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Firth J, Torous J, López-Gil JF, Linardon J, Milton A, Lambert J, Smith L, Jarić I, Fabian H, Vancampfort D, Onyeaka H, Schuch FB, Firth JA. From "online brains" to "online lives": understanding the individualized impacts of Internet use across psychological, cognitive and social dimensions. World Psychiatry 2024; 23:176-190. [PMID: 38727074 PMCID: PMC11083903 DOI: 10.1002/wps.21188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
In response to the mass adoption and extensive usage of Internet-enabled devices across the world, a major review published in this journal in 2019 examined the impact of Internet on human cognition, discussing the concepts and ideas behind the "online brain". Since then, the online world has become further entwined with the fabric of society, and the extent to which we use such technologies has continued to grow. Furthermore, the research evidence on the ways in which Internet usage affects the human mind has advanced considerably. In this paper, we sought to draw upon the latest data from large-scale epidemiological studies and systematic reviews, along with randomized controlled trials and qualitative research recently emerging on this topic, in order to now provide a multi-dimensional overview of the impacts of Internet usage across psychological, cognitive and societal outcomes. Within this, we detail the empirical evidence on how effects differ according to various factors such as age, gender, and usage types. We also draw from new research examining more experiential aspects of individuals' online lives, to understand how the specifics of their interactions with the Internet, and the impact on their lifestyle, determine the benefits or drawbacks of online time. Additionally, we explore how the nascent but intriguing areas of culturomics, artificial intelligence, virtual reality, and augmented reality are changing our understanding of how the Internet can interact with brain and behavior. Overall, the importance of taking an individualized and multi-dimensional approach to how the Internet affects mental health, cognition and social functioning is clear. Furthermore, we emphasize the need for guidelines, policies and initiatives around Internet usage to make full use of the evidence available from neuroscientific, behavioral and societal levels of research presented herein.
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Affiliation(s)
- Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - John Torous
- Division of Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - José Francisco López-Gil
- One Health Research Group, Universidad de las Americas, Quito, Ecuador
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jake Linardon
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Alyssa Milton
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Australian Research Council, Centre of Excellence for Children and Families over the Life Course, Sydney, NSW, Australia
| | | | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ivan Jarić
- Laboratoire Ecologie, Systématique et Evolution, Université Paris-Saclay, Gif-sur-Yvette, France
- Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
| | - Hannah Fabian
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - Henry Onyeaka
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Health Sciences, Universidad Autônoma de Chile, Providência, Chile
| | - Josh A Firth
- Department of Biology, University of Oxford, Oxford, UK
- School of Biology, University of Leeds, Leeds, UK
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Richson BN, Abber SR, Wierenga CE. Conceptualizing avoidant/restrictive food intake disorder via an executive functioning lens. Int J Eat Disord 2024. [PMID: 38804560 DOI: 10.1002/eat.24233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024]
Abstract
Avoidant/restrictive food intake disorder (ARFID) is a heterogeneous disorder wherein restrictive eating is primarily attributed to non-shape/weight-based reasons (e.g., sensory sensitivity) that empirical research continues to explore. Mounting evidence suggests that ARFID often presents alongside neurodevelopmental diagnoses (NDs) or divergent neurodevelopment broadly. Executive functioning (EF) differences often characterize divergent neurodevelopmental trajectories. Additionally, restrictive eating in anorexia nervosa has been conceptualized as related to EF factors (e.g., set shifting). Given the neurodevelopmental phenotype that may be associated with ARFID and the role of EF in anorexia nervosa, this paper proposes EF as a potentially important, yet understudied factor in ARFID pathology. We posit that various observed ARFID behavioral/cognitive tendencies can be conceptualized in relation to EF differences. We contextualize commonly observed ARFID presentations within "core" EF components (i.e., cognitive flexibility, working memory, inhibitory control), leading to hypotheses about EF in ARFID. Finally, we offer additional considerations/directions for future research on EF in ARFID. Increased research on EF in ARFID is needed to consider this potential common factor in the etiology and maintenance of this heterogeneous disorder. We aim to promote further consideration of EF in ARFID etiology, maintenance, and treatment-outcome research. PUBLIC SIGNIFICANCE: This article proposes that aspects of executive functioning (EF) may play a role in the onset and maintenance of avoidant/restrictive food intake disorder (ARFID), although this notion is largely untested by existing research. Further research on the role of EF in ARFID may assist with refining models and treatments for this heterogeneous disorder.
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Affiliation(s)
- Brianne N Richson
- Sanford Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Sophie R Abber
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Christina E Wierenga
- Department of Psychiatry, University of California San Diego Eating Disorders Center for Treatment and Research, San Diego, California, USA
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Ramalho SM, Conceição E, Tavares AC, Freitas AL, Machado BC, Gonçalves S. Loss of Control over Eating, Inhibitory Control, and Reward Sensitivity in Children and Adolescents: A Systematic Review. Nutrients 2023; 15:2673. [PMID: 37375576 DOI: 10.3390/nu15122673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
OVERVIEW In recent years, there has been increasing clinical and empirical interest in the concept of pediatric loss of control over eating, particularly about its link with the executive functions related to the concept of impulsivity, such as inhibitory control and reward sensitivity. However, there has yet to be a comprehensive literature synthesis about the associations between these variables. A comprehensive literature synthesis would help identify future research directions to advance the field in this area. Therefore, this systematic review aimed to synthesize evidence concerning the associations between loss of control over eating, inhibitory control, and reward sensitivity in children and adolescents. METHODS The systematic review was conducted according to the guidelines proposed by PRISMA in Web of Science, Scopus, PubMed, and PsycINFO. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the risk of bias. RESULTS Twelve studies met the selection criteria and were included in the final review. Overall, methodological heterogeneity, variability in assessment methods, and the age of participants make it difficult to draw general conclusions. Nevertheless, most studies with community samples of adolescents indicate that inhibitory control difficulties are linked to the concept of loss of control eating. The presence of obesity seems to be associated with inhibitory control difficulties, regardless of the presence of loss of control eating. Studies on reward sensitivity are scarcer. However, it has been suggested that higher reward sensitivity is related to loss of control eating behaviors in young people, particularly binge eating. CONCLUSIONS The literature on the link between loss of control eating and trait-level facets of impulsivity (low inhibitory control and higher reward sensitivity) among young people remains limited, and more studies on children are needed. Findings from this review may make healthcare professionals more aware of the potential clinical importance of targeting the trait-level facets of impulsivity and help to inform existing and future weight-loss/maintenance interventions in childhood and adolescence.
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Affiliation(s)
- Sofia Marques Ramalho
- Centro de Investigação em Psicologia para o Desenvolvimento (CIPD), 4100-346 Porto, Portugal
- Instituto de Psicologia e de Ciências da Educação, Universidade Lusíada (Porto), 4100-348 Porto, Portugal
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, 4704-553 Braga, Portugal
| | - Ana Cristina Tavares
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, 4704-553 Braga, Portugal
| | - Ana Luísa Freitas
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, 4704-553 Braga, Portugal
| | - Bárbara César Machado
- Research Centre for Human Development (CEDH), Faculdade de Educação e Psicologia, Portuguese Catholic University, 4169-005 Porto, Portugal
| | - Sónia Gonçalves
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, 4704-553 Braga, Portugal
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Field AE. Is set-shifting a risk factor for anorexia nervosa or a broader range of disordered eating? Int J Eat Disord 2022; 55:415-417. [PMID: 35060623 DOI: 10.1002/eat.23679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/22/2021] [Accepted: 01/10/2022] [Indexed: 11/08/2022]
Abstract
Steegers et al. using data from the Generation R cohort study examined whether set-shifting difficulties at age 4 predict body dissatisfaction, weight status, and restrictive eating at age 9 as a way to examine whether cognitive rigidity was a risk factor for an eating disorder. The authors concluded that set-shifting difficulties problems were predictive of features of anorexia nervosa. An alternative interpretation is that set shifting is predictive of large weight changes and eating behaviors more generally. It is not clear that set-shifting predicts becoming underweight. Set shifting appears protective against larger weight gains. It is possible that set shifting is related to degree to which the children resist the myriad of cues to eat for reasons other than hunger. Whether this is due to a higher degree of awareness, genetics, or other reasons should be investigated. The results demonstrate that the cognitive process that relate to restrictive behaviors are complex. To better understand those relationships, it will be essential for the field to adopt a conceptualization of eating disorders that includes the earliest stages (disordered eating) of the full range of eating disorders.
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Affiliation(s)
- Alison E Field
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
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Berchio C, Micali N. Cognitive assessment using ERP in child and adolescent psychiatry: Difficulties and opportunities. Psychiatry Res Neuroimaging 2022; 319:111424. [PMID: 34883368 DOI: 10.1016/j.pscychresns.2021.111424] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 02/07/2023]
Abstract
Event related potentials (ERPs) represent powerful tools to investigate cognitive functioning in child and adolescent psychiatry. So far, the available body of research has largely focused on advancements in analysis methods, with little attention given to the perspective of assessment. The aim of this brief report is to provide recommendations for cognitive ERPs assessment that can be applied across diagnostic categories in child and adolescent psychiatry research. First, we discuss major issues for ERPs testing using examples from common psychiatric disorders. We conclude by summing up our recommendations for methodological standards and highlighting the potential role of ERPs in the field.
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Affiliation(s)
- Cristina Berchio
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Child and Adolescent Psychiatry, Department of Child and Adolescent Health, Geneva University Hospital, Geneva, Switzerland; Great Ormond Street Institute of Child Health, University College London, London, UK
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Miranda-Olivos R, Testa G, Lucas I, Sánchez I, Sánchez-González J, Granero R, Jiménez-Murcia S, Fernández-Aranda F. Clinical factors predicting impaired executive functions in eating disorders: The role of illness duration. J Psychiatr Res 2021; 144:87-95. [PMID: 34601380 DOI: 10.1016/j.jpsychires.2021.09.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/08/2021] [Accepted: 09/22/2021] [Indexed: 01/30/2023]
Abstract
Poor performance in executive functions is observed in individuals with eating disorders (EDs). These impairments have usually been associated with the presence of comorbid psychopathology or with higher severity of EDs. However, few studies have explored the interaction between illness duration and deficits in executive functions. The present study investigates the association between ED duration and performance in decision-making, inhibitory control, and cognitive flexibility in the anorexia nervosa restrictive subtype (AN-R), bulimic/purging subtype (AN-BP), and binge spectrum disorders (BSDs) (namely, bulimia nervosa and binge eating disorder) among 116 women with EDs compared with 123 women healthy controls (HCs). Using cumulative survival analysis, we estimated the risk of deficits related to illness duration. Predictors of executive dysfunctions were assessed by regression analysis, including as potential predictors illness duration, severity of general psychopathology, and ED symptomatology. Results showed poor decision-making and cognitive flexibility in participants with EDs compared with HCs. ED duration was associated with poor inhibitory control in the AN-BP group and poor cognitive flexibility in the BSD group. The illness duration increased the risk of presenting early deficits in executive function. In decision-making and inhibitory control, the AN-R group showed the earliest deficits, whereas in cognitive flexibility it was the BSD group. ED duration predicted impaired cognitive flexibility in the BSD group and impaired inhibitory control in the AN-BP group, whereas the severity of general psychopathological symptoms was a predictor of impaired cognitive flexibility in individuals with AN-R. These results highlight the relevance of illness duration in executive dysfunctions in EDs.
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Affiliation(s)
- Romina Miranda-Olivos
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Giulia Testa
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Ignacio Lucas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Isabel Sánchez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Jessica Sánchez-González
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Schaumberg K, Zerwas SC, Bulik CM, Fiorentini C, Micali N. Prospective associations between childhood social communication processes and adolescent eating disorder symptoms in an epidemiological sample. Eur Child Adolesc Psychiatry 2021; 30:1929-1938. [PMID: 33064208 PMCID: PMC8050127 DOI: 10.1007/s00787-020-01655-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 09/25/2020] [Indexed: 02/03/2023]
Abstract
Deficits in social cognition and communication, the processes associated with human social behavior and interaction, have been described in individuals with eating disorder psychopathology. The current study examined whether social communication characteristics present in middle childhood (ages 8-14) were associated with eating disorder behaviors, cognitions, and diagnoses across adolescence (ages 14-18) in a large, population-based sample. Participants (N = 4864) were children enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based, prospective study of women and their children. Regression methods tested prospective associations between social functioning using a facial emotion recognition task and parentally reported social communication symptoms (or difficulties), measured by the Social Communication Disorder Checklist (SCDC), with eating disorder symptoms and diagnoses. Misattribution of faces as sad or angry at age 8.5 was associated with purging and anorexia nervosa diagnosis at age 14, respectively, among girls. Furthermore, autistic-like social communication difficulties during middle childhood were associated with bulimia nervosa symptoms during adolescence among both girls and boys. Results did not support global associations between measured social communication deficits and eating disorder risk in this sample, but specific difficulties with facial emotion recognition and social communication may enhance the risk for disordered eating behaviors.
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Affiliation(s)
- Katherine Schaumberg
- Department of Psychiatry, University of Wisconsin, 6001 Research Park Blvd, Madison, WI, 53719, USA.
| | - Stephanie C. Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States,Department of Nutrition, University of North Carolina at Chapel Hill, United States,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Chiara Fiorentini
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States,Institute of Child Health, University College London, United Kingdom
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Gorrell S, Flatt RE, Bulik CM, Le Grange D. Psychosocial etiology of maladaptive exercise and its role in eating disorders: A systematic review. Int J Eat Disord 2021; 54:1358-1376. [PMID: 33942917 PMCID: PMC8811798 DOI: 10.1002/eat.23524] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Although maladaptive exercise (ME) is widely recognized as a clinical feature in transdiagnostic eating disorders, less is known about psychosocial factors that give rise to and perpetuate this behavior. This systematic review aimed to examine the empirical status of this association. METHOD We reviewed 46 full text articles examining longitudinal associations between psychosocial variables and ME. RESULTS Eighteen studies met full inclusion criteria. Based on our qualitative synthesis, evidence suggests reasonably consistent associations between early concern with weight and shape, and negative affect on later development of ME. DISCUSSION Inconsistent and insufficient assessment of ME across a majority of studies underscores caution in interpretation of results, but guides important discussion for future clinical and research efforts.
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Affiliation(s)
- Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California
| | - Rachael E. Flatt
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cynthia M. Bulik
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California,Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, Chicago, Illinois
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