Screen Violence and Youth Behavior

Night Screen Time is Associated with Cognitive Function in Healthy Young Adults: A Cross-Sectional Study

Background

In recent years, a significant shift toward remote work, virtual education, and social distancing measures was witnessed, thereby leading people to increasingly depend on digital devices for communication, work, and entertainment. This increased exposure to screens has raised concerns regarding its potential impact on cognitive function.

Purpose

This study investigated the relationship between screen time and cognitive function among healthy young adults.

Methods

One hundred forty-five healthy individuals (mean age 21.55 ± 2.84 years) participated in this cross-sectional study. Sociodemographic information including age, sex, height, weight, and level of education were obtained. Participants reported screen time using a screen time questionnaire. Cognitive function tests including, Paced Auditory Serial Addition Task (PASAT), Montreal Cognitive Assessment (MoCA) and Symbol Digit Modalities Test (SDMT) were conducted. Multilinear regression analyses were used to examine the associations between age, sex, level of education, screen time, and cognitive function.

Results

One hundred thirty-nine participants (76 women) completed the study. Increased night screen time, bachelor's educational level, and women were associated with lower PASAT scores (R2=0.258; p≤0.047). Moreover, increased night screen time was associated with lower MoCA scores (R2=0.029; p=0.035). However, no associations were found between night screen time and SDMT scores.

Conclusion

Participants who had higher night screen exposure had lower cognitive scores in the information speed processing, working memory, calculation, and attention domains. Considering these findings, this study emphasizes on the importance of setting a future recommended screen time guidelines for young adults as well as to promote healthy cognitive habits in order to preserve cognitive function and reduce the risk of developing neurodegenerative disease in the future. Future prospective cohort studies involving a more diverse age range is needed.

Problematic situations related to social media use and competencies to prevent them: results of a Delphi study

A three-round Delphi method was used to study the problematic situations that adolescents may encounter when using the social media, and the competencies needed to address these situations. A panel of Finnish experts (N = 22) provided an open-ended list of problematic situations and competencies in 2020-2021. These were then evaluated and ranked according to their significance. The experts provided an information-rich list of both problematic situations and competencies. Finally, 16 problematic situations and 19 competencies were ranked in order of importance by the experts. The most important problematic situations were direct and indirect cyberbullying and sexual harassment. The most important competencies were the ability to act responsibly, knowing what kinds of activity are prohibited, and knowing whom to contact on exposure to cyberbullying or harassment. The findings can be used in developing policies, recommendations, and solutions aimed at counteracting the harmful effects of social media on wellbeing during adolescence.

Superhero media, aggression, and prosocialness: Relations in adults and gender's moderating role

The present study aimed to observe the relationships between superhero media exposure, aggression, and prosocialness in adults. We also investigated gender's moderating role. A total of 700 Brazilians participated in the study (age mean =  25.77, SD = 8.63, SE = 0.32, 57% men). Results showed a positive relation between superhero media exposure, prosocialness (r = .18), and all aggression factors (physical: r = .13; verbal: r = .08; aggressive emotions: r = .16). Aggressive emotions mediated indirect effects of exposure (physical aggression: λ = 0.12, p < .01, 95% confidence interval [CI] = 0.05-0.21; verbal aggression: λ = 0.10, p < .01, 95% CI = 0.05-0.18). Finally, gender moderated the relationship between exposure and prosocialness (b = 0.13, t = 2.07, p = .03).

Examining correlates of aggression and mediating effect of psychological distress between exposure to media violence and aggression in lebanese adults

BACKGROUND

Violent media is the most consumed type of media in Lebanon. Many studies have linked exposure to media violence to increased aggression and psychological distress. As Lebanon is going through socio-political turmoil, we aimed to [1] explore the correlates of aggression (i.e., sociodemographic factors, BMI, loneliness, social competence, and psychological distress) in a sample of Lebanese adults from the general population, and [2] to examine the mediating effect of psychological distress in the association between exposure to media violence and aggression in this sample.

METHODOLOGY

Adults were recruited through online convenience sampling. We employed scales to assess content-based media exposure (C-ME), aggression (BPAQ-SF), psychological distress (DASS-8), loneliness (JGLS), and perceived social competence (PSCS).

RESULTS

Exposure to media violence was associated with all four aggression subtypes (verbal, physical, hostility, and anger). Psychological distress partially mediated all these associations; higher exposure to media violence was significantly associated with more psychological distress, which was significantly associated with higher levels of all types of aggression. Moreover, higher exposure to media violence was significantly associated with higher levels of all types of aggression.

CONCLUSION

In the sociopolitical context of Lebanon, violent media could be considered a public hazard. Psychological distress likely potentiates the association between exposure to violent media and aggression. Future research should focus on determining what components of psychological distress underpin this mediation.

High-Risk Gaming Is Associated with Frequent Substance Use: An Exploratory Survey among Young Adults

INTRODUCTION

Internet gaming disorder (IGD) is an emerging condition within the field of behavioural addictions. IGD has been demonstrated to be highly comorbid with many other mental health disorders. Among these, substance use has been associated with IGD, and there are underlying similarities between behavioural addictions and substance use disorders. The main aims of the present study were (i) to investigate the association between high-risk gaming and substance use among young adults drawn from the general Italian population; and (ii) to explore the psychopathological correlates of high-risk gaming.

METHODS

Lifetime substance use, type of substances consumed, and frequency of use were investigated through an online survey in a sample of 913 adults aged 18-40 years. High-risk gaming was assessed using the ten-item Internet Gaming Disorder Test (IGDT-10). Psychopathology was assessed using the Revised 90-item Symptom Checklist (SCL-90-R).

RESULTS

High-risk gaming prevalence rate was 4.4%. High-risk gamers scored higher on all dimensions of psychopathology, confirming the association between high-risk gaming and psychiatric distress. Regarding substance use, high-risk gamers were more commonly polysubstance users and more commonly made use of psychodysleptic substances. High-risk gamers were more commonly frequent substance users, and 32.5% of high-risk gamers used or had used psychoactive substances often or everyday throughout their lives.

DISCUSSION AND CONCLUSION

The findings are in line with the concept of a common neurobiological vulnerability for both gaming and substance use. There is the need for more research to examine the phenomenology of gaming and its interplay with substance use to help develop effective interventions and prevention strategies.

Prospective Associations Between Preschool Exposure to Violent Televiewing and Psychosocial and Academic Risks in Early Adolescent Boys and Girls

OBJECTIVE

Risks of early exposure to media violence remain unclear. This study examines typical early childhood violent media exposure and subsequent psychosocial and academic risks.

METHODS

Our longitudinal birth cohort comprised 978 girls and 998 boys. Child-reported and teacher-reported measures of adjustment at age 12 years were linearly regressed on parent-reported televised violence exposure at ages 3.5 and 4.5 years while adjusting for individual/family confounders.

RESULTS

For girls, preschool violent televiewing was associated with increases in emotional distress (b = 0.31; 95% confidence interval [CI], 0.13-0.49) and decreases in classroom engagement (b = -0.97; 95% CI, -1.55 to -0.40), academic achievement (b = -2.60; 95% CI, -3.48 to -1.72), and academic motivation (b = -0.58; 95% CI, -1.09 to -0.07) at age 12 years. For boys, preschool violent televiewing was associated with increases in emotionally distressed (b = 0.33; 95% CI, 0.13-0.53), inattentive (b = 0.25; 95% CI, 0.06-0.45), conduct disordered (b = 0.11; 95% CI, 0.00-0.21), and socially withdrawn behavior (b = 0.23; 95% CI, 0.05-0.40), as well as decreases in classroom engagement (b = -0.84; 95% CI, -1.57 to -0.12), academic achievement (b = -1.19; 95% CI, -2.15 to -0.23), and academic motivation (b = -0.58; 95% CI, -1.13 to -0.03) at age 12 years.

CONCLUSION

Compared with no preschool exposure, violent televiewing is associated with distinct and enduring psychosocial risks by early adolescence. Acknowledging such risks remains a pertinent health literacy target for pediatric professionals, parents, and communities.

Uptake and Acceptability of MyChoices: Results of a Pilot RCT of a Mobile App Designed to Increase HIV Testing and PrEP Uptake Among Young American MSM

Young men who have sex with men (YMSM) remain at disproportionate risk for HIV acquisition in the United States (US), yet use of evidence-based prevention strategies, including routine HIV testing and pre-exposure prophylaxis (PrEP), remain low. Smartphones and mobile app usage are nearly ubiquitous in this population. Given the potential for scalability, a mobile app to increase HIV testing and PrEP use among YMSM has the potential to make an extraordinary public health impact if efficacious. Based on extensive formative, community-engaged research, we developed a theory-driven mobile app-MyChoices-to increase HIV testing and PrEP uptake among YMSM. In a pilot randomized controlled trial (RCT), participants (n = 60) were randomized 2:1 to receive MyChoices or standard of care (SOC). Data from 3 to 6-month post-baseline assessments demonstrate that the app was highly acceptable (System Usability Score; mean = 75.8, SD = 10.7) and feasible (94% used the MyChoices app at least once; mean = 15.3 sessions, SD = 9.8). While not powered to assess efficacy, those in the MyChoices arm had 22% higher prevalence of HIV testing over follow-up compared to those in the SOC arm (NS). There was no difference in PrEP uptake. A fully-powered efficacy trial is warranted; if efficacy is demonstrated, the MyChoices app could be easily scaled to reach YMSM across the US.

Children's mobile-gaming preferences, online risks, and mental health

This study examined the relationships between children's mobile gaming preferences, online risks, and mental health. Data were obtained from a sample of 2,702 third and fourth grade students from 16 elementary schools in Taiwan and 9 schools in China. A self-administered questionnaire was used. The mental state of the children who participated in the study was assessed using the Strengths and Difficulties Questionnaire (SDQ), while mobile gaming addiction was assessed using the short form of the Internet Gaming Disorders Scale (IGDS9-SF). The results showed that about 54% of children played mobile games with others (multi-player), while 31% played mobile games alone, and 15% did not play mobile games. Multiple logistic regression results indicated that behaviors such as participating in multi-player games, playing violent games, a poor parent-child relationship, and living in a rural area were associated with a greater risk of mobile gaming addiction. Involvement in multi-player games, playing violent games, mobile gaming addiction, and exposure to mobile violence/pornography were associated with greater risks of cyber aggression/victimization. Multiple regression results showed that being a multi-player, playing violent games, mobile gaming addiction, exposure to violence/pornography, exposure to cyber aggression/victimization, and having a poor parent-child relationship were associated with emotional and behavioral problems.

Violent Media in Childhood and Seriously Violent Behavior in Adolescence and Young Adulthood

PURPOSE

To quantify the relative odds of self-reported seriously violent behavior in adolescence and young adulthood given one's self-reported violent media diet in childhood.

METHODS

Baseline data were collected nationally online from 1,586 youth 10-15 years of age in 2006. Follow-up data were collected in 2010-2011 and 2016. Children reported the amount of music, video games, television, websites with real people, and cartoons that depicted "physical fighting, hurting, shooting, or killing." Seriously violent behavior was assessed 5 and 10 years later.

RESULTS

887 adolescents completed the survey at baseline and 5-year follow-up. The relative odds of reporting seriously violent behavior over time were 2.45-fold higher (p < .001) with each incremental increase in one's baseline violent media diet. After adjusting for other potentially influential characteristics, results persisted (aOR = 1.70, p = .01). The relative odds also were elevated for those frequently exposed to violence in music (aOR = 3.28, p = .03), television (aOR = 3.51, p < .001), and video games (aOR = 3.27, p = .02). 760 young adults completed measures at baseline and 10-year follow-up. The relative odds of seriously violent behavior increased 2.18-fold (p = .001) with each incremental increase in one's baseline violent media diet. After adjusting for other factors, the association persisted (aOR = 1.72, p = .03). Frequent exposure to violence in video games (aOR = 3.28, p = .03) and television (aOR = 3.14, p = .02) also were implicated.

DISCUSSION

Exposure to violent media in childhood may be one modifiable influence on seriously violent behavior in adolescence and adulthood, even for those who have other risk factors.

Anti-anger Effects of Herbal Medicine: A Mini-Review of Rat Studies

OBJECTIVE

To analyze the available data on the anti-anger effects of herbal medicines (HMs) as well as their underlying mechanisms in rat models.

METHODS

From 6 electronic databases [PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang, Oriental Medicine Advanced Searching Integrated System (OASIS), and Research Information Sharing Service (RISS)], relevant animal experiments were searched by using "anger," "rats," and "animal" as search keywords. The last search was conducted on November 22, 2019, and all experiments involving rat models of anger and treatment using HMs published until the date of the search were considered.

RESULTS

A total of 24 studies with 16 kinds of HMs were included. Most studies have used the "tail irritating method" and "social isolation and resident intruder" method to establish anger models. According to the included studies, the therapeutic mechanisms of HMs for anger regulation and important herbs by their frequency and/or preclinical evidence mainly incladed regulation of hemorheology (Bupleuri Radix, Paeoniae Radix Alba, and Glycyrrhizae Radix), regulation of sex hormones (Bupleuri Radix, Cyperi Rhizoma, and Paeoniae Radix Alba), regulation of neurotransmitters (Cyperi Rhizoma), regulation of anger-related genes (Bupleuri Radix, Glycyrrhizae Radix, and Paeoniae Radix Alba), and other effects. Overall, Liver (Gan) qi-smoothing herbs including Bupleuri Radix and Cyperi Rhizoma were the most frequently used.

CONCLUSIONS

This review found the frequent methods to establish an anger model, and major mechanisms of anti-anger effects of HMs. Interestingly, some Liver qi-smoothing herbs have been frequently used to investigate the anti-anger effects of HM. These findings provide insight into the role and relevance of HMs in the field of anger management.

Gene-environment interactions between CREB1 and childhood maltreatment on aggression among male Chinese adolescents

Both the genetic and environmental factors may affect aggression susceptibility. However, the conclusions of these associations remain discrepant. In addition, studies that explored the association between CREB1 and aggression were meager. The aim of our present study was to assess whether CREB1 polymorphisms were related to aggression and also to explore the interactive effects of CREB1 variants and childhood maltreatment on aggression. A total of 488 individuals with aggressive behavior and 488 controls were recruited. Aggression and childhood maltreatment were surveyed by standardized self-administered questionnaires. Buccal cells were also obtained and genotyping was conducted using SNPscan. Logistic regressions were applied to investigate both individual effects of CREB1 polymorphisms and the interactive influences with childhood maltreatment on aggression. We found that adolescents who carried the rs4675690 T allele in CREB1 showed a higher level of aggression compared with those who carried wildtype genotypes (CC) under the dominant model (OR = 1.67, 95% CI, 1.16–2.40) after controlling for age and childhood maltreatment. Moreover, we also found that rs4675690 T allele had a synergic additive interaction with childhood sexual abuse and emotional neglect on aggression. The significant interactive effects of CREB1 polymorphisms and childhood maltreatment on aggression were reported for the first time.

Screen media use in hospitalized children: a prospective observational study

Screen media use in hospitalized children is more prevalent than such media use in a home setting. Research on characteristics and extent to which screen media are used in hospitalized children in addition to associated factors is scarce. This study aims to examine the duration and factors associated with screen media use in hospitalized children. From February to November 2020, a cross-sectional study was conducted in hospitalized children (age range 1-194 months, median age 44.5 (IQR 14-123.5) months) and their caregivers at a single tertiary care hospital using a media questionnaire combined with a thorough interview. Of 254 participants who were enrolled, 239 (94%) had been exposed to screen media in the hospital with a median duration of exposure of 6 (IQR 2-11) h/day. Children who used more than one screen media device (standardized beta (β) = 0.16, p < 0.001), having difficulty stopping media use (β = 0.16, p < 0.001), having lower numbers of positive discipline techniques over media use (β = 0.16, p = 0.001), and less media co-viewing with verbal interaction with their caregivers (β = 0.12, p = 0.004) were significantly associated with longer screen media use in a hospital setting.   Conclusion: Hospitalized children spent 6 h/day on screen media. Fostering positive discipline over media use and co-viewing with verbal interaction during screen time may minimize screen media overuse in hospitalized children. What is Known: • Screen media use in hospitalized children is often observed during ward rounds. • Hospitalized children had increased access to screen media in hospital rooms compared to their homes. What is New: • Difficulty stopping media use, having lower numbers of positive discipline techniques over media use, and less media co-viewing with caregivers were associated with longer screen media use in hospitalized children. • Fostering positive discipline over media use and verbal interaction from caregivers during media co-viewing may minimize screen media overuse in hospitalized children.

A Pilot RCT Evaluating InThistoGether, an mHealth HIV Prevention Program for Ugandan Youth

Despite data suggesting that older adolescence is an important period of risk for HIV acquisition in Uganda, tailored HIV prevention programming is lacking. To address this gap, we developed and tested nationally, InThistoGether (ITG), a text messaging-based HIV prevention program for 18-22 year-old Ugandan youth. To assess feasibility and acceptability, and preliminary indications of behavior change, a randomized controlled trial was conducted with 202 youth. Participants were assigned either to ITG or an attention-matched control group that promoted general health (e.g., self-esteem). They were recruited between December 2017 and April 2018 on Facebook and Instagram, and enrolled over the telephone. Between 5-10 text messages were sent daily for seven weeks. Twelve weeks later, the intervention ended with a one-week 'booster' that reviewed the main program topics. Measures were assessed at baseline and intervention end, 5 months post-randomization. Results suggest that ITG is feasible: The retention rate was 83%. Ratings for the content and program features met acceptability thresholds; program experience ratings were mixed. ITG also was associated with significantly higher rates of condom-protected sex (aIRR = 1.68, p < 0.001) and odds of HIV testing (aOR = 2.41, p = 0.03) compared to the control group. The odds of abstinence were similar by experimental arm however (aOR = 1.08, p = 0.86). Together, these data suggest reason for optimism that older adolescent Ugandans are willing to engage in an intensive, text messaging-based HIV prevention programming. Given its wide reach and low cost, text messaging should be better utilized as an intervention delivery tool in low-income settings like Uganda. Findings also suggest that ITG may be associated with behavior change in the short-term. (Trial registration: ClinicalTrials.gov ID# NCT02729337).

Screen time use impacts low-income preschool children's sleep quality, tiredness, and ability to fall asleep

BACKGROUND

Sleep is increasingly recognized as a vital part of health. Screen time has been linked to sleep quality in children. The purpose of this study was to analyze associations between screen time and sleep characteristics among low-income preschoolers.

METHODS

A total of 1,700 preschool-aged children participated in this study at 50 federally and state-funded preschool centers in Michigan. Baseline measurement for an ongoing longitudinal intervention trial was obtained for cross-sectional use. At baseline, parents reported the number of hours their child spent engaging in screen time on a typical week day and weekend. An aggregate measure of total screen time was created. Parents reported on the quality of their child's sleep, how often they were tired during the day, and whether they had difficulty falling asleep. A mixed model linear regression was created to analyze data.

RESULTS

Controlling for child's age, race, and parental income, children who engaged in more screen time were significantly more likely to have more trouble falling or staying asleep, be tired during the day, and had worse quality of sleep (P values = .004, .006 and .001, respectively). Spearman correlations of screen time, sleep variables and demographics show parents of Black children reported significantly higher weekly screen time than parents of non-Black children (r = 0.23, P < .001) and that tiredness was associated with Black race (r = 0.15, P < .001), Hispanic/Latino ethnicity (r = -0.14, P < .001), and parental education (r = 0.06, P = .016).

CONCLUSION

This report confirms prior associations between screen time and sleep reported in other pediatric populations. Further research is needed to confirm these results in other populations using more rigorous measures of screen time, sleep, and physical activity, as well as longitudinal assessments. Despite these limitations, findings suggest that interventions to help parents limit children's screen time and impact their sleep health merit investigation.

Effect of Implicit Prejudice on Intergroup Conflict: The Cognitive Processing Bias Perspective

Principles of intergroup conflict are a core issue in social psychology fields. Studies have found that social prejudice has a significant correlation with intergroup conflict, apart from the personal characteristics and the contextual factors. However, none of those studies concentrated on the triggering role of the prejudice to the social phenomena in Eastern culture. Accordingly, the dependent variable detection paradigms used in three experiments were the Emotional Stroop Task, the Lexical Decision Task (LDT), and the Story Completion Protocol (SCP), the present research took the patient-physician conflict in domestic China as the example to detect the effect of social prejudice on the attention selective bias, memory accessibility, and the explanation of attribution bias of the aggressive information processing during the triggering of patient-physician intergroup conflict. The result showed that there was social patient-physician prejudice dissociation, which means that implicit patient-physician prejudice was observed but explicit social prejudice was not. In addition, the implicit patient-physician prejudice priming had a significant effect on patients' reaction times of Emotional Stroop task and SCP, but no effect of LDT. It indicated that the implicit prejudice did not improve memory accessibility in the later stages of information processing, but rather triggered selective attention bias and hostile attribution bias in preceding stages. Such a conclusion supported the Interpretation-First Model of aggressive information processing.

Designing Evidence-Based Preventive Interventions That Reach More People, Faster, and with More Impact in Global Contexts

This article demonstrates the substantial similarities globally among preventive, evidence-based interventions (EBIs) designed to address HIV by providing four examples: an HIV family-focused intervention, the Community Popular Opinion Leader intervention, a South African maternal/child health program, and an EBI for sex workers in India. Each identified the key problems in the target population, utilized well-established social cognitive theories, created processes for engaging the target population, set standards for staff accountability, and included routine data collection to facilitate iterative program improvements over time. Building EBIs based on these common, robust features is an alternative design strategy to replication with fidelity. These components provide a road map for researchers, especially those using new technologies, and for local providers seeking to deliver EBIs that match their clients' and communities' needs. Technology platforms and community organizations may serve as resources for designers of the next generation of EBIs, offering an alternative to repeatedly validating the same interventions and replicating them with fidelity.

Transitions in aggression among children: Effects of gender and exposure to online violence

This study assessed aggression statuses and transitions among children and examined the effects that gender and exposure to online violence can exert on aggression. A sample of 2155 children recruited from 30 primary schools in Taipei, Taiwan completed surveys in both 2015 (5th grade) and 2016 (6th grade). Latent transition analysis (LTA) was performed, and the results identified three latent statuses of aggression: "None," "School aggression," and "Cyber-aggression." About 10% of children behaved aggressively. When in their 5th-grade year, boys were more likely than girls to be a school aggressor (6.48% vs. 4.04%) or a cyber-aggressor (2.37% vs. 1.64%). Among boys who originally were considered to be a school aggressor, 36.19% remained so, 58% renounced their school aggression status, and 5.81% became a cyber-aggressor. Among girls who originally were considered to be a cyber-aggressor, 22.23% remained so, 68.29% renounced their cyber-aggression status, and 9.48% became a school aggressor. Controlling for student's academic performance, household income, and parents' marital status, exposure to online violence was a statistically significant predictor of aggression status for both boys and girls. Children's exposure to online violence appeared to increase the risk of aggression.

Artificial intelligence against hate: Intervention reducing verbal aggression in the social network environment

This article presents a quasi-experimental intervention study designed to reduce the level of verbal aggression on a social networking service (Reddit). The interventions were based on three psychological mechanisms: induction of a descriptive norm, induction of a prescriptive norm, and empathy induction. Each intervention was generated using a communicating bot. Participants exposed to these interventions were compared with a control group that received no intervention. The bot-generated normative communications (both the ones priming descriptive and the ones priming prescriptive norms), as well as the empathizing intervention, reduced the proportion of verbal aggression posted by Reddit accounts. All three interventions proved effective in reducing verbal violence when compared with the control condition.

Evaluation of video game playing status in school-age children with various variables

Objective

Excessive video game playing has several health implications on children. In this study, we evaluate the factors related to video game use in school-aged children.

Material and Methods

This cross-sectional descriptive study included 160 children aged 6-8 years who applied to outpatient clinics at the Department of Pediatrics at Başkent University Hospital. Each parent completed a structured questionnaire including demographic information, video game use, average daily screen time, and parental habits and concerns about their children's screen use.

Results

The mean age of first video game use was (mean±SD) 2.8±1.1 years. The minimum age for playing video games was 1 year. Male children spent more time playing video games. Both parental age and maternal education level were higher in the group of video gamers compared with non-gamers (p<0.05). Average time spent playing video games was 2.7±1.6 hours/day. The group of video gamers had a considerably younger age for starting watching television and higher rates for other video gamers at home than non-gamers (p=0.036 and p<0001, respectively). The group of video gamers had significantly higher rates for having a computer, tablet, and game console at home compared with non-gamers (p<0.05).

Conclusions

Our study indicates a statistically significant relationship between the age of starting watching television, gender of child, parent's age, maternal education, and the categories of video gaming habits. Developing strategies toward avoiding early screen exposure in children should be taken into consideration, because it is directly related to video gaming habits in children.

ADHD symptoms and callous-unemotional traits as predictors of violent media use in adolescence

We investigated ADHD symptoms and CU traits as predictors of violent media use in adolescence, controlling for delinquency and ODD symptoms. The effects on of disinhibition and arousal to negative stimuli, core characteristics of ADHD symptoms and CU traits, and of gender were investigated. At age 15, 88 adolescents, 50 % boys reported on CU traits, ADHD symptoms and delinquency. Parents rated the adolescents' CU traits, ADHD- and ODD symptoms. At age 16, adolescents reported on their media habits and performed tests of disinhibition and arousal to negative stimuli. Boys had higher levels of CU traits and violent media use and girls had higher levels of arousal to negative pictures. CU traits and inattention symptoms predicted violent media use, the latter association applying only to boys, with CU traits being the strongest predictor. Low arousal to threat pictures explained variance in violent media use, above CU traits. Attraction to violent media seems affected by problem behaviors, with CU traits coming forth as especially important.

The Paradox of Interactive Media: The Potential for Video Games and Virtual Reality as Tools for Violence Prevention

Interactive media such as video games and virtual reality (VR) provide users with lived experiences that may be dangerous or even impossible in daily life. By providing interactive experiences in highly authentic, detail-rich contexts, these technologies have demonstrated measurable success in impacting how people think, feel, and behave in the physical world. At the same time, violent interactive media content has been historically connected with a range of antisocial effects in both popular press and academic research. Extant literature has established a small-but-statistically significant effect of interactive media violence on aggressive thoughts and behaviors, which could serve as a risk factor for interpersonal violence. However, left unexplored is the seemingly paradoxical claim that under some conditions, interactive media experiences might protect against interpersonal violence. Drawing on advances in media theory and research and the evolution of interactive media content and production practices, the current manuscript suggests ways in which interactive media violence may be leveraged to lower the likelihood of real-world violence experiences. For example, research on both violent and non-violent games has found that players can (a) express guilt after committing violent acts, (b) report reflective and introspective emotional reactions during gameplay, and (c) debate the morality of their actions with others. Regarding VR, studies have demonstrated that (a) witnessing physical violence in immersive spaces led participants to take the perspective of victims and better understand their emotional state and (b) controlled exposure to traumatic or violent events can be used for treatment. Broadly, studies into video games and VR demonstrate that the impact of actions in virtual worlds transfer into the physical worlds to influence (later) attitudes and behaviors. Thus, how these experiences may be potentially harnessed for social change is a compelling and open consideration, as are side-effects of such interventions on vulnerable groups. The current manuscript summarizes emerging research perspectives (as well as their limitations) to offer insight into the potential for interactive media violence to protect against real-world violence victimization and perpetration.

Parent-Child Discrepancies in Reports of Exposure to Violence/Pornography on Mobile Devices and the Impact on Children's Psychosocial Adjustment

This study assessed the discrepancies between reports from parents and children concerning children's exposure to violence/pornography on mobile devices and the impact on the psychosocial adjustment of children. Data were obtained from a sample of 2,230 parent-child dyads recruited from 16 elementary schools (1,140 dyads) in Taiwan and 9 schools (1,090 dyads) in China. A self-administered questionnaire was used. The results showed that about 30 percent of children reported being exposed to violence on mobile devices. Approximately 70 percent of their parents were unaware of their child's exposure to violence on mobile devices. About 16 percent of children reported exposure to pornography on mobile devices, and 80 percent of their parents were unaware of this exposure. Multinomial logistic regression results showed that after controlling for parent and child sociodemographic variables, factors related to parental unawareness of child exposure to violence on mobile devices included a child's ownership of mobile devices, smartphone/tablet use time, a lower level of parental understanding, and a residence in China or in a rural area, whereas the parent-child relationship and a child's smartphone/tablet use time were associated with parents who were unaware of their child's exposure to pornography. Multiple regression results showed that children who were living with household poverty, had a poor parent-child relationship, spent much time using a smartphone/tablet, and with parents who were unaware of their exposure to violence/pornography on mobile devices were more likely to have emotional and behavioral problems.

Unpacking Associations between Mood Symptoms and Screen Time in Preadolescents: a Network Analysis

Mounting evidence highlights the link between screen time and adolescent mood problems. However, there are several shortcomings to the extant literature: (1) this link is underexplored in preadolescents, (2) most existing studies look at mood problems using categorical diagnoses rather than from a symptom-level perspective, despite the heterogeneity within mood disorders, (3) few studies have simultaneously examined the links of mood symptoms with different types of screen time, and (4) family/child-level factors that have shown links to youth psychopathology are not typically considered. This study, for the first time, examined the relationships of mood symptoms with different types of screen time, while accounting for theoretically important factors-parental monitoring and the behavioral inhibition/activation systems (BIS/BAS)-in preadolescents aged 9 to 10 from 9986 families participating in the Adolescent Brain and Cognitive Development Study. Using mixed graphical models, we found that screen time involving age-inappropriate content was stably and significantly associated with various elevated mood symptoms, independent from other types of screen time, BIS/BAS, and parental monitoring. Additionally, age-inappropriate screen time was associated with increased overall symptom connectivity. Further, preadolescents engaged in high levels of age-inappropriate screen time reported different symptom profiles (i.e., differences in symptom centralities) from common pediatric mood problems. Our findings underline the multifaceted role (i.e., direct associations with symptoms, a moderator for symptom relationships, associations with distinct symptom profiles) of age-inappropriate screen time in preadolescent mood problems. These findings serve as foundations for future research that may facilitate early detection of preadolescents at risk of mood problems.

Does watching violent electronic and social media content lead to increased levels of aggression? A survey among adolescents in an urban slum of metropolitan Karachi

Objectives Increased levels of aggression and desensitization of adolescents has been witnessed as a result of exposure to violent social/electronic media content. It is imperative for policymakers to study such behavioral outcomes in order to make sound policies regarding media literacy. The objective of the study therefore was to assess relationship between violent electronic/social media exposure and level of aggression. Methods A cross sectional study was conducted among adolescents aged 9-19 years in peri-urban slum of Karachi. Content-based Media Exposure scale and Buss and Perry questionnaire, internationally validated tools were used to collect data. Level of aggression was the main outcome variable which was analyzed. Results Four hundred and twenty-two adolescents participated in the survey. Usage of television was significantly higher in the younger age group whereas the effect of watching violent content among the adolescents varied. It was observed that 153 (36.3%) respondents felt stressed and 24 (5.7%) felt aggressive after watching violent content on electronic and social media. The contents showing people who fight (39.6 ± 5.6, p-value<0.05), who steal (39.5 ± 7.5, p-value=<0.05) and destroyed someone else's belongings (40.6 ± 7.6, p-value=<0.05) had a significant effect on the level of aggression. Regression analysis predicted a strong positive association of exposure of violent content with level of aggression (β=0.43). Conclusions The usage of violent content on social and electronic media was popular among adolescents, and produced negative effects on the behavior of adolescents. Measures should be taken to introduce media literacy of the children in Pakistan, especially in the peri-urban slums.

A Mobile Game (Safe City) Designed to Promote Children's Safety Knowledge and Behaviors: Protocol for a Randomized Controlled Trial

Background

Children have high levels of curiosity and eagerness to explore. This makes them more vulnerable to danger and hazards, and they thus have a higher risk of injury. Safety education such as teaching safety rules and tips is vital to prevent children from injuries. Although game-based approaches have the potential to capture children’s attention and sustain their interest in learning, whether these new instructional approaches are more effective than traditional approaches in delivering safety messages to children remains uncertain.

Objective

The aim of this study is to test the effectiveness of a game-based intervention in promoting safety knowledge and behaviors among Hong Kong school children in Grades 4-6. It will also examine the potential effect of the game-based intervention on these children’s functioning and psychosocial difficulties.

Methods

This study comprises the development of a city-based role-playing game Safe City, where players are immersed as safety inspectors to prevent dangerous situations and promote safety behavior in a virtual city environment. The usability and acceptability tests will be conducted with children in Grades 4-6 who will trial the gameplay on a mobile phone. Adjustments will be made based on their feedback. A 4-week randomized controlled trial with children studying in Grades 4-6 in Hong Kong elementary schools will be conducted to assess the effectiveness of the Safe City game–based intervention. In this trial, 504 children will play Safe City, and 504 children will receive traditional instructional materials (electronic and printed safety information). The evaluation will be conducted using both child self-report and parent proxy-report data. Specifically, child safety knowledge and behaviors will be assessed by a questionnaire involving items on knowledge and behaviors, respectively, for home safety, road safety, and sport-related safety; child functioning will be assessed by PedsQL Generic Core Scales; and psychosocial difficulties will be assessed by the Strength and Difficulties Questionnaire. These questionnaires will be administered at 3 time points: before, 1 month, and 3 months after the intervention. Game usage statistics will also be reviewed.

Results

This project was funded in September 2019. The design and development of the Safe City game are currently under way. Recruitment and data collection will begin from September 2020 and will continue up to March 1, 2021. Full analysis will be conducted after the end of the data collection period.

Conclusions

If the Safe City game is found to be an effective tool to deliver safety education, it could be used to promote safety in children in the community and upgraded to incorporate more health-related topics to support education and empowerment for the larger public.

Trial Registration

ClinicalTrials.gov NCT04096196; https://clinicaltrials.gov/ct2/show/NCT04096196

International Registered Report Identifier (IRRID)

PRR1-10.2196/17756

Risk Factors for the Development of Aggressive Behavior From Middle Childhood to Adolescence: The Interaction of Person and Environment

In this article, I examine the development of aggressive behavior from middle childhood to adolescence as a result of the interaction between the person and the environment and discuss implications for intervention measures. Three main questions are addressed and illustrated by examples from recent research: What are intrapersonal risk factors for the development and persistence of aggressive behavior from middle childhood to adolescence? What factors in the social environment contribute to the development of aggressive behavior? How do individual dispositions and environmental risk factors interact to explain developmental trajectories of aggressive behavior?

Videogames and guns in adolescents: T ests of a bipartite theory

The possible role of video gaming in imprinting aggressive and specifically gun-related behaviors has been elusive, and findings regarding these associations have been inconsistent. I address this gap by proposing and testing a bipartite theory that can explain inconsistent results regarding the previously assumed linear association between videogames and gun-related behaviors. The theory suggests that this association follows a U-shape. It posits that at low levels of video gaming time, video gaming displaces gun-related behaviors and shelters adolescents by keeping them occupied and by reducing opportunities and motivation to acquire guns. However, at some level of gaming time (because most popular games adolescents play include violent aspects), the assumed imprinting of aggressive behaviors overpowers the positive displacement force, and this can trivialize and naturalize gun-carrying behaviors, and ultimately increase motivation to obtain and carry guns. I tested this theory with two national samples of American adolescents (n1 = 24,779 and n2 = 26,543, out of which 403 and 378, respectively, reported bringing a gun to school in the last month). Multiple analyses supported the proposed U-shaped association. These findings show that the moral panic over video games is largely unsubstantiated, especially among light to moderate gamers.

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I propose a U-shaped association between video-gaming and gun-related behaviors.

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At low levels of video gaming time, video gaming displaces gun-related behaviors.

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At high levels, it imprints gun-related behaviors and naturalizes them. Similar effects were not observed with regards to TV watching time.

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This can explain inconsistent past findings based on an assumed linear association.

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Moral panic over light to moderate video gaming is largely unsubstantiated.

Screen Time and Children with Autism Spectrum Disorder

BACKGROUND

Research is increasingly raising concerns regarding the negative consequences of children's use of screens.

SUMMARY

This article reviews the literature on the benefits and risks of screen time with attention to explaining possible reasons that children with autism are more at risk for the negative effects of screen time. Based on the science of learning literature, a framework for choosing appropriate digital media for children with autism is described. The 3-component framework considers the characteristics of the child, the context in which digital media are used, and the content of the media. Key Message: Using the framework, the speech-language pathologist will be better able to select appropriate digital media content for children with autism that is engaging (while not being distracting), encourages the child to be actively involved with the media, is meaningful in the child's life, and incorporates social interactions with others.

Twenty Questions (and Answers) About Media Violence and Cyberbullying

For decades, pediatricians have been concerned about the impact of media on the health and well-being of children and adolescents. Robust research has found an association between exposure to media violence and real-life aggression in children and teens. Other effects include desensitization, fear, and attitudes that violence is a means of resolving conflict. Ongoing research finds similar associations between exposure to video game violence and real-life attitude and behavior. Cyberbullying is an emerging threat to youth. Parents, pediatricians, schools, and government all have roles to play to mitigate the potential harmful effects of violent media on children and teens.

Anhedonia, screen time, and substance use in early adolescents: A longitudinal mediation analysis

INTRODUCTION

Screen time is associated with substance use risk among adolescents; however, less is known about the underlying factors that explain this association.

METHODS

This research examined anhedonia, a facet of depression noted by the reduced capacity to experience pleasure, as a mediating factor in the relationship between screen time (hours spent watching television, using internet, and/or playing video games outside of school) and substance use (alcohol and/or cigarettes). We used a longitudinal survey design among a sample of students aged 9-11 years in the 4th to 6th grades in Southern California, United States of America [N = 709 (354 males)].

RESULTS

Structural equation modeling (SEM) findings revealed longitudinal mediation effects of anhedonia on the association between screen time and substance use, while controlling for baseline screen time, baseline individual and peer substance use, race/ethnicity, and gender. Moderation analysis based on a multiple-group approach revealed that gender was not a significant moderator of this mediation pathway.

CONCLUSIONS

Adolescents may become desensitized and exhibit a blunted response to hedonic effects from increased screen time. This may result in increased anhedonia and greater risk for substance use through the need to compensate for the reduced experience of rewards. These findings have implications for future school-based substance use prevention and intervention programs.

Digital media: Promoting healthy screen use in school-aged children and adolescents

Digital media are integrated into the everyday lives of children and adolescents, with potential benefits and risks for learning, mental and physical health, and for social life. This statement examines the cognitive, psychosocial, and physical effects of digital media on school-aged children and adolescents, with a focus on family routines, context, and activities. Evidence-based guidance for clinicians and families involves four principles: healthy management, meaningful screen use, positive modelling, and balanced, informed monitoring of screen time and behaviours.

Will esports result in a higher prevalence of problematic gaming? A review of the global situation

BACKGROUND AND AIMS

Video gaming is highly prevalent in modern culture, particularly among young people, and a healthy hobby for the majority of users. However, in recent years, there has been increasing global recognition that excessive video gaming may lead to marked functional impairment and psychological distress for a significant minority of players. Esports is a variant of video gaming. It is a relatively new phenomenon but has attracted a considerable number of followers across the world and is a multimillion dollar industry. The aim of this briefing paper is to review the global situation on esports and related public health implications.

METHODS

A non-systematic review was conducted. Information obtained from the Internet and PubMed was collated and presented as genres of games, varieties and magnitudes of impacts, popularity, fiscal impact in monetary terms, government involvement, and public health implications.

RESULTS

There are several different kinds of esports but there was no clear categorization on the genre of games. Many tournaments have been organized by gaming companies across the world with huge prize pools, and some of these events have government support. Little information on the health effects associated with esports was identified.

DISCUSSION AND CONCLUSIONS

A majority of the sources of information were from commercial settings, and failed to declare conflicts of interest, which may result in a biased picture of the current situation. When gaming activity is being further promoted under the umbrella of esports, it seems reasonable to expect an increase in problematic gaming and thus increased prevalence of gaming disorder and hazardous gaming. With increasing demand for treatment services for gaming addition/disorder in different countries across the world, it is a significant public health concern. More empirically based research on this topic is needed.

Les médias numériques : la promotion d'une saine utilisation des écrans chez les enfants d'âge scolaire et les adolescents

Les médias numériques font partie du quotidien des enfants et des adolescents. Ils comportent des bienfaits potentiels et des risques pour leur apprentissage, leur santé mentale et physique et leur vie sociale. Le présent document de principes aborde les effets cognitifs, psychosociaux et physiques de ces médias sur les enfants d'âge scolaire et les adolescents, notamment sur les habitudes, le contexte et les activités de la famille. Les conseils fondés sur des données probantes destinés aux cliniciens et aux familles reposent sur quatre principes : une gestion saine, une utilisation constructive, un exemple positif et une surveillance équilibrée et éclairée du temps d'écran et des comportements s'y rapportant.

Positive and Negative Themes Depicted in Combat-Related Sports Films

Participation in boxing, mixed martial arts, and wrestling is extremely popular among children and adolescents. The objective of this study was to determine themes depicted in a select number of combat-related films. Twenty films were independently viewed and analyzed by 4 reviewers. The average number of positive and negative themes was 34.4 and 18.1 mean events/hour for all included films, respectively. The most common positive themes were “positive interactions with family/friends/fans,” “importance of mentorship,” and “positive interactions with a coach/trainer” (4.23, 3.63, and 3.06 mean events/hour, respectively). The most common negative themes were “choosing to do the wrong thing,” “negative interactions with family/friends/fans,” and “poor sportsmanship” (2.70, 2.00, and 1.58 mean events/hour, respectively). In conclusion, the co-viewing of combat-related films among pediatric athletes and their coaches/trainers and/or parents in order to focus on “teachable moments” may encourage the acquisition and development of positive themes and the avoidance and de-emphasis of negative themes.

Pathologic Use of Video Games and Motivation: Can the Gaming Motivation Scale (GAMS) Predict Depression and Trait Anxiety?

Videogaming is an increasingly prevalent activity among adolescents worldwide. The present study aimed at adapting the Gaming Motivation Scale (GAMS) to the Italian context, assessing its psychometric properties and verifying its sensitivity to predict depression and anxiety levels. From a sample of 1899 participants, a group of 388 adolescents who participated in the survey was divided into two subgroups of Heavy (HG, N = 188) and Light Gamers (LG, N = 200). A sub-sample of N = 172 adolescents also filled-in CESD and STAI to assess, respectively, depression and trait anxiety. Internal consistency and factorial structure of the Italian version of GAMS (GAMS-it) have been evaluated. Moreover, a latent regression structural equation model by predicting the CES-D and STAI scores with the GAMS-it factors has been carried out. GAMS-it has adequate validity and reliability levels, showing a very similar factorial structure to the original version. Therefore, this scale can be used to evaluate gaming motivation, which is useful for gaming motivation screening. Finally, it has been found that lower gaming motivation can be related to high level of depression and anxiety. The present findings provide a coherent picture, supporting the reliability and validity of the GAMS-it, that appears potentially useful in predicting anxiety and depression levels in a population of adolescents.

Hands Up! Atypical Defensive Reactions in Heavy Players of Violent Video Games When Exposed to Gun-Attack Pictures

Threatening cues and surrounding contexts trigger specific defensive response patterns. Posturography, a technique for measuring postural strategies, has been used to evaluate motor defensive reactions in humans. When exposed to gun pointed pictures, humans were shown to exhibit an immobility reaction. Short and long-term exposure to violent video games was shown to be a causal risk factor for increased violent and aggressive behavior. Assaultive violence with a gun is a major trigger for motor defensive reactions, and post-traumatic stress disorder (PTSD) is the most characteristic psychiatric sequelae. Recent studies point to links between PTSD symptoms and emotional shortfalls in non-clinical trauma-exposed samples. The present study investigated defensive reactions to gun threat and PTSD symptoms in heavy players of violent video games compared to non-players. Male university students were screened according to use of violent video games and divided in three groups: non-players, moderate players, and heavy players. Stimuli were pictures depicting a man pointing a gun directed at the participant. In matched control pictures, non-lethal objects replaced the gun. Posturography was recorded and PTSD symptoms were assessed. When exposed to the threat pictures, non-players exhibited the expected reduction in amplitude of body sway (immobility), heavy players presented atypical augmented amplitude of body sway, and moderate players showed intermediate reactivity. Heavy players presented a significant distinct reaction compared to non-players. They also scored significantly higher in PTSD symptoms than non-players. Disadvantageous defensive reactions and higher vulnerability to PTSD symptoms, revealed in the present study, add to other shortcomings for heavy players.

The relationships between video game experience and cognitive abilities in adolescents

Objectives: Video games are especially popular among adolescents and young adults as a form of entertainment and the amount of time spent playing video games has increased rapidly. The main objective of this study is to assess the effect of video games on cognitive functions in adolescents. Methods: An exploratory, cross-sectional study was employed to investigate cognitive function in adolescent video game players. Cognitive functions, including memory, attention, and executive functions, were evaluated in 46 adolescents who had been playing video games regularly for at least 1 h per day, 5 days per week, for at least a year, and 31 adolescents (who played video games <5 h per week) using cognitive function assessment tests. Other data, such as demographics, medical information, video game types, and time spent playing video games were collected by questionnaires. Results: No significant difference was detected between the groups in terms of age, gender, IQ levels, and sociodemographic variables. Our findings show that visual memory results were slightly better in the playing group. Moreover, in the group that plays video games regularly, the increase in daily time spent playing games significantly increased the total error value in the Stroop Test and total interference value in California Verbal Learning Test-Children's Version test. We also found that more time is spent on online games compared with traditional games. Conclusions: In this study, we emphasize the pathological and uncontrolled consumption of video games and the possible consequences of time spent playing games. Our findings indicate the need for more extensive research. Future research should address the various implications of video game play, especially between the potentially positive and negative effects of video games.

From Digital Mental Health Interventions to Digital "Addiction": Where the Two Fields Converge

Scientific literature from the last two decades indicates that, when it comes to mental health, technology is presented either as panacea or anathema. This is partly because researchers, too frequently, have planted themselves either in the field of digital mental health interventions (variably called "telepsychiatry", "digital therapeutics", "computerized therapy", etc.), or in that of the problems arising from technology, with little cross-fertilization between the two. Yet, a closer look at the two fields reveals unifying themes that underpin both the advantages and dangers of technology in mental health. This article discusses five such themes. First, the breakneck pace of technology evolution keeps digital mental health interventions updated and creates more potentially problematic activities, leaving researchers perennially behind, so new technologies become outdated by the time they are studied. Second, the freedom of creating and using technologies in a regulatory vacuum has led to proliferation and choice, but also to a Wild-West online environment. Third, technology is an open window to access information, but also to compromise privacy, with serious implications for online psychology and digital mental health interventions. Fourth, weak bonds characterize online interactions, including those between therapists and patients, contributing to high attrition from digital interventions. Finally, economic analyses of technology-enabled care may show good value for money, but often fail to capture the true costs of technology, a fact that is mirrored in other online activities. The article ends with a call for collaborations between two interrelated fields that have been-till now-mutually insular.

An Explanatory Model for the Relationship between Motivation in Sport, Victimization, and Video Game Use in Schoolchildren

(1) Background: Society is changing amazingly fast, and this is bringing about changes in the way that people spend their free time. In the 21st century, free time is increasingly spent using technological devices such as video games, thus increasing levels of sedentariness. The aim of the present study was to define an explanatory model for the problematic use of video games, physical activity, motivational climate in sports, and victimization in schoolchildren, and to analyze the relationships between these variables according to gender; (2) Methods: A total of 734 schoolchildren, of both sexes, participated in this research study. They were aged from 10 to 12 and lived in the province of Granada (Spain). The main instruments used were the questionnaires PMCSQ-2, PAQ-C, QERV, and SVS. A multigroup structural equation model was used, which had an excellent fit (χ² = 319.472; df = 72; p < 0.001; CFI = 0.962; NFI = 0.952; IFI = 0.962; RMSEA = 0.048); (3) Results: The practice of physical activity was related negatively and indirectly to the problematic use of video games ((r = −0.085, boys); (r = −0.081, girls)), and this in turn was related positively and directly to victimization ((r = 0.094, boys); (r = 0.174, girls)). Additionally, task climate was inversely related to the problematic use of video games for girls (r = −0.133), and ego climate was directly related to the use of these devices only with regard to boys (r = 0.250). (4) Conclusions: It must be noted that schoolchildren’s pathological use of video games is closely related to lower levels of physical activity. In addition, those motivational climates in sports that are oriented towards performance exacerbate this pathological behavior, which accentuates the importance of promoting motivational climates that are oriented towards tasks in schoolchildren.