Regular and problematic leisure-time Internet use in the community: results from a German population-based survey

The Relationships between Compulsive Internet Use, Alexithymia, and Dissociation: Gender Differences among Italian Adolescents

Internet Gaming Disorder, Internet Addiction, Problematic Internet Use and Compulsive Internet Use cause distress and significant impairment in important areas of a person's functioning, in particular among young people. The literature has indicated that males show higher levels of problematic internet use than females. People can use the internet to avoid or alleviate negative affects; in fact, problematic internet use is associated with alexithymia and dissociation. Few studies have focused on the different stages of adolescence, gender differences, and the relationships between the aforementioned variables. This research aims to fill this gap. Five hundred and ninety-four adolescents aged between 13 and 19 filled in the Compulsive Internet Use Scale, the Toronto Alexithymia Scale, the Adolescents Dissociative Experiences Scale, and other ad hoc measures. Surprisingly, females reported higher compulsive internet use compared with males. Moreover, they referred more difficulties/symptoms and greater levels of alexithymia than males. No differences across the stages of adolescence were found. Different strengths in the relationships between variables were found according to gender. Moderated mediation analyses indicated that dissociation is an important mediator in the relation between alexithymia and Compulsive Internet Use only among females. This study shed new light on gender differences around problematic internet use and some related risk factors, in order to identify and develop prevention and treatment programs to face this topical and relevant issue.

Pattern of smartphone use, prevalence and correlates of problematic use of smartphone and social media among school going adolescents

Background

Adolescents are likely to quickly adopt newer technologies and face detrimental effects of the same.

Aim

This study assessed the prevalence and correlates of problematic smartphone and social media use among school-going adolescents.

Methods

Cross-sectional study was conducted amongst class 8-10 students. Data were collected using an anonymous survey in English which included (a) sociodemographic information, (b) pattern of smartphone use and smartphone addiction scale-short version (SAS-SV), and (c) pattern of social media use and social media disorder (SMD) scale. Educative session on responsible smartphone use was followed by post-session data collection which included patient health questionnaire (PHQ-2), generalized anxiety questionnaire (GAD-2), hyperactivity subscale of strength and difficulty questionnaire (SDQ), and conscientiousness and emotional stability subscales of ten-item personality inventory questionnaire (TIPI) and post-session feedback.

Results

Three hundred and twenty out of 325 responses were analyzed (180 male and 140 female). About 8% (n = 27) used smartphone for more than four hours. Prevalence of problematic smartphone use was 12.5% and problematic social media use was 11.9%. Problematic smartphone use was associated with duration of smartphone use per day and problematic social media use, which was in turn found to be associated with Facebook use and frequency of Instagram posts. About 80.6% (n = 256) participants agreed that such sessions should be conducted in schools.

Conclusions

One in ten school going adolescents are likely to be having problematic smartphone and social media use. Awareness sessions in schools about responsible mobile phone use may be an acceptable strategy.

Mixed comparison of interventions for different exercise types on students with Internet addiction: a network meta-analysis

Background

Internet addiction (IA) has a significant negative impact on students. The condition of students with IA can be improved by exercise, which has been identified as an effective intervention strategy. However, the relative effectiveness of different exercise types and the most effective ones remains unknown. This study presents a network meta-analysis to compare six exercise types (team sport, double sport, single sport, team + double sport, team + single sport, and team + double + single sport) based on their effectiveness in reducing Internet addiction and maintaining mental health.

Methods

Systematic searches were conducted in PubMed, EMBASE, Cochrane Library, CNKI, Wan Fang, CQVIP, Web of Science, CBM, EBSCO, APA PsycNet, and Scopus, and all relevant studies from the beginning to 15 July 2022 were included on. According to the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria, the listed studies' bias risk was assessed, while the network meta-analysis was performed using STATA 16.0.

Results

A total of 39 randomized controlled trials that met all inclusion criteria including 2,408 students with IA were examined. The meta-analysis results showed that compared with the control group, exercising significantly improved loneliness, anxiety, depression, and interpersonal sensitivity (p < 0.05). Specifically, the network meta-analysis discovered that the single sport, team sport, double sport, team + double sport, and team + double + single sport had significant effects on improving Internet addiction as compared to the respective control group (p < 0.05); the single sport, team sport, and double sport tend to be effective compared with controls in improving mental health (p < 0.05). Compared with the other five types of sports, the double sport was ranked first and showed the greatest potential to be the best choice (cluster ranking value = 3699.73) in improving Internet addiction (SUCRA = 85.5) and mental health (SUCRA = 93.1).

Conclusion

Exercise could be suggested as the best alternative when treating IA in students, based on the extensive positive effects of exercise on IA, anxiety, depression, interpersonal sensitivity, loneliness, and mental health in IA students. Double sport may be the best type of exercise for Internet-addicted students. However, to further examine the benefits of exercise for IA students, more research is required.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=377035, identifier: CRD42022377035.

Gadget addiction among school-going children and its association to cognitive function: a cross-sectional survey from Bangladesh

BACKGROUND

People are becoming more dependent on technology than ever before. Today's children and adults are heavily plugged into electronics, which raises concerns for their physical and cognitive development. This cross-sectional study was conducted to assess the relationship between media usage and cognitive function among school-going children.

METHODS

This cross-sectional study was conducted in 11 schools in 3 of Bangladesh's most populous metropolitan areas: Dhaka, Chattogram and Cumilla. A semistructured questionnaire with three sections was used to obtain data from the respondents: (1) background information, (2) PedsQL Cognitive Functioning Scale and (3) Problematic Media Use Measure Short Form. Stata (V.16) was used for statistical analysis. Mean and SD were used to summarise quantitative variables. Qualitative variables were summarised using frequency and percentage. The χ² test was used to explore bivariate association between categorical variables, and a binary logistic regression model was fit to investigate the factors associated with the cognitive function of the study participants after adjusting for confounders.

RESULTS

The mean age of total of 769 participants was 12.0±1.8 years, and the majority (67.31%) were females. The prevalence of high gadget addiction and poor cognitive function was 46.9% and 46.5%, respectively, among the participants. After adjusting the factors, this study found a statistically significant relationship (adjusted OR 0.4, 95% CI 0.3 to 0.7) between gadget addiction and cognitive function. In addition, the duration of breast feeding was a predictor of cognitive function as well.

CONCLUSION

This study found digital media addiction as a predictor of decreased cognitive performance in children who use digital gadgets regularly. Although the cross-sectional design of the study precludes causal relationships from being determined, the study finding deserves further examination via longitudinal research.

The prevalence of internet addiction and its association with quality of life among clinically stable patients with major depressive disorder

BACKGROUND

Internet addiction (IA) is associated with mental health problems but its impact on quality of life (QOL) is understudied. We examined the prevalence of IA and its association with QOL in clinically stable patients with major depressive disorder (MDD).

METHODS

In a cross-sectional survey between September 2020 and July 2021, the Young's Internet Addiction Test (IAT), the Patient Health Questionnaire-2 (PHQ-2) and the World Health Organization Quality of Life Brief version scale (WHOQOL-BREF) were administered to 1267 patients with MDD. Logistic regression was used to examine the correlates of IA, while analysis of covariance (ANCOVA) was used to examine the association between IA and QOL."

RESULTS

The prevalence of IA (IAT total scores ≥50) was 27.2 % (95 % CI: 24.7 %-29.6 %) in MDD patients. Compared to patients without IA, those with IA had lower QOL (F_{(1, 1267)} = 19.1, P < 0.001). Logistic regression revealed that higher education (senior high school and above; OR = 1.85, 95 % CI: 1.13-3.03), family history of psychiatric disorders (OR = 1.72, 95 % CI: 1.08-2.73), and higher PHQ-2 total score (OR = 1.23, 95 % CI: 1.14-1.32) were positively associated with IA while older age (OR = 0.93, 95 % CI: 0.91-0.96) was inversely related to IA.

CONCLUSION

IA is much more common in clinically stable patients with MDD compared to the reported figures in the general population. It would be prudent to screen and monitor internet use in MDD patients and treat those with IA.

Digital inequality in communication during a time of physical distancing: The case of COVID-19

In times of physical distancing, such as during the COVID-19 pandemic, people are likely to turn to digital communication to replace in-person interactions. Yet, persisting digital inequality suggests that not everyone will be equally able or disposed to increasing digital communication during a public health crisis. Using survey data from a national sample of U.S. participants (N = 2,925) that we collected during the early months of the pandemic, we analyzed how sociodemographics, living arrangements, and Internet experiences and skills relate to increases and decreases in various digital communication methods. We find that people privileged in their socioeconomic status, their Internet skills and online experiences are more likely to increase and less likely to decrease digital communication during the pandemic. The findings illustrate how digital inequalities can put already disadvantaged groups at greater risk of diminished social contact during a public health crisis. We discuss the theoretical implications of our findings for digital inequality research, the practical implications for inclusive crisis responses, and directions for future research.

Trait Anxiety and Social Media Fatigue: Fear of Missing Out as a Mediator

Background

Interdisciplinary literature indicates different correlates of social media fatigue (hereinafter: SMF). Some studies show that high levels of anxiety may induce lowered Internet use and lead social media users to withdraw from Internet activities. Since the relationship between anxiety and social media use is complex, it is important to investigate mediating factors that may indirectly contribute to or exacerbate this association. Therefore, the main aim of this study is to verify whether fear of missing out (hereinafter: FoMO) is a potential factor accounting for why anxiety is associated with SMF.

Participants Methods and Data Collection

The research was conducted on a group of 264 adolescents and adults (85% women). The mean age of the respondents was M = 23.76 with SD = 5.98 (range = 14-50 years). The data were collected via online social networking among college students, their family members and friends. The participants answered the Trait Anxiety Scale (TAS), Social Media Fatigue Scale (SMFS), Fear of Missing Out Scale (FoMO), and  Revised Life Orientation Test (LOT-R).

Results

The outcomes showed that respondents with higher levels of trait anxiety report more intense cognitive, behavioral, emotional, and overall online fatigue. Concurrently, individuals who experience  FoMO on the Internet declare being tired of social media use. Moreover, FoMO mediates the association between trait anxiety and all three dimensions of SMF, and its overall result.

Conclusion

The present research increases our understanding of the possible role of apprehension related to missing out on the anxiety and fatigue connected to engagement in social media. It is possible to assess that trait anxiety might induce higher SMF when individuals experience a general apprehension that others are doing or having things that they do not.

The role of self-esteem in Internet addiction within the context of comorbid mental disorders: Findings from a general population-based sample

BACKGROUND AND AIMS

Internet Addiction (IA) has consistently been related to comorbid psychiatric disorders and lowered self-esteem. However, most studies relied on self-report questionnaires using non-representative samples. This study aims to analyze the relative impact of self-esteem and comorbid psychopathology with lifetime IA in a population-based sample of excessive Internet users using clinical diagnoses assessed in a personal interview.

METHODS

The sample of this study is based on a general population survey. Using the Compulsive Internet Use Scale, all participants with elevated Internet use scores were selected and invited to a follow-up interview. Current DSM-5 criteria for Internet gaming disorder were rephrased to apply to all Internet activities. Out of 196 participants, 82 fulfilled the criteria for IA. Self-esteem was measured with the Rosenberg's Self-Esteem Scale.

RESULTS

Self-esteem is significantly associated with IA. For every unit increase in self-esteem, the chance of having IA decreased by 11%. By comparison, comorbidities such as substance-use disorder (excluding tobacco), mood disorder, and eating disorder were significantly more likely among Internet-addicted than in the non-addicted group. This could not be reported for anxiety disorders. A logistic regression showed that by adding self-esteem and psychopathology into the same model, self-esteem maintains its strong influence on IA.

DISCUSSION AND CONCLUSIONS

Self-esteem was associated with IA, even after adjustment for substance-use disorders, mood disorder, and eating disorder. Self-esteem and psychopathology should be considered in prevention, intervention measures, as well as in the conception of etiological models.

The Relationship Between Trait Procrastination, Internet Use, and Psychological Functioning: Results From a Community Sample of German Adolescents

Adolescents with a strong tendency for irrational task delay (i.e., high trait procrastination) may be particularly prone to use Internet applications simultaneously to other tasks (e.g., during homework) and in an insufficiently controlled fashion. Both Internet multitasking and insufficiently controlled Internet usage may thus amplify the negative mental health implications that have frequently been associated with trait procrastination. The present study explored this role of Internet multitasking and insufficiently controlled Internet use for the relationship between trait procrastination and impaired psychological functioning in a community sample of N = 818 early and middle adolescents. Results from multiple regression analyses indicate that trait procrastination was positively related to Internet multitasking and insufficiently controlled Internet use. Insufficiently controlled Internet use, but not Internet multitasking, was found to partially statistically mediate the association between trait procrastination and adolescents’ psychological functioning (i.e., stress, sleep quality, and relationship satisfaction with parents). The study underlines that adolescents with high levels of trait procrastination may have an increased risk for negative outcomes of insufficiently controlled Internet use.

Differences in the relationship between traumatic experiences, self-esteem, negative cognition, and Internet addiction symptoms among North Korean adolescent defectors and South Korean adolescents: A preliminary study

North Korean adolescent defectors experience adaptation difficulties along with a wide range of psychosocial problems, but no study has yet examined their Internet addiction symptoms. We compared early traumatic experiences, self-esteem, negative cognition, and Internet addiction symptoms, as well as the relationships between these variables, between North Korean adolescent defectors and South Korean adolescents. Fifty-six North Korean adolescent defectors and 112 age- and sex- matched South Korean adolescents participated. The analyses examined the relationship between traumatic experiences and Internet addiction symptoms, with negative automatic thoughts or low self-esteem as mediators of these relations. North Korean adolescent defectors tended to have higher levels of negative automatic thoughts and more severe Internet addiction symptoms, as well as better self-esteem, than did South Korean adolescents. Furthermore, only among North Korean adolescent defectors, traumatic experiences were positively associated with Internet addition symptoms via increasing negative automatic thoughts. North Korean adolescent defectors are more susceptible to Internet addiction, negative cognitions, and early traumatic experiences compared to South Korean adolescents. However, the cross-sectional design of this study precludes consideration of the causality of these relationships. Interventions aiming to correct negative cognitions and increase self-esteem may be helpful for North Korean adolescent defectors with problematic Internet use.

Peer attachment, specific patterns of internet use and problematic internet use in male and female adolescents

Problematic internet use may lead to serious psychosocial dysfunction. Recent studies have found comparable prevalence in both male and female adolescents. We pursue the neglected questions how male and female adolescents differ regarding their patterns of internet use and how gender, peer attachment and patterns of use are related to pathological internet use. In 2410 adolescents (1307 girls and 1103 boys) aged 12-18 years from different types of school we assessed peer attachment, frequency and use of eight specific applications and indicators of pathological internet use. Three patterns of internet use, 'social'; 'sex and games" and 'functional' were identified and connections between variables were modeled by ordered sequences of regression. We found that problematic internet use-sex and games as well as social usage-was more prevalent in boys. Insecure peer attachment predicted problematic internet use in both sexes. Also, excessive usage of internet games and sex mediated the influence of peer attachment insecurity on problematic internet use, but only for boys. Our study identified that adolescents with insecure peer attachment are at higher risk for problematic internet use. With regard to specific types of internet use, the consumption of online games and sex was identified as risk factor in boys with increasing age. Further studies are needed to understand and possibly subgroup problematic internet use behavior in girls. Our findings suggest that increasing the quality of peer relationships may be promising approach in the prevention and treatment of problematic internet use.

Prevalence and determinants of online-sex use in the German population

Introduction

The unlimited access to sexual features in the World Wide Web has raised concerns about excessive and problematic online-sex use. However, little is known about antecedents of internet-sex use of different intensity. Based on a representative German sample of 2,522 participants between the ages of 14 and 97 years, the aims of the present study were (1) to determine the prevalence rates of online-sex users with the short version (ISST_GSV) of the Internet Sex Screening Test and (2) to associate online-sex use with anxious vs. avoidant partner attachment patterns and “Big Five” personality traits as potential antecedents.

Results

The ISST is a brief, one-dimensional and reliable measure of online-sex activities (r_tt = .69). Overall, 14.7% of respondents reported occasional and 4.2% intensive online-sex use. In multivariate analysis, online-sex use was significantly positively associated with male sex, younger age, unemployment and an anxious partner attachment pattern and negatively with conscientiousness and agreeableness.

Conclusions

Arousal and satisfaction by virtual enactment of sexual phantasies may be attractive for anxiously attached persons who find it difficult to commit to a real life relationship due to fear of rejection or low self-esteem. More knowledge about the individual antecedents of intensive online-sex use may also be helpful for the development of consultation and treatment strategies for excessive and addictive online-sex use.

Reader and author gender and genre in Goodreads

There are known gender differences in book preferences in terms of both genre and author gender but their extent and causes are not well understood. It is unclear whether reader preferences for author genders occur within any or all genres and whether readers evaluate books differently based on author genders within specific genres. This article exploits a major source of informal book reviews, the Goodreads.com website, to assess the influence of reader and author genders on book evaluations within genres. It uses a quantitative analysis of 201,560 books and their reviews, focusing on the top 50 user-specified genres. The results show strong gender differences in the ratings given by reviewers to books within genres, such as female reviewers rating contemporary romance more highly, with males preferring short stories. For most common book genres, reviewers give higher ratings to books authored by their own gender, confirming that gender bias is not confined to the literary elite. The main exception is the comic book, for which male reviewers prefer female authors, despite their scarcity. A word frequency analysis suggested that authors wrote, and reviewers valued, gendered aspects of books within a genre. For example, relationships and romance were disproportionately mentioned by women in mystery and fantasy novels. These results show that, perhaps for the first time, it is possible to get large-scale evidence about the reception of books by typical readers, if they post reviews online.

Social Networking Sites and Addiction: Ten Lessons Learned

Online social networking sites (SNSs) have gained increasing popularity in the last decade, with individuals engaging in SNSs to connect with others who share similar interests. The perceived need to be online may result in compulsive use of SNSs, which in extreme cases may result in symptoms and consequences traditionally associated with substance-related addictions. In order to present new insights into online social networking and addiction, in this paper, 10 lessons learned concerning online social networking sites and addiction based on the insights derived from recent empirical research will be presented. These are: (i) social networking and social media use are not the same; (ii) social networking is eclectic; (iii) social networking is a way of being; (iv) individuals can become addicted to using social networking sites; (v) Facebook addiction is only one example of SNS addiction; (vi) fear of missing out (FOMO) may be part of SNS addiction; (vii) smartphone addiction may be part of SNS addiction; (viii) nomophobia may be part of SNS addiction; (ix) there are sociodemographic differences in SNS addiction; and (x) there are methodological problems with research to date. These are discussed in turn. Recommendations for research and clinical applications are provided.

Neural correlate of Internet use in patients undergoing psychological treatment for Internet addiction

BACKGROUND

The new version of Diagnostic and Statistical Manual of Mental Disorders (DSM-5th) proposed the Internet Gaming Disorder for the diagnosis of Internet addiction (IA) considering the neurobiological evidence of the craving.

AIMS

The aim was to test the neural correlate in response to the Internet cue in patients with IA.

METHODS

Sixteen males with IA diagnosis (clinical group) and 14 healthy male (control group) were recruited for an experimental visual task composed of Internet images and emotional images. During the visual presentation of Internet cue, electroencefalographic data were recorded using Net Station 4.5.1 with a 256-channels HydroCel Geodesic Sensor Net. Event-related potential (ERP) components and low-resolution electromagnetic tomography (sLoreta) were analysed.

RESULTS

sLoreta analyses showed that patients from the clinical group presented a higher primary somatosensorial cortex and lower paralimbic, temporal and orbito-frontal activation in response to both Internet and emotional images compared to those of the control group.

CONCLUSIONS

These results suggest that clinically recognized pathological use of Internet could be linked to dissociative symptoms.

An exploratory examination of At-Risk/Problematic Internet Use and disordered eating in adults

PURPOSE

At-Risk/Problematic Internet Use (ARPIU) has been associated with impairment in multiple domains including psychopathology. The present study examined the relationship between ARPIU and disordered eating in a large community sample.

METHODS

Participants (n=1000) completed an online survey about health behaviors. Two thresholds of ARPIU and disordered eating each were examined.

RESULTS

The ARPIU and Sub-ED (subthreshold eating disorders) groups reported greater depressive symptoms and poorer self-control than the Control group; the Sub-ED group reported greater impulsivity than the Control group. The ARPIU and Sub-ED groups significantly differed in key features related to each condition. Finally, the co-occurrence of ARPIU and Sub-ED was associated with greater depression. In the second set of analyses based on more stringent thresholds, the Problematic Internet Use (PIU) and ED groups differed on all measures compared to the Control group. The PIU and ED groups also differed on key features related to each condition, but did not differ on measures of impulsivity or self-control. The co-occurrence of PIU and ED was associated with greater depressive symptoms than either PIU or ED independently.

CONCLUSIONS

ARPIU and Sub-ED share links to depression and poor self-control and these may represent possible therapeutic targets across Internet-use and disordered-eating behaviors. Co-occurring PIU and ED at either lenient or stringent thresholds is associated with greater depression. Future studies should examine the temporal nature of these associations and the extent to which targeting depression, Internet use, or disordered eating may lead to improvements across domains.

Problematic Internet use, well-being, self-esteem and self-control: Data from a high-school survey in China

Given the prevalence of Internet use among youth, there is concern that a subset of Internet-using youth may exhibit problematic or addictive patterns of Internet use. The present study examines the association between problematic Internet use (PIU), demographic variables, and health-related measures among Chinese adolescents. Survey data from 1552 adolescents (male=653, mean age=15.43years) from Jilin Province, China, were collected. According to the Young Diagnostic Questionnaire for Internet Addiction (YDQ), 77.8% (n=1207), 16.8% (n=260), and 5.5% (n=85) showed adaptive, maladaptive, and problematic Internet use, respectively. Multinomial logistic regression analysis revealed that gender and family income per month differed between youth showing problematic and adaptive patterns of Internet use. Well-being, self-esteem, and self-control were related to severity of problematic Internet use, with greater severity typically associated with poorer measures in each domain. The findings that severity of problematic Internet use is associated with specific socio-demographic features and temperamental and well-being measures suggest that specific groups of youth may be particularly vulnerable to developing problematic Internet use. Early prevention/intervention programs targeting at-risk groups may help improve public health.

German Anxiety Barometer-Clinical and Everyday-Life Anxieties in the General Population

The objective of this study was to test a time-efficient screening instrument to assess clinically relevant and everyday-life (e.g., economic, political, personal) anxieties. Furthermore, factors influencing these anxieties, correlations between clinical and everyday anxieties and, for the first time, anxiety during different stages of life were assessed in a representative sample of the general population (N = 2229). Around 30% of the respondents manifested at least one disorder-specific key symptom within 1 year (women > men), 8% reported severe anxiety symptoms. Two thirds of respondents reported minor everyday anxieties and 5% were strongly impaired, whereby persons with severe clinical symptoms were more frequently affected. A variety of potential influencing factors could be identified. These include, in addition to socioeconomic status, gender, general health, risk-taking, and leisure behavior, also some up to now little investigated possible protective factors, such as everyday-life mental activity. The observed effects are rather small, which, however, given the heterogeneity of the general population seems plausible. Although the correlative design of the study does not allow direct causal conclusions, it can, however, serve as a starting point for experimental intervention studies in the future. Together with time series from repeated representative surveys, we expect these data to provide a better understanding of the processes that underlie everyday-life and clinical anxieties.

Prevalence of problematic internet use in Slovenia

Background

Internet use is an integral part of our everyday activities; however, Internet use may become problematic and harmful in a minority of cases. The majority of reported prevalence rates of problematic Internet use refer to adolescent samples, whereas epidemiological studies on representative adult populations are lacking. This study aimed to reveal the prevalence and characteristics of problematic Internet use in Slovenia.

Methods

Problematic Internet Use Questionnaire (PIUQ) was included in European Health Interview Study (EHIS) on representative Slovenian sample. The frequency of Internet use and problematic Internet use were both assessed.

Results

59.9% of Slovenian adult population uses the Internet daily, and 3.1% are at risk of becoming problematic Internet users, 11% in the age group from 20 to 24 years. Those being at risk for becoming problematic Internet users are younger (mean age 31.3 vs. 48.3 for non-problematic users), more likely to be males (3.6% of males, whereas 2.6% of females are affected), students (12.0%), unemployed (6.3%) or unable to work (8.7%), single (6.5%), with high education (4.5%). Regression analysis revealed that the strongest predictor of being at risk for problematic Internet use is age (ß=-0.338, p<0.001); followed by high educational level (ß=0.145; p<0.001) and student status (ß=0.136; p<0.001).

Conclusion

3.1% of Slovenian adult population are at risk of becoming problematic Internet users, whereas 3 out of 20 Slovenian adolescents aged from 18 to 19 years are at risk (14.6%). Prevention programs and treatment for those affected are paramount, especially for the young generation.

Procrastination, Distress and Life Satisfaction across the Age Range - A German Representative Community Study

Addressing the lack of population-based data the purpose of this representative study was to assess procrastination and its associations with distress and life satisfaction across the life span. A representative German community sample (1,350 women; 1,177 men) between the ages of 14 and 95 years was examined by the short form of the General Procrastination Scale (GPS-K; 1) and standardized scales of perceived stress, depression, anxiety, fatigue and life satisfaction. As hypothesized, procrastination was highest in the youngest cohort (14–29 years). Only in the youngest and most procrastinating cohort (aged 14 to 29 years), men procrastinated more than women. As we had further hypothesized, procrastination was consistently associated with higher stress, more depression, anxiety, fatigue and reduced satisfaction across life domains, especially regarding work and income. Associations were also found with lack of a partnership and unemployment. Findings are discussed with regard to potential developmental and cohort effects. While procrastination appears to be a pervasive indicator for maladjustment, longitudinal analyses in high-risk samples (e.g. late adolescence, unemployment) are needed to identify means and mechanisms of procrastinating.

[Problematic internet use (PIN)--a review of assessment questionnaires and risk factors]

Internet is nowadays an integral part of our lives. However, excessive internet use, which is in many ways comparable to substance addictions and behavioral addictions, has become of growing interest in popular media, health policy and scientific research. Nevertheless, there is still considerable controversy with respect to diagnostic criteria and assessment questionnaires, and the diagnosis does not yet appear in any official diagnostic system such as the DSM-5 or ICD-10. Due to the lack of consistent diagnostic criteria for problematic internet use and both the use of different assessment questionnaires and classification systems, the reported prevalence rates vary significantly across studies. Thus, the comparison of study results is limited.In this review article a brief overview of the various diagnostic criteria and assessment questionnaires as well as the prevalence of problematic internet use (PIN) will be given. Furthermore, several usage-related and person-related risk factors of PIN will be discussed. With regards to the latter, the focus will be on both sociodemographic and psychiatric risk factors and on personality traits.

Neural substrates of risky decision making in individuals with Internet addiction

OBJECTIVE

With the wide and rapid expansion of computers and smartphones, Internet use has become an essential part of life and an important tool that serves various purposes. Despite the advantages of Internet use, psychological and behavioral problems, including Internet addiction, have been reported. In response to growing concern, researchers have focused on the characteristics of Internet addicts. However, relatively little is known about the behavioral and neural mechanisms that underlie Internet addiction, especially with respect to risky decision making, which is an important domain frequently reported in other types of addictions.

METHOD

To examine the neural characteristics of decision making in Internet addicts, Internet addicts and healthy controls were scanned while they performed a financial decision-making task.

RESULTS

Relative to healthy controls, Internet addicts showed (1) more frequent risky decision making; (2) greater activation in the dorsal anterior cingulate cortex and the left caudate nucleus, which are brain regions involved in conflict monitoring and reward, respectively; and (3) less activation in the ventrolateral prefrontal cortex, an area associated with cognitive control/regulation.

CONCLUSION

These findings suggest that risky decision making may be an important behavioral characteristic of Internet addiction and that altered brain function in regions associated with conflict monitoring, reward and cognitive control/regulation might be critical biological risk factors for Internet addiction.

Exposure to online hate material and social trust among Finnish youth

Purpose

– Trust is one of the key elements in social interaction; however, few studies have analyzed how the proliferation of new information and communication technologies influences trust. The authors examine how exposure to hate material in the internet correlates with Finnish youths’ particularized and generalized trust toward people who have varying significance in different contexts of life. Hence, the purpose of this paper is to provide new information about current online culture and its potentially negative characteristics.

Design/methodology/approach

– Using data collected in the spring of 2013 among Finnish Facebook users (n=723) ages 15-18, the authors measure the participants’ trust in their family, close friends, other acquaintances, work or school colleagues, neighbors, people in general, as well as people only met online.

Findings

– Witnessing negative images and writings reduces both particularized and generalized trust. The negative effect is greater for particularized trust than generalized trust. Therefore, exposure to hate material seems to have a more negative effect on the relationships with acquaintances than in a more general context.

Research limitations/implications

– The study relies on a sample of registered social media users from one country. In future research, cross-national comparisons are encouraged.

Originality/value

– The findings show that trust plays a significant role in online setting. Witnessing hateful online material is common among young people. This is likely to have an impact on perceived social trust. Hateful communication may then impact significantly on current online culture, which has a growing importance for studying, working life, and many leisure activities.

Stress moderates the relationship between problematic Internet use by parents and problematic Internet use by adolescents

PURPOSE

Based on the theoretical framework of Problem Behavior and Stress Reduction theories for problematic Internet use (PIU), this study aimed to investigate the relationship between parental PIU and the PIU among adolescents taking into consideration the stress levels of young people.

METHODS

This was a population-based parent and adolescent dyad health survey utilizing a random sampling technique. PIU for both parents and adolescents was measured by the Internet addiction test designed by Young. The stress level of adolescents was assessed using the stress subscale of the Depression Anxiety Stress Scale (DASS). Data were analyzed using logistic regression modeling techniques with adjustment for potential confounding factors with analysis on the modification effect of stress levels on the relationship between parent and adolescent PIU.

RESULTS

Of the total 1,098 parent and adolescent dyads with usable information, 263 adolescents (24.0%) and 62 parents (5.7%) could be classified as moderate and severe problematic users of the Internet. About 14% (n = 157) of adolescents could be classified with moderate-to-severe stress. Regression analysis results suggested a significant interaction between parental PIU and adolescents' stress levels on adolescent PIU. Stratified regression analyses by stress level resulted in a significant parent and adolescent PIU relationship in the low stress group (odds ratio, 3.18; 95% confidence interval 1.65-6.14). However, the association between parent and adolescent PIU in the high stress group became insignificant.

CONCLUSIONS

There was a significant parent and adolescent PIU relationship; however, this relationship is differentially affected by the stress status of the adolescent. The direct implication of the results is that parental Internet use should also be assessed and included as part of the treatment regime for adolescents.

Identifying problematic Internet users: development and validation of the Internet Motive Questionnaire for Adolescents (IMQ-A)

Background

Internationally, up to 15.1% of intensive Internet use among adolescents is dysfunctional. To provide a basis for early intervention and preventive measures, understanding the motives behind intensive Internet use is important.

Objective

This study aims to develop a questionnaire, the Internet Motive Questionnaire for Adolescents (IMQ-A), as a theory-based measurement for identifying the underlying motives for high-risk Internet use. More precisely, the aim was to confirm the 4-factor structure (ie, social, enhancement, coping, and conformity motives) as well as its construct and concurrent validity. Another aim was to identify the motivational differences between high-risk and low-risk Internet users.

Methods

A sample of 101 German adolescents (female: 52.5%, 53/101; age: mean 15.9, SD 1.3 years) was recruited. High-risk users (n=47) and low-risk users (n=54) were identified based on a screening measure for online addiction behavior in children and adolescents (Online-Suchtverhalten-Skala, OSV_K-S). Here, “high-risk” Internet use means use that exceeds the level of intensive Internet use (OSV_K-S sum score ≥7).

Results

The confirmatory factor analysis confirmed the IMQ-A’s 4-factor structure. A reliability analysis revealed good internal consistencies of the subscales (.71 up to .86). Moreover, regression analyses confirmed that the enhancement and coping motive groups significantly predicted high-risk Internet consumption and the OSV_K-S sum score. A mixed-model ANOVA confirmed that adolescents mainly access the Internet for social motives, followed by enhancement and coping motives, and that high-risk users access the Internet more frequently for coping and enhancement motives than low-risk users. Low-risk users were primarily motivated socially.

Conclusions

The IMQ-A enables the assessment of motives related to adolescent Internet use and thus the identification of populations at risk. The questionnaire enables the development of preventive measures or early intervention programs, especially dealing with internal motives of Internet consumption.

Predictive factors and psychosocial effects of Internet addictive behaviors in Cypriot adolescents

BACKGROUND

Internet addictive behaviors are associated with a plethora of psychosocial adversities. The study objectives were to assess the determinants and psychosocial correlates associated with Internet addictive behaviors among adolescents.

MATERIALS AND METHODS

A cross-sectional study design was applied among a random sample (n=805) of Cypriot adolescents (mean age: 14.7 years). Self-completed questionnaires, including Internet use characteristics, Young Internet Addiction Test, and Strengths and Difficulties Questionnaire, were utilized.

RESULTS

Among the study population, the prevalence rates of borderline addictive Internet use (BIU) and addictive Internet use (AIU) were 18.4% and 2%, respectively. Adolescents with BIU had an increased likelihood of concomitantly presenting with abnormal peer relations (AOR: 5.28; 95% confidence interval, CI: 3.37-23.38), conduct problems (AOR: 4.77; 95% CI: 2.82-8.08), hyperactivity (AOR: 5.58; 95% CI: 2.58-12.10) and emotional symptoms (AOR: 2.85; 95% CI: 1.53-5.32). Adolescent AIU was significantly associated with abnormal conduct (AOR: 22.31; 95% CI: 6.90-72.19), peer problems (AOR: 7.14; 95% CI: 1.36-37.50), emotional symptoms (AOR: 19.06; 95% 6.06-60.61), and hyperactivity (AOR: 9.49, 95% CI: 1.87-48.19). The determinants of BIU and AIU included accessing the Internet for the purposes of retrieving sexual information (AOR: 1.17; 95% CI: 1.17-3.23) and participating in games with monetary awards (AOR: 1.90; 95% CI: 1.15-3.14).

CONCLUSIONS

Both BIU and AIU were adversely associated with notable behavioral and social maladjustment among adolescents.

Internet addiction and its correlates among high school students: a preliminary study from Ahmedabad, India

PURPOSE

Internet addiction (IA) is an upcoming and less researched entity in psychiatry, especially in low and middle income countries. This is the first such effort to study IA amongst Indian school students of class 11th and 12th and to find its correlation with socio-educational characteristics, internet use patterns and psychological variables, namely depression, anxiety and stress.

METHODS

Six hundred and twenty one students of six English medium schools of Ahmedabad participated, of which 552 (88.9%) who completed forms were analyzed. Young's Internet Addiction Test and 21 item Depression Anxiety and Stress Scale were used to measure IA and psychological variables respectively. Logistic regression analysis was applied to find the predictors of IA.

RESULTS

Sixty-five (11.8%) students had IA; it was predicted by time spent online, usage of social networking sites and chat rooms, and also by presence of anxiety and stress. Age, gender and self-rated academic performance did not predict IA. There was a strong positive correlation between IA and depression, anxiety and stress.

CONCLUSIONS

IA may be a relevant clinical construct, and needs extensive research even in developing nations. All high school students suffering from depression, anxiety and stress must be screened for IA, and vice versa.

[The future of psychotherapy in psychosomatic medicine]

OBJECTIVE

To review the current perspectives and trends of psychotherapy as a key area of psychosomatic medicine with regard to both societal and scientific challenges as well as patient health care services. Also, to draw conclusions regarding the future training and practice of psychosomatic medicine and psychotherapy.

RESULTS

Psychotherapy is confronted with many new challenges because of the high prevalence of mental and psychosomatic disorders, because of their increasing recognition as major health problems and because of the rapid technological and demographic changes going on in modern society. Despite its growth, psychotherapeutic care is still limited in many, especially rural, regions and for patients with complex psychosomatic and somatopsychic disorders.

CONCLUSIONS

New models of training as well as integrated and multimodal care are needed in order to provide both, rapid, low-threshold and specialized, disorder-specific care.

Problematic Internet Use, Mental Health and Impulse Control in an Online Survey of Adults

BACKGROUND AND AIMS

Internet use has become a popular entertainment source and has become highly integrated into daily life. However, some people display problematic or addictive usage of the Internet. The present study attempts to fill current knowledge gaps regarding at-risk/problematic Internet use (ARPIU) and its relation to various health and functioning measures.

METHODS

Online survey data from 755 adults in the United States were analyzed using chi-square and ANOVAs.

RESULTS

The ARPIU group did not differ from the non-ARPIU group with respect to substance use. Individuals with ARPIU were, however, more likely to report at-risk/problematic engagement in video-game playing and gambling. Compared to the non-ARPIU group, the ARPIU group reported poorer self-control and higher levels of impulsivity and depression.

CONCLUSIONS

ARPIU appears associated with other risk behaviors, particularly those that might be performed on the Internet. Future studies should examine the extent to which the Internet may promote engagement in these risk behaviors and the extent to which preventative interventions targeting better self-control or negative mood states might help a range of non-substance-related addictive behaviors.

Suchtartige Internetnutzung als komorbide Störung im jugendpsychiatrischen Setting

Einleitung: Die exzessiv suchtartige Internetnutzung bei Kindern und Jugendlichen, welche sich in ähnlichen Symptomen äußern kann wie klassische Abhängigkeitserkrankungen, ist ein Phänomen, dem Wissenschaft und Praxis immer mehr Beachtung schenken. Prävalenzen von 3 % unter Kindern und Jugendlichen deuten auf ein häufig vorkommendes Problem hin, das bei Betroffenen zu Funktionseinschränkungen führt und mit hohem Leidensdruck einhergeht. Ungeklärt ist, wie häufig Internetsucht unter Patienten jugendpsychiatrischer Einrichtungen auftritt. Methodik: Zur erstmaligen Bestimmung der Prävalenz von Internetsucht unter psychiatrisch behandelten Jugendlichen wurde ein standardisiertes Screening-Instrument (OSV-S) zur Klassifikation der Internetnutzung an 81 Patienten zwischen 8 und 17 Jahren eingesetzt. Eine weitere klinische Beschreibung erfolgte mittels des Youth Self-Reports und der Child Behavior Checkliste. Ergebnisse: 11.3 % der Patienten erfüllten die Kriterien der Internetsucht. Diese Patienten haben ein höheres Durchschnittsalter und wiesen erhöhte Werte in Ängstlichkeit und Depressivität auf. Schlussfolgerungen: Diese Pilotstudie verdeutlicht, dass in jugendpsychiatrischen Einrichtungen komorbide Internetsucht häufig vorkommt. Patienten mit komorbider Internetsucht zeichnen sich durch spezifische Symptombelastungen aus. Eine gezielte störungsspezifische Psychotherapie ist zu diskutieren.

The Contribution of Game Genre and other Use Patterns to Problem Video Game Play among Adult Video Gamers

AIMS: To assess the contribution of patterns of video game play, including game genre, involvement, and time spent gaming, to problem use symptomatology. DESIGN: Nationally representative survey. SETTING: Online. PARTICIPANTS: Large sample (n=3,380) of adult video gamers in the US. MEASUREMENTS: Problem video game play (PVGP) scale, video game genre typology, use patterns (gaming days in the past month and hours on days used), enjoyment, consumer involvement, and background variables. FINDINGS: Study confirms game genre's contribution to problem use as well as demographic variation in play patterns that underlie problem video game play vulnerability. CONCLUSIONS: Identification of a small group of game types positively correlated with problem use suggests new directions for research into the specific design elements and reward mechanics of "addictive" video games. Unique vulnerabilities to problem use among certain groups demonstrate the need for ongoing investigation of health disparities related to contextual dimensions of video game play.

Effects of a manualized short-term treatment of internet and computer game addiction (STICA): study protocol for a randomized controlled trial

Background

In the last few years, excessive internet use and computer gaming have increased dramatically. Salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse have been defined as diagnostic criteria for internet addiction (IA) and computer addiction (CA) in the scientific community. Despite a growing number of individuals seeking help, there are no specific treatments of established efficacy.

Methods/design

This clinical trial aims to determine the effect of the disorder-specific manualized short-term treatment of IA/CA (STICA). The cognitive behavioural treatment combines individual and group interventions with a total duration of 4 months. Patients will be randomly assigned to STICA treatment or to a wait list control group. Reliable and valid measures of IA/CA and co-morbid mental symptoms (for example social anxiety, depression) will be assessed prior to the beginning, in the middle, at the end, and 6 months after completion of treatment.

Discussion

A treatment of IA/CA will establish efficacy and is desperately needed. As this is the first trial to determine efficacy of a disorder specific treatment, a wait list control group will be implemented. Pros and cons of the design were discussed.

Trial Registration

ClinicalTrials (NCT01434589)

Impaired inhibitory control in 'internet addiction disorder': a functional magnetic resonance imaging study

'Internet addiction disorder' (IAD) is rapidly becoming a prevalent mental health concern in many countries around the world. The neurobiological underpinnings of internet addiction should be studied to unravel the potential heterogeneity in the disorder. The present study examines the neural correlates of response inhibition in males with and without IAD using an event-related functional magnetic resonance imaging (fMRI) Stroop task. The IAD group demonstrated significantly greater 'Stroop effect'-related activity in the anterior and posterior cingulate cortices compared with their healthy peers. These results may suggest diminished efficiency of response-inhibition processes in the IAD group relative to healthy controls.

Therapie der Computerspiel- und Internetsucht

Einleitung: Die Problematik exzessiver Computerspiel- und Internetnutzung wurde insbesondere in den letzten Jahren durch die erhöhte Verfügbarkeit des Internets zu einem Focus des Interesses in der psychiatrischen und psychologischen Forschung. Besonders der enorm facettenreiche Spielesektor bildet hierbei eine neue Interaktionsform. Zur Behandlung von Computerspiel- und Internetabhängigkeit gibt es bisher nur wenig empirisch fundierte wissenschaftliche Forschung und dem entsprechend auch wenig evaluierte spezifische psychotherapeutische Konzepte. Methodik: Der folgende Artikel soll einen Überblick über bisherige allgemeine und therapiespezifische Forschungsbefunde zur Computerspiel- und Internetabhängigkeit geben. Dabei werden diagnostische Verfahren, Erklärungsansätze sowie aus den Studienergebnissen abgeleitete verhaltenstherapeutische Ansätze vorgestellt und diskutiert. Ergebnisse: Aufgrund der hohen Komorbidität von Angst- und depressiven Störungen, die besonders mit sozialen Kompetenz Defiziten und schlechten Stressbewältigungsstrategien assoziiert sind, stehen verhaltenstherapeutische Interventionen in Gruppen, die auf die Analyse des Problemverhaltens und seiner aufrechterhaltenden Bedingungen abzielen, in der Behandlung von Patienten mit exzessivem Computerspiel- und Internetgebrauch im Vordergrund. Daneben deuten neurobiologische Befunde als auch Ergebnisse aus der Persönlichkeitsforschung auf ähnliche Mechanismen hin, die zu der Entstehung und Aufrechterhaltung von substanzbezogenen Abhängigkeiten beitragen. Hieraus lassen sich Elemente aus der suchtspezifischen Therapie, wie cue-exposure Training mit dem Avatar als auch Situationsanalysen, die mit dem exzessiven Verhalten gekoppelt sind, auf die Behandlung die von Computerspiel und Internetabhängigen sehr gut transferieren. Schlussfolgerungen: Aus bisherigen Forschungsbefunden lassen sich zwar therapeutische Konzepte für die Behandlung von computerspiel- und internetabhängigen Patienten ableiten, es bedarf jedoch an empirischen Studien die den Transfer dieser Interventionen etablieren. Die zu beobachtende Psychopathologie unterstützt die Annahme Computerspiel- und Internetabhängigkeit als eigenes Störungsbild in die klinischen Manuale des DSM V unter die Kategorie Sucht und verwandte Störungen einzuordnen.

Precursor or sequela: pathological disorders in people with Internet addiction disorder

Background

This study aimed to evaluate the roles of pathological disorders in Internet addiction disorder and identify the pathological problems in IAD, as well as explore the mental status of Internet addicts prior to addiction, including the pathological traits that may trigger Internet addiction disorder.

Methods and Findings

59 students were measured by Symptom CheckList-90 before and after they became addicted to the Internet. A comparison of collected data from Symptom Checklist-90 before Internet addiction and the data collected after Internet addiction illustrated the roles of pathological disorders among people with Internet addiction disorder. The obsessive-compulsive dimension was found abnormal before they became addicted to the Internet. After their addiction, significantly higher scores were observed for dimensions on depression, anxiety, hostility, interpersonal sensitivity, and psychoticism, suggesting that these were outcomes of Internet addiction disorder. Dimensions on somatisation, paranoid ideation, and phobic anxiety did not change during the study period, signifying that these dimensions are not related to Internet addiction disorder.

Conclusions

We can not find a solid pathological predictor for Internet addiction disorder. Internet addiction disorder may bring some pathological problems to the addicts in some ways.