1
|
Staśkiewicz-Bartecka W, Kardas M. Eating Disorders Risk Assessment and Body Esteem among Amateur and Professional Football Players. Nutrients 2024; 16:945. [PMID: 38612979 PMCID: PMC11013787 DOI: 10.3390/nu16070945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The purpose of this study was to assess the risk of eating disorders and attitudes toward one's own body among football players at amateur and professional levels. METHODS The study included 90 players from football clubs located in the Upper Silesia Metropolitan Area, participating in the 4th and 5th leagues in Poland. A survey questionnaire was used to conduct the study, which consisted of a metric section, an Eating Attitudes Test, and Body Esteem Scale questionnaires. The players were divided into two groups according to their sports level. RESULTS Results showed that 24.4% of players were overweight, while 75.6% had a normative body weight. Approximately 16.7% met the criteria indicating susceptibility to an eating disorder. Body Esteem Scale interpretations revealed moderate body appraisal among players. CONCLUSIONS Both amateur and professional athletes showed no significant difference in eating disorder risk, but professionals rated their bodies higher. Social media use, particularly on Twitter and Instagram, is correlated with eating disorders, with longer daily use associated with lower body ratings.
Collapse
Affiliation(s)
- Wiktoria Staśkiewicz-Bartecka
- Department of Food Technology and Quality Evaluation, Department of Dietetics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland;
| | | |
Collapse
|
2
|
Rozgonjuk D, Blinka L, Löchner N, Faltýnková A, Husarova D, Montag C. Differences between problematic internet and smartphone use and their psychological risk factors in boys and girls: a network analysis. Child Adolesc Psychiatry Ment Health 2023; 17:69. [PMID: 37309011 DOI: 10.1186/s13034-023-00620-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/23/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Problematic internet and smartphone use are significant health challenges for contemporary adolescents. However, their mutual relationship is unclear because studies investigating these phenomena are scarce. The present study aimed to investigate the psychological risks and protective factors associated with problematic internet and smartphone use. METHOD A representative sample of Slovak adolescents (N = 4070, Mage = 14.38, SDage = 0.77, 50.5% girls) from the Health Behavior in School-aged Children project was analyzed using network analysis separately for boys and girls. RESULTS The results showed weak (for boys) and moderate (for girls) associations between problematic internet use and problematic smartphone use. Risk factors showed stronger associations with problematic internet use than problematic smartphone use, with the exception of fear of missing out, which was strongly associated with problematic smartphone use. The central nodes were externalizing problems for boys and internalizing problems, externalizing problems, and resilience for girls. CONCLUSION The study concluded that while problematic internet use and problematic smartphone use are somewhat related, they differ at the psychological level. In addition, the phenomena are rather different between boys and girls.
Collapse
Affiliation(s)
- Dmitri Rozgonjuk
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany
- Institute of Mathematics and Statistics, University of Tartu, Tartu, Estonia
| | - Lukas Blinka
- Psychology Research Institute, Faculty of Social Studies, Masaryk University, Joštova 10, 60200, Brno, Czech Republic.
| | - Nana Löchner
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany.
| | - Anna Faltýnková
- Psychology Research Institute, Faculty of Social Studies, Masaryk University, Joštova 10, 60200, Brno, Czech Republic
| | - Daniela Husarova
- Department of Health Psychology and Methodology Research, Faculty of Medicine, P.J. Safarik University in Kosice, Košice, Slovakia
| | - Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany
| |
Collapse
|
3
|
Wang ZL, Potenza MN, Song KR, Dong GH, Fang XY, Zhang JT. Subgroups of internet gaming disorder based on addiction-related resting-state functional connectivity. Addiction 2023; 118:327-339. [PMID: 36089824 DOI: 10.1111/add.16047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/31/2022] [Indexed: 01/05/2023]
Abstract
AIMS To identify subgroups of people with internet gaming disorder (IGD) based on addiction-related resting-state functional connectivity and how these subgroups show different clinical correlates and responses to treatment. DESIGN Secondary analysis of two functional magnetic resonance imaging (fMRI) data sets. SETTING Zhejiang province and Beijing, China. PARTICIPANTS One hundred and sixty-nine IGD and 147 control subjects. MEASUREMENTS k-Means algorithmic and support-vector machine-learning approaches were used to identify subgroups of IGD subjects. These groups were examined with respect to assessments of craving, behavioral activation and inhibition, emotional regulation, cue-reactivity and guessing-related measures. FINDINGS Two groups of subjects with IGD were identified and defined by distinct patterns of connectivity in brain networks previously implicated in addictions: subgroup 1 ('craving-related subgroup') and subgroup 2 ('mixed psychological subgroup'). Clustering IGD on this basis enabled the development of diagnostic classifiers with high sensitivity and specificity for IGD subgroups in 10-fold validation (n = 218) and out-of-sample replication (n = 98) data sets. Subgroup 1 is characterized by high craving scores, cue-reactivity during fMRI and responsiveness to a craving behavioral intervention therapy. Subgroup 2 is characterized by high craving, behavioral inhibition and activations scores, non-adaptive emotion-regulation strategies and guessing-task fMRI measures. Subgroups 1 and 2 showed largely opposite functional-connectivity patterns in overlapping networks. CONCLUSIONS There appear to be two subgroups of people with internet gaming disorder, each associated with differing patterns of brain functional connectivity and distinct clinical symptom profiles and gender compositions.
Collapse
Affiliation(s)
- Zi-Liang Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Marc N Potenza
- Department of Psychiatry and Child Study Center, Yale University School of Medicine, New Haven, CT, USA.,Connecticut Council on Problem Gambling, Wethersfield, CT, USA.,Connecticut Mental Health Center, New Haven, CT, USA.,Department of Neuroscience and Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Kun-Ru Song
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Guang-Heng Dong
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, China
| | - Xiao-Yi Fang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| |
Collapse
|
4
|
Alshakhsi S, Chemnad K, Almourad MB, Altuwairiqi M, McAlaney J, Ali R. Problematic internet usage: the impact of objectively Recorded and categorized usage time, emotional intelligence components and subjective happiness about usage. Heliyon 2022; 8:e11055. [PMID: 36281419 PMCID: PMC9587279 DOI: 10.1016/j.heliyon.2022.e11055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/06/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022] Open
Abstract
Most research on Problematic Internet Usage (PIU) relied on self-report data when measuring the time spent on the internet. Self-reporting of use, typically done through a survey, showed discrepancies from the actual amount of use. Studies exploring the association between trait emotional intelligence (EI) components and the subjective feeling on technology usage and PIU are also limited. The current cross-sectional study aims to examine whether the objectively recorded technology usage, taking smartphone usage as a representative, components of trait EI (sociability, emotionality, well-being, self-control), and happiness with phone use can predict PIU and its components (obsession, neglect, and control disorder). A total of 268 participants (Female: 61.6%) reported their demographic and completed a questionnaire that included Problematic Internet Usage Questionnaire short form (PIUQ-SF-6), Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), level of happiness with the amount and frequency of smartphone use, and living conditions (whether alone or with others). Their smartphone usage was objectively recorded through a dedicated app. A series of one-way ANOVA revealed no significant difference in PIU for different living conditions and a significant difference in the subjective level of happiness with phone usage (F (3, 264) = 7.55, p < .001), as well as of the frequency of usage where the unhappy group had higher PIU (F (3, 264) = 6.85, p < .001). Multiple linear regression analysis showed that happiness with phone usage (β = -.17), the actual usage of communication (β = .17), social media (β = .19) and gaming apps (β = .13), and trait EI component of self-control (β = -.28) were all significant predictors of PIU. Moreover, gender, age, and happiness with the frequency of phone usage were not significant predictors of PIU. The whole model accounted for the total variance of PIU by 32.5% (Adjusted R2 = .287). Our study contributes to the literature by being among the few to rely on objectively recorded smartphone usage data and utilizing components of trait EI as predictors.
Collapse
Affiliation(s)
- Sameha Alshakhsi
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar
| | - Khansa Chemnad
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar
| | | | - Majid Altuwairiqi
- College of Computers and Information Technology, Taif University, Saudi Arabia
| | - John McAlaney
- Faculty of Science and Technology, Bournemouth University, UK
| | - Raian Ali
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar
| |
Collapse
|
5
|
Gender-related differences in involvement of addiction brain networks in internet gaming disorder: Relationships with craving and emotional regulation. Prog Neuropsychopharmacol Biol Psychiatry 2022; 118:110574. [PMID: 35569619 DOI: 10.1016/j.pnpbp.2022.110574] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/03/2022] [Accepted: 05/07/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Abnormal interactions among addiction brain networks associated with intoxication, negative affect, and anticipation may have relevance for internet gaming disorder (IGD). Despite prior studies having identified gender-related differences in the neural correlates of IGD, gender-related differences in the involvement of brain networks remain unclear. METHODS One-hundred-and-nine individuals with IGD (54 males) and 111 with recreational game use (RGU; 58 males) provided resting-state fMRI data. We examined gender-related differences in involvement of addiction brain networks in IGD versus RGU subjects. We further compared the strength between and within addiction brain networks and explored possible relationships between the strength of functional connectivities within and between addiction brain networks and several relevant behavioral measures. RESULTS The addiction brain networks showed high correct classification rates in distinguishing IGD and RGU subjects in men and women. Male subjects with versus without IGD showed stronger functional connectivities between and within addiction brain networks. Moreover, the strength of the connectivity within the anticipation network in male IGD subjects was positively related to subjective craving. However, female subjects with versus without IGD showed decreased functional connections between and within addiction brain networks. The strength of connectivity between the anticipation and negative-affect brain networks in female IGD subjects was negatively related to maladaptive cognitive emotion-regulation strategies. CONCLUSIONS Addiction brain networks have potential for distinguishing IGD and RGU individuals. Importantly, this study identified novel gender-related differences in brain-behavior relationships in IGD. These results help advance current neuroscientific theories of IGD and may inform gender-informed treatment strategies.
Collapse
|
6
|
Kwon S, Kim R, Lee JT, Kim J, Song S, Kim S, Oh H. Association of Smartphone Use With Body Image Distortion and Weight Loss Behaviors in Korean Adolescents. JAMA Netw Open 2022; 5:e2213237. [PMID: 35594044 PMCID: PMC9123497 DOI: 10.1001/jamanetworkopen.2022.13237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
IMPORTANCE Despite high use of smartphones among adolescents, little is known about the association of smartphone use with body image and related behaviors. OBJECTIVE To examine the associations of duration of smartphone use and types of content most frequently accessed via smartphone with body image distortion and weight loss behaviors in adolescents. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the population-based Korea Youth Risk Behavior Web-Based Survey 2017. Participants comprised a nationally representative sample of 53 133 Korean adolescents aged 12 to 18 years. Data were collected from June 1 to July 18, 2017. The analysis was performed from February 7, 2020, to March 30, 2022. EXPOSURES Self-reported duration of smartphone use (min/d) and types of content (educational or informational searches; chatting, messaging, or email; social networking services or forums; games; videos, movies, or music; webtoons or web novels; and shopping or other activities) most frequently accessed during smartphone use. MAIN OUTCOMES AND MEASURES Body image distortion (overperception of body weight), weight loss attempt, use of inappropriate weight loss strategies (skipping meals, eating only 1 food at a time, vomiting, or using laxatives), and healthy weight loss behaviors (muscle-strengthening and aerobic physical activity). Multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and 95% CIs, accounting for survey sampling and adjusting for potential confounders. RESULTS Among 53 133 participants, the mean (SD) age was 15.0 (1.8) years; 50.7% of participants were female, and 49.3% were male. After adjusting for types of content accessed, prolonged smartphone use (≥301 min/d) was positively associated with body image distortion (boys: OR, 1.17; 95% CI, 1.07-1.28; girls: OR, 1.20; 95% CI, 1.10-1.30) and inappropriate weight loss strategies (boys: OR, 1.54; 95% CI, 1.25-1.90; girls: OR, 2.45; 95% CI, 2.14-2.79) in both sexes compared with minimal smartphone use (1-120 min/d). After adjusting for duration of smartphone use, the use of smartphones mainly for videos, movies, or music (OR, 1.15; 95% CI, 1.02-1.29), webtoons or web novels (OR, 1.28; 95% CI, 1.10-1.48), and games (OR, 1.17; 95% CI, 1.03-1.32) was positively associated with body image distortion in boys compared with the use of smartphones mainly for educational or informational content. Among boys, the use of smartphones mainly for chatting, messaging, or email was positively associated with muscle-strengthening activity (OR, 1.31; 95% CI, 1.18-1.44) and aerobic physical activity (OR, 1.41; 95% CI, 1.29-1.55), as was the use of smartphones mainly for social networking services or forums (muscle-strengthening activity: OR, 1.27; 95% CI, 1.13-1.42; aerobic physical activity: OR, 1.28; 95% CI, 1.15-1.43). Among girls, the use of smartphones mainly for chatting, messaging, or email was positively associated with weight loss attempts (OR, 1.34; 95% CI, 1.19-1.51) and the use of inappropriate weight loss strategies (OR, 1.57; 95% CI, 1.25-1.99), as was the use of smartphones mainly for social networking services or forums (weight loss attempts: OR, 1.20; 95% CI, 1.07-1.36; use of inappropriate weight loss strategies: OR, 1.37; 95% CI, 1.08-1.73). CONCLUSIONS AND RELEVANCE In this cross-sectional study, both the duration of smartphone use and the types of content most frequently accessed via smartphone were associated with body image distortion and weight loss behaviors in adolescents. These findings suggest a need for the identification of strategies to help adolescents develop healthy smartphone use behaviors.
Collapse
Affiliation(s)
- Sohyeon Kwon
- Interdisciplinary Program in Precision Public Health, College of Health Science, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, College of Health Science, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Jong-Tae Lee
- Interdisciplinary Program in Precision Public Health, College of Health Science, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Jinho Kim
- Interdisciplinary Program in Precision Public Health, College of Health Science, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Sunmi Song
- Rehabilitation Science Program, Department of Health Science, Graduate School of Korea University, Seoul, Republic of Korea
| | - Seongcheol Kim
- School of Media and Communication, Korea University, Seoul, Republic of Korea
| | - Hannah Oh
- Interdisciplinary Program in Precision Public Health, College of Health Science, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| |
Collapse
|
7
|
Identification of central symptoms in Internet addictions and depression among adolescents in Macau: A network analysis. J Affect Disord 2022; 302:415-423. [PMID: 35065088 DOI: 10.1016/j.jad.2022.01.068] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Internet addiction (IA) and depression are common among adolescents and often are co-occurring. This study examined the network structures of IA and depressive symptoms (depression hereafter) in adolescents. METHODS A total of 1,009 adolescents were recruited. IA and depression were measured using the Internet Addiction Test (IAT) and the 9 items-Patient Health Questionnaire (PHQ-9), respectively. A network analysis was conducted to identify central symptoms and bridge symptoms using centrality indices. Network stability was evaluated using the case-dropping procedure. The Network Comparison Test (NCT) was conducted to examine whether network characteristics differed by gender. RESULTS Network analysis revealed that nodes IAT-15 ("Preoccupation with the Internet"), IAT-2 ("Neglect chores to spend more time online"), PHQ-6 ("Guilty"), and IAT-16 ("Request an extension for longer time spent online") were the most central symptoms within the model of coexisting IA and depression. The most important bridge symptom was node IAT-11 ("Anticipation for future online activities"), followed by IAT-12 ("Fear that life is boring and empty without the Internet") and IAT-19 ("Spend more time online over going out with others"). Gender did not significantly influence the network structure. The IA and depression network model showed a high degree of stability. CONCLUSION The central symptoms along with key bridge symptoms identified could be potentially targeted when treating and preventing IA and depression among adolescents.
Collapse
|
8
|
Internet Addiction: The Role of Parental Care and Mental Health in Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412876. [PMID: 34948485 PMCID: PMC8700934 DOI: 10.3390/ijerph182412876] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 12/03/2022]
Abstract
Internet addiction in adolescence is a social issue which is being increasingly discussed worldwide. Hence, deepening the knowledge of its development is necessary to prevent short- and long-term negative outcomes. This study involving 266 adolescents (mean age = 16.1 years, SD = 1.4) aimed at analyzing the relationship between quality of parental care, Internet addiction and adolescents’ mental health, by means of the following self-report tools: the Parental Bonding Instrument, the Internet Addiction Test, and the Strengths and Difficulties Questionnaire. The findings, collected through structural equation model analyses, showed that perceived care from both father and mother had significant indirect effects on Internet addiction problems through adolescents’ mental health problems. Furthermore, Internet addiction problems were demonstrated to be negatively associated with maternal care but not with paternal care. The study provides empirical support to the need of family-based prevention and intervention programs to take care of Internet addiction.
Collapse
|
9
|
Lioupi C, Loumakou M, Sarafidou GO. Predictors of excessive internet use among adolescents in Greece after the economic recession: The role of psychopathology, parental rearing practices, self-efficacy and internet-related activities. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02228-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
10
|
Simkute D, Nagula I, Tarailis P, Burkauskas J, Griskova-Bulanova I. Internet Usage Habits and Experienced Levels of Psychopathology: A Pilot Study on Association with Spontaneous Eye Blinking Rate. J Pers Med 2021; 11:288. [PMID: 33918557 PMCID: PMC8068990 DOI: 10.3390/jpm11040288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 12/21/2022] Open
Abstract
Increasing availability of the internet has resulted in the increased prevalence of problematic online behaviors. Reliable and affordable neurobiological and psychological biomarkers that distinguish problematic internet use (PIU) from functional online activities are of utmost importance. Previous studies have shown a relationship between spontaneous eye blinking rate (sEBR) and changes in dopamine regulation in neurological and psychiatric disorders, including substance use disorders. In this study, we utilized sEBR to examine the potential link between individual differences in dopaminergic neurotransmission and PIU. In sum, 62 subjects participated in this study (median age 25, IQR 6 years, 34 females). The Problematic Internet Use Questionnaire (PIUQ-9), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), Clark-Beck Obsessive-Compulsive Inventory (CBOCI) and Barratt Impulsiveness Scale (BIS-11) were used for psychological assessment. The sEBRs were assessed with an electrooculogram recorded from above and below the left eye and from the right and left outer canthi. The group with PIU (PIUQ-9 > 20) expressed higher levels of impulsivity and compulsive behavior symptoms than the control group. In the group with PIU, impulsivity levels were inversely related to sEBR, and a trend of negative association of sEBR with compulsive behavior was observed. Future research should enroll subjects with high levels of PIU and strongly expressed psychopathology levels to further address the utility of sEBR as a potential biomarker.
Collapse
Affiliation(s)
- Dovile Simkute
- Institute of Biosciences, Life Sciences Centre, Vilnius University, Sauletekio Av. 7, LT-10257 Vilnius, Lithuania; (D.S.); (I.N.); (P.T.)
| | - Igor Nagula
- Institute of Biosciences, Life Sciences Centre, Vilnius University, Sauletekio Av. 7, LT-10257 Vilnius, Lithuania; (D.S.); (I.N.); (P.T.)
| | - Povilas Tarailis
- Institute of Biosciences, Life Sciences Centre, Vilnius University, Sauletekio Av. 7, LT-10257 Vilnius, Lithuania; (D.S.); (I.N.); (P.T.)
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno Str. 4, LT-00135 Palanga, Lithuania;
| | - Inga Griskova-Bulanova
- Institute of Biosciences, Life Sciences Centre, Vilnius University, Sauletekio Av. 7, LT-10257 Vilnius, Lithuania; (D.S.); (I.N.); (P.T.)
| |
Collapse
|
11
|
Tsui YYY, Cheng C. Internet Gaming Disorder, Risky Online Behaviour, and Mental Health in Hong Kong Adolescents: The Beneficial Role of Psychological Resilience. Front Psychiatry 2021; 12:722353. [PMID: 34721101 PMCID: PMC8554051 DOI: 10.3389/fpsyt.2021.722353] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022] Open
Abstract
In the present cyber age, Internet gaming disorder (IGD) and risky online behaviour are prevalent, and adolescents are especially vulnerable to such emergent problems. Few studies have explored the protective factors that mitigate harm caused by IGD and various common risky online behaviours. This study examined the prevalence of IGD and risky online behaviour, their hypothesised associations with depressive symptoms, and the beneficial role of psychological resilience as an underlying psychological mechanism. The participants included 1,099 Chinese junior secondary school students (33% boys, mean age = 13.5 years, age range = 10-17 years) who completed a battery of validated self-report questionnaires at their schools. The results revealed that 4% of the participants were at high risk of IGD and 6% were at an overall risk level of IGD. Depressive symptoms were positively associated with IGD and risky online behaviour, and psychological resilience mediated both of these associations. These results imply that clinicians and teachers should incorporate psychological resilience training into intervention approaches to mitigate IGD and risky online behaviour.
Collapse
Affiliation(s)
- Yvonne Yin-Yau Tsui
- Department of Psychology, The University of Hong Kong, Hong Kong, Hong Kong, SAR China
| | - Cecilia Cheng
- Department of Psychology, The University of Hong Kong, Hong Kong, Hong Kong, SAR China
| |
Collapse
|
12
|
Cerniglia L, Cimino S, Marzilli E, Pascale E, Tambelli R. Associations Among Internet Addiction, Genetic Polymorphisms, Family Functioning, and Psychopathological Risk: Cross-Sectional Exploratory Study. JMIR Ment Health 2020; 7:e17341. [PMID: 33361057 PMCID: PMC7790611 DOI: 10.2196/17341] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 10/02/2020] [Accepted: 10/20/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND International research has emphasized that youths are at higher risk for the onset of internet addiction (IA), but studies investigating biological, psychological, and social factors associated with this condition are limited. OBJECTIVE This study aims to investigate the possible association between IA and genetic polymorphisms in monoamine oxidase A (MAO-A), serotonin-transporter (5-HTTPR), dopamine receptor (DRD4), and dopamine transporter (DAT1) genes by considering the role played by the perception of young adults in their family functioning and their depression, anxiety, and avoidant personality problems. METHODS In a sample of 104 male and female young adults aged between 19 and 23 years (mean age 21.87, SD 2.29 years) recruited from universities in the central southern part of Italy, we addressed the presence of IA using the Young criteria of the IA test. Moreover, the perception of young adults of their family functioning and their psychopathological symptoms were assessed through the Family Assessment Device (FAD) and the Adult Self-Report, respectively. RESULTS We found no significant association between IA and any genetic polymorphisms, neither among males or females. Young adults with IA reported significantly higher scores in the subscale of FAD affective responsiveness (AR; P=.01) and in depressive problems (P=.02), anxiety problems (P=.009), and avoidant personality problems (P=.003) than those in the control group. Results of mediation analyses showed a mediation role played by depressive symptoms (B=0.99; 95% CI 0.22 to 1.97) and avoidant personality problems (B=1.09; 95% CI 0.32 to 2.05) of young adults on the relationship between the FAD, AR, and IA. Finally, this relationship was moderated by the genotype of the 5-HTTLPR (P<.001), DAT1 (P<.001), and MAO-A (P<.001) genes in young adults. CONCLUSIONS This exploratory study supports the recent evidence on the mutual relationship among biological, individual, and social risk factors associated with IA in young adulthood. Our findings may have important clinical implications for the development of prevention and treatment programs.
Collapse
Affiliation(s)
- Luca Cerniglia
- International Telematic University Uninettuno, Rome, Italy
| | | | | | | | | |
Collapse
|
13
|
Zhang X, Li JH, Wang J, Li J, Long ZT, Cao FL. Childhood Neglect and Psychological Distress Among Pregnant Women: The Chain Multiple Mediation Effect of Perceived Social Support and Positive Coping. J Nerv Ment Dis 2020; 208:764-770. [PMID: 32740144 DOI: 10.1097/nmd.0000000000001210] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to investigate the association between childhood neglect and psychological distress in pregnant women and to assess whether perceived social support and coping styles mediated this association. Pregnant women (N = 276) recruited from the prenatal clinic of a comprehensive hospital in China participated in this study. Participants reported their experiences of childhood neglect and abuse, depression, anxiety, perceived social support, and coping styles. Childhood neglect was positively associated with psychological distress. Perceived social support mediated the relationship between childhood neglect and psychological distress. Perceived social support and positive coping acted as chain mediators between childhood neglect and psychological distress. Childhood neglect is a risk factor for psychological distress during pregnancy independent of childhood abuse; perceived social support and positive coping can influence this relationship.
Collapse
Affiliation(s)
- Xuan Zhang
- School of Nursing, Shandong University, Jinan
| | - Jia-Huan Li
- School of Nursing, Shandong University, Jinan
| | - Juan Wang
- School of Nursing, Shandong University, Jinan
| | - Jie Li
- School of Nursing, Shandong University, Jinan
| | - Zhou-Ting Long
- Zaozhuang Vocational College, Zaozhuang, Shandong, PR China
| | | |
Collapse
|
14
|
Demirtepe-Saygılı D, Metin-Orta I. An Investigation of Cyberloafing in Relation to Coping Styles and Psychological Symptoms in an Educational Setting. Psychol Rep 2020; 124:1559-1587. [PMID: 32814513 DOI: 10.1177/0033294120950299] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cyberloafing, the intentional use of the Internet for personal purposes during class hours, has received the scholars' attention due to the increased access to digital devices in educational settings. Considering the possible negative consequences of misuse of the Internet on health and well-being, the current study aims to investigate the underlying mechanisms of this relationship by examining in detail the role of coping strategies. The sample consisted of 272 undergraduate students. The participants were asked to fill out items measuring cyberloafing behaviors, coping strategies (emotion-focused and problem-focused), and psychological symptoms (depression, anxiety, anger, and somatization). The results revealed that cyberloafing is positively related to psychological symptoms. Furthermore, it is observed that cyberloafing moderates the relationship between emotion-focused coping and psychological symptoms such that at high levels of cyberloafing, emotion-focused coping is associated with higher levels of psychological symptoms. These findings contribute to the existing literature on students' psychological well-being in terms of highlighting its relation with coping strategies and problematic Internet use.
Collapse
|
15
|
Karaca S, Karakoc A, Can Gurkan O, Onan N, Unsal Barlas G. Investigation of the Online Game Addiction Level, Sociodemographic Characteristics and Social Anxiety as Risk Factors for Online Game Addiction in Middle School Students. Community Ment Health J 2020; 56:830-838. [PMID: 31907803 DOI: 10.1007/s10597-019-00544-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/31/2019] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to investigate the online game addiction (OGA) level and the risk factors involved in OGA among middle school students. The descriptive cross-sectional study was conducted at seven middle schools in the province of Istanbul. The data were collected with a questionnaire, the Computer Game Addiction Scale for Children (CGASC) and the Social Anxiety Scale for Children (SASC); 1174 students who played online computer games were included in the study. It was found that 5.7% of the sample group were addictive users, that 44% were problematic users and that an older age, a higher level of social anxiety (SA), having a mother who is employed, having parents who completed high school or a higher level of education, and the time spent on the computer are risk factors for OGA.
Collapse
Affiliation(s)
- Semra Karaca
- Psychiatry Nursing Department, Faculty of Health Science, Marmara University, Istanbul, Turkey.
| | - Ayse Karakoc
- Midwifery Department, Faculty of Health Science, Marmara University, Istanbul, Turkey
| | - Ozlem Can Gurkan
- Maternity Nursing Department, Faculty of Health Science, Marmara University, Istanbul, Turkey
| | - Nevin Onan
- Nursing Department, High School of Health, Karabuk University, Karbuk, Turkey
| | - Gul Unsal Barlas
- Psychiatry Nursing Department, Faculty of Health Science, Marmara University, Istanbul, Turkey
| |
Collapse
|
16
|
Restrepo A, Scheininger T, Clucas J, Alexander L, Salum GA, Georgiades K, Paksarian D, Merikangas KR, Milham MP. Problematic internet use in children and adolescents: associations with psychiatric disorders and impairment. BMC Psychiatry 2020; 20:252. [PMID: 32456610 PMCID: PMC7251845 DOI: 10.1186/s12888-020-02640-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/30/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Problematic internet use (PIU) is an increasingly worrisome issue, as youth population studies are establishing links with internalizing and externalizing problems. There is a need for a better understanding of psychiatric diagnostic profiles associated with this issue, as well as its unique contributions to impairment. Here, we leveraged the ongoing, large-scale Child Mind Institute Healthy Brain Network, a transdiagnostic self-referred, community sample of children and adolescents (ages 5-21), to examine the associations between PIU and psychopathology, general impairment, physical health and sleep disturbances. METHODS A total sample of 564 (190 female) participants between the ages of 7-15 (mean = 10.80, SD = 2.16), along with their parents/guardians, completed diagnostic interviews with clinicians, answered a wide range of self-report (SR) and parent-report (PR) questionnaires, including the Internet Addiction Test (IAT) and underwent physical testing as part of the Healthy Brain Network protocol. RESULTS PIU was positively associated with depressive disorders (SR: aOR = 2.43, CI: 1.22-4.74, p = .01; PR: aOR = 2.56, CI: 1.31-5.05, p = .01), the combined presentation of ADHD (SR: aOR = 1.91, CI: 1.14-3.22, p = .01; PR: n.s.), Autism Spectrum Disorder (SR: n.s.; PR: aOR = 2.24, CI: 1.34-3.73, p < .001), greater levels of impairment (SR: Standardized Beta = 4.63, CI: 3.06-6.20, p < .001; PR: Standardized Beta = 5.05, CI: 3.67-6.42, p < .001) and increased sleep disturbances (SR: Standardized Beta = 3.15, CI: 0.71-5.59, p = .01; PR: Standardized Beta = 3.55, CI: 1.34-5.75, p < .001), even when accounting for demographic covariates and psychiatric comorbidity. CONCLUSIONS The association between PIU and psychopathology, as well as its impact on impairment and sleep disturbances, highlight the urgent need to gain an understanding of mechanisms in order to inform public health recommendations on internet use in U.S. youth.
Collapse
Affiliation(s)
- Anita Restrepo
- grid.428122.f0000 0004 7592 9033Healthy Brain Network, Child Mind Institute, New York, NY USA
| | - Tohar Scheininger
- grid.428122.f0000 0004 7592 9033Healthy Brain Network, Child Mind Institute, New York, NY USA
| | - Jon Clucas
- grid.428122.f0000 0004 7592 9033MATTER Lab, Child Mind Institute, New York, NY USA
| | - Lindsay Alexander
- grid.428122.f0000 0004 7592 9033Healthy Brain Network, Child Mind Institute, New York, NY USA
| | - Giovanni A. Salum
- grid.8532.c0000 0001 2200 7498Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Kathy Georgiades
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Diana Paksarian
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD USA
| | - Kathleen R. Merikangas
- grid.416868.50000 0004 0464 0574Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD USA
| | - Michael P. Milham
- grid.428122.f0000 0004 7592 9033Healthy Brain Network, Child Mind Institute, New York, NY USA ,grid.428122.f0000 0004 7592 9033Center for the Developing Brain, Child Mind Institute, New York, NY USA ,grid.250263.00000 0001 2189 4777Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, USA ,grid.428122.f0000 0004 7592 9033Child Mind Institute, New York, NY USA
| |
Collapse
|
17
|
Perceived stress and online compulsive buying among women: A moderated mediation model. COMPUTERS IN HUMAN BEHAVIOR 2020. [DOI: 10.1016/j.chb.2019.09.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
18
|
Are males more likely to be addicted to the internet than females? A meta-analysis involving 34 global jurisdictions. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2019.04.021] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
19
|
Liu SJ, Lan Y, Wu L, Yan WS. Profiles of Impulsivity in Problematic Internet Users and Cigarette Smokers. Front Psychol 2019; 10:772. [PMID: 31019482 PMCID: PMC6458249 DOI: 10.3389/fpsyg.2019.00772] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 03/20/2019] [Indexed: 01/13/2023] Open
Abstract
Problematic Internet use (PIU) has been gradually recognized as a mental health issue among adolescents and young students. PIU shows many similarities with substance use disorders, but the shared and distinct mechanisms underlying them are unclear. The purpose of the current study was to explore the relationships between impulsive traits and PIU as well as cigarette smoking behaviors among young adults. Two independent samples of university students (N 1 = 1281, N 2 = 1034, respectively) over 3 years were assessed with multiple measurements of impulsivity, including the Barratt Impulsiveness Scale-11 (BIS-11), the UPPSP Impulsive Behaviors Scale (UPPSP), and the Delay-discounting Test (DDT). Logistic regression models revealed that across the two independent samples, BIS-11 Attentional Impulsiveness was the common trait positively predicting both PIU and cigarette smoking. While BIS-11 Motor Impulsiveness as well as UPPSP Lack of Perseverance, Lack of Premeditation, and Negative Urgency were the typical traits linked to PIU as positive predictors, UPPSP Sensation Seeking was the unique trait linked to cigarette smoking as a positive predictor. These results suggested that specific dimensions of impulsivity might be concurrently implicated in PIU and cigarette smoking among young adults, putatively representing important trait marks for addictive behaviors.
Collapse
Affiliation(s)
- Su-Jiao Liu
- Department of Psychology, School of Philosophy and Sociology, Jilin University, Changchun, China
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, China
| | - Yan Lan
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, China
| | - Lin Wu
- Department of Sociology, Wuhan University, Wuhan, China
| | - Wan-Sen Yan
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, China
| |
Collapse
|
20
|
Rokkum JN, Gentile DA. Primary Versus Secondary Disorder in the Context of Internet Gaming Disorder. CURRENT ADDICTION REPORTS 2018. [DOI: 10.1007/s40429-018-0222-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
21
|
Kamal NN, Kamal NN. Determinants of Problematic Internet use and its Association with Disordered Eating Attitudes among Minia University Students. Int J Prev Med 2018; 9:35. [PMID: 29721236 PMCID: PMC5907427 DOI: 10.4103/ijpvm.ijpvm_489_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 02/14/2018] [Indexed: 12/17/2022] Open
Abstract
Background To determine the association between problematic Internet use (PIU) and disordered eating attitudes (DEAs) and to detect the potential risk factors for PIU among University students in Minia, Egypt. Methods A cross-sectional study was carried out among a random sample (n = 2365) of Minia University students. PIU was assessed using The Problematic Internet Use Scale (PIUS), and the DEAs were assessed using eating attitudes test-26 questionnaire. Results Of the 2365 students, 424 (17.9%) had DEAs, and it was more in females than males (22.3% and 14.5%, respectively). The mean of the PIUS score also was significantly higher in males than females (120.3 ± 30.5, and 117.5 ± 30.6, respectively). A positive moderate correlation (r = 0.48, P < 0.05) was detected between PIU and DEAs. Conclusions The results of this study indicate that PIU is significantly correlated with DEAs among University students in Minia, Egypt, and further studies are needed to identify the association between DEAs and PIU.
Collapse
Affiliation(s)
- Nashwa Nabil Kamal
- Department of Public Health, Faculty of Medicine, Minia University, Minya, Egypt
| | - Nashaat Nabil Kamal
- Department of Public Health, Faculty of Medicine, Minia University, Minya, Egypt
| |
Collapse
|
22
|
Adolescent Internet Abuse: A Study on the Role of Attachment to Parents and Peers in a Large Community Sample. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5769250. [PMID: 29707572 PMCID: PMC5863292 DOI: 10.1155/2018/5769250] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/08/2018] [Indexed: 02/08/2023]
Abstract
Adolescents are the main users of new technologies and their main purpose of use is social interaction. Although new technologies are useful to teenagers, in addressing their developmental tasks, recent studies have shown that they may be an obstacle in their growth. Research shows that teenagers with Internet addiction experience lower quality in their relationships with parents and more individual difficulties. However, limited research is available on the role played by adolescents' attachment to parents and peers, considering their psychological profiles. We evaluated in a large community sample of adolescents (N = 1105) the Internet use/abuse, the adolescents' attachment to parents and peers, and their psychological profiles. Hierarchical regression analyses were conducted to verify the influence of parental and peer attachment on Internet use/abuse, considering the moderating effect of adolescents' psychopathological risk. Results showed that adolescents' attachment to parents had a significant effect on Internet use. Adolescents' psychopathological risk had a moderating effect on the relationship between attachment to mothers and Internet use. Our study shows that further research is needed, taking into account both individual and family variables.
Collapse
|
23
|
Baloğlu M, Özteke Kozan Hİ, Kesici Ş. Gender Differences in and the Relationships Between Social Anxiety and Problematic Internet Use: Canonical Analysis. J Med Internet Res 2018; 20:e33. [PMID: 29367182 PMCID: PMC5803528 DOI: 10.2196/jmir.8947] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 10/20/2017] [Indexed: 12/22/2022] Open
Abstract
Background The cognitive-behavioral model of problematic Internet use (PIU) proposes that psychological well-being is associated with specific thoughts and behaviors on the Internet. Hence, there is growing concern that PIU is associated with psychological impairments. Objective Given the proposal of gender schema theory and social role theory, men and women are predisposed to experience social anxiety and engage in Internet use differently. Thus, an investigation of gender differences in these areas is warranted. According to the cognitive-behavioral model of PIU, social anxiety is associated with specific cognitions and behaviors on the Internet. Thus, an investigation of the association between social anxiety and PIU is essential. In addition, research that takes into account the multidimensional nature of social anxiety and PIU is lacking. Therefore, this study aimed to explore multivariate gender differences in and the relationships between social anxiety and PIU. Methods Participants included 505 college students, of whom 241 (47.7%) were women and 264 (52.3%) were men. Participants’ ages ranged from 18 to 22 years, with a mean age of 20.34 (SD=1.16). The Social Anxiety Scale and Problematic Internet Use Scale were used in data collection. Multivariate analysis of variance (MANOVA) and canonical correlation analysis were used. Results Mean differences between men and women were not statistically significant in social anxiety (λ=.02, F3,501=2.47, P=.06). In all three PIU dimensions, men scored higher than women, and MANOVA shows that multivariate difference was statistically significant (λ=.94, F3,501=10.69, P<.001). Of the canonical correlation functions computed for men, only the first was significant (Rc=.43, λ=.78, χ29=64.7, P<.001) and accounted for 19% of the overlapping variance. Similarly, only the first canonical function was significant for women (Rc=.36, λ=.87, χ29=33.9, P<.001), which accounted for 13% of the overlapping variance. Conclusions On the basis of the findings, we conclude that enhanced educational opportunities for women and their increasing role in the society have led women to become more active and thus closed the gap in social anxiety levels between men and women. We found that men showed more difficulties than women in terms of running away from personal problems (ie, social benefit), used the Internet more excessively, and experienced more interpersonal problems with significant others due to Internet use. We conclude that men are under a greater risk of social impairments due to PIU. Our overall conclusion is that there is a substantial amount of association between social anxiety and PIU and the association is stronger for men than it is for women. We advise that future research continue to investigate PIU and social anxiety as multidimensional constructs.
Collapse
Affiliation(s)
- Mustafa Baloğlu
- Department of Special Education, Faculty of Education, Hacettepe University, Ankara, Turkey
| | - Hatice İrem Özteke Kozan
- Department of Counseling, Ahmet Kelesoglu Faculty of Education, Necmettin Erbakan University, Konya, Turkey
| | - Şahin Kesici
- Department of Counseling, Ahmet Kelesoglu Faculty of Education, Necmettin Erbakan University, Konya, Turkey
| |
Collapse
|
24
|
Mindfulness-Oriented Recovery Enhancement for Video Game Addiction in Emerging Adults: Preliminary Findings from Case Reports. Int J Ment Health Addict 2017. [DOI: 10.1007/s11469-017-9765-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|
25
|
Park S, Lee Y. Associations of body weight perception and weight control behaviors with problematic internet use among Korean adolescents. Psychiatry Res 2017; 251:275-280. [PMID: 28222311 DOI: 10.1016/j.psychres.2017.01.095] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/12/2017] [Indexed: 11/26/2022]
Abstract
We examined the association of body mass index (BMI), body weight perception, and weight control behaviors with problematic Internet use in a nationwide sample of Korean adolescents. Cross-sectional data from the 2010 Korean Youth Risk Behavior Web-based Survey collected from 37,041 boys and 33,655 girls in middle- and high- schools (grades 7-12) were analyzed. Participants were classified into groups based on BMI (underweight, normal weight, overweight, and obese), body weight perception (underweight, normal weight, and overweight), and weight control behavior (no weight control behavior, appropriate weight control behavior, inappropriate weight control behavior). The risk of problematic Internet use was assessed with the Korean Internet Addiction Proneness Scale for Youth-Short Form. Both boys and girls with inappropriate weight control behavior were more likely to have problematic Internet use. Underweight, overweight, and obese boys and girls were more likely to have problematic Internet use. For both boys and girls, subjective perception of underweight and overweight were positively associated with problematic Internet use. Given the negative effect of inappropriate weight control behavior, special attention needs to be given to adolescents' inappropriate weight control behavior, and an educational intervention for adolescents to control their weight in healthy ways is needed.
Collapse
Affiliation(s)
- Subin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Republic of Korea.
| | - Yeeun Lee
- Department of Psychology, Korea University, Republic of Korea
| |
Collapse
|
26
|
Hicks S, Brown A. Higher Facebook use predicts greater body image dissatisfaction during pregnancy: The role of self-comparison. Midwifery 2016; 40:132-40. [DOI: 10.1016/j.midw.2016.06.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 06/06/2016] [Accepted: 06/24/2016] [Indexed: 11/25/2022]
|
27
|
Glass R, Li S, Pan R. Personality, Problematic Social Network Use and Academic Performance in China. JOURNAL OF COMPUTER INFORMATION SYSTEMS 2015. [DOI: 10.1080/08874417.2014.11645726] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
28
|
Video Game Addiction, Engagement and Symptoms of Stress, Depression and Anxiety: The Mediating Role of Coping. Int J Ment Health Addict 2015. [DOI: 10.1007/s11469-015-9578-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
29
|
Li X, Tao Q, Fang Y, Cheng C, Hao Y, Qi J, Li Y, Zhang W, Wang Y, Zhang X. Reward sensitivity predicts ice cream-related attentional bias assessed by inattentional blindness. Appetite 2015; 89:258-264. [PMID: 25681293 DOI: 10.1016/j.appet.2015.02.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 01/23/2015] [Accepted: 02/04/2015] [Indexed: 11/21/2022]
Abstract
The cognitive mechanism underlying the association between individual differences in reward sensitivity and food craving is unknown. The present study explored the mechanism by examining the role of reward sensitivity in attentional bias toward ice cream cues. Forty-nine college students who displayed high level of ice cream craving (HICs) and 46 who displayed low level of ice cream craving (LICs) performed an inattentional blindness (IB) task which was used to assess attentional bias for ice cream. In addition, reward sensitivity and coping style were assessed by the Behavior Inhibition System/Behavior Activation System Scales and Simplified Coping Style Questionnaire. Results showed significant higher identification rate of the critical stimulus in the HICs than LICs, suggesting greater attentional bias for ice cream in the HICs. It was indicated that attentional bias for food cues persisted even under inattentional condition. Furthermore, a significant correlation was found between the attentional bias and reward sensitivity after controlling for coping style, and reward sensitivity predicted attentional bias for food cues. The mediation analyses showed that attentional bias mediated the relationship between reward sensitivity and food craving. Those findings suggest that the association between individual differences in reward sensitivity and food craving may be attributed to attentional bias for food-related cues.
Collapse
Affiliation(s)
- Xiaoming Li
- Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, and School of Life Sciences, University of Science and Technology of China, Hefei, 230026, China; Department of Medical Psychology, Anhui Medical University, Hefei 230032, China
| | - Qian Tao
- Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ya Fang
- Department of Medical Psychology, Anhui Medical University, Hefei 230032, China
| | - Chen Cheng
- Department of Medical Psychology, Anhui Medical University, Hefei 230032, China
| | - Yangyang Hao
- Department of Medical Psychology, Anhui Medical University, Hefei 230032, China
| | - Jianjun Qi
- Department of Medical Psychology, Anhui Medical University, Hefei 230032, China
| | - Yu Li
- Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, and School of Life Sciences, University of Science and Technology of China, Hefei, 230026, China
| | - Wei Zhang
- Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, and School of Life Sciences, University of Science and Technology of China, Hefei, 230026, China
| | - Ying Wang
- Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, and School of Life Sciences, University of Science and Technology of China, Hefei, 230026, China
| | - Xiaochu Zhang
- Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, and School of Life Sciences, University of Science and Technology of China, Hefei, 230026, China; School of Humanities & Social Science, University of Science & Technology of China, Hefei 230026, China; Center of Medical Physics and Technology, CAS, Hefei Institutes of Physical Science, Hefei 230031, China; Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, 230027, China.
| |
Collapse
|
30
|
An integrative review of coping related to problematic computer use in adolescence. Int J Public Health 2015; 61:317-27. [PMID: 26012847 DOI: 10.1007/s00038-015-0693-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 04/09/2015] [Accepted: 05/14/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES Problematic computer use is the use of computer technology that may be health-endangering and may cause immediate or later negative physical or psychological health outcomes or disturb well-being in users. The main purpose of this study was to review current empirical research on coping strategies which adolescents apply in the context of problematic computer use and the coping-relevant impacts of problematic computer use. METHODS An integrative review of empirical studies using the Web of Science, Google Scholar, reference lists and forward tracking was conducted. Of the 404 articles identified, 28 peer-reviewed, full-text articles that directly addressed coping in relation to problematic Internet use, computer overuse and cyberbullying were included in the review. RESULTS This review identified the structure of specific coping strategies related to problematic computer use as well as the general patterns of relationships between reviewed instances of problematic computer use, situational coping and dispositional coping. CONCLUSIONS Instrumental action and talking with others were the most frequent strategies used by adolescents to cope with cyberbullying. The structure of the coping strategies related to problematic Internet use and computer overuse is highly differentiated, revealing a new and promising area for future research.
Collapse
|
31
|
Bischof-Kastner C, Kuntsche E, Wolstein J. Identifying problematic Internet users: development and validation of the Internet Motive Questionnaire for Adolescents (IMQ-A). J Med Internet Res 2014; 16:e230. [PMID: 25299174 PMCID: PMC4210952 DOI: 10.2196/jmir.3398] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 08/09/2014] [Accepted: 08/16/2014] [Indexed: 12/02/2022] Open
Abstract
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, OSVK-S). Here, “high-risk” Internet use means use that exceeds the level of intensive Internet use (OSVK-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 OSVK-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.
Collapse
|
32
|
Ha YM, Hwang WJ. Gender Differences in Internet Addiction Associated with Psychological Health Indicators Among Adolescents Using a National Web-based Survey. Int J Ment Health Addict 2014. [DOI: 10.1007/s11469-014-9500-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
33
|
Freshman year mental health symptoms and level of adaptation as predictors of Internet addiction: a retrospective nested case-control study of male Chinese college students. Psychiatry Res 2013; 210:541-7. [PMID: 23896352 DOI: 10.1016/j.psychres.2013.07.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 05/28/2013] [Accepted: 07/05/2013] [Indexed: 11/20/2022]
Abstract
A retrospective nested case-control study was designed to explore whether freshman year mental health status and level of adaptation are predictors of Internet addiction. The study cohort was 977 college students at a university in northwest China. In the first college year, the students' mental health status and adaptation level were assessed using the Chinese College Student Mental Health Scale (CCSMHS) and the Chinese College Student Adjustment Scale (CCSAS). In the following 1-3 years, 62 Internet-addicted subjects were identified using Young's 8-item diagnostic questionnaire. Controls were matched for demographic characteristics. Using logistic regression analysis, freshman year mental health status, including factors such as somatization, anxiety, depression and self-contempt, and freshman year adaptive problems were found to be causal factors and predictors of Internet addiction. Freshman with features of depression, learning maladaptation and dissatisfaction could be an important target-intervention population for reducing Internet addiction.
Collapse
|
34
|
Koronczai B, Kökönyei G, Urbán R, Kun B, Pápay O, Nagygyörgy K, Griffiths MD, Demetrovics Z. The mediating effect of self-esteem, depression and anxiety between satisfaction with body appearance and problematic internet use. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2013; 39:259-65. [PMID: 23841866 DOI: 10.3109/00952990.2013.803111] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Given that dissatisfaction with bodily appearance can sometimes lead to the avoidance of personal contacts and the increase of internet use, this study examines this relationship. The direct role of dissatisfaction with bodily appearance along with the possible mediation effects of depression, anxiety and self-esteem were tested. METHODS A total of 694 participants completed an online questionnaire (58.5% male, mean age 21.5 years), containing measures on problematic internet use, depression and anxiety symptoms, self-esteem and satisfaction with body image. Path analyses were used to test direct and indirect effects. RESULTS Satisfaction with body appearance had a significant negative direct effect on problematic internet use among both sexes. Though, satisfaction with body appearance had a positive effect on self-esteem and negative on anxiety, neither self-esteem nor anxiety had a direct significant effect on problematic internet use. The effect of dissatisfaction with body appearance was mediated via the self-esteem-depression path toward problematic internet use. CONCLUSIONS Dissatisfaction with physical appearance seems to have a significant role in individuals' immersing themselves in internet use.
Collapse
Affiliation(s)
- Beatrix Koronczai
- Institute of Psychology, Eotvos Lorand University, Budapest, Hungary
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Asiri S, Fallahi F, Ghanbari A, Kazemnejad-leili E. Internet addiction and its predictors in guilan medical sciences students, 2012. Nurs Midwifery Stud 2013; 2:234-9. [PMID: 25414864 PMCID: PMC4228546 DOI: 10.5812/nms.11626] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 04/25/2013] [Accepted: 04/26/2013] [Indexed: 12/01/2022] Open
Abstract
Background: Internet is one of the technologies of the modern era that is being extensively used around the world. It is believed that excessive Internet use can be pathological and addictive. Though, academic use of the Internet is primarily intended for learning and research, students are one of the groups at risk of Internet addiction. Objectives: Due to the expanding use of Internet among the university students, this study was conducted to examine the Internet addiction and its predictors among Guilan University of Medical Sciences students. Materials and Methods: A cross-sectional study was conducted on 583 students during the first semester of 2012. A two-stage stratified random sampling was conducted and a two-part instrument was used for data collection. The first part of the instrument was consisted of questions about demographic characteristics and the second part was the Young's Internet addiction inventory. Chi-square, Kruskal-Wallis testes, Spearman correlation coefficient and ranked logistic regression were used for data analysis. Results: About 5.7% of the students were moderately dependent to the Internet, while 44.1% were at risk for Internet addiction. Significant relationships were observed between the Internet addiction with age (P < 0.001), gender (P < 0.001), marital status (P < 0.001), major (P = 0.016), Grade point average (P = 0.017), semester of studying (P = 0.009) and student residence place (P = 0.014). However, no significant relationship was observed between the internet addiction score and level of discipline, parental job status and education level or the students’ accommodation. Conclusion: About half of the participants in this study were at risk of Internet addiction. This finding can be a warning sign for the authorities in universities to pay more attention to this issue. A wide range of education along with empowering programs may be needed to inform the university students about the advantages and disadvantages of internet and the correct manner of using it.
Collapse
Affiliation(s)
- Shahla Asiri
- Department of Community Health Nursing, Guilan University of Medical Sciences, Rasht, IR Iran
| | - Fatemeh Fallahi
- Department of Community Health Nursing, Guilan University of Medical Sciences, Rasht, IR Iran
- Corresponding author: Fatemeh Fallahi, Department of community health nursing, Guilan University of Medical Sciences, Rasht, IR Iran , Tel.: +98-3614460868, E-mail:
| | - Atefeh Ghanbari
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, IR Iran
| | | |
Collapse
|
36
|
Rodgers RF, Melioli T, Laconi S, Bui E, Chabrol H. Internet addiction symptoms, disordered eating, and body image avoidance. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2013; 16:56-60. [PMID: 23320871 DOI: 10.1089/cyber.2012.1570] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Internet addiction is an increasing concern among young adults. Self-presentational theory posits that the Internet offers a context in which individuals are able to control their image. Little is known about body image and eating concerns among pathological Internet users. The aim of this study was to explore the association between Internet addiction symptoms, body image esteem, body image avoidance, and disordered eating. A sample of 392 French young adults (68 percent women) completed an online questionnaire assessing time spent online, Internet addiction symptoms, disordered eating, and body image avoidance. Fourteen men (11 percent) and 26 women (9.7 percent) reported Internet addiction. Body image avoidance was associated with Internet addiction symptoms among both genders. Controlling for body-mass index, Internet addiction symptoms, and body image avoidance were both significant predictors of disordered eating among women. These findings support the self-presentational theory of Internet addiction and suggest that body image avoidance is an important factor.
Collapse
Affiliation(s)
- Rachel F Rodgers
- Center for Research on Psychopathology, Toulouse University-Le Mirail, Toulouse, France.
| | | | | | | | | |
Collapse
|
37
|
Wendt GW, Lisboa CSDM. Agressão entre pares no espaço virtual: definições, impactos e desafios do cyberbullying. ACTA ACUST UNITED AC 2013. [DOI: 10.1590/s0103-56652013000100005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
O presente artigo visa apresentar uma revisão da literatura sobre publicações teóricas e empíricas relacionadas ao processo de cyberbullying. Embora existam poucos estudos sobre o tema e haja carência de evidências empíricas na América Latina, o cyberbullying tem sido concebido enquanto uma categoria específica, única e sem precedentes de violência, podendo ser mais abrangente que o fenômeno bullying por ocorrer a qualquer momento e sem um espaço circunscrito e delimitado fisicamente. Os estudos mostram que vítimas de cyberbullying podem estar mais propensas a tentarem suicídio, bem como mais vulneráveis ao desenvolvimento de problemas sociais e emocionais, como a evasão escolar e desempenho acadêmico prejudicado. Além disso, as pesquisas mostram que os envolvidos neste fenômeno apresentam risco aumentado para abuso de substâncias psicoativas e desenvolvimento de sintomas de ansiedade e depressão quando comparados àqueles que não vivenciaram essa forma de agressão entre pares. Assim, aponta-se a importância de um debate atual sobre os aspectos relacionados à prevenção e intervenção em relação ao cyberbullying, envolvendo a família, a escola e também os responsáveis pelo desenvolvimento e execução de políticas públicas.
Collapse
|
38
|
Wei HT, Chen MH, Huang PC, Bai YM. The association between online gaming, social phobia, and depression: an internet survey. BMC Psychiatry 2012; 12:92. [PMID: 22839747 PMCID: PMC3545926 DOI: 10.1186/1471-244x-12-92] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 07/16/2012] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Online gaming technology has developed rapidly within the past decade, and its related problems have received increasing attention. However, there are few studies on the psychiatric symptoms associated with excessive use of online games. The aim of this study is to investigate the characteristics of online gamers, and the association between online gaming hours, social phobia, and depression using an internet survey. METHODS An online questionnaire was designed and posted on a popular online game websites, inviting the online gamers to participate the survey. The content of the questionnaire included demographic data, profiles of internet usage and online gaming, and self-rating scales of Depression and Somatic Symptoms Scale (DSSS), Social Phobia Inventory (SPIN), and Chen Internet Addiction Scale (CIAS). RESULTS A total of 722 online gamers with a mean age of 21.8 ± 4.9 years completed the online survey within one month. 601 (83.2%) participants were male, and 121 (16.8%) were female. The mean weekly online gaming time was 28.2 ± 19.7 hours, which positively associated with history of online gaming (r = 0.245, p < 0.001), total DSSS (r = 0.210, p < 0.001), SPIN (r = 0.150, p < 0.001), and CIAS (r = 0.290, p < 0.001) scores. The female players had a shorter history of online gaming (6.0 ± 3.1 vs. 7.2 ± 3.6 years, p = 0.001) and shorter weekly online gaming hours (23.2 ± 17.0 vs. 29.2 ± 20.2 hours, p = 0.002), but had higher DSSS (13.0 ± 9.3 vs. 10.9 ± 9.7, p = 0.032) and SPIN (22.8 ± 14.3 vs. 19.6 ± 13.5, p = 0.019) scores than the male players. The linear regression model showed that higher DSSS scores were associated with female gender, higher SPIN scores, higher CIAS scores, and longer weekly online gaming hours, with controlling for age and years of education. CONCLUSION The online gamers with longer weekly gaming hours tended to have a longer history of online gaming, and more severe depressive, social phobic, and internet addiction symptoms. Female online gamers had fewer weekly online gaming hours and a shorter previous online gaming history, but tended to have more severe somatic, pain, and social phobic symptoms. The predictors for depression were higher social phobic symptom, higher internet addiction symptoms, longer online gaming hours, and female gender.
Collapse
Affiliation(s)
- Han-Ting Wei
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Cheng Huang
- Department of Rehabilitation, Taipei Hospital, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, No.201, Sec. 2, Shipai Rd, Taipei City, Beitou District, Taiwan
| |
Collapse
|