A ‘components’ model of addiction within a biopsychosocial framework

Communication attributes modify the anxiety risk associated with problematic social media use: Evidence from a prospective diary method study

PURPOSE

Social media use in younger people has shown mixed associations with mental health. We hypothesized that communication types during social media use might alter the relationship between problematic social media use (PSMU) and anxiety over time. We aimed to identify how four dimensions of communication influence the link between PSMU and anxiety.

METHODS

We recruited a cohort of undergraduate students aged 18-26 to participate in daily surveys over two weeks using a diary method to assess daily social media use, PSMU, anxiety symptoms, and the four dimensions of communication: Consumption, Broadness, Online Exclusivity, and Parasociality. Lagged logistic regression models with generalized estimating equations evaluated the influence of daily PSMU and communication type on subsequent anxiety levels.

RESULTS

Out of 79 participants, 1009 daily records were analyzed. PSMU positively correlated with anxiety (Kendall rank correlation τ = 0.30). Interaction analysis indicated that levels of parasociality and consumption moderated the association between PSMU components and anxiety outcomes. In young adults with high levels of consumption or parasociality, a 1-standard-deviation rise in PSMU's social conflict component led to an 11 %-13 % increase in next-day anxiety scores. This association was absent for those with low to moderate levels of parasociality and consumption.

DISCUSSION

Elevated levels of passive consumption and one-sided interactions amplify the anxiety risk associated with PSMU. Further longitudinal evidence can elucidate the connections between communication types, social media exposure, and anxiety, guiding the development of a model for healthy social media use.

The Role of Perfectionistic Self-Presentation and Problematic Instagram Use in the Relationship Between Self-Concept Clarity and Body Disconnection: A Serial Mediation Model

By combining authors who hypothesized that modern technology has greatly increased people's ability and people's possibility to distance themselves from their embodied awareness and those who have shown that communication through social media is more congenial to people with a tendency towards perfectionistic self-presentation (PSP), this study analyses the influence of self-concept clarity (SCC) in bodily dissociation (BD) and hypothesizes that people with a low SCC are more prone to BD and that PSP and problematic Instagram use (PIU) may play a serial mediating role in this relationship. Two hundred and 19 women (Mage = 31.8 ± 11.25) completed an online survey that included the Italian-validated versions of the Perfectionistic Self-Presentation Scale, the Scale of Body Connection and the Bergen Facebook Scale modified for Instagram use. A Serial Mediation Model (Hayes's PROCESS Model 6) shows that both PSP and PIU significantly serially mediate the association between SCC and BD (β = -.025 SE = .011, 95% CI = [-.0498, -.0070]) and that there is a mediating effect of PIU between SCC and BD (β = -.04 SE = .020, 95% CI = [-.0865, -.0098]), but no mediating effect of PSP between SCC and BD was found (β = -.052 SE = .031, 95% CI = [-.1184, +.0039]). A possible explanation is that people with low SCC try to avoid others noticing their imperfections because they fail to integrate it into their self-concept and tend to use Instagram in a problematic way because this tool allows them to largely control the information they share. This use, in turn, alters their state of mind-body connection and this increases the disconnection from one's bodily sensations. The absence of mediation by the PSP between SCC and BD and the presence of PIU mediation between SCC and BD underlines the importance of technology in this relationship. The implications and limitations of this study will be discussed.

Distinct roles of specific metacognitive beliefs in adolescent problematic mobile phone use: A Cross-Lagged panel network analysis

Problematic mobile phone use (PMPU) among adolescents is increasingly recognized as a significant behavioral health concern. Previous studies have found general metacognitive beliefs can positively predict PMPU. However, the longitudinal relationship between specific metacognitive beliefs and addictive behaviors has not been fully explored. This study aimed to explore the longitudinal relationship between metacognitions about mobile phone use, metacognitions about desire thinking, and PMPU among adolescents using cross-lagged panel network analysis. A sample of 993 adolescents were surveyed at two points over six months. Findings indicated that negative metacognitions about mobile phone use and positive metacognitions about desire thinking emerged as two prominent bridge nodes. Negative metacognitions about mobile phone use were strongly associated with withdrawal and relapse symptoms, while positive metacognitions about desire thinking correlated with tolerance and relapse. These results suggest that interventions aimed at addressing PMPU should consider the distinct impacts of different metacognitive beliefs and tailor their approaches accordingly.

Self-discontinuity in behavioral addictions: A psychodynamic framework

Models based on substance use criteria have been employed to classify maladaptive engagement in various everyday activities as genuine addictions. However, symptom-based models have potential limitations, which includes in some cases reduced clinical utility and an increased risk of diagnostic inflation. The current article presents an alternative psychodynamic theoretical framework to elucidate the psychological processes underlying the development of putative behavioral addictions. According to this framework, behavioral addictions are conceptualized as strategies for regulating overwhelming feelings rooted in childhood trauma. Exposure to childhood trauma may lead to the segregation of unbearable trauma-related mental states from awareness through persistent dissociative processes. Thus, behavioral addictions may provide individuals with an illusory sense of control over unbearable feelings while simultaneously reinforcing the segregation of trauma-related mental states. The compulsive engagement in such activities can be seen as an attempt at self-medication, though it ultimately exacerbates discontinuities in self-experience. This theoretical framework is further illustrated through a clinical vignette, highlighting its implications for both assessment and treatment.

Evaluating Problematic Smartphone Use Among Chinese Primary School Students Using SABAS: An IRT and Network Analysis

OBJECTIVES

This study assessed the psychometric properties of the Smartphone Application-Based Addiction Scale (SABAS) among Chinese primary school students, focusing on validity, reliability, and factor structure using Item Response Theory (IRT) and Network Analysis (NA).

METHODS

Data were collected from 1108 primary school students in China (52.98% female; ages 7-14 years; M = 10.58, SD = 0.99). SABAS was assessed using Item Response Theory (IRT) for factor structure, item parameters, cut-off scores, and reliability, while Differential Item Functioning (DIF) detected gender biases. Network Analysis (NA) examined the interrelationships among SABAS items.

RESULTS

Confirmatory factor analysis supported SABAS's unidimensional structure (RMSEA = 0.055, CFI = 0.984, TLI = 0.973, SRMR = 0.025). IRT indicated high item discrimination (α = 1.47-2.47) and identified a cut-off score of 27, classifying 1.7% of students as high-risk for problematic smartphone use. Gender DIF was noted in item 6, with boys showing higher relapse tendencies (p < 0.05). NA highlighted the centrality of tolerance and withdrawal items.

CONCLUSIONS

SABAS is a reliable tool for assessing problematic smartphone use in Chinese primary school students, particularly those at moderate to high risk.

Methodological issues in behavioral addictions' research: A call for an unbiased analysis of excessive behaviors

In the psychological literature, there has been a proliferation of new behavioral addictions, often biased by an aprioristic and confirmatory approach that applied the addiction framework without adequately considering other potential explanations of excessive behaviors. This position paper further extends the critiques previously pointed out in the literature by highlighting the methodological issues underlying the current behavioral addiction research and the need for future studies to avoid a confirmatory and aprioristic approach (whatever the etiological hypothesis). Analyzing repetitive behaviors in their own specifies could help find a balance between the risk of over-pathologizing common behaviors and not exploring new potential clinical disorders related to everyday (excessive) behaviors associated with functional impairment and deserving public health attention. Finally, we underline the value of recalling that if an existing diagnosis might explain the problematic behavior under consideration, a new clinical disorder should not be introduced in the literature.

Personality predictors of exercise addiction in competitive sport

Exercise addiction is increasingly recognized as a possible threat to athletes' well-being, especially in elite sports. However, research on underlying personality predictors predisposing athletes to exercise addiction remains limited. This study hypothesized several key personality attributes including athletic identity, sport motivation, perfectionism, and neuroticism as possible risk factors of exercise addiction in elite athletes and examined relationships between these personality attributes and symptoms of exercise addiction in 168 Czech elite athletes aged from 18 to 30 years. Results showed that 16.5% of athletes exhibited signs of exercise addiction, while 76.7% were at risk with low symptom severity. Multiple linear regression indicated that neuroticism, introjected regulation, and athletic identity significantly predicted exercise addiction (F(3, 164) = 32.63, p < .001, R2 = .36). These findings underscore the importance of psychological factors in understanding exercise addiction among athletes. The high prevalence suggests discrepancies in diagnosing exercise addiction and inconsistent use of diagnostic tools, necessitating cautious interpretation of the results.

Translation and validation of the Portuguese version of the internet severity and activities addiction questionnaire (ISAAQ-10) towards the identification of problematic social media use: A population study

BACKGROUND

Problematic usage of the internet (PUI) refers to a pattern of internet use that results in negative consequences in an individual's life. It encompasses a broad spectrum of activities, which require assessment in terms of both severity and diversity, for a comprehensive understanding. This study aimed to translate the Internet Severity and Activities Questionnaire (ISAAQ-10) into Portuguese, to analyze its psychometric properties and to explore the validity of the ISAAQ-10 social networking use activity score towards identifying problematic social media use.

METHODS

A snowball sampling method was used, with participants completing an online survey comprising sociodemographic questions and the Portuguese versions of the ISAAQ-10, Internet Addiction Test-10 (IAT-10), Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), and Bergen Social Media Addiction Scale (BSMAS). The psychometric analysis included internal reliability testing using Cronbach's alphas and test-retest reliability, a confirmatory factor analysis (CFA), and convergent validity testing between the ISAAQ-10 and IAT-10. The concurrent validity of the ISAAQ-10 was also examined.

RESULTS

A total of 590 young adults (85.1 % female), aged between 18 and 35 years, participated in this study. The ISAAQ-10 presented good internal consistency (α = 0.93), with a test-retest correlation of r = 0.865; 95 % CI: 0.669-0.939. and a unidimensional structure that explained 48.3 % of the total variance. The convergent validity of the ISAAQ-10's total score was established through a high Pearson's correlation (r = 0.574; p ≤ .001) with the IAT-10's total score. Pearson's correlations between the ISAAQ-10 gaming activity score and the IGDS9-SF (r = 0.873; p < .001), and between the ISAAQ-10 social networking use activity score and the BSMAS (r = 0.670; p < .001), respectively, supported the instrument's concurrent validity.

CONCLUSION

This work provides support for the Portuguese translation of the ISAAQ-10, which can be employed to identify the severity of problematic usage of the internet in a population sample. It also provides the first validation of the ISAAQ-10 social networking use activity score, which can be employed to identify problematic social media use within a predominately female university student sample. This study further establishes the ISAAQ-10 as a valid and reliable tool for population studies and, specifically, for the identification of problematic social media use.

Unraveling the Complexity of Internet Addiction: A Multi-Faceted Perspective from Five Key Studies

Internet addiction (IA) is one of the global concerns of our time, and research continues on understanding its psychological, neurobiological, and behavioral bases [...].

Exploring Food Addiction Across Several Behavioral Addictions: Analysis of Clinical Relevance

BACKGROUND/OBJECTIVES

Recently, interest in studying food addiction (FA) in the context of behavioral addictions (BAs) has increased. However, research remains limited to determine the FA prevalence among various BAs. The current study aimed to investigate FA in a clinical sample of patients seeking treatment for gaming disorder, compulsive buying-shopping disorder (CBSD), compulsive sexual behavior disorder, and the comorbid presence of multiple BAs, as well as to determine the sociodemographic characteristics, personality traits, and general psychopathology of this clinical population. In addition, we analyzed whether FA is linked to a higher mean body mass index (BMI).

METHODS

The sample included 209 patients (135 men and 74 women) attending a specialized behavioral addiction unit. The assessment included a semi-structured clinical interview for the diagnosis of the abovementioned BAs, in addition to self-reported psychometric assessments for FA (using the Yale Food Addiction Scale 2. 0, YFAS-2), CBSD (using the Pathological Buying Screener, PBS), general psychopathology (using the Symptom Checklist-Revised, SCL-90-R), personality traits (using the Temperament and Character Inventory-Revised, TCI-R), emotional regulation (using Difficulties in Emotion Regulation Strategies, DERS), and impulsivity (using Impulsive Behavior Scale, UPPS-P). The comparison between the groups for the clinical profile was performed using logistic regression (categorical variables) and analysis of covariance (ANCOVA), adjusted based on the patients' gender. The sociodemographic profile was based on chi-square tests for categorical variables and analysis of variance (ANOVA) for quantitative measures.

RESULTS

The prevalence of FA in the total sample was 22.49%. The highest prevalence of FA was observed in CBSD (31.3%), followed by gaming disorder (24.7%), and the comorbid presence of multiple BAs (14.3%). No group differences (FA+/-) were found in relation to sociodemographic variables, but the comorbidity between FA and any BA was associated more with females as well as having greater general psychopathology, greater emotional dysregulation, higher levels of impulsivity, and a higher mean BMI.

CONCLUSIONS

The comorbidity between FA and BA is high compared to previous studies (22.49%), and it is also associated with greater severity and dysfunctionality. Emotional distress levels were high, which suggests that the group with this comorbidity may be employing FA behaviors to cope with psychological distress. However, a better understanding of the latent mechanisms that contribute to the progression of this multifaceted comorbid clinical disorder is needed. One aspect that future studies could consider is to explore the existence of FA symptoms early and routinely in patients with BAs.

A longitudinal network analysis of the relationship between love addiction, insecure attachment patterns, and interpersonal dependence

The present study employed a network analysis approach to explore interrelationships among love addiction, attachment anxiety, attachment avoidance, and interpersonal dependence. The sample included 80 couples (N = 160) in romantic relationships, assessed longitudinally through online self-reports at the study's initiation and three months later. The findings revealed that attachment anxiety correlated strongly with low self-confidence, attachment avoidance related to autonomy, and love addiction showed a positive association with emotional dependence but a negative association with attachment avoidance. These findings underscore the associations among love addiction, insecure attachment patterns, and dimensions of interpersonal dependence. Addressing the core link between love addiction and insecure attachment patterns may enhance the psychological well-being of both partners in a couple.

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.

Mindful attention awareness reduces binge watching engagement: The mediating role of emotion regulation difficulties

Mindful attention awareness (MAA) has a protective role on the development of a wide range of problematic behaviors. Yet, no data is available on the relationship between MAA and binge watching (BW) - broadly defined as consecutively watching multiple episodes of TV series. To fill this gap, 442 adults completed an online battery of questionnaires measuring MAA, emotion regulation difficulties and BW engagement and symptoms. The results of the correlational and path analyses indicated that MAA was negatively associated with both positive and negative BW; furthermore, these negative effects were mediated by reductions in impulse control difficulties, as well as by increases in emotional awareness and enhanced access to emotion regulation strategies. These findings suggest that mindfulness-based interventions aimed at reducing emotion regulation difficulties might be effective in reducing the negative consequences that may arise from the engagement in problematic forms of BW.

Short-term effectiveness of gambling treatment in the Daily Clinic for Gambling Addiction

In response to the high prevalence of gambling addiction within the population, a specialised Daily Clinic for Gambling Addiction was established at the University Psychiatric Hospital "St. John" in Zagreb (Croatia). This clinic offers a unique three-month, semi-structured, intensive multidimensional and multidisciplinary treatment approach delivered by a team of specialised mental health professionals. Treatment interventions include individual and group psychotherapy, socioemotional skills training, family therapy, support groups and other modalities. In collaboration with researchers from the University of Zagreb Faculty of Education and Rehabilitation Sciences, the study team is conducting a scientific evaluation to determine the outcomes of the treatment. This study presents results on its' short-term effectiveness, based on a sample of N = 209 patients (Mean Age = 33.54; Males = 92.8%; Females = 7.2%) who underwent treatment between 2017 and 2021. To assess the effectiveness of the treatment, a research design incorporating two measurement sessions (pre-test and post-test) was employed. This design utilised a comprehensive battery of validated instruments, each targeting specific constructs or domains of psychosocial functioning that the intervention aims to address. The assessment tools included: (1) Problem Gambling Severity Index-PGSI, (2) Gambling Attitudes Scale-GAS, (3) Coping Inventory for Stressful Situations-CISS, (4) The Gambling Beliefs Scale-short version, (5) Problem Solving and Refusal Skills Scale, (6) Depression, Anxiety, Stress Scale-DASS-21, (7) Generalised Self-Efficacy Scale-GSE, and (8) Multidimensional Scale of Perceived Social Support. The results indicate significant positive improvements in gamblers' psychosocial functioning with the following large effect sizes: gambling-related consequences (r = 0.84), task oriented coping (Cohen's d = 0.79), emotion oriented coping (Cohen's d = 1.06), attitudes (r = 0.67), superstition (r = 0.61), illusion of control (r = 0.62), depression (r = 0.78), anxiety (r = 0.71), stress (r = 0.73), problem-solving skills (r = 0.73) and general self-efficacy (r = 0.61). The effects on refusal skills (Cohen's d = 0.48) as well as on alcohol (Cohen's d = 0.24) and marihuana (r = 0.26) were small to medium. Findings are discussed in terms of appropriate treatment approaches for gambling addiction, methodological challenges in measuring effects and implications for future evaluation research. In general, this treatment protocol provides promising effects for gambling addiction.

Vaping, Acculturation, and Social Media Use Among Mexican American College Students: Protocol for a Mixed Methods Web-Based Cohort Study

BACKGROUND

The tobacco industry has a history of targeting minority communities, including Hispanic individuals, by promoting vaping through social media. This marketing increases the risk of vaping among Hispanic young adults, including college students. In Texas, college enrollment among Mexican Americans has significantly increased over recent years. However, little research exists on the link between social media and vaping and the underlying mechanisms (ie, outcome expectations, attitudes, and beliefs) explaining how vaping-related social media impacts vaping among Mexican American college students. Moreover, there is limited knowledge about how acculturation moderates the association between social media and vaping. Hispanic individuals, particularly Mexican Americans, are the largest ethnic group in Texas colleges; thus, it is crucial to understand the impact of social media and acculturation on their vaping behaviors.

OBJECTIVE

We outline the mixed methods used in Project Vaping, Acculturation, and Media Study (VAMoS). We present descriptive analyses of the participants enrolled in the study, highlight methodological strengths, and discuss lessons learned during the implementation of the study protocol related to recruitment and data collection and management.

METHODS

Project VAMoS is being conducted with Mexican American students attending 1 of 6 Texas-based colleges: University of Texas (UT) Arlington, UT Dallas, UT El Paso, UT Rio Grande Valley, UT San Antonio, and the University of Houston System. This project has 2 phases. Phase 1 included an ecological momentary assessment (EMA) study and qualitative one-on-one interviews (years 1-2), and phase 2 includes cognitive interviews and a 4-wave web-based survey study (years 2-4) with objective assessments of vaping-related social media content to which participants are exposed. Descriptive statistics summarized participants' characteristics in the EMA and web-based survey.

RESULTS

The EMA analytic sample comprised 51 participants who were primarily female (n=37, 73%), born in the United States (n=48, 94%), of middle socioeconomic status (n=38, 75%), and aged 21 years on average (SD 1.7 years). The web-based survey cohort comprised 1492 participants self-identifying as Mexican American; Tejano, Tejana, or Tejanx; or Chicano, Chicana, or Chicanx heritage who were primarily female (n=1042, 69.8%), born in the United States (n=1366, 91.6%), of middle socioeconomic status (n=1174, 78.7%), and aged 20.1 years on average at baseline (SD 2.2 years). Of the baseline cohort, the retention rate in wave 2 was 74.7% (1114/1492).

CONCLUSIONS

Project VAMoS is one of the first longitudinal mixed methods studies exploring the impact of social media and acculturation on vaping behaviors specifically targeting Mexican American college students. Its innovative approach to objectively measuring social media exposure and engagement related to vaping enhances the validity of self-reported data beyond what national surveys can achieve. The results can be used to develop evidence-based, culturally relevant interventions to prevent vaping among this rapidly growing minority population.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/63584.

The impact of gambling advertising on gambling severity: a path analysis of factors of psychological distress in individuals with gambling disorder

Background

There is a consensus in the literature that gambling advertising disproportionately affects those experiencing higher gambling severity. However, the relationship of gambling advertising and severity is typically assessed among samples recruited from online panels using screening tools as the method to categorize the gambling severity status of participants. Alternatively, other studies use small groups of gamblers (i.e., qualitative studies). The present paper reports findings from a sample of gamblers diagnosed with gambling disorder by professional clinicians via individual interviews. The study investigated the association between gambling advertising and gambling severity by looking at other psychologically relevant variables such as impulsivity, emotion regulation, and general psychopathology.

Methods

A sample of 210 consecutive treatment-seeking patients was recruited from a public hospital from June 2019 to January 2021. A path analysis model was run to determine the relationship between the variables. Gambling advertising was constructed as a latent variable, comprising the perceived impact of gambling advertising, persuasion knowledge, and the attitudes towards gambling advertising.

Results

Gamblers with greater gambling severity reported higher perceived impact of gambling advertising, and more positive attitudes toward gambling advertising. Gambling advertising was a mediator in the paths between emotion regulation and gambling severity, and between impulsivity and gambling severity.

Conclusion

The study demonstrates among individuals with verified gambling disorder that there is a relationship between gambling advertising and gambling severity. Regulators have an empirical basis on which to restrict the exposure to gambling advertising of vulnerable groups.

Understanding problematic TikTok use: A systematic review of emerging diagnostic and therapeutic implications in clinical psychology

TikTok's rapid rise has spurred concerns about its potential to cause problematic use behaviors, which some consider akin to addiction. This systematic review seeks to understand the diagnostic and therapeutic implications of TikTok use within the scope of clinical psychology. From September 15, 2023 to March 30, 2024 a systematic review was conducted to investigate whether this new pathological condition can be recognized as a behavioral addiction. We searched the following databases for relevant studies: PubMed, National Center for Biotechnology Information (NCBI), PsycINFO, MDPI, Frontiers in Psychology, ScienceDirect, and ReserchGate. We identified a total of 294 unique articles. 45 full-text articles were assessed for eligibility and only 21 of these met the eligibility criteria and were included in the final systematic review. We identified factors like salience, craving, and abstinence related to problematic TikTok use, confirming its potential risk as a behavioral addiction. Currently, there are neither established guidelines, nor an acceptable number of clinical cases, to determine the inclusion of TikTok addiction within an official classification. Additional considerations include the assessed target population, geographical differences, and the lack of specific treatments or interventions. Our study confirms that problematic TikTok use must be considered an addiction both for the considerable risk it entails and for its developmental trajectory. Through the analysis of the included studies, we confirmed elevated levels of salience, abstinence, tolerance, craving, excessive use, desire to control consumption, and alterations in daily life habits associated with problematic TikTok use.

Assessing Short-Video Dependence for e-Mental Health: Development and Validation Study of the Short-Video Dependence Scale

BACKGROUND

Short-video dependence (SVD) has become a significant mental health issue around the world. The lack of scientific tools to assess SVD hampers further advancement in this area.

OBJECTIVE

This study aims to develop and validate a scientific tool to measure SVD levels, ensuring a scientifically determined cutoff point.

METHODS

We initially interviewed 115 highly engaged short-video users aged 15 to 63 years. Based on the summary of the interview and references to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for behavioral addictions, we proposed the first version of the short-video dependence scale (SVDS). We then screened the items through item analysis (second version) and extracted common factors using exploratory factor analysis (third version) and confirmatory factor analysis (final version). Convergent validity was tested with other scales (Chinese Internet Addiction Scale [CIAS] and DSM-5). Finally, we tested the validity of the final version in 16,038 subjects and set the diagnostic cutoff point through latent profile analysis and receiver operating characteristic curve analysis.

RESULTS

The final version of the SVDS contained 20 items and 4 dimensions, which showed strong structural validity (Kaiser-Meyer-Olkin value=0.94) and internal consistency (Cronbach α=.93), and good convergent validity (rCIAS=0.61 and rDSM-5=0.68), sensitivity (0.77, 0.83, 0.87, and 0.62 for each of the 4 dimensions), and specificity (0.75, 0.87, 0.80, and 0.79 for each of the 4 dimensions). Additionally, an SVDS score of 58 was determined as the best cutoff score, and latent profile analysis identified a 5-class model for SVD.

CONCLUSIONS

We developed a tool to measure SVD levels and established a threshold to differentiate dependent users from highly engaged nondependent users. The findings provide opportunities for further research on the impacts of short-video use.

Gaming disorder and psychological distress among Iranian adolescents: the mediating role of sleep hygiene

BACKGROUND

Evidence on psychological outcomes of gaming disorder (GD) is still scarce. This study aimed to investigate the mediating role of sleep hygiene in the relationship between GD and psychological distress (depression and anxiety) among Iranian adolescents.

METHODS

This was a cross-sectional study among school students in Qazvin city, Iran. We administered GD, anxiety, and depression questionnaires in a paper-and-pencil format. GD was measured using the GD S4-SF scale, and anxiety and depression were evaluated using the DASS-21. We assessed sleep health as a mediator using the Sleep Hygiene Behaviors scale. Covariance-Based Structural Equation Modeling (CB-SEM) was employed for data analysis, accounting for sex and physical activity as the main confounders. Statistical significance was determined using various fit indices and confidence intervals.

RESULTS

The sample consisted of 600 adolescents (41% female). CB-SEM revealed a positive but not statistically significant association between GD and depression, along with a negative statistically significant association with anxiety. Notably, sleep hygiene was identified as a partial mediator in the relationship between GD and depression, indicating that poor sleep practices may exacerbate depressive symptoms among adolescents with GD. However, no mediating effect was observed for anxiety.

CONCLUSION

Our data supported a mediating role for sleep hygiene in the association between GD and depression among participants. Our results highlight the critical need for targeted policy interventions to improve sleep hygiene among adolescents with GD.

I Did 10,000 Steps so I Earned This Treat: Problematic Smartwatch Use and Exercise Tracking Associations with Compensatory Eating and Sedentary Activity

Smartwatches are digital devices, similar to smartphones, and come with the possibility of problematic use. Problematic technology use is the experience of psychological distress or reduced daily functioning in response to excessive or addictive technology use. The purpose of this study was to explore whether problematic use of smartwatch devices for exercise tracking influences user's health behaviors such as eating habits and sedentary activity. An online survey was conducted among college-aged smartwatch users (n = 221). Results showed that using smartwatches for exercise tracking has a positive relationship with compensatory eating behavior (i.e., increasing caloric intake after exercise) when the use is higher in problematic use. This study concludes that although smartwatch devices are promoted to aid healthy behaviors, their impact on positive health outcomes may be limited for some users, to the extent that compensatory eating can derail fitness goals and may exacerbate eating behaviors. Future research should aim to develop health messaging for smartwatch users to make them aware of the potential for compensatory eating behavior to undermine their goals in the face of excessive smartwatch use for fitness purposes.

Adolescents and Social Media: Longitudinal Links Between Motivations for Using Social Media and Subsequent Internalizing Symptoms

Knowledge is lacking on whether adolescents' motivations for social media use predict internalizing symptoms, and few studies have considered the moderating role of extraversion. In 2017 (T1) and 2018 (T2), 197 adolescents (49.70% girls, Mage = 13.15, SD = 0.36) from a large metropolitan area participated in this study. Adolescents reported on their social media use motivations and extraversion (at T1) and depressive and anxiety symptoms (T1 and T2). Latent class analysis revealed four motivation profiles at T1: (1) entertainment and fun (30.97%); (2) avoidance and escapism (14.21%); (3) meeting new people, feel involved (16.75%); (4) boredom (38.07%). Social motivations (profile 3) predicted elevated internalizing symptoms at T2. Avoidance and boredom motivations (profile 2 and 4) predicted internalizing symptoms for adolescents with low extraversion. Social media use motivations and extraversion distinguish adolescents who benefit from social media from those who experience difficulties.

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.

Between Clicks and Care: Investigating Social Media Addiction and Work Engagement Among Nurses in Saudi Arabia

Background/Objectives: The aim of this study was to investigate the relationship between social media networking addiction (SMNA) and work engagement (WE) among nurses at a government hospital in Jeddah, Saudi Arabia, as well as to assess the overall levels of SMNA and WE within this population. Methods: A quantitative, correlational, cross-sectional design was employed with an online survey instrument, involving 283 nurses from the government hospital. The data were analyzed using SPSS software version 26. Results: Nurses exhibited low levels of SMNA and average levels of WE. A negative relationship was identified between SMNA and WE. Conclusions: The findings indicate that SMNA influences various dimensions of WE differently. A significant negative relationship was observed between SMNA and the dimensions of vigor, absorption, and overall WE. However, SMNA did not significantly impact the dedication dimension, which emerged as the highest-scoring aspect among nursing professionals. Therefore, this study recommends raising awareness among nurses regarding the detrimental impact that excessive social media usage can have on their professional responsibilities and mental health, the implementation of clear social media usage guidelines, regular assessment of the trends in social media usage among nurses and the introduction of educational programs to raise awareness and promote responsible usage.

The mediating effect of social network sites addiction on the relationship between childhood psychological abuse and depression in college students and the moderating effect of psychological flexibility

BACKGROUND

Experience of child psychological abuse in college students is likely to increase their risk of depression, but the potential psychological mechanisms between the two require further exploration. This study supplemented the risk and protective factors between child psychological abuse and depression in college students by introducing social network sites addiction (SNSA) as a mediating factor and psychological flexibility as a moderating factor.

METHODS

A cross-sectional survey was conducted on 655 college students from two universities in Hunan Province, China. Self-reported measures included childhood psychological abuse, depression, SNSA, and psychological flexibility. Descriptive and correlational analyses were performed on these variables, followed by the establishment of a structural equation model.

RESULTS

Child psychological abuse was positively associated with depression (r = .507, p < .001) and SNSA (r = .208, p < .001) in college students and negatively associated with psychological flexibility (r = -.293, p < .001). SNSA played a mediating role between childhood psychological abuse and depression (β = .170, SE = 0.035, p < .001) in college students, while psychological flexibility attenuated the strength of the relationship between the latter two (β = -.095, SE = 0.031, p < .01).

CONCLUSION

The study further elucidates the psychological mechanisms underlying the relationship between childhood psychological abuse and depression in college students. SNSA may mediate the relationship between the two, while psychological flexibility may buffer the strength of the relationship between them. Future research should explore interventions enhancing college students' psychological flexibility after childhood psychological abuse to cut the risk of depression.

The relationship between smartphone addiction and sleep disorder among college students: negative emotions as a mediator and gender as a moderator

Background

College students are disproportionately affected by smartphone addiction, which has been linked to various health impairments, including sleep disorders. This study explores the relationship between smartphone addiction and sleep disorders, with a focus on negative emotions as a mediator and gender as a moderator.

Methods

Cluster sampling was used to survey 1056 Chinese college students. The Mobile Phone Addiction Index, Negative Affect Scale, and Sleep Disorder Scale were administered. Versions of SPSS 27.0 and PROCESS macro 4.0 were used for data analysis, employing Models 15 and 4 to examine moderation and mediation, respectively.

Results

A strong direct correlation was identified between smartphone addiction and sleep disorder, with negative emotions mediating this relationship, accounting for 33.7% of the effect. Gender significantly moderated the mediation process, with females demonstrating a greater correlation than males between sleep disorders and negative emotions.

Conclusion

Negative emotions partially mediated smartphone addiction's association with sleep disorder, whereas gender significantly moderated this mediation. These findings underscore the complex dynamics among smartphone addiction, emotional well-being, and sleep among college students.

Problematic Online Video Watching, Boredom Proneness and Loneliness Among First-Year Chinese Undergraduates: A Two-Wave Longitudinal Study

Purpose

While previous cross-sectional studies have investigated the relationship between problematic online video watching and mental health issues, longitudinal studies exploring their bidirectional relationship remain relatively scarce. This study aimed to fill this gap by conducting a two-wave longitudinal design.

Participants and Methods

Six hundred and ninety-nine first-year undergraduates voluntarily completed two rounds of questionnaire surveys assessing problematic online video watching, boredom proneness and loneliness with an interval of 4 months. To test the research hypotheses, cross-lagged panel models were performed using AMOS 24.0.

Results

Our results revealed the that (1) Boredom proneness and problematic online video watching were mutually influenced. (2) Loneliness at T1 positively predicted the level of problematic online video watching at T2 but not vice versa. (3) Boredom proneness mediated the link between loneliness and problematic online video watching. (4) Chinese first-year undergraduates' levels of problematic online video watching and boredom proneness significantly increased during their educational transition period from high school to university.

Conclusion

The present study enhances our understanding of the dynamic relationships between problematic online video watching, boredom proneness and loneliness, highlighting the targeted prevention and interventions for first-year undergraduates.

Pornography Use and Associated Factors in Adolescents: A Cross-Jurisdictional Approach (Spain vs. Mexico)

Pornography use is common among adolescents. However, there has been limited in-depth examination of cross-country differences in adolescent pornography use. Therefore, the main aim of the present study was to understand cross-jurisdictional differences in problematic pornography use (PPU) in 1810 adolescents from Spain and Mexico. The relationship between sociodemographic variables, loneliness, sexual risk behaviors, and religiosity with PPU and cross-jurisdictional differences between the two Spanish-speaking populations was assessed. In the Spanish sample, pornography use was a mediator of risky sexual behaviors, with this association being greater in males, older individuals, and those with a non-heterosexual orientation. In the Mexican sample, non-use of condoms was directly statistically predicted by older age, poor familial relationships, low religiosity, and more frequent pornography use. Jurisdictional differences in relationships between variables were observed in the two samples (Spanish and Mexican). Clinical implications and potential sociocultural factors that may underlie observed differences in the two Spanish-speaking cultures are considered and warrant additional investigation.

Interaction Between Social Support and Muscle Dysmorphia: The Role of Self-Efficacy and Social Media Use

Muscle dysmorphia (MD) consists of a type of body dysmorphic disorder and involves a distorted perception of one's muscles, strict diets, and workouts. Mostly, studies focus on adult male athletes, especially bodybuilders, while research on adolescents and women is limited. Our study aims to explore potential protective or risk factors influencing MD, using a mediation model calculated through Structural Equation Modeling (SEM) and at the same time help to involve female individuals in the exploration of a distress traditionally and predominantly analyzed only in male individuals. The model examines whether problematic social media use (PSMU) and generalized self-efficacy (GSE) are potential first- and second-level mediators, respectively, in the relationship between perceived social support (PSS) and MD. The sample consisted of 2325 individuals of both sexes aged 14-29 years. Structural equation models were used to assess effect sizes, regressions, and direct and indirect effects of perceived social support on muscle dysmorphia and general self-efficacy both on problematic social media use and muscle dysmorphia. Our results suggest that inadequate perceived social support may reduce individuals' perceived effectiveness in managing daily challenges, potentially leading to problematic use of social media, which may contribute to muscle dysmorphia symptoms. Future interventions could promote a healthier perception of one's body, improving confidence in individuals' coping strategies and strengthening the social environment of reference.

The impact of social media addiction on the negative emotions of adolescent athletes: the mediating role of physical appearance comparisons and sleep

Extensive use of social media is commonly associated with the development of social media dependency and amplification of adverse emotions among adolescent athletes. Descriptive statistics, correlation analysis, and path analysis were employed to investigate the impact of social media addiction on the negative emotions experienced by adolescent athletes. This study included a sample of 362 adolescent athletes (aged 14-21) participating in various sports events at training facilities in Guangdong and Hunan. Data collection was performed using the Social Media Addiction Scale, Body Appearance Comparison Scale, Pittsburgh Sleep Quality Index (PSQI), and the Depression, Anxiety, and Stress Scale (DASS-21). The findings suggest that social media addiction contributes directly to heightened negative emotions in adolescent athletes. In addition, physical appearance comparisons and sleep quality were identified as mediating factors that intensify the influence of social media addiction in terms of negative emotions. Consequently, it is recommended to underline the importance of mental health support for adolescent athletes, implement effective strategies for managing social media use, promote healthy body image perceptions, enhance sleep quality, and address negative emotions among adolescent athletes.

Associations between social networks, messaging apps, addictive behaviors, and sleep problems in adolescents: the EHDLA study

Objective

The current study aims to provide a comprehensive analysis of the relationships between social network (SN) use, messaging apps use, and addictive behaviors related to SNs, and sleep-related problems in a sample of Spanish adolescents.

Methods

This was a cross-sectional study using data from the Eating Healthy and Daily Life Activities (EHDLA) project, which involved adolescents aged 12-17 years from three secondary schools in Valle de Ricote (Region of Murcia, Spain). A sample of 632 adolescents was studied. The use of SN (i.e., Facebook, Twitter, Instagram, Snapchat or TikTok) or messaging applications (i.e., WhatsApp) was assessed via a scale including one item for each SN, in which adolescents were asked what type of SN they used and the usage profile of each SN. The Short Social Networks Addiction Scale-6 Symptoms (SNAddS-6S) was used to determine SN addictive behaviors. Generalized linear regression analyses with a negative binomial distribution were performed to determine the associations of SN use or SN addictive behaviors with sleep-related problems. These analyses were adjusted for age, sex, body mass index, socioeconomic level, physical activity, sedentary behavior, and adherence to the Mediterranean diet.

Results

Higher SN use was related to greater presence of sleep-related problems [prevalence ratio (PR) = 1.04; 95% confidence interval (CI) 1.01-1.07; p = 0.015]. Additionally, the higher the score on the addictive behaviors toward SN use scale was, the more sleep-related problems were identified (PR = 1.15; 95% Cl 1.09 to 1.21; p < 0.001). Specifically, only the use of Twitter was significantly associated with sleep-related problems (PR = 1.10; 95% Cl 1.01 to 1.21; p = 0.035). In terms of addictive behaviors related to SN use, mood modification, relapse, withdrawal, and conflict were significantly associated with sleep-related problems (mood modification: PR = 1.58; 95% CI 1.36 to 1.84; p < 0.001; relapse: PR = 1.24; 95% CI 1.07 to 1.43; p = 0.004; withdrawal: PR = 1.28; 95% CI 1.08 to 1.51; p = 0.004; conflict: PR = 1.19; 95% CI 1.01 to 1.39; p = 0.037).

Conclusion

Our results suggest a relationship between SN use, SN addictive behaviors, and sleep-related problems in adolescents. These cross-sectional results should be confirmed in longitudinal and intervention studies.

Problematic social media use in 3D? Relationships between traditional social media use, social virtual reality (VR) use, and mental health

This research expanded on prior work exploring the relationship between social media use, social support, and mental health by including the usage of social virtual reality (VR). In Study 1 (undergraduate students; n = 448) we examined divergent relationships between problematic social media use (e.g., Facebook, TikTok), total use, and users' mental health indicators (e.g., depression, anxiety, social isolation). To determine whether problematic social media use patterns extended to immersive 3-D environments, we sampled active social VR users (e.g., Rec Room) in Study 2 (n = 464). Problematic social VR use was related to decreased real-life social support (β = -.62, 95%CI [-.80, -.44]), but not to VR social support (β = -.06, 95%CI [-.25, .14]). Conversely, the amount of social VR use was only related to increased social VR (β = .06, 95%CI [.04, .15]) but not to real-life social support (β = -.02, 95%CI [-.05, .04]). Study 2 also revealed a finding that may be unique to the 3-D immersive environment: the amount of social VR use facilitated better mental health for VR users, but only through stronger perceived social support on social VR but not in real life. This result highlights the potential of immersive media to promote mental well-being by facilitating engaging and meaningful social interactions.

The role of impulsivity and emotional dysregulation in smartphone overdependence explored through network analysis

Smartphone overdependence is a maladaptive behavior characterized by excessive and uncontrollable smartphone use despite negative consequences. Impulsivity and emotional dysregulation, which are multidimensional constructs with each factor exerting a different effect, have been found to influence the development and persistence of smartphone overdependence. This study utilized network analysis to investigate the intricate relationships between the factors of impulsivity, emotional dysregulation, and smartphone overdependence. A sample of 687 adults in their twenties completed an online survey. Central nodes of the network were "Impulse-control difficulties," "Positive Urgency," "Salience" and "Relapse," and bridge nodes included a "Lack of emotional awareness and understanding," "Negative Urgency," "Lack of Perseverance," and "Impulse-control difficulties." These findings suggest that emotion-related impulsivity plays a pivotal role in smartphone overdependence and emotional dysregulation, with impulsivity acting as a critical mediator between emotional dysregulation and smartphone overdependence.

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.

Social media addiction and borderline personality disorder: a survey study

Background and aims

Borderline personality disorder (BPD) is a serious and difficult to treat psychiatric condition characterized by affective and interpersonal instability, impulsivity, and self-image disturbances. Although the relationship between BPD and substance use disorders has been well-established, there has been considerably less research regarding behavioral addictions in this population. The purpose of this study is to determine the prevalence of social media addiction (SMA) among individuals with BPD and to explore whether it is related to aspects of disorder symptomology.

Methods

300 adults completed an online survey via Prolific. Individuals completed the McLean Screening Instrument for BPD (MSI-BPD), along with the Bergen Social Media Addiction Scale (BSMAS). Additionally, all participants reported how often they use social media for the following reasons: distraction from interpersonal problems, reassurance seeking, self-confidence issues, and anger/revenge.

Results

Of the 289 subjects that completed all measures, 38 (13.1%) screened positive for BPD. Individuals screening positive for BPD were more likely to meet criteria for SMA than controls, and they were more likely to report using social media for interpersonal distraction, reassurance seeking, self-confidence issues, and anger/revenge seeking than controls. Among individuals with BPD, SMA was positively associated with the frequency of each of these behaviors, except for anger/revenge seeking.

Discussion and conclusion

The results of this study demonstrate that SMA is common among the BPD population and may be related to aspects of disorder symptomology. Whether SMA worsens BPD symptoms or whether addressing SMA could lead to improvements in the BPD remains to be seen and is an important area for future research.

Necessary Conditions in Social Media Addiction: Identifying Key Antecedents

This study aims to address the fragmented understanding of the antecedents of social media addiction (SMA) by examining key factors and their roles as necessary and sufficient conditions. By integrating key variables from previous research, including the Dark Triad traits, self-regulation, social anxiety, and Fear of Missing Out (FoMO), the study investigates their relationships with SMA. Data were collected through 369 questionnaires and analyzed using regression analysis and Necessary Condition Analysis (NCA). The findings reveal that Machiavellianism, narcissism, and FoMO are significantly associated with SMA, while only Machiavellianism and FoMO are identified as necessary conditions. These results contribute to the theoretical understanding of SMA by identifying critical antecedents and offer practical insights for designing targeted interventions to mitigate its impact.

A Multi- Mediation Analysis on the Impact of Social Media and Internet Addiction on University and High School Students' Mental Health Through Social Capital and Mindfulness

INTRODUCTION

Social media addiction (SMA) and internet addiction (IA) are increasingly prevalent, impacting mental health (MH) globally. This study investigates the mediating roles of mindfulness and social capital (SC) in the relationship between SMA, IA, and MH among Ethiopian high school and university students, contributing to the Sustainable Development Goal (SDG) 3 of good health and well-being.

METHODS

A cross-sectional study was conducted with 1160 university and 1473 high school students in Dessie, Ethiopia. Participants completed validated questionnaires assessing SMA, IA, mindfulness, SC, and MH. Structural Equation Modeling (SEM) with a multi- mediation Model (SMM) was used to examine the hypothesized relationships.

RESULTS

SEM revealed that both SMA and IA had a direct negative effect on mindfulness, SC, and MH in in both high school and university students. Notably, mindfulness and SC significantly and positively predicted MH, indicating their protective role against the negative effects of SMA and IA. Furthermore, both mindfulness or SC fully or partially mediated the relationship between SMA, IA, and MH, highlighting their crucial role in explaining the association.

CONCLUSIONS

This study provides evidence for the crucial roles of mindfulness and SC in buffering the negative effects of SMA and IA on MH among Ethiopian students. The findings highlight the need for educational and health interventions that foster mindfulness and SC to enhance student mental health and promote a healthy digital environment. These results offer valuable insights for educators, health professionals, and policymakers in Ethiopia and other developing countries facing similar challenges.

The Clinical Sequelae of the COVID-19 Pandemic: Loneliness, Depression, Excessive Alcohol Use, Social Media Addiction, and Risk for Suicide Ideation

BACKGROUND

Depression, loneliness, and alcohol use disorder are associated with suicide ideation. The ongoing COVID-19 pandemic has challenged our social structures with social distancing and isolation policies implemented worldwide, severely restricting social interactions. Studies regarding the effects of the pandemic are starting to shed light on the harmful psychological effects of these policies.

AIMS

This study aims to identify whether the increase in suicidal ideation among college students (mostly young adults) during the pandemic was due to the known risk factors of loneliness, depression, alcohol use disorder, social media addiction, and other background variables.

METHOD

Nine hundred and eleven college students completed self-report questionnaires assessing suicidal risk, depressive symptoms, loneliness, excessive alcohol use, and social media use.

RESULTS

During the pandemic suicidal ideation was associated with loneliness (χ2 = 54.65, p < 0.001), depressive symptoms (χ2 = 110.82, p < 0.001), alcohol use disorder (χ2 = 10.02, P < 0.01) and social media addiction (χ2 = 13.73, P < 0.001). Being single [OR = 2.55; p < 0.01], and self-identifying as a non-heterosexual [OR = 2.55; p < 0.01] were found to constitute additional risk factors.

LIMITATIONS

The structural nature of quantitative self-report scales does not offer the flexibility of gaining a deeper understanding of causes, specific to particular circumstances that may lead participants to ideate on suicide, even briefly.

CONCLUSIONS

Social distancing and isolation policies during the COVID-19 pandemic constitute an additional factor in the risk for suicide ideation.

Associations between social media use and positive mental health among adolescents: Findings from the Canadian Health Behaviour in School-aged Children Study

Social media use (SMU) has rapidly increased among children and adolescents in the past decade, and has been linked with poorer mental health. However, moderate SMU can facilitate connectedness among peers, which may have positive impacts for well-being - these associations are underexplored. This study examined the associations between SMU and several indicators of PMH in a nationally representative sample of 13,113 adolescents in grades 6 to 10 from the 2017/2018 cycle of the Canadian Health Behavior in School-aged Children (HBSC) study. SMU was measured using a four-level composite of intensity (non-active, active, intense) and problematic SMU (addictive-like symptoms, regardless of intensity). Four dichotomous indicators of PMH were examined: self-efficacy, self-confidence, life satisfaction, and psychological well-being. Covariates included grade, gender, cultural/racial background, and socioeconomic status. Unadjusted and adjusted mixed effects logistic regression models accounting for school-level clustering were run, with separate models for each PMH indicator and active SMU set as the referent. When compared to active SMU, problematic SMU was associated with lower levels of all PMH indicators, and intense SMU was associated with lower life satisfaction. In gender-stratified models, intense SMU was associated with lower life satisfaction among girls. In grade-stratified models, non-active SMU was associated with lower self-confidence for adolescents in grades 9 and 10. In all, problematic SMU is generally associated with lower odds of reporting high PMH. Longitudinal research is required to ascertain directionality of these findings, and to examine how these associations may have changed as a result of the COVID-19 pandemic.

Is medical training solely to blame? Generational influences on the mental health of our medical trainees

INTRODUCTION

The negative impact of medical training on trainee mental health continues to be a concern. Situated within a sociocultural milieu, Generation Z and Generation Y, defined by their highly involved parents and the widespread use of technology, currently dominate undergraduate and graduate medical education respectively. It is necessary to explore medical trainees' generational characteristics and job-related factors related to stress, burnout, depression, and resilience. This might provide different perspectives and potential solutions to medical trainees' mental health.

METHODS

A cross-sectional study was conducted among medical trainees (students and residents) from two institutions in Qatar. A self-administered online survey included measures for trainees' social media overuse, their parent's parenting style, the educational support by the clinical teacher, job (demands, control, and support), and work-life balance and their relation with their stress, burnout, depression, and resilience. Relationships were tested with multiple linear regression analyses.

RESULTS

Of the 326 medical trainees who responded, 142 (44%) trainees - 93 students and 49 residents - completed all items and were included in the analysis. Social media overuse and inability to maintain a work-life balance were associated with higher levels of stress, depression, and student burnout. Higher levels of job support were associated with lower levels of stress, depression, and resident burnout, and a higher level of resilience. Job control was associated with lower burnout levels. Parenting style was unrelated to trainees' mental health.

DISCUSSION

The two generations 'Y' and 'Z' dominating current medical training showed more stress-related complaints when there is evidence of social media overuse and failure to maintain a work-life balance, while job support counterbalances this, whereas parenting style showed no effect. Measures to enhance medical trainees' mental health may include education about the wise use of social media, encouraging spending more quality social time, and enhancing job support and job control.

The Development and Validation of the Adolescent Problematic Gaming Scale (PGS-Adolescent)

This study aims to develop and validate the Adolescent Problematic Gaming Scale (PGS-Adolescent). Following established scientific protocols, we developed an initial version of the PGS-Adolescent scale and validated it using data from 448 valid survey responses collected from adolescents in China. The dataset was split into two parts: 225 responses were allocated for exploratory factor analysis (EFA), and 223 for confirmatory factor analysis (CFA). The EFA and CFA processes necessitated the removal of 10 items due to low factor loadings, low communalities, misalignment with intended factors, and inadequate item retention. Significantly, all the survey items measuring daily-life disturbance (DD) were excluded. The final 20-item PGS-Adolescent scale includes four constructs: interpersonal relationships (IRE), schooling disruption (SD), physical consequences (Phy-C), and psychological consequences (Psy-C). Researchers may consider directly applying the validated PGS-Adolescent scale or evaluating its applicability and validity in diverse populations and contexts.

The Effect of Social Media Consumption on Emotion and Executive Functioning in College Students: an fNIRS Study in Natural Environment

As of 2023, 69% of adults and 81% of teens in the U.S. use social media. This study explores the immediate effects of social media consumption on executive functioning (EF) and emotion in college students, using a wearable fNIRS system to monitor brain activity in a naturalistic setting. Twenty participants were assessed pre- and post-social media use through EF tasks and emotion questionnaires. Results revealed 55% of participants were classified as addicted, with an average Instagram usage of 5 hours per week. Following social media exposure, significant impairments were observed in tasks like n-back and Go/No-Go, alongside altered brain activity. Specifically, increased medial prefrontal cortex (mPFC) activity indicated heightened cognitive effort and performance monitoring, while decreased dorsolateral prefrontal cortex (dlPFC) and ventrolateral prefrontal cortex (vlPFC) activity were associated with impaired working memory and response inhibition. Inferior frontal gyrus (IFG) activity reductions correlated with difficulties in inhibiting motor responses to No-Go stimuli. Emotional changes were minimal, except for reduced happiness in the control group. These findings highlight the negative impact of social media on EF, emphasizing the need for interventions promoting healthier digital habits.

Prevalence and associations of problematic smartphone use with smartphone activities, psychological well-being, and sleep quality in a household survey of Singapore adults

INTRODUCTION

Despite the many benefits of smartphones, researchers have raised concerns over problematic smartphone use (PSU) and its negative effects on physical and psychological well-being. Studies examining PSU and its impact among adults remain limited. Hence, we aim to examine the prevalence of PSU among adults in Singapore, and explore its associations with smartphone activities, sleep quality, and psychological well-being, as well as age and gender-related differences in these associations.

METHODS

A household survey (n = 1200) was conducted among multi-ethnic Singapore adults aged 21 to 60. The survey employed a proportionate stratified random sampling approach. The Smartphone Addiction Scale-Short Version was used to determine risk of PSU. Adjusted multivariable logistic regressions, age-stratified (21-30, and above 30) analyses and sensitivity analyses were performed.

RESULTS

The survey response rate was 45.7%. PSU prevalence rate was estimated to be 34.0%. Adults at risk were younger (OR = 3.72, p < 0.001), had poor sleep quality (OR = 2.94), reported depressive (OR = 2.84, p = 0.001) or anxiety symptoms (OR = 2.44, p < 0.001), tend to use smartphones for social media (OR = 2.81, p = 0.002) or entertainment (OR = 2.72, p < 0.001). Protective factors include higher levels of social support (OR = 0.76, p = 0.007), using smartphones for calling family (OR = 0.39, p = 0.003) and friends (OR = 0.53, p = 0.030), and spending four hours or less of smartphone usage duration (OR = 0.40, p < 0.001). Sensitivity analyses confirmed these findings. Associations between PSU and poor sleep quality (OR = 3.72, p < 0.001), depressive (OR = 3.83, p < 0.001), and anxiety symptoms (OR = 2.59, p = 0.004) and social media usage (OR = 3.46, p < 0.001) were more pronounced in adults over 30. PSU was more prevalent among females in those aged 21-30 (OR = 2.60, p = 0.022). Social support appears to be a protective factor for adults over 30 (OR = 0.64, p < 0.001) but was not observed in those aged 21-30. Among males, younger age (21-30 years), poor sleep quality, depressive symptoms, and anxiety symptoms, and using social media and entertainment apps were significantly associated with PSU. Females showed similar associations. Social support appears to be a protective factor for females (OR = 0.70, p = 0.018), but this association was not observed for males. Shorter smartphone usage times were inversely associated with PSU in both genders.

CONCLUSION

A substantial proportion of adults exhibited PSU. Findings highlight the differential associations between PSU and psychological well-being, social support, interactions with technology, and sleep quality. These associations are influenced by age which has implications for preventive efforts.

Risk Factors for Love Addiction in a Sample of Young Adult Students: A Multiple Mediation Model Exploring the Role of Adult Attachment, Separation Anxiety, and Defense Mechanisms

In certain situations, romantic engagement with a partner can have detrimental effects on an individual's well-being and overall health, exhibiting features attributable to addictive behaviors. Considering the clinical significance of this phenomenon and its prevalence among adolescents and young adults, the objective of this study was to investigate the potential associations between some risk factors for love addiction in a sample of university students, with a specific focus on adult attachment, separation anxiety, and defense mechanisms. A total of 332 participants (Mage = 23 years; SD = 2.462) completed a survey consisting of the Love Addiction Inventory-Short Form, Relationship Questionnaire, Seven Domains Addiction Scale (Separation Anxiety domain), and Forty Item Defense Style Questionnaire. The data were analyzed using Pearson's correlation, and a multiple mediation model was also implemented. Results showed that fearful attachment was significantly and positively associated with love addiction. Furthermore, this relationship was mediated by separation anxiety and neurotic/immature defense mechanisms too. These findings contribute to the existing literature on love addiction and provide valuable insights for future research and clinical practice.

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 effect of grandparental care on social networking sites addiction in college: mediated by social anxiety and loneliness

OBJECTIVE

Grandparental care has become a common phenomenon, yet there is still limited research on the long-term psychological effects on children raised by their grandparents. This study aims to explore the impact of early grandparental care experiences on university students' social networking sites addiction, social anxiety, and loneliness.

METHODS

A random cluster sampling method was employed to select college students from a medical school in Jiangxi for a questionnaire survey. The study measured social networking sites addiction, social anxiety, and loneliness using the Bergen Social Media Addiction Scale (BSMAS), Interaction Anxiety Scale (IAS), and Loneliness Scale (ULS-6) respectively. Additionally, grandparental care was assessed through individual questions. Data analysis was conducted using mediated effects modeling.

RESULTS

In total, 4318 participants were recruited. 45.2% of participants were male and 54.8% were female. The study found a significant positive association between grandparental care experience and social networking sites addiction, social anxiety, and loneliness. The study revealed that social anxiety mediated 20.0% of the effect between grandparental care experiences and social networking sites addiction, while loneliness mediated 16.0% of this effect. Moreover, social anxiety and loneliness together mediated 12.0% of the chained effects between grandparental care experiences and social networking sites addiction.

CONCLUSION

Grandparental care has no direct impact on social networking sites addiction in adulthood. Social anxiety and loneliness play a mediating role between grandparental care and social networking sites addiction. Therefore, schools and families should prioritize efforts to enhance the physical and mental well-being of individuals receiving grandparental care. This can be achieved through targeted health promotion initiatives.

Nothing about us without us! How users configure clinical treatment in Italian residential communities: ethnography of therapeutic engagement

The effectiveness of the interventions in the Therapeutic communities (TC) depends not only on the quality of the specialized knowledge and methodologies adopted, but also on the meanings consumers give to them. Building the therapeutic alliance is a key element in reducing high drop-out rates and predicting more favorable outcomes. This research investigated the discourses practiced by 45 people with substance use disorders who had been accessing a therapeutic community for less than 15 days, with the aim of delving into the meanings given to treatment and pathway goals in the service, to analyze what theories are used to explain consumption and therapeutic change. The study made use of Discourse analysis (DA) and Positional theory with a protocol of written open-ended questions. The results show how participants configure the community pathway adopting a passive role, underestimating the need to co-participate in treatment design and bringing in poorly formalized goals. The collected texts provide a better understanding of the perspective of community users, emphasizing the need to share spaces of co-design from the very beginning in order to promote empowering, reasoning about the implications of the various discourses produced by consumers to explain their autobiography and to envision paths of change.

Scoping review of withdrawal's role in contemporary gaming disorder research: Conceptualizations and operationalizations

The global gaming community now exceeds 3 billion players, prompting increased attention from social and medical sciences regarding gaming-related disorders. Internet Gaming Disorder (IGD) was incorporated into DSM-5 in 2013, and Gaming Disorder (GD) found its place in ICD-11 in 2019. A contentious criterion in IGD, not present in GD, revolves around withdrawal symptoms. This paper offers a theoretical foundation on gaming withdrawal symptoms in gaming-related disorders and conducts a scoping review of withdrawal operationalization and conceptualization in 40 selected studies, following PRISMA-ScR guidelines. Most studies employed a correlation framework, relying on convenience samples and self-assessment questionnaires. A smaller portion focused on clinical samples and case studies. Withdrawal was predominantly conceptualized in terms of affective components, with less emphasis on behavioural, cognitive, physical, or neurological aspects. The prevailing terminology for gaming-related disorders was IGD, with only three studies referencing GD as defined in ICD-11. Notably, just six experimental studies included abstinence control. We advocate for an expansion of research on withdrawal symptoms, particularly through experimental studies that implement abstinence within experimental groups and offer alternative operationalizations beyond dominant self-assessment measures.

What Is Excessive? The Screening Frequency of Online Sexual Activities Among Community and Subclinical Males

OBJECTIVE

The purpose of this study was to investigate the different categories of males within two groups, namely a community male sample who engaged in online sexual activities (OSAs) and a subclinical male sample who were out of control in viewing pornography and had sought help. Additionally, the study aimed to determine the threshold for excessive OSAs in both samples.

METHODS

A total of 568 community adult males who engaged in OSAs and 567 adult males seeking help for pornography use were recruited online. A latent profile analysis (LPA) was used to identify potential profiles within the samples. Cut-point analyses were conducted to determine optimal cutoff scores for OSAs in each sample.

RESULTS

The LPA revealed two categories with different cutoff scores for OSAs within each sample. Excessive OSA can be a screening tool for detecting out-of-control behavior. More stringent criteria for identifying excessive OSAs can aid in distinguishing problematic pornography use (PPU) from impaired control in viewing sexually-explicit materials (SEMs). Two subcategories of loss of control emerged: high OSAs frequency impaired control and high viewing SEMs impaired control.

CONCLUSION

The threholds of excessive OSAs varies among community and sub-clinical male samples; this knowledge can assist in screening out individuals with impaired control and selecting individuals with PPU from the subclinical sample.