Lateral orbitofrontal gray matter abnormalities in subjects with problematic smartphone use

Neuroanatomical and functional substrates of the short video addiction and its association with brain transcriptomic and cellular architecture

Short video addiction (SVA) has emerged as a growing behavioral and social issue, driven by the widespread use of digital platforms that provide highly engaging, personalized, and brief video content. We investigated the neuroanatomical and functional substrates of SVA symptoms, alongside brain transcriptomic and cellular characteristics, using Inter-Subject Representational Similarity Analysis (IS-RSA) and transcriptomic approaches. Behaviorally, we found that dispositional envy was associated with SVA. Structurally, SVA was positively correlated with increased morphological volumes in the orbitofrontal cortex (OFC) and bilateral cerebellum. Functionally, the dorsolateral prefrontal cortex (DLPFC), posterior cingulate cortex (PCC), cerebellum, and temporal pole (TP) exhibited heightened spontaneous activity, which was positively correlated with SVA severity. Transcriptomic and cellular analyses also showed specific genes linked to gray matter volume (GMV) associated with SVA, with predominant expression in excitatory and inhibitory neurons. These genes showed distinct spatiotemporal expression patterns in the cerebellum during adolescence. This study offers a comprehensive framework integrating structural, functional, and neurochemical evidence to highlight the neural-transcriptomic underpinnings of SVA symptoms in a non-clinical population.

Narrative Review of the Morphofunctional Underpinnings and Comprehensive Rehabilitation Strategies for Smartphone-addicted University Students

The widespread availability of mobile phones has contributed to a high prevalence of digital addiction worldwide. Smartphone addiction or problematic smartphone use (SA/PSU) has become a widespread issue, especially among university students. Due to concerns about SA/PSU and cyber addiction in young people, research has focused on the structural and functional effects on the brain and the behavioral consequences of spending too much time on mobile phones. This review investigates the impact of excessive smartphone use on this demographic group's physical and mental health. An advanced search on PubMed based on primary keywords, clustered in syntactic associations looked for academic work focusing on: ((((smartphone addiction) and (problematic smartphone use)) and (students) and (Physical exercises)) and (Physical Activity). The relationship (((smartphone addiction) and (problematic smartphone use) and (systematic review) identified 22 papers, published between 2016 and 2024, 16 of which were during the Covid era and post-pandemic periods (2020-2024). Smartphone overuse-induced alterations in cerebral gray matter were observed in four trials. The beneficial influence of physical activity on smartphone addiction was emphasized in 11 publications (selected 9) identified by the advanced search with the syntactic relationship. The narrative review offers a comprehensive overview of effective strategies for addressing SA/PSU. This includes utilizing exercise and psychological interventions to combat digital addiction. Furthermore, studies have looked into the potential benefits of physical exercise and specific strategies addressing these issues. Engaging in physical activity may help offset the negative effects of SA/PSU, and targeted strategies are necessary for preventing and treating these problems in young people. Political and educational decision factors must implement targeted strategies and integrated social education policies to prevent smartphone overuse and pejorative consequences in adolescents and young people.

Unveiling the grip of mobile phone addiction: an in-depth review

Mobile Phone Addiction represents an emergent addictive disorder that gravely jeopardizes the physical and mental health of adolescents worldwide, necessitating exhaustive research. Current reviews of MPA are in dire need of updates and enhancements. Therefore, this review aggregates the extant research spanning the past two decades on the prevalence, pathogenesis, comorbidities, assessment, and treatment of MPA, aiming to furnish a reference for future investigations into this condition.

Clinical Manifestations' Spectrum of Smartphone Addiction: Moving from an Addiction toward a Clinical Syndrome

Background

Smartphone addiction is an emerging type of addiction in the digital era, characterized by smartphone dependence that negatively affects human health with a wide range of psychological and physical manifestations.

Objective

This study aimed to evaluate the detailed clinical manifestations of smartphone addiction as a delineated clinical syndrome.

Methods

A cross-sectional study design was employed to assess smartphone addiction prevalence and its health impacts among Syrian undergraduates using the Smartphone Addiction Scale-Short Version (SAS-SV 2013), the Kessler psychological distress scale (K-6), and a comprehensive assessment of the clinical manifestations frequently linked to smartphone addiction in the literature. Different statistical modeling techniques were applied; a P value of < .05 was considered statistically significant.

Results

Of 1532 invited undergraduates, 1401 (91.45%) completed the assessment adequately. Most participants were females (59.7%) and below 23 years of age (73.2%). The prevalence of smartphone addiction was 67.80%; statistically significant smartphone addiction associations were revealed with psychological distress (P < .0001) with odds ratios of 3.308. Most screened physical manifestations also showed a significant association with smartphone addiction.

Conclusion

A high prevalence of smartphone addiction was observed with a broad spectrum of associated mental and physical manifestations. As smart device addiction becomes a global health concern, combining the clinical findings reported in the related literature into one clinical identity is necessary to develop a holistic management approach for the delineated clinical syndrome.

Comparative efficacy of different interventions on executive function in adolescents with internet use disorder

BACKGROUND

The formation and relapse of Internet use disorder (IUD) are related to the decline in executive function. Previous studies have indicated that exercise intervention and high-definition transcranial direct current stimulation (HD-tDCS) can improve the cognitive abilities of adolescents with IUD. However, the combined intervention's impact on executive function in these adolescents remains unclear. Therefore, this study aims to explore the effects and differences of multimodal exercise, HD-tDCS intervention, and combined intervention on the executive function of adolescents with IUD.

METHODS

Forty-eight adolescents with IUD were randomly assigned to the multimodal exercise group, HD-tDCS intervention group, combined intervention group, and control group. The intervention groups received 4 weeks of moderate-intensity multimodal exercise, HD-tDCS intervention (2 mA, 20min/session, 3 times/week), or combined multimodal exercise with HD-tDCS intervention. The control group received conventional educational learning. Executive function measurements were taken before intervention, after intervention, and 2 weeks post-intervention.

RESULTS

Compared to pre-intervention, different interventions effectively improved the behavioral performance of adolescents with IUD in executive function tasks. In comparison to single interventions, the combined intervention significantly outperformed multimodal exercise and HD-tDCS intervention in influencing the executive function (especially inhibitory control and working memory) in adolescents with IUD.

CONCLUSION

Combined multimodal exercise with HD-tDCS intervention proves to be an effective means of enhancing executive function in adolescents with IUD, particularly contributing to the improvement of explicit behavioral performance related to executive function.

Treatment readiness and prognosis for problematic smartphone use: Evaluation of the Stages of Change, Readiness, and Treatment Eagerness Scale (SOCRATES) and log data

Aim

While moderate smartphone use contributes to information gathering and relationship building, excessive smartphone use, also referred to as problematic smartphone use (PSU), has raised concerns because of its addictive nature and associated health consequences. This study aimed to investigate the relationship between treatment readiness and prognosis in individuals with PSU and to assess the predictive ability of smartphone log data in evaluating treatment readiness.

Methods

A sample of 47 patients with PSU participated in this study. Treatment readiness was assessed using the Stages of Change, Readiness, and Treatment Eagerness Scale (SOCRATES), and log data were collected using a smartphone log application.

Results

The results showed a significant correlation between baseline SOCRATES scores and the difference in Global Assessment of Functioning scores between baseline and 6 months (Spearman's ρ = 0.640, P-value = .001), suggesting that treatment readiness may explain part of the treatment outcomes (Pearson's r 2 = 0.379, P-value = 0.032). In addition, baseline log data, including the log acquisition rate, showed a positive correlation with treatment readiness (Spearman's ρ = 0.328, P-value = 0.045).

Conclusion

These findings provide valuable insights into the relationship between treatment readiness and clinical outcomes in patients with PSU, and suggest the potential of log data as objective indicators of treatment motivation.

A Systematic Review of Structural and Functional MRI Studies Investigating Social Networking Site Use

An understanding of the neurocognitive profile underlying the use of social networking sites (SNSs) can help inform decisions about the classification of problematic SNS use as an addictive disorder and elucidate how/when 'SNS addiction' might develop. The present review aimed to synthesize structural and functional MRI research investigating problematic/compulsive forms of SNS use or regular (non-addicted) SNS use behaviours. We conducted a systematic search for research articles published in English using the Web of Science, PubMed, and Scopus databases up to October 2022. Studies meeting our inclusion criteria were assessed for quality and a narrative synthesis of the results was conducted. Twenty-eight relevant articles were identified comprising structural MRI (n = 9), resting-state fMRI (n = 6) and task-based fMRI studies (n = 13). Current evidence suggests that problematic SNS use might be characterised by (1) reduced volume of the ventral striatum, amygdala, subgenual anterior cingulate cortex, orbitofrontal cortex and posterior insula; (2) increased ventral striatum and precuneus activity in response to SNS cues; (3) abnormal functional connectivity involving the dorsal attention network; (4) inter-hemispheric communication deficits. Regular SNS use behaviours appear to recruit regions involved in the mentalising network, the self-referential cognition network, the salience network, the reward network and the default mode network. Such findings are at least partially consistent with observations from the substance addiction literature and provide some provisional support for the addictive potential of SNSs. Nonetheless, the present review is limited by the small number of eligible studies and large heterogeneity in the methods employed, and so our conclusions should remain tentative. Moreover, there is a lack of longitudinal evidence suggesting SNSs cause neuroadaptations and thus conclusions that problematic SNS use represents a disease process akin to substance use addictions are premature. More well-powered longitudinal research is needed to establish the neural consequences of excessive and problematic SNS use.

Neuroimaging the effects of smartphone (over-)use on brain function and structure-a review on the current state of MRI-based findings and a roadmap for future research

The smartphone represents a transformative device that dramatically changed our daily lives, including how we communicate, work, entertain ourselves, and navigate through unknown territory. Given its ubiquitous availability and impact on nearly every aspect of our lives, debates on the potential impact of smartphone (over-)use on the brain and whether smartphone use can be "addictive" have increased over the last years. Several studies have used magnetic resonance imaging to characterize associations between individual differences in excessive smartphone use and variations in brain structure or function. Therefore, it is an opportune time to summarize and critically reflect on the available studies. Following this overview, we present a roadmap for future research to improve our understanding of how excessive smartphone use can affect the brain, mental health, and cognitive and affective functions.

Reduced left dorsolateral prefrontal activation in problematic smartphone users during the Stroop task: An fNIRS study

Introduction

The widespread use of smartphones has triggered concern over problematic smartphone use (PSPU), as well as the need to elucidate its underlying mechanisms. However, the correlation between cortical activation and deficient inhibitory control in PSPU remains unclear.

Methods

This study examined inhibitory control using the color-word matching Stroop task and its cortical-activation responses using functional near-infrared spectroscopy (fNIRS) in college students with PSPU (n = 56) compared with a control group (n = 54).

Results

At the behavioral level, Stroop interference, coupled with reaction time, was significantly greater in the PSPU group than in the control group. Changes in oxygenated hemoglobin (Oxy-Hb) signals associated with Stroop interference were significantly increased in the left ventrolateral prefrontal cortex, left frontopolar area, and bilateral dorsolateral prefrontal cortex (DLPFC). Moreover, the PSPU group had lower Oxy-Hb signal changes associated with Stroop interference in the left-DLPFC, relative to controls.

Discussion

These results provide first behavioral and neuroscientific evidence using event-related fNIRS method, to our knowledge, that college students with PSPU may have a deficit in inhibitory control associated with lower cortical activation in the left-DLPFC.

Structural and Functional Neural Correlates in Individuals with Excessive Smartphone Use: A Systematic Review and Meta-Analysis

Background: Despite known association of internet addiction with a reduced brain volume and abnormal connectivity, the impact of excessive smartphone use remains unclear. Methods: PubMed, Embase, ClinicalTrial.gov, and Web of Science databases were systematically searched from inception to July 2022 using appropriate keywords for observational studies comparing differences in brain volumes and activations between excessive smartphone users and individuals with regular use by magnetic resonance imaging. Results: Of the 11 eligible studies retrieved from 6993 articles initially screened, seven and six evaluated brain volumes and activations, respectively. The former enrolled 421 participants (165 excessive smartphone users vs. 256 controls), while the latter recruited 276 subjects with 139 excessive smartphone users. The results demonstrated a smaller brain volume in excessive smartphone users compared to the controls (g = −0.55, p < 0.001), especially in subcortical regions (p < 0.001). Besides, the impact was more pronounced in adolescents than in adults (p < 0.001). Regression analysis revealed a significant positive association between impulsivity and volume reduction. Regarding altered activations, the convergences of foci in the declive of the posterior lobe of cerebellum, the lingual gyrus, and the middle frontal gyrus were noted. Conclusions: Our findings demonstrated a potential association of excessive smartphone use with a reduced brain volume and altered activations.

Impact of smartphone overuse on 1-year severe depressive symptoms and momentary negative affect: Longitudinal and experience sampling findings from a representative epidemiological youth sample in Hong Kong

Smartphone overuse can have detrimental impacts on youth mental health. How it may be longitudinally associated with depressive symptoms and functioning, and with daily momentary affect, remains to be investigated. A total of 3,033 young people were consecutively recruited from a large-scale epidemiological youth mental health study in Hong Kong. A subsample (n = 936) was followed-up after 1 year, with experience sampling data collected from 177 participants. Separate multivariable logistic regression models were applied to examine the prospective associations between smartphone overuse and depressive symptoms, with multilevel models fitted to examine its associations with momentary affect. The prevalence of smartphone overuse in the Hong Kong youth population was 29.3%. Smartphone overuse was significantly associated with more depressive symptoms and functional impairments both cross-sectionally and longitudinally. The associations between smartphone overuse and 1-year depressive symptoms were significant, even when accounting for baseline symptoms, social media use, and other risk and protective factors. Baseline depressive symptoms, in contrast, were not associated with 1-year smartphone overuse after adjusting for baseline smartphone overuse. Smartphone overuse was also significantly associated with higher levels of momentary negative affect, even when accounting for depressive symptoms. Strategies to mitigate the impact of smartphone overuse can have important long-term implications.

Neural Correlates of Physical Activity Moderate the Association Between Problematic Mobile Phone Use and Psychological Symptoms

Background

Despite the evidence of an association between problematic mobile phone use (PMPU) and psychological symptoms, a few studies explore whether physical activity (PA) could moderate the effect of PMPU on psychological symptoms and its neural substrates. The aim of this study was to examine the association between PMPU and psychological symptoms in late adolescents, along with the potential moderating effect of PA and neural basis by brain gray matter volume (GMV).

Methods

A total of 251 college students reported on their PMPU, PA, and psychological symptoms and subsequently underwent structural magnetic resonance imaging to explore the neural basis of their PA characteristics. A multiple regression model was performed to detect brain GMV associated with PA by the voxel-based morphometry (VBM) method. Moderating analysis was conducted using PROCESS macro in the SPSS software.

Results

Behavioral results showed that PMPU was correlated to depression, anxiety, and stress, and PA has significantly moderated the association between PMPU with depression, anxiety, and stress. The VBM analysis showed that PA was correlated to GMV of the right fusiform gyrus (FFG), left precuneus (PCUN), left insula (INS), and left triangular part of inferior frontal gyrus (IFGtriang). Moreover, GMV of the left INS moderated the relationship between PMPU and depression.

Conclusion

This study has shed light on the neural perspective of PA that moderates the relationship between PMPU and depressive symptom.

Functional connectivity between the parahippocampal gyrus and the middle temporal gyrus moderates the relationship between problematic mobile phone use and depressive symptoms: Evidence from a longitudinal study

BACKGROUND AND AIM

Problematic mobile phone use (PMPU) is prevalent and increases the risk for a variety of health problems. However, few studies have explored the neural mechanisms that might render adolescents more or less vulnerable. Here, we aimed to identify whether PMPU is associated with depressive symptoms and whether this relationship is moderated by intrinsic functional connectivity (iFC) which is associated with PMPU.

METHODS

In this longitudinal study, we included 238 students (mean age = 19.05, SD = 0.81) that came from a university in Hefei, China. They all finished MRI scans at baseline and completed questionnaires both at baseline and 1 year later. A self-rating questionnaire for adolescent problematic mobile phone use and depression anxiety stress scale-21 were used to assess PMPU and depressive symptoms. We first assessed the relationship between PMPU and depressive symptoms using an autoregressive cross-lagged model. Then, we detected the brain regions that were associated with PMPU. Moreover, the neuroimaging results were extracted to explore whether the iFC of these brain regions moderated the relationship between PMPU and depression.

RESULTS

Consistent with our hypotheses, PMPU was positively associated with depressive symptoms, and the relationship between PMPU and depressive symptoms was moderated by iFC of the left parahippocampal gyrus-right middle temporal gyrus both at baseline and after 1 year (β = 0.554, P = 0.003; β = 0.463, P = 0.016, respectively).

CONCLUSIONS

These results advance the understanding of PMPU and suggest that iFC of the left parahippocampal gyrus-right middle temporal gyrus may be a neurobiological contributor to its relationship with depressive symptoms.

Structural gray matter differences in Problematic Usage of the Internet: a systematic review and meta-analysis

Problematic Usage of the Internet (PUI) has been linked to diverse structural gray matter changes in individual data studies. However, no quantitative synthesis across studies has been conducted. We aimed to identify gray matter regions showing significant spatial convergence across neuroimaging studies in PUI. We searched PubMed and PsycINFO up to 10/03/2021 and included original, cross-sectional comparative studies that examined structural gray matter imaging in PUI versus control groups; reported a whole-brain analysis; and provided peak coordinates for gray matter differences. From a total of 624 potentially relevant studies, 15 (including 355 individuals with PUI and 363 controls) were included in a meta-analysis of voxel-based morphometry studies. Anatomical likelihood estimation (ALE) meta-analysis was performed using extracted coordinates and identified significant spatial convergence in the medial/superior frontal gyri, the left anterior cingulate cortex/cingulate gyrus, and the left middle frontal/precentral gyri. Datasets contributing to these findings all indicated reduced gray matter in cases compared to controls. In conclusion, voxel-based morphometric studies indicate replicable gray matter reductions in the dorsolateral prefrontal cortex and anterior cingulate cortex in PUI, regions implicated in reward processing and top-down inhibitory control. Further studies are required to understand the nature of gray matter differences across PUI behaviors, as well as the contribution of particular mental health disorders, and the influence of variation in study and sample characteristics.

Altered resting-state functional connectivity of the dorsal anterior cingulate cortex with intrinsic brain networks in male problematic smartphone users

The excessive use of smartphones is associated with various medical complications and mental health problems. However, existing research findings on neurobiological mechanisms behind problematic smartphone use are limited. In this study, we investigated functional connectivity in problematic smartphone users, focusing on the default mode network (DMN) and attentional networks. We hypothesized that problematic smartphone users would have alterations in functional connectivity between the DMN and attentional networks and that such alterations would correlate with the severity of problematic smartphone use. This study included 30 problematic smartphone users and 35 non-problematic smartphone users. We carried out group independent component analysis (group ICA) to decompose resting-state functional magnetic resonance imaging (fMRI) data into distinct networks. We examined functional connectivity using seed-to-seed analysis and identified the nodes of networks in group ICA, which we used as region of interest. We identified greater functional connectivity of the dorsal anterior cingulate cortex (dACC) with the ventral attention network (VAN) and with the DMN in problematic smartphone users. In seed-to-seed analysis, problematic smartphone users showed atypical dACC-VAN functional connectivity which correlated with the smartphone addiction proneness scale total scores. Our resting-state fMRI study found greater functional connectivity between the dACC and attentional networks in problematic smartphone users. Our findings suggest that increased bottom-up and interoceptive attentional processing might play an important role in problematic smartphone use.

Smartphone Addiction and Associated Health Outcomes in Adult Populations: A Systematic Review

BACKGROUND

Smartphones play a critical role in increasing human-machine interactions, with many advantages. However, the growing popularity of smartphone use has led to smartphone overuse and addiction. This review aims to systematically investigate the impact of smartphone addiction on health outcomes.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to carry out the systematic review. Five electronic databases including Medline, Web of Science, PsycINFO, PubMed, and Scopus were searched to identify eligible studies. Eligible studies were screened against predetermined inclusion criteria and data were extracted according to the review questions. This review is registered in PROSPERO (CRD42020181404). The quality of the articles was assessed using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

RESULTS

A total of 27 of 2550 articles met the inclusion criteria. All of the studies were cross-sectional and focused on physical, mental, and neurological health outcomes. The majority of the studies focused on mental health outcomes and consistent associations were observed between smartphone addiction and several mental health outcomes. Anxiety and depression were commonly found to mediate mental health problems. A wide range of physical health sequelae was also associated with smartphone addiction. Furthermore, there was an association between smartphone addiction and neurological disorders.

CONCLUSIONS

Our findings suggest that there are consistent associations between smartphone addiction and physical and mental health, especially mental health. Social awareness campaigns about smartphone addiction and its impact on physical and mental health are needed. Further studies, especially randomized controlled trials, are warranted to validate the impacts of smartphone addiction.

Anxiety sensitivity mediates relations between anxiety (but not depression) and problematic smartphone use severity, adjusting for age and sex, in Chinese adolescents early in the COVID-19 pandemic

Risk factors for problematic smartphone use (PSU) have rapidly become an important area of research due to the prevalence of smartphones and functional impairment associated with PSU. Our aim was to examine relations between established predictors of PSU (depression and anxiety) and a potential mediator of PSU (anxiety sensitivity; AS). Participants (N = 4752) from junior and senior high schools in Tianjin, China completed a web‐based survey with measures of depression, anxiety, AS, and PSU. Descriptive and inferential analyses revealed significant differences between males and females on depression severity, and between junior and senior high school students on AS and PSU severity. Results of structural equation modeling indicated that anxiety was positively associated with AS when adjusting for depression; and AS was significantly associated with greater PSU severity, adjusting for age and sex. Additionally, AS mediated relations between anxiety and PSU severity. Current findings on AS are consistent with theoretical models of problematic internet use (Interaction of Person‐Affect‐Cognition‐Execution) and previous research linking AS to other kinds of behavioral addictions (e.g., smoking, alcohol use).

Reduced Volume of a Brainstem Substructure in Adolescents with Problematic Smartphone Use

Objectives

Despite the growing concern regarding the adverse effects related to problematic smartphone use (PSU), little is known about underlying morphologic changes in the brain. The brainstem is a deep brain structure that consists of several important nuclei associated with emotions, sensations, and motor functions. In this study, we sought to examine the difference in the volume of brainstem substructures among adolescents with and without PSU.

Methods

A total of 87 Korean adolescents participated in this study. The PSU group (n=20, age=16.2±1.1, female:male=12:8) was designated if participants reported a total Smartphone Addiction Proneness Scale (SAPS) score of ≥42, whereas the remaining participants were assigned to the control group (n=67, age=15.3±1.7, female:male=19:48). High-resolution T1 magnetic resonance imaging was performed, and the volume of each of the four brainstem substructures [midbrain, pons, medulla, and superior cerebellar peduncle (SCP)] was measured. Analysis of covariance was conducted to reveal group differences after adjusting for effects of age, gender, whole brain-stem volume, depressive symptoms, and impulsivity.

Results

The PSU group showed a significantly smaller volume of the SCP than the control group (F=8.273, p=0.005). The volume of the SCP and the SAPS score were negatively correlated (Pearson’s r=-0.218, p=0.047).

Conclusion

The present study is the first to reveal an altered volume of the brainstem substructure among adolescents with PSU. This finding suggests that the altered white matter structure in the brainstem could be one of the neurobiological mechanisms underlying behavioral changes in PSU.

A Systematic Review of Prevention and Intervention Strategies for Smartphone Addiction in Students: Applicability During the COVID-19 Pandemic

"During this coronavirus (COVID-19) pandemic, smartphones play an important role in online classes, study, and entertainment. However, excessive use may lead to smartphone addiction (SPA). The incidence of SPA among students has increased with the spread of COVID-19 and threatens to impair home-based students’ learning efficiency and physical and mental health. This study aimed to provide a comprehensive overview of the latest achievements in SPA prevention and treatment, and a theoretical basis for future experimental research and clinical treatment, while considering their applicability during the current pandemic. We researched the core literature in Chinese, English, and Korean databases from 2000 to 2021; 3208 articles were identified. After reading the titles, abstracts, and full texts, 53 articles were selected. Research on SPA interventions was relatively limited; we identified six types of prevention and treatment measures: psychotherapies, cognitive training, behavioral intervention, application restriction, social intervention, and complementary and alternative medicine. They can be implemented by students, parents, or online experts. Future research should focus on developing early measures to identify and prevent SPA and enhance students’ change motivation."

Anterior cingulate gyrus acts as a moderator of the relationship between problematic mobile phone use and depressive symptoms in college students

This study aimed to investigate the brain grey matter volume (GMV) related to problematic mobile phone use (PMPU), and whether these regions of GMV play a potential moderating role in the relationship between PMPU and depressive symptoms. We recruited 266 students who underwent magnetic resonance imaging (MRI) scanning. PMPU and depressive symptoms were assessed by a self-rating questionnaire for adolescent PMPU and patient health questionnaire-9, respectively. A multiple regression model was performed to detect GMV and white matter (WM) integrity associated with PMPU by voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) methods, and the moderating analysis was conducted by PROCESS using SPSS software. VBM analysis found an inverse correlation between the GMV of the anterior cingulate gyrus (ACC) and right fusiform gyrus (FFG) with PMPU (P_FDR < 0.05), and TBSS analysis revealed that fractional anisotropy (FA) in the body of the corpus callosum was negatively correlated with PMPU. The correlation between PMPU and depressive symptoms was moderated by the GMV of the ACC. These results suggest that the GMV of the ACC and right FFG, as well as FA in the body of the corpus callosum, was related to PMPU, and we further found that increased GMV of the ACC could reduce the relationship between PMPU and depressive symptoms in college students.

Identifying Internet Addiction and Evaluating the Efficacy of Treatment Based on Functional Connectivity Density: A Machine Learning Study

Although mounting neuroimaging studies have greatly improved our understanding of the neurobiological mechanism underlying internet addiction (IA), the results based on traditional group-level comparisons are insufficient in guiding individual clinical practice directly. Specific neuroimaging biomarkers are urgently needed for IA diagnosis and the evaluation of therapy efficacy. Therefore, this study aimed to develop support vector machine (SVM) models to identify IA and assess the efficacy of cognitive behavior therapy (CBT) based on unbiased functional connectivity density (FCD). Resting-state fMRI data were acquired from 27 individuals with IA before and after 8-week CBT sessions and 30 demographically matched healthy controls (HCs). The discriminative FCDs were computed as the features of the support vector classification (SVC) model to identify individuals with IA from HCs, and the changes in these discriminative FCDs after treatment were further used as features of the support vector regression (SVR) model to evaluate the efficacy of CBT. Based on the informative FCDs, our SVC model successfully differentiated individuals with IA from HCs with an accuracy of 82.5% and an area under the curve (AUC) of 0.91. Our SVR model successfully evaluated the efficacy of CBT using the FCD change ratio with a correlation efficient of 0.59. The brain regions contributing to IA classification and CBT efficacy assessment were the left inferior frontal cortex (IFC), middle frontal cortex (MFC) and angular gyrus (AG), the right premotor cortex (PMC) and middle cingulate cortex (MCC), and the bilateral cerebellum, orbitofrontal cortex (OFC) and superior frontal cortex (SFC). These findings confirmed the FCDs of hyperactive impulsive habit system, hypoactive reflecting system and sensitive interoceptive reward awareness system as potential neuroimaging biomarkers for IA, which might provide objective indexes for the diagnosis and efficacy evaluation of IA.

Excessive Smartphone Use Is Associated With Health Problems in Adolescents and Young Adults

Background and Aims: This present paper will review the existing evidence on the effects of excessive smartphone use on physical and mental health. Results: Comorbidity with depression, anxiety, OCD, ADHD and alcohol use disorder. Excessive smartphone use is associated with difficulties in cognitive-emotion regulation, impulsivity, impaired cognitive function, addiction to social networking, shyness and low self-esteem. Medical problems include sleep problems, reduced physical fitness, unhealthy eating habits, pain and migraines, reduced cognitive control and changes in the brain's gray matter volume. In Conclusion: Excessive smartphone use is associated with psychiatric, cognitive, emotional, medical and brain changes that should be considered by health and education professionals.

Altered functional connectivity of the dorsal attention network among problematic social network users

Many smartphone users spend excessive amounts of time online and cannot control their behavior, and the addictive overuse of social-networking services has been shown to be associated with diminished executive control. Attentional control is a cognitive process crucial to exerting executive functions. The purpose of this study was to investigate functional connectivity (FC) characteristics of attention networks in problematic social-network users. We performed seed-based resting-state FC analyses for 29 males and 10 females with excessive social network use and 32 healthy males and 17 healthy females. The right intraparietal sulcus and frontal eye fields were considered seeds of the dorsal attention network (DAN), and the right temporoparietal junction and ventral frontal cortex were considered seeds of the ventral attention network (VAN). Clinical characteristics predictive of FC findings in problematic social network users were identified through hierarchical multiple regression analysis. In FC analysis with DAN seeds, FC between the right intraparietal sulcus and the right middle occipital gyrus was stronger in problematic social network users than in controls, and FC between the right frontal eye field and the right dorsolateral prefrontal cortex was weaker than that in controls. There was no significant difference between the groups in FC analysis with VAN seeds. Hierarchical regression analyses showed that usage times on social networking platforms significantly predicted the negative effects on the strength of FC between the intraparietal sulcus and the dorsolateral prefrontal cortex. These findings indicated that problematic social network use reflects changes in the neural circuits underlying attentional control. Weaking of prefrontal control for attention networks would have a significant impact on failure to control one's time spent on social networks.

Caudate nucleus volume mediates the link between glutamatergic neurotransmission and problematic smartphone use in youth

BACKGROUND AND AIMS

Problematic smartphone use (PSU) is growing rapidly among teens. It has similar presentations as other behavioral addictions in terms of excessive use, impulse control problems, and negative consequences. However, the underlying neurobiological mechanisms remain undiscovered. We hypothesized that structural changes in the striatum might serve as an important link between alteration in glutamate signaling and development of PSU.

METHODS

Among 88 participants, twenty (F:M, 12:8; age 16.2 ± 1.1) reported high scores in the smartphone addiction proneness scale (SAPS) with a cut-off score of 42; the other 68 (F:M, 19:49; age 15.3 ± 1.7) comprised the control group. Sociodemographic data and depression, anxiety, and impulsivity traits were measured. Striatal volumes (caudate, putamen, and nucleus accumbens) were estimated from T1 imaging data. Serum glutamate levels were estimated from peripheral blood samples. Group comparisons of each data were performed after controlling for age and gender. Mediation analyses were conducted to test the indirect effects of glutamate level alteration on PSU through striatal volumetric alteration.

RESULTS

The PSU group showed a decrease in both caudate volumes than the control group. Left caudate volume was positively correlated with serum glutamate level, and negatively with impulsivity traits and SAPS scores. The mediation model revealed a significant indirect effect of serum glutamate on SAS scores through the reduced left caudate volume.

DISCUSSION AND CONCLUSIONS

This study suggests that altered glutamatergic neurotransmission may be associated with PSU among teens, possibly through reduced left caudate volume. Current findings might support neural mechanisms of smartphone addiction.

Neural correlates of cue reactivity in individuals with smartphone addiction

Popularity of smartphones has dramatically increased in the past years, accompanied by increased concerns regarding potentially adverse effects on physical and mental health. Addictive behavior associated with excessive smartphone use, frequently referred to as "smartphone addiction" (SPA), has attracted increased scientific interest. However the neural correlates of SPA are unknown. We used functional magnetic resonance imaging at 3T to investigate the neural correlates of cue reactivity (CR) in individuals with SPA (n = 21) compared to controls (n = 21). SPA was assessed using the Smartphone Addiction Inventory (SPAI), and neural activity was measured by a modified CR task. Contrasts of images of smartphones vs. neutral stimuli and stimuli including active vs. inactive smartphones (p < 0.001, uncorrected for height, followed by correction for spatial extent) were analyzed. In the first contrast, group differences in medial prefrontal (MPFC), occipital, temporal, and anterior cingulate (ACC) cortices, in temporoparietal regions, and cerebellum were found. For active vs. inactive smartphones, group differences were found in frontal operculum/anterior insula and precentral gyrus. Negative correlations were found between MPFC, ACC, precuneus, and precentral gyrus and specific SPAI subscores, i.e. compulsive behavior, functional impairment and withdrawal. This study suggests spatial similarities of CR-related brain activation between addictive smartphone use and other well-known addictive disorders.

Effect of the mobile phone-related background on inhibitory control of problematic mobile phone use: An event-related potentials study

The present study aims to provide electrophysiological evidence for deficient inhibitory control in problematic mobile phone use and to investigate whether reduced inhibition is more pronounced during exposure to a mobile phone related background cue. A screen scale of smartphone addiction was completed by 227 college students, and finally an experimental group and a control group consisting of 20 problematic mobile phone users and 19 controls were included in the study. Event-related potentials were recorded during a backgrounded Go/NoGo task performed by those two groups, in which either a frequent Go signal (letter "M") or a rare NoGo signal (letter "W") was superimposed on three different background cues: neutral, mobile phone application-related and mobile phone using-related pictures. Results showed that problematic mobile phone users performed more commission errors than controls following mobile phone application background. Furthermore, problematic mobile phone users displayed a weaker NoGo P3 amplitude than controls on the mobile phone application background. The result might suggest that there is no general impairment of inhibitory control in problematic mobile phone use. The deficient inhibitory control on behavioral and psychophysiological level appeared merely in the mobile phone-related background. Such deficient stimuli-specific inhibitory control appears at the late stage of inhibitory control. Prevention programs should be designed to curtail exposure to the mobile phone-related stimulus and enhance cognitive control of potential problematic mobile phone users.

The Matthew Effect in Recovery from Smartphone Addiction in a 6-Month Longitudinal Study of Children and Adolescents

The clinical course of problematic smartphone use (PSU) remains largely unknown due to a lack of longitudinal studies. We recruited 193 subjects with smartphone addiction problems for the present study. After providing informed consent, the subjects completed surveys and underwent comprehensive interviews regarding smartphone usage. A total of 56 subjects among the 193 initially recruited subjects were followed up for six months. We compared baseline characteristics between persistent addicted users and recovered users at the end of the 6-month follow-up. Persistent problematic smartphone users displayed higher baseline smartphone addiction severity and were more prone to develop mental health problems at the follow-up. However, baseline depressive or anxiety status did not significantly influence the course of PSU. PSU behaved more like an addictive disorder rather than a secondary psychiatric disorder. Harm avoidance, impulsivity, higher Internet use, and less conversation time with mothers were identified as poor prognostic factors in PSU. Lower quality of life, low perceived happiness, and goal instability also contributed to persistent PSU, while recovery increased these scores as well as measures of self-esteem. These findings suggest that the Matthew effect is found in the recovery of PSU with better premorbid psychosocial adjustment leading to a more successful recovery. Greater clinical resources are required for interventions in vulnerable populations to modify the course of this increasingly prevalent problematic behavior worldwide.

Structural and functional correlates of smartphone addiction

Popularity and availability of smartphones have dramatically increased in the past years. This trend is accompanied by increased concerns regarding potentially adverse effects of excessive smartphone use, particularly with respect to physical and mental health. Recently, the term "smartphone addiction" (SPA) has been introduced to describe smartphone-related addictive behavior and associated physical and psychosocial impairment. Here, we used structural and functional magnetic resonance imaging (MRI) at 3 T to investigate gray matter volume (GMV) and intrinsic neural activity in individuals with SPA (n = 22) compared to a control group (n = 26). SPA was assessed using the Smartphone Addiction Inventory (SPAI), GMV was investigated by means of voxel-based morphometry, and intrinsic neural activity was measured by the amplitude of low frequency fluctuations (ALFF). Compared to controls, individuals with SPA showed lower GMV in left anterior insula, inferior temporal and parahippocampal cortex (p < 0.001, uncorrected for height, followed by correction for spatial extent). Lower intrinsic activity in SPA was found in the right anterior cingulate cortex (ACC). A significant negative association was found between SPAI and both ACC volume and activity. In addition, a significant negative association between SPAI scores and left orbitofrontal GMV was found. This study provides first evidence for distinct structural and functional correlates of behavioral addiction in individuals meeting psychometric criteria for SPA. Given their widespread use and increasing popularity, the present study questions the harmlessness of smartphones, at least in individuals that may be at increased risk for developing smartphone-related addictive behaviors.

The Modulation of Reward and Habit Systems by Acupuncture in Adolescents with Internet Addiction

Purpose

Acupuncture is an effective therapy for Internet addiction (IA). However, the underlying mechanisms of acupuncture in relieving compulsive Internet use remain unknown. Neuroimaging studies have demonstrated the role of the ventral striatum (VS) in the progress of IA; hence, the aim of this study was to explore the effects of acupuncture on the resting-state functional connectivity (rsFC) and relevant network of VS in IA.

Methods

Twenty-seven IA individuals and 30 demographically matched healthy control subjects (HCs) were recruited in this study. We acquired the functional magnetic resonance imaging (fMRI) data in IA subjects before and after 40 days of acupuncture treatment. Seed-to-voxel and ROI-to-ROI analyses were applied to detect the rsFC alterations of the VS and related network in IA subjects and to investigate the modulation effect of acupuncture on the rsFC.

Results

Compared with HCs, IA subjects exhibited enhanced rsFC of the right ventral rostral putamen (VRP) with the left orbitofrontal cortex (OFC), premotor cortex (PMC), cerebellum, and right ventromedial prefrontal cortex (vmPFC). In the network including these five ROIs, IA also showed increased ROI-to-ROI rsFC. Using a paired t-test in IA subjects before and after 40 days of acupuncture, the increased ROI-to-ROI rsFC was decreased (normalized to HC) with acupuncture, including the rsFC of the right VRP with the left OFC, PMC, and cerebellum, and the rsFC of the left cerebellum with the left OFC, PMC, and right vmPFC. Furthermore, the change in rsFC strength between the right VRP and left cerebellum in IA individuals was found positively correlated with the Internet craving alleviation after acupuncture.

Conclusions

These findings verified the modulation effect of acupuncture on functional connectivity of reward and habit systems related to the VS in IA individuals, which might partly represent the underlying mechanisms of acupuncture on IA.

Rumination and negative smartphone use expectancies are associated with greater levels of problematic smartphone use: A latent class analysis

Problematic smartphone use (PSU) is related to psychopathology symptoms, such as depression and anxiety. However, less is known about how responses to and coping with psychopathology correlate with PSU. We conducted a web survey of 286 American college students, querying depression and anxiety symptoms, rumination (a coping process to avoid negative emotion), PSU, and expectancies about smartphone use for mood alleviation. We conducted latent class analysis (LCA) of PSU symptom ratings, finding support for two latent subgroups of participants, involving mild and severe PSU, especially distinguished by severity of withdrawal symptoms. Rumination and negative smartphone use expectancies (i.e., to reduce distress) positively related to the more symptomatic PSU class. Results are discussed in context of the I-PACE theoretical model of problematic internet use (PIU). We emphasize the importance of response variables in I-PACE, such as internet-related cognitive bias and coping, over background psychopathology variables in influencing PIU and PSU.

Self-Reported Screen Time on Social Networking Sites Associated With Problematic Smartphone Use in Chinese Adults: A Population-Based Study

Background: Problematic smartphone use (PSU) has been associated with screen time in general, but little is known about the effect of different screen-based activities. We examined the associations of self-reported time spent on overall and specific screen-based activities with PSU and its addictive symptoms in Hong Kong Chinese adults. Methods: We analyzed data from 562 smartphone owners (56.5% female; 82.1% aged 25-64 years) in a population-based telephone survey in 2017. PSU was measured using Smartphone Addiction Scale-Short Version (range 10-60) which includes symptoms of daily-life disturbance, withdrawal, cyberspace-oriented relationship, overuse, and tolerance. Screen time was self-reported as average hours per day spent on the internet, online book/newspaper/magazine, online video, and social networking sites (SNS). Multivariable linear regression analyzed the associations of self-reported screen time with PSU severity and symptoms. Interaction effects of sex, age group, educational attainment, and monthly household income were examined. Results: Self-reported time spent on overall screen-based activities was associated with PSU severity (β = 1.35, 95% CI 0.15, 2.55) and withdrawal and overuse symptoms, after adjusting for sociodemographic and health-related variables. Independent association was observed for self-reported SNS time with PSU severity (β = 1.42, 95% CI 0.35, 2.49) and symptoms of withdrawal and cyberspace-oriented relationship, after mutually adjusting for time on other activities. The strongest association between self-reported SNS time and PSU severity was observed in younger than older adults (β = 4.36, 95% CI 2.58, 6.13; P for interaction = 0.004). Conclusions: The independent association of self-reported SNS time with PSU and core addictive symptoms highlighted the addiction potential of SNS use, particularly in younger users.

Social Media Usage and Development of Psychiatric Disorders in Childhood and Adolescence: A Review

Social media platforms, such as Facebook, Twitter, and Instagram, are now part of almost everyone's social life, especially for the newer generations. Children and teenagers grew up together with these Internet-based services, which have become an integral part of their personal and social life. However, as reported in various studies, psychological and psychiatric problems are sometimes associated with problematic usage of social media. The primary purpose of this review is to provide an overview of the cognitive, psychological, and social outcomes correlated with a problematic use of social media sites during the developmental stages, from age 10 to 19 years. With a specific focus on depression, anxiety, eating, and neurodevelopmental disorders, the review also discusses evidence related to genetic and neurobiological issues, together with the implications in clinical work and future directions under a multidisciplinary perspective. While the scientific community has made significant progress in enhancing our understanding of the impact of social media on teenagers' lives, more research integrating biological and environmental factors is required to fully elucidate the development of these disorders.