Manifesto for a European research network into Problematic Usage of the Internet

Digital Hazards for Feeding and Eating: What We Know and What We Don't

PURPOSE OF REVIEW

We aimed to accrue recent evidence exploring effects of modern online activities (e.g., Internet use) on feeding and eating disorder symptoms, and related traits. We examined available evidence to ascertain any direct influences from online activities on feeding and eating disorders, thereby shedding light on putative mechanisms by which those influences may occur.

RECENT FINDINGS

Many facets of problematic usage of the Internet correlate cross sectionally with eating disorder and related psychopathology. There is evidence to suggest that significant effects do exist in the direction of specific Internet activities contributing to eating disorder symptoms, viewed dimensionally. Putative mechanisms are discussed. However, a significant number of eating disorder phenotypes and Internet-related activities remain under-researched. Specific facets of engagement with the online environment appear to confer risk for feeding and eating problems, evidence being strongest for non-clinical studies using dimensional measures. More research is required to rigorously confirm causal effects, including in patients meeting formal diagnostic criteria for eating disorders. We also highlight the need for high-quality evidence to explore how eating disorder phenotypes are commonly as well as uniquely affected by different online activities. Such research is needed in order that scientific understanding in this area can be translated to protect those most at risk of disordered eating, including through changes in public health approaches and clinical practice.

Managing Problematic Usage of the Internet and Related Disorders in an Era of Diagnostic Transition: An Updated Review

INTRODUCTION

Problematic Usage of the Internet (PUI) refers to a broad and likely heterogeneous group of Internet-related conditions associated with behavioural disturbances and functional impairment.

METHODS

Within PUI several conditions have been reported, including Gaming Disorder, Shopping Addiction, Cyberchondria, Gambling Disorder, Cyberpornography Addiction and Cyberbullying. While increasing reports in the field try to define the epidemiologic and clinical boundaries of these conditions, the rapid and continuous evolution of Internet related behaviours as well as their problematic/pathological expressions are often difficult to diagnose, assess, approach with treatment interventions and follow-up.

RESULTS

In addition, some of the PUI-related conditions show characteristics of addiction to the Internet as a preferential tool to engage in specific behaviours, while some others exclusively manifest on the Internet, making it necessary to find distinct assessment and treatment pathways.

CONCLUSION

The inclusion of Internet Gaming Disorder in Section III by the DSM-5 and the recognition of Gaming Disorder by the ICD-11 opened the way for a systematic clinical investigation of this and other PUI-related conditions, particularly in terms of preventive and therapeutic strategies. The present article is aimed at offering an updated clinical overview on the main expressions of PUI, focussing on the latest acquisitions in this evolving field.

Exploring the Relationship Between Mental Well-Being, Exercise Routines, and the Intake of Image and Performance Enhancing Drugs During the Coronavirus Disease 2019 Pandemic: A Comparison Across Sport Disciplines

Introduction: Physical distancing under the coronavirus disease 2019 (COVID-19) pandemic had a significant impact on lifestyles, including exercise routines. In this study, we examined the relationship between mental health and addictive behaviors, such as excessive exercise and the use of image and performance enhancing drugs (IPEDs) across 12 sport disciplines. Materials and methods: A large cross-sectional sample of the adult population (N = 2,295) was surveyed. The mean age was 33.09 (SD = 11.40). The number of male participants was 668 (30.0%). The use of IPEDs was assessed in conjunction with psychometric measures such as the Exercise Addiction Inventory (EAI) and the Appearance Anxiety Inventory (AAI). The participants were grouped into activity group (AG) and non-activity group (NAG) according to the presence or absence of their exercise habits. The results were compared between these groups, as well as across sport disciplines, while taking into account the relationship between different psychological measures and IPEDs consumption. Results: The frequency of IPEDs use was higher among AG (34.6%) than NAG (14.6%), although AG participants reported less history of addictions (7.1%) than NAG (11.8%). The logistic regression analysis revealed that scores equal to or above cutoff points, in both the EAI and AAI, predicted the IPEDs use. Regarding the differences across the various sport disciplines, those who were involved in practicing Weight Lifting and Cross Fit were found to be more at risk of excessive exercising and more inclined to use a wide range of IPEDs. Conclusions: Although exercise could help to increase well-being and prevent addictions during the COVID-19 pandemic, our results show that those in the AG are particularly vulnerable to excessive IPEDs use. Sport disciplines associated with higher EAI and AAI scores have also shown a higher tendency to excessive IPEDs use. Furthermore, the factor of having above the cutoff scores in EAI or AAI in each sport could indicate larger IPEDs consumption regardless of the discipline. In light of the current findings, it is necessary to better define the "non-excessive" levels of exercise in various sport disciplines and an adequate intake of IPEDs to ensure the safety and well-being of people during a pandemic.

Measurement of shopping addiction and its relationship with personality traits and well-being among Polish undergraduate students

There is still a scarcity of studies showing the relative contribution of different personality characteristics differentiating various behavioral addictions within an integrated model. In comparison to other addictions, fairly little is known about the role of specific personality traits in compulsive shopping. In addition, few studies have investigated the unique contribution of shopping addiction in terms of explaining different facets of well-being above and beyond personality characteristics previously shown to be related to psychosocial functioning. The present study shows validation of the Bergen Shopping Addiction Scale (BSAS) and a tentative integrated model of potential shopping addiction personality risk factors. BSAS was administered to 1156 Polish students. In addition, demographic variables, and personality traits (Big Five), self-esteem, self-efficacy, perceived narcissism, loneliness, social anxiety, and well-being indicators were measured. BSAS had acceptable fit with the data and demonstrated good reliability. The investigated model showed that shopping addiction was related to higher extraversion, perceived narcissism, and social anxiety, and lower agreeableness and general self-efficacy. Woman and older participants scored higher on BSAS. Shopping addiction was further related to all facets of impaired well-being and explained worse general health, and decreased sleep quality above and beyond other variables in the model. The results support the notion that shopping addiction may have specific personality risk factors with low agreeableness as an outstanding characteristic. This has implications for the development of early prevention and intervention programs.

Measurement of the problematic usage of the Internet unidimensional quasitrait continuum with item response theory

Problematic usage of the internet (PUI) describes maladaptive use of online resources and is recognized as a growing worldwide issue. Here, we refined the Internet Addiction Test (IAT) for use as a screening tool to measure generalized internet use problems in normative samples. Analysis of response data with parametric unidimensional item response theory identified 10 items of the IAT that measured most of the PUI latent trait continuum with high precision in a subsample of 816 participants with meaningful variance in internet use problems. Selected items may characterize minor, or early stages of, PUI by measuring a preoccupation with the Internet, motivations to use online activities to escape aversive emotional experiences and regulate mood, as well as secrecy, defensiveness, and interpersonal conflict associated with internet use. Summed scores on these 10 items demonstrated a strong correlation with full-length IAT scores and comparable, or better, convergence with measures of impulsivity and compulsivity. Proposed cut-off scores differentiated between individuals potentially at risk of developing PUI from those with few self-reported internet use problems with good sensitivity and specificity. Differential item function testing revealed measurement equivalence between the sexes, Caucasians and non-Caucasians. However, evidence for differential test functioning between independent samples drawn from South Africa and the United States of America suggests that raw scores cannot be meaningfully compared between different geographic regions. These findings have implications for conceptualization and measurement of PUI in normative samples.

We provide recommendations for measuring symptoms of problematic usage of the internet, which can be identified in a subset of the population using our refined version of the IAT and suggested cut-off scores. Relevant self-reported internet use problems include a preference for online over face-to-face social interactions, use of the internet to regulate emotions, excessive online engagement, interpersonal conflict, and emotional withdrawal following cessation of internet use.

Prevention Strategies to Address Problematic Gaming: An Evaluation of Strategy Support Among Habitual and Problem Gamers

Psychosocial problems arising from excessive gaming are a public health issue across the developed world. In its most serious form, problematic gaming is recognized as gaming disorder (GD) in the ICD-11. Research has tended to focus on the value of outpatient treatment for GD, but less attention has been paid to broader prevention strategies to address less serious but nevertheless harmful gaming behaviors. Another gap in this literature has been the lack of involvement of the gaming community as stakeholders to identify feasible prevention approaches. This study investigated: (1) regular and problematic gamers' level of support for different prevention strategies within primary, secondary, and tertiary approaches; and, (2) whether self-efficacy is associated with greater support for prevention strategies, as predicted by the Health Belief Model. A total of 992 participants completed an online survey that evaluated support for problem gaming prevention strategies and included measures of self-efficacy, gaming involvement, and GD symptoms, psychological distress, and mental health help-seeking behaviors. Participants reported stronger support for primary prevention strategies, including education, screening, and warning labels, than for other prevention approaches. Overall, 61% of participants expressed support for primary prevention as compared to secondary (39%) and tertiary (36%) approaches. There was stronger support for outpatient care (48%) than inpatient services (25%). In-game shutdown features received the lowest support (65% disapproval). Contrary to the Health Belief Model, self-efficacy was not associated with prevention support. Younger, female, and less frequent gamers were more likely to support primary and secondary prevention strategies. These findings suggest that gamers may be more favorable toward prevention measures aligned with informed decision-making, autonomy, and self-directed actions. Gamers may be strongly opposed to modifications to the structure of gaming activities (e.g., shutdown features). Future research should evaluate the efficacy and cost-effectiveness of problem gaming prevention measures in different populations and regions.

Citizen Consultation on Problematic Usage of the Internet: Ethical Considerations and Empirical Insights From Six Countries

Citizens and scientists can work together to improve the collective well-being, if citizens are inspired to help the advancement of science, and researchers motivated to listen to the voices of citizens. The benefits of such collaboration are increasingly recognized by both citizens and scientists, as reflected in the growing number of related publications and initiatives. This is especially relevant for emerging areas of research, where early involvement of citizens could help to envision, prioritize, and plan prospective studies. The Problematic Usage of the Internet (PUI) is one such area, which is fast becoming a public mental health concern. However, there remains a lack of clarity regarding the practical guidelines and ethical requirements for citizen involvement at the earliest stages of PUI. In our paper, we propose a conceptual framework and a template for initial involvement of citizens in PUI. They are derived from our community case studies, conducted in six European countries (Georgia, Greece, Malta, North Macedonia, Portugal, and Spain) and consisting of consultation with diverse groups of interested citizens (students, parents, teachers, and health professionals). Informed by our consultation exercises, we also highlight four ethical aspects for citizen involvement in the research on PUI or novel disciplines in general. They follow simple guiding principles to ensure that scientists will: enable a long-term commitment and inclusive opportunities for citizens, challenge established power hierarchies, and support collaboration, co-production and co-authorship with citizens. We believe that the proposed practical guidelines and ethical considerations, provide a valuable foundation on which to advance our understanding and generate international strategies for citizen involvement in PUI.

Frequency of use, moral incongruence and religiosity and their relationships with self-perceived addiction to pornography, internet use, social networking and online gaming

BACKGROUND AND AIMS

Moral incongruence involves disapproval of a behavior in which people engage despite their moral beliefs. Although considerable research has been conducted on how moral incongruence relates to pornography use, potential roles for moral incongruence in other putative behavioral addictions have not been investigated. The aim of this study was to investigate the role of moral incongruence in self-perceived addiction to: (i) pornography; (ii) internet addiction; (iii) social networking; and (iv) online gaming.

DESIGN

A cross-sectional, preregistered, online survey using multivariable regression.

SETTING

Online study conducted in Poland.

PARTICIPANTS

1036 Polish adults aged between 18 and 69 years.

MEASUREMENTS

Measures included self-perceived behavioral addiction to pornography, internet use, social networking and online gaming and their hypothesized determinants (moral incongruence, frequency of use, time of use, religiosity, age and gender).

FINDINGS

Higher moral incongruence (β = 0.20, P < 0.001) and higher religiosity (β = 0.08, P < 0.05) were independently associated with higher self-perceived addiction to pornography. Additionally, frequency of pornography use was the strongest of the analyzed predictors (β = 0.43, P < 0.001). A similar, positive relationship between high moral incongruence and self-perceived addiction was also present for internet (β = 0.16, P < 0.001), social networking (β = 0.18, P < 0.001) and gaming addictions (β = 0.16, P < 0.001). Religiosity was uniquely, although weakly, connected to pornography addiction, but not to other types of addictive behaviors.

CONCLUSIONS

Moral incongruence may be positively associated with self-perception of behavioral addictions including not only pornography viewing, but also internet use, social networking and online gaming.

Characterizing the building blocks of Problematic Use of the Internet (PUI): The role of obsessional impulses and impulsivity traits among Italian young adults

BACKGROUND

Problematic Use of the Internet (PUI) is a considerable issue of the modern era, but its risk factors are still poorly understood. Impulsivity and obsessive-compulsive symptoms have been associated with PUI, but this relationship is still debated. In this article we focus on the relationships of PUI with obsessive-compulsive and impulsive symptoms in a cohort of Italian young adults, in order to identify possible vulnerability factors for PUI.

METHODS

A sample of 772 Italian individuals aged 18-30 (mean age 23.3 ± 3.3 years old; 38% males and 62% females) was assessed via online survey using the Internet Addiction Test (IAT), the Mini International Neuropsychiatric Interview (MINI) Screen, the Padua Inventory-Washington State University Revision (PI-WSUR) and the Barratt Impulsiveness Scale (BIS-11).

RESULTS

Ninety-seven subjects (12.6% of the sample) reported IAT scores at risk for PUI. PUI participants reported higher levels of impulsivity, obsessive-compulsive symptoms and a higher burden of co-occurrent psychiatric symptoms. In a logistic regression model, obsessional impulses to harm (OR = 1.108, p < 0.001), attentional impulsivity (OR = 1.155, p < 0.001) and depressive symptomatology (OR = 1.246, p = 0.012) had significant association with PUI. Finally, higher severity of PUI has been associated with manic/psychotic symptoms and with attentional impulsivity.

CONCLUSIONS

Our findings confirmed the role of impulsivity in PUI, while also underling the association of obsessional impulses with this pathological behavior. We could hypothesize a trigger role of obsessive impulses for the engagement in PUI, together with factors as negative affective states. Further research is needed with respect to more severe forms of PUI, also for establishing tailored interventions.

Autism, Problematic Internet Use and Gaming Disorder: A Systematic Review

The present study investigated the association between autism and problematic internet use (PIU) and gaming disorder (GD). A systematic literature search was conducted in accordance with PRISMA guidelines. A total of 2286 publications were screened, and 21 were deemed eligible for inclusion in the review. The majority of the studies found positive associations between PIU and subclinical autistic-like traits with weak and moderate effect sizes and between PIU and Autism Spectrum Disorder (ASD) with varying effect sizes. Additionally, individuals with ASD were more likely to exhibit symptoms of GD with moderate and strong effect sizes. Future research would benefit from high-quality studies examining GD and PIU at a clinical level and their relationship with both clinical and subclinical autism.

Internet and Pornography Use During the COVID-19 Pandemic: Presumed Impact and What Can Be Done

The COVID-19 pandemic continues to cause an immense psychosocial strain worldwide. Excessive use of the internet during these psychologically trying times, fueled by physical isolation as a result of lockdowns, has translated into dysfunctional behaviors. A growing body of evidence suggests an unprecedented increase in internet use and consumption of online pornography during the pandemic, and possibly even directly caused by it. In this review, the authors report data from relevant sources to show the rise in pornography use during lockdowns in different countries worldwide. In addition to a brief overview of the neurobiology of internet addiction broadly and problematic online pornography use specifically, similarities with substance use disorders are explained. Further, the current status of the debate about defining diagnostic criteria is discussed. Finally, the review sheds light on the potential detrimental outcomes during the future post-pandemic "re-adaptation," while simultaneously offering preventative and management strategies for harm reduction. The authors conclude that foresightedness with utilizing existing tools and therapies and exercising appropriate amounts of caution could go a long way in addressing the challenges that lie ahead in the post-pandemic era.

Problematic usage of the internet and eating disorder and related psychopathology: A multifaceted, systematic review and meta-analysis

Eating disorders are widespread illnesses with significant impact. There is growing concern about how those at risk of eating disorders overuse online resources to their detriment. We conducted a pre-registered systematic review and meta-analysis of studies examining Problematic Usage of the Internet (PUI) and eating disorder and related psychopathology. The meta-analysis comprised n = 32,295 participants, in which PUI was correlated with significant eating disorder general psychopathology Pearson r = 0.22 (s.e. = 0.04, p < 0.001), body dissatisfaction r = 0.16 (s.e. = 0.02, p < 0.001), drive-for-thinness r = 0.16 (s.e. = 0.04, p < 0.001) and dietary restraint r = 0.18 (s.e. = 0.03). Effects were not moderated by gender, PUI facet or study quality. Results are in support of PUI impacting on eating disorder symptoms; males may be equally vulnerable to these potential effects. Prospective and experimental studies in the field suggest that small but significant effects exist and may have accumulative influence over time and across all age groups. Those findings are important to expand our understanding of PUI as a multifaceted concept and its impact on multiple levels of ascertainment of eating disorder and related psychopathology.

Mental health and internet use by university students: coping strategies in the context of COVID-19

The aim of this study was to estimate the prevalence of Common Mental Disorders (CMD) among university students and analyze the relation between disorders and internet use and the use of coping strategies in the face of social isolation during the COVID-19 pandemic. We conducted a quantitative cross-sectional study using a non-probability sample of 275 students. Data was collected online using the Self-Reporting Questionnaire, Problematic Internet Use Scale and a coping strategies inventory. We conducted a descriptive and inferential analysis of the data and multiple linear regression was performed to determine the variables that best explained the variation in the problematic internet use. Prevalence of CMD was 58.5% and the presence of CMD was positively correlated with frequency of internet use and the use of avoidant coping strategies, based on confrontation, the search for social support and acceptance of responsibility (p<0.05). The presence of CMD and the use of confrontation coping strategies were the variables that best explained problematic internet use (R2=0.33%; p<0.00). High levels of digital socialization should be taken into account in mental health care actions aimed at university students in the context of COVID-19.

The link between problematic internet use, problematic gaming, and psychological distress: does sleep quality matter?

INTRODUCTION

This study aimed to examine the mediating role of sleep quality in the association of problematic internet use (PIU) and problematic gaming with psychological distress among college students in China.

METHODS

Data of 1040 full-time students from multiple colleges in China were examined. Respondents were asked about their internet use and gaming behaviors, sleep quality, psychological distress, and sociodemographic characteristics. The mediating role of sleep quality in the PIU- and problematic gaming-psychological distress link was examined respectively.

RESULTS

PIU was associated with decreased sleep quality (r = .32, p < .001) and increased psychological distress (r = .46, p < .001). Problematic gaming was also associated with decreased sleep quality (r = .22, p < .001) and increased psychological distress (r = .46, p < .001). Sleep quality accounted for 23.5% of the indirect effect of PIU on psychological distress, and 17.9% of the indirect effect of problematic gaming on psychological distress.

CONCLUSIONS

Sleep quality had a meaningful mediating effect on the PIU-psychological distress link, but only exerted a small mediating effect on the problematic gaming-psychological distress link. In addition to promoting healthy internet usage, strategies aimed at mitigating the negative effect of excessive internet use on psychological health might benefit from those aimed at improving sleep quality.

Video Game Streaming in Young People and Teenagers: Uptake, User Groups, Dangers, and Opportunities

In recent years, live video streaming platforms for video games have been gaining popularity. These types of services, which enable anyone to broadcast and consume live content, are revolutionising the current video game landscape. Users approach the emergence of and participation in these platforms driven by a range of motivations. It is essential to characterise the different forms of participation in services such as Twitch to evaluate the phenomenon and reflect on its advantages and disadvantages. To that end, a survey was carried out of 580 young people and adolescents aged between 14 and 24. The aim of this study is thus to explore the uptake of these platforms, as well as identify user groups, distinguish between different motivations, and address the associated benefits and harms. Applying a methodology based on factor analysis and cluster analysis, user profiles were characterised according to their specific features, gaming/viewing hours, self-perception of their skill level as a player, devices used, and type or genre of video game. Four subgroups of gamers/viewers were thus identified: casual, social, hobby, and problematic. The results showed that older users and female users feature more prominently in the first two groups, as do those spending less time on video games and live streaming platforms. Conversely, in the hobby and problematic groups, we observe just the opposite. The existence of profiles at possible risk of addiction underlines how, at a preventive level, there is a need for more in-depth research on these types of services and greater public awareness of the dangers of uncontrolled use.

Variability of Pornographic Content Consumed and Longest Session of Pornography Use Associated With Treatment Seeking and Problematic Sexual Behavior Symptoms

INTRODUCTION

Most of the previous studies on problematic pornography use and related behavior have focused on such descriptors of pornography use habits as frequency or time devoted to pornography use.

AIM

We argue that this constitutes a narrow view and indicators that characterize other aspects of explicit content consumption, namely (i) longest session of pornography viewing (which may be related to binge behavior), as well as (ii) variability of consumed pornographic content, can also be useful indicators.

METHODS

An online study based on a sample of 132 heterosexual men seeking treatment for problematic pornography use, referred by therapists after their initial visit and 437 non-treatment seekers in the control group.

MAIN OUTCOME MEASURES

The main outcomes of this study are reported longest, non-stop session of viewing pornography, variability in consumed pornographic content (including paraphilic and violent pornography), actual treatment seeking for problematic pornography use and severity of symptoms, and average weekly time devoted to pornography use.

RESULTS

Our analysis showed that longest session of viewing pornographic content as well as the variety of consumed pornography influenced the decision to seek treatment and the severity of symptoms even when the sheer amount of time devoted to pornography use was controlled.

CONCLUSION

This is one of the few studies examining the role of engagement in prolonged sessions of pornography use and the variability of consumed pornographic content in the clinical context of problematic sexual behavior. The study's main limitations are its relatively narrow method of operationalization of variability of pornographic content and longest session of pornography viewing, as well as its cross-sectional, online, and anonymous character. As the described factors have an important influence on treatment seeking and the severity of experienced symptoms, they should be considered in the process of assessing compulsive sexual behavior disorder and related symptoms. Lewczuk K, Leśniak J, Lew-Starowicz M, et al. Variability of Pornographic Content Consumed and Longest Session of Pornography Use Associated With Treatment Seeking and Problematic Sexual Behavior Symptoms. Sex Med 2021;9:100276.

Impulsivity Mediates Associations Between Problematic Internet Use, Anxiety, and Depressive Symptoms in Students: A Cross-Sectional COVID-19 Study

Background: Problematic internet use (PIU) is a serious global mental health issue that especially manifested during the Coronavirus disease (COVID-19) pandemic. Engagement in PIU as an impulsive coping with mental distress may pose a long-lasting threat to develop anxiety and depressive disorders. The first aim of our study was to investigate the prevalence of PIU and mental distress symptoms during the COVID-19 pandemic among university students in Lithuania. The second aim was to test the hypothesis that PIU affects anxiety and depressive symptoms through the mediating role of impulsivity. Methods: The cross-sectional study was comprised of 619 university students (92.9% females and 7.1% males) with a mean age of 22 ± 3 years who participated in an online survey from May to November, 2020. Participants completed the following scales: the Problematic Internet Use Questionnaire-9, the Generalized Anxiety Disorder Questionnaire-7, the Patient Health Questionnaire-9, and the Barratt Impulsiveness Scale-11. K-means cluster analysis and one-way multivariate analysis of variance were used for group comparison in terms of internet use time and habit change during COVID-19 pandemic. Structural equation modeling was applied to examine the mediating effect of impulsivity in association between PIU and mental distress, while controlling for age. Results: In sum, 45.1% of the participants reported PIU and 38.1% had markedly expressed symptoms of anxiety while 43.6% of the students reported moderate to severe depressive symptoms. During the COVID-19 pandemic 76% of the students reported at least moderate increase in their internet use time. Anxiety and depressive symptoms were significantly higher in the group of frequent internet users. The results of the structural equational modeling analysis showed a statistically significant effect of PIU on subjective anxiety symptoms and the statistically significant effect of PIU on subjective depression symptoms, both mediated via impulsivity. Conclusions: During COVID-19 pandemic, PIU, anxiety and depression symptoms are highly prevalent among students. Findings also suggest that relationships between PIU, anxiety and depressive symptoms are mediated via impulsivity. These results underscore the importance of the inclusion of impulsivity factor in the studies analyzing longitudinal effects of PIU on mental distress during COVID-19 pandemic.

How has Internet Addiction been Tracked Over the Last Decade? A Literature Review and 3C Paradigm for Future Research

Background:

The popularity of the internet aggravated by its excessive and uncontrolled use has resulted in psychological impairment or addiction. Internet addiction is hypothesized as an impulse-control disorder of internet use having detrimental impacts on daily life functions, family relationships, and emotional stability. The goal of this review is to provide an exhaustive overview of the empirical evidence on internet addiction and draw attention to future research themes.

Methods:

We performed a literature search on ScienceDirect and PubMed to review original research articles with empirical evidence published on peer-reviewed international journals from 2010 to 2019. Eight hundred and 26 articles were eligible for analysis. Frequency and descriptive statistics were calculated by Microsoft Excel.

Results:

A substantial contribution has been coming from researchers from China, Turkey, Korea, Germany, and Taiwan respectively. Despite controversies regarding its definition and diagnostic procedures, internet addiction has become the focal point of a myriad of studies that investigated this particular phenomenon from different exposures. Given observed literature review data regarding research design, data acquisition, and data analysis strategies, we proposed the 3C paradigm which emphasizes the necessity of research incorporating cross-disciplinary investigation conducted on cross-cultural settings with conscientious cross-validation considerations to gain a better comprehension of internet addiction.

Conclusions:

The findings of the present literature review will serve both academics and practitioners to develop new solutions for better characterize internet addiction.

Validation and Psychometric Properties of the Persian Version of the 21-Item Game Addiction Scale With a Sample of Adolescents and Young Adults

Background: Excessive gaming has become a psychological health issue for both gamers and their social environments. This observation holds true for western but also non-western countries such as Iran. The aim of the present study was to translate and validate a Persian version of the Game Addiction Scale 21 (GAS 21) using a sample of adolescents and adults. Methods: A total of 412 participants (mean age: 22.16 years; 55.3% females) took part in the study. They completed questionnaires covering sociodemographic information and gaming-related information, as well as the Persian version of the GAS 21, the GAS 7, the Internet Addiction Test, and the Generalized Self-Efficacy Scale. Results: Of the initial 21 items of the Persian version of the GAS 21, five proved redundant and were eliminated. Factors analyses yielded four factors explaining 66.35% of the variance: 1. Withdrawal; 2. Feelings of guilt and addiction; 3. Mood modification; 4. Issues of time budget. Cronbach's alphas were satisfactory (alphas > 0.87). To validate the results, scores on the translated version were compared with the well-established Young Internet Addiction test. Factors correlated positively (rs between 0.21 and 0.31) with overall score on this latter test but, against expectations, positively with the generalized self-efficacy scale. Conclusions: A Persian version of the Game Addiction Scale-21 proved to be a useful tool for assessing the risk of game addiction behavior. Further, the solution with 16 items loading on four factors appears respond to the ecological need of parsimony.

Problematic Use of the Internet in Subjects With Bipolar Disorder: Relationship With Posttraumatic Stress Symptoms

Background: Literature shows a high risk for problematic use of the Internet (PUI) in mood disorders, especially in bipolar disorder (BD). In subjects with BD, traumatic events and posttraumatic stress disorder (PTSD) are related to alcohol or substance use disorder, as well as to gambling disorder. However, little is known about the possible association between traumatic exposure and PUI. The present study was aimed at examining the relationship between PUI and trauma exposure, besides PTSD symptoms, in subjects with BD. Methods: A sample of 113 subjects with BD was screened to putative PUI. Furthermore, they completed the Trauma and Loss Spectrum Self-Report (TALS-SR) to assess traumatic events and posttraumatic stress symptoms. Results: Twenty-four subjects (21.2%) reported putative PUI. Subjects with putative PUI presented significantly higher scores in the TALS-SR domains Potentially Traumatic Events, Re-experiencing, Maladaptive coping, and Arousal, as well as in the TALS-SR total score. In a logistic regression model, a positive association emerged between Potentially Traumatic Events and Arousal TALS-SR domains and putative PUI. Conclusion: One in five patients with BD screened positive for PUI. A significant association between PUI and lifetime traumatic events as well as PTSD symptoms emerged, highlighting the relevance of the comorbidity between PTSD and PUI in subjects with BD.

Genetics of OCD and Related Disorders; Searching for Shared Factors

Obsessive compulsive disorder (OCD) and several other obsessive-compulsive related disorders (OCRDs) including hoarding disorder, body dysmorphic disorder (BDD), skin picking disorder, trichotillomania and the newly arising public health conditions of online gaming and gambling disorders, under the umbrella of Problematic Usage of the Internet (PUI), not only share some common phenotypes, but there is evidence to suggest share some genetic risk factors. The simple fact that these disorders segregate within families points to this notion. However, the current data are still scarce. This chapter focuses on identifying the shared genetic factors. To address this question, a systematic review of the literature investigating genetic findings in OCD and OCRDs including PUI was conducted, with a focus on their genetic similarities. Greater knowledge of the specific genetic risks shared among OCRDs would be expected to open new avenues in the understanding of the biological mechanisms causing the development of these phenotypes, as well as provide opportunities to develop new animal and cellular models testing new therapy avenues.

Internet Use and Problematic Use in Seniors: A Comparative Study in Switzerland and Poland

Background: Seniors have been only little considered in studies examining problematic internet use and associated health issues, although they may present risk factors that make them particularly vulnerable for the development of problematic internet use. Objectives: (1) To compare Internet use and problematic use among seniors in Switzerland and Poland; (2) To examine the relationships between problematic internet use, impulsivity traits and well-being as previous studies showed that internet can be used to cope with negative emotions or life dissatisfaction. Methods: A cross-sectional survey conducted between June 2016 and April 2017 with 264 older internet users aged above 60 years old recruited in Switzerland (88) and Poland (176) assessing sociodemographic variables, online activities, problematic internet use, impulsivity traits and well-being. Results: The two groups differed in their reported online activities in that Polish participants reported more searching for information and buying, whereas Swiss participants reported significantly greater problematic internet use than Polish participants. Finally, a multiple linear regression analysis performed on the whole sample indicated that lower well-being and being a Swiss participant were both significantly associated with greater problematic internet use, after age, gender, level of education, impulsivity traits have been controlled for. Discussion: Swiss seniors showed a more problematic internet use than Polish participants who focused more in their online activities on utility use of internet. The relationships between problematic internet use and well-being suggest that older adults use internet mainly to cope with negative emotion or life dissatisfaction. Socio-cultural differences that could account for these group differences as well as difference with young adults are discussed.

The Future of Obsessive-Compulsive Spectrum Disorders: A Research Perspective

Obsessive-compulsive disorder (OCD) sits at the epicenter of a spectrum of related conditions (often referred to as obsessive-compulsive related disorders (OCRD) or obsessive-compulsive spectrum disorders (OCSD)) that can be as disabling as they are varied in presentation. Research in the field now encompasses diverse disciplines ranging from inflammatory mechanisms to computational psychiatry, to neurocognitive endophenotypes to functional imaging to pharmacogenomics to brain stimulation approaches. As these disorders become more clearly elucidated, there is a need to continually re-evaluate the implications of research findings and to incorporate these findings into new treatment approaches that benefit both patients and clinicians. Even the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) is intended to be flexible and to incorporate validated and reliable biomarkers and neuroscience findings as they become available. This concluding chapter highlights just a few areas of study that promise to influence our understanding of the pathophysiology and clinical practice of OCRD. These include patient-centered outcomes research, the study of developmental brain trajectories in spectrum conditions, robot models of OCRDs, goal-directed versus habit-based behaviors, pharmacogenomics, problematic use of the Internet, and digital interventions. For example, digital medicine may become increasingly useful by identifying patients early on in the course of their illness; providing biomarkers to subtype patients; predicting treatment response; serving as a more proximal outcome measure of treatment response; or providing easily accessible and less costly forms of care. In order to address unmet clinical needs in OCRD, it is helpful to take an interdisciplinary perspective, and the work described in this collection of articles is likely to be invaluable in shaping the future of the field.

Psychometric Properties of the Nine-Item Problematic Internet Use Questionnaire in a Brazilian General Population Sample

Objective: The goal of the study is to adapt and examine the psychometric properties of the Brazilian version of the nine-item Problematic Internet Use Questionnaire (PIUQ-SF-9). Methods: A convenience sample of Brazilian internet users aged between 18 and 89 years (72.7% female, mean age 38.7 years ± 13.5) was recruited online from September 2018 to July 2019 (test sample = 1,525; retest sample = 237). Participants responded to the adapted version of the PIUQ-SF-9, as well as the Center for Epidemiologic Studies-Depression Scale (CES-D-10) and sociodemographic questions. Results: A bifactor model with one general factor and three specific dimensions (obsession, neglect and control disorder) yielded the best fit indices [χ² = 67.66, df = 15, CFI = 0.99, TLI = 0.99, RMSEA = 0.048 (0.037-0.060), RMSEA p close = 0.587 and SRMR = 0.01]. McDonald's hierarchical omega coefficient was 0.76 for the general factor and varied between 0.16 and 0.33 for the specific dimensions. The intraclass correlation coefficient was 0.73 for the general factor and varied between 0.64 and 0.72 for the specific dimensions. The MIMIC model supported the scale's construct validity as the relationship of the predictors (age, time spent online, self-perception of problematic internet use, and depression symptoms) with the PIUQ-SF-9 factors was in line with the assumptions based on the literature. Conclusion: PIUQ-SF-9 seems to be a brief and culturally validated instrument with sound psychometric properties to be used in future studies on problematic internet use in the Brazilian population.

Evaluating the quality of evidence for gaming disorder: A summary of systematic reviews of associations between gaming disorder and depression or anxiety

Gaming disorder has been described as an urgent public health problem and has garnered many systematic reviews of its associations with other health conditions. However, review methodology can contribute to bias in the conclusions, leading to research, policy, and patient care that are not truly evidence-based. This study followed a pre-registered protocol (PROSPERO 2018 CRD42018090651) with the objective of identifying reliable and methodologically-rigorous systematic reviews that examine the associations between gaming disorder and depression or anxiety in any population. We searched PubMed and PsycInfo for published systematic reviews and the gray literature for unpublished systematic reviews as of June 24, 2020. Reviews were classified as reliable according to several quality criteria, such as whether they conducted a risk of bias assessment of studies and whether they clearly described how outcomes from each study were selected. We assessed possible selective outcome reporting among the reviews. Seven reviews that included a total of 196 studies met inclusion criteria. The overall number of participants was not calculable because not all reviews reported these data. All reviews specified eligibility criteria for studies, but not for outcomes within studies. Only one review assessed risk of bias. Evidence of selective outcome reporting was found in all reviews-only one review incorporated any of the null findings from studies it included. Thus, none were classified as reliable according to prespecified quality criteria. Systematic reviews related to gaming disorder do not meet methodological standards. As clinical and policy decisions are heavily reliant on reliable, accurate, and unbiased evidence synthesis; researchers, clinicians, and policymakers should consider the implications of selective outcome reporting. Limitations of the current summary include using counts of associations and restricting to systematic reviews published in English. Systematic reviewers should follow established guidelines for review conduct and transparent reporting to ensure evidence about technology use disorders is reliable.

The effects of parental control and warmth on problematic internet use in adolescents: A prospective cohort study

BACKGROUND AND AIMS

Problematic internet use (PIU) is a highly prevalent condition with severe adverse effects. The literature suggests that parent-child bonding and parental behavioral control exert protective effects against PIU. However, the most relevant studies rely on simplistic measurement of parenting, cross-sectional designs and mixed-aged samples. Our study analyzed the effect of maternal and paternal parenting on PIU by using a prospective design and a cohort sample of same-aged children.

METHODS

Data from 1,019 Czech 12-year-old sixth-graders who were followed until ninth grade were used. Maternal and paternal responsiveness and strictness were reported by children using the Parental Acceptance-Rejection Questionnaire (PARQ) and the Parental Control Scale (PCS). PIU was measured by the Excessive Internet Use Scale (EIUS).

RESULTS

The self-reported PIU prevalence in nine-graders (15-year-old) was 8.1%. Parenting, reported by adolescents 18 months before PIU screening, showed significant relationships with PIU: parental responsiveness was negatively and moderately associated, while maternal strictness showed a weak positive association; the authoritative parenting style in both parents decreased PIU, with a PIU probability of 3.21%, while a combination of maternal authoritarian and paternal neglectful parenting was associated with PIU probability as high as 20.9%.

DISCUSSION AND CONCLUSIONS

The self-reported prevalence of PIU in Czech adolescents was found to be high. The effects of parenting on PIU were similar to the effects of parenting on other problematic behavior among adolescents. Our findings showed the need for interventions to prevent PIU by helping parents to apply optimal parenting styles.

Psychiatric disorders in children and adolescents during the COVID-19 pandemic

Introduction

The Covid-19 pandemic has generated an unprecedented multimodal (health, occupational, economic, and social) crisis, which will impact developing countries. Confinement as a preventive measure is itself a threat that produces a social impact. Pandemic and confinement have become a psychosocial adversity factor that affects families and their children. During the pandemic, children and adolescents with a psychiatric disorder may experience exacerbation of their symptoms. However, little is known about this, since studies on this population during the pandemic are scarce.

Objective

To review the data available in the current literature on the effect of the pandemic on children and adolescents with a previous psychiatric disorder.

Methods

A literature search was carried out using PubMed, Scielo and, due to the exceptional conditions of the pandemic situation, directly using internet search engines. Both English and Spanish papers were included.

Results

The information found is presented in the following sections: family and children during the pandemic, evaluation of mental disorders in children and young people during the pandemic, pre-existing psychiatric disorders during the pandemic, and telepsychiatric care. Specific information is presented on attention deficit hyperactivity disorder, autism spectrum disorder, intellectual disability, anxiety disorder, obsessive compulsive disorder, and post-traumatic stress disorder. The current pandemic due to COVID-19 and confinement are a psychosocial adversity that threatens the stability of the family. Such a stressor can cause exacerbation of symptoms of a previous mental disorder. Children and adolescents with psychiatric disorders are a vulnerable population and require specialised care. Telepsychiatry is becoming a modality with multiple advantages.

The effects of parental control and warmth on problematic internet use in adolescents: A prospective cohort study

BACKGROUND AND AIMS

Problematic internet use (PIU) is a highly prevalent condition with severe adverse effects. The literature suggests that parent-child bonding and parental behavioral control exert protective effects against PIU. However, the most relevant studies rely on simplistic measurement of parenting, cross-sectional designs and mixed-aged samples. Our study analyzed the effect of maternal and paternal parenting on PIU by using a prospective design and a cohort sample of same-aged children.

METHODS

Data from 1,019 Czech 12-year-old sixth-graders who were followed until ninth grade were used. Maternal and paternal responsiveness and strictness were reported by children using the Parental Acceptance-Rejection Questionnaire (PARQ) and the Parental Control Scale (PCS). PIU was measured by the Excessive Internet Use Scale (EIUS).

RESULTS

The self-reported PIU prevalence in nine-graders (15-year-old) was 8.1%. Parenting, reported by adolescents 18 months before PIU screening, showed significant relationships with PIU: parental responsiveness was negatively and moderately associated, while maternal strictness showed a weak positive association; the authoritative parenting style in both parents decreased PIU, with a PIU probability of 3.21%, while a combination of maternal authoritarian and paternal neglectful parenting was associated with PIU probability as high as 20.9%.

DISCUSSION AND CONCLUSIONS

The self-reported prevalence of PIU in Czech adolescents was found to be high. The effects of parenting on PIU were similar to the effects of parenting on other problematic behavior among adolescents. Our findings showed the need for interventions to prevent PIU by helping parents to apply optimal parenting styles.

Online activities as risk factors for Problematic internet use among students in Bahir Dar University, North West Ethiopia: A hierarchical regression model

BACKGROUND

Problematic internet use (PIU) among youth has become a public health concern. Previous studies identified socio-demographic background risk factors for PIU. The effects of online activities on youth PIU behavior are not well investigated.

METHODS

This cross-sectional study assessed the roles of online activities for PIU behavior of undergraduate students in Bahir Dar University, North West Ethiopia. Data were collected from 812 randomly selected regular program students recruited from 10 departments. Respondents completed a pre-tested structured questionnaire. Hierarchical logistic regression models were used for analyses.

RESULTS

The results indicated that social networking (75.5%), entertainment (73.6%), academic works (70.9%), and online gaming (21.6%) are the important online activities students are engaging in the internet. About 33% and 1.8% of students showed symptoms of mild and severe PIU, respectively. Taking online activities into account improved the model explaining PIU behavior of students. Online activities explained 46% of the variance in PIU. Using the internet for social networking (AOR = 7.078; 95% CI: 3.913-12.804) and online gaming (AOR = 2.175; 95% CI: 1.419-3.335) were risk factors for PIU.

CONCLUSIONS

The findings revealed that more than a third of the respondents showed symptoms of PIU. Online activities improved the model explaining PIU behavior of students. Thus, university authorities need to be aware of the prevalence of PIU and introduce regulatory mechanisms to limit the usage of potentially addictive online activities and promoting responsible use of the internet.

Moderator effect of sex in the clustering of treatment-seeking patients with gambling problems

BACKGROUND

There are no studies based on a person-centered approach addressing sex-related differences in the characteristics of treatment-seeking patients with gambling disorder (GD). The main objective of the current study is to identify empirical clusters of GD based on several measures of the severity of gambling behavior, and considering the potential role of patient sex as a moderator.

METHODS

An agglomerative hierarchical clustering method was applied to an adult sample of 512 treatment-seeking patients (473 men and 39 women) by using a combination of the Schwarz Bayesian Information Criterion and log-likelihood function.

RESULTS

Three clusters were identified in the subsample of men: cluster M1 (low-mild gambling severity level, 9.1%), cluster M2 (moderate level, 60.9%), and cluster M3 (severe level, 30.0%). In the women subsample, two clusters emerged: cluster W1 (mild-moderate level, 64.1%), and cluster W2 (severe level, 35.9%). The most severe GD profiles were related to being single, multiple gambling preference for nonstrategic plus strategic games, early onset of the gambling activity, higher impulsivity levels, higher dysfunctional scores in the personality traits of harm avoidance, and self-directedness, and higher number of lifespan stressful life events (SLE). Differences between the empirical men and women clusters were found in different sociodemographic and clinical measurements.

CONCLUSIONS

Men and women have distinct profiles regarding gambling severity that can be identified by a clustering approach. The sociodemographic and clinical characterization of each cluster by sex may help to establish specific preventive and treatment interventions.

Systematic review and meta-analysis of epidemiology of internet addiction

BACKGROUND

The field of internet addiction has experienced significant debates on conflicting epidemiology. This meta-analysis investigated the prevalence rates of generalized internet addiction (GIA) and internet gaming disorder (IGD).

METHODS

We included 113 epidemiologic studies covering 693,306 subjects published from 1996 to 2018 (for 31 nations) that reported prevalence rates for GIA or IGD. We examined pooled prevalence of GIA and IGD and the hypothesized moderators including year, geographic regions, types of scales, and sample representativeness.

RESULTS

All 133 effect sizes included 53,184 subjects with GIA or IGD. Weighted average prevalence for GIA and IGD were 7.02 % (95 % CI, 6.09 %-8.08 %) and 2.47 % (95 % CI, 1.46 %-4.16 %) respectively. For GIA, prevalence was increased over time and prevalence rates variated among different scales. IGD prevalence was neither moderated by year, regions, nor sample representativeness.

CONCLUSIONS

The prevalence of GIA was higher than the prevalence of IGD. The GIA prevalence was increasing over time and variated with different assessments. Our results reveal that GIA may reflect a pattern of increasing human-machine interaction.

Clinical advances in obsessive-compulsive disorder: a position statement by the International College of Obsessive-Compulsive Spectrum Disorders

In this position statement, developed by The International College of Obsessive-Compulsive Spectrum Disorders, a group of international experts responds to recent developments in the evidence-based management of obsessive-compulsive disorder (OCD). The article presents those selected therapeutic advances judged to be of utmost relevance to the treatment of OCD, based on new and emerging evidence from clinical and translational science. Areas covered include refinement in the methods of clinical assessment, the importance of early intervention based on new staging models and the need to provide sustained well-being involving effective relapse prevention. The relative benefits of psychological, pharmacological and somatic treatments are reviewed and novel treatment strategies for difficult to treat OCD, including neurostimulation, as well as new areas for research such as problematic internet use, novel digital interventions, immunological therapies, pharmacogenetics and novel forms of psychotherapy are discussed.

Preventing problematic internet use during the COVID-19 pandemic: Consensus guidance

As a response to the COVID-19 pandemic, many governments have introduced steps such as spatial distancing and "staying at home" to curb its spread and impact. The fear resulting from the disease, the 'lockdown' situation, high levels of uncertainty regarding the future, and financial insecurity raise the level of stress, anxiety, and depression experienced by people all around the world. Psychoactive substances and other reinforcing behaviors (e.g., gambling, video gaming, watching pornography) are often used to reduce stress and anxiety and/or to alleviate depressed mood. The tendency to use such substances and engage in such behaviors in an excessive manner as putative coping strategies in crises like the COVID-19 pandemic is considerable. Moreover, the importance of information and communications technology (ICT) is even higher in the present crisis than usual. ICT has been crucial in keeping parts of the economy going, allowing large groups of people to work and study from home, enhancing social connectedness, providing greatly needed entertainment, etc. Although for the vast majority ICT use is adaptive and should not be pathologized, a subgroup of vulnerable individuals are at risk of developing problematic usage patterns. The present consensus guidance discusses these risks and makes some practical recommendations that may help diminish them.

Which conditions should be considered as disorders in the International Classification of Diseases (ICD-11) designation of "other specified disorders due to addictive behaviors"?

BACKGROUND

Gambling and gaming disorders have been included as "disorders due to addictive behaviors" in the International Classification of Diseases (ICD-11). Other problematic behaviors may be considered as "other specified disorders due to addictive behaviors (6C5Y)."

METHODS

Narrative review, experts' opinions.

RESULTS

We suggest the following meta-level criteria for considering potential addictive behaviors as fulfilling the category of "other specified disorders due to addictive behaviors":1. Clinical relevance: Empirical evidence from multiple scientific studies demonstrates that the specific potential addictive behavior is clinically relevant and individuals experience negative consequences and functional impairments in daily life due to the problematic and potentially addictive behavior.2. Theoretical embedding: Current theories and theoretical models belonging to the field of research on addictive behaviors describe and explain most appropriately the candidate phenomenon of a potential addictive behavior.3. Empirical evidence: Data based on self-reports, clinical interviews, surveys, behavioral experiments, and, if available, biological investigations (neural, physiological, genetic) suggest that psychological (and neurobiological) mechanisms involved in other addictive behaviors are also valid for the candidate phenomenon. Varying degrees of support for problematic forms of pornography use, buying and shopping, and use of social networks are available. These conditions may fit the category of "other specified disorders due to addictive behaviors".

CONCLUSION

It is important not to over-pathologize everyday-life behavior while concurrently not trivializing conditions that are of clinical importance and that deserve public health considerations. The proposed meta-level-criteria may help guide both research efforts and clinical practice.

Problematic Internet Use among Youths

Problematic Internet Use (PIU) has of late come to the major attention of researchers of risky behaviours. For parents and teachers in turn, the various pathological forms of Internet use have become more and more noticeable. In recent years, the operationalisation of the term PIU has also been discussed and attempts to measure its various phenomena have been made. In our study, we used the quantitative method—a diagnostic survey designed on the basis of a tool of the Supreme Audit Office and Scientific and Academic Computer Network (Naukowa i Akademicka Sieć Kompureowa NASK), The survey was conducted in the first half of 2017 in Poland, among 3569 adolescents (median 16, SD = 1.28). The purpose of the research was to investigate the scale of PIU among Polish youths. For most young people, PIU is a major social problem. The majority also declare that more than half of their friends have problems with using electronic media (smartphones and the Internet in particular). On the basis of the data collected, it is estimated that 60% of adolescents use media in a functional way, whereas 40% of young electronic media users show visible PIU symptoms, of which 5% do so at a destructive level (all symptoms). Gender does not co-occur with PIU; however, family structure (where both parents are present), the setting of rules for the use of electronic media, and the place of residence are all protective factors. There is a need for constantly improved tools for measuring PIU, as well as preventive programs focused on developing self-control and helping young people understand their own emotions.

Problematic internet use: an exploration of associations between cognition and COMT rs4818, rs4680 haplotypes

OBJECTIVE

Problematic internet users suffer from impairment in a variety of cognitive domains. Research suggests that COMT haplotypes exert differential effects on cognition. We sought to investigate differences in the genetic profiles of problematic internet users and whether those could shed light on potential cognitive differences.

METHODS

We recruited 206 non-treatment seeking participants with heightened impulsive traits and obtained cross-sectional demographic, clinical, and cognitive data as well as the genetic haplotypes of COMT rs4680 and rs4818. We identified 24 participants who presented with problematic internet use (PIU) and compared PIU and non-PIU participants using one-way analysis of variance (ANOVA) and chi square as appropriate.

RESULTS

PIU was associated with worse performance on decision making, rapid visual processing, and spatial working memory tasks. Genetic variants were associated with altered cognitive performance, but rates of PIU did not statistically differ for particular haplotypes of COMT.

CONCLUSION

This study indicates that PIU is characterized by deficits in decision making and working memory domains; it also provides evidence for elevated impulsive responses and impaired target detection on a sustained attention task, which is a novel area worth exploring further in future work. The effects observed in the genetic influences on cognition of PIU subjects imply that the genetic heritable components of PIU may not lie within the genetic loci influencing COMT function and cognitive performance; or that the genetic component in PIU involves many genetic polymorphisms each conferring only a small effect.

Pornography use in the setting of the COVID-19 pandemic

With the global expansion of the COVID-19 pandemic, social or physical distancing, quarantines, and lockdowns have become more prevalent. Concurrently, Pornhub, one of the largest pornography sites, has reported increased pornography use in multiple countries, with global traffic increasing over 11% from late February to March 17, 2020. While some substantial increases have coincided with Pornhub making its premium services free to countries in lockdowned or quarantined jurisdictions, countries without such free premium access have also reported increases in the range of 4-24%. In addition, pornography searches using the terms "coronavirus", "corona", and "covid" have reached more than 9.1 million. In this letter, we discuss COVID-19-related pornography-use patterns and the impact they may have with respect to problematic pornography use.

Aligning the "Manifesto for a European Research Network into Problematic Usage of the Internet" with the Diverse Needs of the Professional and Consumer Communities Affected by Problematic Usage of Pornography

The Manifesto for a European research network into Problematic Usage of the Internet was published in May 2018. It was written from the perspective of the COST Action Network, a programme of the European Cooperation in Science and Technology CA16207 and is expected to have significant influence on research funding priorities over the next decade. The Manifesto identified nine key research priorities to advance understanding in the field. Our analysis shows that while at the most general level it identified problematic usage of pornography (PUP) as a key research priority, it then barely mentioned it again within the body of the report. This paper uses the Manifesto's framework to suggest research areas into the problematic usage of pornography which are of particular relevance to clinicians and other professionals working in the field who want to develop approaches to assist individuals and target groups affected by PUP. It also looks at potential research opportunities inspired by the lived-experience of users withdrawing from PUP. A large number of opportunities are identified for new work on PUP across all nine key research areas of the Manifesto.

Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence

BACKGROUND

Cyberchondria (CYB) has been described relatively recently as a behaviour characterized by excessive online searching for medical information that is associated with increasing levels of health anxiety. Although CYB has received some attention from researchers, there is no consensus about many of its aspects.

AIMS

We describe one of the first reported cases of a treatment-seeking patient with CYB. We review the published literature on the definition of CYB, its assessment, epidemiology, cost and burden, psychological models and mechanisms associated with CYB, relationships between CYB and mental disorders and prevention and treatment strategies.

METHODS

Systematic review of all peer-reviewed papers published within the PubMed, PsycINFO, and Cochrane Library databases.

RESULTS

61 articles were selected. Nearly all the studies were descriptive and cross-sectional recruiting sample mainly from the general/university student population and collecting self-report data via online surveys. Data on epidemiology, clinical features, course, comorbidity and therapeutic interventions were scarce. CYB showed a self-reported association with health anxiety, hypochondriasis and obsessive-compulsive disorder (OCD) as well as other forms of problematic usage of the internet (PUI) The psychological mechanisms associated with CYB include low self-esteem, anxiety sensitivity, intolerance of uncertainty, pain catastrophizing and certain meta-cognitive beliefs.

CONCLUSION

A working definition of CYB includes excessive online health searches that are compulsive and may serve the purpose of seeking reassurance, whilst leading to a worsening of anxiety or distress and further negative consequences. CYB represents a clinically relevant transdiagnostic compulsive behavioural syndrome, closely related to PUI and usually presenting in association with health anxiety, hypochondriasis and/or OCD. CYB is clearly in need of further study and we identify key areas for future research.

Handle the Autism Spectrum Condition During Coronavirus (COVID-19) Stay At Home period: Ten Tips for Helping Parents and Caregivers of Young Children

COVID-19 has become pandemic [...].

Handle the Autism Spectrum Condition During Coronavirus (COVID-19) Stay At Home period: Ten Tips for Helping Parents and Caregivers of Young Children

COVID-19 has become pandemic [...].

Differences in associations between problematic video-gaming, video-gaming duration, and weapon-related and physically violent behaviors in adolescents

Seemingly mixed findings have been reported on possible relationships between video-gaming and violent or aggressive behaviors. Given the prevalence of gaming in adolescents and potential harms associated with violent behaviors, relationships between problematic gaming, gaming engagement, and risk behaviors involving weapons and physical violence require further research. This study examined in a large sample of high-school students the relationships between problem-gaming severity, gaming duration, and violence-related measures including weapon-carrying, having been threatened by someone with a weapon, perceived insecurity, physical fights and serious fights leading to injuries. Potential moderation by sensation-seeking and impulsivity was also tested. Participants were 3,896 Connecticut high-school adolescents. Chi-square, logistic regression, and moderation models were conducted. Adolescents with at-risk/problem gaming, compared to low-risk and non-gaming adolescents, reported more weapon-carrying, having been threatened with weapons, feeling unsafe at school, and serious fighting leading to injury. Among those reporting gaming, weekly time spent gaming was associated with problem-gaming severity. Those with longer (versus shorter) gaming durations were more likely to report weapon-carrying and feeling unsafe at school. Sensation-seeking moderated associations between at-risk/problem gaming and weapon-carrying frequency. Associations between gaming quantity and problem-gaming severity and measures of weapon-carrying and physical violence in adolescents suggest that understanding further their mechanistic relationships may be important in promoting safer developmental trajectories for youth. Future longitudinal studies may provide important insight into the etiologies underlying these relationships and such information may help develop more effective prevention and intervention strategies.

All that glitters is not gold. The rise of gaming in the COVID-19 pandemic

The COVID-19 pandemic has led to an unprecedented situation, with incalculable health, social, and economic consequences. At the start of the outbreak, the financial markets collapsed, although not all sectors suffered equally. The gaming and eSports industry is one of those that has suffered the least from the fall in the markets. Millions of people locked up at home, bored, stressed, and anguished, gave gaming and eSports companies growing prominence throughout the first half of 2020. This prominence has elicited interest in analyzing which variables can influence the returns in an industry in better financial health than many others. Using a logit–probit model, this research aims to analyze the relationship between financial (VIX, S&P GSCI Gold Index) and social (worldwide daily variation in total deaths from COVID-19 and worldwide Google attention on coronavirus) variables and the returns offered by the video game and eSports exchange traded fund (ESPO). The results show that the influence of social variables is weaker than the influence of financial variables. There is a significant inverse relationship between market volatility and ESPO returns and a highly significant relationship between ESPO returns and gold returns. While the relationship of ESPO returns with worldwide Google attention on coronavirus is significant, the relationship with worldwide daily variation in total deaths from COVID-19 is not. The conclusions of the study are discussed at the end of the paper.