Conceptualising social media addiction: a longitudinal network analysis of social media addiction symptoms and their relationships with psychological distress in a community sample of adults

BACKGROUND

Problematic social media use has been identified as negatively impacting psychological and everyday functioning and has been identified as a possible behavioural addiction (social media addiction; SMA). Whether SMA can be classified as a distinct behavioural addiction has been debated within the literature, with some regarding SMA as a premature pathologisation of ordinary social media use behaviour and suggesting there is little evidence for its use as a category of clinical concern. This study aimed to understand the relationship between proposed symptoms of SMA and psychological distress and examine these over time in a longitudinal network analysis, in order better understand whether SMA warrants classification as a unique pathology unique from general distress.

METHOD

N = 462 adults (Mage = 30.8, SDage = 9.23, 69.3% males, 29% females, 1.9% other sex or gender) completed measures of social media addiction (Bergen Social Media Addiction Scale), and psychological distress (DASS-21) at two time points, twelve months apart. Data were analysed using network analysis (NA) to explore SMA symptoms and psychological distress. Specifically, NA allows to assess the 'influence' and pathways of influence of each symptom in the network both cross-sectionally at each time point, as well as over time.

RESULTS

SMA symptoms were found to be stable cross-sectionally over time, and were associated with, yet distinct, from, depression, anxiety and stress. The most central symptoms within the network were tolerance and mood-modification in terms of expected influence and closeness respectively. Depression symptoms appeared to have less of a formative effect on SMA symptoms than anxiety and stress.

CONCLUSIONS

Our findings support the conceptualisation of SMA as a distinct construct occurring based on an underpinning network cluster of behaviours and a distinct association between SMA symptoms and distress. Further replications of these findings, however, are needed to strengthen the evidence for SMA as a unique behavioural addiction.

A Reevaluation of the Factor Structure, Reliability, and Validity of the Spiritual Well-Being Questionnaire (SWBQ)

The 20-item Gomez and Fisher (Personal Individ Differ 35:1975-1991, 2003) Spiritual Well-Being Questionnaire (SWBQ) is a widely used measure of spiritual well-being. Its theoretical model is a higher-order model with primary factors for personal, communal, environmental, and transcendental well-being, and a secondary global spiritual well-being factor. The current study, conducted in Australia, reevaluated the factor structure of the SWBQ. Unlike previous studies, the current study also used exploratory structural equation modeling (ESEM) to examine the factor structure of the SWBQ and selected the preferred model using not only global model fit values, but also the clarity, reliabilities, and validities of the factors in the models. A total of 227 adults (males = 63; females = 164; M age = 26.1 years; SD = 5.2 years) completed the SWBQ. Based on the model selection criteria applied in the study, the ESEM model with four group factors was selected as the preferred model. However, there was also adequate support for the proposed theoretical higher-order model and the first-order oblique model with the four well-being factors. Concerning our preferred model, its factors showed reasonable clarity for factor loadings and (omega) reliabilities. However, only the communal domain scale was supported empirically for external validity. The implications of the findings for the theoretical model, the use of the SWBQ, and future studies are discussed. In this respect, there are three potential models (theorized higher-order model, 4-factor first-order oblique model, and the ESEM model proposed in this study) that warrant further detailed investigation with a larger, more representative population and additional validation measures.

Social media use and abuse: Different profiles of users and their associations with addictive behaviours

Introduction

Social media use has become increasingly prevalent worldwide. Simultaneously, concerns surrounding social media abuse/problematic use, which resembles behavioural and substance addictions, have proliferated. This has prompted the introduction of 'Social Media Addiction' [SMA], as a condition requiring clarifications regarding its definition, assessment and associations with other addictions. Thus, this study aimed to: (a) advance knowledge on the typology/structure of SMA symptoms experienced and: (b) explore the association of these typologies with addictive behaviours related to gaming, gambling, alcohol, smoking, drug abuse, sex (including porn), shopping, internet use, and exercise.

Methods

A sample of 968 [Mage = 29.5, SDage = 9.36, nmales = 622 (64.3 %), nfemales = 315, (32.5 %)] adults was surveyed regarding their SMA experiences, using the Bergen Social Media Addiction Scale (BSMAS). Their experiences of Gaming, Internet, Gambling, Alcohol, Cigarette, Drug, Sex, Shopping and Exercise addictions were additionally assessed, and latent profile analysis (LPA) was implemented.

Results

Three distinct profiles were revealed, based on the severity of one's SMA symptoms: 'low', 'moderate' and 'high' risk. Subsequent ANOVA analyses suggested that participants classified as 'high' risk indicated significantly higher behaviours related to internet, gambling, gaming, sex and in particular shopping addictions.

Conclusions

Results support SMA as a unitary construct, while they potentially challenge the distinction between technological and behavioural addictions. Findings also imply that the assessment of those presenting with SMA behaviours, as well as prevention and intervention targeting SMA at risk groups, should consider other comorbid addictions.

Differences between DSM-5-TR and ICD-11 revisions of attention deficit/hyperactivity disorder: A commentary on implications and opportunities

Current ICD-11 descriptions for attention deficit hyperactivity disorder (ADHD) were recently published online, in the same year as the DSM-5-TR (text revised edition) was released. In this commentary, we compare and contrast the DSM-5/DSM-5-TR and ICD-11 diagnostic criteria, summarize important differences, and underscore their clinical and research implications. Overall, three major differences emerge: (1) The number of diagnostic criteria for inattention (IA), hyperactivity (HY) and impulsivity (IM) symptoms (i.e., DSM-5-TR has nine IA and nine HY/IM symptoms, whereas ICD-11 has eleven IA and eleven HY/IM symptoms); (2) the clarity and standardization of diagnostic thresholds (i.e., the diagnostic thresholds for symptom count in IA and HY/IM domains are explicitly specified in DSM-5-TR, whereas in ICD-11 they are not); and (3) the partitioning of HY and IM symptoms into sub-dimensions (i.e., difference in partitioning HY and IM symptom domains relates to the differences between the current and previous editions of DSM and ICD, and this has important research implications). Currently, no ICD-11 based ADHD rating scales exist and while this absence represents an obstacle for respective research and clinical practice, it also presents opportunities for research development. This article highlights these challenges, possible remedies and novel research opportunities.

Co-occurrence of Common Biological and Behavioral Addictions: Using Network Analysis to Identify Central Addictions and Their Associations with Each Other

The present study used network analysis to examine the network properties (network graph, centrality, and edge weights) comprising ten different types of common addictions (alcohol, cigarette smoking, drug, sex, social media, shopping, exercise, gambling, internet gaming, and internet use) controlling for age and gender effects. Participants (N = 968; males = 64.3%) were adults from the general community, with ages ranging from 18 to 64 years (mean = 29.54 years; SD = 9.36 years). All the participants completed well-standardized questionnaires that together covered the ten addictions. The network findings showed different clusters for substance use and behavioral addictions and exercise. In relation to centrality, the highest value was for internet usage, followed by gaming and then gambling addiction. Concerning edge weights, there was a large effect size association between internet gaming and internet usage; a medium effect size association between internet usage and social media and alcohol and drugs; and several small and negligible effect size associations. Also, only 48.88% of potential edges or associations between addictions were significant. Taken together, these findings must be prioritized in theoretical models of addictions and when planning treatment of co-occurring addictions. Relatedly, as this study is the first to use network analysis to explore the properties of co-occurring addictions, the findings can be considered as providing new contributions to our understanding of the co-occurrence of common addictions.

Inter-relationships between ADHD, ODD and impulsivity dimensions in emerging adults revealed by network analysis: extending the ‘trait impulsivity hypothesis’

Background

The trait-impulsivity hypothesis posits impulsivity as the underlying substrate of Attention-deficit/hyperactivity disorder (ADHD) and Oppositional defiant disorder (ODD) symptom expressions. The current study applied network analysis to evaluate the inter-relationships of dimensions within ADHD (inattention and hyperactivity/impulsivity) and ODD (anger/irritable, vindictiveness, and argumentative/defiant behavior) with components of impulsivity as captured by the UPPS-P model (negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and positive urgency).

Method

A total of 324 emerging adults (women = 246) from the general community completed questionnaires covering these dimensions.

Results

Our findings showed that the ADHD and ODD dimensions were associated differentially with different types of impulsivity, in their unique patterns of network connectivities, a possibility that has had little attention in the trait-impulsivity hypothesis literature.

Conclusions

This study is the first to tease out the unique associations of the ADHD and ODD dimensions with different types of impulsivity, and in that way provide new contributions to our understanding of the existing trait impulsivity theory. Our findings would be especially relevant to those interested in understanding how different dimensions of trait impulsivity underly the ADHD and ODD dimensions.

Are there country-specific differences in the use of pegvisomant for acromegaly in clinical practice? An analysis from ACROSTUDY

OBJECTIVE

A comprehensive picture of pegvisomant use for treating acromegaly in routine clinical practice in different countries is lacking. We aimed, therefore, to document country-specific behaviors in real-life pegvisomant use, and the main safety and effectiveness outcomes in the ACROSTUDY.

DESIGN

ACROSTUDY is an open-label, non-interventional, post-marketing safety surveillance study.

METHODS

A descriptive analysis was performed using data from the six top-recruiter ACROSTUDY countries, i.e., Germany (n = 548 patients), Italy (n = 466), France (n = 312), USA (n = 207), Spain (n = 200) and the Netherlands (n = 175). These nations accounted for > 85% of the ACROSTUDY cases.

RESULTS

The mean pegvisomant dose at treatment start was lowest in the Netherlands (9.4 mg/day), whereas it ranged between 10.9 and 12.6 mg/day in the other countries. At year 5, the mean pegvisomant dose was around 15 mg/day in all countries, except France (18.1 mg/day). At starting pegvisomant, patients treated with monotherapy ranged between 15% in the Netherlands and 72% in Spain. Monotherapy remained lowest over time in the Netherlands. In all countries, the percentage of patients with normal IGF-1 increased steeply from < 20% at baseline to 43-58% at month 6 and 51-67% at year 1. After that, we observed minor changes in the rate of acromegaly control in all countries. The Netherlands peaked in disease control at year 2 (72%). The proportion of patients reporting changes in pituitary tumor size was generally low. Serious treatment-related adverse events were < 5% in all countries.

CONCLUSIONS

Our study provided a detailed summary of real-life use of pegvisomant in the six top-recruiter ACROSTUDY nations.

Factor structure of ten psychoactive substance addictions and behavioural addictions

Over the past two decades, many problematic/excessive behaviours have increasingly been conceptualized as addictions due to their similarity with more traditional psychoactive substance addictions. The primary aim of the present study was to simultaneously examine the factor structure of three psychoactive substance addictions (alcohol use, cigarette smoking, and substance use) and seven behavioural addictions (sex, social media use, shopping, exercise, online gambling, internet gaming, and internet use), using exploratory factor analysis (EFA; N = 481) and confirmatory factor analysis (CFA; N = 487). A total of 968 participants completed an online survey including ten psychometric scales assessing the ten different potentially addictive behaviours. EFA supported a two-factor solution, with different factors for the psychoactive substance and behavioural addictions (excluding exercise addiction). CFA supported the two-factor model in a separate sample. There was good support for the concurrent and discriminant validities of the CFA latent factors and the reliability of the behavioural latent factor in the two-factor CFA model. While there was support for the concurrent and discriminant validities of the psychoactive substance latent factor, there was insufficient support for its reliability. The taxonomic, theoretical, and clinical implications of the findings are discussed.

POS1334 OCULAR CICATRICIAL PEMPHIGOID: IS THERE AN ASSOCIATION WITH AUTOIMMUNE DISEASES?

Background

Ocular Cicatricial Pemphigoid (OCP) is an infrequent, systemic cicatricial immune-mediated disease, belonging to the group of membranous-mucosal pemphigoids (MMP). Due to the possibility of coexistence of multiple autoimmune diseases (ADs), OCP could be associated with other diseases. In the literature, association of OCP and ADs is reported in 9-35% of patients, but most reports correspond to MMP.

Objectives

To assess the prevalence of autoimmune diseases associated with OCP and to analyse clinical, laboratorial and treatment associations between these entities.

Methods

A multicentre cross-sectional study of patients with a diagnosis (clinical and/or by biopsy) of OCP derived from ophthalmology was performed.

The population was divided into two groups according to their association or not with other ADs. Clinical, laboratorial and treatment variables were described and compared between both groups. In addition, a multivariate descriptive logistic regression analysis was performed to identify variables that could suggest the association between OCP and ADs.

Results

A total of 88 patients were recruited, 66 (75%) females, with a mean age at diagnosis of 64.3 years (SD 11.9). The median follow-up time was 1 year. The diagnosis was done by biopsy in 86,8%. Ocular bilateral disease was present in 95,3% of patients. There was a median delay from symptoms onset to diagnosis of 2 years. A history of malignancy was reported in 13,6%. Extraocular involvement was evidenced in 11,5% (4% compromised skin and 9,1% other mucous membranes). Regarding the previous clinical findings, no statistically significance was found between the groups with and without ADs. Systemic treatment was depicted as follows: oral corticosteroids (60,2%) (p-value < 0.001), corticosteroids pulses (5,7%), dapsone (3,4%), methotrexate (79,5%), mycophenolate (15,9%), azathioprine (23,9%), rituximab (5,7%), immunoglobulin (1,1%); topical corticosteroids (96,6%) and ocular infiltration (2,3%). The group associated ADs included 24 patients (27.3%). Within them, the most prevalent diagnosis was Sjogren’s syndrome (13.6%), followed by Hashimoto´s thyroiditis (9,1%) and rheumatoid arthritis (3,4%). Most of the patients presented Foster stages 1 (45.3%) and 2 (29.3%) at diagnosis. In the ADs group, statistically significant associations were observed with ANA, SS-A and SS-B antibodies, rheumatoid factor, and hypergammaglobulinemia. In the descriptive multivariate logistic regression model, it was detected that hypergammaglobulinemia was associated with ADs and OCP, adjusted for age, sex, smoking, skin and mucosal involvement, and erythrocyte sedimentation rate (OR 8.7; 95% CI 1.6 to 46.8; p= 0.012), Table 1.

Table 1.

Multiple logistic regression analysis with OCP associated with ADs as dependent variable.

ORCI95P valueGender0.20.04 - 1.10.07Age at diagnosis1.020.9 - 1.10.25Smoking0.50.1 - 1.70.26Skin and mucosa compromise1.20.2 - 8.20.83ESR0.980.95 - 1.020.58Hypergammaglobulinemia8.71.6 - 46.80.012

ESR: Erythrocyte Sedimentation Rate. OR: Odd Ratio. CI95: confidence interval

Conclusion

Due to the autoimmune nature of OCP, it could coexist with other ADs. In this research, it was observed that more than a quarter of the population presented with such association and hypergammaglobulinemia could suggest it. A systematic search for this coexistence should be carried out to avoid sequelae or incomplete treatment in pathologies that are currently potentially treatable.

References

[1]Lamberts A et al. European guidelines on diagnosis and management of mucous membrane pemphigoid, initiated by the European Academy of Dermatology and Venereology – Part I. 2021;1750–64.

[2]Schmidt E et al. European Guidelines on diagnosis and management of mucous membrane pemphigoid, initiated by the European Academy of Dermatology and Venereology – Part II. 2021;1926–48.

[3]Narla S, Silverberg JI. Associations of pemphigus or pemphigoid with autoimmune disorders in US adult inpatients. J Am Acad Dermato. 2019;15-25.

Acknowledgements

On behalf of the Study Working Group of Rheumatological Ocular Diseases, Argentinian Society of Rheumatology.

Disclosure of Interests

None declared

The role of internet gaming in the association between anxiety and depression: A preliminary cross-sectional study

BACKGROUND

Disordered Internet gaming is thought to be perpetuated by one's need to escape their real-life distress or mental health symptoms, which may in turn generate depressive feelings. Nevertheless, moderate engagement with Internet games has also been suggested to provide relief, thus improving one's mood. This study aspires to clarify the contribution of Internet gaming and gender in the association between anxiety and depression.

METHODS

A large sample of Internet gamers (N = 964) were recruited online. Disordered Internet gaming was assessed with the Internet Gaming Disorder Scale, 9 Items Short Form (IGD9S-SF). Anxiety and depression symptoms were assessed using the Depression, Anxiety and Stress Scale, 21 items (DASS-21).

RESULTS

Regression, moderation and moderated moderation analyses accounting for the effects of gender on the relationship between disordered gaming, anxiety, and depression found a significant effect for anxiety symptoms on depression symptoms and a significant interaction between anxiety and Internet gaming disorder on depression symptoms. Findings support the theory that although anxious gamers bear a higher depression risk, this is buffered with lower and exacerbated with higher disordered gaming symptoms.

CONCLUSION

Findings suggest a dual role of Internet gaming in the association between anxiety and depression, depending on the intensity of one's disordered gaming symptoms. Depression prevention and intervention protocols should be optimized by considering the effects of Internet gaming among anxious gamers by focusing on the intensity of a gamer's involvement and any gaming disorder symptoms. Further research should include clinical samples to better understand this interaction.

AB0736 ASSOCIATION BETWEEN ERYTHROCYTE DISTRIBUTION WIDTH AND SYSTEMIC SCLEROSIS-ASSOCIATED INTERSTITIAL LUNG DISEASE

Background

Interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) account for 60% of deaths related to scleroderma (SSc). The erythrocyte distribution width (RDW) has been used as a marker of poor prognosis in different pathologies. In SSc, RDW has been found to be elevated in PAH and has been proposed as a predictor of cardiorespiratory compromise.

Objectives

The aim of this study is to evaluate the association between increased RDW and the presence of EPI in patients with SSc.

Methods

This is a multicenter, retrospective, cross-sectional study of patients diagnosed with SSc (ACR/EULAR 2013) from January 2011 to August 2021. Other concomitant autoimmune diseases, malignancy, active infections, iron-deficiency or pernicious anaemia and transfused patients were excluded. The diagnosis of PID was made by high-resolution computed tomography (HR-CT) and the extension evaluated by Goh criteria. A review of medical records was conducted, collecting clinical and demographic characteristics, interstitial pattern by HR-CT, assessed, acute phase reactants, capillaroscopy, functional respiratory tests (PFT) and echocardiographic resolution. Patients diagnosed with PAH by right heart catheterization were not excluded in this study but recorded.

Results

Seventy-five patients were included, with a mean age of 59.4 (SD 14.1 CI95% 56-6), from which 67 (89%) were women. A median of 8 years of disease evolution was observed RIC 8). Limited SS was observed in 50 (66%) and diffuse SS in 24 (32%). EPI was observed in 50 (66%) of which NSIP 25 (33%), NSIP-f 15 (20%) and UIP 10 (13%). The extension of the disease was limited in 25 (33%) and extensive in 19 (25%). Capillaroscopic findings were normal in 2 (3.4%), nonspecific in 1 (1.7%), early SD in 9 (15.3%), active SD in 22 (37.3%), and late SD in 25 (42.4%); in sixteen patients there was no capillaroscopy.

We observed an increase in RDW in the EPI group with a statistically significant difference OR 6.06 CI95% 2-17 (p 0.001).

The median RDW is higher in patients with ILD and PAH than in healthy people (p<0.0001).

We found a low negative correlation between RDW / FVC r (63) -.25 p 0.042 and RDW / FEV1 r (63) .30 p 0.015.

Conclusion

In the present study we have been able to evidence that there is a statistically significant relationship between the percentage of RDW and the presence of PID. When analysing the association between patients without pulmonary compromise, ILD and PAH and the percentage of RDW, we were able to find a statistically significant difference between the three groups. It is necessary to continue with studies with a larger number of patients to grant robustness to the results.

References

[1]Muangchan, et al: 15% rule in SSc. The Journal of Rheumatology 2013; 40; 9; doi:10.3899/jrheum.121380.

[2]Cottin and Brown. Interstitial lung disease associated with systemic sclerosis (Ssc-ILD) Respiratory Research (2019) 20:13

[3]Thayer, T. E. et al. Unbiased Phenome-wide Association Studies of Red Cell Distribution Width Identifies Key Associations with Pulmonary Hypertension. Annals of the American Thoracic Society. doi:10.1513/annalsats.201809-594oc.

[4]Zhao J,Mo H, Guo X,Wang Q, Xu D, Hou Y, Tian Z, Liu Y,Wang H, Lai J, Li M, ZengX (2018) Red blood cell distribution width as a related factor of pulmonary arterial hypertension in patients with systemic sclerosis. Clin Rheumatol 37:979–985.

[5]Goh NSL, Desai SR, Veeraraghavan S, et al. Interstitial Lung Disease in Systemic Sclerosis: A Simple Staging System. American Journal of Respiratory and Critical Care Medicine. 2008. June;177(11):1248–54.

[6]Hax V, Bredemeier M, Didonet Moro AL, et al. Clinical algorithms for the diagnosis and prognosis of interstitial lung disease in systemic sclerosis. Seminars in Arthritis and Rheumatism. 2017. October;47(2):228–34.

[7]Peralta S. Guías Argentinas De Consenso En Diagnóstico Y Tratamiento De La Hipertensión Pulmonar. Sociedad Argentina de Cardiología. Área de Consensos y Normas. Vol 85 Suplemento 3. Octubre 2017.

Acknowledgements

Participating centers

Disclosure of Interests

None declared

Network analyses of Oppositional Defiant Disorder (ODD) symptoms in children

Based on parent and teacher ratings of their children, this study used regularized partial correlation network analysis (EBIC glasso) to examine the structure of DSM-5 Oppositional Defiant Disorder (ODD) symptoms. Parent and teachers (N = 934) from the general community in Malaysia completed questionnaires covering DSM-5 ODD symptoms. The most central ODD symptom for parent ratings was anger, followed by argue. For teacher ratings, it was anger, followed by defy. For both parent and teacher ratings, the networks revealed at least medium effect size connections for temper and argue, defy, and argue, blames others, and annoy, and spiteful and angry. Overall, the findings were highly comparable across parent and teacher ratings, and they showed a novel understanding of the structure of the ODD symptoms. The clinical implications of the findings for assessment and treatment of ODD are discussed.

Personality inventory for DSM–5-Brief Form (PID-5-BF): Measurement invariance across men and women

The study examined the measurement invariance (configural, metric, scalar, and residual) of the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Brief Form (PID-5-BF; Krueger et al., 2013) across gender for the theorized Five-Factor oblique model. A large group of adults (N = 502), with ages ranging from 18 to 67 years, from the Australian general community completed the PID-5-BF. When the Δχ² test was applied, multiple-group confirmatory factor analysis supported configural invariance and full metric and residual invariance. For scalar invariance, at least seven items (constituting 13 thresholds) across the different dimensions lacked invariance for one or more of its thresholds. In addition, controlling all these noninvariance thresholds, women had higher latent mean scores for Negative Affect, and men had higher scores for Antagonism and Disinhibition. When the Δcomparative fit index (ΔCFI) test was applied, the findings also supported the configural invariance model and the full metric and residual invariance models. With the exception of one threshold, all the other thresholds were also invariant. The psychometric and practical implications of the findings are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Confirmatory factor analysis and exploratory structural equation modeling of the factor structure of the Questionnaire of Cognitive and Affective Empathy (QCAE)

The Questionnaire of Cognitive and Affective Empathy (QCAE) is a multiple dimensional measure of cognitive empathy [comprising primary factors for perspective taking (PT), online simulation (OS)], and affective empathy [comprising primary factors for emotion contagion (EC), proximal responsivity (PRO), and peripheral responsivity (PER)]. This study used independent clusters confirmatory factor analysis (ICM-CFA) and exploratory structural equation modeling (ESEM) to examine the scale’s factor structure. A general community sample of 203 (men = 43, women = 160) between 17 and 63 years completed the QCAE. Although both the five-factor oblique and second order factor models showed good model fit, and clarity in the pattern of factor loadings, in the second-order factor model, none of the primary factors loaded significantly on their respective secondary factors, thereby favoring the five-factor oblique model. The factors in this model were supported in terms of external validity. Despite this, the factor for PRO in this model showed low reliability for meaning interpretation. A revised four-factor oblique model without the PRO factor showed good fit, clarity in the pattern of factor loadings, and reliability and validity for the factors in this model, thereby suggesting this to be the best model to represent ratings on the QCAE.

Network analyses of internet gaming disorder symptoms and their links with different types of motivation

The study used regularized partial correlation network analysis (EBICglasso) to examine the structure of DSM-5 internet gaming disorder (IGD) symptoms (network 1); and the associations of the IGD symptoms in the network with different types of motivation as defined in the self-determination theory i.e., intrinsic motivation (engaging in an activity for something unrelated to the activity), identified regulation (engaging in the activity because it aligns with one's values and/or goals), external regulation (engagement in activity being driven by external rewards and/or approval), and amotivation (engaging in an activity without often understanding why) (network 2). Participants were 968 adults from the general community. They completed self-rating questionnaires covering IGD symptoms and different types of motivation. The findings for network 1 showed mostly positive connections between the symptoms within the IGD network. The most central symptom was loss of control, followed by continuation, withdrawal symptoms, and tolerance. In general, these symptoms were more strongly connected with each other than with the rest of the IGD symptoms. The findings for network 2 showed that the different types of motivation were connected differently with the different IGD symptoms. For instance, the likeliest motivation for the preoccupation and escape symptoms is intrinsic motivation, and for negative consequences, it is low identified regulation. Overall, the findings showed a novel understanding of the structure of the IGD symptoms, and the motivations underlying them. The clinical implications of the findings for assessment and treatment of IGD are discussed.

Genetic findings in miscarriages and their relation to the number of previous miscarriages

PURPOSE

Early pregnancy loss leads to a devastating situation for many couples. Genetic disorders found in the pregnancy tissue are a frequent cause of miscarriages. It is unclear whether maternal age or previous miscarriages are associated with a higher chromosomal anomaly rate. This study aimed to determine the cytogenetical distribution of chromosomal disorders in couples after one or more previous miscarriages as well as the influence of maternal age.

METHODS

406 fetal tissue samples obtained after spontaneous abortion between 2010 and 2014 were successfully karyotyped. This included 132 couples with at least two losses and 274 couples with sporadic miscarriage. Normal and abnormal karyotype rate was determined for age, parity, gravidity, gestational week and number of previous miscarriages by logistic regression analysis.

RESULTS

145 (35.71%) fetal tissue samples had a normal karyotype, and 261 (64.8%) did not. After adjusting for age, older patients have a statistically significantly higher probability of genetic disorders in the pregnancy tissue (p < 0.001, OR 1.064, 95% CI 1.03-1.11). With each additional year, the probability of finding chromosomal abnormalities in a miscarriage increased by 6.4%. Patients younger than 35 years have a lower probability of having chromosomal disorders in the aborted material after two or more miscarriages than after sporadic miscarriages (50.7 vs. 58.9%) (p = 0.014, OR 0.67, 95% CI 0.48-0.914). Nevertheless, the risk of embryonic chromosomal disorders in patients aged 35 and above increased from 75.5% in sporadic miscarriages to 82.4% after more than one pregnancy losses (p = 0.59, OR 1.14, 95% CI  - 0.72 to 1.92).

CONCLUSION

Chromosomal disorders found after one or more previous miscarriages are related to patients' age. Couples suffering two or more miscarriages should be further researched, especially in younger patients.

POS0667 TOFACITINIB IN PATIENTS WITH RHEUMATOID ARTHRITIS IN REAL-WORLD SETTINGS: A NATIONAL MULTICENTER STUDY OF 167 PATIENTS FROM ARGENTINA

Background:

Tofacitinib (TOF), an oral JAK inhibitor, is approved for the treatment of rheumatoid arthritis (RA) either as monotherapy or in combination with background methotrexate (MTX). Despite the current evidence of efficacy from randomized controlled trials and open-label long-term extension studies, evidence of effectiveness and safety in real-world settings is limited, not only in Argentina but also in Latin America.

Objectives:

To describe effectiveness, safety and persistence of TOF therapy in RA patients from public and private medical centers from Argentina. In addition, establish prognostic factors for clinical remission at 3 months and TOF monotherapy at 12 months.

Methods:

A retrospective, observational and multicentre study was performed from an analysis of medical records of 10 medical centers. RA patients (ACR/EULAR, 2010) and age ≥ 18 years who had received or are under treatment with TOF until June 2020 were included. The data collection was done on a standard database that included baseline data and at 3, 6 and 12 months. Clinical remission was defined as DAS28-ESR < 2,6. Adverse events, treatment duration, TOF treatment persistence at last visit and discontinuation cause were assessed. Comparison to baseline values was performed using Wilcoxon sign for numerical variables and McNemar´s test for categorical variables. Treatment persistence was analyzed using Kaplan Meier´s technique. Multivariate analysis was performed using R software and its library packages (Lme4, Tidyverse and ggpubr). A p value < 0.05 was considered significant.

Results:

A total of 167 patients were included (78.4% were female). At baseline, the median age was 53 years (IQR 43-63 years), median disease duration was 4 years (IQR 2-13 years). RF was positive in 85.6% of patients, ACPA in 80.8% and structural radiological damage was present in 71.8%. Previous use of MTX was 97%, leflunomide 74.8% and biologic therapy 42.5% (28.74% 1 biologic, 11.98% 2 biologics and 1.8% ≥ 3 biologics). TOF dose: 48% 11 mg/day and 52% 5 mg BID. A statistically significant difference was observed not only in disease activity (p<0.0001) but also in the requirement of MTX and PDN (p<0.0001) in the 12 months evaluated. Remission significantly increased from baseline to month 3 and to a much lesser extent to month 6 (p < 0.001). The mean duration of treatment with TOF was 20.10 ± 15.25 months. Treatment persistence was 93.84% at 3 months and 91.24% at 6 months. In those patient who achieved REM at month 3, a statistically significant differences in duration of RA (p 0.0002), structural radiological damage (p 0.011), basal disease activity (p 0.018) and prior treatment with biological therapy (p 0.017) was found when compared with patients who remained active. Furthermore, in univariate logistic regression analysis, 5 years or more of disease duration was associated with a 3 times higher risk of not achieving clinical remission at 3 months (odds ratio = 0.35, 95% CI = 0.15-0.83). In the multivariate logistic regression analysis, previous biological therapy was the only predictor associated with a decrease in the probability of clinical remission (p < 0.008). Adverse events were registered in 26 patients (herpes zoster, n = 9).

Conclusion:

The effectiveness of TOF was observed not only in the clinical response achieved but also in the dose titration or withdrawal of MTX and PDN. The safety profile did not show any difference from long-term extension studies. At 12 months, 86.81% of the patients persisted with TOF therapy. We found prognostic factors associated with clinical remission at 3 months but those associated with monotherapy at 12 months could not be defined due to small number of patients analyzed that could have generated lack of statistical power, although more studies are required to confirm these assumptions.

Disclosure of Interests:

Maria Del Rosario Maliandi: None declared, Yanina Silvia Malvano: None declared, Alejandra Cusa: None declared, María Julieta Gamba: None declared, Ramiro Gomez Speakers bureau: Abbvie, Novartis, Julio Got: None declared, Oscar Gut: None declared, Ursula Vanesa Paris: None declared, Maria Andrea Spinetto: None declared, Carolina Mariach: None declared, Alejandra Ines Abalo: None declared, Adrián Estevez Speakers bureau: Bristol-Meyer-Squibb, Jose Luis Velazco Zamora: None declared, Juan Pablo Vinicki: None declared

POS1005 ASSESSMENT OF DAREA AND MODIFIED DAREA IN AN ARGENTINIAN-GUATEMALAN REACTIVE ARTHRITIS COHORT

Background:

Reactive Arthritis (ReA) is an inflammatory joint disease and, as in rheumatoid or psoriatic arthritis, composite indices are the most useful tools to measure disease activity. The Disease Activity Index for Reactive Arthritis (DAREA) is the only developed index for ReA, which requires a 66/68 joint count and CRP for its assessment, the latter being difficult to acquire in our setting. Therefore, we developed a simplified index, the modified DAREA (DAREAm), with a lower joint count and ESR for its evaluation.

Objectives:

1) To evaluate the DAREA and the DAREAm in a cohort of patients with diagnosis of ReA and post-infectious arthritis 2) To assess the correlation of the DAREA and DAREAm with several clinical variables, functional capacity and quality of life in a cohort of patients with ReA.

Methods:

Patients with diagnosis of ReA (Calin’79) and post-infectious arthritis were included. Demographic data were collected, patient´s pain and global assessment were evaluated through a visual analog scale (VAS) and a 3-point scale (no pain = 0, mild = 1, moderate = 2, severe = 3), physician´s global assessment, morning stiffness (MS) and VAS fatigue. Functional capacity was assessed by HAQ and quality of life according to EuroQol-5 dimensions (EQ-5D), and the activity indices DAS28, DAREA and DAREAm were calculated. Statistical analysis: a descriptive analysis of the variables and correlation between numerical variables with Spearman rank correlation were performed.

Results:

57 patients were included, 53 with diagnosis of ReA, the majority post urogenital (63%) and gastrointestinal (17%), and 4 with diagnosis of post-infectious arthritis. Fifty six percent were male, mean age: 40 years old (SD ± 14) and median ReA duration: 15 months (IQR 2-45). The number of painful and swollen joints in a 66/68 joint count showed a median of 2 (IQR 0-3) and 1 (IQR 1-2) respectively. Median VAS pain 43 (IQR 15-70), patient´s disease activity 40 (IQR 20-60) and physician´s 40 (IQR 20-60), MS 10 (IQR 0-50) and fatigue 30 (IQR 0-80). Median DAS28 3.6 (IQR 2.3-4.3), DAREA 7.4 (IQR 2.5-10.6), DAREAm 8.6 (IQR 4.6-12.7), HAQ 0.625 (IQR 0.125-1). The dimensions with the greatest compromise in the EQ-5D were pain/discomfort (63%) and anxiety/depression (51%), and the median VAS EQ-5D was 60 (IQR 32-80). DAREA correlated with DAREAm (rs= 0.89; p <0.001), DAS28 (rs= 0.84; p <0.001), medical VAS (rs= 0.60; p <0.001), MS (rs= 0, 50; p <0.001), HAQ (rs= 0.53; p <0.001), VAS fatigue (rs= 0.57; p <0.001) and mobility subscales of the EQ5D (rs= 0.56; p <0.001), pain/discomfort (rs= 0.49; p <0.001) and anxiety/depression (rs= 0.61; p <0.001). The DAREAm correlated with DAS28 (rs= 0.93; p <0.001), physician VAS (rs= 0.58; p <0.001), fatigue VAS (rs= 0.53; p <0.001), HAQ (rs= 0 .51; p <0.001) and the EQ5D subscales: mobility (rs= 0.64; p <0.001), pain/discomfort (rs= 0.56; p <0.001) and anxiety/depression (rs= 0.66; p <0.001)

Conclusion:

This is the first study that assess activity indices in a cohort of patients with ReA. The DAREAm demonstrated a very good correlation with both DAREA and DAS28. We encourage the use of this simplified index in daily practice to evaluate patients with ReA.

Disclosure of Interests:

None declared.

ADHD symptoms, the current symptom scale, and exploratory structural equation modeling: A psychometric study

The aim of the study was to use exploratory structural equation modelling (ESEM) to investigate support for an ADHD factor model with group factors for inattention (IA), hyperactivity (HY), and impulsivity (IM), as proposed in in ICD-10. A total of 202 adults (121 females and 81 males), aged between 18 and 35 years, from the general community, completed the Current Symptoms Scale (CSS). The results for the model showed good global fit, good convergent and divergent validities. However, the IA and IM factors, but not the HY factor, were clearly defined and demonstrated acceptable reliabilities. Taken together, these finding indicate that a revised ESEM model without the HY factor (i.e. with only the IA and IM symptoms) is an appropriate structure for modeling adult ratings of the ADHD behaviors described in the CSS. The taxonomic, theoretical and clinical implications of the findings for ADHD in general are discussed.

In search of the optimum structural model for Internet Gaming Disorder

BACKGROUND

Internet gaming Disorder (IGD) constitutes a recently proposed clinical disorder (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 2013). The present study examined if IGD is best conceptualized as categorical (present/absent), or dimensional (severity ranging from low to high), or both (i.e., hybrid of categorical/dimensional).

METHODS

Ratings of the nine DSM-5 IGD symptoms, as presented in the Internet Gaming Disorder Scale 9-Short Form (Pontes & Griffiths, Comput Hum Behav 45:137-143, 2015), from 738 gamers, aged 17 to 72 years, were collected. Confirmatory factor analysis (CFA), latent class analysis (LCA), and factor mixture modelling analysis (FMMA) procedures were applied to determine the optimum IGD model.

RESULTS

Although the findings showed most support for a FFMA model with two classes and one factor, there was also good statistical and substantive support for the one-factor CFA model, and the LCA model with three classes.

CONCLUSION

It was concluded that while the optimum structure of IGD is most likely to be a hybrid model (i.e., concurrently categorical and dimensional), a uni-dimensional model and/or a three-class categorical model are also plausible.

Unraveling the Optimum Latent Structure of Attention-Deficit/Hyperactivity Disorder: Evidence Supporting ICD and HiTOP Frameworks

Attention Deficit/hyperactivity disorder (ADHD) is conceptualized differently in the Diagnostic and Statistical Manual (DSM-5), the International Classification of Diseases-10 (ICD-10), and the Hierarchical Taxonomy of Psychopathology (HiTOP) frameworks. This study applied independent cluster confirmatory factor analysis (ICM-CFA), exploratory structure equation model with target rotation (ESEM), and the S-1 bi-factor CFA approaches to evaluate seven ADHD models yielded by different combinations of these taxonomic frameworks. Parents and teachers of a community sample of children (between 6 and 12 years of age) completed the Disruptive Behavior Rating Scale (for ADHD symptoms) and the Strengths and Difficulties Questionnaire (for validation). Our findings for both parent and teacher ratings provided the most support for the S-1 bi-factor CFA model comprised of (i) a g-factor based on ICD-10 impulsivity symptoms as the reference indicators and (ii) inattention and hyperactivity as specific factors. However, the hyperactivity-specific factor lacked clarity and reliability. Thus, our findings indicate that ADHD is best viewed as a disorder primarily reflecting impulsivity, though with a separable inattention (but no hyperactivity) component, i.e., "ADID (attention deficit/impulsivity disorder)." This model aligns with the HiTOP proposals.

Neuroticism and extraversion as predictors of negative and positive emotional information processing: comparing Eysenck's, Gray's, and Newman's theories

This study compared how extraversion, neuroticism, and extraversion × neuroticism are related to processing of pleasant and unpleasant emotional information as predicted by Eysenck's, Gray's, and Newman's theories. Initially, the participants' levels of extraversion (as measured by the sociability subscale) and neuroticism were assessed with Eysenck's Personality Inventory. They were then tested individually. After completing a questionnaire of current positive and negative moods, they completed three tasks measuring processing of pleasant, unpleasant, and also neutral information. The results showed that extraversion was associated positively with the processing of pleasant information, while neuroticism was associated positively with the processing of unpleasant information. These findings support predictions from Eysenck's theory. Copyright © 2002 John Wiley & Sons, Ltd.

Gifted Children with ADHD: How Are They Different from Non-gifted Children with ADHD?

The present study focused on inattention and hyperactivity/impulsivity differences of gifted children with and without attention deficit-hyperactivity disorder (ADHD). Based on clinical assessment utilizing the Anxiety Disorders Interview Schedule for Children (ADISC-IV) and the Wechsler Intelligence Scale for Children—Fourth Edition, attendees of a public outpatient child service (boys = 359, girls = 148), with mean age 10.60 years (SD = 3.08 years), were allocated into four groups: ADHD (N = 350), gifted (N = 15), gifted/ADHD (N = 18), and clinical controls (N = 124). The Strengths and Weaknesses of ADHD-Symptoms and Normal Behavior Scale dimensionally assessed inattention and hyperactivity/impulsivity variations. Compared to the gifted/ADHD group, the ADHD group had higher scores for inattention and comparable scores for hyperactivity/impulsivity. For most symptoms, the ADHD groups (gifted or not) rated higher than the non-ADHD groups (control and gifted without ADHD). Findings appeared to indicate that (i) ADHD is a valid diagnosis among children who are gifted, (ii) gifted children might tend to be less inattentive than non-gifted ADHD children, and (iii) ADHD-gifted children appear to differ from the non-ADHD-gifted children with regard to specific hyperactive and impulsive behaviors. The practical implication of these findings is that clinicians may wish to focus on these symptoms when diagnosing ADHD among children with high intelligence.

Proteus Effect Profiles: how Do they Relate with Disordered Gaming Behaviours?

Gamers represent themselves in online gaming worlds through their avatars. The term "Proteus Effect" (PE) defines the potential influences of the gamers' avatars on their demeanour, perception and conduct and has been linked with excessive gaming. There is a significant lack of knowledge regarding likely distinct PE profiles and whether these could be differentially implicated with disordered gaming. A normative group of 1022 World of Warcraft (WoW) gamers were assessed in the present study (Mean _age = 28.60 years). The Proteus Effect Scale (PES) was used to evaluate the possible avatar effect on gamers' conduct, and the Internet Gaming Disorder Scale-Short-Form was used to examine gaming disorder behaviors. Latent class profiling resulted in three distinct PE classes, 'non-influenced-gamers' (NIGs), 'perception-cognition-influenced-gamers' (PCIGs), and 'emotion-behaviour-influenced-gamers' (EBIGs). The NIGs reported low rates across all PES items. The PCIGs indicated higher avatar influence in their perception-experience but did not report being affected emotionally. The EBIGs indicated significantly higher avatar influence in their emotion and behaviour than the other two classes but reported stability in their perception of aspects independent of their avatar. Gaming disorder behaviours were reduced for the NIGs and progressively increased for the PCIGs and the EBIGs.

Reinforcement Sensitivity Theory of Personality Questionnaire: Factor Structure Based on CFA and ESEM, and Associations with ADHD

Revised reinforcement sensitivity theory (r-RST) of personality is a major neuropsychological theory of motivation, emotion and personality. This paper presents the results of a study examining: (1) the factor structure of the Reinforcement Sensitivity Theory of Personality Questionnaire (RST-PQ) using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM); and (2) the relationships of the r-RST constructs in the RST-PQ with attention deficit hyperactivity disorder (ADHD) symptom groups of inattention (IA) and hyperactivity/impulsivity (HI). A total of 572 (Sample 1) and 309 (Sample 2) adults completed the RST-PQ. Participants in Sample 2 also completed a questionnaire measuring ADHD symptoms. Results revealed more support for the ESEM model with six factors than the CFA model. For both the ESEM and CFA models, both IA and HI symptom groups were associated positively with the RST-PQ constructs of behavioral inhibition system (BIS) and behavioral approach system (BAS) Impulsivity, with IA also associated negatively with the BAS-Goal-Drive Persistence. The theoretical implications of these findings for understanding the factor structure of the RST-PQ, and for ADHD (IA and HI) in terms of r-RST, are discussed.

Associations between comorbid stress and Internet Gaming Disorder symptoms: Are there cultural and gender variations?

INTRODUCTION

The American Psychiatric Association has requested additional studies examine risk, protective, and cultural factors in relation to Internet Gaming Disorder (IGD). The present study aimed to explore the association between stress as a potential IGD risk effect, the possible exacerbating role of cultural orientation (vertical individualism [VI]), and how this may vary between genders.

METHODS

The sample included adult gamers from the USA, UK, and Australia. Analyses were conducted via linear regression, moderation, and moderated moderation.

RESULTS

The results suggested that higher stress symptoms act to increase IGD risk. Gender and VI also influenced this association.

DISCUSSION

Males presenting with higher levels of stress and VI were at greater risk of IGD compared to females who exhibited a reduction in IGD-related behaviors. This demonstrates a need for more research to determine how culture and gender can act to mitigate or worsen the risks associated with excessive gaming.

Ecofriendly Approach for the Control of a Common Insect Pest in the Food Industry, Combining Polymeric Nanoparticles and Post-application Temperatures

One of the most common insect pests is Plodia interpunctella (Hübner) (Lepidoptera: Pyralidae), which affects different food commodities. A new effective approach for the management of insect pests is the development of new formulations based on essential oils (EO). However, few works informed about the relationship between insecticidal activity of EO or essential oils loaded polymeric nanoparticles (EOPN) and post-application temperature. In our work, palmarosa [Cymbopogon martinii (Roxb.) Watson], geranium (Geranium maculatum L.), and peppermint (Mentha piperita L.) oils were formulated in a polyethylene glycol 6000 matrix to obtain EOPN. Geranium and palmarosa EOPN had sizes of 259 and 191 nm, respectively; the encapsulation efficiency (EE) was close to 90%, and the samples were monodisperse. The sizes from peppermint EOPN were around 380 nm, with an EE of 72%, and were polidisperse. In a contact toxicity bioassay, the insecticidal effect of the oils was increased by all EOPN, with palmarosa oil being the most toxic. In addition, the oils and their nanoparticles showed a significantly negative temperature coefficient when applied by contact. In a fumigant bioassay, just palmarosa and peppermint EOPN enhanced the oil activity and palmarosa EO and EOPN showed the highest toxic effect. In this case, the EO and EOPN insecticidal activity was unaffected by environmental temperature variation.

Internal and external validity of the brief version of the Multidimensional Personality Questionnaire: Exploratory structural equation modelling

The present study used exploratory structural equation modelling (ESEM) to examine the theorized dimension structure of the brief version of the Multidimensional Personality Questionnaire (MPQ-BR) at the scale-level (i.e., 11 lower-order primary factors loading on four higher-order factors) and item-level (sets of 12 items loading on 11 lower-order primary factors). A total of 214 adults from the community addressed the MPQ-BR and the Behavioral Inhibition System (BIS)/Behavioral Approach System (BAS) scales. The findings revealed poor fit and poorly defined factors at the item-level alongside adequate fit and well-defined factors at the scale-level. The higher-order factors in the latter model were supported for external validity in terms of demonstrating the expected theoretical and empirical correlations with the scales of the BIS/BAS scales. Result related implications for professional application, as well as potential revisions of the MPQ-BF are illustrated.

User-avatar bond profiles: How do they associate with disordered gaming?

AIMS

The avatar constitutes the in-game representation of the gamer. Although aspects of the user-avatar bond (UAB) have been associated with disordered gaming, there is a need for clearer understanding concerning the impact of potential UAB profiles.

METHODS

To address this need, the present study recruited a normative sample of 1022 World of Warcraft (WoW) players (M_age = 28.55 years, SD = 9.90). Participants completed the User-Avatar Questionnaire (to assess UAB aspects such as identification, immersion, and compensation), the Proteus-Effect Scale (to assess transference of the avatar's behaviour in real life), and the Internet Gaming Disorder Scale-Short-Form (to assess disordered gaming).

RESULTS

Latent class analysis indicated the existence of three UAB profiles, 'differentiated gamers' (DGs), 'identified gamers' (IGs) and 'fused gamers' (FGs). The DGs were characterized by low scores across all UAB aspects. The IGs did not report significant Proteus Effect (PE) or immersion behaviours, and despite being more identified with their avatar, did not significantly compensate through it. The FGs presented with higher PE, immersion, and compensation, although they did not significantly identify with their avatars, possibly due to having idealized them. Disordered gaming behaviours were significantly lower for the DGs and sequentially higher for the IGs and the FGs. Preoccupation and mood modification behaviours related to gaming disorder were distinctively associated with FGs.

CONCLUSION

Disordered gaming assessment and treatment implications of the UAB profiles are discussed.

Confirmatory Factor Analysis and Exploratory Structural Equation Modeling of the Structure of Attention-Deficit/Hyperactivity Disorder Symptoms in Adults

This study examined the structure of attention-deficit/hyperactivity disorder (ADHD) symptoms in an adult community sample using first-order confirmatory factor analysis, exploratory structural equation modeling (ESEM), and bifactor confirmatory factor analysis and ESEM models, with two group factors (inattention [IA] and hyperactivity/impulsivity [HY/IM]) and two different three group factors (IA, hyperactivity [HY], and impulsivity [IM]; and IA, motoric HY/IM, and verbal HY/IM). A total of 738 adults (males = 374 and females = 364) between 17 and 72 years of age completed the Adult ADHD Self-Report Scale. The results provided most support for the ESEM model with group factors for IA, motoric HY/IM, and verbal HY/IM. The factors in this model were reasonably well defined, had good internal consistency omega reliabilities, and had support for their external validities, thereby making it a suitable model for ratings of the ADHD symptoms presented in the Adult ADHD Self-Report Scale. The theoretical and clinical implications of the findings are discussed.

Parry-Romberg Syndrome and Temporal Lobe Refractory Epilepsy: Case Report

The Parry-Romberg syndrome (PRS), also known as hemifacial atrophy, is a rare neurocutaneous disease with the prevalence of 1/700,000 cases. It is more common in women than men, with an early onset of disease usually within the first two decades of life. Even though the etiology of PRS is unknown, it is thought to be a multifactorial disease that involves hereditary, posttraumatic, autoimmune, infectious, and neoplastic factors. There are a variety of systemic manifestations described in PRS including neurological conditions that range from intractable headache to refractory epilepsy. The manifestations must be identified in a timely manner to ensure an early therapeutic intervention, considering that an appropriate approach during the initial phase might halt the disease progression and markedly improve the quality of life in these patients. This article is aimed to describe the case of a 23 years old female with left hemifacial atrophy and dermatologic, dental, and neurologic compromise, associated with refractory temporal lobe epilepsy evidenced in neuroimaging and electrodiagnostic testings.

Oppositional Defiant Disorder Dimensions: Associations with Traits of the Multidimensional Personality Model among Adults

The occurrence of Oppositional Defiant Disorder (ODD) behaviours among adults has been supported by a proportion of scholars. The current work examines potential ODD dimensions and their associations with the primary personality traits of Tellegen's [57] multi-dimensional conceptualization during adulthood. Two independent, general community, adult groups [Group 1: N = 214; mean age (SD) = 35.74 (16.60); Group 2: N = 205; mean age (SD) = 29.00 (12.42)] completed the Current Symptom Scale involving the eight ODD criteria. Group 2 additionally addressed the Multidimensional Personality Questionnaire -Brief Form (MPQ-BF). A series of Confirmatory Factor Analyses (CFA) were implemented. The three-dimensional ODD conceptualization of Burke and colleagues [14] referring to "Negative Affect", "Oppositional Behavior", and "Antagonistic Behavior" was confirmed. Considering personality traits, valuable associations were revealed between Oppositional Behavior and Aggression, Antagonistic Behavior and Social Potency as well as Harm Avoidance, and finally, Negative Affect and Stress Reaction, as well as Aggression. The dimensionality of ODD behaviours in adulthood and its correspondence with particular personality traits is approached in the context of psychological practice.

Factor structure of the Sleep Disturbance Scale for Children (SDSC) in those with Attention Deficit and Hyperactivity Disorder (ADHD)

Objective

Method

Results

Conclusion

•

The original SDSC factor structure could not be replicated in an ADHD sample.

•

The fit of competing factor structures was evaluated.

•

An optimal structure including six-specific and a general factor was identified.

•

The alternative structure reported adequate psychometric properties.

•

The SDSC may be used to yield a total sleep difficulties score in ADHD samples.

Personality inventory for DSM-5, Brief Form: Factor structure, reliability, and coefficient of congruence

The Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Brief Form (PID-5-BF), is a 25-item self-report questionnaire that measures the severity of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-proposed personality pathology constructs of negative affectivity, detachment, antagonism, disinhibition, and psychoticism. The current study used exploratory factor analysis, exploratory structural equation modeling, and confirmatory factor analysis to examine the support for the theoretically proposed 5-factor model. In total, 502 adults (male = 182, female = 320, age = 18-67 years [M = 28.93, SD = 10.95]) provided ratings for the PID-5-BF. For the theorized 5-factor model, there was support for its factor structure, internal consistency reliabilities (Cronbach's, ordinal alpha, and omega) of the factors, and coefficient of congruence of the factors considering a previous Danish study. The findings also supported a strong general factor for a bifactor model involving a general factor alongside the 5 group factors. Together, the findings support the use of the 5 personality pathology constructs and the total PID-5-BF scores in clinical and research settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Cognitive Behavioral Therapy Online for Adult Depression: A 10 Year Systematic Literature Review

Background:

Acceptance, adherence and efficacy aspects of Cognitive Behavioural Therapy (CBT) online have invited significant interest, especially in the context of “stepped care” models, which advocate progressive stages of intervention in addressing depression. Objectives: The current work aspires to comprehensively identify critical factors linked to the applicability of online CBT, in order to inform clinical practices and future research targeting depressive behaviors in early and middle adulthood.

Methods:

To serve these goals: a) the PRISMA systematic literature perspective is followed; b) a systematic search of online databases between 2008-2018 was undertaken and; c) a compositehybrid model, resulting from the integration of broadly adopted conceptualizations from the areas of psychological treatment and internet use behaviors, was combined with an interpretative phenomenological analysis perspective to organize the findings.

Results:

In total, 28 studies were included in the present review. Factors defining the efficacy, adherence and acceptability of online CBT targeting depression (during early and middle adulthood) were classified into parameters related to the individual receiver, the context and the CBT activities involved.

Conclusion:

Despite the cautiousness warranted by the limitations, as well as the diverge methodology of the reviewed studies, findings appear to favour the provision of brief, therapist supported, online CBT interventions, especially in addressing moderate depression during early and middle adulthood.

ROC Analyses of Relevant Conners 3-Short Forms, CBCL, and TRF Scales for Screening ADHD and ODD

Receiver operating characteristic curve analysis was used to examine and compare the diagnostic accuracy of the Conners 3-Parent Short Form (C 3-P(S)), and the Conners 3-Teacher Short Form (C 3-T(S)) inattention and hyperactivity/impulsivity scales, and the Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) attention problems scales, to distinguish those with and without attention deficit/hyperactivity disorder (ADHD). It also examined and compared the diagnostic accuracy of the C 3-P(S) and C 3-T(S) Aggression (AG) scales, and the CBCL and TRF Aggressive Behavior (AB) scales, to distinguish those with and without oppositional defiant disorder (ODD). The study used archival data (N = 150-261) involving a large group of clinic-referred children aged between 6 and 11 years who had been interviewed for clinical diagnosis of ADHD and ODD using the Anxiety Disorders Interview Schedule for Children (ADISC-IV) as the reference standard, and then administered one or more of the screening measures. The findings provided empirical support for the use of the C 3-P(S) and CBCL for identifying ADHD and ODD, with the CBCL aggressive behavior scale having better ability to detect ODD. The implications of the findings for using the screening scales for diagnoses of ADHD and ODD are discussed.

Exercise, Mood, Self-Efficacy, and Social Support as Predictors of Depressive Symptoms in Older Adults: Direct and Interaction Effects

Background

Depression is a chronic condition that affects up to 15% of older adults. The healthogenic effects of regular exercise are well established, but it is still unclear which exercise-related variables characterise the antidepressant effects of exercise. Thus, the purpose of this study was to examine the extent to which exercise-related variables (exercise behaviour, exercise-induced mood, exercise self-efficacy, and social support) can predict depressive symptoms in a cohort of community-dwelling older adults.

Methods

This study employed a cross-sectional analysis of questionnaire data from a sample of 586 community-dwelling older Australians aged 65 to 96 years old. Participants completed the Center for Epidemiologic Studies Depression Scale, modified CHAMPS Physical Activity Questionnaire for Older Adults, Four-Dimension Mood Scale, Self-Efficacy for Exercise Scale, and Social Provisions Scale – Short Form. Bivariate correlations were performed, and hierarchical multiple regression was subsequently used to test the regression model.

Results

Exercise behaviour, exercise-induced mood, exercise self-efficacy, and social support were all negatively associated with depressive symptoms (r = −0.20 to −0.56). When the variables were entered as predictors into the hierarchical multiple regression model, social support was the strongest predictor of depressive symptoms (β = −0.42), followed by exercise-induced mood (β = −0.23), and exercise self-efficacy (β = −0.07). Exercise behaviour did not explain any additional variance in depressive symptoms. A modest interaction effect was also observed between exercise-induced mood and social support.

Conclusion

These findings indicate that social support is the strongest predictor of depressive symptomology in community-dwelling older adults, particularly when combined with positive exercise-induced mood states. When addressing the needs of older adults at risk of depression, healthcare professionals should consider the implementation of exercise programmes that are likely to benefit older adults by improving mood, enhancing self-efficacy, and building social support.

A-23 Mental Illness and Emotional Functioning as Moderated by Executive Functioning: Incarcerated Population

Objective

The purpose of this study is to investigate whether executive functioning will moderate the relationship of a history of mental illness on aggression in a male forensic population.

Method

Using an archival database from a larger study, 232 male inmates (ages 21 and 49 years old) from three medium/maximum Maryland Correctional facilities were recruited using a pseudo-random selection process during intake. Participants were administered three EF tasks (Cambridge Decision Making Task, Logan Stop-Signal Task, and Stroop Interference Task), history of mental illness was obtained using the Symptom Checklist-90, and aggression was assessed with the Novaco Reaction to Provocation Questionnaire.

Results

Hierarchical multiple regressions were conducted. For overall aggression reactivity, inhibition moderated depression (IR2 = .025, F(3, 224) = 9.977, p < .001, β = -.246, p = .015) and psychoticism (IR2 = .019, F(3, 224) = 8.216, p < .001, β = -.136, p = .031). For reactive aggression subtype, inhibition moderated depression (IR2 = .025, F(3, 224) = 2.679, p = .048, β = .071, p = .017). For proactive aggression subtype, cognitive flexibility moderated anxiety (IR2 = .018, F(3, 224) = 4.731, p = .003, β = -.014, p = .039); and depression (IR2 = .022, F(3, 224) = 3.888, p = .010, β = -.017, p = .025).

Conclusions

Overall, there was mixed findings for inhibition. On Cambridge Decision Making task, inhibition moderated the predictive relationship of depression on reactive aggression and psychoticism and overall aggression but not for other measures of inhibition. For another inhibition task (Stroop), inhibition did not significantly moderate any mental illness on severity of aggression. Cognitive flexibility moderated the predictive relationships of anxiety and depression on proactive aggression. Findings suggest targeting cognitive flexibility for inmates diagnosed with anxiety depression, and psychosis when treating aggression in a male forensic population.

Associations between attention deficit hyperactivity and internet gaming disorder symptoms: Is there consistency across types of symptoms, gender and countries?

BACKGROUND

Videogame addiction has been suggested as a tentative disorder in 2013 by the American Psychiatric Association (APA) and was recently officially recognized as a mental health disorder by the World Health Organization (WHO). Although a few studies have identified attention deficit and hyperactivity disorder (ADHD) as a key risk factor for Internet Gaming Disorder (IGD), the interplay between ADHD and IGD symptoms with gender differences across cultures remains to be further examined.

OBJECTIVE

This study examined the moderating effects of gender in the association between ADHD and IGD across two nations.

METHOD

A cross-sectional online survey was developed to recruit 164 Australian (Mage = 23.01, SD = 3.35, Minage = 18, Maxage = 31, Males n = 121, 73.80%) and 457 U.S.-North American (Mage = 25.25 years, SD = 2.76, Minage = 18 years, Maxage = 29 years, Males = 265, 57.98%) Massively Multiplayer Online (MMO) players aged between 18 and 29 years.

RESULTS

The hierarchical linear regression, moderation and moderated moderation analyses revealed that participants presenting greater inattention and hyperactivity symptoms exhibited higher levels of IGD-related behaviors in the two samples. Moreover, these associations differed across genders between the two countries. Specifically, more hyperactive-impulsive, as well as inattentive males in the USA presented higher levels of disordered gaming.

CONCLUSION

The results highlight the need for more cross-cultural and symptom-focused research in the broader IGD field.

Test-Retest Measurement Invariance of the Nine-Item Internet Gaming Disorder Scale in Two Countries: A Preliminary Longitudinal Study

The reliable longitudinal assessment of Internet Gaming Disorder (IGD) behaviors is viewed by many as a pivotal clinical and research priority. The present study is the first to examine the test-retest measurement invariance of IGD ratings, as assessed using the short-form nine-item Internet Gaming Disorder Scale (IGDS9-SF) over an approximate period of 3 months, across two normative national samples. Differences referring to the mode of the data collection (face-to-face [FtF] vs. online) were also considered. Two sequences of successive multiple group confirmatory factor analyses (CFAs) were calculated to longitudinally assess the psychometric properties of the IGDS9-SF using emergent adults, gamers from (i) the United States of America (USA; N = 120, 18–29 years, Meanage = 22.35, 51.6% male) assessed online and; and (ii) Australia (N = 61, 18–31 years, Meanage = 23.02, 75.4% male) assessed FtF. Configural invariance was established across both samples, and metric and scalar invariances were supported for the USA sample. Interestingly, only partial metric (factor loadings for Items 2 and 3 non-invariant) and partial scalar invariance (i.e., all thresholds of Items 1 and 2, and thresholds 1, 3, for Items 4, 6, 8, and 9 non-invariant) were established for the Australian sample. Findings are discussed in the light of using IGDS9-SF to assess and monitor IGD behaviors over time in both in clinical and non-clinical settings.

Assessing Online Flow Across Cultures: A Two-Fold Measurement Invariance Study

The association between online Flow and Internet Gaming Disorder (IGD) has attracted significant attention. Despite the consensus that online Flow plays a pivotal role in the development of IGD and other Internet addictive behaviors, there has been a lack of consistency in measurement scales used to assess online Flow. Even widely used measures of online Flow have not been psychometrically assessed across culturally diverse populations of gamers. Such an assessment would enhance the accuracy of cross-cultural comparisons. Attending to this need, the present study assessed the psychometric properties of the binary coded (i.e., Yes, No) Online Flow Questionnaire (OFQ), while concurrently taking into consideration country, age, language, and mode of data collection (online or face-to-face) differences. Two sequences of successive multiple group confirmatory factor analyses were used to assess the psychometric properties of the OFQ, between: (a) emergent adults from the United States of America (N = 482, Mage = 25.23, SD = 2.746) and Australia (N = 168, Mage = 23.55, SD = 3.37) and (b) adolescents from Greece (N = 1579, Mage = 16.12, SD = 0.849) and Cyprus (N = 1372, Mage = 15.54, SD = 0.656). Configural and partial metric invariance were confirmed between the United States and Australian samples. For the Greek and Cypriot samples, results indicated full configural and metric invariance. These results provide initial information to researchers and clinicians of the extent to which the OFQ maintains its consistency when used across cultures and invite for further cross-cultural studies in the field. Implications, as well as limitations, are discussed.