Assessing online gaming and pornography consumption patterns during COVID-19 isolation using an online survey: Highlighting distinct avenues of problematic internet behavior

Emotional regulation in Gaming Disorder: A systematic review

BACKGROUND AND OBJECTIVES

Problematic video game use is a source of concern. In addictions, difficulties with emotional regulation have become an important variable of interest. However, their study in relation to problematic video game use remains insufficient.

METHODS

A systematic review was conducted following PRISMA 2020 guidelines; 322 studies were screened, resulting in a final sample of k = 18 studies. The methodological quality of these studies was rated as moderate according to the McMaster Critical Review Form for Quantitative studies (CRF-Q).

RESULTS

There is evidence of relationship between different facets of emotional regulation and the presence of problematic video game use. Particularly, video games serve as escape strategy for suppressing emotional expression. There is no consensus regarding the nature of the relationship between emotional regulation, psychopathology, and problematic video game use, with various proposals suggesting moderation and mediation. There is also no consensus regarding the mediation of gender in the relationship between emotional dysregulation and problematic video game use. The level of certainty regarding the validity of the results was moderate.

DISCUSSION AND CONCLUSIONS

Emotional dysregulation plays a role in problematic video game use, especially through strategies as emotional suppression, and lack of abilities to understand and control emotions. It is important to consider emotional regulation as a potential target for research and intervention in clinical populations.

SCIENTIFIC SIGNIFICANCE

We review the largest sample of papers on problem gaming and emotion regulation to date. Our results highlight the importance of emotion regulation and, specially, emotional suppression, or negative escapism, on problematic video game use.

Pornography and sexual function in the post-pandemic period: a narrative review from psychological, psychiatric, and sexological perspectives

The COVID-19 pandemic and lockdowns had significant impacts on sexual functioning and behavior. Partnered sexual activity decreased overall, while solo sex activities such as masturbation and pornography consumption increased exponentially. Given the ongoing debate about the effects of pornography on sexual function, it was prudent to consider how the increase in porn consumption during the pandemic might have impacted sexual function in the post-pandemic period. Results indicated that despite the increased rates of use during lockdowns, there remains no evidence supporting the relationship between sexual dysfunction and porn use during and following the pandemic period. On the contrary, pornography consumption and solo sex activities offered an alternative to conventional sexual behavior during a highly stressful period and were found to have positive effects of relieving psychosocial stress otherwise induced by the pandemic. Specifically, those who maintained an active sexual life experienced less anxiety and depression, and greater relational health than those who were not sexually active. It is important to consider factors including frequency, context, and type of consumption when analyzing the impact of pornography on sexual function. While excessive use can have negative effects, moderate use can be a natural and healthy part of life.

Pornography use, problematic pornography use, impulsivity, and sensation seeking: a meta-analysis

BACKGROUND

While some individuals engage in recreational pornography use (PU), others may develop an uncontrolled pattern of use termed problematic pornography use (PPU). PPU is characterized by persistent, excessive, or compulsive engagement with pornographic content, despite distress and adverse consequences. Impulsivity has been identified as a factor associated with PU and PPU.

AIM

The present meta-analysis aims to sum up the existing research on the relationship between impulsivity and PU/PPU and investigate whether age and gender could moderate this relationship.

METHODS

A keyword-based systematic literature search was performed to identify articles that assessed PU/PPU and impulsivity. Extracted correlations were converted into Fisher's Z. Meta-regression analyses were also performed. Publication bias was assessed by Egger's regression intercept.

OUTCOMES

Outcomes included general impulsivity and its dimensions (ie, negative and positive urgency, lack of premeditation and perseverance), sensation seeking, PU, and PPU.

RESULTS

Meta-analytic results of the random effects model showed a significant positive correlation between impulsivity as total score and PU (n = 1504, k = 4, Fisher's Z = 0.21, P < .001) and PPU (n = 20174, k = 13, Fisher's Z = 0.17, P < .001). Significant and positive associations were also found between sensation seeking and PU (n = 11707, k = 11, Fisher's Z = 0.14, P < .001) and PPU (n = 20152, k = 9, Fisher's Z = 0.06, P < .001). Concerning the relationship between PPU and different dimensions of impulsivity, almost all the associations were significant and positive. The dimension of positive urgency and attentional and nonplanning impulsivity showed the strongest association. Age (β = -0.50, Q = 101.26, df = 11, P < .001) and gender (female = 1; β = -0.46, Q = 102.54, df = 12, P < .001) moderated the association between general impulsivity and PPU. No risk of publication bias emerged.

CLINICAL IMPLICATIONS

Prevention programs of PPU should focus on impulsivity and certain key dimensions (eg, positive urgency, attentional and nonplanning impulsivity) and be tailored to individual impulsivity profiles, considering age and gender differences.

STRENGTHS AND LIMITATIONS

The primary strength of this meta-analysis is that it considers various conceptualizations of impulsivity. However, the results are to be interpreted with caution since >30% of relevant studies had to be excluded because information could not be gathered from the study authors.

CONCLUSION

These results suggest that general impulsivity is linked to PU and PPU and that specific dimensions of impulsivity (ie, attentional impulsivity, nonplanning impulsivity, and positive urgency) can serve as risk factors for PPU.

Problematic Pornography Use, Mental Health, and Suicidality among Young Adults

The relationship between suicidality and problematic pornography use (PPU) is not clear, and the limited research data that exists show contradictory results. The present study aims to explore the associations between these two variables in a sample of young adults, taking into account gender differences and the role of loneliness, emotional states, and well-being. A total of 332 national and international students (60% female) at an Italian University with a mean age of 23 years (SD = 2.84) completed an anonymous online survey during the period from March 2023 to May 2023. The results show that PPU was associated with higher levels of anxiety, depression, stress, loneliness, and suicide ideation, as well as lower life satisfaction. Gender comparison analysis revealed significantly higher scores for PPU and loneliness among men, while women scored higher in stress, anxiety, and life satisfaction. Significant correlations between PPU and suicidal ideation and having a suicide plan were established for female participants despite their lower scores in PPU. Multiple regression analysis revealed that PPU and its interaction with gender were both significant predictors of suicidal ideation. Future attention should be paid to how young women may be influenced by exposure to sexually explicit materials, while always considering the role of loneliness.

Automatic detection of problem-gambling signs from online texts using large language models

Problem gambling is a major public health concern and is associated with profound psychological distress and economic problems. There are numerous gambling communities on the internet where users exchange information about games, gambling tactics, as well as gambling-related problems. Individuals exhibiting higher levels of problem gambling engage more in such communities. Online gambling communities may provide insights into problem-gambling behaviour. Using data scraped from a major German gambling discussion board, we fine-tuned a large language model, specifically a Bidirectional Encoder Representations from Transformers (BERT) model, to predict signs of problem-gambling from forum posts. Training data were generated by manual annotation and by taking into account diagnostic criteria and gambling-related cognitive distortions. Using cross-validation, our models achieved a precision of 0.95 and F1 score of 0.71, demonstrating that satisfactory classification performance can be achieved by generating high-quality training material through manual annotation based on diagnostic criteria. The current study confirms that a BERT-based model can be reliably used on small data sets and to detect signatures of problem gambling in online communication data. Such computational approaches may have potential for the detection of changes in problem-gambling prevalence among online users.

Post-COVID-19 internet addiction, depression, and pornography addiction among adolescents: Findings from a nationwide study in Bangladesh

Background and Aims

Regulations response to COVID-19 has increased internet addiction (IA), depression, and pornography addiction (PA) among adolescents worldwide. The objective of this nationwide study was to assess the current prevalence rate of IA, depression, and PA after the post-COVID-19 period among school-going adolescents in Bangladesh.

Methods

A total of 8832 male and female adolescents participated in this research. The cross-sectional study was conducted online using a simple random sampling method. Including the sociodemographic variables, Young's IA Test (IAT-20) Scale, Patient Health Questionnaire (PHQ-9), and Pornography Craving Questionnaire (PCQ-12) were used to measure IA, depression, and PA. By SPSS version 25.0, the prevalence and correlation between IA, depression, and PA were analyzed using the Chi-square test, binary logistic regression, and a bivariate co-relation matrix.

Results

Sixty-three percent, 76.6%, and 62.9% of the students were suffering from IA, depression, and PA respectively. Depressive and anxious symptoms were significantly associated with IA. Female students were more depressed than males. Males were more addicted to pornography than females. Students who utilized social media but didn't exercise had greater depression and PA. IA, depression, and PA were correlated.

Conclusion

The research emphasizes the need for comprehensive mental health treatments, digital literacy programs, and family and teacher participation to reduce IA, depression, and PA among adolescents post-COVID-19. Promotion of physical exercise and supporting policies to build safer online settings for adolescents are also encouraged.

Problematic Gaming during COVID-19 Pandemic: A Systematic Review, Meta-Analysis, and Meta-Regression

The COVID-19 pandemic led to government measures enforcing isolation in order to mitigate the spread of the virus. Consequently, online activities, including gaming, increased during this challenging period. Thus, it was possible that problematic gaming (PG) patterns also increased. In this systematic review and meta-analysis, we estimated the prevalence of PG during the COVID-19 pandemic and examined differences among subpopulations. The evaluation of 38 studies revealed that the overall prevalence of PG during the COVID-19 pandemic was 3.6%. Furthermore, higher PG scores were found in undergraduate and gamer subpopulations, as well as in studies using the Gaming Addiction Scale. Finally, meta-regression analyses suggest that stricter government measures, as identified by the Government Stringency Index, may have contributed to a lower prevalence of PG behaviors. A potential explanation of this finding is that containment measures had a protective function with respect to emotional distress, and thus towards PG; alternatively, it could be that current measures for PG become less precise if an individual's functioning is already impaired due to other reasons, such as COVID-19 restrictions. Further theoretical, methodological, and practical implications of the findings are discussed.

Large-Scale Web Scraping for Problem Gambling Research: A Case Study of COVID-19 Lockdown Effects in Germany

The COVID-19 pandemic and the measures to prevent its spread have had a negative impact on substance use behaviour. It is likely that social distancing and lockdown measures have also altered gambling behaviour, for instance shifting from land-based to online gambling. We used large-scale web scraping to analyse posting behaviour on a major German online gambling forum, gathering a database of more than 200k posts. We examined the usage of different subforums, i.e. terrestrial, online gambling and problem gambling sections, and changes in posting behaviour related to the casino closures that were part of the nationwide restrictions in Germany in 2020. There was a marked increase in newly registered users during the first lockdown compared to the preceding weeks, an increase in the number of posts in the online gambling subforum and concurrent decrease in the terrestrial gambling subforum. Further, the number of short-latency replies was higher during the first lockdown compared to the preceding weeks. Many users who posted in both the online and terrestrial forum contributed at least once to the problem gambling subforum, implying that the topic of problem gambling is widely discussed. Our findings may indicate a shift from terrestrial to online gambling during lockdown, and mirror the general increase in screen time and usage of online platforms after the onset of the COVID-19 pandemic. The analyses help to identify lockdown-related effects on gambling behaviour. These potentially detrimental effects pose a special threat for individuals at risk and may require monitoring and special public health measures.

Association between problematic Internet use and specific Internet activities and COVID-19- and earthquake-related stress, anxiety, and depression symptoms among Croatian young adults

Background

During the COVID-19 pandemic and concomitant earthquakes in Croatia in 2020, increased Internet use (IU) and Internet-based addictive behaviors were associated with decreasing mental well-being. We determined the changes in IU, problematic IU (PIU), and problematic specific Internet activities in young adults during the prolonged stress caused by the pandemic and earthquakes, age differences in PIU and differences in perceived source of stress (pandemic or earthquakes), and association between PIU and increase in specific Internet activities and stress, anxiety, and depression symptoms in young adults.

Methods

A cross-sectional online survey conducted from September 30, 2021 to October 17, 2021 included 353 young adults aged 22.6 ± 2.1 years, 382 early adults aged 32.1 ± 4.4 years, and 371 middle-aged adults aged 49.0 ± 6.5 years. Data on sociodemographic characteristics, stressors (without perceived stressors, only pandemic-related stressor, only earthquake-related stressor, and both pandemic and earthquake-related stressors), PIU and IU were collected with a self-report questionnaire. The Impact of Event Scale and the Hospital Anxiety Depression Scale were used to evaluate mental symptoms. PIU and problematic specific Internet activities were assessed using Tao et al.'s criteria. Data were anaylzed with paired-sample Wilcoxon test, McNemar's and Pearson's chi-square tests, and structural equation modeling.

Results

In 17% of young adults, we found increased PIU (OR = 5.15, 95% CI [2.82, 10.18]), problematic social media use (OR = 2.77, 95% CI [1.56, 5.14]), and uncontrolled online shopping (OR = 5.75, 95% CI [1.97, 22.87]) (p < 0.001 for all). PIU and problematic social media use were more common among young adults (60.8%), as well as problematic online gaming (25.9%). Problematic social media use was more frequent among young adults reporting pandemic stress than among those without perceived stress (69.9% vs. 43.2%). Increased online gaming predicted more severe avoidance symptoms (p = 0.041), increased social media use predicted more severe depression symptoms (p = 0.017), increased online shopping predicted more severe intrusion (p = 0.013) and anxiety symptoms (p = 0.001). PIU predicted more severe intrusion (p = 0.008), avoidance (p = 0.01), anxiety (p < 0.001), and depression (p = 0.012) symptoms.

Conclusion

Different effects of the pandemic and earthquakes on IU could reflect a different effect of various stressors on Internet behavior of young adults. Type of problematic Internet behavior may predict for the type of mental health problem.

Understanding Problematic Gaming During the Covid-19 Pandemic in Adolescents and Adults: A Systematic Review of the Literature

Objective

A growing body of evidence suggests that online gaming increased during the COVID-19 outbreak. This systematic review aims to summarize extant literature that reported on problematic gaming among both adolescents and adults during the pandemic and to identify available research on the bidirectional association between problematic gaming and mental health outcomes.

Method

A systematic search was carried out through PubMed, Web of Knowledge and AGRIS, Embase, Medline, PsychINFO (from January 2020 to January 2023), using keywords related to problematic gaming and mental health outcomes. Both cross-sectional and longitudinal empirical studies which used validated measures of problematic gaming and mental health outcomes during the COVID-19 pandemic were included.

Results

Twenty-five empirical articles were eligible for the current review, comprising 28,978 participants. The majority of the selected studies had cross-sectional designs. Overall, most eligible studies showed significant association between problematic gaming and negative mental health outcomes during the pandemic. Correlations were mostly found between problematic gaming, depression and anxiety.

Conclusions

Future research focusing on the relationship between problematic gaming and mental health outcomes should go beyond the considerable weaknesses due to methodological limitations of cross-sectional design, sampling and measures.

Biopsychosocial factors of gaming disorder: a systematic review employing screening tools with well-defined psychometric properties

Background and aims

Considering the growing number of gamers worldwide and increasing public concerns regarding the negative consequences of problematic gaming, the aim of the present systematic review was to provide a comprehensive overview of gaming disorder (GD) by identifying empirical studies that investigate biological, psychological, and social factors of GD using screening tools with well-defined psychometric properties.

Materials and methods

A systematic literature search was conducted through PsycINFO, PubMed, RISS, and KISS, and papers published up to January 2022 were included. Studies were screened based on the GD diagnostic tool usage, and only five scales with well-established psychometric properties were included. A total of 93 studies were included in the synthesis, and the results were classified into three groups based on biological, psychological, and social factors.

Results

Biological factors (n = 8) included reward, self-concept, brain structure, and functional connectivity. Psychological factors (n = 67) included psychiatric symptoms, psychological health, emotion regulation, personality traits, and other dimensions. Social factors (n = 29) included family, social interaction, culture, school, and social support.

Discussion

When the excess amount of assessment tools with varying psychometric properties were controlled for, mixed results were observed with regards to impulsivity, social relations, and family-related factors, and some domains suffered from a lack of study results to confirm any relevant patterns.

Conclusion

More longitudinal and neurobiological studies, consensus on a diagnostic tool with well-defined psychometric properties, and an in-depth understanding of gaming-related factors should be established to settle the debate regarding psychometric weaknesses of the current diagnostic system and for GD to gain greater legitimacy in the field of behavioral addiction.

Profiles of Pornography Use Based on Addictive Mechanisms and Psychopathological Features

Studies using person-centered approaches to further explore the profiles of pornography users throw their psychiatric features are lacking. This study was designed to examine the different profiles of pornography users based on the addictive dimensions of Problematic Pornography Use (PPU) and to characterize these profiles according to psychopathological variables such as depression, anxiety, attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). A sample of 1001 French adults participated to a survey containing scales related to psychopathological variables, cybersexual addiction and PPU. PPU was assessed with the French Version of Problematic Pornography Consumption Scale (Fr-PPCS-18). An Agglomerative Hierarchical Classification was performed on the basis of FR-PPCS-18. A student's t-test was used to observe PPU and psychopathological differences between profiles. Findings revealed three profiles of users: non-problematic users (66.5%), at-risk users (29.9%), and problematic users (3.6%). There were significant differences between the three profiles concerning levels of global PPU, PPU mechanisms, cybersexual addiction symptoms, ADHD symptomatology and depressive symptomatology. Results confirmed the existence of different levels of severity of pornography use corresponding to three different profiles. Also, findings revealed the influence of ADHD symptoms, obsessive-compulsive symptoms and depressive symptoms on PPU.

Generalised anxiety disorder, depressive symptoms and their subjective change after the first wave of COVID-19 among gamers in Poland

Previous studies have indicated that levels of emotional distress were considerably elevated during the COVID-19 pandemic; however, some longitudinal studies did not confirm these findings. There is a very limited number of studies on specific subpopulations, such as video gamers in this particular period. Playing video games may have either a beneficial influence on mental health by diminishing stress or a detrimental impact in terms of increasing depression and anxiety. It is, therefore, important to establish whether regular gamers differ from the general population in terms of symptoms of depression and anxiety during COVID-19. A total of 1023 participants (aged 18-50) participated in the study. The sample was composed of gamers and was representative of the Polish population. Participants completed a modified version of GAD-7, PHQ-9 online, addressing subjective change in anxiety and depressive symptoms. 25% of the sample reported clinically significant anxiety levels, and 35% mentioned depression. There were no differences in anxiety and depression levels between the investigated sample of gamers and the general population. However, up to 30% of individuals reported an increase in subjective change in anxiety or depressive symptoms during COVID-19. A further 30% reported a downward subjective change in anxiety or depressive symptoms during COVID-19. The remaining 40% declared a lack of change in the subjective change in anxiety or depressive symptoms during COVID-19. Those who reported an increase scored substantially higher in anxiety and depression than other groups. This indicates that the COVID-19 pandemic may have impacted people's mental health along a syndemic-syndaimonic continuum. COVID-19 might have been harmful to those with already poorer mental health and beneficial to those with good mental health. It is also important to plan interventions targeting vulnerable individuals who report clinically significant levels of anxiety and depression - women and younger adults and those who subjectively perceive their emotional condition to deteriorate during the COVID-19 lockdown.

Effects of a 7-Day Pornography Abstinence Period on Withdrawal-Related Symptoms in Regular Pornography Users: A Randomized Controlled Study

Little is known about whether withdrawal-like symptoms manifest when regular pornography users attempt to abstain from pornography. The present study used a randomized controlled design to examine whether (1) negative abstinence effects that may be potentially reflective of withdrawal-related symptoms manifest when a non-clinical sample of regular pornography users attempt to abstain from pornography for a 7-day period and (2) these negative abstinence effects would only manifest (or manifest more strongly) for those with higher levels of problematic pornography use (PPU). A total of 176 undergraduate students (64.2% female) who were regular pornography users (defined as having used pornography ≥ three times a week in the past 4 weeks) were randomly assigned to an abstinence group (instructed to attempt abstinence from pornography for 7 days, n = 86) or a control group (free to watch pornography as usual, n = 90). Participants completed measures of craving, positive and negative affect, and withdrawal symptoms at baseline and each night of the 7-day period. Contrary to the confirmatory hypotheses, there were no significant main effects of group (abstinence vs. control) or group × PPU interaction effects on any of the outcome measures, controlling for baseline scores. These findings indicate that no evidence of withdrawal-related symptoms was found for abstaining participants, and this was not dependent on level of PPU. However, exploratory analyses showed a significant three-way interaction (group × PPU × past 4-week frequency of pornography use [FPU]) on craving, where an abstinence effect on craving was found at high levels of PPU only once past 4-week FPU reached the threshold of daily use. While these exploratory findings should be interpreted with caution, they suggest that abstinence effects could potentially manifest when there is a combination of high PPU and high FPU-a hypothesis that warrants investigation in future prospective abstinence studies.

Effect of COVID-19 pandemic on internet gaming disorder among general population: A systematic review and meta-analysis

Internet gaming disorder (IGD) has been rising in recent years. The COVID-19 pandemic has led to a noticeable shift in the way people interact with technology, which could have further contributed to an increase in IGD. Post-pandemic, the concern for IGD is likely to continue as people have become increasingly reliant on online activities. Our study aimed to assess the prevalence of IGD among the general population globally during the pandemic. Relevant studies that assessed IGD during COVID-19 were identified using PubMed, EMBASE, Scopus, CINAHL, and PsycNET between 2020, Jan 1 and 2022, May 23. We used NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies to assess the risk of bias, and GRADEpro for the certainty of the evidence. Three separate meta-analyses were performed using Comprehensive meta-analysis software and Revman 5.4. In total, 362 studies were identified, of which 24 observational (15 cross-sectional and 9 longitudinal) studies among 83,903 population were included in the review, and 9 studies in the meta-analysis. The risk of bias assessment showed an overall fair impression among the studies. The meta-analysis for a single group of 3 studies showed the prevalence rate of 8.00% for IGD. Another meta-analysis of 4 studies for a single group showed a pooled mean of 16.57 which was lower than the cut-off value of the IGDS9-SF tool. The two-group meta-analysis of 2 studies showed no significant difference between the groups before and during COVID-19. Our study showed no clear evidence of increased IGD during COVID-19 due to limited number of comparable studies, substantial heterogeneity, and low certainty of evidence. Further well-designed studies are needed to provide stronger evidence to implement suitable interventions to address IGD worldwide. The protocol was registered and published in the International Prospective Register for Systematic Review (PROSPERO) with the registration number CRD42021282825.

Uncovering sample heterogeneity in gaming and social withdrawal behaviors in adolescent and young adult gamers in Hong Kong

OBJECTIVE

The current study aimed to examine the latent heterogeneity of gaming and social withdrawal behaviors in internet gamers and their associations with help-seeking behaviors.

METHOD

The present study recruited 3430 young people (1874 adolescents and 1556 young adults) in Hong Kong in 2019. The participants completed the Internet Gaming Disorder (IGD) Scale, Hikikomori Questionnaire, and measures on gaming characteristics, depression, help-seeking, and suicidality. Factor mixture analysis was used to classify the participants into latent classes based on their latent factors of IGD and hikikomori in separate age groups. Latent class regressions examined the associations between help-seeking and suicidality.

RESULTS

Both adolescents and young adults supported a 4-class, 2-factor model on gaming and social withdrawal behaviors. Over two-third of the sample were classified as healthy or low-risk gamers with low IGD factor means and low prevalence of hikikomori. Around one-fourth was moderate-risk gamers with elevated prevalence of hikikomori, higher IGD symptoms and psychological distress. A minority of the sample (3.8%-5.8%) belonged to high-risk gamers with the highest IGD symptoms and prevalence of hikikomori and heightened suicidal risks. Help-seeking in low-risk and moderate-risk gamers was positively associated with depressive symptoms and negatively associated with suicidal ideation. Perceived usefulness of help-seeking was significantly linked with lower likelihoods of suicidal ideation in the moderate-risk gamers and suicide attempt in the high-risk gamers.

CONCLUSIONS

The present findings explicate the latent heterogeneity of gaming and social withdrawal behaviors and associated factors on help-seeking and suicidality among internet gamers in Hong Kong.

Prevalence and predictors of pornography exposure during the third wave of the COVID-19 pandemic: A web-based cross-sectional study on students in Bangladesh

Background

Pornography exposure, particularly among students, in Bangladesh, has increased in the twenty-first century. However, pornography exposure during the COVID-19 pandemic, when people were compelled to "stay at home" and relied extensively on the internet for all forms of activities, including academia, socializing, and communication, has remained unexplored. The present study aimed to assess the prevalence of pornography exposure among students during the third wave of the COVID-19 pandemic and to determine the associated predictors.

Methods

A web-based cross-sectional study was carried out among students with certain specifications, i.e., current students at high school/college/university with access to the internet and valid social media accounts. By administering a semi-structured e-questionnaire using Google Forms, a total of 646 valid responses were retained for this study. The data were analyzed in two phases by Pearson's Chi-square and multiple logistic regression model, using IBM SPSS Statistics, version 25. The results were expressed as an adjusted odds ratio (AOR) with a 95% confidence interval (95% CI).

Results

The findings suggest that 75.9% of students were exposed to pornography during the third wave of the COVID-19 pandemic and preferred to watch the amateur/professional genre of pornography. Pornography exposure was significantly associated with age and relationship status, as students aged 22-24 years (95% CI: 1.01-2.41; p = 0.045) and over 25 years (95% CI: 1.61-10.03; p = 0.003) were more likely to watch pornography, while married students and those in relationships (95% CI: 1.24-3.49; p = 0.006) also watched pornography during the pandemic. In contrast, students who were living alone (95% CI: 0.38-0.92; p = 0.021), were living in the Khulna division (95% CI: 0.16-0.52; p < 0.001) or had a negative attitude toward pornography (95% CI: 0.94-0.99; p = 0.002) were less likely to be exposed to pornography.

Conclusion

Pornography exposure was higher among students in Bangladesh during the COVID-19 pandemic, and religiosity and disapproving attitudes toward pornography negatively influenced the pornography exposure. For a better understanding of the complex dynamics of socio-demographic issues with pornography exposure among students, extensive research is required for policymakers to devise appropriate strategies and interventions to ensure healthy and safe sex life for the younger population.

Problematic Internet Use, Anxiety, Depression, and Stress Symptoms in Adults with COVID-19 Pandemic and Earthquake Experience: Insights from Croatian Online Survey

In 2020, Croatia was hit by the COVID-19 pandemic and two earthquakes. As previous research showed that Internet use (IU) increased during the COVID-19 pandemic, we carried out an online survey to determine the levels of problematic Internet use (PIU) and problematic specific Internet activities before and during the prolonged stress caused by the COVID-19 pandemic as well as earthquakes. We also determined the correlation between the PIU and specific Internet activities and anxiety, depression, and stress symptoms. According to the responses of 1,118 participants from all Croatian regions, PIU increased by 14.1 percent (odds ratio [OR] 6.2), problematic social media use by 12.6 percent (OR 4.8), and uncontrolled online shopping by 5.3 percent (OR 5.8) in comparison with presurvey period. The PIU increase was significantly higher in participants reporting only pandemic-related stress than in those reporting both pandemic- and earthquake-related stress. Problematic social media use increased in those reporting only pandemic-related stress and both pandemic- and earthquake-related stress. The strongest correlation between PIU and problematic social media use and anxiety, depression, intrusion, and avoidance symptoms was found among those reporting both pandemic- and earthquake-related stress. The correlation between psychiatric measures and PIU and problematic specific Internet activities varied depending on the source of experienced or perceived stress. Our findings show the relationship between the problematic stress-related Internet behaviors, different types of stressors, and their impact on the overall PIU and problematic specific Internet activities in situations of prolonged stress.

Evaluating a cross-lagged panel model between problematic internet use and psychological distress and cross-level mediation of school administrator support on problematic internet use: The serial mediating role of psychological needs thwarting of online teaching and psychological distress

BACKGROUND

To reduce the transmission of COVID-19, many teachers across the globe, including teachers in China, were required to teach online. This shift to online teaching can easily result in psychological need thwarting (PNT) of teachers' psychological basic needs (autonomy, competence, and relatedness), leaving them vulnerable to negative psychological outcomes. Resulting negative emotional state may lead to problematic internet use (PIU), which can lead to further psychological distress, forming a vicious cycle.

METHODS

The present study was conducted using a cross-lagged panel model (with longitudinal data) and hierarchical linear modeling (HLM) (with cross-sectional data). The aims were to investigate (i) the reciprocal relationships between two specific forms of PIU [problematic social media use (PSMU) and problematic gaming (PG)] and psychological distress among schoolteachers, and (ii) the influence of administrators' support on schoolteachers' PIU through a cross-level serial mediation model (PNT of online teaching was the first mediator and psychological distress was the second mediator affected by PNT of online teaching). Primary and secondary schoolteachers (N = 980; mean age = 34.76; 82.90% females) participated in two surveys (Time 1: mid-November 2021; Time 2: early-January 2022).

RESULTS

Results indicated that (i) high psychological distress at Time 1 was associated with increased levels of PSMU and PG at Time 2. Inversely, PG at Time 1 was associated with increased psychological distress at Time 2, although PSMU at Time 1 did not have a significant influence on psychological distress at Time 2; (ii) during Time 1, increased administrative support contributed to alleviating teachers' psychological needs thwarting of online teaching, thereby lowering their psychological distress which, in turn, resulted in a decrease in PG.

CONCLUSION

PG had a stronger negative influence on teachers' psychological distress than PSMU. To relieve teachers' PG, administrative support can alleviate teachers' psychological needs thwarting of online teaching and psychological distress. Based on this finding, school managers must consider effective ways to support teachers during mandatory online teaching.

Sexual Health During COVID-19: A Scoping Review

INTRODUCTION

The COVID-19 pandemic impacted profoundly on the wellbeing and social interactions of the world population, and all dimensions of sexual health were potentially affected by globally implemented preventive measures.

OBJECTIVES

The scoping review aimed to compile existing research investigating possible effects of COVID-19 lockdowns on adult sexual health, that is, sexual behavior, functioning, and satisfaction. Further, studies on the interplay between mental health and sexual well-being during the pandemic were reviewed.

METHODS

The review was conducted in accordance with guidelines established by the Joanna Briggs Institute and the Extension for Scoping Reviews (PRISMA-ScR) Checklist. On October 11-12, 2021, PubMed, Embase, PsycInfo, Cinahl, Cochrane, Sociological Abstracts and Scopus were systematically searched for relevant peer-reviewed papers employing quantitative methodology. Additionally, unpublished ("grey") research studies on the subject were retrieved. The screening, data extraction, and analysis of evidence were conducted by 4 independent reviewers using an iterative approach.

RESULTS

Based on 107 studies included, the scoping review showed that the pandemic had had a wide impact on all dimensions of sexual health. Except for solo sex activities, mainly negative COVID-19 implications were identified, although findings were, in sum, characterized by complexity and unpredictability. Thus, sexual behavior, functioning, and satisfaction during the pandemic appeared to be mitigated by a broad range of sociodemographic and contextual factors. Finally, sexual health seemed deeply entwined with overall mental health.

CONCLUSION

The scoping review revealed a broad range of COVID-19-related effects on sexual health, including an overall decline in partnered sex and a concurrent increase in solo sex activities. It also emphasized a need for future research to shed light on possible long-term consequences of the pandemic in various population groups and on all aspects of sexual health. Toldam NE, Graugaard C, Meyer R, et al. Sexual Health During COVID-19: A Scoping Review. Sex Med Rev 2022;10:714-753.

Internet use and internet-based addictive behaviours during coronavirus pandemic

PURPOSE OF REVIEW

The COVID-19 outbreak profoundly influenced human lives on different levels. This narrative review aims to present recent data relating to the COVID-19 pandemic and internet use and internet-based addictive behaviours [problematic Internet use (PIU), Internet addiction, Internet gaming disorder, problem gambling or gambling disorder, social media addiction including smartphone use disorder, problematic pornography use, and compulsive buying].

RECENT FINDINGS

During the COVID-19 pandemic, the prevalence of Internet use and Internet-based addictive behaviours increased in all age groups. The COVID-19 pandemic and related containment measures were been associated with increased levels of stress, anxiety, and depression in the general population, especially among children and adolescents, which are the vulnerable groups for the development of mental disorders during the crisis. Furthermore, the fear resulting from the disease, the 'lockdown' measures, high levels of uncertainty regarding the future, and financial insecurity increased levels of loneliness, PIU, and Internet addiction.

SUMMARY

Longitudinal researches focused on the negative impacts of Internet use in prolonged stress situations on mental health, vulnerable groups, and quality of life (QoL) are needed to help clinicians and policymakers to reduce adverse consequences. Prevention programs for Internet use and Internet-based addictive behaviours must be customized to meet the needs of children, adolescents, and adults. Also, treatment programs must be tailored to the needs of patients with different Internet-based addictions.

The Moderating Role of Psychological Flexibility on the Association between Distress-Driven Impulsivity and Problematic Internet Use

Background: Problematic internet use is receiving increasing attention in the addiction field, yet the mechanisms driving such behaviours remain unclear. Previous research has shown that impulsivity- and compulsivity-related constructs may interactively contribute to a range of problematic behaviours. The current study examined whether distress-driven impulsivity and psychological flexibility may interactively contribute to problematic internet use, which has not been addressed in prior literature. Method: Two hundred and one participants completed an online survey. Bootstrapped moderation analysis was conducted to examine the collected data on distress-driven impulsivity, psychological flexibility, and their interaction in relation to problematic internet use. Results: The interaction between distress-driven impulsivity and psychological flexibility was significantly related to problematic internet use. Simple slope tests confirmed that distress-driven impulsivity was associated with problematic internet use among individuals with low flexibility levels. Conclusions: Our findings highlight the moderating role of psychological inflexibility in the association between distress-driven impulsivity and problematic internet use. Prevention and/or early interventions for problematic internet use should consider targeting psychological inflexibility and distress-driven impulsivity.

Changes and correlates of screen time in adults and children during the COVID-19 pandemic: A systematic review and meta-analysis

Background

Screen time has increased as a result of the COVID-19 pandemic, and several correlates have been associated with these increases. These changes, however, have not been aggregated. It was the aim of this review to (a) aggregate changes in screen time in adults and children, and (b) report on variables in relation to screen time during the COVID-19 pandemic.

Methods

A systematic review of major databases was undertaken for studies published from inception to 06/12/2021, using a pre-published protocol (PROSPERO ID: CRD42021261422). Studies reporting (a) screen time pre-versus-during the pandemic, (b) screen time percentage change, or (c) correlates of screen time during the pandemic were included. A random effects meta-analysis was undertaken with subgroup analysis by age group and type of screen time.

Findings

After review, 89 studies (n = 204,734; median age=20·6; median female=53·3%) were included. The majority of studies were cross-sectional. With regards to total screen time, primary aged children (6-10 years) reported largest increases (1·4 hrs/day; 95%CI 1·1-1·7), followed by adults (>18 years; 1·0 hrs/day; 95%CI 0·7-1·2), adolescents (11-17 years; 0·9 hrs/day; 95%CI 0·3-1·5), and young children (0-5 years; 0·6 hrs/day 95%CI 0·3-0·9 hrs/day). For leisure screen time (non-work/non-academic), primary aged children reported largest increases (1·0 hrs/day 95%CI 0·8-1·3), followed by adults (0·7hr/day 95%CI 0·3-1·2), young children (0·6 hrs/day; 95%CI 0·4-0·8), with adolescents reporting the lowest increase (0·5 hrs/day 95%CI 0·3-0·7). Several correlates were associated with reported increases in screen time, including adverse dietary behaviours, sleep, mental health, parental health, and eye health.

Interpretation

Pooled evidence suggest that primary aged children reported the highest increase in both total and leisure screen time during COVID-19. It is recommended that screen time should be reduced in favour of non-sedentary activities. This study has the potential to inform public health policy and future guidance regarding screen time, and to inform future research in this area.

Funding

No funding was received for this study.

The Effects of Playing Video Games on Stress, Anxiety, Depression, Loneliness, and Gaming Disorder During the Early Stages of the COVID-19 Pandemic: PRISMA Systematic Review

During the initial phases of the COVID-19 pandemic, playing video games has been much more than just a pastime. Studies suggested that video games for many individuals have helped to cope with such difficult life experience. However, other research indicates that gaming may have had harmful effects. Within this context, this systematic review aimed to describe the literature on the effects of video games during the early stages of the COVID-19 crisis on stress, anxiety, depression, loneliness, and gaming disorder (GD), examining the study characteristics and outcomes. A systematic search of the literature was made following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. It was preregistered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY)-INPLASY202180053. The search databases were PsycINFO, Web of Science, and Medline. The search string was: [("video game*") OR ("computer game*") OR ("gaming")] AND [("COVID-19")]. Twenty-four studies met the inclusion criteria. Four research explored the effects of playing video games during the COVID-19 pandemic on stress, anxiety, and depression. Four studies investigated loneliness, while 18 research investigated game disorder. Video games, especially augmented reality and online multiplayer ones, mitigated stress, anxiety, depression, and loneliness among adolescents and young adults during stay-at-home restrictions. However, in the case of at-risk individuals (i.e., particularly male youths), playing video games had detrimental effects.

Self-perceived substance and behavioral addictions among Jewish Israeli adolescents during the COVID-19 pandemic

This study examined self-perceived substance and behavioral addictions among Israeli adolescents during the COVID-19 pandemic across different sociodemographic categories. The sample comprised 2,074 adolescents (40% males, 60% females) aged 12-19 years who completed the survey anonymously and with parental consent. We examined what is the prevalence of self-perceived substance and behavioral addictions in this population in the COVID-19 pandemic context. Participants reported self-perceived addictions to social networks (70%), shopping (46%), binge eating (34%), gaming (30%), sex-related behavior (15%), psychoactive substance (31%, including alcohol, tobacco, cannabis, and/or cocaine), and gambling (3%). Moreover, differences were found to be directly related to age, biological sex, religiosity, socioeconomic status, and immigration status. From a lay epidemiological perspective, the current research expands our knowledge about self-perceived addiction among adolescents during the COVID-19 pandemic, offering better understanding of the likelihood probability factors for self-perceived addiction among adolescents and its related negative outcomes, including increased risk factors for later adult life.

No Significant Changes in Addictive and Problematic Behaviors During the COVID-19 Pandemic and Related Lockdowns: A Three-Wave Longitudinal Study

Introduction

The COVID-19 outbreak and related lockdowns brought substantial changes in people's lives and led to concerns about possible increases of addictive behaviors at the initial stages of the pandemic. To examine these concerns, the aim of the present study was to assess longitudinal changes in addictive and problematic behaviors (i.e., problematic social media use, Internet gaming disorder, gambling disorder, problematic pornography use, and compulsive sexual behavior disorder) over time during the COVID-19 pandemic.

Methods

Three waves of data collection took place in different stages of the COVID-19 outbreak in Hungary in a general population, from the first wave of lockdowns to the second and third waves of restrictions (May, 2020; N T1 = 1747; June-August, 2020; N T2 = 656; January, 2021; N T3 = 411). Latent growth curve models were calculated to assess the potential changes in addictive and problematic behaviors over time.

Results

Latent growth curve models showed that the sample varied in their initial scores, but there were no significant changes over time in any of the examined behaviors, except for compulsive sexual behavior disorder, which demonstrated a small but significant increase (i.e., positive and significant slope factor). However, the rate of this change was negligible. Overall, there were no noteworthy changes over time regarding any of the examined addictive and problematic behaviors.

Conclusion

Contrary to initial concerns, no substantial changes over time were observed regarding the examined addictive behaviors during the COVID-19 pandemic and related lockdowns. These findings indicate that those who had no previous problem with these addictive behaviors, might have not developed a problem, and those who had problem with either of the behaviors previously, might have not experienced a significant increase in their symptoms.

The impact of COVID-19 on addiction treatment in New Zealand

COVID-19 public health measures, including lockdowns, have disrupted psychological service delivery for substance use and behavioural addictions. This study aimed to examine how addictions treatment had been affected by COVID-19 related factors from the perspective of addiction and mental health service providers. Participants (n = 93) were experienced service managers and clinicians in New Zealand who completed an online survey. Clinicians reported increased presentations for problems related to internet gambling (n = 57, 61%), gaming (n = 53, 57%), social media use (n = 52, 56%), and pornography (n = 28, 30%). A qualitative analysis of responses generated six themes. Themes included service management and increased administrative burden, and service delivery reconfiguration. Access improved for some clients because of convenience and reduced structural barriers. However, online service delivery was problematic for those with unstable or no internet access and devices that could not support video conferencing and/or lack of safe, confidential or private spaces at home. Increased client complexity and restricted in-person care prompted changes to focus, and content of clinical interventions, and some respondents offered more frequent but shorter appointments. Clinicians who provided services by phone or email, rather than video conferencing, reported treatment was less effective, with reduced rapport and engagement a contributing factor. The New Zealand addictions sector has responded to COVID-19 by increasing treatment access through distance-based options. Maintaining multifaceted models of care that are agile to rapidly changing environments presents unique challenges but is critical to addressing the needs of people impacted by addiction.

The Impact of the SARS-CoV-2 Pandemic on Reproduction, Sexual Function and Behaviors: A Review of the Main Trends and Findings

Objective: This review sought to describe the main trends and findings on the SARS-CoV-2 and the pandemic's effect on reproduction (i.e., effects on fertility, reproductive tissue, pregnancy, vertical and sexual transmission) and sexual function and behaviors. Methods: A review was conducted on studies assessing these variables through the Scopus and PubMed databases between the years 2019-2021. Results: Results showed SARS-CoV-2 pandemic and social distancing measures have affected-and in some cases not-different aspects of people's reproductive function, sexual function and behaviors. Conclusions: Suggestions are offered for researchers and professionals focused on future research and clinical practice.

Do Academic Stress, Burnout and Problematic Internet Use Affect Perceived Learning? Evidence from India during the COVID-19 Pandemic

Distress in online classrooms and problematic internet use are two issues that have caused student burnout and affect perceived learning during the COVID-19 pandemic. Given the high pressure placed on students throughout COVID-19, it is critical to understand the influence of problematic internet use (PIU), psychological stress, academic burnout, and resilience on perceived learning (PL). A cross-sectional analytical study was chosen to collect data from 350 learners pursuing undergraduate and postgraduate business/management degrees in Karnataka, India. The data were analyzed using SPSS (Statistical Package for Social Science) and Smart PLS 3. The present study reports a non-significant negative total effect of stress on PL, while there was a significant positive direct effect but a significant indirect negative effect of multiple mediators, namely PIU, burnout, and resilience. In the relationship between stress and PL, burnout has full competitive mediation, and the suppressive effect of burnout and resilience wipes out the beneficial benefit of stress on PL, resulting in reduced PL. As a societal problem, a change in educational policy and prevention strategies for students and organizations (reducing the number of courses, number of exams, and handling parental expectations) would be effective. Emotional intelligence to improve resilience, which assists students in sailing through a current challenging situation and using IT for reducing negative and unexpected emotional outbursts should be encouraged.

The Interplay Between Problematic Online Pornography Use, Psychological Stress, Emotion Dysregulation and Insomnia Symptoms During the COVID-19 Pandemic: A Mediation Analysis

PURPOSE

Although a link between problematic online pornographic use (POPU) and insomnia symptoms has been established, psychological and psychopathological mechanisms underlying this relationship are still not clear. Psychological stress and emotion dysregulation have been pointed out as relevant in the development and maintenance of insomnia. This study aims to explore the associations between POPU, psychological stress, emotion dysregulation and insomnia symptoms and to understand the mediating role of psychological stress and emotion dysregulation in the relationship between POPU and insomnia symptoms.

PARTICIPANTS AND METHODS

A sample of 776 Italian adults aged 19-48 years (51.4% female; M age = 28.49; SD = 7.33) completed questionnaires regarding demographics, COVID-19-related variables, POPU, psychological stress, emotion dysregulation, and insomnia symptoms.

RESULTS

After controlling for demographic covariates and COVID-19-related variables, multiple mediation model showed that higher psychological stress and emotion dysregulation fully mediated the link between POPU and insomnia.

CONCLUSION

The findings underscore the significance of the negative consequences of POPU and underline the importance of working on this and its effects on psychological stress and emotion dysregulation to limit insomnia.

How Does Psychological Distress Due to the COVID-19 Pandemic Impact on Internet Addiction and Instagram Addiction in Emerging Adults?

International research has underlined a worrying increase in Internet and Instagram addiction among emerging adults during the COVID-19 pandemic. Although the role played by alexithymia and psychological distress due to COVID-19 has been evidenced, no study has explored their complex relationship in predicting emerging adults' Internet and Instagram addiction. The present study aimed to verify whether peritraumatic distress due to the COVID-19 pandemic mediated the relationship between emerging adults' alexithymia and their Internet/Instagram addiction, in a sample composed of n = 400 Italian emerging adults. Results showed that females had higher peritraumatic distress due to COVID-19 than males, whereas males had higher externally oriented thinking and higher levels of Internet addiction than females. Emerging adults' psychological distress due to COVID-19 significantly mediated the effect of alexithymia on Internet and Instagram addiction. Our findings supported the presence of a dynamic relationship between individual vulnerabilities and the co-occurrence of other psychological difficulties in predicting emerging adults' Internet and Instagram addiction during the pandemic, with important clinical implications.

Changes in substance use and other reinforcing behaviours during the COVID-19 crisis in a general population cohort study of young Swiss men

BACKGROUND AND AIMS

There are concerns about the potential impact of the coronavirus disease (COVID-19) pandemic on substance use (SU) and other reinforcing behaviours (ORB). This paper investigates changes in SU and ORB among young men during the COVID-19 crisis (i.e. March-June 2020).

METHODS

Before and during the COVID-19 crisis, 2,344 young Swiss men completed questionnaires covering SU (i.e. alcohol, cigarettes, illegal cannabis), ORB (i.e. gaming, watching TV series, internet pornography) and sociodemographic and work-related characteristics (i.e. deterioration in the work situation, change in working hours, change in working hours from home, healthcare workers' and other professionals' contacts with potentially infected people, linguistic region, call up to military or civil protection unit, living situation, age).

RESULTS

Latent-change score models showed significant decreases of 17% for drinking volume and frequency of heavy episodic drinking, and a significant increase of 75% for time spent gaming and watching TV series. Subgroups showed greater relative increases. French-speaking participants, those who experienced a deterioration in their work situation and healthcare workers in contact with potentially infected people reported increased cigarette use. Those without children increased gaming, whereas those who worked fewer hours, experienced a deterioration in their work situation or were French-speaking did more gaming and watched more TV series. Those who lived alone or were German-speaking watched more internet pornography.

CONCLUSION

During the COVID-19 crisis, young Swiss men drank less alcohol and spent more time gaming and watching TV series. Changes in SU and ORB were not homogenous in the young Swiss men population.

Internet Use and Adolescents' Physical and Mental Health: the Mediating Role of Self-consciousness and Peer Relationships

In recent years, online gaming and cyber pornography have become problematic activities among Internet users. When individuals immerse themselves in these activities, the experience of flow can negatively influence users’ physical and mental health and interpersonal relationships. Thus, this study analyzed the mediating roles of self-consciousness and peer relationships in the relationships between online gaming, cyber pornography, and physical and mental health. We obtained data from fifteen senior high schools in Taiwan (N = 1838 students; first year, 996 students, and second year, 842 students) by conducting a 2-year longitudinal survey. Statistical analyses were performed using structural equation modeling. The results indicated that adolescents’ online gaming was positively associated with their physical and mental health; however, it was negatively associated with their self-consciousness. In addition, when they became absorbed in cyber pornography, they lost track of time and lost self-consciousness, and it influenced their peer relationships. Self-consciousness and peer relationships mediated the relationships between cyber pornography and participants’ physical and mental health. We identified relationships between online gaming, cyber pornography, elements of flow, and physical and mental health. The findings of this research can offer guidelines for policy makers and educators who evaluate adolescents’ Internet use and behavior to provide proper access to Internet use and promote by building a healthy Internet environment in educational activities.