School-Related Risk Factors of Internet Use Disorders

Tomorrow Never Comes: The Risks of Procrastination for Adolescent Health

This study explores the relationship between procrastination and declining healthy habits among adolescents, a topic lacking systematic reviews in the existing literature. The primary purpose is to lay the groundwork for promoting mental health and preventing procrastination as risky behavior. This systematic review examined five areas related to procrastination and its influence on healthy lifestyle habits in adolescents: technology and procrastination; sleep and procrastination; academic procrastination; and the COVID-19 pandemic. The findings highlight that technology misuse is linked with procrastination; adolescents tend to procrastinate when going to sleep; academic procrastination negatively impacts long-term educational achievements, and the COVID-19 pandemic has exacerbated this phenomenon. Ultimately, it is concluded that procrastination is related to all these aspects and has detrimental effects on adolescents' physical and psychological development.

The role of academic procrastination on Internet addiction among Thai university students: A cross-sectional study

Background

The internet has become an inevitable tool for information-seeking and communication in today's modern era. However, ironically it has driven humankind to become more dependent, leading to addiction. Internet addiction has increased exponentially at all levels of society, especially university students, impeding their physical, psychological, and social well-being.

Objective

This study aimed to examine the relationship between academic procrastination and internet addiction and determine the influence of academic procrastination on internet addiction among Thai university students.

Methods

A cross-sectional study was conducted involving 470 participants selected through multi-stage cluster random sampling from a university in eastern Thailand. The data collection was conducted between 29 November 2022 and 27 January 2023. The data were gathered using a demographic data form, an internet addiction test, and a procrastination assessment scale for the students' questionnaire. Descriptive statistics, Pearson correlation coefficient, and simple linear regression were employed for data analysis.

Results

The results revealed that academic procrastination (M = 49.68, SD = 12.61) and internet addiction (M = 65.26, SD = 5.60) were at a moderate level. A positive correlation was identified between academic procrastination and internet addiction (r = 0.33, p <0.01), indicating a low relationship. Academic procrastination also had a significant predictive power on internet addiction, accounting for 11.3% of the variance (R2 adjusted = 0.113, F (1, 468) = 59.583, p <0.001).

Conclusion

The findings indicated the significant role of academic procrastination on internet addiction. Therefore, it is crucial that nurses should formulate interventions by considering this factor and emphasize self-regulatory and time-management skills and practical ways to limit internet dependence. Furthermore, the findings suggest that nurses could assess the procrastination level among students, devise prevention strategies, and organize awareness campaigns to instill information about rational internet use that aids in mitigating the risks and preventing them from getting addicted.

Procrastination Predicts Future Internet Use Disorders in Adolescents but Not Vice Versa: Results from a 12-Month Longitudinal Study

BACKGROUND

Use of Internet applications is often associated with postponing real-life obligations. Previous cross-sectional studies have reported a positive association between procrastination and Internet use disorders (IUDs). Further, procrastination is included in theoretical models explaining the development of IUDs. However, little is known about the temporal relationship; thus, longitudinal studies identifying the specific predictive direction are required.

METHODS

Using a cross-lagged panel design, a total of 240 students who were at high risk for IUDs, aged between 12 and 18 years (M = 15.17, SD = 1.66) were assessed at baseline (t1) and reassessed one year later (t2) with standardized measures for IUDs and procrastination.

RESULTS

Our results showed that IUD symptom severity at t2 was significantly predicted both by IUD symptom severity at t1 and procrastination at t1. However, procrastination at t2 was predicted only by procrastination at t1 but not by IUD symptom severity at t1.

CONCLUSIONS

We could not find a reciprocal relationship between procrastination and IUD symptom severity. Procrastination appears to be a causal risk factor for IUDs, but not a consequence. As a modifiable risk factor, procrastination is a promising starting point for preventive and therapeutic interventions for IUDs.

Does Time Spent Online Affect Future Psychopathology in Adolescents?

Abstract. Theoretical background: In cross-sectional studies, high levels of online time proved to be empirically related to a higher risk of online behavioral addictions, which in turn are cross-sectionally and longitudinally associated with psychopathology. First results indicated that online behavioral addictions could predict a higher psychopathological burden. Objective: We empirically examined whether online time is also a predictor of future psychopathology in youth. Methods: In a longitudinal study, we explored whether 249 adolescents (55.0 % girls, aged 15.31 years, SD = 1.78) were at increased risk for problematic Internet use at baseline (t1) and 12-month later (t2) using standardized questionnaires regarding psychopathology (SDQ), online behavioral addictions (CIUS), and time spent online. Results: In linear regression analyses, online time was not a statistically significant predictor of any psychopathological burden 12 months later (at t2), after controlling for gender, age, online behavioral addictions, and respective symptoms of psychopathology (all at t1). Discussion and conclusion: Time spent online does not seem to predict future psychopathological strain during adolescence.

Effectiveness of Cognitive Behavioral Therapy-Based Intervention in Preventing Gaming Disorder and Unspecified Internet Use Disorder in Adolescents: A Cluster Randomized Clinical Trial

IMPORTANCE

Behavioral addictions were introduced as novel mental disorders in the International Classification of Diseases, 11th Revision, based on evidence that human behavior itself can become addictive, similar to addiction to substances. However, previous studies on prevention of gaming disorder and unspecified internet use disorder lacked randomization, follow-up measurements, and diagnostic interviews that assessed incidence rates; this trial was intended to fill this gap.

OBJECTIVES

To investigate whether the PROTECT (Professioneller Umgang mit technischen Medien [Professional Use of Technical Media]) intervention can reduce the symptom severity and prevent full syndrome and subthreshold onset of gaming disorder and unspecified internet use disorder in at-risk adolescents.

DESIGN, SETTING, AND PARTICIPANTS

A multicenter cluster randomized clinical trial conducted recruitment, screening, intervention delivery, and data collection among at-risk adolescents aged 12 to 18 years in 33 high schools in Germany. Inclusion criteria for the study and symptom severity analyses were elevated symptoms of gaming disorder and unspecified internet use disorder. A subsample that met the inclusion criteria for incidence analyses (no full syndrome of gaming disorder or unspecified internet use disorder, depression, or anxiety at baseline) was analyzed for illness onset. Participants were randomized to either the PROTECT intervention group or the assessment-only control group. Participants were assessed at baseline, 1-month follow-up, 4-month follow-up, and 12-month follow-up between October 1, 2015, and September 30, 2018. Based on intent-to-treat principle, data analyses were conducted from February 8, 2019, to May 7, 2021.

INTERVENTIONS

PROTECT, a theory-driven, manualized, cognitive behavioral therapy-based indicated preventive group intervention that is delivered in 4 sessions by trained psychologists. It targets changes in addictive reward processing and pathological cognitive mechanisms.

MAIN OUTCOMES AND MEASURES

The primary outcome was symptom severity (measured by CSAS [Computerspielabhängigkeitsskala], a modified German video game dependency scale with a score range of 0-56 [higher scores indicating greater pathology]) along with incidence rates (assessed by a structured clinical interview) after 12 months. Secondary outcomes were comorbid psychopathology and problem behaviors.

RESULTS

A total of 422 at-risk adolescents (mean [SD] age, 15.11 [2.01] years; 229 female participants [54.3%]) were randomized to either the PROTECT intervention group (n = 167; mean [SD] risk score, 29.05 [6.98]) or the assessment-only control group (n = 255; mean [SD] risk score, 26.21 [5.01]) and were included in the symptom severity analyses. Compared with the control group, the PROTECT group showed a significantly greater reduction in symptom severity of gaming disorder or unspecified internet use disorder (γ11 = -0.128; 95% CI, -0.246 to -0.011; P = .03), reflecting a 39.8% vs 27.7% reduction of symptoms with an effect size of Cohen d = 0.67 (baseline vs 12-month follow-up) for the PROTECT group. Differences in incidence rates did not reach statistical significance. The PROTECT group showed a significantly greater decrease in procrastination (γ11 = -0.458; 95% CI, -0.735 to -0.180; P < .001) over 12 months, but no significant differences were found for other secondary outcomes.

CONCLUSIONS AND RELEVANCE

Results of this trial showed that the PROTECT intervention effectively reduced symptoms of gaming disorder and unspecified internet use disorder over 12 months. The intervention did not change incidence rates of gaming disorder or unspecified internet use disorder.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02907658.

Factors related to the dual condition of gambling and gaming disorders: A path analysis model

BACKGROUND AND AIMS

Gaming disorder has experienced rapid growth in the last decade among youth and adult populations, in parallel to the expansion of the videogame industry. The objective of this study was to explore the underlying process to explain the dual diagnosis of gaming with gambling disorder.

METHODS

The sample included n = 117 patients who met clinical criteria for gaming disorder, recruited from a tertiary care unit specialized in the treatment of behavioral addictions. Path analysis (implemented through structural equation modeling) assessed the direct and mediational mechanisms between the dual condition of gaming + gambling disorder and sociodemographic variables and personality traits.

RESULTS

The comorbid gaming + gambling disorder was met for 14.5% of the participants (additionally, 6.0% of the sample also met criteria for problematic gambling). The dual diagnosis was directly related to an older age at onset of the addiction problems, a higher level of the novelty seeking trait and being in active work. Employment status also mediated the relationship between persistence levels and chronological age. Greater psychopathological distress was related to females, higher levels of harm avoidance and persistence and lower levels of self-directedness.

CONCLUSIONS

The results of this study provide empirical evidence for the specific factors that increase the likelihood of the dual gaming + gambling disorder. Clinical settings should consider these features to improve gaming diagnosis and treatment. Preventive programs should also be focused on the most vulnerable groups to prevent onset and progression of this comorbid condition.

The Impact of Online Game Addiction on Adolescent Mental Health: A Systematic Review and Meta-analysis

Abstract: Introduction: The World Health Organization (WHO) in 2019 determined that Internet Gaming Disorders (IGD) were included as mental health disorders. Among adolescents, excessive online gaming has become a lifestyle and is associated with psychological symptoms (psychopathological symptoms and life satisfaction), social health (social interactions) and physical health (general health and body mass index). The IGD has now become a problem all over the world.   AIM: This study aims to analyze the impact of online game addiction on adolescents using the Preferred Reporting Items for Systematic Reviews (PRISMA) approach.   MATERIALS AND METHODS: Subjects were searched extensively from the Pubmed, Sage, Science Direct, and Scopus databases. The search used the keywords "online game addiction", "mental health", and "youth". The inclusive criteria for the included  literature in this study  were as follow; the literature had to be sourced from journal article, written in English, available in full text, the published between  2011-2021, and the age of the adolescent subject should be 13-18 years. We identified 81 articles of which 20 were deemed relevant for this systematic review.   RESULTS: This review study shows that problematic online gaming behavior has a strong negative correlation with various subjective health outcomes.   CONCLUSION: Early relevant prevention for  adolescents from the IGD is the appropriate use of  internet/ gadgets as the only option to avoid or to reduce the symptoms of internet addiction and online games.   Keywords : Online game addiction; Mental health; Adolescents; Good Health and Wellbeing

Problematic Gaming in Youth and Its Association with Different Dimensions of Quality of Life

Objective: The problematic use of computer games was included in the DSM-5 and in the ICD-11. Initial research revealed associations between problematic gaming (PG) and quality of life (QoL). However, clarification is needed concerning which dimensions of the multidimensional construct QoL are particularly relevant for PG. Method: To answer this question empirically, we asked 503 parents (mean age: 47.63 years) to rate their 503 children (average age: 14.60 years) regarding QoL and PG, using validated questionnaires on parental assessments of adolescent PG and health-related QoL to collect the data. Correlation analyses were calculated to determine bivariate relations, and a multiple linear regression was used to conduct a multivariable analysis. Results: In the bivariate analyses, a higher severity of PG was associated with a lower health-related QoL in all five surveyed dimensions. In the multivariable model (corrected R² = 0.35), we observed statistically significant associations between higher severity of PG and male sex and lower age of the adolescent as well as lower QoL in the dimensions of physical well-being and school environment. Conclusions: According to the findings of the present study, physical well-being and school environment should be especially focused on in preventive approaches against the development of PG in youth.

Associations of emotional and behavioral problems with Internet use among Chinese young adults: the role of academic performance

BACKGROUND

To investigate the independent association between different types of emotional and behavioral problems and Internet use (i.e., Internet use time and problematic Internet use [PIU]) among Chinese young adults, and to test whether these associations vary by academic performance.

METHODS

Data was drawn from the 2019 National School-based Chinese Adolescents Health Survey, and 30,581 undergraduates (mean age: 19.9 [SD: 1.6] years) completed standard questionnaires qualifiedly. Daily hours of Internet use, PIU, emotional and behavioral problems, and academic performance were measured.

RESULTS

After adjusting for control variables and academic performance, students who reported having emotional problems (daily hours: adjusted unstandardized β estimate=0.14, 95% CI=0.12~0.15; PIU: adjusted unstandardized β estimate=1.82, 95% CI=1.77~1.89), conduct problems (daily hours: adjusted unstandardized β estimate=0.12, 95% CI=0.09~0.15; PIU: adjusted unstandardized β estimate=1.76, 95% CI=1.67~1.84), hyperactivity (daily hours: adjusted unstandardized β estimate=0.08, 95% CI=0.06~0.12; PIU: adjusted unstandardized β estimate=1.46, 95% CI=1.38~1.54), and peer problems (daily hours: adjusted unstandardized β estimate=0.03, 95% CI=0.002~0.05; PIU: adjusted unstandardized β estimate=0.53, 95% CI=0.44~0.62) were more likely to engaged in prolonged daily Internet use and PIU. In contrast, prosocial behavior was negatively associated with Internet use time and PIU. Stratified analyses showed that some of the associations in poor academic performers were stronger than in students with good and average academic performance.

LIMITATIONS

The cross-sectional design limited the ability to make causal inferences.

CONCLUSIONS

The findings suggest that the efforts to prevent abnormal Internet use should be focused on students with emotional and behavioral problems or poor academic performance.

Assessing ICD-11 gaming disorder in adolescent gamers by parental ratings: Development and validation of the Gaming Disorder Scale for Parents (GADIS-P)

BACKGROUND AND AIMS

The addiction to digital games is associated with substantial impairments in daily functioning and adolescents are particularly at risk. Screening instruments for the new ICD-11 diagnosis Gaming Disorder (GD) are rare and only include self-ratings thus far. Since adolescents' insight might be limited due to young age or symptom denial, external ratings are essential. We therefore aimed to develop and validate the Gaming Disorder Scale for Parents (GADIS-P) in a representative sample of parents and young gamers.

METHODS

GADIS-P was developed as an adaptation of a recently published self-rating scale. It was validated in 800 parents and their frequently gaming children between 10 and 17 years with standardized questionnaires in an online survey. Item structure was investigated by confirmatory factorial analysis. Gaming time, pathological gaming according to DSM-5, emotional dysregulation, and academic performance were used to derive criterion validity. Accordance with self-ratings was determined. ROC-Analyses were computed to determine cut-off values.

RESULTS

A presumed two-factorial structure of GADIS-P could be confirmed describing cognitive-behavioral symptoms and negative consequences. The instrument showed good to excellent internal consistency (Cronbach's α = 0.89-0.92, McDonald's ω = 0.92-0.95) and criterion validity with moderate to strong correlations regarding gaming behavior (r/ϱ = 0.35-0.76), excellent discriminatory power, and moderate accordance with the adolescents' self-ratings (kappa = 0.47-0.58).

DISCUSSION AND CONCLUSIONS

As the first successfully validated tool for the assessment of ICD-11 GD in adolescents by parental judgment, GADIS-P can make an important contribution to reliable GD screening in clinical and research settings.

[Media-associated disorders in childhood and adolescence: Evidence paper of the joint addiction commision of the German societies and professional associations of child and adolescent psychiatry and psychotherapy]

Media-associated disorders in childhood and adolescence: Evidence paper of the joint addiction commision of the German societies and professional associations of child and adolescent psychiatry and psychotherapy Abstract. Media-associated disorders (MAD) describe the problematic use of the internet, certain electronic devices in general as well as digital applications. During childhood and adolescence, digital games and social media are the most commonly used applications. In May 2019, as first MAD "gaming disorder" was included as a clinical diagnosis in the ICD-11. The prevalence of MAD in German children and adolescents is estimated to lie between 3 % and 5 %. In most cases, MAD are accompanied by psychiatric comorbidities. MAD ensue because of dysfunctional learning processes in combination with general and specific risk factors. They are associated with neural changes like those of substance-associated addictions. Diagnostics can be based on validated questionnaires and clinical exploration, though a standardized diagnostic path is not yet common. Treatment depends on the level of severity and generally comprises outpatient, day-clinic, and inpatient therapy approaches with elements from cognitive-behavioral therapy and under parental involvement. Suitable treatments are not yet available in all German regions and have also not been sufficiently evaluated. Moreover, only a few studies exist on the efficacy of prevention measures addressing MAD in children and adolescents. Thus, further research is strongly required.