Effects of different interventions on internet addiction: A meta-analysis of random controlled trials

Cross-lagged panel relationship between physical activity atmosphere, psychological resilience and mobile phone addiction on college students

Mobile phone addiction (MPA) is widespread on university campuses and has many negative effects on individuals. A good physical activity atmosphere (PAA) has been shown to be effective in improving individuals' mental health, including psychological resilience (PR), but it is not clear whether it can alleviate MPA. Therefore, this study investigates the effects of both on MPA through a longitudinal study and provides a theoretical basis for reference. A total of 964 international students from different countries were selected from 8 colleges and universities in Beijing, and 2 longitudinal follow-up surveys were conducted using the Physical Activity Atmosphere Scale, the Psychological Resilience Scale, and the Mobile Phone Addiction Scale. Correlation and path model analyses were conducted using Pearson and cross-lagged panel model (CLPM). The correlation results showed that T1-PAA, T2-PAA were significantly positively correlated with T1-PR, T2-PR (r = 0.577, 0.306, P < 0.001) and T1-PR, T2-PR were significantly negatively correlated with T1-MPA, T2-MPA (= -0.225, -0.236, P < 0.001). CLPM results showed that college student PAA stably positively predicted PR (t = 0.518, P < 0.001). PAA (t = -0.131, P < 0.001) and PR (t = -0.159, P < 0.001) negatively predicted MPA levels. (1) Improving PAA not only alleviates MPA in college students, but also improves PR levels. (2) PR also has an inhibitory effect on MPA, so increasing PR will enhance the effect of PAA. (3) PAA negatively predicts MPA and positively predicts PR in college students.

Application of machine learning in predicting adolescent Internet behavioral addiction

Objective

To explore the risk factors affecting adolescents' Internet addiction behavior and build a prediction model for adolescents' Internet addiction behavior based on machine learning algorithms.

Methods

A total of 4461 high school students in Chongqing were selected using stratified cluster sampling, and questionnaires were administered. Based on the presence of Internet addiction behavior, students were categorized into an Internet addiction group (n=1210) and a non-Internet addiction group (n=3115). Gender, age, residence type, and other data were compared between the groups, and independent risk factors for adolescent Internet addiction were analyzed using a logistic regression model. Six methods-multi-level perceptron, random forest, K-nearest neighbor, support vector machine, logistic regression, and extreme gradient boosting-were used to construct the model. The model's indicators under each algorithm were compared, evaluated with a confusion matrix, and the optimal model was selected.

Result

The proportion of male adolescents, urban household registration, and scores on the family function, planning, action, and cognitive subscales, along with psychoticism, introversion-extroversion, neuroticism, somatization, obsessive-compulsiveness, interpersonal sensitivity, depression, anxiety, hostility, paranoia, and psychosis, were significantly higher in the Internet addiction group than in the non-Internet addiction group (P < 0.05). No significant differences were found in age or only-child status (P > 0.05). Statistically significant variables were analyzed using a logistic regression model, revealing that gender, household registration type, and scores on planning, action, introversion-extroversion, psychoticism, neuroticism, cognitive, obsessive-compulsive, depression, and hostility scales are independent risk factors for adolescent Internet addiction. The area under the curve (AUC) for multi-level perceptron, random forest, K-nearest neighbor, support vector machine, logistic regression, and extreme gradient boosting models were 0.843, 0.817, 0.778, 0.846, 0.847, and 0.836, respectively, with extreme gradient boosting showing the best predictive performance among these models.

Conclusion

The detection rate of Internet addiction is higher in males than in females, and adolescents with impulsive, extroverted, psychotic, neurotic, obsessive, depressive, and hostile traits are more prone to developing Internet addiction. While the overall performance of the machine learning models for predicting adolescent Internet addiction is moderate, the extreme gradient boosting method outperforms others, effectively identifying risk factors and enabling targeted interventions.

Interventions for Digital Addiction: Umbrella Review of Meta-Analyses

BACKGROUND

Numerous studies have explored interventions to reduce digital addiction outcomes, but inconclusive evidence makes it difficult for decision-makers, managers, and clinicians to become familiar with all available literature and find appropriate interventions.

OBJECTIVE

This study aims to summarize and assess the certainty of evidence of interventions proposed to decrease digital addiction from published meta-analyses.

METHODS

An umbrella review of published meta-analyses was performed. We searched PubMed, Cochrane Library, Web of Science, and Embase for meta-analyses published up to February 2024. Eligible studies evaluated interventions using randomized controlled trials, nonrandomized controlled trials, or quasi-experimental studies and were assessed for methodological quality using Assessment of Multiple Systematic Reviews version 2. A random effects model was used to analyze data, considering heterogeneity and publication bias. Grading of Recommendations, Assessment, Development, and Evaluations was applied to assess evidence with certainty.

RESULTS

A total of 5 studies assessing 21 associations were included in the umbrella review, of which 4 (80%) were high-quality meta-analyses. Weak evidence was observed in 19 associations, whereas null associations appeared in the remaining 2 associations. These associations pertained to 8 interventions (group counseling, integrated internet addiction [IA] prevention programs, psychosocial interventions, reality therapy, self-control training programs, cognitive behavioral therapy, interventions to reduce screen time in children, and exercise) and 9 outcomes (self-control, self-esteem, internet gaming disorder symptoms, time spent gaming, IA scores, screen use time, interpersonal sensitivity longlines, anxiety, and depression). Cognitive behavioral therapy reduces anxiety (standardized mean difference [SMD] 0.939, 95% CI 0.311 to 1.586), internet gaming disorder symptoms (SMD 1.394, 95% CI 0.664 to 2.214), time spent gaming (SMD 1.259, 95% CI, 0.311 to 2.206), and IA scores (SMD -2.097, 95% CI -2.814 to -1.381). Group counseling had a large effect on improving self-control (SMD 1.296, 95% CI 0.269 to 2.322) and reducing IA levels (SMD -1.417, 95% CI -1.836 to -0.997). Exercise intervention reduced IA scores (SMD -2.322, 95% CI -3.212 to -1.431), depression scores (SMD -1.421, 95% CI -2.046 to -797), and interpersonal sensitivity scores (SMD -1.433, 95% CI -2.239 to -0.627).

CONCLUSIONS

The evidence indicates that current interventions to reduce digital addiction are weak. Data from more and better-designed studies with larger sample sizes are needed to establish robust evidence.

TRIAL REGISTRATION

PROSPERO CRD42024528173; crd.york.ac.uk/PROSPERO/display_record.php?RecordID=528173.

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.

Network modeling of problematic social media use components in college student social media users

Background

While the constitutive features of problematic social media use (PSMU) have been formulated, there has been a lack of studies in the field examining the structure of relationships among PSMU components.

Method

This study employed network analytic methods to investigate the connectivity among PSMU components in a large sample of 1,136 college student social media users (M age = 19.69, SD = 1.60). Components of PSMU were assessed by the Bergen Social Media Addiction Scale (BSMAS) derived from a components model of addiction. We computed two types of network models, Gaussian graphical models (GGMs) to examine network structure and influential nodes and directed acyclic graphs (DAGs) to identify the probabilistic dependencies among components.

Result

Relapse component consistently emerged as a central node in the GGMs and as a parent node of other components in the DAGs. Relapse and tolerance components exhibited strong mutual connections and were linked to the most vital edges within the networks. Additionally, conflict and mood modification nodes occupied more central positions within the PSMU network for the low-BSMAS-score subgroup compared with the high-BSMAS-score subgroup.

Conclusion

Our findings shed new light on the complex architecture of PSMU and its potential implications for tailored interventions to relieve PSMU.

Computer and Internet Use Among Children and Adolescents in Greece: Levels of Addiction

OBJECTIVE

The digitalization of our daily living has changed dramatically the internet and digital media use among all ages. However, children and adolescents are particularly vulnerable to potential dangers and addiction risks. Our objective was to evaluate the computer and internet addiction levels in children and adolescents through their parents' reports.

METHODS

A cross-sectional study was conducted in the region of Megara (Attica, Greece) for two months (September-November 2022). In total, 205 parents (74 fathers, 131 mothers) of school-age children participated, completing the study questionnaire (demographic data and the Adolescent Computer Addiction Scale - parental version (20 items in a 1-5 Likert Scale).

RESULTS

 Based on the addiction scale score, only 2.45% (N=5) of the parents rated high scores indicating serious addictive behaviors regarding internet use. The majority were parents of boys (58%) and the mean age of children was 10.92±2.81years (five to 18 years). According to parental reports, the mean age of primary access to a computer or device with internet access was 7.18±2.29 years (two to 13 years). Regarding internet use, 58.5% of the children had access to the internet via smartphone, used the internet one to two hours/day (46.1%), and 62% of children had internet access in their bedroom. Children whose parents used the internet more than five hours/day displayed a greater addiction (F=3.06, df=3.187, p=0.03). A significant positive correlation was also found among children age (r=0.388, p<0.01), computer and internet availability in children's bedrooms, and internet addiction (t=4.43, df=189, p≤0.001 and t=3.88, df=189, p≤0.001, respectively). In summary, parents reported moderate or severe addiction in 7.2% of boys and 5.1% of girls. However, it should be noted that the exact cut-off points were difficult to determine due to a lack of objective criteria for diagnosing addiction severity.

CONCLUSIONS

The levels of addiction in our study according to the parents' reports were limited and only a small number of parents reported highly addictive behaviors. However, there is a direct correlation between increased parental internet use that can significantly increase children's addiction levels. Parents act as role models that may increase children's exposure to the internet and lead to addiction.

Effectiveness of sports intervention: A meta-analysis of the effects of different interventions on adolescent internet addiction

BACKGROUND

To evaluate the effects of different interventions on adolescent internet addiction, a meta-analysis and network meta-analysis were performed to determine the possible intervention effects of these interventions.

METHODS

Computer searches of the China National Knowledge Network, Wanfang, VIP, EMBASE, PubMed, Web of Science, EBSCO, and Cochrane Library databases were performed. The relevant randomized controlled trials were designed to assess the effects of interventions on adolescent internet addiction. The retrieval period ranged from the establishment of the database to January 31, 2024. Literature screening, data extraction, and bias risk assessment were carried out independently by two researchers. CMA 3.3, Stata 17.0 software and Review Manager 5.3 were used for the data analysis.

RESULTS

A total of 89 studies with 6876 samples were included. A traditional meta-analysis of 51 single interventions and controlled studies revealed that sports intervention, cognitive behavior therapy, family therapy, mindfulness intervention, attention bias training and group counseling significantly improved adolescent Internet addiction [standardized mean difference (SMD) = -1.75, 95 % CI (-2.07, -1.44), p < 0.01; I2 = 94 %] compared to no-treatment groups. A network meta-analysis showed that combined intervention (Sucra = 93.5) had the highest probability of being the best intervention for adolescent Internet addiction, and acupuncture interventions showed the most promise as a single intervention modality; however, due to the limited number of studies, we believe that sports intervention could be the most appropriate single intervention.

DISCUSSION

The evidence provided by existing studies shows that compared with other single interventions, combined interventions have the greatest effect on adolescent IA, and sports may be the best single intervention. However, because of the limitations of sample size and quality of individual studies, the strength of the evidence still needs to be further verified by additional standardized and high-quality studies.

A meta-review of screening and treatment of electronic "addictions"

Concerns surrounding electronic addictions, an umbrella term including any clinically significant technology-based addictive problem, have increased as technology has advanced. Although researchers and clinicians have observed detrimental effects associated with excessive technology use, there is no agreed-on definition or set of criteria for these problems. The lack of a consistent understanding of electronic addictions has led to a lack of consistency in both assessment and treatment studies, precluding strong recommendations for effective screening and clinical intervention. This meta-review integrates findings from 22 systematic reviews and meta-analyses of electronic addictions to determine which measures and interventions may effectively measure and treat electronic addictions. We conducted a meta-review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Findings suggest that although some measures may have good internal consistency and reliability among college students, there was a general lack of consistency in how measures were used across studies, making comparison difficult. Psychological and exercise-based interventions were shown to reduce symptoms of electronic addictions short-term, but no treatment was superior to others in overall symptom reduction. Most included reviews raise serious concerns about the lack of consensus on what constitutes an electronic addiction. Consequently, it was not possible to draw conclusions about the overall efficacy of any measurement tools or interventions. We provide suggestions for next steps to establish the phenomenology of electronic addictions before additional research on assessment and intervention is conducted.

Network meta-analysis of the effectiveness of different interventions for internet addiction in college students

BACKGROUND

Internet addiction jeopardizes teenagers' physical and mental health, as well as their academic performance, and causes a variety of cognitive dysfunctions and psychological and mental health illnesses, among other things. It is a huge issue that families, schools, and society must address immediately.

OBJECTIVES

This study used network meta-analysis to evaluate the impact of several interventions on college students' Internet addiction. The goal was to identify the most effective interventions and establish a reference for future interventions. We systematically searched relevant literature in domestic and international databases such as Web of Science, PubMed, EMBASE, Cochrane Library, Pro Quest, China Knowledge, Wan fang, Wipo, etc. We assessed the risk of bias according to the revised Cochrane Randomized Trials Risk of Bias Tool (RoB2) and used R Studio Software and Stata 14.0 for traditional meta-analysis and network meta-analysis. A network meta-analysis based on the IAT scale showed that comprehensive interventions had the highest probability of being the best intervention for IA (SUCRA = 90.6 % based on IAT); focused solution short-term therapy had the highest probability of being the best intervention for IA based on the CIAS-R (19 White Feather) scale (SUCRA = 100 %).

CONCLUSIONS

The majority of interventions have a significant influence on the treatment of IA, and improvements in Internet addiction symptoms are more noticeable when a combination of interventions is used rather than just one.

Videoconference-Delivered Cognitive Behavioral Therapy for Parents of Adolescents With Internet Addiction: Pilot Randomized Controlled Trial

BACKGROUND

The rise in internet addiction, including web-based gaming and social networking services, is a serious concern. Even with access to medical institutions and counseling services, individuals with internet addiction, particularly adolescents, often refuse medical treatment or counseling. Parent-focused psychological intervention may lead to positive outcomes by improving the parent-adolescent relationship and helping parents identify and modify their adolescent's problematic behaviors, including internet addiction.

OBJECTIVE

This study was a pilot randomized controlled trial to test the feasibility of remote cognitive behavioral therapy via videoconferencing for parents of adolescents with internet addiction.

METHODS

A total of 13 parents of adolescents aged 12-20 years with internet addiction were recruited and randomly assigned to either 12 sessions of the videoconference-delivered cognitive behavioral therapy (vCBT) group (n=6, 46%) or the waitlist control group (n=7, 54%). The study period was from March 1, 2018, to March 31, 2022. The primary outcome was the scores of the Young Internet Addiction Test reported by the adolescents. The secondary outcomes were adolescents' hours of internet use per day (Internet Addiction Test), reported by the adolescents and by their parents; the Young Diagnostic Questionnaire, completed by the parents; and the quality of life of the adolescents and the parents, measured by the EQ-5D-5L. These were evaluated at weeks 0 and 13.

RESULTS

As the primary outcome, the mean total Internet Addiction Test score decreased from 67.7 (SD 18.3; 6/13, 46%) at week 0 to 56.2 (SD 25.1; 5/9, 56%) at week 13 in the vCBT group, compared to an increase from 66.9 (SD 21.9; 7/13, 54%) to 68.0 (SD 18.7; 4/9, 44%) in the control group. For all outcomes, no significant differences were found between the 2 groups (all P>.05).

CONCLUSIONS

This study suggested the practical feasibility of vCBT for parents of adolescents with internet addiction. Further large-scale, multicenter randomized controlled trials are necessary to examine the effectiveness.

TRIAL REGISTRATION

UMIN Clinical Trials Registry UMIN000032483; https://tinyurl.com/yuhen6c9.

Study protocol of a proposed Neurofeedback-Assisted Mindfulness Training Program on symptoms of anxiety and psychological distress associated with smartphone use in young adults: a randomized controlled trial

Background

Nomophobia is a specific phobia characterized by the appearance of anxiety, nervousness, discomfort and distress when the mobile phone is not used and is considered an emerging public health problem because of the negative consequences on the physical and mental health of young people and adolescents, especially women. Neurofeedback-Assisted Mindfulness Training Programs may prove beneficials for improving self-control abilities, a key ability in addressing addictive behaviors. The main objective of this study is to evaluate the impact, in a young population aged 18-35 years, of an intervention based on Neurofeedback-Assisted Mindfulness Training Program (NAMTP) on disorders associated with problematic use of mobile phones. The effect of the intervention on the total score in the nomophobia test and habits of internet and social network use, as well as on signs of depression, anxiety and stress will be analyzed. As a secondary objective, the effect of the intervention on signs of insomnia will be analyzed.

Methods and design

Randomized, controlled clinical-trial with two-parallel groups. 40 young adults (18-35 years) will be included and randomly assigned to Intervention Group-NAMTP or Control Group (CG). The NAMTP will include a total of 25 sessions (2-3/week) during 3-months. Each session will have a duration of 10/15 min. The instrument to be used for the neurofeedback sessions is MUSE® (InteraXon Inc.). Study variables will be collected at the baseline visit and at the final visit (3-months after randomization). During these visits, questionnaires will be administered to evaluate the main and secondary variables that will include the Smartphone Addiction Scale-Short Version, Nomophobia Questionnaire, Depression, Anxiety and Stress Scale 21-item (DASS-21) and Athens Insomnia Scale.

Discussion

This trial will make an important contribution to the need for evidence of effective education programs and other primary care interventions through new non-invasive interventions in reducing the risk of developing addictions to new technologies and alleviating the symptoms of discomfort associated with this problem.

Ethics and dissemination

The project was approved by the Clinical Research Ethics Committee of the Salamanca Health Area (CEIm Code: PI 2023 071340).

Clinical trial registration

ClinicalTrials.gov, http://www.Clinicaltrials.gov/ct2/show/NCT06188910.

Treatment Approaches for Problematic Pornography Use: A Systematic Review

Problematic pornography use (PPU) is an emerging condition associated with several negative psychological and sexual outcomes. This study aimed to systematically review treatment approaches for PPU. Potentially eligible studies were searched for in PubMed/MEDLINE, Embase, PsycINFO, and Web of Science up to April 1, 2023. The quality of the evidence was assessed with the use of the Joanna Briggs Institute's checklists, the Cochrane risk-of-bias tools, and the GRADE approach. A total of 8936 references were retrieved, and 28 studies were included in the systematic review (n = 500 participants). Included studies were case reports (k = 16), case series (k = 1), quasi-experimental investigations (k = 7), and randomized clinical trials (k = 4). The majority of included studies presented overall low quality and significant risk of bias, with all interventions receiving a low or very low rating according to the GRADE approach. Most studies investigated psychological interventions, with the predominance of second and third wave cognitive behavioral therapy interventions. Pharmacological treatments included opioid antagonists (naltrexone in most cases) and antidepressants, while one study investigated a protocol that included rTMS. Several investigations described the combination of psychological and pharmacological approaches. Most studies did not report on side effects, with online and self-help interventions presenting significant issues in terms of treatment adherence. Even though there are promising options that may have efficacy for the treatment of patients with PPU, the literature in the topic still presents significant limitations that compromise the reaching of more definitive conclusions.

Effects of non-pharmacological interventions on youth with internet addiction: a systematic review and meta-analysis of randomized controlled trials

Objective

To assess the overall effectiveness of non-pharmacological interventions on internet addiction (IA) in youth.

Method

Randomized controlled trials (RCTs) published from their inception to April 1, 2023 were searched in Cochrane, Embase, Medline, Web of Science, China National Knowledge Infrastructure, China Science and Technology Journal Database, Chinese BioMedical Literature Database, and WanFang Data. Two reviewers independently extracted data and evaluated bias using the Cochrane Risk of Bias tool.

Results

Sixty-six studies performed from 2007 to 2023, with a total of 4,385 participants, were identified. The NPIs included group counseling, cognitive behavioral therapy, sports intervention, combined interventions, eHealth, educational intervention, positive psychology intervention, sand play intervention, and electrotherapy. The results revealed that NPIs significantly reduced IA levels (standardized mean difference, SMD: -2.01, 95% confidence interval, CI: -2.29 to -1.73, I2 = 93.0%), anxiety levels (SMD: -1.07, 95%CI: -1.41 to -0.73, I2 = 72.4%), depression levels (SMD: -1.11, 95%CI: -1.52 to -0.7, I2 = 84.3%), and SCL-90 (SMD: -0.75, 95%CI: -0.97 to -0.54, I2 = 27.7%). Subgroup analysis stratified by intervention measure showed that cognitive behavioral therapy, group counseling, sports intervention, combined intervention, educational intervention, positive psychology intervention, sandplay intervention, and mobile health were all effective in relieving symptoms of IA except electrotherapy.

Conclusion

NPIs appear to be effective in the treatment of IA in youth, which would act as an alternative treatment of IA. Further studies with larger sample sizes and robust designs are needed.

Yoga as an Adjuvant with Multimodal Psychological Interventions for Excessive Use of Technology: A Randomized Controlled Trial from India

Background

Multimodal approach of psychotherapy has been found to be effective for managing the excessive use of technology. Yoga, a holistic mind-body therapy, has been observed to be a useful adjuvant in managing substance use disorders. Yoga is also known to reduce stress and enhance overall well-being. The aim of this study was to examine whether yoga as an adjuvant treatment to psychotherapy is better than psychotherapy alone in reducing dysfunction and severity due to excessive technology use.

Methods

A two-arm randomized controlled prospective study design was followed with assessor blinding and allocation concealment. Thirty consenting young adults (22 males), scoring above 36 on the Internet Addiction Test, were randomly allocated to either: Group A = psychotherapy + yoga or Group B = psychotherapy alone. Both groups received 8 sessions of psychotherapy in the 1st month. In addition, Group A received additional 10 sessions a specific yoga program (by trained professionals). After that, monthly booster sessions (supervised yoga sessions performed with direct one-on-one contact with the yoga therapist) were organized and post-assessment was conducted at 12 weeks. Each subject was assessed using the Internet Addiction Test-Short Form, Internet Gaming Disorder Scale-Short Form, Smartphone Addiction Scale-Short Version, and Kessler Psychological Distress Scale at baseline and after 12 weeks.

Results

As compared to Group B, Group A had significantly reduced Internet use (F = 5.61, P = 0.02, ηp 2 = 0.17), smartphone use (F = 4.76, P = 0.03, ηp 2 = 0.15), psychological distress (F = 7.71, P = 0.01, ηp 2 = 0.22), and weekday use (Z = -2.0, P = 0.05, ηp 2 = 0.15) along with enhanced treatment adherence and retention.

Conclusion

Yoga as an adjuvant therapy with multimodal psychological intervention for excessive use of technology was found to be effective. This carries clinical implications for mental health professionals.

Differences in Approach and Avoidance Motivation Sensitivities Predicting Participation and Performance in Strength Sport

ABSTRACT

Cusimano, K, Freeman, P, Moran, J, and Yamaguchi, M. Differences in approach and avoidance motivation sensitivities predicting participation and performance in strength sport. J Strength Cond Res 38(1): 180-184, 2024-Gray's Reinforcement Sensitivity Theory proposes that individual differences in behavior are due to the sensitivity to 2 brain systems: the behavioral inhibition system (BIS), which regulates aversive emotions to threatening stimuli, and the behavioral approach system (BAS), which regulates positive emotions toward rewarding or nonpunishing stimuli. The current study investigated whether BIS and BAS sensitivity predicts participation and performance in strength sports. A sample of 177 competitive strength athletes (male = 148; female = 29; mean age = 28.68; SD = 6.24 years) and 178 control participants (male = 89; female = 89; mean age = 29.39; SD = 7.42) completed the BIS/BAS scale, with strength athletes also providing their Wilks scores as a measure of sporting performance. Independent t tests showed significantly higher BIS (MD = 2.37, p = 0.003, 95% CI [0.79, 3.94], d = 0.31) and total BAS (MD = 11.71, p < 0.001, 95% CI [9.26, 14.15], d = 1.00) sensitivity in strength athletes than individuals in the control group. A 3-step hierarchical regression analysis revealed that the number of training years (β = 0.506, p < 0 .001), BIS (β = -203, p = 0.005) and BAS drive (β = 0.188, p = 0.012) made significant unique contributions to predicting the Wilks score, with no significant contributions of age, sex, BAS fun seeking, and BAS reward responsiveness. The findings indicate that the overall reward sensitivity (total BAS score) and reward seeking (BAS drive) are associated positively with participation and performance in strength sports, respectively. Given the association of these brain systems to addiction and other psychiatric disorders, the findings could have implications in psychiatric treatment and sporting recruitment.

Exercise intervention to reduce mobile phone addiction in adolescents: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

The growing problem of adolescent mobile phone addiction has attracted significant attention, underscoring the importance of identifying approaches to address it. Exercise has been found to reduce adolescent mobile phone addiction; however, its mechanism remains unclear. This review aims to elucidate the potential moderating factors between exercise and mobile phone addiction based on previous studies to provide a reference for adolescents to effectively participate in exercise to reduce mobile phone addiction.

METHODS

Articles were searched in the CNKI, Web of Science, Scopus, Cochrane, PsycINFO, and PubMed databases according to the inclusion criteria and followed the Preferred Reporting Items for Systematic Assessment and Meta-analysis (PRISMA). The quality of the literature was assessed by two independent reviewers using the Cochrane Collaboration Risk of Bias tool for methodological quality assessment. Meta-analysis was performed using Stata 15.1 software for Meta-analysis, standardized mean difference (SMD) was combined using a random effects model, and subgroup analysis was used to explore heterogeneity.

RESULTS

A total of 12 studies, 17 samples, and 861 subjects were included in the meta-analysis, and all studies were randomized controlled trials. The findings revealed that the exercise intervention significantly reduced mobile phone addiction in adolescents (SMD = -3.11; 95% CI: -3.91, -2.30; p < 0.001). The intervention effect was moderated by multiple variables, such as the measurement tools, exercise intervention types, cycles, frequency, and duration of a single exercise intervention.

CONCLUSION

Our findings suggest that exercise could serve as an effective strategy for preventing or ameliorating mobile phone addiction in adolescents. Based on the results of this study, we encourage mobile phone-addicted adolescents to engage in a single exercise using a mix of skills for 30-60 min three or more times weekly for more than eight consecutive weeks.

The Effect of Distress Tolerance Training on Problematic Internet Use and Psychological Wellbeing Among Faculty Nursing Students: A Randomized Control Trial

Background

Distress tolerance skills have the potential to decrease problematic internet use and improve psychological wellbeing by cognitive reframing and goal-oriented problem-solving.

Aim

To assess the impact of distress tolerance training on problematic internet use and psychological wellbeing among university nursing students.

Methods

A randomized control trial used at the faculty of nursing using simple random sampling method. Tools: Distress Tolerance Scale, problematic internet use questionnaire, and Ryff psychological wellbeing scale. Data were collected from 60 nursing students over a period of 4 months.

Results

Distress tolerance level was increased among study group from 20.75±14.29 to 72.75±24.09 and sustained for 3 months to 62.44 ±20.77 with statistically significant (f=7.090, p=0.006) and large effect size 0.75. When compared to no change among the control group as mean scare start by 22.35±14.29 to 23.44±16.09 and after 3 months to 21.75± 17.44 with insignificant difference (f=0.454, p=0.574). The mean score of problematic internet use shows highly statistically significant decrement in the study group between three period of time (pretest= 62.93, immediately post= 52.13, and post 3 months=52.70) with large effect size 0.78 (f=95.029, p<0.001), in compared to control group that showed insignificant no changes (pretest= 64.0±14.54, immediately post= 63.13±12.87, and post 3 months=63.53±11.36) with (f=1.012, p=0.332). In addition, the total mean score of psychological well-being was increased immediately after therapy and later for three months of therapy (pretest= 128.47, immediately post=148.77, and post 3 months= 153.60) with highly statistically significant (f=41.197, p<0.001) with effect size 0.85, compared to no change among control group (pretest=125.97±32.58, immediately post= 126.23±30.86, and post 3 months=126.43±29.78) with (f=0.208, p=0.698).

Conclusion

Efficacy of distress tolerance skills intervention had been proven in altering poor psychological wellbeing among students with problematic internet use. It helps students to learn new skills and use more adaptive strategies to overcome distress tolerance difficulties.

Digital Addiction Intervention for Children and Adolescents: A Scoping Review

Digital devices play a significant role in the learning and living of children and adolescents, whose overuse or addiction has become a global concern. This scoping review seeks to synthesize existing studies to investigate relevant interventions and their effects on digital addiction in children (ages 0-18). To understand the latest advances, we have identified 17 studies published in international peer-reviewed journals between 2018-2022. The findings revealed that, first, most interventions for digital addiction in children and adolescents were cognitive-behavioral therapies (CBT) or CBT-based interventions, which could improve anxiety, depression, and related symptoms of digital addiction. Second, rather than directly targeting addictive behaviors, some family-based interventions aim to strengthen family functions and relationships. Finally, digital-based interventions, such as website-based, application-based, and virtual reality interventions, are promising in adolescent digital addiction interventions. However, these studies shared the same limitations: small sample sizes, short intervention durations, no control group, and nonrandomized assignments. The small sample size problem is difficult to solve by offline intervention. Meanwhile, online digital-based intervention is still in its infancy, resulting in limited generalizability of the findings and the inability to popularize digital intervention. Accordingly, future intervention studies should integrate various assessments and interventions to form an integrated platform to provide interventions for addicted children and adolescents worldwide.

A short-term manual for webcam-based telemedicine treatment of Internet use disorders

In recent decades, the number of people who experience their Internet use behavior as problematic has risen dramatically. In Germany, a representative study from 2013 estimated the prevalence of Internet use disorder (IUD) to be about 1.0%, with higher rates among younger people. A 2020 meta-analysis shows a global weighted average prevalence of 7.02%. This indicates that developing effective IUD treatment programs is more critical than ever. Studies show that motivational interviewing (MI) techniques are widely used and effective in treating substance abuse and IUDs. In addition, an increasing number of online-based health interventions are being developed to provide a low-threshold treatment option. This article presents a short-term online-based treatment manual for IUDs that combines MI techniques with therapy tools from cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT). The manual includes 12 webcam-based therapy sessions, each lasting 50 min. Each session is framed by a standardized beginning, conclusion, outlook, and flexible session content. In addition, the manual contains example sessions to illustrate the therapeutic intervention. Finally, we discuss the advantages and disadvantages of online-based therapy compared to analog treatment settings and provide recommendations for dealing with these challenges. By combining established therapeutic approaches with an online-based therapeutic setting based on flexibility and motivation, we aim to provide a low-threshold solution for treating IUDs.

Effective interventions for gaming disorder: A systematic review of randomized control trials

Objective

To identify effective intervention methods for gaming disorder (GD) through a rigorous assessment of existing literature.

Methods

We conducted a search of six databases (PubMed, Embase, PsycINFO, CNKI, WanFang, and VIP) to identify randomized controlled trials (RCTs) that tested GD interventions, published from database inception to December 31, 2021. Standardized mean differences with 95% confidence intervals were calculated using a random effects model. Risk of bias was assessed with the Risk of Bias 2 (RoB 2) tool.

Results

Seven studies met the inclusion criteria. Five interventions were tested in these studies: group counseling, craving behavioral intervention (CBI), transcranial direct current stimulation (tDCS), the acceptance and cognitive restructuring intervention program (ACRIP), and short-term cognitive behavior therapy (CBT). Four of the five interventions (the tDCS was excluded) were found to have a significant effect on GD. The results of the quality assessment showed that the included studies had a medium to high risk in the randomization process and a medium to high risk of overall bias.

Conclusion

Rigorous screening identified that four interventions are effective for GD: group counseling, CBI, ACRIP, and short-term CBT. Additionally, a comprehensive review of the literature revealed that improvements could be made in the conceptualization of GD, experimental design, sample representativeness, and reporting quality. It is recommended that future studies have more rigorous research designs and be based on established standards to provide more credible evidence to inform the development of GD interventions.

An Integrated Yoga and Cognitive Behavioral Therapy Intervention for Managing Excessive Use of Internet among the Youth: A Case Series

Background

Internet addiction is a behavioral problem that is managed by pharmacological and nonpharmacological methods. The nonpharmacological methods focus on enhancing skills for healthy use of technology and promoting mindfulness and mental relaxation. Yoga therapy is an effective tool to reduce psychological stress and promote self-regulation and mindfulness. Thus, present work focused on developing an integrated yoga and cognitive behavioral therapy intervention (Y-CBT) for the management of excessive use of technology amongst adolescents and young adult students.

Methods

Feasibility of the Y-CBT program was tested by implementing 10 sessions of yoga and 6 sessions of CBT program for 2 weeks by certified Yoga therapist and psychologist, respectively. This was followed by online booster sessions once a week, and post assessments were conducted at 12 weeks. A total of 4 college-going students with the excessive use of technology were recruited from tertiary specialty service for promotion of healthy use of technology. Each participant was assessed using short-version of internet addiction test (s-IAT), Smartphone Addiction Scale-Short Version, Kessler's Psychological distress scale for baseline, and follow-up assessment after completion of the program.

Results

The Y-CBT program was found feasible and useful in reducing internet use, smart phone use, and psychological distress. There were no reported side-effects. A trend was observed for increase compliance toward treatment at follow-up. Future studies should explore this further with robust methodology.

Randomized Controlled Evaluation of a Group-Based Training for Parents of Adolescents with Gaming Disorder or Social Network Use Disorder

BACKGROUND

Internet Use Disorder (IUD), Gaming Disorder (GD), and Social Network Use Disorder (SNUD) are common phenomena among adolescents and young adults. Negative consequences of such disorders can be observed in the individuals themselves and in the family system. Although parents can influence their children in many ways, they are rarely considered in interventions. The present study examines the effectiveness of a group-based training for parents of adolescents with IUD, GD, or SNUD.

METHODS

A total of 76 parents of adolescents (12 to 20 years) were randomly assigned to the intervention group (IG) or the waiting list control group. Parents in the IG participated over eight weeks in six sessions of training (topics: psychoeducation, parenting behaviour, parent-child relationships, parent-child communication, and stress and relaxation). Questionnaires on adolescent symptomatology, parent-child relationships, and parental burden were collected before and after the intervention/waiting period.

RESULTS

The training reduced the IUD symptomatology of adolescents from the parents' perspective. GD symptomatology improved for at-risk users, though not for pathological users. Some aspects of the parent-child relationships improved in the mothers' judgment. Parental stress was already low before the training.

CONCLUSIONS

The presented parent group training can be used to improve IUD symptomatology in adolescents and is effective in the context of early intervention for at-risk computer gamers.