Global prevalence of digital addiction in general population: A systematic review and meta-analysis

Unraveling the core symptoms across distinct trajectories of problematic Internet use among 27,577 adolescents: Cross-lagged panel network analyses

Problematic Internet Use (PIU) often begins in adolescence and develops along diverse trajectories. Understanding the interaction between PIU symptoms and identifying the core PIU symptoms that drive distinct trajectories among adolescents are crucial. We employed cross-lagged panel network analyses to examine temporal relationships of PIU symptoms among Chinese adolescents across four developmental trajectories over two time points. A total of 27,577 adolescents (Mean age = 13.8, SD = 1.5) participated in this study. Demographic variables and PIU symptoms were collected from December 17 to 26, 2021 (T1) and from May 17 to June 5, 2022 (T2). The symptom "Reluctant to stop" in the resilient group and "Uncontrollable checking" in the alleviating group at T1 were most predictive of remission of other symptoms at T2, while "Empty life" in the deteriorating group and "Feeling of missing" in the persistent dysfunction group were most strongly associated with worsening of other PIU symptoms. Improving self-control is likely to promote healthy and beneficial Internet use among adolescents, while enhancing social connection and fostering exercise habits may help mitigate negative emotions and reduce the emergence of additional PIU symptoms among adolescents who have developed PIU.

Effects of cognitive behavioral therapy (CBT) on addictive symptoms in individuals with internet gaming disorders: A systematic review and meta-analysis

OBJECTIVE

We examined the effects of Cognitive Behavioral Therapy (CBT) on addiction symptoms in patients with internet gaming disorders and examined the moderating effects of participant characteristics, research methodologies, and features of interventions.

METHODS

We systematically searched nine databases through May 2024 without date restrictions using the following search terms: (cognitive behavio* therapy) AND (addict* OR dependen*) AND ((internet or gaming) AND dis*). Studies included were primary studies with evaluating CBT in patients with internet gaming disorders. Studies were included if they used a control group and were written in English. Both randomized control trials and quasi-experimental designs were included. We used a random-effects model to compute effect sizes (ESs) using Hedges' g, forest plot, and Q and I2 statistics as measures of heterogeneity. We also examined moderator analyses.

RESULTS

We found 13 studies with 1,115 participants (19.08±3.99 years old) that met inclusion criteria for this meta-analysis. Overall, patients with internet gaming disorders in the CBT group demonstrated significantly lower addiction symptoms (g = 0.72, 95 %CI:.420, 1.011, p<.001) compared to controls. Regarding moderators, funding, characteristics' participants at baseline, group discussion, length of intervention and dose were moderators affecting the ES.

CONCLUSION

CBTs are moderately effective interventions to reduce addiction symptoms among patients with internet gaming disorders. Clinicians might consider encouraging CBTs as alternative treatments for patients with internet gaming disorders. CBTs with a long length and high dose of intervention for practicing are likely to have a greater effect in reducing addiction symptoms.

Psychological risk factors for problematic social network use: An overview of systematic reviews and meta-analyses

Problematic Social Network Use (PSNU) is a widespread and harmful public health issue. Therefore, it is unsurprising that the literature has focused on identifying possible risk factors contributing to this behavior. However, most identified factors were found to be shared with other problematic online behaviors. Therefore, the present overview aims to identify the psychological risk factors consistently associated with PSNU and evaluate whether the emerging risk factors were shared across Internet Gaming Disorder, Problematic Pornography Use, and Compulsive Online Shopping. A systematic search of four databases was conducted to identify systematic reviews/meta-analyses investigating the relationship between PSNU and psychological risk factors. Then, a bibliometric analysis was performed to examine whether the identified factors were shared across other problematic online behaviors. Thirty-five systematic reviews/meta-analyses were included, examining general and behavior-specific predisposing factors. General predisposing factors associated with PSNU included insecure attachment, high neuroticism, low conscientiousness, low self-esteem, depression, anxiety, stress, social anxiety, loneliness, and fear of missing out. Behavior-specific factors, though less frequently studied, highlighted the role of unmet psychological needs, Preference for Online Social Interaction, and motives related to emotion regulation and socialization. The bibliometric analysis revealed that many risk factors for PSNSU are shared with other problematic online behaviors. However, certain specificities emerged, including distinct motivations driving these behaviors. Findings suggest that PSNU shares a spectrum of risk factors with other problematic online behaviors, yet specific etiological and motivational differences remain. Overall, the findings underscore integrating shared and specific risk factors to improve tailored prevention and intervention strategies.

Childhood psychological maltreatment and addictive social media use in Chinese adolescents: A path model of sense of control and negative affect as mediators

BACKGROUND

Addictive social media use (SMU) is a global concern, especially among adolescents. Recent studies have suggested that childhood psychological maltreatment may contribute to the development of addictive SMU. However, this association and its underlying mechanisms require further exploration.

OBJECTIVE

Guided by compensatory control theory and compensatory Internet-use theory, this study investigates whether and how adolescents' addictive use of social media is influenced by childhood psychological maltreatment. Specifically, we examined two factors related to childhood psychological maltreatment-sense of control and negative affect (measured by depression and anxiety individually)-as potential mediators.

METHODS

In a cross-sectional design, 994 adolescents (aged 13-16, with a mean age of 14.37 years, SD = 0.66, 44 % girls) from one middle school in China completed a pencil-and-paper survey assessing childhood psychological maltreatment, sense of control, depression, anxiety, and addictive SMU. A structural equation model was used to test the hypotheses.

RESULTS

After controlling for sociodemographic characteristics (e.g., gender, age, and only child), the results indicated that childhood psychological maltreatment indirectly affects addictive SMU via the independent mediating effects of depression and anxiety, as well as the sequential mediating effects of the sense of control and depression and the sense of control and anxiety.

CONCLUSIONS

The findings revealed compensation mechanisms underlying the relationship between childhood psychological maltreatment and adolescents' addictive SMU, which highlights alleviating negative affect (depression, anxiety) may play a more critical role in the development of addictive SMU.

The mediation role of low social-connectedness in association of internet gaming disorder and anger among adolescents: a multi-centre, large-sample and cross-sectional study

BACKGROUND

Although internet improves modern life, the corresponding consequences of internet gaming disorder (IGD), low social-connectedness and anger-emotion are emerging as global concerns. However, the association between these psychopathologies remain unclear.

METHODS

This survey enrolled 9,616 adolescents (11-19 years) from multi-center in China from September 2022 to March 2023. Association of self-reported social-connectedness (20-item revised Social Connectedness Scale, SCS) with IGD (9-item Internet Gaming Disorder Scale-short Form) and anger (6-item DSM-5-TR-Level 2-Anger Form) were characterized.

RESULTS

197 (2.05%) adolescents had been estimated as probable IGD, 364 (3.79%) reported severe-anger, and 1056 (10.98%) shown low reality social-connectedness (RSCS). The female (OR:2.16, 95%CI: 1.67-2.79), younger (OR:1.12; 95%CI: 1.04-1.20), IGD (OR:5.17; 95%CI: 3.30-8.08) were independent correlators of sever-anger after controlling the confounding of low RSCS (OR:7.21; 95%CI: 5.61-9.27). Furthermore, the RSCS could partially mediate the effects of IGD on Anger with indirect-effect of 29.50%.

CONCLUSION

The effect of IGD contribution to anger might be not only directly accomplished by IGD itself, and also influenced by indirectly mediation of low social-connectedness with reality, especially in the negative dimension.

Longitudinal Network Associations Between Symptoms of Problematic Gaming and Generalized and Social Anxiety Among Adolescents

Problematic gaming has emerged as a significant problem among adolescents today, yet there is still an ongoing debate over the validity and relevance of its diagnostic criteria. Some critical steps have been recommended, including examining the structure of problematic gaming and exploring its comorbidity with generalized and social anxiety. To address these research aims, this study used network analysis, both cross-sectionally and longitudinally, to identify the most central symptoms of problematic gaming and elucidate the mechanisms underlying its co-occurrence with generalized and social anxiety in adolescents. A sample of 1893 Chinese adolescents (52.85% boys, 47.15% girls; Mage = 15.42 years, SD = 0.52) participated in a two-wave longitudinal study with a 12-month interval. The findings showed that giving up other activities, loss of control, tolerance, and continuation were the most central problematic gaming symptoms for both waves, as revealed by cross-sectional analyses. Moreover, the social anxiety symptom of social avoidance and distress-general was the most prominent in bridging different constructs across cross-sectional and longitudinal networks. The longitudinal findings further revealed that the generalized anxiety symptom of restlessness was closely connected to problematic gaming symptoms, indicating its influential role as a harmful mechanism underlying problematic gaming. Our results underscore the necessity to reconsider the criteria of problematic gaming. In addition, the symptoms of social avoidance and distress-general and restlessness can be prioritized as targets for preventing and treating problematic gaming in adolescents.

Impulsivity and problematic social network sites use: A meta-analysis

INTRODUCTION

Problematic Social Network Sites Use (PSNSU) has been defined as the inability to self-regulate one's use of social networks that adversely affects the user's interpersonal relationships, work or academic activities, and psychological well-being. Among PSNSU risk factors, impulsivity has gained attention. Evidence has emerged about the importance of considering impulsivity from a multidimensional approach since specific dimensions of impulsivity were found to be involved in specific addictive behaviors. Therefore, the present meta-analysis aims to examine the association between PSNSU and (i) general impulsivity and (ii) specific dimensions of impulsivity.

METHOD

A keyword-based systematic literature search was performed for eligible studies in which impulsivity and PSNSU were assessed. The meta-analysis was conducted following the most updated PRISMA guidelines.

RESULTS

Forty-one studies were included in the quantitative analysis with 43 independent samples. Meta-analytic results of the random effects model showed a significant positive correlation between general impulsivity and PSNSU (Fisher's Z = 0.29; CI 0.24, 0.35; Z = 10.66). Concerning dimensions of impulsivity, meta-analytic results of the random effects model revealed a significant positive correlation between PSNSU and lack of premeditation (Fisher's Z = 0.11 CI 0.09, 0.13; Z = 13.25) and between PSNSU and lack of perseverance (Fisher's Z = 0.19; CI 0.17, 0.20; Z = 22.67). Significant positive correlations between PSNSU and attentional impulsivity (Fisher's Z = 0.18; CI 0.12, 0.23; Z = 6.29), non-planning impulsivity (Fisher's Z = 0.10; CI 0.02, 0.19; Z = 2.35), and motor impulsivity (Fisher's Z = 0.22; CI 0.16, 0.27; Z = 7.45) were also found.

DISCUSSION

These results confirmed that PSNSU is positively associated with impulsivity and helped to clarify which specific dimensions of impulsivity are involved in this association.

Classification of internet addiction using machine learning on electroencephalography synchronization and functional connectivity

BACKGROUND

Internet addiction (IA) refers to excessive internet use that causes cognitive impairment or distress. Understanding the neurophysiological mechanisms underpinning IA is crucial for enabling an accurate diagnosis and informing treatment and prevention strategies. Despite the recent increase in studies examining the neurophysiological traits of IA, their findings often vary. To enhance the accuracy of identifying key neurophysiological characteristics of IA, this study used the phase lag index (PLI) and weighted PLI (WPLI) methods, which minimize volume conduction effects, to analyze the resting-state electroencephalography (EEG) functional connectivity. We further evaluated the reliability of the identified features for IA classification using various machine learning methods.

METHODS

Ninety-two participants (42 with IA and 50 healthy controls (HCs)) were included. PLI and WPLI values for each participant were computed, and values exhibiting significant differences between the two groups were selected as features for the subsequent classification task.

RESULTS

Support vector machine (SVM) achieved an 83% accuracy rate using PLI features and an improved 86% accuracy rate using WPLI features. t-test results showed analogous topographical patterns for both the WPLI and PLI. Numerous connections were identified within the delta and gamma frequency bands that exhibited significant differences between the two groups, with the IA group manifesting an elevated level of phase synchronization.

CONCLUSIONS

Functional connectivity analysis and machine learning algorithms can jointly distinguish participants with IA from HCs based on EEG data. PLI and WPLI have substantial potential as biomarkers for identifying the neurophysiological traits of IA.

Recommendations for Physical Exercise as a Strategy to Reduce Problematic Use of the Internet and Digital Devices: A Perspective

Excessive use of the Internet and digital devices has become a growing public health concern, contributing to mental health issues, sedentary lifestyles, and decreased well-being. Despite the increasing prevalence of digital overuse, there is no consensus on effective interventions to mitigate its impact. This article aimed to provide an updated perspective on current research into problematic use of digital devices and the Internet, and to explore the potential of physical exercise as a key strategy in prevention and treatment programs aimed at reducing such use. Based on the two previous objectives, this study also aimed to provide author-informed recommendations for digital detox interventions, supporting the inclusion of regular exercise, particularly outdoor exercise in natural environments, as a central component of such programs. Thirteen recommendations for physical exercise programs to be included as core parts of digital detox are suggested: (a) the type of physical exercise selected according to the participant's motivations, (b) exercise intensity and volume adapted to the participant's characteristics, (c) the avoidance of digital devices during exercise, (d) a duration of ≥12 weeks and ≥3 days/week, (e) the integration of other physical activities for a more active lifestyle, (f) the enhancement of mental health as a main goal, (g) collaborative and competitive physical exercise and sports, (h) the participant's awareness of the improvements through feedback and information, (i) mindful activities, (j) outdoor physical activities and exercise, especially in natural environments, (k) conducted by multidisciplinary teams, (l) assessments using validated tests and scales, and (m) evaluation of long-term effects. In summary, this perspective article supports the inclusion of physical exercise as a key strategy in digital detox programs by offering recommendations for intervention designs aimed at reducing problematic digital use and enhancing overall well-being in individuals who have developed maladaptive patterns of digital device use.

Gender differences in the prevalence and psychopathological mechanisms of internet addiction among Iranians aged 18 to 24: A nationwide study

BACKGROUND

The rapid advancement of technology has revolutionized interaction, learning, and entertainment but also led to Internet addiction, characterized by excessive internet use causing impairment or distress.

OBJECTIVE

The study explores gender differences in prevalence, risk factors, and clinical aspects of Internet addiction among Iranian youth, highlighting cultural and societal influences.

METHODS

A nationwide sample of 3149 individuals aged 18 to 24 was categorized into two groups: those with Internet addiction (n = 1040) and those without (n = 2109). Participants completed the Childhood Trauma Questionnaire-28, Dissociative Experiences Scale (DES), Difficulties in Emotion Regulation Scale (DERS), and Internet Addiction Test (IAT). Data analyses were conducted using SPSS software version 26, with a significance level set at <0.05.

RESULTS

Overall prevalence of Internet addiction was found to be 33 %, with a higher incidence in males (63.3 %) compared to females (36.7 %) (χ2 = 13.28, p = 0.001). In men, the severity of Internet addiction was significantly linked to emotional abuse (β = 0.20, p˂0.001), DES (β = 0.39, p˂0.001), and DERS (β = 0.16, p˂0.001) (F(3, 654) = 89.85, p˂0.001, R2 = 0.29); while in women, it was associated with emotional abuse (β = 0.18, p˂0.001) and dissociative experiences (β = 0.16, p˂0.001) (F(2, 379) = 13.70, p˂0.001, R2 = 0.06). The DES partially mediated the relationship between emotional abuse and IAT scores in both genders, whereas DERS only did so in males.

CONCLUSIONS

The study suggests Internet addiction as a maladaptive coping mechanism for early emotional abuse, highlighting the need for prevention programs and emotion regulation interventions. Future research should consider longitudinal effects and cultural influences.

The relationship between parental affective disorders and digital addiction in children and adolescents: A systematic review and meta-analysis

BACKGROUND AND AIMS

This study aims to comprehensively evaluate the correlation between parental affective disorders and four common digital addiction in children and adolescents.

METHODS

The research was conducted in MEDLINE, PsycINFO, Embase, CINAHL, and Web of Science. The meta-analysis included studies focusing on parental affective disorders and digital addiction to the Internet, smartphones, social media, and gaming among children and adolescents, using longitudinal, cohort, or cross-sectional study designs, and reporting correlation effect sizes or other data that could be converted to correlation r. Pooled Pearson's correlations were calculated using the random-effect model.

RESULTS

Nineteen studies were included (sample sizes ranged from 104 to 4,385), with ten on gaming addiction, four on smartphone addiction, three on Internet addiction, and two on social media addiction. The meta-analysis revealed a small but significant correlation (pooled r [95 %CI] = 0.15 [0.11-0.19]) between parental affective disorders and digital addiction in children and adolescents. This correlation was stronger in studies focusing on offspring's smartphone addiction (r [95 %CI] = 0.25 [0.17, 0.33]), and studies conducted in Asia (r [95 %CI] = 0.17 [0.12, 0.22]), and increased slightly from 0.09 to 0.10 to 0.15-0.16 by years in 2017 and 2024.

DISCUSSION AND CONCLUSIONS

Parental affective disorders were positively correlated with offspring's digital addiction, particularly on smartphone addiction and in Asian families. Improving parental mental health as a complementary strategy of clinical treatments might be more effective in reducing digital addiction in offspring. Further research is needed to explore the potential underlying mechanisms to gain a deeper understanding.

To hoard or not to hoard purchased items - does it matter? A clinical cross-sectional study on compulsive buying-shopping disorder

BACKGROUND

Research with individuals with compulsive buying-shopping disorder (CBSD) indicated that comorbid hoarding disorder (HD), as determined by questionnaire cutoffs, is associated with more severe CBSD. This study investigated a clinical sample with CBSD and determined the prevalence of HD by clinical interview, explored whether hoarding refers to consumer goods and/or non-purchased, free items, and compared patients with (HD+) and without (HD-) comorbid HD regarding materialism, impulsiveness, general psychopathology, CBSD and HD symptoms. Additionally, the relationship between CBSD symptoms and other study variables was explored in the total sample.

METHOD

All patients (N = 81) underwent a clinical interview and answered the Pathological Buying Screener (PBS), the German Saving Inventory-Revised (GSI-R), and measures for materialism, impulsiveness, depression and anxiety.

RESULTS

Seventeen patients had comorbid HD, of which 82 % hoarded predominantly purchased items. The HD+ group scored higher than the HD- group on the clutter and difficulty discarding GSI-R subscales, but not on the excessive acquisition GSI-R subscale or the PBS. There were no group differences in materialism, impulsiveness, and general psychopathology. The correlation between the PBS and the GSI-R in the total sample was driven by the high correlation between the PBS and the excessive acquisition GSI-R subscale. Higher PBS/GSI-R excessive acquisition scores were related to higher materialism and more psychopathology.

CONCLUSION

The findings indicate that hoarding in CBSD is mostly related to purchased consumer goods and not associated with a higher symptom severity of CBSD. Further investigation into the specifics of hoarding in the context of CBSD is necessary.

Global prevalence of internet addiction among university students: a systematic review and meta-analysis

PURPOSE OF REVIEW

The prevalence of internet addiction among university students has been extensively studied worldwide, however, the findings have been mixed. This meta-analysis aimed to examine the global prevalence of internet addiction in university students and identify its potential moderators.

RECENT FINDINGS

A total of 101 eligible studies, comprising 128020 participants across 38 countries and territories, were included. The pooled global prevalence of internet addiction among university students was 41.84% [95% confidence interval (95% CI): 35.89-48.02]. Significant differences in the prevalence were observed across different income levels, regions, periods of COVID-19 pandemic, and cut-off values of the Internet Addiction Test (IAT). Sample size was negatively associated with internet addiction prevalence, while depression prevalence was positively associated with internet addiction prevalence. Male students had a significantly higher risk of internet addiction compared to female students [pooled odd ratio (OR): 1.32, 95% CI: 1.19-1.46].

SUMMARY

This meta-analysis found that the prevalence of internet addiction was high among university students, which has increased since the COVID-19 pandemic. Screening and intervention measures to address internet addiction should prioritize students with an increased risk including male students, those from lower-income regions and those with depression.

Psychometric validation of Young's Internet Addiction Test among Chinese undergraduate students

The global prevalence of internet addiction is escalating annually and uncontrollable use of the internet can cause significant physical and psychological damage. Young's Internet Addiction Test (IAT), widely utilized across diverse cultures, has demonstrated structural inconsistencies in previous research, with some items requiring refinement. This study aimed to validate the IAT among Chinese undergraduate students and assess its psychometric properties. The IAT's structure was initially explored through Exploratory Factor Analysis (EFA) using pilot study data (n=376), with internal consistency and test-retest reliability (n=96) evaluated. Subsequently, Confirmatory Factor Analysis (CFA) was conducted using data from the actual study (n=1042) to confirm the structure. Results showed that a three-factor solution explained 61.29% of the total variance with a satisfactory model fit (χ2/df = 4.382, RMSEA = 0.057, CFI = 0.952, TLI = 0.943, SRMR = 0.045, AIC = 798.755) and psychometric properties, validating the IAT's utility for future investigations of internet addiction in Chinese undergraduates. Notably, a high prevalence of moderate internet addiction was observed within the sample, highlighting the significance of this issue in the target population and emphasizing the need for further research and potential interventions.

The relationship between Internet addiction and academic burnout in undergraduates: a chain mediation model

BACKGROUND

In the hybrid teaching context, the impact of Internet addiction on academic burnout and its underlying mechanism is still unclear. This study aims to investigate the effect of Internet addiction on academic burnout, and the chain mediating effect of academic engagement and academic self-efficacy in the relationship between Internet addiction and academic burnout.

METHODS

This study adopted a quantitative and correlational research design. A stratified random sampling method was used and a sample of 534 undergraduates (148 male and 386 female) from three normal universities participated in this study. Instruments used were the Chinese version of the Internet Addiction Test, the Chinese version of the Utrecht Work Engagement Scale-Student, the Chinese version of the Academic Self-efficacy Scale, and the Learning Burnout Scale of Undergraduates. Data were collected through self-report questionnaires and structural equation modeling was adopted to test the hypotheses using AMOS 24.0 software.

RESULTS

The findings revealed that Internet addiction demonstrated a statistically significant positive association with academic burnout among undergraduate students. Analysis of mediating effects indicated that academic engagement served as a significant mediator in the relationship between Internet addiction and academic burnout. However, academic self-efficacy failed to exhibit a significant mediating effect between these variables. Further examination revealed a significant chain mediating effect of academic engagement and academic self-efficacy in the relationship between Internet addiction and academic burnout.

CONCLUSION

Internet addiction influences academic burnout of undergraduate students both directly and indirectly through academic engagement and academic self-efficacy. Effective interventions could be implemented in universities to mitigate the negative effects of Internet addiction by enhancing academic engagement and academic self-efficacy, which may reduce students' vulnerability to academic burnout and its associated educational consequences such as course withdrawal, decreased academic performance, or dropping out.

Is physical activity associated with lower risk of social network problematic use or addiction? A systematic review and meta-analysis

BACKGROUND AND PURPOSE

The global rise in social media usage has led to an increasing prevalence of social network problematic use or addiction (SNPUA). Although previous research has identified a negative association between physical activity (PA) levels and some problematic digital behaviors, the relationship between PA and SNPUA remains unclear. Thus, the aim of this systematic review and meta-analysis was to examine possible associations between PA and SNPUA.

METHODS

The search was registered in OSF and was conducted in November 2024 using the following search terms: ('Physical activity' or exercise) and (addiction or 'problematic use') and ('social network' or 'social media' or Instagram or Facebook or 'Tik Tok'). It was carried out in PubMed and Web of Science databases. A total of 255 articles were retrieved and 24 of them met the inclusion criteria. Meta-analysis was conducted using Review Manager 5.4 software.

RESULTS

The majority of studies included university students (n = 14) and primary or secondary school students (n = 7). The participants' mean age ranged from 13.9 to 27.43 years. Female participants accounted for 50.8 % of the total sample. The meta-analysis involving 150,000+ participants revealed that PA is inversely related to SNPUA. Most of the included studies (14/24), involving 94 % of the sample, reported that those participants who engage in a higher amount of PA had lower levels of SNPUA.

CONCLUSION

PA could be an effective tool to prevent or reduce social network addiction levels. However, inconsistency in collecting data on PA and SNPUA makes it difficult to draw solid conclusions.

Psychological Well-Being, Substance Use, and Internet Consumption Among Students and Teaching Staff of the Faculty of Veterinary Medicine: Risk and Protective Factors Associated with Well-Being and Dissatisfaction

Background: Veterinary students experience high levels of mental health issues. Objectives: To analyze substance use, internet consumption, and mental health factors among students and academic staff of the Faculty of Veterinary Medicine of the University of Las Palmas de Gran Canaria, identifying factors associated with well-being and dissatisfaction. Methods: A total of 226 respondents participated, including 177 students (78.3%) and 49 staff members (21.7%). Data were collected between 30 October 2024 and 14 January 2025 using an adapted EDADES-based survey assessing substance use (alcohol, tobacco, electronic nicotine delivery systems (ENDSs), anxiolytics, and illicit drugs), internet habits, and psychological well-being among participants. Binary logistic regression was applied to identify factors associated with dissatisfaction. Results: Students exhibited higher binge drinking rates, greater ENDS consumption, and more problematic internet use than staff. Significant gender differences were observed, with females reporting greater emotional distress and a higher need for psychological support. Water pipe use (OR = 2.79, 95% CI = 1.45-5.38), anxiolytic consumption (OR = 2.31, 95% CI = 1.08-4.92), and excessive internet use (OR = 4.83, 95% CI = 1.66-14.1) were associated with lower overall satisfaction. Age was inversely associated with dissatisfaction (OR = 0.96, 95% CI = 0.94-0.98), and females were significantly more likely to report dissatisfaction (OR = 2.79, 95% CI = 1.45-5.38). Conclusions: Veterinary students exhibited higher psychological distress than teaching staff. Implementing targeted interventions to address substance use and internet habits is needed in order to enhance psychological well-being.

The influence of children's emotional regulation on internet addiction during the COVID-19 pandemic: the mediating role of depression

Internet addiction (IA) and depression present significant public health challenges, especially during a pandemic. Previous research conducted outside of pandemic contexts highlighted the importance of emotional regulation (ER) for depression, with specific strategies such as cognitive reappraisal (CR) and expressive suppression (ES) showing effectiveness in predicting the internalization of problems. However, knowledge regarding ER strategies for depression and IA during the pandemic remains limited, thus hindering our implementation of effective strategies. This study aimed to examine the relationships between IA, ER strategies, and depressive symptoms, and to identify protective factors against depression and IA. Additionally, it sought to investigate the mediating role of depressive symptoms. Data were collected from 824 students across the pre-pandemic and pandemic periods. Results highlight the risks associated with ES for both depressive symptoms and IA, while CR demonstrates potential in reducing depressive symptoms and IA. Interventions that promote the development of CR and discourage reliance on ES can effectively mitigate depressive symptoms and IA.

Adaptation and Validation of the Spanish Version of the Smartphone Application-Based Addiction Scale (SABAS)

Smartphone addiction is very prevalent among university students and can negatively impact both their physical and mental health. This study aimed to translate the smartphone application-based addiction scale (SABAS) into Spanish and evaluate its psychometric properties among Spanish university students. A total of 297 university students (222 women and 75 men) participated in this study (M age = 20.88, SD = 4.58) by completing a sociodemographic questionnaire, the smartphone addiction scale-short version, the depression, anxiety, and stress scale-21, the fear of missing out scale, and the SABAS. The SABAS was translated into Spanish using the forward-backward method. The factor structure was analyzed using confirmatory factor analysis, while reliability was assessed with Cronbach's alpha and McDonald's omega coefficients. The SABAS showed acceptable reliability (α = 0.72; ω = 0.73), and all of its items were kept. Factor analysis revealed that the Spanish version of the SABAS was unifactorial and demonstrated excellent validity (χ2 = 10.285; p = 0.246; RMSEA = 0.034; CFI = 0.991; SRMR = 0.030). Significant associations were also observed between the SABAS score and the number of hours of smartphone use, fear of missing out, and psychological distress. Despite its brevity, the Spanish version of the SABAS provides good validity and reliability. Therefore, it can be used as a tool for screening smartphone addiction in Spanish university students.

Problematic Social Media Use or Social Media Addiction in Pediatric Populations

With the advent of smartphones and the popularization of social media sites at the beginning of the twenty-first century, children and adolescents have been exposed to a world of virtual interactions in social networking sites that are designed to increase engagement of the user for profit. In this article, we review the epidemiology of use of social media, its addictive features, and potential negative consequences of problematic use, and the research on current interventions known to reduce use. We also give recommendations spanning from the policy to the individual level for children to build a healthier relationship with these sites.

Short-term exposure to aggressive card game: releasing emotion without escalating post-game aggression

Introduction

Competitive card games, a widespread hobby, often contain aggressive or violent elements. According to the general aggression model, such card games may increase players' aggressive cognition, emotions, and behaviors. Therefore, this study recruited 168 participants aiming to examine the specific impacts of short-term aggressive card game exposure on post-game aggression.

Method

Post-game cognition, emotions, and behaviors were assessed by spatial cueing task, positive and negative affect schedule, and maze selection task, respectively. Furthermore, the Penn emotion recognition test was employed to explore the emotional cognitive bias after short-term exhibiting aggressive behaviors in the card game.

Results

Results revealed that short-term exposure to the aggressive card game did not significantly increase aggressive cognition or behaviors. Conversely, in-game aggressive behaviors reduced negative emotions, increased positive emotions, and trended to perceive neutral emotions as happiness.

Discussion

These findings suggest that aggressive elements in card games could enhance emotional well-being without escalating postgame aggression. Future studies are needed to examine the long-term effects of aggressive card games, providing deeper insights into their development and application.

Nomophobia Questionnaire (NMP-Q) Across China, Bangladesh, Pakistan, and Iran: Confirmatory Factor Analysis, Measurement Invariance, and Network Analysis

The popularity and advancement of smartphones generate a new phenomenon of smartphone addiction. To promote early identification of individuals at risk of smartphone addiction, healthcare providers could assess if an individual has nomophobia (i.e., anxiety and worry of having no smartphone at hand). The present study aimed to evaluate the psychometric properties of the Nomophobia Questionnaire (NMP-Q) across four countries: China, Bangladesh, Pakistan, and Iran. Via cross-sectional design and convenience sampling, 7871 participants (5969 Chinese, 534 Bangladeshi, 666 Pakistani, and 702 Iranian) completed the NMP-Q. Confirmatory factor analysis (CFA) and network analysis were used to examine the psychometric properties of the NMP-Q across the four countries. CFA identified a four-factor structure (Tucker-Lewis index = 0.934, comparative fit index = 0.943, standardized root mean square residual = 0.037, and root mean square error of approximation = 0.079) for the NMP-Q, and the four-factor structure was measurement invariant across genders and countries. Network analysis results supported the CFA findings via visualized correlations among the NMP-Q items. The four-factor structure of the NMP-Q was consistently found in the four countries of China, Bangladesh, Pakistan, and Iran, indicating that the NMP-Q includes four specific domains. Measurement invariance suggests the NMP-Q may effectively assess nomophobia across genders and countries.

Transdiagnostic Compulsivity Traits in Problematic Use of the Internet Among UK Residents: Cross-Sectional Network Analysis Study

BACKGROUND

The societal and public health costs of problematic use of the internet (PUI) are increasingly recognized as a concern across all age groups, presenting a growing challenge for mental health research. International scientific initiatives have emphasized the need to explore the potential roles of personality features in PUI. Compulsivity is a key personality trait associated with PUI and has been recognized by experts as a critical factor that should be prioritized in PUI research. Given that compulsivity is a multidimensional construct and PUI encompasses diverse symptoms, different underlying mechanisms are likely involved. However, the specific relationships between compulsivity dimensions and PUI symptoms remain unclear, limiting our understanding of compulsivity's role in PUI.

OBJECTIVE

This study aimed to clarify the unique relationships among different dimensions of compulsivity, namely, perfectionism, reward drive, cognitive rigidity, and symptoms of PUI using a symptom-based network approach.

METHODS

A regularized partial-correlation network was fitted using a large-scale sample from the United Kingdom. Bridge centrality analysis was conducted to identify bridge nodes within the network. Node predictability analysis was performed to assess the self-determination and controllability of the nodes within the network.

RESULTS

The sample comprised 122,345 individuals from the United Kingdom (51.4% female, age: mean 43.7, SD 16.5, range 9-86 years). The analysis identified several strong mechanistic relationships. The strongest positive intracluster edge was between reward drive and PUI4 (financial consequences due to internet use; weight=0.11). Meanwhile, the strongest negative intracluster edge was between perfectionism and PUI4 (financial consequences due to internet use; weight=0.04). Cognitive rigidity showed strong relationships with PUI2 (internet use for distress relief; weight=0.06) and PUI3 (internet use for loneliness or boredom; weight=0.07). Notably, reward drive (bridge expected influence=0.32) and cognitive rigidity (bridge expected influence=0.16) were identified as key bridge nodes, positively associated with PUI symptoms. Meanwhile, perfectionism exhibited a negative association with PUI symptoms (bridge expected influence=-0.05). The network's overall mean predictability was 0.37, with PUI6 (compulsion, predictability=0.55) showing the highest predictability.

CONCLUSIONS

The findings reveal distinct relationships between different dimensions of compulsivity and individual PUI symptoms, supporting the importance of choosing targeted interventions based on individual symptom profiles. In addition, the identified bridge nodes, reward drive, and cognitive rigidity may represent promising targets for PUI prevention and intervention and warrant further investigation.

Techonoference and Problematic Smartphone Use: The Roles of Attachment and Environmental Sensitivity

The present study examined the potential mediation effects of parental attachment and peer attachment, and the moderating effect of environmental sensitivity between parental technoference and adolescents' problematic smartphone use. A sample of 908 junior high school students (Mage = 13.41 years, SD = 0.76) anonymously completed questionnaires. The results revealed that : (1) both mother and father attachment could mediate the pathway from parental technoference to adolescents' problematic smartphone use; (2) adolescent's environmental sensitivity moderated the direct and indirect pathway between parental technoference, mother attachment, and adolescents' problematic smartphone use. Specifically, adolescents with higher environmental sensitivity had greater problematic smartphone use when they experienced greater parental technoference. Moreover, adolescents with lower environmental sensitivity exhibited less problematic smartphone use when they had better mother-child attachment. The present study revealed a complex interplay between family and individual factors that contribute to adolescents' problematic smartphone use.

Psychometric validation of the Bangla Digital Addiction Scale for Teenagers and its associated factors among adolescents: MeLiSA study

BACKGROUND

Digital addiction among adolescents is an escalating concern with profound psychological implications, yet validated tools to measure it and studies exploring its relationship remain limited.

AIMS

To validate the Bangla Digital Addiction Scale for Teenagers (Bangla DAST) and identify factors of digital addiction among Bangladeshi adolescents.

METHODS

Using a two-stage stratified cluster sampling method, data from 1496 adolescents in Bangladesh were collected and analysed using non-parametric tests, Spearman correlations and multiple regression models.

RESULTS

The two-factor structure, encompassing attachment to digital devices (Factor 1) and compulsive use in different places (Factor 2) was supported by confirmatory factor analysis (comparative fit index 0.97, Tucker-Lewis index 0.95, root mean square error of approximation 0.06 [90% CI: 0.056-0.07] and standardised root mean square residual 0.048). McDonald's omega was 0.81 for the total scale, 0.77 for Factor 1 and 0.63 for Factor 2. Convergent validity was supported by significant associations between digital addiction and psychological symptoms. Factors of digital addiction included age (b = 0.517, P = 0.020), academic grade (b = 0.737, P = 0.021), depression (b = 0.334, P < 0.001), anxiety (b = 0.400, P < 0.001) and insomnia (b = 0.504, P < 0.001). In contrast, female gender (b = -1.250, P = 0.001), not sleeping alone (b = -0.846, P = 0.029) and reduced smartphone usage (b = -1.895, P < 0.001) were associated with lower digital addiction scores. The model accounted for 23.1% of the variance in digital addiction.

CONCLUSIONS

The Bangla DAST appears to be a psychometrically valid and reliable tool and can be used for further studies assessing digital addiction among Bangladeshi adolescents. The study highlights the need for targeted preventive measures, particularly focusing on at-risk groups.

Internet gaming disorder and suicidal behaviors mediated by sleep disturbance: a large-scale school-based study in 135,174 Chinese middle school students

Emerging research suggests a positive association between Internet gaming disorder (IGD) and suicidal behaviors. However, existing studies predominantly focus on suicidal ideation rather than suicide attempts and often do not adequately control for potential psychological confounders. The mechanism linking IGD to suicidality remains unclear. This study aims to assess the independent association between IGD and suicidal behaviors and to examine the mediating role of sleep disturbance among Chinese adolescents. We recruited 135,174 middle school students from Zigong City using cluster sampling. Data on demographics, suicidal ideation, and suicidal attempts were collected. IGD was assessed using the Internet Gaming Disorder Scale-Short Form. Mental distress, including depression, anxiety, hyperactivity/inattention, conduct problems, sleep problems, and psychotic experiences, was evaluated using standardized questionnaires. Multiple logistic regression models and mediation analysis were conducted. The prevalence rates of IGD, suicidal behaviors, suicidal ideation, and suicide attempts were 1.6%, 16.7%, 11.9%, and 9.8%, respectively. Adolescents with IGD showed a significantly higher risk for suicidality: nearly 60% reported suicidal behaviors, 50% reported suicidal ideation, and 40% reported suicide attempts. Both IGD and gaming usage were independently linked to suicidal behaviors. Sleep disturbance partially mediated the relationship between IGD and suicidal behaviors, accounting for 47.0% of the total effect. Our studies call for timely and regular assessments for suicidality and sleep disturbance in IGD. Targeted interventions addressing sleep disturbance might reduce suicidal risk among adolescents with IGD.

Flourishing through Social Development Activities and Social Support: A Holistic Strategy for Problematic Smartphone Use

While some research has indicated the relationship between participation in social development activities (PSDA) and perceived social support (PSS) with problematic smartphone use (PSU), there has been a lack of studies examining these relationships through the lens of the flourishing theory, particularly among adolescents. To address this gap in the literature, this study conducted between April and May 2022 included 4965 high school students from 20 different cities in Türkiye. Researchers utilized questionnaires assessing participants' demographic information, levels of participation in social development activities, The Smartphone Application-Based Addiction Scale, The Short Version of the Scales of General Well-Being (GWB), and The Multidimensional Scale of Perceived Social Support as instruments. Structural Equation Modeling was employed for analyzing the relationships between variables using IBM SPSS v26 and AMOS v24 software packages. Hierarchical regression analysis was used to understand how GWB and PSS were associated with the relationships between PSDA and PSU. Findings indicated a predominantly negative relationship between PSDA and PSU, with GWB mediating this relationship negatively across all PSDA and PSS playing a contributory role in many indirect relationships between PSDA and PSU, if not directly. The importance of the approach in interventions aimed at addressing PSU was emphasized.

Persuasive strategies in digital interventions to combat internet addiction: A systematic review

BACKGROUND

The internet provides valuable benefits in supporting our lives. However, concerns arise regarding internet addiction, a behavioural disorder due to excessive and uncontrolled internet use that has harmful effects on human health and wellbeing. Studies highlighted the potential of digital behaviour change interventions to address health behaviour problems. However, little is known about how and to what extent persuasive strategies can be utilised in digital interventions to combat internet addiction. Accordingly, this systematic review aims to investigate the design and implementation of persuasive strategies in digital interventions to combat internet addiction, including their contexts, features, and outcomes.

METHODS

We searched for peer-reviewed articles from four databases (Scopus, Web of Science, ACM, and PubMed). The Persuasive Systems Design (PSD) model and Behaviour Change Technique (BCT) taxonomy were used to identify persuasive strategies. We included 14 primary studies discussing digital interventions to address the problem and their outcomes.

RESULTS

Four persuasion contexts were identified, including 1) self-management systems to reduce internet use, 2) analytics systems to examine use patterns and provide behavioural suggestions, 3) parental control systems to manage children's internet use, and 4) unattractive settings to discourage internet use. The promising interventions used the following persuasion route: help the user determine behaviour goals, facilitate actions to accomplish behaviour goals, and reinforce the user to perform behaviour goals. Potential persuasive strategies were also identified, including goal-setting, action planning, task reduction, tunnelling how to perform a behaviour, tailored and personalised suggestions/prompts, reminders, trustworthiness, anticipated regret, and social support strategies.

CONCLUSION

Our findings shed light on the promising persuasive contexts and strategies to combat internet addiction using digital interventions. We suggest future research and practices to utilise our findings to develop effective digital interventions, especially for combatting internet addiction in vulnerable populations like children or people from developing regions.

Problematic smartphone use in a representative sample of US adults: Prevalence and predictors

The exponential growth in worldwide smartphone adoption has led to mounting concerns about problematic smartphone use (PSU), with some studies of variably defined PSU yielding prevalence rates as high as 20 to 30%. The present study aims to (a) estimate the prevalence of PSU while emphasizing functional impairment, and (b) examine the degree to which a set of demographic, contextual, behavioral and mental health variables can predict PSU. A representative U.S. sample of 1,989 participants completed an online survey using a cross-sectional design aimed at examining PSU. Data were analyzed using two different but complementary machine learning algorithms. The results indicate a PSU prevalence of 0.75% to 1.2 % when a functional impairment criterion is required. The most important predictors of PSU are related to smartphone use behavior, followed by contextual factors (being a parent of under-age children, increase in use during the COVID-19 pandemic), age and some psychopathological factors. Overall, the study suggests that the prevalence of functionally impairing PSU may be much lower than what has been reported based on less stringent definitions. The results highlight the necessity to account for impact on key spheres of functioning in diagnosing PSU to avoid pathologizing a ubiquitous behavior that may be intensive but not necessarily pathological. They also open up relevant perspectives for the prevention of PSU.

Examining the Roles of Problematic Internet Use and Emotional Regulation Self-Efficacy on the Relationship Between Digital Game Addiction and Motivation Among Turkish Adolescents

Digital game addiction and problematic internet use have emerged as significant issues, attracting growing attention from educators, psychologists, and policymakers. This study aimed to examine the mediating role of emotional regulation self-efficacy and the moderating role of problematic internet use in the effect of digital game addiction on academic motivation in Turkish adolescents. A correlational research method was utilized to address research questions. A total of 1156 high school students voluntarily participated in the study. Self-report questionnaires (the Short Academic Motivation Scale, Digital Game Addiction Scale, Regulatory Emotional Self-Efficacy Scale and Young's Internet Addiction Scale Short Form) were used to collect data in 2024. In the analysis of the data, Pearson Product Moment Correlation Coefficient, mediator and moderator analyses were conducted using statistical software. The analysis provided evidence of the negative effect of digital game addiction on academic motivation. Additionally, emotional regulation self-efficacy was found to partly mediate the relationship between digital game addiction and academic motivation. Furthermore, problematic internet use moderated the relationship between digital game addiction and academic motivation in adolescents. The results suggested enhancing adolescents' emotional regulation self-efficacy and reducing problematic internet use are crucial steps towards mitigating the negative effects of digital game addiction on academic motivation.

Neuroanatomical and functional substrates of the short video addiction and its association with brain transcriptomic and cellular architecture

Short video addiction (SVA) has emerged as a growing behavioral and social issue, driven by the widespread use of digital platforms that provide highly engaging, personalized, and brief video content. We investigated the neuroanatomical and functional substrates of SVA symptoms, alongside brain transcriptomic and cellular characteristics, using Inter-Subject Representational Similarity Analysis (IS-RSA) and transcriptomic approaches. Behaviorally, we found that dispositional envy was associated with SVA. Structurally, SVA was positively correlated with increased morphological volumes in the orbitofrontal cortex (OFC) and bilateral cerebellum. Functionally, the dorsolateral prefrontal cortex (DLPFC), posterior cingulate cortex (PCC), cerebellum, and temporal pole (TP) exhibited heightened spontaneous activity, which was positively correlated with SVA severity. Transcriptomic and cellular analyses also showed specific genes linked to gray matter volume (GMV) associated with SVA, with predominant expression in excitatory and inhibitory neurons. These genes showed distinct spatiotemporal expression patterns in the cerebellum during adolescence. This study offers a comprehensive framework integrating structural, functional, and neurochemical evidence to highlight the neural-transcriptomic underpinnings of SVA symptoms in a non-clinical population.

Network analysis of interactions of rumination and anxiety on smartphone dependence symptoms

Objective

Rumination and anxiety have been posited as correlates of smartphone dependence (SPD). However, little is known regarding how the components of both affect SPD symptoms at subtle levels. Therefore, we used the network analysis approach to identify the connections at a micro level to provide possible interventions for reducing SPD symptoms.

Methods

Using symptom-level network analysis, we used the ruminative response scale-10, the generalized anxiety disorder scale-7, and the mobile phone addiction index scale-17 to investigate Chinese preservice teachers (M age = 21.1, N = 1160). Subsequently, we estimated a graphical lasso correlation network for these teachers, which encompassed rumination components, anxiety components, and SPD symptoms. Specifically, the central and bridge centralities within the network structure were examined for the impacts of rumination and anxiety on SPD symptoms.

Results

The three intracluster connections of rumination, anxiety, and SPD were tighter than the intercluster, with structural connections in rumination and anxiety networks closer than the triggered SPD symptoms cluster. Importantly, reflection reactions towards "write down what you are thinking and analyze it" (a component of rumination) were identified as a central and bridging node that might be a target for intervention for SPD symptoms.

Conclusion

We identify potential edge-bridging rumination and anxiety on SPD and locate highly central components within each cluster via network analysis.

Longitudinal relationship between internet addiction and psychotic-like experiences among Chinese college students

BACKGROUND

While previous cross-sectional studies have suggested a link between psychotic-like experiences (PLEs) and internet addiction (IA), longitudinal evidence remains scarce. This study aimed to explore the prospective relationship between IA and PLEs among college students.

METHOD

A total of 636 college students (80 % female) were assessed in November 2022 and again one year later. IA was measured using the Internet Addiction Diagnosis Questionnaire (IADQ), and PLEs were assessed with the 16-item Prodromal Questionnaire (PQ-16). Demographic, psychological, and environmental factors were collected and controlled. Multiple logistic regression and cross-lagged panel analyses examined the longitudinal associations between IA and PLEs.

RESULTS

At baseline, the prevalence of IA and PLEs was 11.3 % and 16.8 %, respectively. Higher baseline IADQ scores (Adjusted odds ratio = 1.035; 95 % confidence interval = 1.002-1.069; p = 0.036) were independently associated with an increased risk of PLEs at follow-up, while baseline PQ-16 scores were not linked to later IA. Cross-lagged panel analysis revealed that IA at baseline predicted later PLEs (β = 0.082, p = 0.043), whereas baseline PLEs did not predict IA (β = 0.049, p = 0.255). Specifically, IA predicted unusual thoughts (β = 0.122, p = 0.003) and negative PLEs (β = 0.111, p = 0.008), but not perceptual abnormalities (β = 0.040, p = 0.301).

CONCLUSION

IA may be an independent risk factor for PLEs in college students, particularly for unusual thoughts and negative PLEs, but not for perceptual abnormalities. Targeted interventions addressing IA may help reduce PLEs.

Digital traps: How technology fuels nomophobia and insomnia in Taiwanese college students

This study investigates the relationship between maladaptive digital technology use, which arises from nomophobia, and insomnia among young adults. It specifically focuses on problematic gaming (PG), problematic social media use (PSMU), and problematic YouTube use (PYTU) as significant forms of digital behavior contributing to this contemporary health concern. Adolescents and young adults, being the first generation raised in a highly digitized environment, encounter unique challenges, including the emergence of behavioral addictions. Our findings indicate a strong association between nomophobia and problematic digital behaviors, with PSMU identified as the most prevalent form of maladaptive use. Additionally, PG and PSMU are recognized as substantial contributors to the development of nomophobia. The interaction of cognitive overstimulation, emotional dysregulation, blue light exposure, time displacement, and reward-driven dependency on these digital platforms promotes compulsive behaviors, which subsequently lead to the onset of insomnia. Utilizing Structural Equation Modeling (SEM), the study illustrates that nomophobia precipitates problematic digital behavior, which in turn results in sleep disturbances, thereby elucidating a clear pathway from digital dependency to insomnia. The limitations of this study include its cross-sectional design and reliance on self-reported data, which may introduce potential biases. Despite these limitations, our findings underscore the critical role of nomophobia in triggering insomnia through various maladaptive digital behaviors. This highlights the urgent need for targeted prevention and intervention strategies aimed at fostering healthier digital habits and alleviating the adverse health effects of excessive technology use, ultimately enhancing well-being in an increasingly interconnected society.

Impact of distress and anxiety due to COVID-19 on digital addictions in university students in the third wave period

Abstract

Background

Digital addictions are a major problem worldwide, which has increased considerably during the COVID-19 pandemic. In this scenario, two important impact factors to explain this problem are stress and anxiety because of COVID-19. The objective of this research was to determine the impact of distress and anxiety due to COVID-19 on digital addictions.

Methods

cross-sectional, explanatory study. A total of 802 students from public and private universities residing in the city of Lima and Callao (Peru), with a mean age of 21.68 (SD = 3.11), selected by convenience sampling, participated in the study. The MULTICAGE CAD-4 questionnaire, the distress scale, and the anxiety scale by COVID-19 were applied.

Results

two models examined with structural equation modeling showed good fit indices (CFI and TLI > .95, RMSEA and SRMR < .06). The first model shows that the latent variables distress and anxiety due to COVID-19 have direct effects on digital addictions as a general construct (R 2 = 22%). The second model shows that the exogenous latent variables (stress and anxiety) have direct effects of different magnitudes on each digital technology, so the variance explained on smartphone addiction was higher (R 2 = 25%) with respect to internet (R 2 = 19%) and video game addiction (R 2 = 6%). It was also found that for every male, there are two females with high levels of distress and anxiety. Regarding the problematic use of smartphones and internet, there is a prevalence of 40% regardless of sex; but as for the problematic use of video games, there is a marked difference between males (18.8%) and females (2.7%).

Conclusion

the distress and anxiety caused by COVID-19 have a direct impact in aggravating digital addictions.

Mobile phone addiction and negative emotions: an empirical study among adolescents in Jiangxi Province

Background

The relationship between mobile phone addiction and negative affect among adolescents is characterized by intricate interconnections. These factors have an impact on the emotional and psychological well-being of young people. While previous studies have provided preliminary insights into this relationship, further in-depth exploration and research is required to fully understand the complex mechanisms behind these relationships and to identify any group differences.

Methods

This study collected questionnaire data from 493 adolescents aged 17-22 years old in Jiangxi Province. The data were analyzed using Pearson correlation analysis, restricted cubic spline (RCS), and structural equation modelling (SEM) with the aim of exploring the mechanisms and differences in the effects of mobile phone addiction on negative emotions of different youth groups.

Results

The findings of the study indicated notable discrepancies in mobile phone addiction by gender and place of residence. Secondly, mobile phone addiction among adolescents positively drives negative emotions. The findings revealed that negative emotions triggered by mobile phone addiction were significantly higher among rural adolescents than urban adolescents; male adolescents exhibited higher levels than female adolescents in the same place of residence. Additionally, family factors, physical exercise and psychological resilience can directly or indirectly inhibit mobile phone addiction among adolescents. Finally, adolescents' psychological resilience can significantly alleviate the negative emotions associated with mobile phone addiction. Physical exercise and family factors can reduce the negative emotional impact of mobile phone addiction by increasing psychological resilience.

Conclusions

This study employs the relationship between mobile phone addiction and negative emotions in adolescents, reveals the complex mechanisms and group differences behind these relationships, and provides a fresh perspective for understanding the impact of mobile phone addiction on adolescents' mental health, as well as a scientific basis for the development of effective interventions.

Network analysis of the association between social anxiety and problematic smartphone use in college students

Background

Social anxiety (SA) and problematic smartphone use (PSU) have become increasingly common among college students in recent decades, with research indicating a mutual increase in risk. This study aim to deepen the understanding of how SA and PSU are interconnected at the symptom-level within this demographic using network analysis.

Methods

We recruited 1,197 college students from four institutions in Shaanxi Province, China. Symptoms of SA and PSU were assessed through self-report questionnaires. A regularized Gaussian graphical model was used to estimate the relationships between these symptoms. We calculated Bridge Expected Influence (BEI) to identify key symptoms contributing to their co-occurrence. Additionally, a network comparison test was conducted to examine potential gender differences in the BEI values of the SA-PSU network.

Results

Distinct relationships were observed between SA and PSU symptoms. Notably, the connections between 'Get embarrassed very easily' (SA3) and 'shyness in new situations' (PSU1), as well as between SA3 and 'Escape or relieve negative moods' (PSU8), showed the strongest inter-construct connections. SA3 and PSU8 were identified as the key symptoms contributing to the co-occurrence, with the highest BEI. Network comparison tests between males and females revealed no significant differences in global expected influence, between-community edges weights, and BEI.

Conclusion

The key bridging symptoms this study identified supports the existing theories about the co-occurrence of SA and PSU, and contributes to understanding the underlying mechanisms. Our findings suggest that interventions targeting negative emotions in daily interactions could be effective in reducing PSU.

Optimal Non-Pharmacological Interventions for Reducing Problematic Internet Use in Youth: A Systematic Review and Bayesian Network Meta-Analysis

The purpose of this network meta-analysis (NMA) is to compare the effect of different non-pharmacological interventions (NPIs) on Problematic Internet Use (PIU). Randomized controlled trials (RCTs) published from their inception to 22 December 2023 were searched in Cochrane Central Register of Controlled Trials, Embase, Medline, Web of Science, China National Knowledge Infrastructure, China Science and Technology Journal Database, Chinese BioMedical Literature Database, and WanFang Data. We carried out a data analysis to compare the efficacy of various NPIs using Bayesian NMA. A battery of analyses and assessments, such as conventional meta-analysis and risk of bias, were performed concurrently. Two reviewers extracted data and evaluated bias using the Cochrane Risk of Bias tool independently. We identified 90 RCTs including 15 different NPIs (5986 participants), namely sports intervention (SI), electroencephalogram biological feedback (EBF), reality therapy (RT), positive psychology therapy (PPT), sandplay therapy (ST), educational intervention (EI), compound psychotherapy (CPT), electroacupuncture therapy (AT), group counseling (GC), family therapy (FT), electrotherapy (ELT), craving behavior intervention (CBI), virtual reality therapy (VRT), cognitive behavior therapy (CBT), and mindfulness therapy (MT). Our NMA results showed that SI, EBF, RT, PPT, ST, EI, CPT, AT, GC, FT, ELT, CBT, CBI, VRT, and MT were effective in reducing PIU levels. The most effective NPI was SI (SMD = -4.66, CrI: -5.51, -3.82, SUCRA = 95.43%), followed by EBF (SMD = -4.51, CrI: -6.62, -2.39, SUCRA = 90.89%) and RT (SMD = -3.83, CrI: -6.01, -1.62, SUCRA = 81.90%). Our study showed that SI was the best NPI to relieve PIU levels in youth. Medical staff should be aware of the application of SI to the treatment of PIU in youth in future clinical care.

Blended digital health intervention for adolescents at high risk with digital media use disorders: protocol for a randomised controlled trial within the Res@t-Consortium

Background

Digital media use disorder (DMUD) is a prevalent problem among young people, which can result in adverse consequences and functional impairments across multiple domains of life due to a persistent inability to regulate one's use, which can lead to the development of psychological problems. In particular, children and adolescents who live in families that are part of the child and youth welfare system and receive support services are considered to be at high risk of developing mental disorders. It is less likely that these families will choose a therapeutic setting for the treatment of DMUD. The objective is to reduce DMUD-related symptoms and improve media use behaviour through the implementation of an app-based training programme.

Methods

The efficacy of Res@t digital, initially conceived as an adjunct to child and adolescent psychiatric treatment, is to be evaluated for n= 32 children and adolescents with a media use disorder or at risk of developing this disorder, and their families enrolled in child and youth welfare services. The efficacy of the app will be evaluated in a randomised controlled trial with a waitlist control group. The primary outcome is the reduction of DMUD symptoms over a 20-week period following the onset of app training. Secondary outcomes include EEG measurements and changes in standardised psychopathological variables.

Discussion

Should the Res@t app prove efficacious when compared to a waitlist control group, it would constitute an evidence-based intervention for the treatment of DMUD in children and adolescents. For high-risk families, the app could serve as a motivational tool to prompt action regarding potential DMUD and facilitates access to therapeutic facilities.

Clinical trial registration

https://drks.de, identifier DRKS00033379.

Effects of exercise interventions on Internet addiction among college students: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Internet addiction (IA) has gradually emerged as a significant public health concern, especially among college students. This study aims to systematically investigate and quantitatively analyze the effects of exercise interventions on IA among college students and provides an objective assessment of the available evidence. For this study, IA is defined as compulsive, excessive Internet use, including via mobile phones, that disrupts daily life and causes significant distress, and we combine Internet addiction and mobile phone addiction in our analysis to provide a comprehensive understanding of this phenomenon.

METHODS

The search for eligible studies was conducted from inception until May 2024 across various databases including Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wan Fang. The risk of bias within the included studies was assessed utilizing the Cochrane Collaboration's risk of bias tool, while methodological quality was evaluated using the modified Jadad Scale.

FINDINGS

A meta-analysis of 19 pairwise comparisons showed that exercise interventions significantly reduced the total IA scores (g = -1.25). Furthermore, the interventions resulted in significant reductions in anxiety (g = -1.30), loneliness (g = -1.57), stress (g = -0.77), inadequacy (g = -1.77), mental health (g = -1.08), fatigue (g = -0.66), and depression (g = -0.56).

CONCLUSIONS

Exercise interventions showed efficacy in decreasing levels of IA and alleviating psychological symptoms in college students with IA. The optimal types of exercise for college students suffering from IA are open motor skill and the combination of both open and closed skill. However, future work is needed given the limited randomized controlled trials and the high heterogeneity of the included studies.

Similarities and differences in core symptoms of problematic smartphone use among Chinese students enrolled in grades 4 to 9: A large national cross-sectional study

Children and adolescents are highly susceptible to problematic smartphone usage. We employed network analysis to explore the similarities and differences in the core symptoms of problematic smartphone use across grades 4-9, using a large nationwide sample. This study included 8552 children and adolescents (Mage = 12.98, SD=1.51) who met the critical value for problematic smartphone use. The results showed that the core symptoms of problematic smartphone use exhibit both similarities and differences between grades 4 and 9. 'Withdrawal symptoms' and 'preoccupation symptoms' were the stable core symptoms of problematic smartphone use across grades 4 to 9, suggesting that problematic smartphone use begin to appear from earlier grades, such as grade 4. 'Feel impatient and fretful', 'never give up' and 'always thinking about' were the core symptoms in grades 4 and 5. 'Longer than I had intended' and 'hard to concentrate' emerged as additional core symptoms in grade 6, with the intensity indicators peaking in grades 8 and 9, suggesting that the issue of problematic smartphone use among Chinese children and adolescents has become intensified and intricate. Symptoms of problematic smartphone use vary across grades and exhibit both continuity and stage specificity. Consequently, to address this issue, the formulation of intervention measures should comprehensively consider both the grade levels and symptoms.

Research landscape and trends of internet addiction disorder: A comprehensive bibliometric analysis of publications in the past 20 years

Background

Internet addiction disorder (IAD) has emerged as a significant public health concern in the digital age, with implications for mental health and social wellbeing. Despite growing recognition, IAD remains a relatively nascent field within academic research.

Methods

We conducted a comprehensive bibliometric analysis to explore the global research landscape and trends of IAD. Our methodology involved analyzing author analysis, journal analysis, keywords, and citations in publications related to IAD from 2004 to 2024.

Results

We identified "internet addiction," "internet gaming disorder," and "adolescent" as the most frequently occurring keywords, highlighting significant research areas within IAD. The analysis revealed that terms like "social media addiction," "problematic smartphone use," and "COVID-19" have gained prominence in recent years, reflecting the evolving nature of digital technology's impact on mental health. Clustering analysis illustrated the interdisciplinary nature of IAD research, integrating insights from psychology, sociology, network science, and psychiatry. Citation analysis identified highly influential papers, such as Kuss and Griffiths' review on social networking addiction and Brand et al.'s I-PACE model for internet-use disorders.

Conclusions

Our findings highlighted the importance of continuing interdisciplinary research to address the multifaceted challenges of IAD. Future research should focus on the intersections of digital behaviors with mental health, personality traits, and social dynamics to develop comprehensive strategies for prevention and intervention.

Looking Back on Digital Medical Education Over the Last 25 Years and Looking to the Future: Narrative Review

BACKGROUND

The last 25 years have seen enormous progression in digital technologies across the whole of the health service, including health education. The rapid evolution and use of web-based and digital techniques have been significantly transforming this field since the beginning of the new millennium. These advancements continue to progress swiftly, even more so after the COVID-19 pandemic.

OBJECTIVE

This narrative review aims to outline and discuss the developments that have taken place in digital medical education across the defined time frame. In addition, evidence for potential opportunities and challenges facing digital medical education in the near future was collated for analysis.

METHODS

Literature reviews were conducted using PubMed, Web of Science Core Collection, Scopus, Google Scholar, and Embase. The participants and learners in this study included medical students, physicians in training or continuing professional development, nurses, paramedics, and patients.

RESULTS

Evidence of the significant steps in the development of digital medical education in the past 25 years was presented and analyzed in terms of application, impact, and implications for the future. The results were grouped into the following themes for discussion: learning management systems; telemedicine (in digital medical education); mobile health; big data analytics; the metaverse, augmented reality, and virtual reality; the COVID-19 pandemic; artificial intelligence; and ethics and cybersecurity.

CONCLUSIONS

Major changes and developments in digital medical education have occurred from around the start of the new millennium. Key steps in this journey include technical developments in teleconferencing and learning management systems, along with a marked increase in mobile device use for accessing learning over this time. While the pace of evolution in digital medical education accelerated during the COVID-19 pandemic, further rapid progress has continued since the resolution of the pandemic. Many of these changes are currently being widely used in health education and other fields, such as augmented reality, virtual reality, and artificial intelligence, providing significant future potential. The opportunities these technologies offer must be balanced against the associated challenges in areas such as cybersecurity, the integrity of web-based assessments, ethics, and issues of digital privacy to ensure that digital medical education continues to thrive in the future.

The TikTok Addiction Scale: Development and validation

Background

There is an absence of valid and specific psychometric tools to assess TikTok addiction. Considering that the use of TikTok is increasing rapidly and the fact that TikTok addiction may be a different form of social media addiction, there is an urge for a valid tool to measure TikTok addiction.

Objective

To develop and validate a tool to measure TikTok addiction.

Methods

First, we performed an extensive literature review to create a pool of items to measure TikTok addiction. Then, we employed a panel of experts from different backgrounds to examine the content validity of the initial set of items. We examined face validity by performing cognitive interviews with TikTok users and calculating the item-level face validity index. Our study population included 429 adults who have been TikTok users for at least the last 12 months. We employed exploratory and confirmatory factor analysis to examine the construct validity of the TikTok Addiction Scale (TTAS). We examined the concurrent validity by using the Bergen Social Media Addiction Scale (BSMAS), the Patient Health Questionnaire-4 (PHQ-4), and the Big Five Inventory-10 (BFI-10). We used Cronbach's alpha, McDonald's Omega, Cohen's kappa, and intraclass correlation coefficient to examine reliability.

Results

We found that the TTAS is a six-factor 15-item scale with robust psychometric properties. Factor analysis revealed a six-factor structure, (1) salience, (2) mood modification, (3) tolerance, (4) withdrawal symptoms, (5) conflict, and (6) relapse, which accounted for 80.70% of the total variance. The concurrent validity of the TTAS was excellent since we found significant correlations between TTAS and BSMAS, PHQ-4, and BFI-10. Cronbach's alpha and McDonald's Omega for the TTAS were 0.911 and 0.914, respectively.

Conclusion

The TTAS appears to be a short, easy-to-use, and valid scale to measure TikTok addiction. Considering the limitations of our study, we recommend the translation and validation of the TTAS in other languages and populations to further examine the validity of the scale.

Role of conscious awareness and Big Five in predicting the digital addiction

Introduction

Digital addiction is discussed in the literature as a type of addiction that negatively affects the personal, social, and societal lives of individuals. Digital addiction is a behavioral addiction that occurs as a result of the problematic and unconscious use of digital tools with features such as compulsive, excessive, impulsivity, and includes human-machine interaction. What is meant to be expressed with conscious awareness is to accept the facts and experiences as they are without judgment, and to be aware of them. With awareness, it is aimed to contribute to individuals to evaluate their past experiences more objectively, to get rid of automatic behavioral and emotional patterns, and to show more moderate reactions by avoiding aggressive reactions. In this context, this study examines the Big Five and Mindfulness as predictive variables for digital addiction, focusing on them as a cause and a solution variable that can be used in interventions for digital addiction. Given its prevalence and negative effects, it is important to identify and analyze the relationship patterns between digital addiction and related variables in order to define and resolve the problem. In this context, the present study aims to determine the levels of conscious awareness and digital addiction among university students and to examine the predictive effect of conscious awareness levels and Big Five variables on predicting digital addiction behaviors.

Methods

The present study is designed to employ the survey method. Data were collected from 1,664 university students selected by using the convenience sampling method, and the data obtained were analyzed by using descriptive statistics and structural equation modeling. The SPSS 25 and LISREL 8.8 software packages were used in the analysis process.

Results and discussion

The results achieved in this study revealed that university students have a moderate level of conscious awareness and that the overall level of digital addiction is generally moderate. The results achieved from the structural equation modeling for the measurement model constructed for the relationships between variables confirmed the validity of the proposed model. It was determined that the model had a good fit with the latent variables, which represent the indicator variables, and also other latent variables. In conclusion, it was found that Big Five and the level of conscious awareness have a reducing effect on digital addiction and serve a protective function against this negativity among university students.

The Impact of Cyberbullying Victimization on Internet Gaming Addiction Among College Students: The Mediating Roles of Basic Psychological Need Satisfaction and Frustration, and the Moderating Role of Parental Autonomy Support

PURPOSE

Research on the relationship between cyberbullying victimization and Internet gaming addiction in China is limited, while the mechanisms underlying this association remain unclear. Based on the Self-Determination Theory, this study establishes a moderated mediation model to test the mediating roles of basic psychological need satisfaction and frustration between cyberbullying victimization and Internet gaming addiction, as well as the moderating role of parental autonomy support in this mediating effect.

METHODS

2819 college students were surveyed using self-reported questionnaires about cyberbullying victimization, basic psychological need satisfaction and frustration, parental autonomy support, and Internet gaming addiction. SPSS 24.0 was utilized to analyze the correlations between variables, and Amos 24.0 was employed to test the structural equation model of this study.

RESULTS

Cyberbullying victimization was found to significantly predict Internet gaming addiction positively. Basic psychological need satisfaction and frustration played partial mediating roles between cyberbullying victimization and Internet gaming addiction respectively. Parental autonomy support further moderated the first half of the mediated model pathway. Specifically, the impact of cyberbullying victimization on basic psychological need satisfaction and frustration are more obvious among college students with high level of parental autonomy support.

CONCLUSION

The findings advance our understanding of how cyberbullying victimization affects Internet gaming addiction.Within the college environment, reducing cyberbullying victimization could prevent Internet gaming addiction. Furthermore, enhancing basic psychological need satisfaction, reducing basic psychological need frustration, and reinforcing parental autonomy support among college students who have experienced cyberbullying would be effective to prevent Internet gaming addiction.

Decoding and modifying dynamic attentional bias in gaming disorder

With the spread of smartphones and computer games, concerns have escalated regarding the rising prevalence of gaming disorder. Patients often display attentional biases, unconsciously turning their attention towards gaming-related stimuli. However, attempts to discover and ameliorate these attentional deficits have yielded inconsistent outcomes, potentially due to the dynamic nature of attentional bias. This study investigated neural mechanisms underlying attentional bias state by combining neuroimaging (functional magnetic resonance imaging -fMRI) with an approach-avoidance task tailored to an individual's gaming preference. We conducted a multivariate pattern analysis of endogenous brain activity in 21 participants with probable gaming disorder. Our analyses revealed that activity patterns in the insula tracked temporal attentional bias states specific to gaming stimuli. A broad network of frontal and parietal regions instead appeared to predict a general temporal attentional bias state. Finally, we conducted a proof-of-concept study for 'just-in-time' attentional bias training through fMRI-decoded neurofeedback of insula activity patterns, named decoded attentional bias training (DecABT). Our preliminary results suggest that DecABT may help to decrease the attractiveness of gaming stimuli via a insula- and precuneus-based neural mechanism. This work provides new evidence for the insula as an endogenous regulator of attentional bias states in gaming disorder and a starting point to develop novel, individualized therapeutic approaches to treat addiction.This article is part of the theme issue 'Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation'.

Adult symptoms of ASD in relation to excessive internet use: The roles of ADHD symptoms and negative mood

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) have been reportedly associated with excessive internet use, also known as internet addiction. As ADHD is the most common comorbidity in ASD, the present study examined the possibility that ADHD symptoms, and/or trait and mood factors linked to ASD, ADHD and internet addiction, could account for the association of ASD with internet addiction symptoms. A nonclinical young adult sample of 248 internet using men and women completed self-report measures of ASD and ADHD symptoms, alexithymia, impulsivity, negative moods and internet addiction symptoms. Scores on the ASD and ADHD symptom measures were normally distributed, consistent with the notion that the corresponding disorders represent extreme, impairing ends of population distributions of their symptoms. Hierarchical regression followed by path analysis indicated that the relationship between ASD and internet addiction symptoms was fully mediated by ADHD symptoms and negative moods. Further, the relationship between ADHD and internet addiction symptoms was partially mediated by impulsivity and negative moods. Present findings point to the mediating roles of ADHD symptoms and negative moods in the association of ASD with internet addiction symptoms.

The association between digital addiction and interpersonal relationships: A systematic review and meta-analysis

Digital addiction (DA) has been identified as an emerging public health problem worldwide. However, the extent and direction of the association between DA and interpersonal relationships (IRs) are unknown. Does DA have adverse effects on IRs, and how credible is the evidence for this association in published analyses of real-world data? Using the PRISMA method, we conducted a meta-analysis to quantitatively synthesize the results of the relevant studies and obtain reliable effect size estimates and performed an analysis of moderating factors. A systematic literature search identified 98 studies involving 134,593 participants and 99 effect sizes. A significant negative association was observed between DA and IRs. Importantly, our meta-analysis revealed that the DA subtype has no significant moderating effect on IRs, suggesting that combining numerous categories of DA rather than focusing on specific forms of DA may be appropriate for understanding the relationship between DA and IRs. Relative to the IR subtype, the association between DA and offline relationships is significant and negative, whereas the association between DA and online relationships is significant and positive. The strength of the relationship is also influenced by the participants' sex ratio, educational level, and measurement tools. These results may help resolve the disagreement over the magnitude and direction of the association between DA and IRs and have potential implications for the treatment of DA.