Parental and Family Factors Associated with Problematic Gaming and Problematic Internet Use in Adolescents: a Systematic Literature Review

Family-Centered Treatment Program for Problematic Gaming and Excessive Screen Use in a Clinical Child and Youth Population (FAME): Protocol for a Feasibility Pilot Mixed Method Study

BACKGROUND

Screen time among children and adolescents has increased dramatically, raising concerns about its impact on development and mental health. While research highlights both potential benefits and risks, excessive use has been linked to issues like anxiety, depression, and gaming addiction. Despite growing concern, effective interventions are scarce. Recognizing the importance of family dynamics in child development, we propose a family-centered program to address problematic gaming and excessive screen use in a clinical population. By involving both children and parents, we aim to create a more comprehensive approach to prevention and treatment.

OBJECTIVE

This study aims to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical child and adolescent psychiatry (CAP) population. We will monitor the recruitment rate; track the retention and attendance rates of both parents and children; and assess whether each session's objectives are met, the content is delivered within the allotted time, and the necessary resources (eg, facilitators and materials) are available. Additionally, we will gather qualitative and quantitative feedback from participants through postprogram surveys and individual interviews with both children and parents.

METHODS

A total of 10 families with ongoing contact with CAP in Skåne, Sweden, will be recruited and offered participation in a family-centered group program targeting children aged 10-18 years with reported difficulties regarding screen gaming or screen use. The intervention to be tested is a newly developed, family-centered, psychoeducational, cognitive behavioral therapy-based intervention addressing both positive and negative aspects of screen use; setting boundaries; the connection between thoughts, feelings, and behaviors; conflict triggers; and sleep hygiene. The primary goal of the pilot study is to test the feasibility of the program, as well as recruitment and the analysis of participants' experiences with the program.

RESULTS

A total of 11 children and their parents were enrolled during first quarter of 2024. A 4-session pilot was delivered in first quarter of 2024, and the first results are expected in the third quarter of 2024.

CONCLUSIONS

The overarching goal of this pilot study is to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical CAP population. The insights gained from this study will guide our future research, which will focus on conducting a larger-scale evaluation of the intervention's impact on family screen time conflicts and inform future strategies for the implementation of family-centered interventions in child and youth clinics.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06098807; https://clinicaltrials.gov/study/NCT06098807.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/56387.

The mediation roles of self-regulation and problematic internet use: How maladaptive parenting during the COVID-19 pandemic influenced adolescents' academic procrastination in the postpandemic era

INTRODUCTION

In the transition to the postpandemic era, adolescents are working to shift their focus back to school. However, the prevalence of academic procrastination is reflective of that the aftereffects of the pandemic are persisting. Literature documents the increases in the negative parenting behaviors and internet use of adolescents during the pandemic. The excessive internet use has to do with adolescents' self-regulatory capabilities and self-regulation is profoundly shaped by parents' parenting practices. Given the connections among these factors, the present study seeks to understand how maladaptive parenting practices during the pandemic influenced adolescents' academic procrastination postpandemic through the mediation of self-regulation and problematic internet use.

METHOD

Using three waves of data from a total of 1062 Chinese adolescents (Mage = 14.9 years old, SD = 1.6, 13-18 years old; 45% female), we used structural equation modeling to examine the direct effect of maladaptive parenting on academic procrastination and its indirect effect via self-regulation and problematic internet use.

RESULTS

Maladaptive parenting during the pandemic did not directly predict adolescent academic procrastination post-pandemic. Yet, maladaptive parenting indirectly influenced academic procrastination both through self-regulation solely and self-regulation and problematic internet use sequentially.

CONCLUSION

The findings demonstrate that parents can contribute to adolescents' academic procrastination by influencing their self-regulation ability, which further impacts their internet use. Self-regulation serves as a robust mediator between parenting and adolescents' problematic behaviors related to internet use and learning. Implications for parents and intervention oriented toward adolescents are discussed.

The association between digital addiction and interpersonal relationships: A systematic review and meta-analysis

Digital addiction (DA) has been identified as an emerging public health problem worldwide. However, the extent and direction of the association between DA and interpersonal relationships (IRs) are unknown. Does DA have adverse effects on IRs, and how credible is the evidence for this association in published analyses of real-world data? Using the PRISMA method, we conducted a meta-analysis to quantitatively synthesize the results of the relevant studies and obtain reliable effect size estimates and performed an analysis of moderating factors. A systematic literature search identified 98 studies involving 134,593 participants and 99 effect sizes. A significant negative association was observed between DA and IRs. Importantly, our meta-analysis revealed that the DA subtype has no significant moderating effect on IRs, suggesting that combining numerous categories of DA rather than focusing on specific forms of DA may be appropriate for understanding the relationship between DA and IRs. Relative to the IR subtype, the association between DA and offline relationships is significant and negative, whereas the association between DA and online relationships is significant and positive. The strength of the relationship is also influenced by the participants' sex ratio, educational level, and measurement tools. These results may help resolve the disagreement over the magnitude and direction of the association between DA and IRs and have potential implications for the treatment of DA.

Effective parental strategies against problematic smartphone use among adolescents: A 6-month prospective study

Problematic Smartphone Use (PSU) among adolescents is growing problem worldwide and multiple studies investigated its associated parental risk and protective factors. The available studies, however, typically do not address the multidimensional nature of PSU. They also rely heavily on cross-sectional designs with a small number of potentially contributing variables. This 6-month prospective study examines the relationships between a large range of parental factors with the three known dimensions of PSU: social environment pressure, emotional gain, and addiction-like behaviors. Specifically the study examines whether, and to what extent, the various dimensions of current and future PSU are related to parental support giving, general quality of communication, specific communication about smartphone use, and the four common mediation strategies. The sample comprised 1187 triads of mothers, fathers, and adolescents. The data-analysis pipeline consisted of three consecutive phases: (1) analyses of parental factors at baseline, (2) analyses of parental factors change over 6-months, and (3) interaction analyses between parental factors and the time-period of the study. The pipeline elicited three factors that moderated the change in PSU over time: Communication about smartphones with mothers, parental support giving, and parental co-use. The implications of these findings are discussed in the context of the existing literature and the familial, microsystem theoretical framework. Altogether, this prospective study scrutinized key parental factors and strategies that could be utilized by parents for coping with one of the most difficult parenting challenges of the digital era. Further research may build upon these findings to develop designated interventions to reduce PSU.

The relationship between family functioning and social media addiction among university students: a moderated mediation model of depressive symptoms and peer support

BACKGROUND

Social media addiction (SMA) is an increasing problem, especially among young adults. Little is known about university students' SMA and family functioning. This study aimed to explore the mediating effect of depressive symptoms and the moderating effect of peer support in the relationship between family functioning and SMA among young adults.

METHODS

A sample of 1862 Chinese university students completed an online survey including the Bergen Social Media Addiction Scale (BSMAS), Family APGAR, the Patient Health Questionnaire (PHQ-9), peer support, and demographic characteristics. Hierarchical regression and moderated mediation analysis were used to test the effects and pathways among them.

RESULTS

Of the 1840 participants, 30.11% experienced SMA, 38.80% had family dysfunction and 15.98% had depressive symptoms. Hierarchical multiple regression showed better family functioning significantly predicted less SMA (β = -0.26, p < 0.001) and lower depressive symptoms (β = -0.58, p < 0.001), after adjusting for covariates. Mediation analysis verified that depressive symptoms mediated the effect of family functioning on SMA (indirect effect = -0.22, 95%CI[-0.28, -0.17]). Furthermore, the interaction of family functioning and peer support was negatively related to depressive symptoms (β= -0.03, 95% CI[-0.05, -0.01]) and the interaction of depressive symptoms and peer support was positively related to SMA (β = 0.01, 95%CI[0.004, 0.02]). Additional analysis further confirmed that peer support decreased depressive symptoms among young adults from dysfunctional families, and increased SMA behaviors in individuals with depressive symptoms.

CONCLUSION

Better family functioning and lower depressive symptoms may contribute to less social media addiction among Chinese university students. Peer support could moderate the mediating role of depressive symptoms on social media addiction in individuals with family dysfunction.

Social anxiety mediates between victimization experiences and internet addiction among adolescents: results from propensity score matching

Background

Previous research has indicated that Victimization Experiences (VE) may be linked to a heightened likelihood of developing psychological symptoms and Internet Addiction (IA) among adolescents. However, the precise mechanism through which VE contributes to IA in adolescents remains uncertain. This study aimed to investigate whether Social Anxiety (SA) serves as a mediation between VE and IA, utilizing the framework of General Strain Theory.

Methods

A cross-sectional survey among 11 middle schools or high schools in Macao was conducted from October to December 2022. Respondents in the victimized group and non-victimized group were 1:1 paired using Propensity Score Matching (PSM) to control the potential confounding factors.

Results

A total of 1,089 questionnaires were valid for analysis and 311 pairs were generated through PSM. Respondents in the victimized group reported significantly higher IA than those in non-victimized group (23.5% vs. 12.5%, p < 0.001) after PSM treatment. Multivariate logistic regression analysis showed that VE (p = 0.015, OR = 1.750, 95% CI = 1.115 to 2.746, E-value = 2.90) and SA (p < 0.001, OR = 1.052, 95% CI = 1.030 to 1.074, E-value = 1.29) were the predictors of IA. The model successfully classified 81.7% of cases overall (R 2 N = 0.133). Further analysis indicated that SA mediates between VE and IA (Z = 3.644, p < 0.001).

Conclusion

This study revealed the potential mediation effect of SA on the link between VE and IA. By acknowledging the mediating influence of SA, researchers and practitioners can develop more accurate and effective strategies to mitigate Internet Addiction among adolescents.

Emotional dysregulation predicts problematic gaming in children and youths: a cross-sectional and longitudinal approach

Adolescents show a high vulnerability for addictive gaming patterns on the one hand and immature emotion regulation (ER) abilities as a risk factor for mental disorders on the other hand. We investigated the predictive value of ER difficulties on problematic gaming (PG) considering age groups (children vs. youths) and gender cross-sectionally and prospectively in a representative sample of German adolescents via online survey with two measurement points 14 months apart. General Poisson, logistic, and multinomial regression models were estimated to predict gaming patterns by ER difficulties controlling for age group and gender. Results revealed ER difficulties to be significantly associated with PG. Moreover, subgroup analyses indicated differing ER patterns for children vs. youths and boys vs. girls: for children, higher PG values were associated with emotional awareness and emotional clarity whereas for youths it was the acceptance of emotional responses. Moreover, gender differences implicated that boys with PG had more deficits in goal-oriented behavior as well as emotional awareness while affected girls were lacking emotional clarity and had problems with the acceptance of their emotional responses. Interestingly, procrastination was a significant predictor for PG irrespective of subgroups. Furthermore, longitudinal analyses indicated that difficulties in ER promoted PG while stronger procrastination tendencies maintained it. With the inclusion of procrastination, which can be understood as a maladaptive ER strategy, a broader picture of ER difficulties as a risk factor for PG could be drawn. The findings support a better understanding of PG etiology and the development of targeted prevention and intervention measures.

Relationship between parenting style and internet addiction: Interpersonal relationship problem as a mediator and gender as a moderator

Purpose

This study assessed the moderating effect of gender on the indirect effects of positive and negative parenting styles on Internet addiction through interpersonal relationship problem.

Methods

A cross-sectional survey of randomly sampled 1194 college students recruited voluntarily from three universities in China was conducted to assess the variables of positive and negative parenting styles, interpersonal relationship problem, and Internet addiction.

Results

Positive parenting style, such as emotional warmth, was a protective factor for the development of Internet addiction, whereas negative parenting style, such as rejection and overprotection, was a potential risk factor for Internet addiction. Furthermore, interpersonal relationship problem completely mediated the association between positive parenting style and Internet addiction but partially mediated the relationship between negative parenting style and Internet addiction. Finally, gender moderated the indirect effect of parenting style on Internet addiction through interpersonal relationship problem.

Conclusion

The correlation between positive parenting style and interpersonal relationship problem was considerably weaker among females, whereas the association between interpersonal relationship problem and Internet addiction was much stronger among females. For the prevention and intervention of Internet addiction, it is important to increase positive parenting style for males while enhancing interpersonal skills training for females. Further longitudinal studies should discuss the effects of paternal and maternal parenting styles on Internet addiction.

Family Functioning Styles and Exercise Addiction: Disengaged, Enmeshed, and Rigid Family Patterns Are Associated with Exercise Addiction

Physical exercise is a widely recommended practice for promoting health, but for some individuals, this activity can result in pathological and morbid behaviour. Therefore, the study of the factors contributing to the onset, development, and progression of exercise addiction is particularly relevant. Within this framework, the present study assessed the effect of family functioning, body image concerns, age, and gender on exercise addiction. A sample of 300 regular exercisers (Mage = 30.3 years, SD = 11.6; 69.7% females, 30.3% males) participated in the study and completed the Family Adaptability and Cohesion Evaluation Scales-IV, Body Image Concern Inventory, and Exercise Addiction Inventory. Data were analysed by implementing a series of moderated moderated-mediations. Results showed that three significant models were relevant. First, positive associations of disengaged (p < 0.05), enmeshed (p < 0.05), and rigid (p < 0.01) family functioning with exercise addiction were found. Furthermore, body image concerns mediated all these relationships, and the interaction between gender and age significantly moderated the effects of body image concerns on exercise addiction (p < 0.05). Such data may be useful for a deeper understanding of the variables associated with the development of exercise addiction, suggesting key elements on which it might be useful to focus in clinical and/or preventive activity.

The relationship between social media addiction, fear of missing out and family functioning: a structural equation mediation model

BACKGROUND

The use of social media became a daily activity for many individuals, with recreational, informational, and social purposes, to name a few. However, for some subjects, the use of these platforms may become problematic and generate functioning impairments in many life areas. Given this, the present research aimed at investigating the factor that may contribute to Social Media Addiction, by focusing on Fear of Missing Out and Family Functioning Patterns.

METHODS

A sample of 303 social media users (Mage = 35.29; SD = 14.87; 65% females, 35% males) completed a survey including the Bergen Social Media Addiction Scale, Family Adaptability and Cohesion Evaluation Scales-IV, and Fear of Missing Out Scale. Data were analysed by implementing Pearson correlation and testing a mediation with the Structural Equation Model approach.

RESULTS

Cohesion, flexibility, and disengagement family functioning patterns were significantly associated with the levels of social media addiction. These dimensions were inserted in the structural equation model, where the full mediation of fear of missing out in their relationship with social media addiction was shown.

CONCLUSIONS

The data showed the protective effect of flexible and cohesive family functioning patterns, as well as the role of disengagement and, sequentially, fear of missing out as risk factors. These findings may provide useful indications to elaborate tailored and effective therapeutic and preventive activity.

The epidemiology and effects of video game addiction: A systematic review and meta-analysis

With the increasing popularity and accessibility of video games, the public concern about their effects - positive and negative - has also increased. In this regard, this systematic review sought to identify and thematically analyze recent studies (in the last five years) and report on video games' epidemiological characteristics and outcomes. A systematic database search was done on ScienceDirect, APA PsycINFO, Emerald, and Scopus databases for articles published from January 1, 2017, to April 1, 2022. The Meta XL software - an add-in for Microsoft Excel - was used to calculate the pooled prevalence level of video game addiction. The database search yielded a total of 693 non-duplicate articles. After applying the inclusion and exclusion criteria, 27 articles were selected to be included in the systematic review. Along with this, 12 articles were considered for the final meta-analysis. The pooled prevalence level of gaming addiction was 5.0 % (95 % CI, 2.1-8.8 %). The I2 value was 99.297 with a p-value of 0.000. The factors that accompanied addictive video gaming were psychological, social, and personal. An addictive gaming behavior was characterized by spending an above-average time on gaming, doing most of the gaming online, and gaming activities interfering with sleep patterns. Some predictors of addictive gaming were emotional dependence, social detachment, increased gaming time, preference for playing online than offline, and increased emotional and psychological stress. Engaging in addictive gaming led to adverse outcomes such as lower academic scores, depression, and anxiety, as well as decreased self-esteem, life satisfaction, and social support. From the collected findings it could be concluded that extreme playing of video games can be classified as addictive. Following the identification of risk factors, appropriate corrective or interventional measures should be developed and applied coherently to newer statistical data.

A cross-sectional study: family communication, anxiety, and depression in adolescents: the mediating role of family violence and problematic internet use

OBJECTIVE

The objective of this study is to explore the relationship between family communication, family violence, problematic internet use, anxiety, and depression and validate their potential mediating role.

METHODS

The study population consisted of Chinese adolescents aged 12 to 18 years, and a cross-sectional survey was conducted in 2022. Structural equation models were constructed using AMOS 25.0 software to examine the factors that influence adolescent anxiety and depression and the mediating effects of problematic internet use and family violence.

RESULTS

The results indicate that family communication was significantly and negatively related to family violence (β = -.494, p < 0.001), problematic internet use (β = -.056, p < .05), depression (β = -.076, p < .01), and anxiety (β = -.071, p < .05). And the finds also indicate that family violence mediated the relationships between family communication and depression (β = -.143, CI: -.198 -.080), and between family communication and anxiety (β = -.141; CI: -.198 -.074). Chain indirect effects between family communication and depression (β = -.051; CI: -.081 -.030) or anxiety (β = -.046; CI: -.080 -.043) via family violence and then through problematic internet use were also found in the present study.

CONCLUSIONS

In conclusion, positive family communication is crucial in reducing anxiety and depression in adolescents. Moreover, problematic internet use and family violence mediate the effects of positive family communication on anxiety and depression. Therefore, improving family communication and promoting interventions aimed at reducing family violence and problematic internet use can help reduce anxiety and depression in adolescents, thus promoting their healthy development.

Active Parental Mediation and Adolescent Problematic Internet Use: The Mediating Role of Parent-Child Relationships and Hiding Online Behavior

In today's information society, with the growing integration of the Internet into individuals' lives, problematic Internet use (PIU) among adolescents has become more prevalent. Therefore, we conducted this study to investigate the correlation between active parental mediation and PIU in adolescents, as well as the potential mediating roles of parent-child relationship and adolescents' hiding online behavior. A total of 539 middle school students (mean age = 13.384) were recruited for this study and participated by completing a series of paper-and-pencil questionnaires. The findings indicated a significant negative relationship between active parental mediation and PIU. Furthermore, both the mediating role of the parent-child relationship and the role of hiding online behavior were found to be significant. Specifically, the mediating role is comprised of two paths: the independent mediating role of the parent-child relationship, and the sequential mediating role involving both the parent-child relationship and hiding online behavior. The study contributes an innovative theoretical perspective to deepen the understanding of the formation mechanism of PIU. Moreover, it offers practical empirical insights for the prevention and intervention of PIU among adolescents.

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.

Problematic Media Use among Children up to the Age of 10: A Systematic Literature Review

INTRODUCTION

Digital screen media use has significantly grown in all age groups and at an increasingly young age, including toddlers, schoolers, and primary school children. Although there is evidence that excessive early childhood media exposure can lead to several negative developmental outcomes, no systematic review on Problematic Media Use (PMU) of children under 10 years old have been provided. The aim of the present systematic review was to identify (i) the main instruments used to measure children's PMU across different studies; (ii) the risk and protective factors which might increase or reduce children's PMU; and (iii) the negative outcomes associated with children's PMU.

METHODS

This study was conducted following the systematic review guidelines proposed in the PRISMA statement. A total of 35 studies published between 2012-2022 and with a mean sample age between 0 and 10 years old were ultimately included in this literature review.

RESULTS

Use of media for more than 2 h a day, male gender, and higher age increased the risk of developing PMU among children. PMU led to several negative consequences for children's development and well-being (e.g., more problematic behaviors, sleep problems, higher depressive symptoms, lower emotional intelligence, and lower academic achievements). Children who experienced negative psychological symptoms, a dysfunctional parent-child relationship, and difficulties in school context were more prone to develop PMU. However, an authoritative parenting style and restrictive parental mediation reduced the risk of developing PMU among children. Finally, self-report measures specifically designed to get the younger children's perspective are still few and not so widely used.

CONCLUSIONS

Overall, this research field is still in its infancy and needs further investigation. Likely, a dysfunctional family system can lead children to experience emotional distress and negative psychological symptoms, which they try to manage by escaping into the virtual world, thus increasing the risk of developing PMU. As the children's PMU is closely affected by the family environment, future prevention interventions should target both children and their parents to improve their self-regulatory and mentalizing capabilities, as well as parental mediation strategies and general parenting practices.

Adolescent problematic gaming and its association with maternal behaviors: A dyadic study focusing on the relational-emotional correlates

INTRODUCTION

Associations between Problematic Gaming (PG) and the relational-emotional correlates of parenting have been reported in the literature. Previous research mostly collected information from adolescents, however, and suggested that little is known about the perceptions of parents and whether these are shared among parent-adolescent dyads. Therefore, this study aimed to (a) examine multiple informants' reports of adolescent PG and maternal behaviors (i.e., warmth and indifference) and (b) disentangle the associations between the behaviors shared by mothers and adolescents from those unique to each member.

METHOD

Data were collected by using self-administered online questionnaires from 137 Italian mother-adolescent dyads in Italy. The mean age of adolescents (n = 92 males, n = 42 females, n = 3 nonbinary) was 14.68 (±1.25) years and that of mothers 47.48 (±4.69) years. Descriptive statistics and common fate model (CFM) analyses were conducted.

RESULTS

Mothers reported higher scores of their offspring's PG. Within-reporter interclass correlations revealed positive associations between maternal indifference and adolescent PG for both informants. CFM indicated that correlations between maternal behaviors and adolescent PG based on shared perceptions did not reach statistical significance, whereas correlations based on unique mothers' perceptions were statistically significant for all the observed relationships.

CONCLUSIONS

In the context of adolescent PG, mothers may have a heightened motivation to perceive their parenting as crucial. The multi-informant approach allows a more accurate examination of the associations between adolescent PG and maternal behaviors and underscores the need to consider discordant assessment of the same phenomenon between mothers and adolescents.

Gaming disorder: A summary of its characteristics and aetiology

The emergence, development, and maintenance of gaming disorder (GD) is the result of an interplay between gaming-related factors, individual factors, and environmental factors. None of these alone are sufficient to cause a disordered state, but it is the interactive co-occurrence of all these factors, which in some cases leads to GD. The goal of the present paper is to discuss in detail these three factors based on relevant and recent findings of the literature. Among gaming-related factors, we discuss online vs. offline videogames, the role of game genres, structural characteristics, game design elements, as well as some important monetization techniques. Among individual factors demographic risk factors, personality traits, motivational factors, comorbid psychopathology, genetic predisposition, and neurobiological processes are considered. Finally, among environmental factors we discuss family factors, early life experiences, the role of peers and school-related factors, as well as the broader context of culture including the popularity of esports.

Problematic Use of Video Games, Social Media, and Alcohol: Associations with Mother-Child Relationship

INTRODUCTION

According to current concepts of developmental tasks, both the use of digital media and the consumption of psychotropic substances are age-typical challenges for adolescents. The majority overcomes these developmental tasks, but a substantial proportion of youth develops problematic usage patterns (e.g., of video games) or problematic consumption behavior (e.g., of alcohol). Empirical findings show the importance of family aspects for these problematic behavior patterns. Currently, it is not clear which specific areas of parent-child relationship are associated in each case and whether there are differences between substance-related and substance-unrelated problematic behavioral patterns.

METHODS

We surveyed 480 adolescents (45.2% females, mean age = 16.84 years) with standardized instruments regarding the mother-child relationship as well as problematic gaming, problematic social media use, and problematic alcohol use. We conducted correlation and multiple linear regression analyses (separately for problematic gaming, problematic social media use, and problematic alcohol use) as well as a multivariate multiple regression analysis.

RESULTS

In the regression analyses, more conflicts with the mother were related to all three behavioral patterns. However, lower cohesion was only statistically significantly associated with problematic alcohol use, but not with problematic gaming and problematic social media use, whereas lower autonomy and more frequent punishment of the child were statistically significantly related to problematic gaming and problematic social media use, but not to problematic alcohol use.

DISCUSSION/CONCLUSION

The findings indicate partially different relational dynamics for substance-related and substance-unrelated problem behaviors (interestingly, for cohesion and autonomy, the 95% confidence intervals of the standardized regression coefficients were not overlapping). The results of the present study could be used in family-based prevention approaches or in treatments in the clinical setting.

The Impact of Parental and Peer Attachment on Gaming Addiction among Out-of-School Adolescents in South Korea: The Mediating Role of Social Stigma

Most studies on gaming addiction have targeted adolescents in schools, while studies on gaming addiction among out-of-school adolescents remain scarce. Therefore, this study investigated the influence of parental and peer attachment on gaming addiction, mediated by social stigma among Korean out-of-school adolescents. The Dropout Youth Panel Survey was used for a sample of 437 dropout adolescents. The results showed that out-of-school adolescents' social stigma fully mediated the relationship between parental and peer attachment and gaming addiction. Parental attachment significantly predicted out-of-school adolescents' gaming addiction by decreasing their social stigma. Peer attachment also influenced gaming addiction in out-of-school adolescents via the mediated effects of social stigma. No direct effect of parental and peer attachment on gaming addiction was found. Social stigma played an important role in decreasing levels of gaming addiction. In addition, our study revealed that the direct and total effects of parental attachment on gaming addiction were greater than the effect of peer attachment. This study empirically verified the importance of social stigma based on modified labeling theory and provides a valid mechanism to describe how Korean out-of-school adolescents develop gaming addictions. The findings suggest effective strategies for prevention and treatment for dropout adolescents in South Korea.

Longitudinal association between parental involvement and internet gaming disorder among Chinese adolescents: Consideration of future consequences as a mediator and peer victimization as a moderator

BACKGROUND AND AIMS

Internet gaming disorder (IGD) in adolescents is a concerning issue. Positive parenting has been found to protect against adolescent IGD, but the underlying mechanisms await further investigation. As such, this study examined the longitudinal association between parental involvement (PI) - a specific type of positive parenting understudied in the literature of adolescent gaming disorder - and IGD. Moreover, this study also tested consideration of future consequences (CFC) as a mediator and peer victimization (PV) as a moderator.

METHODS

A two-wave longitudinal research spanning 6 months apart was conducted. Participants were Chinese adolescents (final N = 434; 222 females; Mage = 14.44 years, SD = 1.56). They provided ratings on PI, PV, and IGD at Wave 1, and CFC-immediate, CFC-future, and IGD at Wave 2.

RESULTS

Descriptive statistics showed that the prevalence rate of IGD was 10.81% and 9.45% at Waves 1 and 2, respectively. Moreover, results of moderated mediation model found that after controlling for Wave 1 IGD and covariates, Wave 1 PI was associated with Wave 2 IGD via preventing adolescents who had higher levels of PV from developing a tendence of CFC-immediate and via promoting adolescents who had lower levels of PV to develop a tendence of CFC-future.

DISCUSSION AND CONCLUSIONS

Altogether, these results suggest that facilitative ecological systems (e.g., positive parenting and good relationships with peers) and personal strengths (e.g., positive future orientation) jointly contribute to the mitigation of adolescent IGD.

Resource-Strengthening Training for Parents of Adolescents with Problematic Gaming (Res@t-P): A Clinical Pilot Study

Background: Problematic gaming (PG) has become an increasing mental health issue among adolescents during the preceding years. The role of parents and the family environment in the development of PG has been repeatedly emphasized. However, the structured involvement of parents in the therapy is still largely insufficient. Resource-strengthening training for parents of adolescents with PG (Res@t-P) is a new parent-centered 8-week group intervention to fill this substantial gap. The present pilot study aimed to collect first information on its potential effectiveness in improving parental and family factors. Methods: The study was conducted in a clinical setting with N = 43 parents of adolescents with PG, applying a pre- and post-follow-up design. Standardized questionnaires on psychological stress perception, family communication, family functioning, media rules, and adolescent PG symptoms were applied at three measurement points (before, at the end of, and 6 weeks after the training). Conditional growth models were estimated. Results: Over time, an improvement in parental and family aspects as well as a reduction in adolescent PG symptoms could be observed. Conclusions: The results of the present pilot study on the effectiveness of Res@t-P are promising. No causal inferences can be drawn at this stage. A randomized-controlled intervention study is highly warranted.

Is Problematic Internet and Smartphone Use Related to Poorer Quality of Life? A Systematic Review of Available Evidence and Assessment Strategies

Purpose of Review

Previous studies have explored the links between problematic Internet use (PIU) or problematic smartphone use (PSU) and quality of life (QOL). In this systematic review, we (i) describe the instruments used to assess QOL or health-related quality of life (HRQOL) in these studies, (ii) critically examine the content validity of the instruments used, and (iii) examine the relationships between PIU, PSU, QOL, and HRQOL.

Recent Findings

We identified 17 PIU and 11 PSU studies in a systematic search. Evidence suggests that PIU and PSU negatively correlate with either QOL or HQOL and most of their domains (especially mental and physical health). Multiple instruments were used to assess QOL or HRQOL in these studies. Our analysis showed an important heterogeneity in the domains covered by these instruments.

Summary

Because of the widespread prevalence of PIU and PSU, which tend to be linked with lower QOL or HRQOL, in particular poor mental and physical health, a more systematic public health campaign is required to target the healthy use of these communication devices. Prevention programs should also target vulnerable individuals, focusing on the most affected domains of QOL and HRQOL (i.e., physical and psychological health). Among the existing instruments, the World Health Organization Quality of Life for adults and the Pediatric Quality of Life Inventory for adolescents (aged 13-18 years) proved to be the most relevant, although new measurement instruments are needed to target domains that are specifically relevant in the context of PIU and PSU (e.g., physical and psychological health domains such as sleep, loneliness, and quality of familial relations).

Parental Depression and Leisure Activity Engagement on Children's Gaming Disorder: A Dyadic Study

Nowadays, playing both online and offline video games is a popular leisure activity among youngsters, but excessive gaming activity engagement may lead to gaming disorder that disrupts daily functioning. Identifying risk and protective factors of this emerging problem is thus essential for devising prevention and intervention strategies. This mixed-method, cross-sectional study aimed to examine the roles of parental depressive symptoms and children’s leisure activity engagement on children’s gaming disorder symptoms. Furthermore, the moderating roles of risky and protective leisure activity engagement were investigated. The sample comprised 104 parent-child dyads recruited from a population-based survey (parents: M_age = 45.59 years, SD = 6.70; children: M_age = 11.26 years; SD = 4.12). As predicted, parental depressive symptoms and children’s gaming activity engagement were positively associated with children’s gaming disorder symptoms, whereas children’s literacy activity engagement was negatively associated with these symptoms. Moreover, engagement in these two types of leisure activity moderated the association between parental depressive symptoms and children’s gaming disorder symptoms in distinct manners, further indicating literacy activities as beneficial and gaming activities as risk-enhancing. These new findings imply that parental depressive symptoms and children’s leisure activity engagement should be considered when designing parent-based programs for gaming disorder prevention and intervention.

Prevalence and Contributing Factors of Childhood Trauma, Anxiety, and Depression Among Adolescents From Two-Child Families in China

The two-child policy has been implemented in China since 2016 and has attracted the attention of the world. Adolescents may face huge psychological challenges in the process of changing family structures and relationships. To date, no mental health survey of adolescents from two-child families has been conducted. We investigated the prevalence and risk factors for childhood trauma, anxiety, and depression in two-child families in a statistically representative sample of Chinese senior high school students from Shanghai. A total of 426 participants were randomly selected from 1,059 students of four senior high schools in different districts of Shanghai. The childhood trauma questionnaire-short form (CTQ-SF), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used as the screening tools. We found that the overall prevalence of childhood trauma, anxiety, and depression among senior high school students in two-child families was 46.70% (95% CI, 39.93-53.47%), 22.17% (95% CI, 16.53-27.81%), and 35.85% (95% CI, 29.34-42.36%), respectively. The two-child families was an important factor associated childhood trauma, emotional neglect, and physical neglect (χ² = 5.984, p = 0.014; χ² = 4.071, p = 0.044; χ² = 4.202, p = 0.040). Ranking in two-child families was a risk factor for childhood trauma (β = -0.135, p = 0.048). Parental preference was a significantly correlated with physical abuse, physical neglect, anxiety, and depression (β = -1.581 to 0.088, p < 0.05). Meanwhile, emotional abuse, physical abuse, emotional neglect, and physical neglect of participants in the two groups were positively correlated with anxiety and depression (r = 0.195-0.478, p < 0.05). There was a significant relationship between sexual abuse and anxiety symptoms in the one-child family group (r = 0.161, p < 0.05). The findings suggest that the overall prevalence of childhood trauma, anxiety and depression among adolescents from two-child families in China was high. The two-child families and family ranking are important factors associated childhood trauma, while parental preference is related to anxiety and depression. These results highlight an urgent need to be addressed by adolescents' mental health service providers and policy-makers.

Neural correlates of problematic gaming in adolescents: A systematic review of structural and functional magnetic resonance imaging studies

Problematic gaming in adolescents is associated with neural alterations in structural and functional imaging studies. Especially frontal regions, associated with cognitive control functions, as well as temporoparietal areas, responsible for attention processes and self-concepts, and frontolimbic and subcortical regions, connected to emotion regulation and reward processing, are affected. The differences provide a further explanation for addictive disorders and emphasize the importance of interventions that address executive and cognitive-affective deficits.

Association between Adverse Childhood Experiences and Time Spent Playing Video Games in Adolescents: Results from A-CHILD Study

Background: Excessive time spent playing video games is associated with adverse health outcomes in adolescents. Although poor child–parent relationship and social relations with peers are considered as possible predictors, little is known as to whether adverse childhood experiences (ACEs) are associated with time spent playing video games. The aim is to examine the association between ACEs and time spent playing video games in adolescents. Methods: We used pooled data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in 2016 and 2018, which is a population-based cross-sectional study in Adachi City, Tokyo, Japan (N = 6799, 4th, 6th, and 8th-grade students). Adolescents answered questionnaires examining the time spent playing video games, per day, on weekdays (“less than 1 h”, “less than 3 h”, and “more than 3 h”) and ACEs (eight types). Results: The results of the ordinal logistic regression analysis showed a positive association between ACE total score and time spent playing video games after adjusting for covariates (1 ACE: OR = 1.28, 95% CI = 1.10–1.48; 2 ACEs: OR = 1.25, 95% CI = 1.06–1.48; 3 + ACEs: OR = 1.44, 95% CI = 1.14–1.82, p for trend < 0.001). Regarding each type of ACE, the experiences of single parenthood, parental history of psychiatric disorders, and peer isolation were independently positively associated with time spent playing video games. Conclusions: Health policy to address ACEs might be important to shorten the time spent playing video games.

School-Based Prevention of Screen-Related Risk Behaviors during the Long-Term Distant Schooling Caused by COVID-19 Outbreak

The COVID-19 outbreak and related restrictions meant a higher incidence of screen-related risk behaviors in both children and adolescents. Our goal was to assess the perceived importance and extent of school-based preventions related to these risks during the long-term, nation-wide distant schooling period in the Czech Republic. The online survey was responded to by the school-based prevention specialists (N = 1698). For the analysis, within-subject analysis of variance (ANOVA) and binominal logistic regression were used. At-risk internet use and cyber-bullying were perceived as pressing, but other risks, for example, excessive internet use or the use of cyberpornography, received substantially less priority. The differences in all grades were significant and moderate to large (η²G between 0.156 and 0.288). The proportion of schools which conducted prevention interventions of screen-related risks was low (between 0.7% and 27.8%, depending on the grade and the type of the risk). The probability of delivering prevention intervention was in all grades significantly predicted by the presence of screen-related problems in pupils (OR 3.76–4.88) and the perceived importance of the screen-related risks (OR 1.55–1.97). The limited capacity of schools to deliver prevention interventions during distant schooling as well as the low awareness and impaired ability to recognize the importance of some screen-related risks should be addressed.

Problematic Internet Use in Adolescents from Divorced Families: The Role of Family Factors and Adolescents' Self-Esteem

Family functioning is salient in explaining adolescents’ problematic internet use (PIU), and precisely this family functioning is under pressure after parental divorce. Moreover, growing up with divorced parents is identified as a risk factor for PIU. Therefore, examining which factors are associated with adolescents’ PIU after divorce is particularly important. Based on self-report data from N = 244 adolescents of divorced families (49.6% boys, M = 13.42), structural equation modeling (SEM) was used to examine the associations of PIU with interparental conflict, triangulation, maternal and paternal warmth, and adolescents’ self-esteem. Potential buffering effects of self-esteem were tested, as well as gender differences in associations. The results showed that more triangulation and less maternal warmth were related to higher levels of PIU, but these effects disappeared after adding self-esteem to the models. Adolescent self-esteem did not significantly buffer the effects of the different family factors on PIU, nor were there any significant gender differences in association. Hence, especially adolescents’ self-esteem seems to be a key aspect for PIU in adolescents from divorced families.

Can Worried Parents Predict Effects of Video Games on Their Children? A Case-Control Study of Cognitive Abilities, Addiction Indicators and Wellbeing

Many parents worry over their children’s gaming habits, but to what extent do such worries match any detrimental effects of excessive gaming? We attempted to answer this question by comparing children of highly concerned parents with other adolescents of the same age. A cohort of parents who identified as highly concerned over their children’s video game habits were recruited for a public study in collaboration with a national television network. Using an online experimental platform in conjunction with surveys of parents’ beliefs and attitudes, we compared their children to age-matched peers in an exploratory case-control study. The scores of children with highly concerned parents on tests of cognitive control (cued task-switching and Iowa Gambling Task) and psychological wellbeing (WHO-5) were statistically similar to controls, suggesting no selective cognitive or psychological detriments from gaming or otherwise in the cases with concerned parents. The case group, however, did spend more time gaming, and scored higher than controls on problem gaming indicators (Gaming Addiction Scale), which also correlated negatively with wellbeing. Within the case group, wellbeing effects seemed mainly to consist in issues of relaxation and sleep, and related to gaming addiction indicators of playing to forget real-world problems, and the feeling of neglecting non-gaming activities. Where most results of research staged for TV never get published, making it difficult to interpret both methods and results, this paper describes findings and participant recruitment in detail. The relationship between parental concern and children’s gaming is discussed, as is the merits and challenges of research conducted with media, such as TV programs and their recruited on-screen participants.