Cyber disorders: the mental health concern for the new millennium

Acupuncture modulates the functional connectivity among the subcortical nucleus and fronto-parietal network in adolescents with internet addiction

BACKGROUND

Internet addiction (IA), recognized as a behavioral addiction, is emerging as a global public health problem. Acupuncture has been demonstrated to be effective in alleviating IA; however, the mechanism is not yet clear. To fill this knowledge gap, our study aimed to investigate the modulatory effects of acupuncture on the functional interactions among the addiction-related networks in adolescents with IA.

METHODS

Thirty individuals with IA and thirty age- and sex-matched healthy control subjects (HCs) were recruited. Subjects with IA were given a 40-day acupuncture treatment, and resting-state functional magnetic resonance imaging (fMRI) data were collected before and after acupuncture sessions. HCs received no treatment and underwent one fMRI scan after enrollment. The intergroup differences in functional connectivity (FC) among the subcortical nucleus (SN) and fronto-parietal network (FPN) were compared between HCs and subjects with IA at baseline. Then, the intragroup FC differences between the pre- and post-treatment were analyzed in the IA group. A multiple linear regression model was further employed to fit the FC changes to symptom relief in the IA group.

RESULTS

In comparison to HCs, subjects with IA exhibited significantly heightened FC within and between the SN and FPN at baseline. After 40 days of acupuncture treatment, the FC within the FPN and between the SN and FPN were significantly decreased in individuals with IA. Symptom improvement in subjects with IA was well fitted by the decrease in FC between the left midbrain and ventral prefrontal cortex and between the left thalamus and ventral anterior prefrontal cortex.

CONCLUSION

These findings confirmed the modulatory effects of acupuncture on the aberrant functional interactions among the SN and FPN, which may partly reflect the neurophysiological mechanism of acupuncture for IA.

Dark Personality Traits and Online Behaviors: Portuguese Versions of Cyberstalking, Online Harassment, Flaming and Trolling Scales

The main objective of this study is to assess moderation effects of online behaviors between personality traits and addiction to Internet. To this end, four instruments were validated for Portuguese version through confirmatory factor analysis and exploratory factor analysis (Study 1) Multiple regression analysis was applied to examine the personality predictors of specific online behaviors while controlling for gender and age; and moderation effects were assessed (Study 2). Results showed good psychometric properties for the four validated scales. Machiavellianism is positively associated with all the dimensions of this study. Psychopathy is positively associated with total Cyberstalking, Cyberstalking Control, Flaming and Trolling. Narcissism is positively associated with all the dimensions, except Online Harassment and Flaming. Machiavellianism is positively associated with Addiction to Internet through Cyberstalking, Flaming and Trolling. Psychopathy is positively associated with Addiction to Internet through Cyberstalking Control and Flaming. Narcissism is also positively associated with Addiction to Internet through Cyberstalking and Trolling. This study demonstrates that dimensions of the dark triad of personality play an important role in Internet addiction through online behaviors. The results of this study have theoretical and practical implications: on the one hand, they reinforces the findings of other studies showing that dimensions of the dark personality triad play an important role in Internet and social network addition, contributing to the literature; and, on the other hand, on a practical level, they allow to conduct awareness campaigns in communities, schools, and work to understand that one can be exposed to unpleasant situations due to behaviors that some people with personality traits of Machiavellianism, narcissism and/or psychopathy that may cause problems affecting the mental, emotional and psychological health of others.

Negative Life Events, Negative Copying Style, and Internet Addiction in Middle School Students: A Large Two-year Follow-up Study

Through a two-year follow-up study among 2,845 middle school students, we examined the impact of baseline negative life events (NLE) on follow-up negative copying style (NCS) and Internet addiction (IA), and the mediation of NCS between NLE and IA. We found that all NLE, NCS, and IA were correlated, and that both NLE and NCS were risk factors for IA. Structural equation modeling (SEM) results showed that NLE were associated with increased NCS (β = 0.17, p < 0.01) and IA (β = 0.16, p < 0.01), that NCS was associated IA ( β = 0.33, p < 0 0.01), and that NCS partially mediated the effect of NLE on IA ( β = 0.17, p < 0.01). This large longitudinal study provided solid empirical evidence that NLE and NCS played important roles in IA among middle school students. Educators and policy makers may adopt corresponding approaches to address IA among this population.

Cyberbullying, Social Media Addiction and Associations with Depression, Anxiety, and Stress among Medical Students in Malaysia

This study aims to determine the prevalence and factors associated with cyberbullying and social media addiction. This cross-sectional study was conducted among 270 medical students from a public university in Kuching, Malaysia. The instruments used in this study included the cyberbullying questionnaire survey, Bergen Social Media Addiction Scale (BSMAS), and the Depression Anxiety Stress Scale 21-item (DASS-21). The prevalence of cyberbullying victimization was 24.4%, whilst 13.0% reported cyberbullying perpetration over the past six months. Male gender was positively associated with both cyberbullying perpetration and cybervictimization, whilst social media addiction was positively associated with cybervictimization. Psychological motives such as positive attitudes toward cyberbullying and gaining power were associated with cyberbullying perpetration. Cybervictimization doubled the tendency to depression (aOR 2.50, 95% CI [1.23, 5.08], p = 0.012), anxiety (aOR 2.38, 95% CI [1.29, 4.40], p = 0.006), and stress (aOR 2.85, 95% CI [1.41, 5.77], p = 0.004), whilst social media addiction was associated with a higher tendency to depression (aOR 1.18, 95% CI [1.10, 1.26], p < 0.001), anxiety (aOR 1.15, 95% CI [1.08, 1.22], p < 0.001), and stress (aOR 1.21, 95% CI [1.12, 1.32], p < 0.001). Medical schools in Malaysia need policies and guidelines against cyberbullying.

Üniversite Öğrencilerinin Kişilik Özellikleri, Üstbiliş, İnternet Kullanım Fonksiyonu ve Problemli İnternet Kullanım Özelliklerinin İncelenmesi

Üniversite öğrencilerinin problemli internet kullanımı ile ilişkili olabilecek faktörlerin incelenmesinin ve olası risk durumlarının belirlenmesinin önemli olduğu düşünülmektedir. Üniversite dönemi, bireylerin ebeveyn kontrolünden uzaklaşıp kendi kararlarını vermeye ve hayatlarına yön vermeye başladıkları kritik bir dönemdir. Sorunlu internet kullanımı ile cinsiyet, psikiyatrik tanı, üstbilişsel inançlar ve kişilik arasındaki ilişki gösterilmiş olmasına rağmen, mevcut araştırma sayısı sınırlıdır ve bulgular çelişkilidir. Ayrıca internet kullanım süresinin ve amacının yer aldığı ve tüm bu değişkenlerin birlikte incelendiği herhangi bir çalışmaya rastlanmamıştır. Bu çalışmada, üniversite öğrencilerinin kişilik özelliklerini, üstbilişsel inançlarını, internet kullanım işlevlerini ve problemli internet kullanımlarını tanı, cinsiyet ve internet kullanım süreleri açısından incelemek amaçlanmıştır. Veriler yaş ortalamaları 20.11 olan 696 üniversite öğrencisinden toplanmıştır. Araştırmada, betimsel ve parametrik olmayan bağımsız gruplar karşılaştırma analizleri kullanılmıştır (Mann Whitney U Testi ve Kruskal-Wallis Testi). Bu çalışmada, Beş Faktör Kişilik Özellikleri Ölçeği (BFKÖ), Üstbiliş Ölçeği-30 (ÜÖ-30), İnternet Kullanım Fonksiyonları Ölçeği (İKFÖ), İnternette Bilişsel Durum Ölçeği (İBDÖ) ve Demografik Bilgi Formu kullanılmıştır. Analiz sonuçlarına göre, kadınların vicdanlılık ve nevrotizm alt ölçeği puanları daha yüksek bulunmuştur. Analiz sonuçları tanıya göre önemli bir fark olduğunu göstermiştir. Psikiyatrik tanısı olan grubun ölçek puanlarının, nevrotizm, açıklık, kontrol edilemezlik ve tehlike, bilişsel güven eksikliği, ÜÖ-30 toplam puanı ve bilgi işlevleri alt boyutlarında daha yüksek olduğu görülmüştür. Nevrotizm, kontrol edilemezlik ve tehlike, sosyal işlevler, sanal duygusal işlevler, sosyal rahatlık, yalnızlık/depresyon, dürtüde azalma, dikkat dağınıklığı ve İBDÖ toplam puanı alt boyut puanlarının internet kullanım süresi ile doğru orantılı olarak arttığı görülmüştür.

Occurrence of problematic Internet use and its correlates among Egyptian adolescent students in international schools in Cairo

Background

Internet addiction is a global phenomenon that has been a topic of great interest to researchers, clinicians, teachers, parents, and community groups. The study aims in determination of the rate of problematic Internet use among a sample of Egyptian adolescent students, relations of problematic Internet use with socio-demographic data, risk factors, and comorbid psychiatric disorders. A sample of 248 Egyptian adolescent school students aged 11 to 18 years old were assessed using the Young’s Internet Addiction Test (IAT), Internet Gaming Disorder (IGD) Scale, Social Media Disorder (SMD) Scale, Youth Self-Report (YSR), and The Mini International Neuropsychiatric Interview for children and adolescents (Mini KID).

Results

Among the study sample, 42.3% of the students suffered from mild Internet addiction, 35.1% suffered from moderate Internet addiction, and 3.6% suffered from severe addiction. 31.5% were risky gamers and 10.5% were disordered gamers; 34.3% had problematic social media disorder and the highest observed psychiatric disorders were major depressive episodes 9.3%, generalized anxiety disorder 7.7%, alcohol dependence 4.4%, attention-deficit hyperactivity disorder 4.4%, social phobia 4%, and a higher percentage of psychiatric disorders among severe Internet addiction 88.9% and among moderate addiction 70.6%, disordered gamers 92.3%, problematic social media users 60%, and a higher mean of hours spent online per day of 6.8 h per day.

Conclusions

Problematic Internet use has a negative impact on Egyptian adolescent students in international schools in study sample and adds to the existing literature regarding the magnitude of Internet addiction and its relationship with different psychiatric disorders.

Carpe diem or carpe mañana? Emotion priming affects intertemporal choice among Internet addicts and normal Internet users

In this digitalized era, Internet addiction has been a severe problem that needs imperative solutions derived from the same mechanism that leads to its addiction. To uncover a more nuanced mechanism for Internet addiction in association with decision-making focus and emotions and thus generate effective interventions, we conducted three experiments to investigate how various forms of emotion priming affect intertemporal choice among Internet addicts and normal Internet users. We divided the emotions into three categories, namely emotional valence (negative and positive emotions), expected emotion type (expected regret, expected joy), and current emotion type (current regret, current joy). In experiment one, we examined the effect of two participant types (Internet addicts and normal Internet users) with three emotion valences (positive, negative, and neutral). In experiment two, we examined the effect of two participant types (Internet addicts and normal Internet users) with three current emotion types (current regret, joy, and neutral). In experiment three, we examined the effect of two participant types (Internet addicts and normal Internet users) with two expected emotion types (expected regret and expected joy). We conducted a completely randomized experimental design in each experiment and used subjective value as the dependent variable index of intertemporal choice. The results showed that the subjective value of Internet addicts was significantly lower than that of normal Internet users across three studies. The subjective value of individuals primed with positive emotions was significantly higher than those primed with negative emotions, no matter whether they were normal Internet users or addicts (experiment one). The subjective value of individuals primed with expected joy was significantly higher than those primed with expected regret, no matter whether they were normal Internet users or addicts (experiment three). When primed with current joy, however, the Internet addicts' subjective value was significantly lower than when primed with current regret, but this did not apply to normal Internet users (experiment two). These results suggest positive emotions and expected joy enhanced long-term goals and greater rewards focus on intertemporal decision-making compared to negative emotions and expected regret. However, current joy facilitated short-term goals, and smaller rewards focus on intertemporal decision-making compared to current regret. The theoretical and practical implications for Internet addiction are also discussed in this paper.

Does internet use promote mental health among middle-aged and older adults in China?

In recent years, China's Internet penetration rate has increased, and the scale of middle-aged and older adults' netizen has continued to expand. However, the impact of internet use on mental health remains controversial. This paper analyzes 14,497 middle-aged and older adults' valid respondents in the 2018 Chinese Family Panel Study (CFPS2018) to evaluate the impact of Internet use on the mental health of middle-aged and older adults and its intermediary mechanisms. The findings show that moderate use of the Internet can significantly reduce depression levels and boost cognitive function in middle-aged and older adults. But excessive internet use will also lead to increased levels of depression and decreased cognitive function. Different Internet use purposes will also lead to different psychological states. Online socializing, entertainment and business activities can significantly reduce depression levels and promote cognitive functions. Online studying and working only have positive effects on cognitive functions, which have no significant relationship to depression levels. In addition, analysis of the mediation effect found that life satisfaction is a path mechanism for Internet use and affect different dimensions of mental health.

Spiritual Well-being as a Mediator between Internet Addiction and Alienation

One of the negative effects of internet addiction on individuals’ personal and social life is alienation. Spiritual well-being affects both internet addiction and the level of alienation. The present study investigated the mediator effect of spiritual well-being in the relationship between internet addiction and alienation. The study was conducted with 320 college students : 183 (57.2%) female and 137 (42.8%) male. The ages of participants ranged from 19 to 35, and the mean age was 20.74. Data were collected using a personal information form, an internet addiction scale, an alienation scale and a spiritual well-being scale. The analyses showed that internet addiction, alienation and spiritual well-being were correlated. Internet addiction significantly predicted alienation and spiritual well-being. Spiritual well-being significantly predicted alienation. It was found that spiritual well-being partially mediated (indirect effect = .1525) the relationship between internet addiction and alienation. These results showed that spiritual well-being can be an important variable in preventing alienation.

Reinforcer pathology of internet-related behaviors among college students: Data from six countries

Research has demonstrated that repeated engagement in low-effort behaviors that are associated with immediate reward, such as Internet use, can result in a pathological reinforcement process in which the behavior is increasingly selected over other activities due, in part, to a low availability of alternative activities and to a strong preference for immediate rather than delayed rewards (delay discounting). However, this reinforcer pathology model has not been generalized to other Internet-related behaviors, such as online gaming or smartphone use. Given the widespread availability of these technologies, it is also important to examine whether reinforcer pathology of Internet-related behaviors is culturally universal or culture-specific. The current study examines relations between behavioral economic constructs (Internet demand, delay discounting, and alternative reinforcement) and Internet-related addictive behaviors (harmful Internet use, smartphone use, online gaming, and Internet sexual behavior) in a cross-sectional sample of college students (N = 1,406) from six different countries (Argentina, Australia, India, Malaysia, the United Kingdom, and the United States). Using structural equation modeling, Internet demand was associated with harmful Internet use, smartphone use, and online gaming; delay discounting was associated with harmful smartphone use; and alternative reinforcement was associated with harmful Internet and smartphone use. The models were partially invariant across countries. However, mean levels of behavioral economic variables differed across countries, country-level gross domestic product, person-level income, and sex at birth. Results support behavioral economic theory and highlight the importance of considering both individual and country-level sociocultural contextual factors in models for understanding harmful engagement with Internet-related behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Rich Get Richer: Extraversion Statistically Predicts Reduced Internet Addiction through Less Online Anonymity Preference and Extraversion Compensation

Internet addiction may arise from multiple factors and personality tendencies have been previously implicated. Prior studies have found that extraversion may be a protective factor mitigating against internet addiction, yielding a "rich-get-richer" effect. However, few studies have explored how extraversion may influence internet addiction from the perspective of online-offline integration. Drawing on a sample of 428 college students, the current study examined a serial mediation model exploring the underlying mechanisms of how extraversion may statistically predict internet addiction through online-offline integration and antecedent factors. The serial mediation model analyses indicated that extraverted internet users exhibited a weaker preference for online anonymity and less online extraversion compensation, thus formulating a higher level of online-offline integration than introverted individuals, which, in turn, appeared to reduce the risk of internet addiction. In contrast, with regard to specific components of online-offline integration, introverted internet users preferred online anonymity, which reduced their relationship integration and increased their likelihood of internet addiction; similarly, the introverted individuals were also more likely to exhibit an extraversion compensation effect. That is, they were more extraverted on the internet than in general; hence, they had a lower level of self-identity integration, resulting in a greater likelihood of experiencing internet addiction. These results highlight the importance of online-offline integration that may account for personality variations in social and psychological outcomes related to internet use, and suggest a role for online anonymity preference and extraversion compensation in influencing specific components of integration.

Cognitive behavioral intervention in dealing with Internet addiction among Arab teenagers in Israel

The current study examines the effectiveness of a cognitive-behavioral intervention program for improving self-control and reducing Internet addiction among Arab adolescents in Israel. The study sample included 160 students who were 7th to 9th graders, recruited from eight schools in northern Israel. All participants exhibited high scores on a questionnaire indicating elevated symptoms of Internet addiction. Students were randomized to one of two groups: the experimental group underwent a systematic intervention to reduce Internet addiction and the control group met once a week for a group conversation. The experimental group (n = 80) included 58 boys and 22 girls with an average age of 13.45 (SD = 1.46). The control group (n = 80) included 54 boys and 26 girls with an average age of 13.91 (SD = 1.92). Each intervention consisted of 8 sessions, with the experimental group receiving cognitive-behavioral treatment and the control group having a weekly classroom conversation. The results demonstrated preliminary efficacy for the intervention, as higher levels of self-control were reported among the experimental group (p < .01) but not the control group, and this contributed to a reduction in scores on the questionnaire assessing Internet addiction in the experimental group (p < .01). The findings suggest that cognitive-behavioral treatments may be a promising avenue for enhancing self-control and reducing symptoms of Internet addiction among this unique student population.

Serial Multiple Mediation of the Correlation Between Internet Addiction and Depression by Social Support and Sleep Quality of College Students During the COVID-19 Epidemic

OBJECTIVE

This cross-sectional study explores the serial multiple mediation of the correlation between internet addiction and depression by social support and sleep quality of college students during the COVID-19 epidemic.

METHODS

We enrolled 2,688 students from a certain university in Wuhu, China. Questionnaire measures of internet addiction, social support, sleep quality, depression and background characteristics were obtained.

RESULTS

The prevalence of depression, among 2,688 college students (median age [IQR]=20.49 [20.0, 21.0] years) was 30.6%. 32.4% of the students had the tendency of internet addiction, among which the proportion of mild, moderate and severe were 29.8%, 2.5% and 0.1%, respectively. In our normal internet users and internet addiction group, the incidence of depression was 22.6% and 47.2%, respectively. The findings indicated that internet addiction was directly related to college students' depression and indirectly predicted students' depression via the mediator of social support and sleep quality. The mediation effect of social support and sleep quality on the pathway from internet addiction to depression was 41.97% (direct effect: standardized estimate=0.177; total indirect effect: standardized estimate=0.128). The proposed model fit the data well.

CONCLUSION

Social support and sleep quality may continuously mediate the link between internet addiction and depression. Therefore, the stronger the degree of internet addiction, the lower the individual's sense of social support and the worse the quality of sleep, which will ultimately the higher the degree of depression. We recommend strengthening monitoring of internet use during the COVID-19 epidemic, increasing social support and improving sleep quality, so as to reduce the risk of depression for college students.

Working Memory Depletion Affects Intertemporal Choice Among Internet Addicts and Healthy Controls

Addiction to the Internet has emerged as a new kind of addictive behavior. Although previous studies have revealed that impairments in working memory led to suboptimal decision making (e.g., a greater willingness to choose smaller, more immediate rewards), little is known about how working memory affects intertemporal choice in Internet addicts and normal users. Thus, this study’s aim was to investigate the effect of working memory task on intertemporal choice in 33 participants addicted to internet and 25 healthy controls. Participants were administered (a) a test for Internet Addiction, (b) a single delay discounting self-report questionnaire (c) a working memory task. Differences between the Internet addicts and the control group were observed in terms of delay discounting rates, reaction times, and in memory accuracy rates. We observed significantly higher delay discounting rates among individuals addicted to the Internet. Moreover, it was documented that reaction times follow the 4-level working memory condition were significantly longer than follow the 2-level condition, in both the Internet addicts and the control group. The current findings suggest that Internet addicts are more likely to make short-sighted decisions than normal Internet users. The higher the level of working memory, the more likely an individual is to choose the present smaller reward, thus making short-sighted decisions, and have longer response times.

Excessive and pathological Internet use - Risk-behavior or psychopathology?

Pathological Internet use (but only with respect to gaming) is classified as mental disorder in the ICD-11. However, there is a large group of adolescents showing excessive Internet use, which may rather be considered adolescent risk-behavior. The aim was to test whether pathological and excessive Internet use should be considered as "psychopathology" or "risk-behavior". A representative, cross-sectional sample of 11.110 students from 10 European Union countries was analyzed. Structural equation models, including the factors "risk-behavior" and "psychopathology" and the variables excessive and pathological Internet use, were tested against each other. "Risk-behavior" was operationalized by several risk-behaviors (e.g. drug abuse, truancy, etc). "Psychopathology" included measures of several mental disorders (e.g. depression, hyperactivity, etc). Excessive Internet use was assessed as the duration and frequency of Internet use. Pathological Internet use was assessed with the Young Diagnostic Questionnaire (i.e., presence of addiction criteria). Excessive Internet use loaded on "risk-behavior" (λ = 0.484, p < .001) and on "psychopathology" (λ = 0.071, p < .007). Pathological Internet use loaded on "risk-behavior" (λ = 0.333, p < .001) and on "psychopathology" (λ = 0.852, p < .001). Chi-square tests determined that the loadings of excessive Internet use (χ² (1) = 81.98, p < .001) were significantly stronger on "risk-behavior" than "psychopathology". Vice versa, pathological Internet use loaded significantly stronger on "psychopathology" (χ² (1) = 107.10, p < .001). The results indicate that pathological Internet use should rather be considered as psychopathology. Excessive Internet use on the other hand, should be classified as adolescent risk-behavior.

Imagining the Future: Future Imagination Training Decreases Delay Discounting Among Internet Addicts and Non-Problematic Users

To test whether future imagination can reduce the delay discounting rate of the Internet addicts, we recruited 40 Internet addicts (treatment sample) and 39 non-problematic users (control sample). We used a 2 (participant type: individuals with Internet addiction vs. non-problematic users) × 2 (training type: future event imagination training vs. control condition) × 2 (training session: first session vs. final session) mixed-subjects design to test our hypothesis. The participant type and training type were between the subjects and the training session was within the subject. Half of each sample (the Internet addicts and non-problematic users) was randomly assigned to complete five sessions of future imagination training and the other half was assigned to describe some daily events they had observed. We used the Barratt Impulsivity Scale (BIS) and delay discounting task to assess our outcome variable, such as addiction, impulsivity, and delay discounting rate. The results showed that the future imagination training significantly reduced the delay discounting rate (also for impulsivity and addiction) for both the Internet addicts and non-problematic users than the control condition. Besides, the negative effect of future imagination training on the delay discounting rates (for impulsivity and addiction) remained consistent across the five training sessions. These findings suggest that the future imagination training can be a useful approach to reduce the impulsivity among those who are addicted to the Internet.

Validation of the Instagram Addiction Scale in Greek Youth

Instagram is one of the fastest growing social networking platforms. A body of evidence suggests that Instagram problematic use and addiction have negative effects on the psychological well-being of young people. The Instagram Addiction Scale, a self-report tool assessing Instagram problematic use and addiction, has been developed recently. The aim of the present study was to validate the Instagram Addiction Scale in the Greek language and to assess its psychometric properties. An online and on-print self-report survey was conducted among Greek youth, aged between 18 and 24 years. The survey included the Instagram Addiction Scale, the Rosenberg Self-esteem Scale, the Perceived Stress Scale, and the Big Five Inventory. A total of 967 respondents participated in the study. The analysis suggested that the Greek version of the Instagram Addiction Scale has good psychometric properties. The principal component factor analysis for construct validity generated two subscales as the original instrument: social effect and impulsion. Internal consistency for the two subscales and the scale’s total score was satisfactory, with Cronbach’s α at 0.76, 0.85 and 0.88, respectively. Correlation analyses revealed positive associations between the perceived stress scale and social effect, and the Instagram Addiction Scale’s total score (p<0.0001 and p=0.002 respectively). This is the first study validating the Instagram Addiction Scale in Greek youth, which can be used by researchers and practitioners for the evaluation of youth problematic use of Instagram.

Validation of the Greek version of the Problematic Internet Use Questionnaire - Short Form (PIUQ-SF-6)

Internet is a necessary tool of everyday routine, however, concerns about the development of abnormal behaviours in relation to its use by adolescents are constantly growing. The need of brief screening tools for problematic internet use in teenagers in Greece is imperative. The purpose of this study was to validate the 6-item short form of the Problematic Internet Use Questionnaire (PIUQ-SF-6) in a Greek sample of adolescents. The sample consisted of 200 adolescents (55.0% males, 61.6% high school students, 38.4% junior high school students) who completed the study’s questionnaires i.e., a demographic questionnaire, the PIUQ-SF-6, the Young’s Diagnostic Questionnaire (YDQ) and the Adolescent Computer Addiction Test (ACAT). The internal consistency of the Greek version of PIUQ-SF-6 was sufficient and acceptable (Cronbach’s alpha coefficient a = 0.80). Confirmatory Factor Analysis was significant, and goodness-of-fit was adequate. For establishing convergent validity, Pearson’s and Spearman’s correlation coefficients were calculated between the PIUQ-SF-6 and ACAT scales and Receiver Operating Characteristic (ROC) analysis (between PIUQ-SF-6 and YDQ) indicated an excellent accuracy. The Greek version of the PIUQ-SF-6 demonstrated satisfactory psychometric properties (reliability and validity) and is recommended as a reliable screening tool for problematic internet use in Greek adolescents.

Problematic internet use profiles and psychosocial risk among adolescents

Objective

Although Problematic Internet Use (PIU) is an emerging area of study in psychology, little is known about the unique features of specific subgroups of internet users and their psychosocial vulnerabilities within robust and nationwide populations.

Methods

The aim of this study was to identify distinct latent groups of internet users based on their PIU risk and to compare their psychosocial outcomes. To achieve this, a nationally representative sample of adolescents of the same grade (N = 1,066, Mean_age = 13.46 years, range = 12–16) was recruited from several schools in Slovenia through stratified random sampling.

Results

A Latent Profile Analysis (LPA) revealed a two-class solution, with Class 1 (n = 853, 80%) featuring ‘low PIU risk’ participants and Class 2 (n = 213, 20%) including ‘high PIU risk’ participants. Behaviorally, the main feature of Class 1 denoted ‘time management difficulties’ while Class 2 was best characterized by ‘mood and time management issues’. Further frequentist and Bayesian analyses indicated that Class 2 presented greater psychosocial risk compared to Class 1 due to significantly higher levels of PIU (generalized and across specific PIU subfactors) coupled with lower levels of subjective well-being and self-control.

Conclusions

Contrary to what was initially envisaged, the two classes did not differ in terms of perceived quality in parent-child relationship. This study shows that PIU patterns and symptom-severity may be developmentally specific, further highlighting the need for clinically age-adjusted PIU screening practices within epidemiological and healthcare settings.

Internet Addiction, Sleep Quality and Depressive Symptoms Amongst Medical Students in Delhi, India

Today, the internet has become an important element in people's lives, and owing to internet access becoming widespread, it has resulted in internet addiction. It is a major concern amongst medical students aiming to develop into health professionals. The implications of this addiction as well as its association with sleep and depression affects their studies, impacts their career goals and has detrimental consequences for society as a whole. The objectives of this study were to assess the proportion of medical undergraduate students and interns with internet addiction (IA), depressive symptoms and poor sleep quality and to study the association of IA with sleep quality and depressive symptoms. A cross-sectional questionnaire-based study was carried out in a medical college in Delhi. Universal sample consisting of all the medical students from first to final year (n = 185) and interns (n = 37) enrolled during the time of the study were included. Sleep quality, internet addiction and depressive symptoms in these students was assessed using Pittsburgh Sleep Quality Index (PSQI) Young's Internet Addiction Test (YIAT) and Patient Health Questionnaire-9 (PHQ) respectively. The average YIAT score was 33.16 ± 15.68. Overall 18%, 59.9%, 46.8% of students scored above validated cutoff scores for internet addiction, poor sleep quality and depression respectively. Prevalence of IA among males and females were 20.4% and 12.9% respectively. Significant correlations were found between potential IA, sleep quality and depression (p < 0.001). The study concluded a strong correlation between IA, disturbed sleep quality and depression. Identifying medical students with potential IA is important because this addiction often coexists with other psychological problems. Thus timely remedial actions and tailored interventions are required to combat IA among medical students.

Pornography Use Could Lead to Addiction and Was Associated With Reproductive Hormone Levels and Semen Quality: A Report From the MARHCS Study in China

This study aimed to investigate the situations of pornography use among male college students of China, to explore the addiction possibility for pornography use, and to study the associations between pornography use and reproductive hormone levels and semen quality. Five hundred sixty-eight participants met the inclusion criteria and finished all of the questionnaires and hormone level and semen parameter examinations. A majority of participants (except one) had pornography use experience, 94.2% participants started pornography use before college, and 95.9% participants reported they had masturbation experience when using pornography. Early contact to pornography, frequent pornography use, high amount of time spending on pornography use, and frequent masturbation during pornography use were correlated with addiction trends. Earlier pornography use was found to be associated with lower serum prolactin (PRL), follicle-stimulating hormone (FSH), and progesterone (Prog), as well as lower sperm concentration and total sperm count. Higher frequency of pornography use was associated with lower serum estrogen (E₂). In conclusion, pornography use was common among male college students in China. Early contact, high frequent use, and high frequency of masturbation during pornography use could lead to addiction trends and aberrant reproductive hormone levels and semen quality.

Connected Mental Health: Systematic Mapping Study

BACKGROUND

Although mental health issues constitute an increasing global burden affecting a large number of people, the mental health care industry is still facing several care delivery barriers such as stigma, education, and cost. Connected mental health (CMH), which refers to the use of information and communication technologies in mental health care, can assist in overcoming these barriers.

OBJECTIVE

The aim of this systematic mapping study is to provide an overview and a structured understanding of CMH literature available in the Scopus database.

METHODS

A total of 289 selected publications were analyzed based on 8 classification criteria: publication year, publication source, research type, contribution type, empirical type, mental health issues, targeted cohort groups, and countries where the empirically evaluated studies were conducted.

RESULTS

The results showed that there was an increasing interest in CMH publications; journals were the main publication channels of the selected papers; exploratory research was the dominant research type; advantages and challenges of the use of technology for mental health care were the most investigated subjects; most of the selected studies had not been evaluated empirically; depression and anxiety were the most addressed mental disorders; young people were the most targeted cohort groups in the selected publications; and Australia, followed by the United States, was the country where most empirically evaluated studies were conducted.

CONCLUSIONS

CMH is a promising research field to present novel approaches to assist in the management, treatment, and diagnosis of mental health issues that can help overcome existing mental health care delivery barriers. Future research should be shifted toward providing evidence-based studies to examine the effectiveness of CMH solutions and identify related issues.

The Current Situation of Internet Addiction and Its Impact on Sleep Quality and Self-Injury Behavior in Chinese Medical Students

OBJECTIVE

The purpose of this cross-sectional survey is to explore the current state of Internet addiction (IA) in Chinese medical students and its connection with medical students' sleep quality and self-injury behavior.

METHODS

Respondents were came from Wannan Medical College, China. The Young's Internet Addiction Test, Pittsburgh Sleep Quality Index (PSQI), Self-Harm Questionnaire were used in this cross-sectional survey. A total of 3,738 medical students were investigated, 1,552 (41.52%) males, 2,186 (58.48%) females. T-test, chi-square test and MANOVA were used for data analysis.

RESULTS

Of the 3,738 medical students, 1,054 (28.2%) reported having IA, 1,126 (30.1%) reported having poor sleep quality, 563 (15.1%) having self-harm behaviors. IA tends to be more female, upper grade students. The sleep quality of IA was worse than that of non-IA (χ2=54.882, p<0.001), and the possibility of self-injury was higher than non-IA (χ2=107.990, p<0.001).

CONCLUSION

This survey shows that the IA detection rate of medical students was 28.2%. Females, higher grade students had a higher IA detection rate. The low sleep quality and self-injury behavior of medical students are associated with IA.

Mental health and risk behaviors of children in rural China with different patterns of parental migration: a cross-sectional study

BACKGROUND

One in seven members of China's population are migrants. There are an estimated 41 million children left behind in rural areas who are living without one or both of their parents. The impact of two- and single-parent migration on child mental health and risk behaviors is unclear. The aim of this study was to compare the mental health and risk behaviors among children whose parents are either both migrating (B-LBC), have one parent migrating (O-LBC) or those whose parents do not migrate (N-LBC).

METHODS

This study was a cross-sectional survey using a self-administered questionnaire conducted in rural areas with high proportions of left behind children (LBC) in Anhui Province, southeast China. The tools used were the Strength and Difficulties Questionnaires, Youth Risk Behavior Survey and the Young's Internet Addiction Test for Chinese.

RESULTS

Full data were available for 699 B-LBC, 552 O-LBC and 741 N-LBC. After adjusting for gender, age, grade, number of siblings and self-rated socio-economic status, B-LBC were significantly more likely to have higher emotional symptoms scores (B(SE) = 0.36(0.11), p < 0.01), higher hyperactivity scores (B(SE) = 0.22(0.11), p < 0.01) and higher total difficulties scores (B(SE) = 0.79(0.29), p < 0.01) than N-LBC. B-LBC were also more likely to be an addicted internet user (OR(95%CI) = 1.91(1.33, 2.76), p < 0.01) compared to N-LBC. However, there were no identified differences between O-LBC and N-LBC or between O-LBC and B-LBC in any measures.

CONCLUSIONS

Our findings found that living with one parent or both parents was associated with better mental health and fewer risk behaviors than was being separated from both parents. Future research is needed to consider the implications of these findings for policies and programs to protect LBC, especially for those with two migrating parents.

Susceptibility of Shy Students to Internet Addiction: A Multiple Mediation Model Involving Chinese Middle-School Students

Recent studies found that some personality traits (e.g., impulsivity, sensation seeking) are frequently related to Internet addiction. In line with previous studies, this study aimed to determine whether shy students readily develop Internet addiction and to identify the causes of their developing Internet addiction. Specifically, this study examined the mediating roles of cognitive flexibility, self-regulation, and self-inconsistency in linking shyness and Internet addiction. A total of 1301 middle-school students in Shandong Province, East China, completed the relevant scales. Correlation analysis revealed that shyness was positively correlated with self-inconsistency and Internet addiction and negatively correlated with self-regulation and self-inconsistency. Cognitive flexibility, self-regulation, and self-inconsistency played fully mediating roles in the relationship between shyness and Internet addiction. The results indicate the significance of shyness-sensitivity for Internet addiction and suggest that cognitive and coping abilities as well as social adjustment factors should be considered when designing interventions to help shy students overcome Internet addiction.

Internet addiction: a new addiction?

The internet today has become an integral part of daily life that facilitates communication, education, and entertainment. The behavioral pattern of excessive internet usage has similarities to substance addiction, such as tolerance, withdrawal, repeated failure to reduce or quit, and impairment in daily life. Yet, there is no consistent physiological change that accompanies excessive use of the internet, as there is in excessive substance use. Neurological and neuroimaging studies of excessive internet users show biological changes in the prefrontal cortex that are similar to those found in other addictive syndromes. Brain structure changes also occur in the temporal cortex and ventral striatum, compromising executive function in planning and reasoning and increasing impulsive risk, resulting in loss of control over internet use. Of all the potential online applications known to cause addiction, only internet gaming disorder has been selected in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a condition for further study.

Internet Gaming Disorder and Its Associated Personality Traits: A Systematic Review Using PRISMA Guidelines

For most individuals, videogame playing is a fun and enjoyable activity that brings many benefits. However, for a small minority, the activity can be problematic and has led to much research into “gaming disorder.” In explanations concerning the contributory factors to gaming disorder, personality traits have been increasingly studied. The present paper carried out a systematic review of available literature using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The inclusion criteria were (i) publication date between 2000 and 2018, (ii) being an empirical study, (iii) written in English and Turkish languages (the two languages spoken by the authors), (iv) published in a scholarly peer-reviewed journal, and (v) conducted an assessment of IGD and personality traits objectively. Studies were excluded from the review if they were (i) single-case studies, (ii) unpublished thesis and dissertation studies, and (iii) not published in a peer-reviewed journal. Following these procedures, 21 eligible empirical studies were included. Results demonstrated that 24 distinct personality traits had been examined in relation to IGD and that some of these traits were demonstrated as risk factors for gaming addiction (although not always in the same direction).

To Each Stress Its Own Screen: A Cross-Sectional Survey of the Patterns of Stress and Various Screen Uses in Relation to Self-Admitted Screen Addiction

BACKGROUND

The relationship between stress and screen addiction is often studied by exploring a single aspect of screen-related behavior in terms of maladaptive dependency or the risks associated with the content. Generally, little attention is given to the pattern of using different screens for different types of stressors, and variations arising from the subjective perception of stress and screen addiction are often neglected. Given that both addiction and stress are complex and multidimensional factors, we performed a multivariate analysis of the link between individual's subjective perceptions of screen addiction, various types of stress, and the pattern of screen usage.

OBJECTIVE

Using the media-repertoires framework to study usage patterns, we explored (1) the relation between subjective and quantitative assessments of stress and screen addiction; and (2) differences in stress types in relation to subjective screen addiction and different types of needs for screens. We hypothesized that interindividual heterogeneity in screen-related behavior would reflect coping differences in dealing with different stressors.

METHODS

A multifactorial Web-based survey was conducted to gather data about screen-related behaviors (such as screen time, internet addiction, and salience of different types of screens and related activities), and different sources of stress (emotional states, perceptual risks, health problems, and general life domain satisfaction). We performed group comparisons based on whether participants reported themselves as addicted to internet and games (A1) or not (A0), and whether they had experienced a major life stress (S1) or not (S0).

RESULTS

Complete responses were obtained in 459 out of 654 survey responders, with the majority in the S1A0 (44.6%, 205/459) group, followed by S0A0 (25.9%, 119/459), S1A1 (19.8%, 91/459), and S0A1 (9.5%, 44/459). The S1A1 group was significantly different from S0A0 in all types of stress, internet overuse, and screen time (P<.001). Groups did not differ in rating screens important for short message service (SMS) or mail, searching information, shopping, and following the news, but a greater majority of A1 depended on screens for entertainment (χ²₃=20.5; P<.001), gaming (χ²₃=35.6; P<.001), and social networking (χ²₃=26.5; P<.001). Those who depended on screens for entertainment and social networking had up to 19% more emotional stress and up to 14% more perceptual stress. In contrast, those who relied on screens for work and professional networking had up to 10% higher levels of life satisfaction. Regression models including age, gender, and 4 stress types explained less than 30% of variation in internet use and less than 24% of the likelihood of being screen addicted.

CONCLUSIONS

We showed a robust but heterogeneous link between screen dependency and emotional and perceptual stressors that shift the pattern of screen usage toward entertainment and social networking. Our findings underline the potential of using ludic and interactive apps for intervention against stress.

Applying behavioral economic theory to problematic Internet use: An initial investigation

The widespread availability of the Internet has had profound social, educational, and economic benefits. Yet, for some, Internet use can become compulsive and problematic. The current study seeks to apply a behavioral economic framework to Internet use, testing the hypothesis that, similar to other addictive behaviors, problematic Internet use is a reinforcer pathology, reflecting an overvaluation of an immediately acquirable reward relative to prosocial and delayed rewards. Data were collected through Amazon's Mechanical Turk data collection platform. A total of 256 adults (Mage = 27.87, SD = 4.79; 58.2% White, 23% Asian; 65.2% had an associate degree or greater) completed the survey. Measures of delay discounting, consideration of future consequences, Internet demand, and alternative reinforcement all contributed unique variance in predicting both problematic Internet use and Internet craving. In aggregate models controlling for all significant predictors, alternative reinforcement and future valuation variables contributed unique variance. Individuals with elevated demand and discounting were at greatest risk for problematic Internet use. Consistent with behavioral economic research among substance abusing samples, individuals engaging in heavy Internet use report elevated motivation for the target behavior coupled with diminished motivation for other potentially rewarding activities, especially those associated with delayed reward. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Impact of the Family Environment on Juvenile Mental Health: eSports Online Game Addiction and Delinquency

Family types in Asian countries are rapidly changing as the society is changing. Thus, in this study, we analyzed and compared how the newly evolving family types (multicultural/dual-income) affect adolescents’ online game addiction, delinquency, and online gaming (eSports) participation motivation. Multiple regression analysis was performed to examine the causal relationships between the variables, and multivariate analysis of variance and analysis of variance were performed for comparative analyses. The results indicate that adolescents from dual-income families scored significantly higher on all factors related to juvenile delinquency and addiction factors (“salience”, “tolerance” and “withdrawal”). Additionally, adolescents from multicultural families revealed significantly higher scores on an addiction factor, “mood modification”. Lastly, adolescents in dual-income families were motivated to play online games to pass the time, and adolescents in multicultural families play online games to engage in social interaction. Results of this study may provide the answers required to help address societal issues related to adolescents in a changing society.

Internet gaming disorder: Feeling the flow of social games

Introduction

Gaming Disorder (GD) was added to the recent publication of the International Classification of Diseases (ICD-11) by the World Health Organization. This aligns with recommendations of the fifth edition of the Diagnostic Statistical Manual for Mental Disorders (DSM-5), issued by the American Psychiatric Association. Accordingly, further relevant research has been invited. The interplay between preference for online social game genres, the degree of online Flow (or immersive pleasure) experienced, and the gamer's biological gender were examined here as contributing factors of IGD.

Method

A normative sample of adult internet gamers was collected online (N = 237, Age = 18-59, Males = 157; 66%; Females = 80; 34%). Participants completed the nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9), the Online Flow Questionnaire (OFQ), and also self-reported demographics and internet/gaming behaviours.

Results

Mediation and moderated mediation analyses indicated that the level of online Flow experienced considerably mediated the association between the preference for social games genres and the intensity of IGD behaviours across both biological genders.

Conclusions

Results suggest that the level of online Flow experienced constitutes a risk factor in relation to the development of IGD. Furthermore, games which mandate social interaction with others present to be conducive to online Flow, and thus enhancing IGD risk irrespective of the biological gender of the gamer. Implications and limitations of the study are discussed.

Motives and Consequences of Online Game Addiction: A Scale Development Study

INTRODUCTION

We aimed to develop the Online Game Addiction Scale (OGAS) and examine its properties.

METHODS

Three hundred and twenty-seven secondary school students (92% males and 8% females) participated in this study. A draft scale that included 69 items was used for assessing its validity and reliability. The exploratory factor analysis was used for assessing construct validity, and Cronbach's alpha coefficient, Spearman-Brown split-half reliability, and test-retest reliability were used for assessing reliability.

RESULTS

After performing the exploratory analyses, a three-factor structure comprising 21 items was obtained, which explained the 59% of variance. The factor loads of the items ranged from 0.606 to 0.876. Reliability analyses revealed that Cronbach's alpha coefficients ranged from 0.83 to 0.91, coefficients of the Spearman-Brown split-half reliability ranged from 0.88 to 0.94, and outcomes of the test-retest reliability ranged from 0.71 to 0.94.

CONCLUSION

Our results revealed that OGAS is a valid and reliable tool that has adequate psychometric properties.

Classification of problematic Internet usage types by motives and contexts with elementary and secondary school-aged counseling clients

BACKGROUND AND AIMS

Past research on the classification of problematic Internet use (PIU) has focused on symptom-based severity and usage motive in order to understand its mechanism. Recently, usage context, such as family or social relationships, has been identified as a key influencing factor of PIU. Therefore, we extended the classification of PIU to include usage context in addition to symptom-based severity and usage motive.

METHODS

To classify PIU types, we conducted two studies. First, we performed a clustering analysis, where 265 counseling cases were clustered into usage types in terms of motive and context. After characterizing each usage type, we examined their hierarchical relationships by considering symptoms. Second, we performed a focus group interview with six counselors to increase the transferability of usage types. This transferability was established by matching counselors' quotations to the usage types. When usage types showed consistency between quotations and the clustering analysis, we identified the progression patterns between hierarchical relationships.

RESULTS

The clustering analysis of motive and context yielded six usage types with three hierarchical relationships. The focus group interview results verified the transferability of these six types and identified two progression patterns between the hierarchical relationships.

DISCUSSION AND CONCLUSION

Although usage motive and context were given equal weight before the clustering analysis, the resulting types revealed that usage context played a greater role in the classification process.