods

In the academic year 2013–2014, secondary schools in Padua (north-eastern Italy) were involved in a survey called “Pinocchio”. A sample of 1325 pupils attending years 6 to 8 (i.e. aged from 11 to 13 years) completed self-administered questionnaires, in which PSNSU was measured by applying the DSM-IV criteria of dependence to identify any social network addiction disorder and its fallout on daily life. Multivariate analysis (ordered logistic regression) was performed to assess an adjusted association between young adolescents’ substance use and PSNSU.

Results

The percentage of pupils classified as problematic social networking site users rose with age (from 14.6% in year 6 to 24.3% in year 7, and 37.2% in year 8), and it was higher in girls (27.1%) than in boys (23.6%). In a fully-adjusted model, PSNSU conferred a higher likelihood of being substance users (OR 2.93 95% CI 1.77–4.85).

Conclusion

This study identified an association between PSNSU and the likelihood of substance use (smoking, alcohol and energy drink consumption), providing further evidence of the need to pay more attention to PSNSU in early adolescence.

What Protects Adolescents with Youth Subculture Affiliation from Excessive Internet Use?

Youth subculture affiliation (SA) appears to be an important risk factor with regard to adolescents' problem behavior. Excessive Internet use (EIU) has emerged as a new type of problem behavior; however, it has not yet been studied in adolescents affiliated with youth subcultures. Thus, the aim of this study was to assess the association between SA and EIU and to explore the role of selected protective factors. We used data from the Health Behaviour in School-aged Children (HBSC) study conducted in 2014 in Slovakia. The final sample for this study comprised 532 adolescents (mean age: 15.4; 49.6% boys). Hierarchical linear regression analysis was conducted to examine the associations of EIU with SA. Adolescents with SA were more likely to report EIU. Adjustment for protective factors decreased the association between EIU and SA. From all tested interactions, only the interaction of SA with family support was found to be significant. The relationship between family support and EIU was mediated via Monitoring by the mother only in adolescents without SA. Our findings imply that the risk of EIU is higher in adolescents with SA. There was a difference in how protective factors worked in adolescents with and without SA.

A preliminary cross-cultural study of Hikikomori and Internet Gaming Disorder: The moderating effects of game-playing time and living with parents

Background

Internet Gaming Disorder (IGD) and Hikikomori (an extreme form of social real-life withdrawal, where individuals isolate themselves from society) have both been suggested as mental disorders that require further clinical research, particularly among young adult populations.

Objective

To add to the extant literature, the present study used a cross-cultural, cross-sectional design to investigate the association between Hikikomori and IGD, and the potential moderating effects of reported game-playing time and living with parents.

Method

Two online samples of 153 Australian and 457 U.S.-North American young adult players of Massively Multiplayer Online (MMO) games were collected. The nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9), and the Hikikomori Social Withdrawal Scale were administered to dimensionally assess IGD and Hikikomori, respectively.

Results

Linear regression analyses confirmed that Hikikomori symptoms are associated with IGD. Additionally, moderation analyses indicated that the association was exacerbated by longer game playing time across both populations. Gamers living with their parents was a significant moderator of the relationship for the Australian sample.

Conclusions

Extreme real-life social withdrawal and IGD are related, and this association is exacerbated for those who spend more time playing MMOs per day, and, for Australian participants, living with their parents.

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Internet Gaming Disorder (IGD) and Hikikomori are two relatively new disorders.

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Hikikomori symptoms are associated with higher IGD scores.

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Longer periods of gaming exacerbated the Hikikomori-IGD association.

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Living with parents exacerbated IGD among Australian gamers.

Internet gaming disorder: Feeling the flow of social games

Introduction

Gaming Disorder (GD) was added to the recent publication of the International Classification of Diseases (ICD-11) by the World Health Organization. This aligns with recommendations of the fifth edition of the Diagnostic Statistical Manual for Mental Disorders (DSM-5), issued by the American Psychiatric Association. Accordingly, further relevant research has been invited. The interplay between preference for online social game genres, the degree of online Flow (or immersive pleasure) experienced, and the gamer's biological gender were examined here as contributing factors of IGD.

Method

A normative sample of adult internet gamers was collected online (N = 237, Age = 18-59, Males = 157; 66%; Females = 80; 34%). Participants completed the nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9), the Online Flow Questionnaire (OFQ), and also self-reported demographics and internet/gaming behaviours.

Results

Mediation and moderated mediation analyses indicated that the level of online Flow experienced considerably mediated the association between the preference for social games genres and the intensity of IGD behaviours across both biological genders.

Conclusions

Results suggest that the level of online Flow experienced constitutes a risk factor in relation to the development of IGD. Furthermore, games which mandate social interaction with others present to be conducive to online Flow, and thus enhancing IGD risk irrespective of the biological gender of the gamer. Implications and limitations of the study are discussed.

The connection between exercise addiction and orthorexia nervosa in German fitness sports

PURPOSE

The combination of physical activity and healthy eating habits has potentially positive effects on health. However, both practices can also lead to pathological behaviors such as exercise addiction (EA) and orthorexia nervosa (ON), thus generating negative effects. So far, studies analyzing the connection between these two phenomena cannot be found. The current paper is aiming to close this gap.

METHODS

The sample (n = 1.008) consisted of 559 male and 449 female active members of three fitness studios, and was analyzed in a cross-sectional study design. The Exercise Addiction Inventory (EAI) was used to establish exercise addiction and the Düsseldorfer Orthorexie Skala (DOS) was used to evaluate orthorectic eating behavior.

RESULTS

Out of the whole sample, 10.2% exhibit EA, while ON is prevalent in 3.4%. Twenty-three (2.3%) individuals suffer from both. There is a significant positive correlation between DOS and EAI (p < .001, r = .421). Female participants (p < .001, r = .452) show a higher correlation compared to male participants (p < .001, r = .418).

CONCLUSION

The results suggest a positive correlation between ON and EA in the context of German fitness sports. Both seem to be serious phenomena and require further investigation.

LEVEL OF EVIDENCE

Level V (cross-sectional descriptive study).

Potential roles of masculine role discrepancy, discrepancy stress, and self-esteem in affecting addictive use of social networking sites among Chinese men: A random population-based study

BACKGROUND AND AIMS

Masculine role discrepancy (i.e., men perceiving themselves not living up to the ideal manhood and being less masculine than the typical "man") and related discrepancy stress were associated with some risk behaviors. No study has looked at their relationships with addictive use of social networking sites (SNSs), an emerging potential public health concern. The study constructed a moderated mediation model to test whether masculine role discrepancy would be positively associated with discrepancy stress, which would, in turn, be positively associated with addictive use of SNS, and whether self-esteem would buffer (moderate) the association between masculine role discrepancy and discrepancy stress.

METHODS

A random population-based cross-sectional telephone survey interviewed 2,000 Hong Kong male adults in the general population.

RESULTS

Currently unmarried and non-cohabiting, younger, and better educated participants reported higher addictive use of SNS scores than others. Adjusted for these variables, masculine role discrepancy and discrepancy stress were positively associated, and self-esteem was negatively associated with addictive use of SNS scores. Path analysis indicated that masculine role discrepancy was associated with addictive use of SNS through discrepancy stress (mediation); self-esteem buffered (moderated) the association between masculine role discrepancy and discrepancy stress; self-esteem was not significantly associated with addictive use of SNS in this model with good fit.

DISCUSSION

The findings support the general strain theory's postulation that strain is associated with stress, which is in turn associated with addictive use of SNS sites. Implications, potential interventions, and future studies are discussed in this study.

A study on the relationship between exercise addiction, abnormal eating attitudes, anxiety and depression among athletes in Israel

BACKGROUND AND AIMS

The aim of this study was to investigate the relationship between exercise addiction, abnormal eating attitudes, anxiety, and depression among competitive and amateur athletes.

METHODS

Participants were 100 athletes of mean age 28.3 years (18-62), of which there were 67 males and 35 females. The sample consisted of competitive and amateur athletes who participated in individual and group sports. They filled in the Exercise Addiction Inventory, Body Shape Questionnaire, a questionnaire assessing Eating Attitudes Test, Spielberger State-Trait Anxiety Inventory, and Beck Depression Inventory (BDI).

RESULTS

Ratings of exercise addiction were positively correlated with BDI scores across the study sample. Exercise addiction ratings were associated with abnormal eating attitudes, but not with trait or state anxiety. Athletes engaging in individual sports scored marginally higher on depression scores than group athletes but there was no difference in depression scores between competitive and amateur athletes. Multiple regression analysis revealed that abnormal eating attitudes contributed significantly to ratings of exercise addiction and explained 7.7% of the variance. According to the Sobel test, the difference in the association between exercise addiction and eating disorder was significant. Therefore, body shape was a mediating factor between eating disorder and exercise addiction.

DISCUSSION AND CONCLUSIONS

This study extends our preliminary findings of an association between exercise addiction and depression. Second, abnormal eating attitudes may explain most of the variance of exercise addiction. This is a further support for previous evidence of comorbidity between exercise addiction and eating disorders.

Developmental Links Between Gaming and Depressive Symptoms

The current longitudinal study tested the reciprocal relationships between video game play and depressive symptoms among 9,421 adolescents from the Add Health (M_age  = 16.15 years, SD = 1.64, 55% female), over 11 years (Waves 2, 3, and 4), ages 16 to 27. Based on structural equation modeling as well as latent growth models, findings indicated that (1) excessive gaming was largely transient over time, from adolescence to early adulthood; (2) excessive gaming predicted increases in depressive symptoms; and (3) in turn, depressive symptoms predicted decreases in gaming over time. Multigroup model tests by sex provided additional evidence that longitudinal relationships from excessive gaming to depressive symptoms were supported for male, but not for female youth.

Maladaptive daydreaming as a new form of behavioral addiction

BACKGROUND AND AIMS

Maladaptive daydreaming (MD) has many features of behavioral addiction, but research exploring this syndrome is limited. This case study provides a qualitative exploration of MD.

METHODS

A structured clinical interview and mental state examination of a patient with MD were video-recorded and transcribed verbatim. Transcripts were subjected to the interpretative phenomenological analysis.

RESULTS

MD was developed as a strategy to cope with distress but led to uncontrollable absorption in fantasy, social withdrawal, and neglecting aspects of everyday life. It was coupled with excessive Internet use and viewing porn.

DISCUSSION AND CONCLUSIONS

Patients should be questioned about MD during clinical assessment. Further studies are necessary to determine whether MD constitutes a separate syndrome or is a part of other behavioral addictions.

Childhood maltreatment and problematic social media use: The role of attachment and depression

Childhood maltreatment is associated with many maladaptive outcomes. This study sought to examine the association between childhood maltreatment and problematic social media use using a cross-sectional sample of young adults aged 17-25 years (n = 1029). Specifically, we studied whether the relationship is mediated through (i) attachment anxiety, (ii) attachment avoidance, or (iii) both attachment dimensions operating in series with depressive symptoms. Results revealed that a history of childhood maltreatment was significantly associated with more problematic social media use. Both anxious and avoidant attachment dimensions independently mediated the relationship between childhood maltreatment and problematic use of social media, but in opposing directions. Avoidant attachment was associated with less problematic social media use, whilst anxious attachment was associated with more problematic social media use. Avoidant attachment and depressive symptoms in series accounted for part of the relationship between childhood maltreatment and problematic social media use. Anxious attachment and depressive symptoms in series fully mediated the relationship between childhood maltreatment and problematic social media use. The results suggest that childhood maltreatment may influence social media use directly, but also indirectly. People experiencing depressive symptoms may overuse social media in an attempt to alleviate their distress. However, causality cannot be established with the current design.

Psychometric evaluation of the Persian Internet Disorder Scale among adolescents

BACKGROUND AND AIMS

Given the growing epidemiological research interest concerning Internet addiction, brief instruments with a robust theoretical basis are warranted. The Internet Disorder Scale (IDS-15) is one such instrument that can be used to quickly assess the Internet addiction in an individual. However, only two language versions of the IDS-15 have been developed. This study translated the IDS-15 into Persian and examined its psychometric properties using comprehensive psychometric testing.

METHODS

After ensuring the linguistic validity of the Persian IDS-15, 1,272 adolescents (mean age = 15.53 years; 728 males) completed the IDS-15, Depression Anxiety Stress Scale (DASS), Internet Gaming Disorder Scale - Short Form (IGDS9-SF), and the Bergen Social Media Addiction Scale (BSMAS). Confirmatory factor analysis (CFA), Rasch models, regression analysis, and latent profile analysis (LPA) were carried out to test the psychometric properties of the Persian IDS-15.

RESULTS

Both CFA and Rasch supported the construct validity of the Persian IDS-15. Multigroup analysis in CFA and differential item functioning in Rasch indicated that male and female adolescents interpreted the IDS-15 items similarly. Regression analysis showed that the IDS-15 correlated with IGDS9-SF and BSMAS (ΔR² = .12 and .36, respectively) is stronger than the DASS (ΔR² = .03-.05). LPA based on IDS-15 suggests three subgroups for the sample. Significant differences in depression, anxiety, IGDS9-SF, and BSMAS were found among the three LPA subgroups.

CONCLUSION

The Persian IDS-15 has robust psychometric properties as evidenced by both classical test theory and Rasch analysis.

The impact of motives for Facebook use on Facebook addiction among ordinary users in Jordan

BACKGROUND

Facebook has become the most popular social networking site with more than 2.07 billion monthly active users. However, this popularity has its pains too reflected by some addictive behavior among its users. Although researchers have recently started to examine the factors that influence Facebook addiction, little research examined the links between motives for Facebook use and Facebook addiction. These studies mainly concentrate on students too. Also, little research has explored this issue among general public in general and among people in Jordan in particular.

AIMS

This study therefore examined the impact of motives for Facebook use on Facebook addiction among ordinary users in Jordan.

METHOD

A sample of 397 ordinary users is employed to achieve the study objective.

RESULTS

Results showed that 38.5% of the participants were addicted to Facebook. Facebook addiction was significantly associated with six motives, namely exhibitionism and companionship, entertainment, escapism and passing time, social curiosity, relationships formation and relationships maintenance.

CONCLUSION

Among these six motives, escapism and passing time, exhibitionism and companionship, and relationships maintenance were the strong predictors of Facebook addiction.

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

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

The relationship between nomophobia and the distraction associated with smartphone use among nursing students in their clinical practicum

Background

The increasing concern about the adverse effects of overuse of smartphones during clinical practicum implies the need for policies restricting smartphone use while attending to patients. It is important to educate health personnel about the potential risks that can arise from the associated distraction.

Objective

The aim of this study was to analyze the relationship between the level of nomophobia and the distraction associated with smartphone use among nursing students during their clinical practicum.

Methods

A cross-sectional study was carried out on 304 nursing students. The nomophobia questionnaire (NMP-Q) and a questionnaire about smartphone use, the distraction associated with it, and opinions about phone restriction policies in hospitals were used.

Results

A positive correlation between the use of smartphones and the total score of nomophobia was found. In the same way, there was a positive correlation between opinion about smartphone restriction polices with each of the dimensions of nomophobia and the total score of the questionnaire.

Conclusions

Nursing students who show high levels of nomophobia also regularly use their smartphones during their clinical practicum, although they also believe that the implementation of policies restricting smartphone use while working is necessary.

Game Addiction Scale Assessment Through a Nationally Representative Sample of Young Adult Men: Item Response Theory Graded-Response Modeling

BACKGROUND

The 7-item Game Addiction Scale (GAS) has been validated under standard confirmatory factor analysis and exhibits good psychometric properties. Whether this scale satisfies the necessary conditions for consideration by item response theory (IRT) modeling remains unknown. However, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) recently proposed criteria, in its section 3, to define internet gaming disorder (IGD) to promote research on this possible condition.

OBJECTIVE

The objective of our study was to (1) analyze GAS in the context of IRT (graded-response) modeling; (2) investigate differential item functioning (DIF), a feature of IRT modeling, in 2 subsamples; and (3) contribute to the ongoing (IGD) debate related to the validity of the DSM-5 criteria using GAS items as a proxy.

METHODS

We assessed 2 large representative samples of Swiss men (3320 French-speaking and 2670 German-speaking) with GAS.

RESULTS

All items comprised high discrimination parameters. GAS items such as relapse, conflict, withdrawal, and problems (loss of interests) were endorsed more frequently in more severe IGD stages, whereas items related to tolerance, salience (preoccupation), and mood modification (escape) were endorsed more widely among participants (including in less severe IGD stages). Several DIF effects were found but were classified as negligible.

CONCLUSIONS

The results of the analyses partly support the relevance of using IRT to further establish the psychometric properties of the GAS items. This study contributes to testing the validity of the IGD criteria, although cautious generalization of our findings is required with GAS being only a proxy of the IGD criteria.

Attachment Anxiety and Problematic Social Media Use: The Mediating Role of Well-Being

Insecure attachment is associated with a myriad of maladaptive outcomes, including low well-being and problematic Internet use. The lack of research investigating the roles that interpersonal attachment styles and psychological well-being play in problematic social media use is surprising. To address this gap, 915 young people aged 18-25 years (M = 20.19, SD = 1.58) completed an online survey measuring attachment styles, psychological well-being, and problematic social media use. We found that both greater attachment anxiety and less avoidance in attachment relationships were associated with problematic use of social media. The data further indicated that there was a significant indirect effect of attachment anxiety on problematic social media use through general feelings of psychological well-being, suggesting that individuals characterized by anxious attachment styles may be using social media as a means of enhancing psychological well-being. As psychological well-being was found to be negatively associated with problematic social media use, our findings bolster calls for enhancing young people's well-being. However, causality cannot be fully established due to the cross-sectional design of this study.

Validation of the Short Gambling Harm Screen (SGHS): A Tool for Assessment of Harms from Gambling

It is common for jurisdictions tasked with minimising gambling-related harm to conduct problem gambling prevalence studies for the purpose of monitoring the impact of gambling on the community. However, given that both public health theory and empirical findings suggest that harms can occur without individuals satisfying clinical criteria of addiction, there is a recognized conceptual disconnect between the prevalence of clinical problem gamblers, and aggregate harm to the community. Starting with an initial item pool of 72 specific harms caused by problematic gambling, our aim was to develop a short gambling harms scale (SGHS) to screen for the presence and degree of harm caused by gambling. An Internet panel of 1524 individuals who had gambled in the last year completed a 72-item checklist, along with the Personal Wellbeing Index, the PGSI, and other measures. We selected 10 items for the SGHS, with the goals of maximising sensitivity and construct coverage. Psychometric analysis suggests very strong reliability, homogeneity and unidimensionality. Non-zero responses on the SGHS were associated with a large decrease in personal wellbeing, with wellbeing decreasing linearly with the number of harms indicated. We conclude that weighted SGHS scores can be aggregated at the population level to yield a sensitive and valid measure of gambling harm.

Exercise Addiction in Practitioners of Endurance Sports: A Literature Review

Practice of endurance sports/activities has gained most devotees over recent decades, thanks to its capacity to maintain and improve health. However, their characteristics and accessibility have facilitated the emergence of addictive behaviors. Excessive practicing can lead to adverse physical and psychological effects seriously prejudicial to health, to the extent that individuals are unable to control this behavior. Recognizing that exercise addiction is still a controversial concept, the aim of the present review is to analyze the state of research into addictive exercise behaviors, specifically centering on running and endurance sports. To this end, a search covering article written in English and dated from 2010 onward was carried out in the Pubmed, Scopus, Web of Science and EBSCOhost databases. Of a total of 2,675 articles in the four databases, 25 were eligible for the final review. The studies reviewed confirmed that excessive practice could encourage the appearance of addictive behaviors and health problems. Most research has reported no age or sex differences in exercise dependence among endurance sport practitioners; however, obsessive passion and dedication to sports activities may be predictors for addiction to exercise. Owing to terminological confusion and the variety of tools used to measure addiction, figures for prevalence differ widely among studies, with values quoted ranging from 3 to 42%. Furthermore, it is clear that there are problems in delimiting, defining and diagnosing this sort of behavior, which has led to addiction to exercise not yet being considered a behavioral disorder.

Predictors of Problematic Smartphone Use: An Examination of the Integrative Pathways Model and the Role of Age, Gender, Impulsiveness, Excessive Reassurance Seeking, Extraversion, and Depression

Background: The progression of mobile phone technology has led to the development of multi-functional smartphones providing access to features such as social media, e-mail, and videos alongside the basic functions of a mobile phone. Increasing amounts of research has explored the potential addictive nature of smartphones to develop a theoretical framework that describes personality factors related to problematic use. The present study examined the Integrative Pathways Model and the effect of age, gender, impulsiveness, excessive reassurance seeking, extraversion, and depression on problematic smartphone use. Method: A total of 147 smartphone users (mean age = 30.96, SD = 12.97, 69.4% female) completed an online survey comprising of measures of problematic smartphone use, excessive reassurance seeking, extraversion, depression, and impulsiveness. Results: Age, impulsiveness, excessive reassurance seeking, and depression were all significantly related to problematic smartphone use, however extraversion was not significantly related. Furthermore, age and impulsiveness were significant independent predictors of problematic smartphone use. No gender differences were found. Conclusions: The findings presented several factors that predict problematic smartphone use, implications and suggestions for future research are discussed.

Psychometric Properties and Factor Structures of Chinese Smartphone Addiction Inventory: Test of Two Models

There has been a growing concern of excessive smartphone use that interferes with people’s daily functioning, most notably among youngsters. The Smartphone Addiction Inventory (SPAI) was constructed to assess this type of information technology addiction. Although the SPAI was developed in a Taiwanese adolescent sample, this measure has not been validated on Chinese youngsters in other regions. Moreover, the initial evidence yielded a four-factor structure, but recent findings obtained an alternative five-factor structure. As no studies have systematically compared these two factor structures, which of the models fits the data better remained unknown. This study aimed to evaluate the empirical validity of both the four- and five-factor structures of the SPAI in a sample of university students from Mainland China (n = 463). Four psychometric properties of the SPAI were examined. First, the structural validity of both factor models was evaluated with confirmatory factor analysis. Satisfactory fit was found for both the five-factor model (RMSEA = 0.06, SRMR = 0.05, CFI = 0.99, TLI = 0.99) and the four-factor model (RMSEA = 0.07, SRMR = 0.06, CFI = 0.98, TLI = 0.98), but the five-factor model demonstrated an overall better model fit. Second, the five-factor model yielded good internal consistencies (all Cronbach α’s > 0.70). Third, concurrent validity of the SPAI was supported by its moderately strong correlations with four widely adopted criterion variables (i.e., loneliness, social anxiety, depression, and impulsivity). Lastly, the convergent validity of the SPAI was demonstrated by its strong, positive correlation with a popular, validated measure of Internet addiction. This study is the first to demonstrate the validity of the newly proposed five-factor model of the SPAI in a sample of Mainland Chinese youngsters.