Relationship between time spent playing internet gaming apps and behavioral problems, sleep problems, alexithymia, and emotion dysregulations in children: a multicentre study

Effects of a nurse-led play-based internet addiction prevention program in early adolescents: A randomized controlled study

OBJECTIVE

This study aimed to investigate the effectiveness of a play-based program on internet addiction severity, daily internet usage, and game-playing duration among early adolescents.

METHODS

The study employed a pretest-posttest randomized controlled design. Data were collected using the Adolescent Information Form, Internet Addiction Test, and Follow-up Form. The intervention group received a nurse-led play-based program, while the control group did not receive any intervention.

RESULTS

Before the program, the IAT scores, daily internet usage, and daily digital game playing time of the groups were similar. After the program, early adolescents' IAT scores, daily internet use, and daily digital game playing time were found to be significantly lower than the pre-program and control groups.

CONCLUSION

A nurse-led play-based program can be used for school-based prevention of internet addiction. However, further studies are needed to evaluate the long-term effects of these interventions on early adolescents at different stages.

Impaired sleep quality mediates the relationship between internet gaming disorder and conduct problems among adolescents: a three-wave longitudinal study

BACKGROUND

Research increasingly demonstrates a positive association between Internet Gaming Disorder (IGD) and conduct problems among adolescents. However, longitudinal data are limited, and the mediating mechanisms remain unclear. This study aimed to examine the predictive effect of IGD on conduct problems and explore the mediating role of impaired sleep quality.

METHOD

A cohort of 20,137 Chinese seventh- and tenth-grade students was recruited and assessed at three time points: November 2020 (T1), 2021 (T2), and 2022 (T3). IGD, conduct problems, and impaired sleep quality were measured using the Internet Gaming Disorder Scale Short Form, the Strengths and Difficulties Questionnaire, and the Pittsburgh Sleep Quality Index, respectively. Mediation analyses were conducted to evaluate the direct and indirect effect of IGD on conduct problems, with subgroup analyses based on sex and developmental stage.

RESULTS

IGD was found to be an independent risk factor for conduct problems both cross-sectionally and longitudinally. Impaired sleep quality partially mediated the relationship between IGD and conduct problems, accounting for approximately 17.3% of the total effect. Subgroup analyses revealed that the mediation effect of impaired sleep quality was more pronounced in early adolescents and varied by sex, with a stronger total and direct effect in boys.

CONCLUSIONS

These findings highlight the need for comprehensive interventions targeting both IGD and impaired sleep quality, tailored to specific sexes and developmental stages, to effectively reduce conduct problems.

Parental Phubbing Behavior and Adolescents' Online Gaming Time: The Mediating Role of Electronic Health Literacy

OBJECTIVE

The purpose of this study is to explore the relationship between parents' phubbing behavior and children's online gaming time. More importantly, we investigated the mediating role of electronic health literacy in this association.

METHODS

A total of 1200 questionnaires were sent out and 1130 effective questionnaires were returned, an effective recovery of 94.17%. As some students did not answer part of the EHL survey, eventually only 867 students were included in this study based on the selected independent variables and the degree of questionnaire completion. Both tools used for measuring parental phubbing and electronic health literacy passed confirmatory factor analyses. To analyze the mediating effect of electronic health literacy on parental phubbing behavior and online gaming time, 5000 datapoints were sampled using the Bootstrapping method.

RESULTS

The results indicated that parents' phubbing was positively related to their children's online gaming time, which was mediated by electronic health literacy, parental phubbing is positively and significantly correlated with electronic health literacy, and electronic health literacy is negatively and significantly correlated with online gaming time among adolescents.

CONCLUSIONS

Electronic health literacy partially mediates the relationship between parental phubbing behavior and adolescent online gaming time, and Chinese students' electronic health literacy is a two-dimensional structure consisting of health information acquisition and application. This study is the first empirical study to explore the relationship between parental phubbing behavior and the amount of time adolescents spend playing games online.

Investigating the mechanisms of internet gaming disorder and developing intelligent monitoring models using artificial intelligence technologies: protocol of a prospective cohort

BACKGROUND

Internet gaming disorder (IGD), recognized by the World Health Organization (WHO), significantly impacts adolescent mental and physical health. With a global prevalence of 3.05%, rates are higher in Asia, especially among adolescents and males. The COVID-19 pandemic has exacerbated IGD due to increased gaming time from isolation and anxiety. Vulnerable groups include adolescents with poor academic performance, introverted personalities, and comorbid mental disorders. IGD mechanisms remain unclear, lacking prospective research. Based on Skinner's reinforcement theory, the purpose of this study is to explore the mechanisms of IGD from individual and environmental perspectives, incorporating age-related changes and game features, and to develop intelligent monitoring models for early intervention in high-risk adolescents.

METHODS

This prospective cohort study will investigate IGD mechanisms in middle and high school students in Shenzhen, China. Data will be collected via online surveys and Python-based web scraping, with a 3-year follow-up and assessments every 6 months. Unstructured data obtained through Python-based web scraping will be structured using natural language processing techniques. Collected data will include personal characteristics, gaming usage, academic experiences, and psycho-behavioral-social factors. Baseline data will train and test predictive models, while follow-up data will validate them. Data preprocessing, normalization, and analysis will be performed. Predictive models, including Cox proportional hazards and Weibull regression, will be evaluated through cross-validation, confusion matrix, receiver operating characteristic (ROC) curve, area under the curve (AUC), and root mean square error (RMSE).

DISCUSSION

The study aims to understand the interplay between individual and environmental factors in IGD, incorporating age-related changes and game features. Active monitoring and early intervention are critical for preventing IGD. Despite limitations in geographic scope and biological data collection, the study's innovative design and methodologies offer valuable contributions to public health, promoting effective interventions for high-risk individuals.

Investigating the interplay between gaming disorder and functional impairments in professional esports gaming

The relationship between Gaming Disorder (GD) and the experience of functional impairments has received considerable theoretical attention in the recent past and current diagnostic approaches underscore the centrality of functional impairments as a requirement for GD diagnosis. However, there is limited empirical evidence illuminating the interplay between GD and functional impairments, particularly among specific vulnerable groups. The present study seeks to bridge this gap by investigating an English-speaking sample (N = 5198) comprising an age- and gender-matched group of Professional Gamers (PG, n = 2599) and Non-Professional Gamers (NPG, n = 2599) sub-sampled from a larger sample of 192,260 individuals. The results revealed that PG were at a greater risk for GD compared to NPG as the prevalence rate of GD among PG (3.31%) was significantly higher and almost doubled that of NPG (1.73%), with PG further exhibiting higher overall GD symptom-load and weekly time spent gaming compared to NPG. Furthermore, PG reported experiencing significantly higher frequency of gaming-related functional impairments compared to NPG, with the in particular affected areas for both PG and NPG being 'school and/or work', 'physical health', and 'family', with other key differences emerging in relation to other outcomes. Overall, the present findings show that not only GD symptom-load but also some functional impairment is higher in PG compared to NPG which highlights the need to develop and support prevention and intervention strategies for this at-risk population.

The relationship between alexithymia, emotion regulation, and sleep problems in school-aged children: A multicentric study

OBJECTIVES

Alexithymia, mood dysregulation, and sleep quality have complicated effects on children's development. The current study aimed to investigate the relationship between alexithymia, emotion regulation, psychiatric problems, and sleep problems among Egyptian school-aged children.

METHODS

A total of 564 Egyptian children, aged 6 to 14, were divided into two groups based on their total Children's Sleep Habits Questionnaire abbreviated score: group 1 (N = 300) with sleep problems and group 2 (N = 264) with non-sleep problems. Their parents completed the Strengths and Difficulties Questionnaire (SDQ) and subjectively assessed the children's emotions using the Children's Alexithymia Measure (CAM) and the Clinical Evaluation of Emotional Regulation-9 (CEER-9).

RESULTS

Males were more proportional in the sleep problems group than others. The sleep problem group was significantly younger and had a longer daily sleep duration than the non-sleep problem group. Alexithymia and emotion dysregulation had the highest mean in the sleep problem group. Furthermore, alexithymia, emotion dysregulation, emotion difficulty, conduct, and prosocial problems were the most significant contributing factors and risk factors for sleep problems in children.

CONCLUSION

Sleep problems in children were associated with younger male children with lengthy daily sleep duration and emotional, behavioural, and prosocial difficulties. Furthermore, alexithymia and emotion dysregulation are significant contributors and risk factors for sleep problems in school-aged children.

Prevalence of internet gaming addiction and its association with sleep quality in medical students

Background

In Asia, there are approximately 2.3 billion internet users. Addiction to internet gaming takes a multifaceted toll on an individual's physical and mental well-being, casting a long shadow over their daily endeavors and also their sleep cycle.

Aim

To study the prevalence of internet gaming addiction and how it affects sleep quality in medical students.

Materials and Methods

A cross-sectional study was performed with a sample size (n = 112) in the Government Medical College, Datia (M.P.), and data were collected using a semi-structured proforma including the Internet Gaming Disorder Scale and Mini Sleep Questionnaire in the study population.

Results

In the study population with age group 18-28 years (mean age: 21 ± 1.7 years), the majority of them belong to the Hindu religion (91.1%), nuclear family (66.1%), and urban community (75.9%). Most students (n = 74) had mild to moderate sleep difficulty related to internet gaming addiction, that is, 65.1%. The most common response was "sometimes" on the Internet Gaming Disorder Scale. A significant association was observed between gaming disorder and parameters of sleep mainly in waking up too early, daytime sleepiness, snoring, feeling tired, and headache upon waking up with gaming disorder.

Conclusion

Among medical students, gaming addiction is significantly associated with poor sleep quality. Steps need to be taken to promote healthy internet use to improve sleep quality and mitigate negative effects to avoid long-term health impacts.

Epilepsy and Attention Deficit Hyperactivity Disorder: Connection, Chance, and Challenges

Comorbidities are common in children with epilepsy, with nearly half of the patients having at least one comorbidity. Attention deficit hyperactivity disorder (ADHD) is a psychiatric disorder characterized by hyperactivity and inattentiveness level disproportional to the child’s developmental stage. The burden of ADHD in children with epilepsy is high and can adversely affect the patients’ clinical outcomes, psychosocial aspects, and quality of life. Several hypotheses were proposed to explain the high burden of ADHD in childhood epilepsy; the well-established bidirectional connection and shared genetic/non-genetic factors between epilepsy and comorbid ADHD largely rule out the possibility of a chance in this association. Stimulants are effective in children with comorbid ADHD, and the current body of evidence supports their safety within the approved dose. Nonetheless, safety data should be further studied in randomized, double-blinded, placebo-controlled trials. Comorbid ADHD is still under-recognized in clinical practice. Early identification and management of comorbid ADHD are crucial to optimize the prognosis and reduce the risk of adverse long-term neurodevelopmental outcomes. The identification of the shared genetic background of epilepsy and ADHD can open the gate for tailoring treatment options for these patients through precision medicine.

The moderating effect of alexithymia on the relationship between stress and cyberchondria

OBJECTIVES

The pandemic has increased the level of perceived stress and provided a fertile soil for Cyberchondria. This study aims to investigate the relationship between stress, cyberchondria, and alexithymia.

METHODS

This cross-sectional study used convenience sampling to carried out on a total 1,117 college students (female/male:536/581; mean age: 19.95 ± 1.32). Cyberchondria Severity Scale (CSS), Toronto Alexithymia Scale (TAS) and Short Depression Anxiety Stress Scales (DASS-21) were used to assessed the present study variables.

RESULTS

Significant differences emerged for CSS scores by gender (t = 3.74, p < 0.01) and had any comorbid disease (t = 2.47, p < 0.05), The Pearson correlation showed Cyberchondria has a significant positive correlation with stress and alexithymia (r = 0.50, p < 0.01, r = 0.36, p < 0.01). Furthermore, the regression analysis described that stress (β = 0.50, p < 0.01) and alexithymia (β = 0.36, p < 0.01) were the significant positive predictors of cyberchondria. Moreover, moderation analysis showed that alexithymia significantly strengthened the association between stress and cyberchondria (F = 107.20, p < 0.01).

CONCLUSION

The study will help medical practitioners to understand how stress and alexithymia can cause an increase in cyberchondria. This will help them to elaborate operational indications for prevention and psychological support.