Assessing the Psychometric Properties of the Internet Addiction Test (IAT) Among Lebanese College Students

Comparing the effectiveness of game literacy education and game coding education in improving problematic internet gaming

Objective

Problematic internet gaming by adolescents has been thought to be associated with low self-esteem, depression, anxiety, and attention problems. We hypothesized that both game literacy and coding education would effectively improve problematic internet use. However, game coding education would be more effective in enhancing self-esteem and social anxiety in adolescents than game literacy education.

Methods

A total of 733 adolescent volunteers were included and randomly assigned to either the game coding education or game literacy education programs. Both programs consisted of eight sessions, each lasting 45 minutes, over four weeks. The coding education sessions included game planning and development lessons and allowed students to create the game's characters, stages, and tutorials directly using Scratch, a free coding program. Game literacy education sessions included lessons on enjoying gaming with a healthy rationale and etiquette. Data on demographics, gaming patterns, and psychological status, including positive/negative perceptions of online games, depression, social anxiety, and self-esteem, were collected.

Results

Both game coding and game literacy education significantly improved YIAS scores compared to baseline, and there was no significant difference in the YIAS scores between the two groups after the interventions. In the hierarchical logistic regression analysis of all participants, higher YIAS scores, stronger negative perceptions of gaming, and lower attention problem scores at baseline predicted lower levels of internet gaming addiction after interventions. In the hierarchical logistic regression analysis among individuals with game coding education, higher YIAS scores, stronger negative perceptions of gaming, lower attention problem scores, and higher self-esteem scores at baseline predicted lower levels of internet gaming addiction after intervention. In addition, game coding education greatly improved negative perceptions of games, self-esteem, and social anxiety compared to game literacy education.

Conclusion

Both game literacy and game coding education effectively mitigate internet game addiction. However, game coding education effectively mitigated problematic internet gaming by improving negative perceptions of games, self-esteem, and social anxiety in adolescents. We found that the application of knowledge by students in creating their own games was more effective than simply developing a conceptual understanding of the games.

Validation of the Amharic version of Internet Addiction Test-20: a cross-sectional study

Background

Internet Addiction is defined as excessive internet use or poorly controlled preoccupations, impulses, or behaviors related to computer use and internet access that cause impairment or suffering. It had devastating effect on people lives, families, productivity, academic performance and rarely engaging in criminal acts like alcohol use, drug addiction, or compulsive gambling. This study aimed to investigate the psychometric properties of the Amharic version of Internet Addiction Test-20 among Addis Ababa University, College of Health Sciences medical students, Addis Ababa, Ethiopia.

Methods

A cross sectional study was carried out among 410 medical students using a convenience sampling method after stratifying them based on their year level. SPSS Version 23 was used to do Pearson's correlation coefficient to determine the convergent validity of Amharic version of IAT. We computed correlation coefficient between the aggregate scores of IAT-20 and the scores for depressive symptoms, problematic substance use, and other characteristics of participants which was assessed using Patient health questionnaire-9 (PHQ-9), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and questionnaire developed to assess demographic and internet use related characteristics, respectively. AMOS 23 software was used to conduct confirmatory factor analysis (CFA) to evaluate the construct validity of Amharic version of IAT. Test-retest reliability was also determined with 2 weeks interval (n = 51).

Results

The data confirmed a two-factor structure. Normed Fit Index (NFI) = 0.89, Tucker Lewis Index (TLI) = 0.91 and Comparative Fit Index (CFI) = 0.92, Root Mean Square Error Approximation (RMSEA) = 0.07, and Standardized Root Mean Residual (SRMR) =0.05 indicated a good fit model structure. There was moderate positive correlation between the aggregate scores of IAT-20 and PHQ-9 scores (r = 0.55, p < 0.00), but weak positive correlation between IAT-20 and ASSIST scores (r = 0.14, p < 0.00). IAT-20 was also found to have good internal consistency (Cronbach's alpha = 0.89 for each factor). The test-retest reliability was also good for all items (Intra Class Correlation Coefficient (ICC) > 0.30) except item 16.

Conclusion

We found that the IAT-20 is psychometrically sound and a simple screening test for Internet Addiction. However, it is important to acknowledge that further studies are necessary to replicate these findings on diverse population.

Relationship between fruit and vegetable consumption and internet addiction with insomnia and depression as multiple mediators during the COVID-19 pandemic: a three-wave longitudinal study in Chinese college students

BACKGROUND

The relationships between fruit and vegetable consumption (FV) and Internet addiction (IA) in college students still remained unknown together with the internal mechanisms. Given the limitations of previous cross-sectional design, longitudinal research was necessary to be conducted to explore more precise correlations. Using the three-wave data in a longitudinal design, this study aimed to explore the association between FV and IA among Chinese college students and potential multiple mediators of insomnia and depression during the COVID-19 pandemic.

METHODS

A total of 579 college students were recruited during three waves (T1: August 2020; T2: November 2020; T3: February 2021). FV (T1), insomnia (T2), depression (T2) and IA (T3) symptoms were reported. The descriptive statistics of the sociodemographic characteristics and correlation analyses of the study variables were calculated. The significance of the mediation effects was measured conducting a bootstrap method with SPSS PROCESS macro.

RESULTS

FV was negatively correlated with IA, and lower FV predicted higher risk of IA. Depression mediated the association between FV and subsequent IA. Insomnia and depression were multiple mediators, which in turn mediated the links between FV and subsequent IA.

CONCLUSIONS

The three-wave longitudinal study has revealed that FV had indirect effects on IA through individual mediating factor of depression and multiple mediating roles of insomnia and depression sequentially. The policy makers, educators and researchers should pay attention to the impact of the interventions from healthy diet, in order to optimize the coping strategies for preventing college students from IA.

Perfect people, happier lives? When the quest for perfection compromises happiness: the roles played by substance use and internet addiction

Building on the Conservation of Resources Theory and the Stress-Coping Model, the present study explored the relationship between perfectionism (rigid, self-critical, narcissistic) and subjective happiness among youth. In this relationship, we also examined the mediating roles of substance use (i.e., drinking and smoking) and Internet addiction symptoms. Our sample comprised 431 Romanian university students aged 18-25 (M = 20.50, SD = 1.58), and most of them were females (79.81%, self-reported gender). Participants completed self-reported anonymous scales through a web-based survey at the beginning of 2023. Correlation analysis results indicated that all forms of perfectionism were associated with Internet addiction symptoms. Self-critical and narcissistic perfectionism and drinking, smoking, and Internet addiction symptoms were negatively associated with subjective happiness. Path analysis suggested that health-risk behaviors completely mediated the effect of perfectionism on subjective happiness. High levels of perfectionism were associated with high levels of health-risk behaviors, and high levels of addictive behaviors were associated with low levels of subjective happiness. We discuss the present findings considering their practical use regarding students' subjective happiness.

Socio-demographic and mental health correlates of internet addiction amongst Hong Kong university students under COVID-19

Introduction

Regarding the problem of Internet addiction (IA) amongst university students under the pandemic, there are several research gaps. Firstly, few studies have examined IA of university students in Hong Kong, which is a Chinese society heavily influenced by Western values. In addition, findings on the socio-demographic correlates and psychological well-being predictors of IA in university students are unclear. Finally, researchers have not systematically examined the interaction effects of socio-demographic factors (particularly gender and personal infection of COVID-19) and psychological morbidity on IA. This pioneer study aimed to investigate the predictive role of socio-demographic factors and psychological morbidity in IA, and the moderating effects of gender and personal infection of COVID-19 on the relationship between psychological morbidity and IA.

Methods

We conducted an online survey (N = 1,020 university students) during the ending phase of Wave 5 of the pandemic in Hong Kong (late 2022 to early 2023). Socio-demographic correlates included age, gender, living status, personal and family financial situation, student status, personal and family infection of COVID-19. Participants responded to validated measures of psychological morbidity, including depression, suicidal behavior, and hopelessness. Hierarchical regression and simple slope analyses were used to examine the predictive role of socio-demographic variables and psychological morbidity in IA and the interactive effect of gender and personal infection of COVID-19 with psychological morbidity on IA.

Results

Personal financial difficulty was a significant socio-demographic predictor of IA. Depression, suicidal behavior, and hopelessness positively predicted IA. We also found a significant interaction effect of gender and psychological morbidity on IA. While the predictive relationship between depression and IA was stronger in males than in females, hopelessness was more strongly related to IA in females than in males. Finally, there was a significant interaction effect of personal infection of COVID-19 and suicidal behavior on IA.

Conclusion

Personal financial difficulty was a socio-economic correlate of IA. Psychological morbidity also predicted IA. Gender and personal infection of COVID-19 moderated the linkage between psychological morbidity and IA. The findings of the study enhance our understanding of individual differences in IA in university students during the pandemic, particularly concerning different ecological risk factors.

Effects of emotional working memory training on problematic internet use, inhibition, attention, and working memory among young problematic internet users: A randomized control study

Problematic internet use (PIU) has been defined as an inability to control impulses to use the internet, and is associated with psychological, social, educational, and/or occupational problems. Considering the harmful effects of PIU, the present study evaluated a treatment intervention aimed at controlling PIU. A randomized control study investigated the effectiveness of emotional working memory training (eWMT) in improving inhibition, attention, and working memory among individuals with PIU in comparison with a placebo group. Young adults (N = 36) with PIU were either trained for 20 sessions in an n-back dual emotional task (eWMT; n = 18) or a feature matching task (placebo; n = 18). Results showed that 20 continuous sessions of eWMT significantly reduced the symptoms of PIU and improved participants' working memory, attention, and inhibition (compared to the placebo group). These preliminary findings suggest that eWMT can be considered a promising treatment to reduce PIU by improving individuals' cognitive and emotional functioning.

Hyperfocus symptom and internet addiction in individuals with attention-deficit/hyperactivity disorder trait

Background

Hyperfocus symptom is the intense concentration on a certain object. It is a common but often overlooked symptom in those with attention-deficit/hyperactivity disorder (ADHD). Hyperfocus disrupts attention control and results in a focus on inappropriate behaviors. It allows individuals to focus on internet use and make them use internet excessively. This excessive internet use can lead to an addiction. This study investigated the status of IA and hyperfocus, the mediation effect of hyperfocus in relation to IA, and the relationship between ADHD subtypes and hyperfocus in those with ADHD symptoms.

Methods

This web-based cross-sectional study included 3,500 Japanese adults who completed internet-based questionnaires, which included the Adult ADHD Self-Report Scale (ASRS), Internet Addiction Test (IAT), and Hyperfocus Scale (HFS) to assess ADHD symptoms, internet dependence, and hyperfocus symptoms, respectively. The mediating role of HFS in the relationship between ASRS and IAT was assessed by mediation analysis. To analyze the relationship between hyperfocus symptoms and ADHD subtypes, we compared the correlation of HFS with the Inattention and Hyperactive Scores of ASRS.

Results

ADHD traits were associated with higher IAT scores (p &lt; 0.001) and higher HFS scores (p &lt; 0.001). Mediation analysis and bootstrap testing showed that HFS significantly mediated the association between ASRS and IAT. Analyses of ADHD subtypes demonstrated that HFS was significantly correlated with the Inattention (R = 0.597, p &lt; 0.001) and Hyperactive (R = 0.523, p &lt; 0.001) Scores. The correlation between HFS and the Inattention Score was significantly higher than that between HFS and the Hyperactive Score (p &lt; 0.001).

Conclusion

Our findings suggest that hyperfocus may play an important role in addictive behavior in ADHD as a manifestation of attentional control malfunction.

Hikikomori Syndrome and Digital Technologies: A Systematic Review

ABSTRACT

Hikikomori syndrome (HS) is a voluntary prolonged social isolation associated with personal and community impact. Previous evidence pointed out a possible relationship between this syndrome with addiction to digital technologies. Here we aim to understand the relationship between HS and digital technology use, overuse, and addictive behaviors, as well as potential therapeutic approaches.We conducted a systematic review of observational and intervention studies available in PubMed/MEDLINE, LILACS, IBECS, Embase, PsycINFO, and SciELO databases, following the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA 2020) criteria. The risk of bias was assessed with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and Consensus-based Clinical Case Reporting Guideline Development (CARE). Eligibility criteria were pre-, at-risk populations, or those with HS diagnosis, and any kind of technological overuse. Seventeen studies were included in the review, of which eight were cross-sectional, eight were case reports, and one was quasi-experimental. Hikikomori syndrome was associated with addition to digital technologies; no cultural differences were found. Environmental factors, such as a history of bullying, low self-esteem, and grief were identified as precursors of addictive behaviors. The included articles addressed addiction to digital technologies, electronic games, and social networks, among others, in HS. HS is cross-culturally associated with such addiction. The management of these patients remains challenging, and no target evidence-based treatments have been developed. The studies included in this review had several limitations, and more studies with a higher level of evidence are needed to support the results.

Development and validation of an instrument for the assessment of internet use in the Indian context

Background

Internet usage is increasing in the young population. Over 560 million internet users, India is the second-largest online market globally, which necessitates the development of an Internet use assessment tool in the Indian context.

Methods

Samples of 560 individuals aged from 16 to 40 years participated. Data were coded in excel sheet for STATA 14.0 analysis evolved to item response theory. Cronbach's alpha was used to determine the internal consistency; concurrent validity was performed using the "Internet Addiction Test." Descriptive statistics, analysis of variance, confirmatory factor analysis, and Pearson's correlation were also determined.

Results

The developed instrument has the Cronbach's alpha reliability value (25 items) of 0.893, which indicates high internal consistency and has a concurrent value of 0.800. Factor analysis of 23 items revealed that the variance of 64.481 revealed all the items loaded in the rotated component matrix. The final 18 items got the item discrimination index was >1.0 with three-factor structure.

Conclusion

The developed reliable and valid instrument can be used for identifying the patterns of internet usage across various settings (research, educational, mental health/clinical, and workplace).

Resting-state heart rate variability, level of stress and resilience in internet gaming disorder and alcohol use disorder

Stress and resilience are involved in the pathophysiology of addictive disorders, and heart rate variability (HRV) is an index of an individual's global capability to regulate psychological responses. In this study, we aimed to identify transdiagnostic and disorder-specific markers in people with addictive disorders by analyzing resting-state HRV and associations with the levels of stress and resilience. We compared relevant data between patients with internet gaming disorder (IGD) and/or alcohol use disorder (AUD) and healthy controls (HCs). In all, 163 adults aged 18-35 years (53 with IGD, 49 with AUD, 61 HCs) participated. The levels of stress and resilience were measured using the Psychosocial Wellbeing Index and the Connor-Davidson Resilience Scale, respectively. The HRV was obtained from each participant during a 5 min resting-state. The IGD and AUD patients exhibited increased levels of stress and decreased resilience compared to the HCs. Patients with either addictive disorder exhibited a lower standard deviation of the normal-to-normal beat interval (SDNN) index [SDNNi] compared to HCs even after adjusting for clinical variables such as depression, anxiety, and impulsivity. In multiple comparison tests among the three groups, the AUD group had lower HRV than HCs, but no differences were observed among the groups after adjusting for the clinical variables. The HRV indices were correlated with the levels of stress, resilience, and disease severity. In conclusion, IGD and AUD patients exhibit lower HRV as indicated by the SDNNi compared to HCs, revealing their vulnerability to stress as well as a common transdiagnostic marker of addiction.

Personality traits of university students with smartphone addiction

BACKGROUND

Nowadays smartphone use is increasing drastically. There is a higher prevalence of smartphone addiction in some specific personality traits.

OBJECTIVES

The goal of this study is to evaluate the association of smartphone addiction with personality traits.

METHODS

This study is correlational research. Three hundred and eighty two students of Tehran universities were asked to answer the smartphone addiction scale (SAS) questionnaire and the Persian version of the Cloninger temperament and character inventory (TCI) questionnaire. After the smartphone addiction questionnaire assessment, individuals with smartphone addiction were identified and compared to the non-smartphone addicted group in terms of personality traits.

RESULTS

One hundred and ten individuals (28.8%) were prone to smartphone addiction. Mean scores of people with smartphone addiction were higher in novelty-seeking, harm avoidance, and self-transcendence than the non-addicts and were statistically significant. In persistence and self-directedness, the mean scores of the smartphone addiction group were lower than the non-addicts and were statistically significant. Individuals with smartphone addiction had higher reward dependence and lower cooperativeness however they were not statistically significant.

CONCLUSIONS

high novelty seeking, harm avoidance, self-transcendence, low persistence, and self-directedness which indicate narcissistic personality disorder, could have a role in smartphone addiction.

Internet addiction and its effects on psychological wellbeing: A community-based study

Background

The internet has become an essential part of life, and it has both beneficial and detrimental effects. There is a plethora of evidence relating to the effect of internet addiction on psychological health. There is also an unmet need to lay the foundation for the differences in usage and the effects on mental health in regard to the use of the internet for rural and urban students.

Materials and Methods

The present study was conducted on 200 adolescent subjects belonging to the urban and rural areas around the city of Varanasi to establish the pattern of use of the internet as well as its psychological implications. The participants were evaluated upon the Internet Addiction Test (IAT) and General Health Questionnaire-12 (GHQ-12), and information pertaining to socio-demographics as well as accessory information related to internet usage were captured through semi-structured proforma.

Results

The results indicated no significant differences in the pattern of internet usage (mean IAT score) as well as psychological health (mean GHQ-12) between urban and rural youth. There was a significant positive association between the overall severity of internet use with poor psychological health (GHQ-12 score). There was a significant difference in the overall mean age as well as the mean age of onset of internet use between both groups (rural versus urban). This study highlighted an important issue of the digital divide based on gender-wise differences in the pattern in the overall sample.

Conclusion

This study highlighted the important differences in the pattern of internet use among the rural and urban populations with its clinical implication being a need to educate the youth regarding the healthy use of technology.

Evaluation of the Psychometric Properties of the Arab Compulsive Internet Use Scale (CIUS) by Item Response Theory Modeling (IRT)

INTRODUCTION

The psychometric properties of the Arab translation of the Compulsive Internet Use Scale (CIUS) have been previously studied by confirmatory factor analysis (CFA) with AMOS software using the asymptotically distribution-free (ADF) estimator. Unidimensionality has been achieved at the cost of correlating several item variance errors. However, several reviews of SEM software packages and estimation methods indicate that the option of robust standard errors is not present in the AMOS package and that ADF estimation may yield biased parameter estimates. We therefore explored a second analysis through item response theory (IRT) using the parametric graded response model (GRM) and the marginal maximum likelihood (MML) estimation method embedded in the LTM package of R software. Differential item functioning (DIF) or item bias across subpopulations was also explored within IRT framework as different samples were investigated. The objective of the current study is to (1) analyze the Arab CIUS scale with IRT, (2) investigate DIF in three samples, and (3) contribute to the ongoing debate on Internet-use-related addictive behaviors using the CIUS items as a proxy.

METHODS

We assessed three samples of people, one in Algeria and two in Lebanon, with a total of 1520 participants.

RESULTS

Almost three out of every five items were highly related to the latent construct. However, the unidimensionality hypothesis was not supported. Furthermore, besides being locally dependent, the scale may be weakened by DIF across geographic regions. Some of the CIUS items related to increasing priority, impaired control, continued use despite harm, and functional impairment as well as withdrawal and coping showed good discriminative capabilities. Those items were endorsed more frequently than other CIUS items in people with higher levels of addictive Internet use.

CONCLUSIONS

Contrary to earlier ADF estimation findings, unidimensionality of the CIUS scale was not supported by IRT parametric GRM in a large sample of Arab speaking participants. The results may be helpful for scale revision. By proxy, the study contributes to testing the validity of addiction criteria applied to Internet use related-addictive behaviors.

Psychometric evaluation of the internet addiction test in India

The Internet Addiction Test is a widely used assessment of symptoms of internet addiction. Although originally proposed as assessing different components of internet addiction, research has been mixed in terms of its factor structure. This study is the first to examine the psychometric properties of the IAT in an Indian population. A large sample (N = 2700) of Indians living in the Southern city of India were recruited door-to-door and completed the IAT and other validity measures. In Study 1, an exploratory factor analysis (n = 1375) indicated a one-factor structure, with 13 items measuring symptoms of internet addiction. This short-form IAT showed construct and convergent validity by correlating with higher daily internet use, higher scores on measures of problematic internet gaming, social media use, and smartphone use, and functional impact. In Study 2, confirmatory factor analysis (n = 1375) indicted this one-factor structure was a good fit to the data, and the correlations with validity measures were replicated. This short-form IAT appears to be valid as a measure of one underlying factor of problematic internet use in young Indian adults.

Prevalence of Internet Addiction and its Correlates Among Regular Undergraduate Medicine and Health Science Students at Ambo University. Cross-Sectional Study

Introduction:

Internet addiction (IA) is causing academic failure, decreased concentration ability, and a negative affective state. In Ethiopia, studies conducted on IA were limited; therefore, this study aimed to assess its prevalence and risk factors among medicine and health science (MHS) students of Ambo University.

Materials and Methods:

This study was a cross-sectional study and included MHS students of Ambo University from July 15 to August 15, 2021. Data were collected using a self-administered questionnaire after receiving informed consent from study participants. The results were analyzed using the statistical software for social sciences version 24. Bivariate and multivariate logistic regressions were performed to explore the relationship between IA and dependent variables.

Results:

Of the 253 participants who participated in the study, 201 (79%) were found to have an IA. Having one’s own computer, Internet access at home and an email account were 2 times more risky to develop IA compared to their counterparts with AOR = 2.615 (95% CI = 1.118-5.956) with a P value of .022, AOR = 2.154 (95% CI = 1.054-4.405) with a P value of .35 and (=2.154 (95% CI = 1.054-4.405 with a P value of .035 respectively. Additionally, those who use the Internet for news were 2.5 times more likely to develop IA compared to those who do not (AOR = 2.551 (95% CI = 1.225-5.349) with a P-value of .013). The use of the Internet for scientific research and education reduces IA by 0.7 times (AOR = 0.323 (95% CI = 0.120-0.868) with a P value of .025).

Conclusions:

The prevalence of IA was found to be high in this study. Therefore, strategies are needed to minimize the prevalence of this problem.

The Six-Item Version of the Internet Addiction Test: Its Development, Psychometric Properties, and Measurement Invariance among Women with Eating Disorders and Healthy School and University Students

Internet addiction (IA) is widespread, comorbid with other conditions, and commonly undetected, which may impede recovery. The Internet Addiction Test (IAT) is widely used to evaluate IA among healthy respondents, with less agreement on its dimensional structure. This study investigated the factor structure, invariance, predictive validity, criterion validity, and reliability of the IAT among Spanish women with eating disorders (EDs, N = 123), Chinese school children (N = 1072), and Malay/Chinese university students (N = 1119). In school children, four factors with eigen values > 1 explained 50.2% of the variance, with several items cross-loading on more than two factors and three items failing to load on any factor. Among 19 tested models, CFA revealed excellent fit of a unidimensional six-item IAT among ED women and university students (χ2(7) = 8.695, 35.038; p = 0.275, 0.001; CFI = 0.998, 981; TLI = 0.996, 0.960; RMSEA = 0.045, 0.060; SRMR = 0.0096, 0.0241). It was perfectly invariant across genders, academic grades, majors, internet use activities, nationalities (Malay vs. Chinese), and Malay/Chinese female university students vs. Spanish women with anorexia nervosa, albeit it was variant at the scalar level in tests involving other EDs, signifying increased tendency for IA in pathological overeating. The six-item IAT correlated with the effects of internet use on academic performance at a greater level than the original IAT (r = -0.106, p < 0.01 vs. r = -0.78, p < 0.05), indicating superior criterion validity. The six-item IAT is a robust and brief measure of IA in healthy and diseased individuals from different cultures.

Internet addiction and sleep quality among medical students during the COVID-19 pandemic: A multinational cross-sectional survey

BACKGROUND

The emergence of the COVID-19 pandemic has affected the lives of many people, including medical students. The present study explored internet addiction and changes in sleep patterns among medical students during the pandemic and assessed the relationship between them.

METHODS

A cross-sectional study was carried out in seven countries, the Dominican Republic, Egypt, Guyana, India, Mexico, Pakistan, and Sudan, using a convenience sampling technique, an online survey comprising demographic details, information regarding COVID-19, the Pittsburgh Sleep Quality Index (PSQI), and the Internet Addiction Test (IAT).

RESULTS

In total, 2749 participants completed the questionnaire. Of the total, 67.6% scored above 30 in the IAT, suggesting the presence of an Internet addiction, and 73.5% scored equal and above 5 in the PSQI, suggesting poor sleep quality. Internet addiction was found to be significant predictors of poor sleep quality, causing 13.2% of the variance in poor sleep quality. Participants who reported COVID-19 related symptoms had disturbed sleep and higher internet addiction levels when compared with those who did not. Participants who reported a diagnosis of COVID-19 reported poor sleep quality. Those living with a COVID-19 diagnosed patient reported higher internet addiction and worse sleep quality compared with those who did not have any COVID-19 patients in their surroundings.

CONCLUSION

The results of this study suggest that internet addiction and poor sleep quality are two issues that require addressing amongst medical students. Medical training institutions should do their best to minimize their negative impact, particularly during the current COVID-19 pandemic.

A Cross-Sectional Study on Internet Addiction Among Adolescent Children of Parents With Mental Illness

BACKGROUND

The internet can cause adverse psychological issues in children whose parents show less competence because of their mental illness. This study aims to find the level of internet addiction among adolescents who have a parent with psychiatric illness and its relationship to the type and duration of their parent's illness.

METHOD

This study was conducted among 283 adolescents whose parents suffered from mental illness. They were selected from the inpatient and outpatient services of a neuropsychiatric hospital in India. Informed written consent was obtained from the parent not suffering from psychiatric illness, and a semistructured interview accommodating various factors and statements from the internet addiction test was used to find the level of internet addiction.

RESULT

A total of 79.5% of adolescents showed scores indicative of internet addiction, with 14.5% of the participants having mild levels of addiction, 60.8% having moderate levels of addiction, and 4.2% having severe levels of addiction. There is a significant relationship between internet addiction scores and the type and duration of psychiatric illness in a parent.

CONCLUSION

The internet addiction scores in adolescents have a significant relationship to the various types of illnesses and the duration of illness of their parents.

How Have Researchers Acknowledged and Controlled for Academic Work Activity When Measuring Medical Students' Internet Addiction? A Systematic Literature Review

Internationally, medical students' Internet Addiction (IA) is widely studied. As medical students use the Internet extensively for work, we asked how researchers control for work-related Internet activity, and the extent to which this influences interpretations of "addiction" rates. A search of PubMed, CINAHL, Web of Science, Scopus, and Google Scholar was conducted on the search phrase of "medical students" and "internet addiction" in March 2020. In total, 98 studies met our criteria, 88 (90%) used Young's Internet Addiction Test, and the studies' IA rates ranged widely. Little note was taken of work-related activity, and, when discussed, had little to no impact on the interpretation of Internet "addiction". Studies seldom accounted for work-related activities, researcher bias appears to influence their position, "usage" appears conflated with "addiction", and correlations between "addiction" and negative behaviours are frequently confused with one-way causation. In spite of IA's not being officially recognised, few researchers questioned its validity. While IA may exist among medical students, its measurement is flawed; given the use of the Internet as a crucial medical education tool, there is the risk that conscientious students will be labelled "addicted", and poor academic performance may be attributed to this "addiction".

Identification of Video Game Addiction Using Heart-Rate Variability Parameters

The purpose of this study is to determine heart rate variability (HRV) parameters that can quantitatively characterize game addiction by using electrocardiograms (ECGs). 23 subjects were classified into two groups prior to the experiment, 11 game-addicted subjects, and 12 non-addicted subjects, using questionnaires (CIUS and IAT). Various HRV parameters were tested to identify the addicted subject. The subjects played the League of Legends game for 30–40 min. The experimenter measured ECG during the game at various window sizes and specific events. Moreover, correlation and factor analyses were used to find the most effective parameters. A logistic regression equation was formed to calculate the accuracy in diagnosing addicted and non-addicted subjects. The most accurate set of parameters was found to be pNNI20, RMSSD, and LF in the 30 s after the “being killed” event. The logistic regression analysis provided an accuracy of 69.3% to 70.3%. AUC values in this study ranged from 0.654 to 0.677. This study can be noted as an exploratory step in the quantification of game addiction based on the stress response that could be used as an objective diagnostic method in the future.

Validation study of the Indonesian internet addiction test among adolescents

BACKGROUND

Internet addiction is a serious problem that can negatively impact both the physical and mental health of individuals. The Internet Addiction Test (IAT) is the most common used instrument to screen internet addiction worldwide. This study sought to investigate the psychometric properties of an Indonesian version of the IAT.

METHODS

The IAT questionnaire was made the focus of forward translation, expert panel discussions, back translation, an item analysis (30 subjects), a pilot study (385 subjects), and field testing (643 subjects). Factor structure was analysed by exploratory (EFA) and confirmatory factor (CFA) analyses, whereas reliability was measured with Cronbach's alpha coefficient.

RESULTS

Factor analysis revealed that the Indonesian version of IAT, consisted of 3 domains, and had good validity (χ2 p < 0.001; RMSEA = 0.076; CFI = 0.95; SRMR = 0.057, and AIC = 784.63). The Cronbach's alpha score is 0.855. A significant association was also observed between the level of internet addiction with gender (p = 0.027) and the duration of internet use per day (p = 0.001).

CONCLUSION

The Indonesian version of IAT provides good validity and reliability in a three-dimensional model. Therefore, it can be utilised as a tool for screening internet addiction in the Indonesian population.

Effects of Electronic Devices and Internet Addiction on Sleep and Academic Performance Among Female Egyptian and Saudi Nursing Students: A Comparative Study

INTRODUCTION

The widespread availability of Internet access and increasing rate of electronic device usage has helped enlighten the world community through copious applications, information resources, and other benefits. However, both the lack of controlled behavior and excessive Internet usage have resulted in a variety of difficulties that can hinder user achievement in many areas.

OBJECTIVES

This study investigated the prevalence of Internet and electronic device addiction among Egyptian and Saudi nursing students, with the aim of identifying any effects on sleep and academic performance.

METHODS

A cross-sectional comparative research design was employed among a systematic random sample comprised of 920 Egyptian and Saudi female nursing students. All participants completed the Young-Internet Addiction Test (IAT), Mobile Phone Involvement Questionnaire (MPIQ), and Epworth Sleepiness Scale (ESS).

RESULTS

Severe Internet Addiction (IA) detected in 42.69% and 10.31% of Saudi and Egyptian participants, respectively. However, Saudi participants were more likely to report high rates of mobile phone usage (P < 0.001), while Egyptian participants tended to score higher on the ESS (17.47 ± 3.99 vs. 16.8 ± 3.83; P = 0.024). For all participants, IAT and MPIQ scores were correlated with ESS results, while IA was specifically associated with poor academic performance. Finally, MPIQ scores were inversely correlated with academic performance for Saudi participants.

CONCLUSION

Smartphone and Internet addiction were notable problems for the Egyptian and Saudi nursing students investigated in this study. Importantly, these conditions adversely affect academic performance and other activity engagement in addition to inducing excessive daytime sleepiness.

Involvement of DAT1 Gene on Internet Addiction: Cross-Correlations of Methylation Levels in 5'-UTR and 3'-UTR Genotypes, Interact with Impulsivity and Attachment-Driven Quality of Relationships

Internet influences our communication, social and work interactions, entertainment, and many other aspects of life. Even if the original purpose was to simplify our lives, an excessive and/or maladaptive use of it may have negative consequences. The dopamine transporter (DAT1) gene was studied in relation to addictions, including excessive use of the Internet. The crucial role of DAT1 was previously underlined in modulating emotional aspects, such as affiliative behaviors. The present research follows a new approach based on cross-correlation between (de)methylation levels in couples of CpG loci, as previously shown. We investigated the possible relationships between Internet addiction, impulsivity, quality of attachment, DAT1 genotypes (from the 3'-untranslated region (UTR) variable number of tandem repeats (VNTR) poly-morphism), and the dynamics of methylation within the 5'-UTR of the DAT1 gene. From a normative sample of 79 youths, we extrapolated three subgroups a posteriori, i.e., one "vulnerable" with high Internet Addiction Test (IAT) scores (and high Barrat Impulsivity Scale (BIS) scores; n = 9) and two "controls'' with low BIS scores and 10/10 vs. 9/x genotype (n = 12 each). Controls also had a "secure" attachment pattern, while genotypes and attachment styles were undistinguished in the vulnerable subgroup (none showed overt Internet addiction). We found a strongly positive correlation in all groups between CpG2 and CpG3. An unsuspected relationship between the 3'-UTR genotype and a 5'-UTR intra-motif link was revealed by CpG5-CpG6 comparison. The negative correlation between the CpG3-CpG5 positions was quite significant in the control groups (both with genotype 10/10 and with genotype 9/x), whereas a tendency toward positive correlation emerged within the high IAT group. In conclusion, future attention shall be focused on the intra- and inter-motif interactions of methylation on the CpG island at the 5'-UTR of DAT1.

Assessing the Psychometric Properties of the Internet Addiction Test in Peruvian University Students

The use of the Internet has been gradually and unstoppably gaining ground in all areas of life, from recreational activities to how social relations are established. However, the existence of clinical cases indicates that the addictive use of the Internet is a problem that seriously affects some people. Among the instruments that measure this construct, the Internet Addiction Test (IAT) stands out. However, instrumental studies of this test are scarce in Latin America. The present study sought to analyze the psychometric properties of the IAT in a sample of 227 Peruvian undergraduate university students. Confirmatory factor analysis was used to provide validity evidence based on the internal structure, and evidence based on the relationship with other variables was also provided. Reliability was estimated through the ordinal alpha coefficient. The results indicated that the IAT adequately fits a bifactor model (with two specific factors, time/control and stress/compensate), obtaining good levels of reliability. Additionally, the IAT scores correlate significantly with the average number of hours per day on the internet and social skills. The results lead to the conclusion that the scores in the IAT have evidence of validity and reliability for its use.

Suicidal ideation among Lebanese adolescents: scale validation, prevalence and correlates

BACKGROUND

In addition to the unstable political situation, Lebanon had experienced a cycle of wars, local armed conflicts, terrorist attacks, and crises (lack of clean water, recurrent power failure, and waste mismanagement, in addition to the growing number of unemployed people, as the number of Syrian refugees has dramatically increased, and led to competition for jobs with locals. All these factors make the Lebanese population prone to mental disorders, particularly suicide, without clear management policies. This study aims to validate the Columbia-Suicide Severity Rating Scale (CSSRS), and determine the prevalence of suicidal ideation and associated factors among a Lebanese nationally representative sample of adolescents from 9th to 12th grades.

METHODS

Participants were 1810 adolescents who enrolled in this cross-sectional study (January-May 2019), using a proportionate random sample of schools from all Lebanese Mohafazat. The Columbia-Suicide Severity Rating Scale was used to screen for suicidal ideation.

RESULTS

The results showed that 28.9% had some type of suicidal ideation [95% CI 26.7-31.1%]. The CSSRS items converged on a one-factor solution, accounting for a total of 85.40% of the variance (α_Cronbach = 0.966). Higher psychological abuse (Beta = 0.041), child physical abuse (Beta = 0.030), alcohol dependence (Beta = 0.062), social fear (Beta = 0.028), victimization/bullying score (Beta = 0.028), impulsivity (Beta = 0.028) and internet addiction (Beta = 0.010) scores were significantly associated with higher suicidal ideation. Same applies to adolescents whose parents are separated compared to living together (Beta = 0.992) and in females compared to males (0.311). On another hand, a higher age (Beta = - 0.182) was significantly associated with lower suicidal ideation.

CONCLUSION

This study provides insights about suicidal ideation among Lebanese adolescents and related risk factors, such as child psychological and physical abuse, alcohol use disorders, social fear, bullying and victimization, impulsivity, and internet addiction.

Validation of the AUDIT scale and factors associated with alcohol use disorder in adolescents: results of a National Lebanese Study

BACKGROUND

This study objective was to evaluate the prevalence of alcohol use disorder (AUD) and related factors (smoking, internet addiction, social anxiety, child abuse, and bullying) among a representative sample of Lebanese adolescents, and to validate and confirm psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT).

METHODS

A cross-sectional study, conducted between January and May 2019, enrolled 1810 adolescents aged between 14 and 17 from schools of all Lebanese districts. From the total number of schools, a proportionate number was selected in each district. AUD was defined as a high AUDIT score (≥8; score range 0-40). A principal component analysis technique to confirm the validity of the construct of the AUDIT scale score was done and a confirmatory analysis to assess the structure of the instrument was conducted. Spearman correlation was used for linear correlation between continuous variables. The Mann-Whitney test was used to compare the means of two groups, while the Kruskal-Wallis test was used to compare three groups or more. A stepwise linear regression was conducted, taking the AUDIT total score as the dependent variable and taking child abuse (psychological, sexual, physical and verbal), cigarette and waterpipe smoking dependence, bullying, social phobia, and internet addiction as independent variables.

RESULTS

The mean AUDIT score was 6.46 ± 8.44 and high risk of AUD was found in 507 (28.0%) adolescents [95% CI 0.259-0.301]. One factor solution of the AUDIT scale was found after running the factor analysis (αCronbach = 0.978). Higher AUDIT scores were significantly associated with higher cigarette (Beta = 0.527; p < 0.001) and waterpipe (Beta = 0.299; p < 0.001) dependence, higher childhood sexual abuse (Beta = 0.656; p < 0.001) and neglect (Beta = 0.126; p < 0.001), higher bullying victimization (Beta = 0.236; p < 0.001).

CONCLUSION

Alcohol use disorder among Lebanese adolescents seems to be associated with several factors, such as cigarette and waterpipe dependence, parents' divorce, higher internet addiction, bullying victimization, and childhood sexual abuse and neglect. Parents and healthcare professionals could use this data for early interventions.

Attachment style and addictions (alcohol, cigarette, waterpipe and internet) among Lebanese adolescents: a national study

Background

The prevalence in the Lebanese general population of cigarette and waterpipe smoking, alcohol drinking and internet use seems to be increasing lately. So far, no study was done relating the above to attachment styles in Lebanese adolescents. Consequently, the objective of our study was to assess the relationship between attachment styles (secure, preoccupied, fearful, and dismissing) and addictions (cigarettes, water pipes, alcohol, and internet) among this population.

Methods

It is a cross-sectional study that took place between January and May 2019. Two thousand questionnaires were distributed out of which 1810 (90.5%) were completed and collected back. A proportionate random sample of schools from all Lebanese Mohafazat was used as recruitment method.

Results

A secure attachment style was significantly associated with lower addiction to alcohol, cigarette, and waterpipe, whereas insecure attachment styles (preoccupied, dismissing and fearful) were significantly associated with higher addiction to cigarette, waterpipe, alcohol, and internet.

Conclusion

Lebanese adolescents with insecure attachment had higher rates of addiction to cigarette, waterpipe, alcohol, and internet. They should be closely monitored in order to reduce the risk of future substance use disorder and/or behavioral addiction development.

Academic procrastination of medical students: The role of Internet addiction

INTRODUCTION

The internet is an essential and widely used tool for college students; however, high internet dependency can have negative consequences for students, especially regarding academic careers. Such students may tend to postpone their academic tasks. Hence, the current study examines the effect of Internet addiction on academic procrastination among medical students.

METHODS

We applied a cross-sectional correlational research design. 233 medical students of Shiraz University of Medical Sciences were selected through convenience sampling and participated in this study. To collect the data, we used two valid and reliable questionnaires. The first was Young's Internet addiction questionnaire (IAT-20), which consists of 20 items based on a 5-point Likert-type scale. The second was Solomon and Rothblum academic procrastination questionnaire, which consists of 18 items based on a 5 point Likert-type scale. We used Pearson correlation, independent T-test, and One-Way ANOVA to analyze the data in SPSS version 22, and considered a significance level of p < 0.05.

RESULTS

Results showed that 57.1% of the respondents were females, and the remaining were males. Findings indicated that 8 (3.43%) of the participants were classified as severe internet-addicted, and 28.85% of them had a high level of academic procrastination. The results indicated that there was a positive and significant correlation between Internet addiction and academic procrastination (r=0.39, with p<0.01). Also, there was a positive correlation between academic procrastination dimensions (writing a term paper, studying for an exam, keeping up with weekly reading assignments, performing administrative tasks, attending meetings and performing academic tasks in general) and Internet addiction (r=0.22, r=0.32, r=0.21, r=0.29, r=0.33, and r=0.23, respectively, with p<0.01). Finally, the results revealed that male students and those living in the dormitory had a higher level of Internet addiction and procrastination compared to female ones and those living at home (p<0.01).

CONCLUSION

The findings of the current research reveal that a considerable number of students have levels of Internet addiction and procrastination; the study highlights that students with high levels of Internet addiction are more likely to be at an increased risk of negative outcomes such as insufficiently controlled Internet use.

Sex Differences in the Relationship between Student School Burnout and Problematic Internet Use among Adolescents

Background: The Internet has many positive sides, but it can also have a negative impact on human emotional-cognitive and behavioral functioning, especially during adolescence. To the most common consequences, the authors add addiction of the teenager to the Internet. This addiction is related to many negative physical and mental problems, including depression, substance abuse and social isolation. Methods: In the study, SSBS (Student School Burnout Scale) was used to measure the level of burnout, and the level of Internet addiction was measured using PUI (Internet Addiction Test). The research was carried out among 230 individuals aged 17–20 years. Results: The results of the research showed that higher level of school burnout is related to higher Internet addiction indicators, and connection was stronger in the male group. Gender significantly predicted Internet addiction and moderated the link between school burnout and Internet addiction. Hierarchical multiple regression analyses confirmed different predictors of Internet addiction for male and female students. However, for both groups, higher burnout due to parents was a significant predictor of Internet addiction (IA). Discussion: Internet addiction was predicted by school burnout, appearing as a result of parental pressure for high school achievements. In addition, school burnout and school-related characteristics have greater prediction power of Internet addiction and its indicators in a male group.