A ‘components’ model of addiction within a biopsychosocial framework

Understanding Appearance-Enhancing Drug Use in Sport Using an Enactive Approach to Body Image

From an enactive approach to human activity, we suggest that the use of appearance-enhancing drugs is better explained by the sense-making related to body image rather than the cognitive evaluation of social norms about appearance and consequent psychopathology-oriented approach. After reviewing the main psychological disorders thought to link body image issues to the use of appearance-enhancing substances, we sketch a flexible, dynamic and embedded account of body image defined as the individual’s propensity to act and experience in specific situations. We show how this enacted body image is a complex process of sense-making that people engage in when they are trying to adapt to specific situations. These adaptations of the enacted body image require effort, perseverance and time, and therefore any substance that accelerates this process appears to be an easy and attractive solution. In this enactive account of body image, we underline that the link between the enacted body image and substance use is also anchored in the history of the body’s previous interactions with the world. This emerges during periods of upheaval and hardship, especially in a context where athletes experience weak participatory sense-making in a sport community. We conclude by suggesting prevention and intervention designs that would promote a safe instrumental use of the body in sports and psychological helping procedures for athletes experiencing difficulties with substances use and body image.

An Exploratory Study of "Selfitis" and the Development of the Selfitis Behavior Scale

In 2014, stories appeared in national and international media claiming that the condition of “selfitis” (the obsessive taking of selfies) was to be classed as a mental disorder by the American Psychiatric Association and that the condition could be borderline, acute, or chronic. However, the stories were a hoax but this did not stop empirical research being carried out into the concept. The present study empirically explored the concept and collected data on the existence of selfitis with respect to the three alleged levels (borderline, acute, and chronic) and developed the Selfitis Behavior Scale (SBS). Initially, focus group interviews with 225 Indian university students were carried out to generate potential items for the SBS. The SBS was then validated using 400 Indian university students via exploratory factor analysis (EFA). Six factors were identified in the EFA comprising environmental enhancement, social competition, attention seeking, mood modification, self-confidence, and social conformity. The findings demonstrate that the SBS appears to be a reliable and valid instrument for assessing selfitis but that confirmatory studies are needed to validate the concept more rigorously.

Assessment of the Italian Version of the Internet Disorder Scale (IDS-15)

Much research has focused on the validation of psychometric tools assessing Internet addiction. One of the newest measures is the Internet Disorder Scale (IDS-15) based on the modified IGD criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This study aimed at investigating the psychometric properties of the Italian version of the IDS-15 by examining the construct and the concurrent and the criterion-related validity and by identifying the taxonomy and the patterns of Internet users. A sample of 471 participants (M_age = 24.72 years, SD = 8.66; 256 males) was recruited from secondary schools, universities, and gaming halls. Confirmatory factor analyses supported the four-dimensional second-order structure and the three levels of the measurement invariance across gender. The reliability and the validity of the scale were confirmed, and the LPAs provided four classes of Internet users on the basis of the scores obtained in all four dimensions of the scale. The psychometric robustness of the Italian version of the IDS-15 was clearly demonstrated. Cross-cultural research should expand and generalize the present findings.

Merging Theoretical Models and Therapy Approaches in the Context of Internet Gaming Disorder: A Personal Perspective

Although, it is not yet officially recognized as a clinical entity which is diagnosable, Internet Gaming Disorder (IGD) has been included in section III for further study in the DSM-5 by the American Psychiatric Association (APA, 2013). This is important because there is increasing evidence that people of all ages, in particular teens and young adults, are facing very real and sometimes very severe consequences in daily life resulting from an addictive use of online games. This article summarizes general aspects of IGD including diagnostic criteria and arguments for the classification as an addictive disorder including evidence from neurobiological studies. Based on previous theoretical considerations and empirical findings, this paper examines the use of one recently proposed model, the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, for inspiring future research and for developing new treatment protocols for IGD. The I-PACE model is a theoretical framework that explains symptoms of Internet addiction by looking at interactions between predisposing factors, moderators, and mediators in combination with reduced executive functioning and diminished decision making. Finally, the paper discusses how current treatment protocols focusing on Cognitive-Behavioral Therapy for Internet addiction (CBT-IA) fit with the processes hypothesized in the I-PACE model.

How can we conceptualize behavioural addiction without pathologizing common behaviours?

Following the recent changes to the diagnostic category for addictive disorders in DSM-5, it is urgent to clarify what constitutes behavioural addiction to have a clear direction for future research and classification. However, in the years following the release of DSM-5, an expanding body of research has increasingly classified engagement in a wide range of common behaviours and leisure activities as possible behavioural addiction. If this expansion does not end, both the relevance and the credibility of the field of addictive disorders might be questioned, which may prompt a dismissive appraisal of the new DSM-5 subcategory for behavioural addiction. We propose an operational definition of behavioural addiction together with a number of exclusion criteria, to avoid pathologizing common behaviours and provide a common ground for further research. The definition and its exclusion criteria are clarified and justified by illustrating how these address a number of theoretical and methodological shortcomings that result from existing conceptualizations. We invite other researchers to extend our definition under an Open Science Foundation framework.

Inclusion of Gaming Disorder in ICD has more advantages than disadvantages

This paper is a response to a recent debate paper in which Aarseth et al. argue that the inclusion of a formal diagnosis and categories for problematic video gaming or Gaming Disorder (GD) in the World Health Organization's 11th Revision of the International Classification of Diseases (ICD-11) is premature and therefore the proposal should be removed. The present authors systematically address all the six main arguments presented by Aarseth et al. and argue that, even though some of the concerns presented in the debate paper are legitimate, the inclusion of GD in ICD-11 has more advantages than disadvantages. Furthermore, the present authors also argue that the two GD subtypes ("GD, predominantly online" and "GD, predominantly offline") are unnecessary and rather problematic; the main category for GD would be perfectly sufficient.

Social media addiction: What is the role of content in YouTube?

Background YouTube, the online video creation and sharing site, supports both video content viewing and content creation activities. For a minority of people, the time spent engaging with YouTube can be excessive and potentially problematic. Method This study analyzed the relationship between content viewing, content creation, and YouTube addiction in a survey of 410 Indian-student YouTube users. It also examined the influence of content, social, technology, and process gratifications on user inclination toward YouTube content viewing and content creation. Results The results demonstrated that content creation in YouTube had a closer relationship with YouTube addiction than content viewing. Furthermore, social gratification was found to have a significant influence on both types of YouTube activities, whereas technology gratification did not significantly influence them. Among all perceived gratifications, content gratification had the highest relationship coefficient value with YouTube content creation inclination. The model fit and variance extracted by the endogenous constructs were good, which further validated the results of the analysis. Conclusion The study facilitates new ways to explore user gratification in using YouTube and how the channel responds to it.

Excessive use of WeChat, social interaction and locus of control among college students in China

In China, the number of college students using mobile phone based messaging and social networking applications like WeChat is increasing rapidly. However, there has been minimal research into the addictive nature of these applications and the psychological characteristics associate with their excessive use. There is also no published scale available for assessing excessive use of WeChat and similar applications. In the current study, we collected data from 1,245 college students in China (715 females) and developed the WeChat Excessive Use Scale (WEUS). We then assessed the relationship between excessive use of WeChat and excessive use of a social networking application-Weibo, problematic use of mobile phones, external locus of control, and social interaction skills. Our 10-item scale featured three factors, namely- "mood modification," "salience" and ''conflict"- critical factors in assessing different forms of addiction. The WEUS was found to be a reliable instrument in assessing excessive use of WeChat as it showed good internal consistency and correlated with other measures of problematic use social networking and mobile phone addiction. Our results showed that excessive users of WeChat are more likely to excessively use Weibo than they are to problematically use mobile phones. Our study also showed that greater excessive use of WeChat is associated with higher external locus of control and greater online social interaction skills. These results reveal that WeChat has unique and strong appeal among college students in China. Further, practitioners should consider dealing with malleable factors like locus of control and real life social skills in treating people with problematic messaging and social networking.

Prevalence of problematic cell phone use in an adult population in Spain as assessed by the Mobile Phone Problem Use Scale (MPPUS)

Problematic cell phone use has alarmingly increased in industrialized countries in the past 10 years. For many perpetrators, it can turn into a behavioural addiction, although this is not a recognized medical condition. Although there are many tools for evaluating this use, one of the most widely used tools is the Mobile Phone Problematic Use Scale (MPPUS), which we test on a representative sample of the population in Spain to obtain an estimate of the prevalence of problematic cell phone use in our midst. The age range consists of 16–65 years, with 1,126 surveys conducted. In this population, we verify that the reliability and internal consistency of the MPPUS (α = 0.939) are maintained. Additionally, the construct validity, considering the derived factors (Abuse and Dependence, Craving and Loss of Control, and Dependence on the Social Environment) are aligned with other research and with diverse external criteria of addiction. We establish four categories of users (Casual, Regular, At Risk, and Problematic) and obtain a prevalence of 15.4% among At Risk Users and 5.1% among Problematic Users. This finding implies a total of 20.5% of Users with Problems. A binary logistic regression analysis shows that age, gender, level of education, and daily cell phone use predict problematic cell phone use. The results, based on multiple criteria, show that such problematic use shares features of recognized addictions, affecting large segments of the population and not only adolescents.

Gambling and Video Game Playing Among Youth

Gambling and video game playing represent two leisure activities in which adolescents and young adults participate. There are psychological and behavioural parallels between some forms of gambling (e.g., slot machines, video lottery terminals, electronic gambling machines) and some types of video games (e.g., arcade games). Both activities operate on behavioural principles of variable reinforcement schedules in order to reward and prolong play and use exciting and stimulating sound and light effects within game play. Additionally, both activities have similar negative effects associated with excessive play (e.g., poor academic performance, moodiness, loss of interest in activities previously enjoyed, and interpersonal conflict). Thus, there is concern that children and adolescents who are attracted to video games, for both psychological rewards and the challenge, may be at greater risk to gamble. We examined the gambling and video game playing behaviour among 1,229 adolescents and young adults. Results indicate that gamblers, relative to non-gamblers, were more likely to play video games. Video game players were more likely than non-players to gamble. Both social and problem gamblers had higher rates of video game playing than did non-gamblers, and addicted gamers had higher rates of gambling than did social and non-gamers. Results from the current study suggest significant overlap in youth participation in both gambling activities and video game playing. These results have implications for future research and the treatment of problem gambling and video game addiction.Les jeux de hasard et les jeux vidéo sont deux loisirs auxquels s’adonnent les adolescents et les jeunes adultes. Il existe des parallèles psychologiques et comportementaux entre certaines formes des jeux de hasard (p. ex., les appareils à sous, les appareils de loterie vidéo, les machines de jeux électroniques) et certains jeux vidéo (p. ex., les jeux d’arcade). Ces deux types de jeux exploitent les principes comportementaux du programme variable de renforcement pour récompenser le joueur et l’amener à jouer plus longtemps et utilisent des effets lumineux et sonores stimulants et excitants pour accroître l’attrait de l’expérience de jeu. De plus, ces deux activités entraînent des effets négatifs similaires chez les joueurs excessifs (p. ex., mauvais résultats scolaires, instabilité émotive, perte d’intérêt pour des activités qui autrefois procuraient du plaisir, conflits interpersonnels). On craint donc que les enfants et les adolescents qui sont attirés par les jeux vidéo, en raison des défis qu’ils proposent et des récompenses psychologiques qu’ils procurent, soient plus à risque de s’adonner aux jeux de hasard. La présente recherche a examiné les comportements de jeu de 1229 adolescents et jeunes adultes relativement aux jeux de hasard et aux jeux vidéo. Les résultats indiquent que les joueurs de jeux de hasard, par rapport aux non-joueurs, étaient plus susceptibles de jouer à des jeux vidéo, et que les joueurs de jeux vidéo étaient pareillement plus susceptibles de s’adonner aux jeux de hasard que les sujets ne jouant pas aux jeux vidéo. Le groupe des joueurs sociaux et celui des joueurs à problèmes présentaient tous deux un taux plus élevé de pratique des jeux vidéo que celui des non-joueurs, et les sujets ayant une dépendance aux jeux vidéo s’adonnaient également en plus forte proportion aux jeux de hasard que les sujets ne pratiquant par les jeux vidéo ou les pratiquant de manière sociale uniquement. Les résultats de la présente étude donnent à croire qu’il y a un chevauchement important entre la pratique des jeux de hasard et celle des jeux vidéo chez les jeunes. Ces résultats ont des incidences sur les futures recherches et le traitement de la dépendance aux jeux de hasard et aux jeux vidéo. 

An Overview of Structural Characteristics in Problematic Video Game Playing

PURPOSE OF REVIEW

There are many different factors involved in how and why people develop problems with video game playing. One such set of factors concerns the structural characteristics of video games (i.e., the structure, elements, and components of the video games themselves). Much of the research examining the structural characteristics of video games was initially based on research and theorizing from the gambling studies field. The present review briefly overviews the key papers in the field to date.

RECENT FINDINGS

The paper examines a number of areas including (i) similarities in structural characteristics of gambling and video gaming, (ii) structural characteristics in video games, (iii) narrative and flow in video games, (iv) structural characteristic taxonomies for video games, and (v) video game structural characteristics and game design ethics. Many of the studies carried out to date are small-scale, and comprise self-selected convenience samples (typically using self-report surveys or non-ecologically valid laboratory experiments).

SUMMARY

Based on the small amount of empirical data, it appears that structural features that take a long time to achieve in-game are the ones most associated with problematic video game play (e.g., earning experience points, managing in-game resources, mastering the video game, getting 100% in-game). The study of video games from a structural characteristic perspective is of benefit to many different stakeholders including academic researchers, video game players, and video game designers, as well as those interested in prevention and policymaking by making the games more socially responsible. It is important that researchers understand and recognize the psycho-social effects and impacts that the structural characteristics of video games can have on players, both positive and negative.

Internet Gaming Disorder as a formative construct: Implications for conceptualization and measurement

Some people have serious problems controlling their Internet and video game use. The DSM-5 now includes a proposal for 'Internet Gaming Disorder' (IGD) as a condition in need of further study. Various studies aim to validate the proposed diagnostic criteria for IGD and multiple new scales have been introduced that cover the suggested criteria. Using a structured approach, we demonstrate that IGD might be better interpreted as a formative construct, as opposed to the current practice of conceptualizing it as a reflective construct. Incorrectly approaching a formative construct as a reflective one causes serious problems in scale development, including: (i) incorrect reliance on item-to-total scale correlation to exclude items and incorrectly relying on indices of inter-item reliability that do not fit the measurement model (e.g., Cronbach's α); (ii) incorrect interpretation of composite or mean scores that assume all items are equal in contributing value to a sum score; and (iii) biased estimation of model parameters in statistical models. We show that these issues are impacting current validation efforts through two recent examples. A reinterpretation of IGD as a formative construct has broad consequences for current validation efforts and provides opportunities to reanalyze existing data. We discuss three broad implications for current research: (i) composite latent constructs should be defined and used in models; (ii) item exclusion and selection should not rely on item-to-total scale correlations; and (iii) existing definitions of IGD should be enriched further.

Simple construct evaluation with latent class analysis: An investigation of Facebook addiction and the development of a short form of the Facebook Addiction Test (F-AT)

In psychological research, there is a growing interest in using latent class analysis (LCA) for the investigation of quantitative constructs. The aim of this study is to illustrate how LCA can be applied to gain insights on a construct and to select items during test development. We show the added benefits of LCA beyond factor-analytic methods, namely being able (1) to describe groups of participants that differ in their response patterns, (2) to determine appropriate cutoff values, (3) to evaluate items, and (4) to evaluate the relative importance of correlated factors. As an example, we investigated the construct of Facebook addiction using the Facebook Addiction Test (F-AT), an adapted version of the Internet Addiction Test (I-AT). Applying LCA facilitates the development of new tests and short forms of established tests. We present a short form of the F-AT based on the LCA results and validate the LCA approach and the short F-AT with several external criteria, such as chatting, reading newsfeeds, and posting status updates. Finally, we discuss the benefits of LCA for evaluating quantitative constructs in psychological research.

Meditation awareness training for the treatment of workaholism: A controlled trial

Background and aims Workaholism is a form of behavioral addiction that can lead to reduced life and job satisfaction, anxiety, depression, burnout, work-family conflict, and impaired productivity. Given the number of people affected, there is a need for more targeted workaholism treatments. Findings from previous case studies successfully utilizing second-generation mindfulness-based interventions (SG-MBIs) for treating behavioral addiction suggest that SG-MBIs may be suitable for treating workaholism. This study conducted a controlled trial to investigate the effects of an SG-MBI known as meditation awareness training (MAT) on workaholism. Methods Male and female adults suffering from workaholism (n = 73) were allocated to MAT or a waiting-list control group. Assessments were performed at pre-, post-, and 3-month follow-up phases. Results MAT participants demonstrated significant and sustained improvements over control-group participants in workaholism symptomatology, job satisfaction, work engagement, work duration, and psychological distress. Furthermore, compared to the control group, MAT participants demonstrated a significant reduction in hours spent working but without a decline in job performance. Discussion and conclusions MAT may be a suitable intervention for treating workaholism. Further controlled intervention studies investigating the effects of SG-MBIs on workaholism are warranted.

Self-reported dependence on mobile phones in young adults: A European cross-cultural empirical survey

Background and aims Despite many positive benefits, mobile phone use can be associated with harmful and detrimental behaviors. The aim of this study was twofold: to examine (a) cross-cultural patterns of perceived dependence on mobile phones in ten European countries, first, grouped in four different regions (North: Finland and UK; South: Spain and Italy; East: Hungary and Poland; West: France, Belgium, Germany, and Switzerland), and second by country, and (b) how socio-demographics, geographic differences, mobile phone usage patterns, and associated activities predicted this perceived dependence. Methods A sample of 2,775 young adults (aged 18-29 years) were recruited in different European Universities who participated in an online survey. Measures included socio-demographic variables, patterns of mobile phone use, and the dependence subscale of a short version of the Problematic Mobile Phone Use Questionnaire (PMPUQ; Billieux, Van der Linden, & Rochat, 2008). Results The young adults from the Northern and Southern regions reported the heaviest use of mobile phones, whereas perceived dependence was less prevalent in the Eastern region. However, the proportion of highly dependent mobile phone users was more elevated in Belgium, UK, and France. Regression analysis identified several risk factors for increased scores on the PMPUQ dependence subscale, namely using mobile phones daily, being female, engaging in social networking, playing video games, shopping and viewing TV shows through the Internet, chatting and messaging, and using mobile phones for downloading-related activities. Discussion and conclusions Self-reported dependence on mobile phone use is influenced by frequency and specific application usage.

Social networking addiction, attachment style, and validation of the Italian version of the Bergen Social Media Addiction Scale

Aim Research into social networking addiction has greatly increased over the last decade. However, the number of validated instruments assessing addiction to social networking sites (SNSs) remains few, and none have been validated in the Italian language. Consequently, this study tested the psychometric properties of the Italian version of the Bergen Social Media Addiction Scale (BSMAS), as well as providing empirical data concerning the relationship between attachment styles and SNS addiction. Methods A total of 769 participants were recruited to this study. Confirmatory factor analysis (CFA) and multigroup analyses were applied to assess construct validity of the Italian version of the BSMAS. Reliability analyses comprised the average variance extracted, the standard error of measurement, and the factor determinacy coefficient. Results Indices obtained from the CFA showed the Italian version of the BSMAS to have an excellent fit of the model to the data, thus confirming the single-factor structure of the instrument. Measurement invariance was established at configural, metric, and strict invariances across age groups, and at configural and metric levels across gender groups. Internal consistency was supported by several indicators. In addition, the theoretical associations between SNS addiction and attachment styles were generally supported. Conclusion This study provides evidence that the Italian version of the BSMAS is a psychometrically robust tool that can be used in future Italian research into social networking addiction.

DSM-5 diagnosis of Internet Gaming Disorder: Some ways forward in overcoming issues and concerns in the gaming studies field

Background and aims The current DSM-5 diagnosis of Internet Gaming Disorder (IGD; American Psychiatric Association [APA], 2013) has led to a number of issues and concerns that we highlighted in our recent paper (Kuss, Griffiths, & Pontes, 2017). Experts in the field responded to our evaluation of these issues resulting in six commentaries. Methods In this paper, we offer responses to the six commentaries to move the scientific field forward. All of the responses to our original paper highlighted many conceptual, theoretical, and/or methodological problems with the proposed IGD diagnosis as outlined in the DSM-5. We outline some ways forward in overcoming issues and concerns in the gaming studies field. Results We argue that rather than stigmatizing gaming per se, the role of scientists and practitioners is to establish a clear-cut distinction between someone who may use games excessively but non-problematically and someone who is experiencing significant impairment in their daily lives as a consequence of their excessive gaming. This responsibility needs to be shared by popular media who are often quick to build a moral panic around gaming behaviors, often based on cherry-picking specific case studies and pieces of research which support their headlines. Conclusion Researchers, practitioners, gaming developers, and the media need to work together and collaboratively to build a realistic and comprehensive understanding of gaming as a normal, enjoyable, and often beneficial sociocultural practice, which for a small minority of excessive users may be associated with the experience of addiction-related symptoms that may require professional support.

Problem Gambling among Adolescent Girls in Croatia-The Role of Different Psychosocial Predictors

Although, compared to boys, adolescent girls gamble less often and less problematically, prevalence studies still show significant numbers of at risk/problem gamblers among girls. However, girl gambling has been on the sidelines of adolescent gambling research. The available studies usually focus only on a narrow set of correlates often ignoring that adolescent gambling is a complex phenomenon determined by various factors. Also, they often measure gambling related consequences with instruments that are not specifically developed for use on adolescents. In order to contribute to a better understanding of adolescent gambling this study focuses on problem gambling among girls. We consider different social, cognitive, motivational and behavioral factors as predictors of girl problem gambling. A total of 1,372 high-school girls from 7 Croatian cities participated in the study. They provided data on their gambling activities, peer gambling, cognitive distortions related to gambling, motivation for gambling, and levels of general risky behavior. As the only instrument developed specifically for use on adolescents, the Canadian Adolescent Gambling Inventory was used to examine adverse gambling consequences. Results show 7.4% of girls can be considered regular gamblers, and out of those who gambled at least once in their lifetime (n = 862), 11.2% already experience mild adverse consequences because of their gambling (at risk gamblers), with 3.2% experiencing serious consequences (problem gamblers). In general, girls seem to prefer lotto and scratch cards, but sports betting seems to be the preferred game of choice among regular girl gamblers. A hierarchical regression model confirmed the importance of much the same factors identified as risky for the development of problem gambling among adolescent boys—cognitive distortions, motives to earn money, to be better at gambling and to relax, the experiences of winning large and the drive to continue gambling, together with social factors such as having friends who also gamble, being involved in other risky and delinquent behavior and higher gambling frequency. Results call into question the importance of the motive to feel better for adolescent girls problem gambling. We discuss implications of our findings for both universal and indicated youth gambling prevention programs.

Serious mental illness among young adult women who use drugs in the club scene: co-occurring biopsychosocial factors

Young women who regularly attend nightclubs are at risk for numerous health and social consequences, including mental distress, sexual and physical victimization and substance dependence. This paper uses a biopsychosocial framework to examine co-occurring mental health problems, victimization, substance dependence, sexual risk and physical pain among a sample of young women who use drugs (N = 222) in Miami's club scene. The majority of women were under 24 years old, Hispanic, and identified as heterosexual. Almost all the women reported past 90-day use of alcohol, ecstasy/MDMA, marijuana, cocaine and prescription opioids and benzodiazepines; 32% of women reported being in a monogamous relationship while 41.9% reported having three or more sexual partners in the past 90 days; 65.3% met DSM-IV criteria for substance dependence; 60.4% met DSM-IV criteria for serious mental illness (SMI) and 59.9% were victimized as minors. Women who had SMI had higher odds of substance dependence, concurrent physical pain, three or more sexual partners in the past 90 days, childhood victimization and severe abuse-related trauma. The high levels of interconnected mental health, victimization, trauma, physical pain, substance dependence and sexual risk factors observed are underreported in the literature, as young women club scene participants appear to be more similar to other marginalized drug-involved populations than previously considered. While further research is needed, it appears these young women are in great need of outreach for primary health, mental health, HIV prevention, increased social support and substance abuse treatment services.

The Development and Validation of the Online Shopping Addiction Scale

We report the development and validation of a scale to measure online shopping addiction. Inspired by previous theories and research on behavioral addiction, the Griffiths's widely accepted six-factor component model was referred to and an 18-item scale was constructed, with each component measured by three items. The results of exploratory factor analysis, based on Sample 1 (999 college students) and confirmatory factor analysis, based on Sample 2 (854 college students) showed the Griffiths's substantive six-factor structure underlay the online shopping addiction scale. Cronbach's alpha suggested that the resulting scale was highly reliable. Concurrent validity, based on Sample 3 (328 college students), was also satisfactory as indicated by correlations between the scale and measures of similar constructs. Finally, self-perceived online shopping addiction can be predicted to a relatively high degree. The present 18-item scale is a solid theory-based instrument to empirically measure online shopping addiction and can be used for understanding the phenomena among young adults.

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

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

Substance Use in Young Swiss Men: The Interplay of Perceived Social Support and Dispositional Characteristics

BACKGROUND

Social environment plays a central role in substance use behaviors. However, it is not clear whether its role varies as a function of individual dispositional characteristics.

OBJECTIVES

To investigate the interaction between dispositional characteristics (i.e. sensation seeking, anxiety/neuroticism) and social environment (i.e. perceived social support [PSS]) in association with substance use.

METHODS

A representative sample of 5,377 young Swiss males completed a questionnaire assessing substance use, sensation seeking, anxiety/neuroticism, and PSS from friends and from a significant other.

RESULTS

Sensation seeking and anxiety/neuroticism were positively related to most substance use outcomes. PSS from friends was significantly and positively related to most alcohol and cannabis use outcomes, and significantly and negatively associated with the use of hard drugs. PSS from a significant other was significantly and negatively associated with most alcohol and cannabis use outcomes. The associations of sensation seeking with drinking volume, alcohol use disorder and the use of illicit drugs other than cannabis were stronger in individuals reporting high levels of PSS from friends than those with low levels. The associations of sensation seeking with risky single-occasion drinking and the use of hard drugs were weaker in participants reporting high levels of PSS from a significant other than in those with low levels.

CONCLUSIONS

Sensation seeking and anxiety/neuroticism may constitute risk factors for substance use and misuse. PSS from friends may amplify the risk for alcohol and illicit drug use (other than cannabis) associated with high sensation seeking, whereas the PSS from a significant other may reduce it.

Exploring Individual Differences in Online Addictions: the Role of Identity and Attachment

Research examining the development of online addictions has grown greatly over the last decade with many studies suggesting both risk factors and protective factors. In an attempt to integrate the theories of attachment and identity formation, the present study investigated the extent to which identity styles and attachment orientations account for three types of online addiction (i.e., internet addiction, online gaming addiction, and social media addiction). The sample comprised 712 Italian students (381 males and 331 females) recruited from schools and universities who completed an offline self-report questionnaire. The findings showed that addictions to the internet, online gaming, and social media were interrelated and were predicted by common underlying risk and protective factors. Among identity styles, 'informational' and 'diffuse-avoidant' styles were risk factors, whereas 'normative' style was a protective factor. Among attachment dimensions, the 'secure' attachment orientation negatively predicted the three online addictions, and a different pattern of causal relationships were observed between the styles underlying 'anxious' and 'avoidant' attachment orientations. Hierarchical multiple regressions demonstrated that identity styles explained between 21.2 and 30% of the variance in online addictions, whereas attachment styles incrementally explained between 9.2 and 14% of the variance in the scores on the three addiction scales. These findings highlight the important role played by identity formation in the development of online addictions.

Internet Addiction, Psychological Distress, and Coping Responses Among Adolescents and Adults

As Internet use grows, so do the benefits and also the risks. Thus, it is important to identify when individuals' Internet use is problematic. In the present study, 449 participants aged from 16 to 71 years of age were sourced from a wide range of English-speaking Internet forums, including social media and self-help groups. Of these, 68.9% were classified as nonproblematic users, 24.4% as problematic users, and 6.7% as addictive Internet users. High use of discussion forums, high rumination levels, and low levels of self-care were the main contributing factors to Internet addiction (IA) among adolescents. For adults IA was mainly predicted through engagement in online video gaming and sexual activity, low email use, as well as high anxiety and high avoidant coping. Problematic Internet users scored higher on emotion and avoidance coping responses in adults and higher on rumination and lower on self-care in adolescents. Avoidance coping responses mediated the relationship between psychological distress and IA. These findings may assist clinicians with designing interventions to target different factors associated with IA.

Online-specific fear of missing out and Internet-use expectancies contribute to symptoms of Internet-communication disorder

Some of the most frequently used online applications are Facebook, WhatsApp, and Twitter. These applications allow individuals to communicate with other users, to share information or pictures, and to stay in contact with friends all over the world. However, a growing number of users suffer from negative consequences due to their excessive use of these applications, which can be referred to as Internet-communication disorder. The frequent use and easy access of these applications may also trigger the individual's fear of missing out on content when not accessing these applications. Using a sample of 270 participants, a structural equation model was analyzed to investigate the role of psychopathological symptoms and the fear of missing out on expectancies towards Internet-communication applications in the development of symptoms of an Internet-communication disorder. The results suggest that psychopathological symptoms predict higher fear of missing out on the individual's Internet-communication applications and higher expectancies to use these applications as a helpful tool to escape from negative feelings. These specific cognitions mediate the effect of psychopathological symptoms on Internet-communication disorder. Our results are in line with the theoretical model by Brand et al. (2016) as they show how Internet-related cognitive bias mediates the relationship between a person's core characteristics (e.g., psychopathological symptoms) and Internet-communication disorder. However, further studies should investigate the role of the fear of missing out as a specific predisposition, as well as specific cognition in the online context.

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Psychopathological symptoms predict a higher fear of missing out on the individual’s Internet-communication applications.

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Psychopathological symptoms predict higher avoidance expectancies towards Internet-communication applications.

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Fear of missing out and avoidance expectancies mediate the effect of psychopathology on Internet-communication disorder.

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Internet-related cognitive bias mediates the relationship between person’s psychopathological symptoms.

The Relationships between Mental Health Symptoms and Gambling Behavior in the Transition from Adolescence to Emerging Adulthood

There is a paucity of longitudinal investigations of gambling behavior in the transition from adolescence to emerging adulthood. We conducted a longitudinal investigation of the associations and patterns of change between mental health symptoms and gambling behavior. A representative sample of Norwegians completed questionnaires containing demographic, mental health, and gambling measures at age 17 (N = 2055), and at ages 18 (N = 1334) and 19 (N = 1277). Using latent class analysis, three classes of gambling behavior were identified: consistent non-gambling (71.1%), consistent non-risk gambling (23.8%), and risky-and-problem gambling (5.1%). Being male, showing higher physical and verbal aggression and having more symptoms of depression were associated with greater odds of belonging to the risky-and-problem gambling class at age 17. Overall, the risky-and-problem gambling class had the highest physical and verbal aggression, anxiety, and depression at 19 years. Our findings elucidate the reciprocal relationship between mental health and gambling behavior in the transition from adolescence to emerging adulthood, and the importance of recognizing these factors in designing targeted interventions.

Social Networking Sites and Addiction: Ten Lessons Learned

Online social networking sites (SNSs) have gained increasing popularity in the last decade, with individuals engaging in SNSs to connect with others who share similar interests. The perceived need to be online may result in compulsive use of SNSs, which in extreme cases may result in symptoms and consequences traditionally associated with substance-related addictions. In order to present new insights into online social networking and addiction, in this paper, 10 lessons learned concerning online social networking sites and addiction based on the insights derived from recent empirical research will be presented. These are: (i) social networking and social media use are not the same; (ii) social networking is eclectic; (iii) social networking is a way of being; (iv) individuals can become addicted to using social networking sites; (v) Facebook addiction is only one example of SNS addiction; (vi) fear of missing out (FOMO) may be part of SNS addiction; (vii) smartphone addiction may be part of SNS addiction; (viii) nomophobia may be part of SNS addiction; (ix) there are sociodemographic differences in SNS addiction; and (x) there are methodological problems with research to date. These are discussed in turn. Recommendations for research and clinical applications are provided.

Factorial validity of the Problematic Facebook Use Scale for adolescents and young adults

Background and aims Recent research on problematic Facebook use has highlighted the need to develop a specific theory-driven measure to assess this potential behavioral addiction. The aim of the present study was to examine the factorial validity of the Problematic Facebook Use Scale (PFUS) adapted from Caplan's Generalized Problematic Internet Scale model. Methods A total of 1,460 Italian adolescents and young adults (aged 14-29 years) participated in the study. Confirmatory factor analyses were performed in order to assess the factorial validity of the scale. Results Results revealed that the factor structure of the PFUS provided a good fit to the data. Furthermore, results of the multiple group analyses supported the invariance of the model across age and gender groups. Discussion and conclusions This study provides evidence supporting the factorial validity of the PFUS. This new scale provides a theory-driven tool to assess problematic use of Facebook among male and female adolescents and young adults.

Coping strategies in individuals at risk and not at risk of mobile phone addiction

The aim of the present study was to provide an answer to the question of whether, and what, differences in stress coping strategies could be found between university students at risk and those not at risk of mobile phone addiction. The study included 408 students aged 19 to 28 years. The following instruments were used: a sociodemographic questionnaire, the Mobile Phone Addiction Assessment Questionnaire (in Polish, Kwestionariusz do Badania Uzależnienia od Telefonu Komórkowego, KBUTK) by Pawłowska and Potembska, and the Coping with Stress Questionnaire (SVF) by Janke, Erdmann, and Boucsein, translated into Polish by Januszewska. The results of the study showed that individuals at risk of mobile phone addiction were more likely to cope with stress by seeking substitute gratification, reacting with resignation, passivity, dejection and hopelessness, blaming themselves, pitying themselves and looking for support. They also tended to ruminate over their suffering, withdraw from social interactions, react with aggression and/or take to drinking.

Validation of the Arabic Version of the Internet Gaming Disorder-20 Test

In recent years, researchers have been trying to shed light on gaming addiction and its association with different psychiatric disorders and psychological determinants. The latest edition version of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) included in its Section 3 Internet Gaming Disorder (IGD) as a condition for further empirical study and proposed nine criteria for the diagnosis of IGD. The 20-item Internet Gaming Disorder (IGD-20) Test was developed as a valid and reliable tool to assess gaming addiction based on the nine criteria set by the DSM-5. The aim of this study is to validate an Arabic version of the IGD-20 Test. The Arabic version of IGD-20 will not only help in identifying Arabic-speaking pathological gamers but also stimulate cross-cultural studies that could contribute to an area in need of more research for insight and treatment. After a process of translation and back-translation and with the participation of a sizable sample of Arabic-speaking adolescents, the present study conducted a psychometric validation of the IGD-20 Test. Our confirmatory factor analysis showed the validity of the Arabic version of the IGD-20 Test. The one-factor model of the Arabic IGD-20 Test had very good psychometric properties, and it fitted the sample data extremely well. In addition, correlation analysis between the IGD-20 Test and the daily duration on weekdays and weekends gameplay revealed significant positive relationships that warranted a criterion-related validation. Thus, the Arabic version of the IGD-20 Test is a valid and reliable measure of IGD among Arabic-speaking populations.

Problematic Social Media Use: Results from a Large-Scale Nationally Representative Adolescent Sample

Despite social media use being one of the most popular activities among adolescents, prevalence estimates among teenage samples of social media (problematic) use are lacking in the field. The present study surveyed a nationally representative Hungarian sample comprising 5,961 adolescents as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD). Using the Bergen Social Media Addiction Scale (BSMAS) and based on latent profile analysis, 4.5% of the adolescents belonged to the at-risk group, and reported low self-esteem, high level of depression symptoms, and elevated social media use. Results also demonstrated that BSMAS has appropriate psychometric properties. It is concluded that adolescents at-risk of problematic social media use should be targeted by school-based prevention and intervention programs.

Internet Gaming Disorder and Well-Being: A Scale Validation

The overuse of online games is known to be inversely related to various indicators of well-being. This article validates the DSM-5 criteria of internet gaming disorder (IGD), and analyzes its links with five indicators of well-being: life satisfaction, loneliness, anxiety, depression, and academic performance in a French-speaking sample of 693 gamers. Exploratory and confirmatory factor analyses showed a one-factor structure of IGD criteria. The IGD scale showed satisfactory validity and reliability and was related in a consistent way with well-being measures. The IGD scale appears to be an appropriate measure to assess video game addiction and will contribute to increase the comparability of international research on video game addiction.

Treatment with the Self-Discovery Camp (SDiC) improves Internet gaming disorder

INTRODUCTION

Internet gaming disorder (IGD) is a novel behavioral addiction that influences the physical, mental, and social aspects of health due to excessive Internet gaming. One type of intensive treatment for IGD is the therapeutic residential camp (TRC), which comprises many types of therapies, including psychotherapy, psychoeducational therapy, and cognitive behavioral therapy. The TRC was developed in South Korea and has been administered to many patients with IGD; however, its efficacy in other countries remains unknown. We investigated the efficacy of the Self-Discovery Camp (SDiC), a Japanese version of a TRC, and the correlations between individual characteristics and outcome measures.

METHODS

We recruited 10 patients with IGD (all male, mean age=16.2years, diagnosed using the DSM-5) to spend 8 nights and 9days at the SDiC. We measured gaming time as well as self-efficacy (using the Stages of Change Readiness and Treatment Eagerness Scale, a measure of therapeutic motivation and problem recognition).

RESULTS

Total gaming time was significantly lower 3months after the SDiC. Problem recognition and self-efficacy towards positive change also improved. Furthermore, there was a correlation between age of onset and problem recognition score.

CONCLUSIONS

Our results demonstrate the effectiveness of the SDiC for IGD, especially regarding gaming time and self-efficacy. Additionally, age of onset may be a useful predictor of IGD prognosis. Further studies with larger sample sizes and control groups, and that target long-term outcomes, are needed to extend our understanding of SDiC efficacy.

Received View of Addiction, Relapse and Treatment

It is important to highlight that attempts at understanding and explaining addiction have been made for centuries. It is, however, just five decades ago, with the growth of science and technology that more interest has been observed in this field. This chapter examines different views and theories that have been posited to understand and explain addiction. More attention will be given to prominent views that seem to draw consensus among researchers and medical practitioners. The first section of the chapter introduces the addiction debate, the different theories that have been provided to explain it from different perspectives and disciplines such as neurosciences, philosophy and psychology. Then, the chapter discusses different views on the role of relapse and what it entails in understanding addiction. The second section discusses different proposed and used forms of treating addiction. Thus, the chapter discusses the received view of addiction, the understanding of relapse as a critical element in addiction and treatments.

Clinical validation of the C-VAT 2.0 assessment tool for gaming disorder: A sensitivity analysis of the proposed DSM-5 criteria and the clinical characteristics of young patients with 'video game addiction'

AIMS

Clinicians struggle with the identification of video gaming problems. To address this issue, a clinical assessment tool (C-VAT 2.0) was developed and tested in a clinical setting. The instrument allows exploration of the validity of the DSM-5 proposal for 'internet gaming disorder'.

METHOD

Using C-VAT 2.0, the current study provides a sensitivity analysis of the proposed DSM-5 criteria in a clinical youth sample (13-23years old) in treatment for video gaming disorder (N=32). The study also explores the clinical characteristics of these patients.

RESULTS

The patients were all male and reported spending extensive amounts of time on video games. At least half of the patients reported playing online games (n=15). Comorbid problems were common (n=22) and included (social) anxiety disorders, PDD NOS, ADHD/ADD, Parent-Child relationship problem, and various types of depressive mood problems. The sensitivity of the test was good: results further show that the C-VAT correctly identified 91% of the sample at the proposed cut-off score of at least 5 out of 9 of the criteria. As our study did not include healthy, extreme gamers, we could not assess the specificity of the tool: future research should make this a priority.

CONCLUSION

Using the proposed DSM-5 cut-off score, the C-VAT 2.0 shows preliminary validity in a sample of gamers in treatment for gaming disorder, but the discriminating value of the instrument should be studied further. In the meantime, it is crucial that therapists try to avoid false positives by using expert judgment of functional impairment in each case.