Current Research and Viewpoints on Internet Addiction in Adolescents

Network meta-analysis of the effectiveness of different interventions for internet addiction in college students

BACKGROUND

Internet addiction jeopardizes teenagers' physical and mental health, as well as their academic performance, and causes a variety of cognitive dysfunctions and psychological and mental health illnesses, among other things. It is a huge issue that families, schools, and society must address immediately.

OBJECTIVES

This study used network meta-analysis to evaluate the impact of several interventions on college students' Internet addiction. The goal was to identify the most effective interventions and establish a reference for future interventions. We systematically searched relevant literature in domestic and international databases such as Web of Science, PubMed, EMBASE, Cochrane Library, Pro Quest, China Knowledge, Wan fang, Wipo, etc. We assessed the risk of bias according to the revised Cochrane Randomized Trials Risk of Bias Tool (RoB2) and used R Studio Software and Stata 14.0 for traditional meta-analysis and network meta-analysis. A network meta-analysis based on the IAT scale showed that comprehensive interventions had the highest probability of being the best intervention for IA (SUCRA = 90.6 % based on IAT); focused solution short-term therapy had the highest probability of being the best intervention for IA based on the CIAS-R (19 White Feather) scale (SUCRA = 100 %).

CONCLUSIONS

The majority of interventions have a significant influence on the treatment of IA, and improvements in Internet addiction symptoms are more noticeable when a combination of interventions is used rather than just one.

The effect of digital game addiction on aggression and anger levels in adolescents: A cross-sectional study

PURPOSE

In this study, it was aimed to determine the effect of digital game addiction on aggression and anger levels in adolescents.

DESIGN AND METHODS

The participants of this cross-sectional study were adolescents. Data were collected using a socio-demographic questionnaire, Game Addiction Scale, and Buss-Perry Aggression Scale. Descriptive statistics, t-test, Anova, correlation and linear regression analysis were used in the analysis of the data.

RESULTS

In this study, game addiction and aggression levels of adolescents were determined as moderate. The game type that adolescents played the most was determined as war games with 35 %. The mean score of the Game Addiction Scale for male adolescents, those with medium and high income levels, those who play digital games for >8 h a day and every day, was found to be significantly higher. In this study, a positive and moderately significant correlation was found between Game Addiction Scale and Aggression Total Scale and Anger subscale (p < 0.05). Especially male gender (β = 0.273), high income status (β = -0.089), long time playing digital games (β = 0.173) and playing digital games every day (β = 0.360) were determined as predictors that increase game addiction.

CONCLUSIONS

Digital game addiction can trigger aggression and anger in adolescents. Nurses play a crucial role in screening and identifying adolescents at risk of game addiction to prevent aggression and anger.

PRACTICE IMPLICATIONS

According to the findings of this research, it is necessary to provide training and counseling to prevent digital game addiction in schools and to plan strategies by psychiatric nurses.

Resting-state brain networks alterations in adolescents with Internet Gaming Disorder associate with cognitive control impairments

Objective

Research indicates that cognitive control is compromised in individuals with internet gaming disorder (IGD). However, the neural mechanisms behind it are still unclear. This study aims to investigate alterations in resting-state brain networks in adolescents with IGD and the potential neurobiological mechanisms underlying cognitive dysfunction.

Materials and methods

A total of 44 adolescent IGD subjects (male/female: 38/6) and 50 healthy controls (male/female: 40/10) were enrolled. Participants underwent demographic assessments, Young's Internet Addiction Scale, Barratt Impulsiveness Scale 11 Chinese Revised Version, the Chinese Adolescents' Maladaptive Cognitions Scale, exploratory eye movement tests, and functional magnetic resonance imaging (fMRI). FMRI data were analyzed using the GIFT software for independent component analysis, focusing on functional connectivity within and between resting-state brain networks.

Results

In comparison to the control group, impulsivity in adolescent IGD subjects showed a positive correlation with the severity of IGD (r=0.6350, p < 0.001), linked to impairments in the Executive Control Network (ECN) and a decrease in functional connectivity between the Salience Network (SN) and ECN (r=0.4307, p=0.0021; r=-0.5147, p=0.0034). Decreased resting state activity of the dorsal attention network (DAN) was associated with attentional dysregulation of IGD in adolescents (r=0.4071, p=0.0017), and ECN increased functional connectivity with DAN. The degree of IGD was positively correlated with enhanced functional connectivity between the ECN and DAN (r=0.4283, p=0.0037).

Conclusions

This research demonstrates that changes in the ECN and DAN correlate with heightened impulsivity and attentional deficits in adolescents with IGD. The interaction between cognitive control disorders and resting-state brain networks in adolescent IGD is related.

When Games Influence Words: Gaming Addiction among College Students Increases Verbal Aggression through Risk-Biased Drifting in Decision-Making

Increased aggression due to gaming addiction is a widespread and highly publicized problem. The underlying processes by which verbal aggression, a more harmful and persistent subcategory of aggression, is affected by gaming addiction may differ from other types of aggression. In this study, data came from 252 randomly recruited current university students (50.79% male, mean age 19.60 years, SD: 1.44 years, range 17 to 29 years). Participants reported gaming addiction and different types of aggression through questionnaires. In addition, two important explanatory processes, inhibitory control, and risk preference, were measured through behavioral experiments. A Bayesian hierarchical drift-diffusion model was employed to interpret the data from the risk preference task. In contrast to previous work, the study found that inhibitory control did not significantly correlate with either gaming addiction or any form of aggression However, the drift rate, a measure of decision-making inclination under risk, partially mediates the relationship between gaming addiction and verbal aggression (but not other forms of aggression). The findings illuminate risk preference under adverse conditions as a key predictor of verbal aggression, offering avenues for early intervention and suggesting game design modifications to mitigate verbal aggression by adjusting reward mechanisms.

The association between anxiety and internet addiction among left-behind secondary school students: the moderating effect of social support and family types

BACKGROUND

The left-behind children (LBC), children and adolescents aged 0-18 whose parents have migrated for economic purposes for extended periods exceeding three months, present a unique social concern. These children remain in their place of household registration, often under the guardianship of relatives, while receiving compulsory education. LBC with growing Internet addiction (IA) have made it urgent to take a close look at the mechanisms and effective interventions for them. Anxiety has been proven to be correlated with IA in adolescents; however, the mechanisms of addiction in this population are less well-fully grasped. Based on the current theories and empirical results, the study examined whether and how social support (SS) and family types moderated the associations between anxiety and IA among left-behind secondary students.

METHODS

Stratified cluster sampling survey. A questionnaire was administered to 5290 secondary school children (2553 classified as left-behind) to explore the relationships between anxiety, IA, left-behind types, family types, and social support. This cross-sectional study employed a stratified cluster sampling survey of students in the ethnic areas of southeast Chongqing. The study sought to appraise the relationships between anxiety and IA in different types of left-behind children and to assess the potential moderating effect of SS on the relationship among the population and its family types differences.

RESULTS

The relationship between anxiety and IA was moderated significantly by social support and family types. Notably, the impact of social support on the moderating effect between IA and anxiety varied among students from both family types. For students from families where both parents had migrated, social support weakened the association between IA and anxiety. Conversely, for students from single-parent families where the parent had migrated, social support seemed to strengthen the relationships between these two issues.

CONCLUSIONS

The moderating effects of SS on the relationship between anxiety and IA differs based on family type among various groups of left-behind secondary students. Gaining insights into the IA mechanisms can guide the development of targeted intervention strategies aimed at minimizing IA among diverse groups of left-behind students.

Internet Altruistic Behaviors in Adolescents: Roles of Attention-Deficit/Hyperactivity Disorder, Impulsiveness, and Perceived Social Support

This study examined the associations of an attention-deficit/hyperactivity disorder (ADHD) diagnosis, impulsivity, and perceived social support with Internet altruistic behaviors (IABs) in adolescents and the associations of IABs with depression, suicidality, and nonsuicidal self-injury in this group. In total, 176 adolescents aged between 11 and 18 years with ADHD and 173 adolescents without ADHD (matched with the ADHD group by sex and age) participated in this study. The adolescents rated their IABs on the Internet altruistic behavior scale, impulsivity on the Barratt impulsiveness scale version 11, and perceived family and peer support on the family and social relationship domains of the Taiwanese quality of life questionnaire for adolescents. The associations of ADHD, impulsivity, and social support with IABs and the associations of IABs with depression, suicidality, and nonsuicidal self-injury were examined through multivariable linear regression analysis. The present study found that more time spent on the Internet (p < 0.001), greater perceived peer support (p < 0.001), greater impulsiveness characterized by a lack of self-control and perseverance (p < 0.001), poorer ability to plan and look ahead (p < 0.001), and an ADHD diagnosis (p = 0.003) were significantly associated with a higher level of IABs. IABs were not significantly associated with severe depression, suicidality, or nonsuicidal self-injury (all p > 0.05). The results of this study indicated that multiple individual and social factors were associated with IABs in adolescents. IABs were not significantly associated with severe depression, suicidality, or nonsuicidal self-injury in adolescents.

Factors Related to Internet Addiction in Adolescents: A Cross-Sectional Study

Background

The term "internet addiction" (IA) describes a compulsive behavior associated with any online activity that disrupts everyday social interactions. Main aim of this research was to determine variables and development predictors of Internet addiction.

Methods

A total of 1,669 respondents participated in this research; 1,040 of them (62.3%) were female, 590 (35.4%) were male, and 39 (2.3%) did not want to declare their gender. The average age of the respondents was 15.09±1.757. Data were collected using an online form consisted of demographic data, questions related to the use of the Internet, the Internet Addiction Scale, and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-auto questionnaire version (TEMPS-A) for adolescents.

Results

The relationship between Internet addiction and age, addictive substance use frequency, purpose, time spent on the internet, and type of temperament has been proven. Analysis results indicate that the risk of developing internet addiction is higher if an adolescent spends 1-3 hours and more than 3 hours daily (2.8 and 8.2 times, respectively). Increasing age numbers for 1 unit (year), the risk of internet addiction developing is decreasing by 11.3%. Hyperthymic temperament type decreases the risk of 70.9% of internet addiction developing.

Conclusion

It is important to highlight importance of our results since practitioners can utilize our findings to create targeted treatments and prevent internet addiction in adolescents.

Problematic usage of the internet among Hungarian elementary school children: a cross-sectional study

INTRODUCTION

Problematic usage of the internet (PUI) is perhaps one of the most frequently studied phenomena of the 21st century receiving increasing attention in both scientific literature and the media. Despite intensive research there have been relatively few meaningful studies among elementary school students in Hungary and worldwide, who may be considered as a high-risk population with regard to problematic internet use. The aim of our study was to carry out a complex research focusing on the prevalence and risk factors of PUI among elementary school children aged 10-15 years (Grade 5-8).

METHODS

Demographics included were gender, age, place of stay, type of residence, family type, parental education, start of internet use, used devices, daily internet use, purpose of internet use, internet accounts, ways of keeping in touch with friends and sporting activities. PUI was evaluated using the paper-based version of the Potentially Problematic Use of the Internet Questionnaire.

RESULTS

Overall, 2000 paper-based questionnaires were successfully delivered and the final analysis included 1168 responses (overall response rate 58.4%). Mean age was 12.55 ± 1.24 years. Female gender (OR = 2.760, p = 0,006, CI 95% 0.065 to 0.384), younger age (11-12 years) (OR = 3.812, p < 0.001, 95% CI: 1.747-4.731), early exposure to the internet (OR = 3.466, p = 0.001, 95% CI 1.535-5.446), living in a small village (OR = 1.081, p = 0.002, 95% CI 1.041-1.186) urgency to answer online (OR = 4.677, p < 0.001, 95% CI: 2.714-6.639), decreased frequency of personal contact with friends (OR = 2.897, p = 0.004, 95% CI: 1.037-1.681), spending more than 6 h online (OR = 12.913, p < 0.001, 95% CI: 10.798-14.892), morning and nighttime internet use (OR = 3.846, p < 0.001, CI 95% 1.886-5.810) and never doing any sports (OR = 2.016, p = 0.044, 95% CI: 1.050-3.354) were independently associated with problematic internet use.

CONCLUSIONS

Based on the results of our questionnaire survey more than 10% seemed to be problematic users in our study population, which is a relatively high rate. Early exposure to the internet as well as younger age were strongly related to this phenomenon. Duration of being online as well as daily time interval of internet use are important predisposing factors. Scarcely studied social factors such as being online at the expense of personal relationships and the lack of physical activity should be payed more attention to prevent the development of PUI.

Secular trends in the prevalence of meeting 24-hour movement guidelines among U.S. adolescents: evidence from NHANES 2007-2016

Background

The 24-Hour Movement Guidelines (24-HMG) recommend a balanced combination of physical activity (PA), sedentary behavior (SB) and sleep (SLP) for optimal health. However, there is limited understanding of how well U.S. adolescents adhere to these guidelines. This study aims to analyze the prevalence trends of meeting the 24-HMG among a nationally representative sample of U.S. general adolescents.

Methods

The study included 2,273 adolescents (55.3% boys) aged 16-19 who participated in the National Health and Nutrition Examination Surveys (NHANES) from 2007 to 2016. The researchers categorized the adolescents based on whether they met various PA, SB, and SLP recommendations, as well as different combinations of these recommendations, separately for boys and girls. The prevalence rate, weighted by survey data, was calculated along with a 95% confidence interval (CI) to assess the changes in meeting the 24-HMG among U.S. adolescents across different survey years and sociodemographic subgroups.

Results

In the 2015-2016 cycle, approximately 6.3% of adolescents did not meet any of the three recommendations, while only 19.2% of adolescents achieved all three guidelines. Compliance with PA and SB recommendations among adolescents has decreased over time, from 72.5% (65.9% to 79.2%) to 64.2% (57.4% to 70.9%) for PA, and from 59.0% (49.6% to 68.4%) to 46.6% (37.8% to 55.5%) for SB, respectively, from 2007-2008 cycle to 2015-2016 cycle. Boys exhibited more favorable patterns in meeting different sets of recommendations compared to girls (p-value <0.001). This includes meeting both PA and SB guidelines (15.5% for boys and 11.1% for girls) and meeting both PA and SLP guidelines (19.5% for boys and 15.7% for girls). The level of parental education was found to have effect on meeting all three guidelines (Ptrend < 0.05).

Conclusion

We analyzed ten consecutive years of representative NHANES data to evaluate the prevalence meeting 24-HMG and found that the proportion of adolescents aged 16-19 in the U.S. who adhered to all three movement guidelines simultaneously has consistently remained low throughout each survey cycle. Notably, there has been a significant decline in the proportion of adolescents meeting the SB guideline.

Prevalence of Internet Addiction and Its Associated Risk Factors Among Medical Students in Sudan: A Cross-Sectional Study

Background Internet addiction has been studied extensively worldwide and shown to have adverse social, psychological, and functional consequences. It has become a global health issue, particularly among young adults. Unfortunately, few studies have been conducted among medical students in Sudan. This study aimed to measure the prevalence of internet addiction and determine its associated risk factors among medical students in Sudan. Methods This cross-sectional study was conducted among medical students using a systematic sampling technique. An online structured questionnaire was used, which included sociodemographic data and the Internet Addiction Test (IAT) to assess the presence and severity of internet addiction, as well as the Kessler Questionnaire to assess psychological distress. Results Among the 307 medical students who participated in this study, 63.8% (n=196) were female. The majority 78.5% (n=242) were aged 18-22 years, and the prevalence of internet addiction was 75.5% (n=232). The addiction levels were as follows: mild, 39.7% (n=122); moderate, 33.2% (n=102); and severe, 2.6% (n=8). Multivariate regression analysis revealed that being a female medical student was associated with a 1.9 times higher risk of internet addiction (adjusted odds ratio (AOR) = 1.87, p = 0.033). Psychological distress was associated with a 6.368-fold higher risk of internet addiction compared to non-distressed students (AOR = 6.368, p < 0.001). Additionally, students in the clinical years had a lower risk of internet addiction, specifically in the fourth and fifth years (AOR = 0.325, p = 0.010; AOR = 0.398, p = 0.043, respectively). Conclusions This study found a high prevalence of internet addiction among medical students at the National University, Khartoum, Sudan, which was strongly associated with mental distress. Effective awareness programs, potentially initiated by educational authorities, are required to educate students on limiting excessive internet usage and addressing associated risk factors. Future research should include longitudinal and multi-university studies to obtain more generalizable results and to investigate the relationship between internet addiction and mental distress more robustly.

Effect of online game policy on smartphone game play time, addiction, and emotion in rural adolescents of China

BACKGROUND

Smartphone game addiction has emerged as a major public health problem in China and worldwide. In November 2019 and August 2021, the National Press and Publication Administration of China implemented two increasingly strict policies, as a means of preventing smartphone game addiction in adolescents aged 18 or below. This study aimed to analyze the effect of the policies on smartphone game play time, addiction, and emotion among rural adolescents in China.

METHODS

We sent the questionnaire to rural adolescents through the online survey tool Questionnaire Star, a professional online survey evaluation platform. The questionnaire included demographic data, smartphone use survey, smartphone game addiction and emotion evaluation scales. The Smartphone Addiction Scale-Short Version (SAS-SV) measured adolescents' smartphone game addiction. The Short Version of UPPS-P Impulsive Behavior Scale (SUPPS-P) and Social Anxiety Scale for Children (SASC) measured emotion. According to SAS-SV score, the enrolled rural adolescents were divided into addiction group and non-addiction group. The t-test, Chi-square test, and repeated measure ANOVA assessed the effect of the policies on adolescents' smartphone game addiction and emotion.

RESULTS

Among enrolled 459 rural adolescents with a mean age of 14.36 ± 1.37years, 151 (32.90%) were in the addiction group and 308 (67.10%) were in the non-addiction group. Adolescents in the addiction group were older, more male, and higher grade. There were time and group effects between the two groups in playtime. After a year of policies implementation, the weekly game time dropped from 3.52 ± 1.89 h to 2.63 ± 1.93 h in the addiction group and from 2.71 ± 1.75 h to 2.36 ± 1.73 h in the non-addiction group. There were also time and group effects in SAS-SV and SASC scores, but not for SUPPS-P score. In the addiction group, the SAS-SV score dropped from 41.44 ± 7.45 to 29.58 ± 12.43, which was below the cut-off value for addiction, and the level of social anxiety was consistently higher than non-addiction group.

CONCLUSIONS

The playtime of rural adolescents spent on smartphone games has decreased significantly due to the restriction of the policies rather than the lack of addiction or social anxiety. The policies had practically significant effects in reducing smartphone game play time for rural adolescents in China.

Exploring internet addiction and its associated factors among college students in Western Rajasthan, India: A mixed-methods study

Background

With near universal use of internet by college students, there is propensity for internet addiction (IA) among them. This study aimed to estimate the prevalence and predict the factors for internet addiction among college students in Jodhpur, Rajasthan, India, and qualitatively explore the factors associated with internet addiction.

Materials and Methods

Explanatory sequential (QUAN-QUAL) mixed-methods design was used. A cross-sectional questionnaire-based survey was conducted among three streams of undergraduate colleges (health, engineering, and others). Survey instruments included Young's internet addiction test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety, and Stress Scale-21 (DASS-21) Items. Focus group discussions (FGDs) and in-depth interviews (IDIs) among the students with mild-to-moderate levels of addiction were conducted to understand the reasons for excessive internet use.

Results

The prevalence of internet addiction (IA) among the college students was 51% and the rates for mild, moderate, and severe addiction were 31.8%, 18.5%, and 0.7%, respectively. Predictors of IA were male gender, age in years, age of first internet use in years, urban origin, accessing internet at college, mobile internet use, using internet to make online friendship, sleep disturbance, depression, anxiety, and stress. Qualitative study identified five major themes related to situations initiating internet use for nonacademic purpose, content of internet use, triggers for internet overuse/addiction (IA), perceived impact of IA, and measures to overcome IA.

Conclusions

Internet addiction was found to be highly prevalent in college students across various streams. Qualitative results provide deeper insights into IA among college students. It is imperative to screen for IA among the students and devise suitable preventive interventions, which can be easily implemented at community level.

The association of problematic usage of the internet with burnout, depression, insomnia, and quality of life among Hungarian high school students

Introduction

The extensive availability of the internet has led to the recognition of problematic usage of the internet (PUI) or so called internet addiction (IA), probably mostly involving adolescents.

Aim

Here we present a study focusing on the incidence and consequences (including burnout, which is relatively rarely studied) of internet addiction among high school students using a questionnaire-based non-random sampling cross-sectional survey. Included questionnaires were the Problematic Internet Use Questionnaire, the Maslach Burnout Inventory General Survey for Students MBI-GS (S), the 9-item short version of Beck Depression Inventory (BDI-SF), the Athens Insomnia Questionnaire and the EQ-5D (quality of life) questionnaire. Data were evaluated the exertion of Student's t-test, chi square test and Pearson's rank-order correlation. Logistic regression analysis was used to determine the significance of the different parameters as independently associated with PUI.

Results

Overall 3,000 paper-based questionnaires were successfully delivered and 2,540 responses received (response rate of 84.6%). 1,309 males (mean age 17.6 ± 1.43 years) (51.5%) and 1,231 females (mean age 17.5 ± 1.4 years) (48.5%) took part in our study. Problematic usage of the internet was detected in 486 (19.1%) students (232 males, mean age 17.6 ± 1.35 years and 254 females, mean age 17.34 ± 1.37 years). In a logistic regression analysis sleep disturbance (OR: 1.84, 95% CI: 1.83-2.03), depression (OR: 1.97, 95% CI: 1.77-2.02) and burnout (OR: 1.8, 95% CI: 1.16-1.94) were significantly associated with PUI.

Conclusion

Nearly one fifth of our study population suffered from PUI, which was strongly associated with school burnout, insomnia and depression, which underlines the importance of this phenomenon.

A longitudinal study on the impact of Internet gaming disorder on self-perceived health, academic performance, and social life of first-year college students

BACKGROUND AND OBJECTIVES

Internet gaming disorder (IGD) is associated with health, social, and academic problems but whether these are consequences of the disorder rather than precursors or correlates is unclear. We aimed to evaluate whether IGD in the 1st year of university predicts health, academic and social problems 1 year later, controlling for baseline health, academic and social problems, demographics, and mental health symptoms.

METHODS

In a prospective cohort study, 1741 university students completed both a baseline online survey in their 1st year and a follow-up survey 1 year later. Log-binomial models examined the strength of prospective associations between baseline predictor variables (IGD, baseline health, academic and social problems, sex, age, and mental health symptoms) and occurrence of health, academic and social problems at follow-up.

RESULTS

When extensively adjusted by the corresponding outcome at baseline, any mental disorder symptoms, sex, and age, baseline IGD was associated only with severe school impairment and poor social life (risk ratio [RR] = 1.77; 95% confidence interval [CI] = 1.14-2.75, p = .011; RR = 1.22; 95% CI = 1.07-1.38, p = .002, respectively).

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

University authorities and counselors should consider that incoming 1st-year students that meet criteria for IGD are likely to have increased academic and social impairments during their 1st year for which they may want to intervene. This study adds to the existing literature by longitudinally examining a greater array of negative outcomes of IGD than previously documented.

Prevalence of problematic Internet use and problematic gaming in Spanish adolescents

Epidemiological studies on problematic Internet use and problematic gaming conducted so far have mainly been carried out with unrepresentative and self-selected convenience samples, resulting in unreliable prevalence rates. This study estimates the prevalence of problematic Internet use and problematic gaming in a large sample of Spanish adolescents (N = 41,507) and identifies risk and protective factors for these risky behaviours. Data were collected online using the Adolescent Problem Internet Use Scale and the Adolescent Gaming Addiction Scale. Using a cut-off approach with measurement instruments inspired by the DSM-5 framework, we found a prevalence of 33% for problematic Internet use and 3.1% for problematic gaming. With a more conservative approach inspired by the ICD-11 framework, prevalence rates decreased to 2.98% for problematic Internet use and 1.8% for problematic gaming. Female gender, higher parents' education, elevated Internet connection time, reporting being online after midnight and using the mobile phone in class predicted problematic Internet use; whereas male gender, "living situation" where families do not have a traditional structure or stable environment, elevated Internet connection time and reporting using the mobile phone in class predicted problematic gaming. A cut-off approach involving scales that recycle substance use criteria (as in the DSM-5) over-pathologize Internet use and gaming behaviours. In contrast, the ICD-11 approach seems to provide more realistic and reliable prevalence rates.

Differences between problematic internet and smartphone use and their psychological risk factors in boys and girls: a network analysis

BACKGROUND

Problematic internet and smartphone use are significant health challenges for contemporary adolescents. However, their mutual relationship is unclear because studies investigating these phenomena are scarce. The present study aimed to investigate the psychological risks and protective factors associated with problematic internet and smartphone use.

METHOD

A representative sample of Slovak adolescents (N = 4070, M_age = 14.38, SD_age = 0.77, 50.5% girls) from the Health Behavior in School-aged Children project was analyzed using network analysis separately for boys and girls.

RESULTS

The results showed weak (for boys) and moderate (for girls) associations between problematic internet use and problematic smartphone use. Risk factors showed stronger associations with problematic internet use than problematic smartphone use, with the exception of fear of missing out, which was strongly associated with problematic smartphone use. The central nodes were externalizing problems for boys and internalizing problems, externalizing problems, and resilience for girls.

CONCLUSION

The study concluded that while problematic internet use and problematic smartphone use are somewhat related, they differ at the psychological level. In addition, the phenomena are rather different between boys and girls.

Neurobiological risk factors for problematic social media use as a specific form of Internet addiction: A narrative review

Problematic social media use (PSMU) is a behavioral addiction, a specific form of problematic Internet use associated with the uncontrolled use of social networks. It is typical mostly for modern adolescents and young adults, which are the first generations fully grown up in the era of total digitalization of society. The modern biopsychosocial model of the formation of behavioral addictions, postulating the impact of a large number of biological, psychological, and social factors on addictive behavior formation, may be quite applicable to PSMU. In this narrative review, we discussed neurobiological risk factors for Internet addiction with a focus on current evidence on the association between PSMU and structural/ functional characteristics of the brain and autonomic nervous system, neurochemical correlations, and genetic features. A review of the literature shows that the vast majority of the mentioned neurobiological studies were focused on computer games addiction and generalized Internet addiction (without taking into account the consumed content). Even though a certain number of neuroimaging studies have been conducted for PSMU, there is practically no research on neuropeptide and genetic associations for PSMU to date. This fact points to the extremely high relevance of such studies.

Treatment Modalities for Internet Addiction in Children and Adolescents: A Systematic Review of Randomized Controlled Trials (RCTs)

BACKGROUND

In recent years, the use of the internet among children and adolescents has dramatically increased, leading to growing concerns regarding the potential risks of excessive internet use and addiction. Addressing these concerns, this systematic review aims to summarize current evidence on the effectiveness of treatment interventions for internet addiction among children and adolescents.

METHOD

We performed a systematic review using PubMed, Web of Science, PsycInfo, and Google Scholar with search terms including "internet addiction", "problematic internet use", "children" or "adolescents", "treatment" and "randomized controlled trial". We found 10 Randomized Controlled Trials (RCTs) meeting the criteria and included them in this systematic review.

RESULTS

This systematic review analyzed 10 randomized controlled trials focused on treatment interventions for internet addiction in adolescents and young adults. The interventions used were diverse, including cognitive-behavioral therapy (CBT), medication, electro-acupuncture (EA), and solution-focused approaches. The measures used to assess the effectiveness of the interventions also varied, but most studies reported moderate to large effect sizes for at least some outcomes. Overall, the studies suggest that interventions such as CBT and EA can be effective in reducing symptoms of internet addiction, internet gaming disorder, and unspecified internet use disorders. School-based programs and brief manualized CBT programs also show promise, though more research is needed to determine their long-term effectiveness.

CONCLUSION

Promising treatment approaches for internet addiction are emerging, but inconsistencies in conceptualization, language, and diagnostic criteria present some challenges. The growing recognition of problematic internet use, as shown by the DSM-5's recognition of Internet Gaming Disorder, highlights the need for a multidisciplinary approach and standardized criteria to facilitate accurate reporting across studies. Continued research is needed to identify effective treatments and diagnostic criteria for internet addiction, with the potential to offer practical insights into effective medications and therapies.

Internet addiction in adolescent psychiatric patient population: A hospital-based Study from China

BACKGROUND

Internet is gradually reshaping adolescents' behaviors in China. It is important to identify the prevalence and risk factors to predict Internet addiction among adolescent psychiatric patients.

METHODS

The survey was conducted among inpatient or outpatient adolescent patients with mental disorders. All participants were interviewed face-to-face and completed Young Internet Addiction Test and other relevant assessments. Binary logistic regression analysis was used to exam between-group differences of internet addiction.

RESULT

The prevalence for internet addiction (mild to severe) in adolescent psychiatric patients was 80.2%, where the prevalence for "medium and severe internet addiction was 25.5%. Logistic regression analysis identified two independent predictors for "medium and severe internet addiction" including the total score of Adolescent Non-suicidal-self-injury (NSSI) Behavior Function Assessment Scale (ANBFAS) and the diagnosis of generalized anxiety disorder (GAD) (R² =0.27, p = .02 for total ANBFAS score, p = .01 for GAD) in psychiatric adolescent patients.

CONCLUSION

The prevalence of internet addiction is notably high among adolescent psychiatric patients in China. Coping for Internet addiction in adolescent psychiatric patients should conclude the coping of NSSI and GAD.

The association of personality polygenic risk score, psychosocial protective factors and suicide attempt in mood disorder

Some personality traits, especially neuroticism, has been found to be associated with suicide attempt (SA) in mood disorder patients. The present study explored the association between personality traits and SA using polygenic risk scores (PRS) for personality among patients with mood disorders. We also investigated the effects of a variety of psychosocial variables on SA. Patients with bipolar disorder (BPD, N = 841) and major depressive disorder (MDD, N = 710) were recruited from hospitals in Taiwan. Lifetime SA and information on psychosocial factors was collected. We calculated the PRS of neuroticism and extraversion. A trend test for SA was performed across quartiles of the PRS for neuroticism and extraversion, and logistic regression analyses were performed to examine the associations between psychosocial factors and SA, accounting for the PRS of personality traits. The prevalence of SA was higher in MDD than in BPD patients. The risk of SA was elevated in MDD patients with a higher quintile of PRS in neuroticism and a lower quintile of PRS in extraversion. The multiple regression analysis results demonstrated that later age of onset, higher family support and resilience, and lower overall social support were protective factors against SA. From the perspective of suicide prevention efforts, strengthening family support and conducting resilience training for patients with mood disorders may be beneficial interventions in clinical settings.

Increasing important roles of child and adolescent psychiatrists in the treatment of gaming disorder: Current status in Japan

Background

Digital gaming is the most common leisure activity among children and adolescents in Japan, especially in males. Playing online gaming has become more common among school-age children over the years. As a result, excessive online gaming in younger children has become a significant social problem in Japan. Previous studies have demonstrated that excessive online gaming could cause various mental health issues in children and adolescents. At medical institutions having child and adolescent psychiatry services, there is an increasing number of children and adolescents with various problems related to excessive gaming. The aim of this study was to investigate the current practice of gaming disorder (GD) in clinical settings in Japan.

Methods

The subjects of this study were all of 414 child and adolescent psychiatrists certified by the Japanese Society for Child and Adolescent Psychiatry (JSCAP). The study questionnaire was mailed to all subjects from the official secretariat of JSCAP. Study subjects were requested to answer the questionnaire anonymously. The survey contained three types of responses: open responses; single and multiple-choice responses; and, responses on a five-point Likert scale. The questionnaire consisted of 14 questions regarding GD.

Results

We received 159 responses. The most common reason for a visit to child and adolescent psychiatry service which results in a subsequent diagnosis of GD was school refusal/absenteeism followed by disruption of sleep-awake rhythm. The most common specialized treatment for GD currently offered at child and adolescent psychiatry service is individual psychotherapy. The two most frequently experienced difficulties in the treatment of GD were low motivation to achieve recovery and a large variety of combined problems other than excessive gaming itself. With regard to the three most common psychiatric comorbidities of GD, they were autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and depression.

Discussion

The results of our survey revealed that although GD is a behavioral addiction, many children and adolescents with GD first visit child and adolescent psychiatry clinics rather than specialized clinics for addiction which are usually designed and staffed for adult patients. Because it is known that GD is more prevalent among young males, including junior high and high school students, GD has become one of the most important clinical issues in child and adolescent psychiatry today. The important roles of child and adolescent psychiatrists in the treatment of GD has been increasing.

The relationship between Internet addiction and childhood trauma in adolescents: The mediating role of social support

Background

Adolescents are at high risk of Internet addiction (IA). Previous studies have shown that the occurrence of IA may be associated with childhood trauma and social support to varying degrees. This study aimed to investigate the pathogenesis of IA in adolescents. Further, to explore the potential mediating role of social support in childhood trauma and IA. This study provides theoretical support for future interventions targeting IA in adolescents.

Methods

This study used a descriptive cross-sectional design. The Childhood Trauma Questionnaire (CTQ), Social Support Rating Scale (SSRS), and Young’s Internet Addiction Test (IAT) were used to conduct an anonymous questionnaire survey among randomly selected adolescents aged less than 18 years old in two cities in southern Anhui Province. Descriptive statistics and correlation analysis were used to test the correlation between IA and other variables. A binary logistic regression model was used to explore the influencing factors of IA. Multiple regression models were examined with process macro and bootstrapping to confirm significant mediating effects.

Results

A total of 844 adolescents, equally divided between males and females, participated in this study, and the prevalence of IA in the region was 23.0%. Through the mediation test, the direct effect of childhood trauma on IA was 0.20 (95% CI [0.12, 0.27], p < 0.001), and the mediating effect of social support on childhood trauma and IA was 0.09 (95% CI [0.06, 0.14]).

Conclusion

The study showed that childhood trauma significantly affected the incidence of IA in adolescents. Social support had a significant mediating effect on childhood trauma and IA and attenuated its negative effects.

Effects of different interventions on internet addiction: A meta-analysis of random controlled trials

OBJECTIVE

To evaluate the effects of different interventions on Internet addiction (IA), a meta-analysis and network meta-analyses were performed.

METHODS

We searched PubMed, Cochrane, Embase, Web of Science, PsycINFO, ProQuest, CNKI, WanFang, VIP database, and CBM from their inception to August 2021 to identify randomized controlled trials (RCTs) where the effects of interventions on IA were assessed. The risk of bias was evaluated according to the Revised Cochrane risk-of-bias tool for randomized trials (RoB2). The R studio Software and Stata 14.0 were used to perform traditional meta-analysis and network meta-analyses.

RESULTS

A total of 59 RCTs including 3832 participants were incorporated into meta-analysis. The results of the traditional meta-analysis of 24 studies showed that CBT, group counseling, sports intervention, and Internet-based intervention could significantly reduce IA levels (SMD = -1.90, 95%CI: -2.26 to -1.55, P < 0.01, I² = 85.9%) as compared to no-treatment control groups. Network meta-analyses based on different scales showed that combined interventions had the highest probability of being the best interventions for IA (SUCRA = 91.0 % based on IAT; SUCRA = 89.0 % based on CIAS).

DISCUSSION

Most interventions have significant effects on the treatment of IA. Compared with single interventions, combined interventions showed a more pronounced improvement in Internet addiction symptoms.

Parenting in the Prevention of Internet Gaming Addiction

Game addiction, smartphone addiction, and Internet disorder in children and adolescents have become the subject of parental concern in recent years. Parenting interventions are the most appropriate choice for parents to reduce excessive use of problematic games, and this review has not been carried out by other researchers before. The purpose of this review was to describe the preventive management of parenting in children and adolescents who are at risk for game addiction, smartphone addiction, and Internet disorders. This paper reviews findings, trends, and new developments in the field concerned (n = 5 studies). The current research was conducted based on a literature search with Preferred Reporting Items for Systematic Reviews and Meta-analyses, and articles were searched with five databases: ProQuest, Ebscohost, Springer Link, PubMed, and Scopus. Furthermore, the keywords used are MeSH determination based on PICOS framework using keywords of Game Disorder OR Smartphone Addictions OR Internet Disorder, parenting, as well as prevention without a time limit for publishing articles. In conclusion, parenting programs are a preventive method that needs to be understood and developed in order to provide significant results in long-term management of game addiction, smartphone addiction, and Internet disorders.

Generalized and Specific Problematic Internet Use in Central Siberia Adolescents: A School-Based Study of Prevalence, Age–Sex Depending Content Structure, and Comorbidity with Psychosocial Problems

We aimed to assess the prevalence, content structure and, psychological comorbidity of PIU in Russian adolescents. In addition, the design of our research provided an opportunity to compare demographic and psychological patterns of different forms of PIU: generalized (PIUgen) and specific problematic video game use (PUgame), as well as problematic social media use (PUsocial). Methods: This is a one-stage cross-sectional observational study of school sampling in three major Siberian cities. A total of 4514 schoolchildren aged 12–18 (mean age 14.52 ± 1.52 years) were surveyed. The Chen Internet Addiction Scale, the Game Addiction Scale for Adolescents, and the Social Media Disorder Scale were used to identify PIU and its types. Results: The prevalence of PIUgen among adolescents in Central Siberia was 7.2%; the prevalence of PUgame was 10.4%; the prevalence of PUsocial was 8.0%. The results of structural equation modelling, as well as the correlation analysis data, suggest two possible patterns of psychosocial problems with PIU—the first one is characteristic of both PIUgen and PUsocial. The second one—which is significantly different—is characteristic of PUgame. Conclusions: Urban adolescents in Central Siberia do not differ significantly from their Asian and European peers. Our findings support the concept of rejecting the term “generalized PIU” as a single psychological construct.

Food Addiction and Emotional Eating Behaviors Co-Occurring with Problematic Smartphone Use in Adolescents?

Addiction in adolescence is increasing and has a significant impact on physical and mental health. Notably, addictions can be comorbid and affect each other. Despite the recent growing interest in food addiction (FA) and problematic smartphone use (PSU), few studies have investigated their association in adolescents. We investigated the relationship between FA and PSU in adolescents and the effects of eating behaviors. A total of 209 adolescents (44.5% male; mean age = 12.86 ± 0.7 years) participated in the current school-based community study. We found a positive correlation between the dimensional Yale Food Addiction Scale for Children 2.0 (dYFAS-C2.0) and the Smartphone Overdependence Scale after adjusting for age, sex, body mass index, and socioeconomic status. The high-risk PSU group accounted for 17.2% of participants. Furthermore, this group showed 2.3 times higher dYFAS-C2.0 scores than the general group. Emotional overeating and satiety responsiveness were correlated with PSU. A comprehensive evaluation of addiction symptoms is needed for proper intervention, especially in adolescents with symptoms of abnormal eating behaviors.

Prevalence and Risk Factors of Problematic Internet Use among Hungarian Adult Recreational Esports Players

Background: Esports are highly prevalent in modern culture, particularly among young people, and are a healthy hobby for the majority of users. However, there is a possible link between video gaming (including esports) and problematic internet use (so-called internet addiction, IA), mostly involving adolescents. Methods: Here we present an online survey focusing on the prevalence and risk factors of internet addiction among adult esports players. Demographics included age, gender, family type, type of work, working years and daily internet use. Medical conditions associated with IA such as smoking, alcohol and drug intake, hypertension, diabetes, ischemic heart disease, musculoskeletal pain and history of depression were also recorded. Results: Overall, 2313 players including 176 females (7.6%) and 2137 males (92.4%) participated in our online survey. Age distribution was the following: 18−25 years 90.3% (2088/2313), 26−35 years 7.95% (184/2313), 36−45 years 0.86% (20/2313), 46−55 years 0.82% (19/2313), 56−62 years 0.04% (1/2313) and 62 years or older 0.04% (1/2313). Internet addiction was detected in 19.9% of players (461/2313) based on the Problematic Internet Use Questionnaire. In a multivariate analysis internet addiction was significantly associated with age between 18 and 25 (OR: 1.675, p = 0.002), being single (OR = 1.505, p = 0.014), internet use > 6 h daily (OR = 4.338, p < 0.001), having < 3 children (OR: 2.037, p = 0.023) and having secondary employment (OR = 1.789, p = 0.037). Regular alcohol intake (OR = 18.357, p < 0.001) and history of depression (OR= 5.361, p = 0.032) were also strongly correlated with IA. Conclusion: This is the first study from Hungary investigating the prevalence and risk factors of internet addiction among adult esports players. One out of five adult gamers suffered from IA. Our study also draws attention to increased risk within this group and risk factors such as younger age, family status and type of employment.

Impulsivity and Depressive Brooding in Internet Addiction: A Study With a Sample of Italian Adolescents During COVID-19 Lockdown

This contribution presents a study conducted on a sample of Italian adolescents (n = 411) in the period of the first COVID-19 lockdown. The study investigated the role and predictive weight of the impulsivity and depressive brooding variables on Internet addiction, using a hierarchical regression analysis. The participants were administered the Uso-Abuso e Dipendenza da Internet [Internet Use-Abuse and Addiction] (UADI-2), the Barratt Impulsiveness Scale-11 (BIS-11), and the Ruminative Response Scale (RRS). In terms of percentage distribution, 28% of the participants were in the full dependency range, while 34.7% demonstrated Internet abuse behavior. The results highlighted not only the predictive value of impulsiveness (β = 0.323) and ruminative thinking (β = 0.258), but also the role of gender (β = -0.205) on Internet addiction. Thus, male participants showed higher levels of Internet addiction, with higher scores on impulsiveness and brooding way of thinking. The study shows that the issue in question is significantly present among adolescents; in addition, not only targeted awareness programmes but also psycho-educational and clinical interventions to promote greater emotional and cognitive control would be necessary as a preventive and mitigating measure. Psychological interventions can help increase self-awareness, develop emotional regulation and impulse control, and correct maladaptive cognitions which in adolescents are mostly driven by a ruminative cognitive style.

The Association of Internet Addiction with Burnout, Depression, Insomnia, and Quality of Life among Hungarian High School Teachers

The extensive availability of Internet has led to the recognition of problematic Internet use (so called Internet addiction, IA) mostly involving adolescents. There are limited data about the prevalence and consequences of IA in adults especially among high school teachers. Here, we present a cross-sectional prospective study focusing on the association of Internet addiction with burnout, depression, insomnia, and lower quality of life among high school teachers taking many co-variates into account. Overall, 623 males (34.3%) and 1194 females (65.7%) participated in our study. Internet addiction was detected in 5.2% (95/1817) based on the Problematic Internet Use Questionnaire. Internet addiction was associated with severe burnout (10.5 vs. 2.7%, p < 0.001), moderate (36.8 vs. 1.7%, p < 0.001), and severe (6.3 vs. 0.1%, p < 0.001) depression, insomnia (23.1 vs. 11.4%, p < 0.001), and severe sleep disturbance (severe insomnia, 27.4 vs. 3.8%, p < 0.001) and lower quality of life in all domains (p < 0.001). There was also a significant correlation of the severity of the above-mentioned parameters and the severity of IA (overall scores, p < 0.001 in all cases). In a multivariate analysis including demographic criteria, risk factors medical conditions and the above-mentioned parameters as co-variates internet addiction was significantly associated with depression (OR = 3.836, CI: 2.92-5.44, p = 0.03), and insomnia (OR: 3.932, CI: 3.6-5.69, p = 0.002). This is the first study from Hungary and is one of the first studies showing the association of IA with mental issues, burnout, and lower quality of life among adults. It underlines the clinical importance of problematic Internet use among adults.

Neurophysiology of Gambling Behavior and Internet Use Vulnerability: A Comparison Between Behavioral and EEG Measures

The present research explored electrophysiological activity (EEG) related to problematic internet use (PIU) vulnerability in a nonclinical population. Vulnerability to PIU was assessed through internet addiction test (IAT) in a sample of 23 participants. Moreover, they underwent a behavioral Iowa gambling task (IGT) for testing decision-making functioning and N2 event-related potentials (ERPs) component was monitored during an attentional inhibitory Go/NoGo task performance with addiction-related background pictures (videogames, online gambling, and neutral stimuli). IAT measure positively correlated with both IGT index and N2 variation at the Go/NoGo task. High-IAT young participants showed specific responses to internet addiction-related cues (pictures representing online gambling) in terms of ERPs amplitude of N2pc for Go trials in Pz. Findings suggested an early attentional facilitation effect for specific addiction-related stimuli, online gambling-related stimuli, suggesting a selective attention bias for salient stimuli in this population. While higher levels of IAT do not seem to correspond to a deficit in decision-making abilities, the selective attention mechanisms show to be partially biased in response to the salience of external cues.

Prevalence and Risk Factors of Internet Addiction among Hungarian High School Students

Introduction: The extensive availability of the internet has led to the recognition of problematic internet use (so-called internet addiction—IA) mostly concerning adolescents. Aim: Here, we present a study focusing on the prevalence and risk factors of internet addiction in Hungarian high school students, using a questionnaire-based survey. Results: Overall, 3000 paper-based questionnaires were successfully delivered and 2540 responses were received (response rate of 84.6%). A total of 1309 males (mean age 17.6 ± 1.43 years) (51.5%) and 1231 females (mean age 17.5 ± 1.4 years) (48.5%) took part in our study. Internet addiction was detected in 486 (19.1%) students (232 males, mean age 17.6 ± 1.35 years, and 254 females, mean age 17.34 ± 1.37 years) based on the Problematic Internet Use Questionnaire. In a multivariate analysis, age (age of 17, OR = 3.688, p < 0.001), family status (living without parents) (OR = 2.091, p = 0.034), the size of the household (more than five people per household) (OR = 2.546, p = 0.026), spending more than 6 h online (OR = 5.457, p < 0.001), and daily time interval (OR = 84.316, p < 0.001) were significantly associated with internet addiction. Alcohol use (OR = 10.341, p = 0.001), drug intake (OR = 6.689, p = 0.001) and musculoskeletal disorders (OR = 3.966, p = 0.047) were also strongly associated with IA. Conclusion: A significant proportion of our students suffered from IA, which is associated with substance intake (possible abuse) and musculoskeletal pain in the multivariate analysis. Our study also draws attention to the preventable risk factors of IA, such as working hours or nighttime internet use, number of hours spent online and family surroundings.