Development of the Internet addiction scale based on the Internet Gaming Disorder criteria suggested in DSM-5

Video games and Facebook addiction among Tunisian adolescents: prevalence and associated factors

OBJECTIVES

As social media and online gaming technology have developed very rapidly over the last two decades, their paired issues are of growing concern worldwide. The aim of our study was to assess the prevalence of video game and Facebook addiction and its predictive factors among Tunisian in school adolescents.

METHODS

We conducted a cross-sectional study among in school adolescents in Sousse, Tunisia, over the first academic term of the 2019-2020 school year using a self-administered questionnaire to a randomly selected representative sample of 1,353 students. The valid Arabic version of the Bergen Facebook Addiction Scale (BFAS), the Video Game Addiction Scale (GAS-7), the Beck Depression Inventory Short Form (13 items) and the Screen for Child Anxiety Related Disorders (SCARED-C) were used to assess facebook addiction disorder (FAD), internet gaming disorder (IGD), depression and anxiety respectively.

RESULTS

More than one in four pupils (26.1 %; CI 95 %: 23.8-28.4 %) were identified as problematic video game users and almost a third of participants (32.5 %; CI 95 %: 30-35 %) reported FAD. IGD was significantly associated with FAD (p<0.001). Likewise, pupils exhibiting depressive symptoms as well as those with anxiety symptoms were significantly more likely to be problematic video games and Facebook users (p<0.001 for each). Being addicted to Facebook (AOR=1.83, 95 % CI: 1.18-2.81), experiencing anxiety disorders (AOR=2.43, 95 % CI: 1.52-3.88), being male (AOR=2.51, 95 % CI: 1.95-3.23) and spending more than 4 h per day surfing the net (AOR=2.55, 95 % CI: 1.65-3.96) were the determinants of IGD in the multivariate analysis. Similarly, being addicted to video games (AOR=1.82, 95 % CI: 1.21-2.73), experiencing anxiety disorders (AOR=1.85, 95 % CI: 1.20-2.86), having experienced academic failure (AOR=1.73, 95 % CI: 1.16-2.56), and spending more than 4 h per day on social media (AOR=3.75, 95 % CI: 2.38-5.90) were the predictors of FAD.

CONCLUSIONS

The prevalence of problematic use of video games and Facebook is alarmingly high. Identifying risk factors can help screen high-risk adolescents. We need additional prevention measures addressing not just adolescents, but all risk factors.

Development study of 2–5 age Technology Addiction Scale (TAS)

PURPOSE

Although it is known that technology use increases in early childhood, no measurement tool has been found to examine technology addictions in children in this period. In this study, the development and validation process of the Technology Addiction Scale (TAS), which can be used to evaluate the technology addiction of children 2-5 years, is described.

DESIGN

The sample of the study consists of 308 children 2-5 years living in one of the big cities of Turkey.

METHODS

Item-total correlation coefficients, Cronbach Alpha reliability analyzes, explanatory and confirmatory factor analyses, and normality analyzes were used in the evaluation of the research data.

FINDINGS

As a result of the analyzes made, the validity and reliability of the 9-item 2-factor (impulsiveness and implicit attitude) TAS scale have been proven. The Cronbach alpha value of the impulsiveness factor was calculated as 0.865, the Cronbach alpha value of the implicit attitude factor was calculated as 0.840, and the total Cronbach alpha value of the scale was 0.90. These Cronbach alpha values show an acceptable level of reliability.

CONCLUSIONS

According to the results of the validity and reliability analyzes, it can be said that TAS can be used as a reliable scale.

Examination of non-cognitive variables affecting academic achievement: a conceptual model proposal

Psychological factors have a significant role in better understanding mechanisms that affect students' academic performance. The intense and long-term stress of the pandemic process has made it necessary to rethink the components which effect the academic achievement of pupils. The purpose of this study is to examine the variables that predict the academic achievement of university students during the pandemic process and to present a model on these variables. The study group has 241 students who continue their undergraduate education in Turkey. The data were collected with a self-description form and 6 scales. The partial Least Squares (PLS) Structural Equation Model was used to analyses the developed research model. In consequence of the study, a relationship was obtained between academic procrastination (AP) and multi-screen addiction (MSA). Covid-19 burnout has a crucial effect on AP, multiscreen addiction, and psychological well-being variables. Motivation and self regulation-attention variables are explanatory of AP. This study contributes to expanding the nomological network regarding the effects of Covid-19 on the psychological well-being and behavior of individuals.

Emotional bias modification weakens game-related compulsivity and reshapes frontostriatal pathways

Addiction is characterized by compulsive engagement despite adverse consequences. Psychobehavioural interventions targeting compulsivity in addictions are relatively rare, particularly for behavioural addictions like internet gaming disorder (IGD). Free from confounding drug-on-brain effects, IGD provides a promising model for understanding neuropsychological processes of addictions. IGD is a global concern in the setting of increasing internet use worldwide. Thus, developing interventions and understanding their mechanisms of action are important. Positive emotional association biases (EABs) towards addiction cues based on reward conditioning may underlie addiction-associated compulsivity. Here, we developed an EAB modification (EABM) protocol and examined whether modifying EABs via cognitive training would alter neurocognitive aspects of addiction-associated compulsivity in IGD. We recruited 90 IGD participants who were randomly assigned to receive EABM or sham training in a 1:1 ratio (clinicaltrials.gov identifier: NCT04068064). The EABM intervention involved six consecutive days of exposure to negative emotional terms linked to gaming stimuli and positive terms linked to non-gaming healthy-alternative stimuli. The sham training involved similar stimuli linked to neutral words. Participants underwent event-related functional MRI while performing a regulation-of-craving task and received several behavioural assessments pretraining and post-training. Primary efficacy measures were changes in gaming-related positive EABs, and compulsive gaming thoughts and behaviours. Behaviourally, EABM (versus sham) training decreased gaming-related positive EABs and compulsive gaming thoughts and behaviours. Neurally, EABM training involved decreased activation in the bilateral dorsal striatum in the regulation-of-craving task and altered left dorsal striatum-centric functional connectivity with ventral prefrontal cortical regions, which correlated with decreases in gaming-related EABs or compulsive gaming thoughts and behaviours. EABM training also implicated activation changes in the right medial frontal gyrus and posterior insula. EABM may reduce compulsive gaming thoughts and behaviours via reshaping functional organization of frontostriatal pathways and insular activity in IGD. The therapeutic potential of EABM should be examined in larger, longer-term studies, as should its application to other addictive disorders.

Evaluation of psychometric properties of the Arabic version of the Internet Disorder Scale (IDS-15)

The internet in modern society has impacted individuals of all ages, especially youth. Over the past 25 years, internet has become increasingly accessible, affordable, and available to a large proportion of individuals worldwide. Despite the clear advantages the internet has brought, adverse effects including potential disordered internet use have been noted among a minority of users. This has led to an increase in the development of screening instruments and numerous validation studies in many countries. Although Arabic is spoken in 25 countries worldwide, little research has been carried out, probably because there is a lack of Arabic instruments assessing problematic internet use. The present study evaluated the psychometric properties of the Arabic version of the 15-item Internet Disorder Scale (IDS-15). A cross-sectional study was conducted among 327 active internet users (35.5 % male; mean age = 21.49 years [SD = 3.06]) using a pen-and-paper-based survey. All participants completed the IDS-15, Bergen Social Media Addiction Scale (BSMAS), and Satisfaction with Life Scale (SWLS). The concurrent validity of the Arabic IDS-15 was satisfactory as its total score was significantly correlated with scores on the BSMAS (standardized coefficient [β] = 0.382), time spent online (β = 0.310), time spent on social media (β = 0.368), time spent on sleep (β = -0.176), and SWLS score (β = -0.281). The internal consistency indicated good internal reliability. Confirmatory factor analysis supported the factor structure of the IDS-15. The Arabic version IDS-15 is a psychometrically sound and robust instrument for assessing internet disorder due to its excellent concurrent validity, good reliability, and satisfactory construct validity.

The Relationships between Gender, Life Satisfaction, Loneliness and Problematic Internet Use during COVID-19: Does the Lockdown Matter?

In response to the COVID-19 pandemic, many governments have attempted to reduce virus transmission by implementing lockdown procedures, leading to increased social isolation and a new reliance on technology and the internet for work and social communication. We examined people’s experiences working from home in the UK to identify risk factors of problematic internet use during the first lockdown period, specifically looking at life satisfaction, loneliness, and gender. A total of 299 adults completed the Problematic Internet Use Questionnaire-Short-Form-6, UCLA-3 Item Loneliness Scale, and Satisfaction with Life Scale online. Through structural equation modelling, we found that loneliness positively predicted problematic internet use while gender had no effect. Life satisfaction and age positively predicted loneliness but had no direct effect on problematic internet use, suggesting loneliness fully mediated their relationship with problematic internet use. Our study serves as a benchmark study of problematic internet use among those working from home during lockdown conditions, which may be utilized by future researchers exploring longitudinal patterns post-pandemic.

Problematic internet use in children according to maternal depression trajectories: A population-based cohort study with 9-year follow-up

OBJECTIVES

We investigated the association between maternal depression trajectories from pregnancy until 2 years postpartum, and problematic internet use in children at nine years of age.

METHODS

A total of 1132 mother-child pairs from the Panel Korea Study for Children were used. Maternal depression was assessed repeatedly using the Kessler scale (K-scale) (during pregnancy, and at 6, 12, and 24 months of age). Problematic internet use was assessed in children 9 years old using the K-scale. The children's behavioral problems were assessed using the Child Behavior Checklist at nine years old. Latent profile analysis was used to identify the group trajectories of maternal depression. We compared the severity of problematic internet use of the children according to the maternal depression trajectories. We also identified behavioral problems in children with problematic internet use in each maternal depression trajectory.

RESULTS

Trajectory analysis identified three group trajectories of maternal depression: no symptoms (n = 478), mild symptoms (n = 534), and moderate symptoms (n = 120). The mild and moderate maternal depression trajectory groups were more associated with high-risk internet use in 9-year-old children compared to the non-depressed group. In children with high-risk internet use, more severe behavioral problems were reported when their mothers had depression.

CONCLUSION

Maternal depression up to two years after childbirth affected problematic internet use in middle childhood.

A Latent Profile Analysis of Problematic Media Device Use and Its Association With Executive Function and Behavioral Problem Among Children: A Population-Based Study

OBJECTIVE

Despite the rapid increase in problematic media device use, relatively little is known about specific characteristics and extent of problematic media device and how they relate to different psychological features.

METHODS

Data extracted from the Panel Korea Study for the Child Cohort Study were used. At the age of 9 years, media device addiction severity was assessed using the K-scale, and children's behavioral outcomes were assessed using the Child Behavior Checklist. Among children with problematic media device use (n=339), we performed latent profile analysis using the K-scale to identify subtypes of problematic media device use, and then compared the child behavioral problems and executive function according to the different subtypes of problematic media device use.

RESULTS

Children with problematic media device use were divided into class 1 (n=51), class 2 (n=138), and class 3 (n=150). Compared with classes 2 and 3, class 1 had more severe problematic media device use, including daily activity disturbance, withdrawal, and tolerance. Class 1 had the most serious behavioral problems and executive function difficulties among classes. Class 2 had greater daily activity disturbance and tolerance than those of class 3, but executive function showed no significant difference between the two classes. In logistic regression analysis, behavioral problems except for somatization were more common in class 1 than in the control group.

CONCLUSION

Results suggest that problematic media device use is associated with significant behavioral problem and executive function difficulties and underscore the need for further clinical and research attention for these specific subgroup members.

Problematic Internet Usage and Self-Esteem in Chinese Undergraduate Students: The Mediation Effects of Individual Affect and Relationship Satisfaction

The aim of this cross-sectional study was to examine the mediating effects of individual affect and relationship satisfaction on the relationship between self-esteem and Problematic Internet Use (PIU). Affect was measured using the Positive and Negative Affect Schedule (PANAS), relationship satisfaction was assessed using a positive and negative semantic dimension scale, self-esteem was measured using the Rosenberg Self-Esteem Scale, and PIU was measured using the Problematic Internet Use scale with a sample of 507 Chinese university students (Mage = 20.41 years, SD = 2.49). The relationships between the variables were tested using structural equation modelling with a multiple mediation model. The results revealed that negative affect and the negative semantic dimensions of relationship satisfaction mediated the relationship between self-esteem and PIU. The implications of the results and the study’s theoretical contributions are discussed.

From screen time to the digital level of analysis: a scoping review of measures for digital media use in children and adolescents

OBJECTIVES

This scoping review aims to facilitate psychometric developments in the field of digital media usage and well-being in young people by (1) identifying core concepts in the area of "screen time" and digital media use in children, adolescents, and young adults, (2) synthesising existing research paradigms and measurement tools that quantify these dimensions, and (3) highlighting important areas of need to guide future measure development.

DESIGN

A scoping review of 140 sources (126 database, 14 grey literature) published between 2014 and 2019 yielded 162 measurement tools across a range of domains, users, and cultures. Database sources from Ovid MEDLINE, PsycINFO and Scopus were extracted, in addition to grey literature obtained from knowledge experts and organisations relevant to digital media use in children. To be included, the source had to: (1) be an empirical investigation or present original research, (2) investigate a sample/target population that included children or young persons between the ages of 0 and 25 years of age, and (3) include at least one assessment method for measuring digital media use. Reviews, editorials, letters, comments and animal model studies were all excluded.

MEASURES

Basic information, level of risk of bias, study setting, paradigm, data type, digital media type, device, usage characteristics, applications or websites, sample characteristics, recruitment methods, measurement tool information, reliability and validity.

RESULTS

Significant variability in nomenclature surrounding problematic use and criteria for identifying clinical impairment was discovered. Moreover, there was a paucity of measures in key domains, including tools for young children, whole families, disadvantaged groups, and for certain patterns and types of usage.

CONCLUSION

This knowledge synthesis exercise highlights the need for the widespread development and implementation of comprehensive, multi-method, multilevel, and multi-informant measurement suites.

Internet addiction in adolescents: Development and validation of Internet Addiction Diagnostic Questionnaire (KDAI)

Internet addiction (IA) is an emerging behavioral problem that constitutes a major health threat to vulnerable populations, including adolescents. However, there is a paucity of IA screening tools specifically designed for adolescents, especially in Indonesia. Therefore, the current study developed and validated the IA Diagnostic Questionnaire (KDAI) in adolescents while acknowledging local cultural influences. The KDAI was conceived through extensive literature reviews, expert discussions based on Delphi methods, a face validity study, focus group discussion (N = 31) for initial reliability testing, and a recruited pilot study (N = 385) and main study (N = 643) for exploratory and confirmatory factor analyses, respectively. The multi-sample analyses demonstrated that the KDAI model with the best fit and reliability comprised a seven-factor structure, including withdrawal, loss of control, increase of priority, negative consequences, mood modification, salience, and impairment. These factors were scrutinized against domains of IA Test, and concurrent validity was ascertained. Subsequently, a receiver operating characteristic curve and area under the curve determined a cutoff score of 108 to discern adolescents with IA. Taken together, the KDAI displayed excellent psychometric indices and sensitivity as a screening tool for IA in adolescents.

Altered functional network activities for behavioral adjustments and Bayesian learning in young men with Internet gaming disorder

BACKGROUND AND AIMS

Deficits in cognitive control represent a core feature of addiction. Internet Gaming Disorder (IGD) offers an ideal model to study the mechanisms underlying cognitive control deficits in addiction, eliminating the confounding effects of substance use. Studies have reported behavioral and neural deficits in reactive control in IGD, but it remains unclear whether individuals with IGD are compromised in proactive control or behavioral adjustment by learning from the changing contexts.

METHODS

Here, fMRI data of 21 male young adults with IGD and 21 matched healthy controls (HC) were collected during a stop-signal task. We employed group independent component analysis to investigate group differences in temporally coherent, large-scale functional network activities during post-error slowing, the typical type of behavioral adjustments. We also employed a Bayesian belief model to quantify the trial-by-trial learning of the likelihood of stop signal - P(Stop) - a broader process underlying behavioral adjustment, and identified the alterations in functional network responses to P(Stop).

RESULTS

The results showed diminished engagement of the fronto-parietal network during post-error slowing, and weaker activity in the ventral attention and anterior default mode network in response to P(Stop) in IGD relative to HC.

DISCUSSION AND CONCLUSIONS

These results add to the literatures by suggesting deficits in updating and anticipating conflicts as well as in behavioral adjustment according to contextual information in individuals with IGD.

Exploratory Factor Analysis of Young's Internet Addiction Test Among Professionals from India: An Online Survey

BACKGROUND

Internet use has spread across the world due to easy accessibility and affordability. However, it has been creating many problems at several levels. So, there is a need to identify the suitability of psychometric properties and the factor structure of the widely used Internet Addiction Test (IAT) in the Indian settings. Our objective was to perform an exploratory factor analysis on the IAT and to test the reliability of the scale.

METHODS

It was a cross-sectional study that included various professional groups. We used an online questionnaire that included sociodemographic details and Young's IAT. Exploratory factor analysis was used to identify the factor structure of Young's IAT in the Indian setup.

RESULTS

The mean age of the sample (N = 1,782) was 27.7 years (SD = 8.74) with a predominantly male population 1040 (58.4%). In total, 1.0% (17) of the sample had significant problems with internet usage, whereas 13% (232) were in the range of frequent/occasional problems, and the mean score on IAT was 32 (SD = 16.42). Exploratory factor analysis revealed two factors that explained 49% of the variance (Kaiser-Meyer-Olkin measure of sampling adequacy: 0.95, Bartlett's test of sphericity: P = 0.000). They were "mood and relationship issues" and "duration and productivity." Cronbach's α was 0.92, which indicates a high level of internal consistency.

CONCLUSION

In Indian settings, IAT can be understood based on the two-factor structure. The scale has excellent reliability. Further studies are needed to replicate these results, by using confirmatory factor analysis and validity testing.

Does Interpersonal Interaction Really Improve Emotion, Sleep Quality, and Self-Efficacy among Junior College Students?

This study discusses the correlation between teenagers' real-life interpersonal interactions and teenagers' online interpersonal interactions with regards to emotion, sleep quality, and self-efficacy. This study adopted a cross-sectional design that included a survey using a structured questionnaire which included demographic data, the Chinese version of the Depression Anxiety Stress Scale (DASS-21), the Pittsburgh Sleep Quality Index (PSQI), the General Self-Efficacy Scale (GSE), the Real Interpersonal Interaction Scale (RIIS), and the Internet Interpersonal Interaction Scale (IIIS). This study enlisted 917 teenage students (age = 17.16 ± 1.48 years). The study found that RIIS had significant negative correlations with DASS and PSQI scores and a significant positive correlation with GSE. Namely, the greater the degree of real-life interpersonal interaction, the lower the degree of negative emotion. Likewise, the more satisfactory sleep quality is, the higher self-efficacy is. In addition, IIIS scores demonstrate significantly positive correlations with DASS and PSQI scores. Therefore, the greater the degree of online interpersonal interaction, the greater the levels of negative emotion, and the poorer the sleep quality is. This study showed that online interpersonal interaction may not improve emotions, sleep quality, or self-efficacy among junior college students. However, real-life interpersonal interaction may improve those three parameters.

A psychometric approach to assessments of problematic use of online pornography and social networking sites based on the conceptualizations of internet gaming disorder

BACKGROUND

The problematic use of online gaming, social networking sites (SNS) and online pornography (OP) is an evolving problem. Contrary to the problematic use of SNS and OP, Internet gaming disorder (IGD) was included in the new edition of the Diagnostic and statistical manual of mental disorders (DSM-5) as a condition for further study. The present study adapted the criteria for IGD to the problematic use of SNS and OP by modifying a validated questionnaire for IGD (Internet Gaming Disorder Questionnaire: IGDQ) and investigating the psychometric properties of the modified versions, SNSDQ and OPDQ.

METHODS

Two online samples (SNS: n = 700, 25.6 ± 8.4 years, 76.4% female; OP: n = 700, 32.9 ± 12.6 years, 76.7% male) completed the SNSDQ/OPDQ, the Brief Symptom Inventory (BSI) and the short Internet Addiction Test (sIAT) and provided information on their SNS/OP use. Standard item and reliability analyses, exploratory and confirmatory factor analyses and correlations with the sIAT were calculated. Problematic and non-problematic users were compared.

RESULTS

The internal consistencies were ω_ordinal = 0.89 (SNS) and ω_ordinal = 0.88 (OP). The exploratory factor analyses extracted one factor for both questionnaires. Confirmatory factor analyses confirmed the results. The SNSDQ/OPDQ scores correlated highly with the sIAT scores and moderately with SNS/OP usage time. Of the users, 3.4% (SNS) and 7.1% (OP) lay above the cutoff for problematic use. Problematic users had higher sIAT scores, used the applications for longer and experienced more psychological distress.

CONCLUSION

Overall, the results of the study indicate that the adaption of the IGD criteria is a promising approach for measuring problematic SNS/OP use.

Psychometric Validation of the Internet Disorder Scale–Short Form in an Italian Adult Sample

Research examining online addictions has conceptualized generalized internet addiction as an “umbrella” term comprising the addictive use of various online activities such as gambling, gaming, pornograpgy consumption shopping, and social media use. This has led to the development of many different psychometric instruments to assess specific forms of online addiction as well as ones that assess disordered internet use more generally. One such scale is the nine-item short-form Internet Disorder Scale (IDS9-SF) based on the DSM-5 criteria for internet gaming disorder. Although the IDS9-SF has been validated in a number of languages, it has not been validated into Italian. Therefore, the present study validated the IDS9-SF utilizing an Italian-speaking sample (N = 1477). Data were initially collected from 963 participants and the sample was equally split to carry out exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) on the Italian IDS9-SF. Results showed that two items were problematic (i.e., in terms of asymmetry and kurtosis) so a slightly modified Italian IDS9-SF was developed (modifying the two items). Data were then collected from a further 514 participants to test the modified Italian IDS9-SF. The second sample was again equally split, and EFA and CFA were carried out. The modified Italian IDS9-SF was found to be a psychometrically robust measure for assessing the risk of internet disorder among Italian adults.

Altered coupling of default-mode, executive-control and salience networks in Internet gaming disorder

Background:

Recently, a triple-network model suggested the abnormal interactions between the executive-control network (ECN), default-mode network (DMN) and salience network (SN) are important characteristics of addiction, in which the SN plays a critical role in allocating attentional resources toward the ECN and DMN. Although increasing studies have reported dysfunctions in these brain networks in Internet gaming disorder (IGD), interactions between these networks, particularly in the context of the triple-network model, have not been investigated in IGD. Thus, we aimed to assess alterations in the inter-network interactions of these large-scale networks in IGD, and to associate the alterations with IGD-related behaviors.

Methods:

DMN, ECN and SN were identified using group-level independent component analysis (gICA) in 39 individuals with IGD and 34 age and gender matched healthy controls (HCs). Then alterations in the SN-ECN and SN-DMN connectivity, as well as in the modulation of ECN versus DMN by SN, using a resource allocation index (RAI) developed and validated previously in nicotine addiction, were assessed. Further, associations between these altered network coupling and clinical assessments were also examined.

Results:

Compared with HCs, IGD had significantly increased SN-DMN connectivity and decreased RAI in right hemisphere (rRAI), and the rRAI in IGD was negatively associated with their scores of craving.

Conclusions:

These findings suggest that the deficient modulation of ECN versus DMN by SN might provide a mechanistic framework to better understand the neural basis of IGD and might provide novel evidence for the triple-network model in IGD.

Learning to lose control: A process-based account of behavioral addiction

Learning psycho(bio)logy has developed a solid corpus of evidence and theory regarding behavior control modes. The present article briefly reviews that literature and its influence on recent models in which the transition from goal-directed to compulsive behavior is identified as the main process underlying substance use disorders. This literature is also relevant to non-substance addictive disorders, and serves as basis to propose a restricted definition of behavioral addiction relying on the presence of behavior-specific compulsivity. Complementarily, we consider whether some activities can become disordered while remaining mostly goal-driven. Based on reinforcement learning models, relative outcome utility computation is proposed as an alternative mechanism through which dysfunctional behaviors (even not qualifying as addictive) can override adaptive ones, causing functional impairment. Beyond issues of conceptual delimitation, recommendations are made regarding the importance of identifying individual etiological pathways to dysregulated behavior, the necessity of accurately profiling at-risk individuals, and the potential hazards of symptom-based diagnosis. In our view, the validity of these recommendations does not depend on the position one takes in the nosological debate.

Internet addiction disorder detection of Chinese college students using several personality questionnaire data and support vector machine

With the unprecedented development of the Internet, it also brings the challenge of Internet Addiction (IA), which is hard to diagnose and cure according to the state-of-art research. In this study, we explored the feasibility of machine learning methods to detect IA. We acquired a dataset consisting of 2397 Chinese college students from the University (Age: 19.17 ± 0.70, Male: 64.17%) who completed Brief Self Control Scale (BSCS), the 11th version of Barratt Impulsiveness Scale (BIS-11), Chinese Big Five Personality Inventory (CBF-PI) and Chen Internet Addiction Scale (CIAS), where CBF-PI includes five sub-features (Openness, Extraversion, Conscientiousness, Agreeableness, and Neuroticism) and BSCS includes three sub-features (Attention, Motor and Non-planning). We applied Student's t-test on the dataset for feature selection and Support Vector Machines (SVMs) including C-SVM and ν-SVM with grid search for the classification and parameters optimization. This work illustrates that SVM is a reliable method for the assessment of IA and questionnaire data analysis. The best detection performance of IA is 96.32% which was obtained by C-SVM in the 6-feature dataset without normalization. Finally, the BIS-11, BSCS, Motor, Neuroticism, Non-planning, and Conscientiousness are shown to be promising features for the detection of IA.

The Clinical Utility of the Chen Internet Addiction Scale-Gaming Version, for Internet Gaming Disorder in the DSM-5 among Young Adults

Objectives: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) includes the diagnostic criteria for Internet gaming disorder (IGD). This study evaluated (1) the screening, diagnostic, and prevalence-estimated cutoff points of the Chen Internet Addiction Scale–Gaming Version (CIAS-G) for IGD in the DSM-5; and (2) the differences in the CIAS-G and subscale scores among individuals with IGD, regular gamers (RGs), and other control subjects. Methods: We recruited 69 participants with IGD, 69 RGs, and 69 healthy participants based on diagnostic interviews conducted by a psychiatrist according to DSM-5 IGD criteria. All participants completed the CIAS-G and were assessed using the clinical global impression scale. Results: The optimal screening and diagnostic cutoff points were 68 or more (sensitivity, 97.1%; specificity, 76.8%) and 72 or more (sensitivity, 85.5%; specificity, 87.0%) for IGD based on DSM-5 criteria, respectively. The 76 or more cutoff point had the highest number needed to misdiagnose and was the optimal prevalence estimated cutoff point. Conclusions: The screening cutoff point could be used to identify individuals with IGD for further diagnostic interviewing to confirm the diagnosis in the clinical setting or for two-stage epidemiological evaluation. The diagnostic cutoff point provides a provisional diagnosis of IGD when diagnostic interviewing is unavailable. The prevalence-estimated cutoff point could be used to estimate the prevalence of IGD in large-scale epidemiological investigations when further diagnostic interviewing is impractical. The clinical and epidemiological utility of CIAS-G warrants further study.

The cross-cultural expression of internet gaming distress in North America, Europe, and China

We compare the forms online gaming-related distress takes cross-culturally, and examine how much such distress resembles the World Health Organization's (WHO) “Gaming disorder,” understood to be an “addiction.” Our preliminary exploratory factor analysis (EFA) in North America (n = 2025), Europe (n = 1198), and China (n = 841) revealed a constant four-factor structure across the three regions, with classic “addiction” symptoms always clustering together on the first and most important factor, though with some variability in regional factors' exact item composition. In the present study, we use second-order confirmatory factor analysis (CFA) to further examine this factor structure and the cultural similarities and differences. Specifically, we focus on confirming the regional structure and composition of an ethnographically developed 21-item gaming distress scale, which contains a wider symptoms pool than typical gaming disorder scales, and thus allows us to better separate generalized gaming distress's “addictive” from other culturally-influenced “problem” experiences and behaviors in each regional case. We use propensity score matching to separate the impact on gaming-related distress of regional culture from demographic variables (North America/Europe: n = 1043 pairs; North America/China: n = 535 pairs). Although our results support current WHO formulations of gaming-related distress as an addictive disorder, we show how cultural forces can shape how “addictive” and “problem” gaming are experienced and thus psychiatrically presented in different parts of the world. In particular, generalized gaming distress's addictive and problematic dimensions seem to be shaped by culture-specific expressions of achievement motivations, social connection and disconnection, and unique psychosomatic experiences.

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Second-order CFA shows similarities and differences between online gaming distress in North America, Europe, and China.

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Our 21-item distress scale allows us to separate “addictive” from “problem” experiences and behaviors in each regional case.

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Propensity score matching helps us separate the impact on gaming distress of regional culture from demographic variables.

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Generalized gaming distress consists of four dimensions, with three closely related to addiction experiences and behaviors.

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Our results support current WHO and APA formulations of gaming-related distress as an addictive disorder.

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Culture also shapes how “addictive” and “problem” gaming are experienced in different parts of the world.

Distinguishing Core from Peripheral Psychiatric Symptoms: Addictive and Problematic Internet Gaming in North America, Europe, and China

We explore the problem of distinguishing the relatively constant versus culturally variable dimensions of mental suffering and disorder in the context of a cross-cultural study of Internet gaming-related distress. We extend the conceptual contrast of "core" and "peripheral" symptoms drawn from game studies and use a framework that synthesizes cultural and neurobiological understandings of emotional distress. In our framework, "core" symptoms are relatively constant across cultures and therefore presumed to be more closely tied to a neurobiological base. By contrast, we treat as "peripheral" symptoms those that are more culturally variable, and thus less directly tied to the neurobiology of addiction. We develop and illustrate this approach with a factor analysis of cross-cultural survey data, resting on previous ethnographic work, through which we compare online gaming distress experienced in North America (n = 2025), Europe (n = 1198), and China (n = 841). We identify the same four-factor structure across the three regions, with Addiction always the first and most important factor, though with variability in regional factors' exact item composition. The study aims to advance an integrative biocultural approach to distinguishing universal as opposed to culturally contingent dimensions of human suffering, and to help resolve debates about whether problem gaming represents a form of addiction.

Transitions in Problematic Internet Use: A One-Year Longitudinal Study of Boys

OBJECTIVE

Longitudinal studies may help elucidate the factors associated with Problematic Internet Use (PIU); however, little prospective research has been conducted on the subject. The aim of the current study was to prospectively examine PIU in children/adolescents and identify the possible risk factors associated with transitions in PIU severity.

METHODS

650 middle-school boys were surveyed at two points one year apart and assessed for PIU using the Internet Addiction Proneness Scale for Youth (KS-II) and on other psychological characteristics.

RESULTS

We found that 15.3% at baseline and 12.4% at one year met the criteria for at-risk/high-risk PIU (ARHRPIU). Both the persistent-ARHRPIU and emerging-ARHRPIU groups revealed greater depressive, motor impulsive, and smart-phone-addiction tendencies than the remitting-ARHRPIU group or the persistent low-risk group. In addition, we found that individuals exhibiting higher hyperkinetic attention-deficit/hyperactivity disorder (ADHD) scores were less likely to remit from ARHRPIU, and that individuals exhibiting more ADHD-related cognitive dysfunction and reporting fewer Internet-game-free days were more likely to demonstrate an emergence of ARHRPIU.

CONCLUSION

The present findings support previous studies in that specific negative-health features are linked to transitions in ARHRPIU. Furthermore, these findings suggest that intervention is needed and may be best targeted at specific groups of youths.

Application of Diagnostic Interview for Internet Addiction (DIA) in Clinical Practice for Korean Adolescents

The increased prevalence of Internet Gaming Disorder (IGD) and the inclusion of IGD in DSM-5 and ICD-11 emphasizes the importance of measuring and describing the IGD symptoms. We examined the psychometric properties of the Diagnostic Interview for Internet Addiction (DIA), a semi-structured diagnostic interview tool for IGD, and verified the application of DIA in clinical practice for Korean adolescents. The DIA is conducted in a manner that interviews both adolescents and their caregivers, and each item has a standardized representative question and various examples. It consists of 10 items based on the DSM-5 IGD diagnostic criteria, which is cognitive salience, withdrawal, tolerance, difficulty in regulating use, loss of interest in other activities, persistent use despite negative results, deception regarding Internet/games/SNS use, use of Internet/games/SNS to avoid negative feelings, interference with role performance, and craving. The study included 103 adolescents divided into three subgroups (mild risk, moderate risk, and addicted group) based on the total score of DIA. Demographic and clinical characteristics were compared among the DIA subgroups using the chi-square test and analysis of variance (ANOVA), and correlation analysis was used to examine the associations of IGD symptoms with clinical variables (e.g., impulsivity, aggression, depression, anxiety, self-esteem). The DIA total score was significantly correlated with Internet and smartphone addiction, depression, state anxiety, self-esteem, impulsivity, aggression, and stress. Furthermore, the moderate risk and addicted group showed significantly higher levels of Internet and smartphone addiction, anxiety, depression, impulsivity, aggression, stress, and lower self-esteem compared with the mild risk group. The Junior Temperament and Character Inventory (JTCI), which measures temperament and character traits, revealed that the mild risk group had higher levels of persistence and self-directedness than did the addicted group. Our findings confirmed the psychometric properties of DIA and the application of the DIA classifications in Korean adolescents.

Evaluating the Psychometric Properties of the 7-Item Persian Game Addiction Scale for Iranian Adolescents

The 7-item Gaming Addiction Scale (GAS) is a brief instrument based on DSM criteria to assess gaming addiction. Although the psychometric properties of the GAS have been tested using classical test theory, its psychometric properties have never been tested using modern test theory (e.g., Rasch analysis). The present study used a large adolescent sample in Iran to test the psychometric properties of the Persian GAS through both classical test and modern test theories. Adolescents (n = 4442; mean age = 15.3 years; 50.3% males) were recruited from Qazvin, Iran. In addition to the GAS, all of them completed the following instruments: the nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), and a generic quality of life instrument. Two weeks later, all participants completed the GAS again. Confirmatory factor analysis (CFA) and Rasch analysis were used to test the unidimensionality of the GAS. Pearson correlation coefficients were used to test the test-retest reliability, and a regression model was used to test the criterion-related validity of the GAS. Both CFA and Rasch analysis supported the unidimensionality of the GAS. Pearson correlations coefficients showed satisfactory test-retest reliability of the GAS (r = 0.78 to 0.86), and the regression model demonstrated the criterion-related validity of the GAS (β = 0.31 with IGDS-SF9; 0.41 with PSQI). Based on the results, the Persian GAS is a reliable and valid instrument for healthcare providers to assess the level of gaming addiction among Persian-speaking adolescents.

Genetic association of human Corticotropin-Releasing Hormone Receptor 1 (CRHR1) with Internet gaming addiction in Korean male adolescents

BACKGROUND

The number of people with Internet gaming addiction (IGA) is increasing around the world. IGA is known to be associated with personal characteristics, psychosocial factors, and physiological factors. However, few studies have examined the genetic factors related to IGA. This study aimed to investigate the association between IGA and stress-related genetic variants.

METHODS

This cross-sectional study was conducted with 230 male high school students in a South Korean city. We selected five stress-related candidate genes: DAT1, DRD4, NET8, CHRNA4, and CRHR1. The DAT1 and DRD4 genes were genotyped by polymerase chain reaction, and the NET8, CHRNA4, and CRHR1 genes were genotyped by pyrosequencing analysis. We performed a Chi-square test to examine the relationship of these five candidate genes to IGA.

RESULTS

Having the AA genotype and the A allele of the CRHR1 gene (rs28364027) was associated with higher odds of belonging to the IGA participant group (p = .016 and p = .021, respectively) than to the non-IGA group. By contrast, the DAT1, DRD4, NET8, and CHRNA4 gene polymorphisms showed no significant difference between the IGA group and control group.

CONCLUSIONS

These results indicate that polymorphism of the CRHR1 gene may play an important role in IGA susceptibility in the Korean adolescent male population. These findings provide a justification and foundation for further investigation of genetic factors related to IGA.

The relationship between coping style and Internet addiction among mainland Chinese students: A meta-analysis

The matter of whether different coping styles are correlated with increased Internet addiction or not remains a topic of debate. Most researchers have argued that Internet addiction is linked to low positive coping and high negative coping; however, others have rejected this opinion. Consequently, this meta-analysis examined the link between coping style and Internet addiction to address this controversy. Seventy-seven studies comprising 46,025 Chinese adolescent students were analyzed. The results suggested a medium negative correlation between positive coping and Internet addiction and a medium positive correlation between negative coping and Internet addiction. Furthermore, coping style measures, Internet addiction, region, and gender moderated these links. The link between negative coping and Internet addiction was largest when positive coping was measured with the Coping Style Questionnaire (CSQ), smaller when using the Simplified Coping Style Questionnaire, and smallest when using other measures. The negative correlation between positive coping and Internet addiction was largest when Internet addiction was measured with the Internet Addiction Test, smaller when using revised Chinese Internet Addiction Scale, and smallest when using other measures. For both positive and negative coping and Internet addiction, the correlations were largest in Eastern China, smaller in Central China, and smallest in Western China.

Psychometric evaluation of the Persian Internet Disorder Scale among adolescents

BACKGROUND AND AIMS

Given the growing epidemiological research interest concerning Internet addiction, brief instruments with a robust theoretical basis are warranted. The Internet Disorder Scale (IDS-15) is one such instrument that can be used to quickly assess the Internet addiction in an individual. However, only two language versions of the IDS-15 have been developed. This study translated the IDS-15 into Persian and examined its psychometric properties using comprehensive psychometric testing.

METHODS

After ensuring the linguistic validity of the Persian IDS-15, 1,272 adolescents (mean age = 15.53 years; 728 males) completed the IDS-15, Depression Anxiety Stress Scale (DASS), Internet Gaming Disorder Scale - Short Form (IGDS9-SF), and the Bergen Social Media Addiction Scale (BSMAS). Confirmatory factor analysis (CFA), Rasch models, regression analysis, and latent profile analysis (LPA) were carried out to test the psychometric properties of the Persian IDS-15.

RESULTS

Both CFA and Rasch supported the construct validity of the Persian IDS-15. Multigroup analysis in CFA and differential item functioning in Rasch indicated that male and female adolescents interpreted the IDS-15 items similarly. Regression analysis showed that the IDS-15 correlated with IGDS9-SF and BSMAS (ΔR² = .12 and .36, respectively) is stronger than the DASS (ΔR² = .03-.05). LPA based on IDS-15 suggests three subgroups for the sample. Significant differences in depression, anxiety, IGDS9-SF, and BSMAS were found among the three LPA subgroups.

CONCLUSION

The Persian IDS-15 has robust psychometric properties as evidenced by both classical test theory and Rasch analysis.

Internet Game Overuse Is Associated With an Alteration of Fronto-Striatal Functional Connectivity During Reward Feedback Processing

Internet gaming disorder is associated with abnormal reward processing in the reward circuit, which is known to interact with other brain regions during feedback learning. Kim et al. (1) observed that individuals with internet game overuse (IGO) exhibit altered behavior and neural activity for non-monetary reward, but not for monetary reward. Here, we extend our analysis of IGO to the functional connectivity of the reward network. Functional MRI data were obtained during a stimulus-response association learning task from 18 young males with IGO and 20 age-matched controls, where either monetary or non-monetary rewards were given as positive feedback for a correct response. Group differences in task-dependent functional connectivity were examined for the ventromedial prefrontal cortex (vmPFC) and ventral striatum (VS), which are known for reward evaluation and hedonic response processing, respectively, using a generalized form of the psychophysiological interaction approach. For non-monetary reward processing, no differences in functional connectivity were found. In contrast, for monetary reward, connectivity of the vmPFC with the left caudate nucleus was weaker for the IGO group relative to controls, while vmPFC connectivity with the right nucleus accumbens (NAcc) was elevated. The strength of vmPFC-NAcc functional connectivity appeared to be behaviorally relevant, because individuals with stronger vmPFC-NAcc connectivity showed lower learning rates for monetary reward. In addition, the IGO group showed weaker ventral striatum functional connectivity with various brain regions, including the right ventrolateral prefrontal cortex, dorsal anterior cingulate regions, and left pallidum. Thus, for monetary reward, the IGO group exhibited stronger functional connectivity within the brain regions involved in motivational salience, whereas they showed reduced functional connectivity the widely distributed brain areas involved in learning or attention. These differences in functional connectivity of reward networks, along with related behavioral impairments of reward learning, suggest that internet gaming disorder is associated with the increased incentive salience or "wanting" of addiction disorders, and may serve as the neurobiological mechanisms underlying the impaired goal-directed behavior.

Internet gaming disorder in children and adolescents: a systematic review

AIM

Internet gaming disorder (IGD) is a serious disorder leading to and maintaining pertinent personal and social impairment. IGD has to be considered in view of heterogeneous and incomplete concepts. We therefore reviewed the scientific literature on IGD to provide an overview focusing on definitions, symptoms, prevalence, and aetiology.

METHOD

We systematically reviewed the databases ERIC, PsyARTICLES, PsycINFO, PSYNDEX, and PubMed for the period January 1991 to August 2016, and additionally identified secondary references.

RESULTS

The proposed definition in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition provides a good starting point for diagnosing IGD but entails some disadvantages. Developing IGD requires several interacting internal factors such as deficient self, mood and reward regulation, problems of decision-making, and external factors such as deficient family background and social skills. In addition, specific game-related factors may promote IGD. Summarizing aetiological knowledge, we suggest an integrated model of IGD elucidating the interplay of internal and external factors.

INTERPRETATION

So far, the concept of IGD and the pathways leading to it are not entirely clear. In particular, long-term follow-up studies are missing. IGD should be understood as an endangering disorder with a complex psychosocial background.

WHAT THIS PAPER ADDS

In representative samples of children and adolescents, on average, 2% are affected by Internet gaming disorder (IGD). The mean prevalences (overall, clinical samples included) reach 5.5%. Definitions are heterogeneous and the relationship with substance-related addictions is inconsistent. Many aetiological factors are related to the development and maintenance of IGD. This review presents an integrated model of IGD, delineating the interplay of these factors.

The Internet Game Use-Elicited Symptom Screen proved to be a valid tool for adolescents aged 10-19 years

AIM

This study tested the diagnostic validity of the nine-item Internet Game Use-Elicited Symptom Screen (IGUESS) tool, which was developed by the authors after the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, identified Internet gaming as a condition that needed further study.

METHODS

A self-report screening test comprising IGUESS and Young's Internet Addiction Test was administered to 121 adolescents (74% boys) with a median age of 14 (range 10-19) recruited from school and health settings in Korea. After the screening test, a clinician conducted one-to-one interviews with all of the subjects to set a gold standard for diagnosis.

RESULTS

The sensitivity and specificity of IGUESS were 87.0 and 86.7%, respectively, for a cut-off score of 10 points, with an area under the curve value of 0.93. Its reliability, as determined by Cronbach's alpha, was 0.94, and the correlation coefficient between IGUESS and Young's Internet Addiction Test was r = 0.902.

CONCLUSION

The findings suggest that a cut-off score of 10 is appropriate for administering the IGUESS in various community-based settings, including schools, to screen for potential subjects in need of further assessment for Internet gaming problems.

Craving behavioral intervention for internet gaming disorder: remediation of functional connectivity of the ventral striatum

Psychobehavioral intervention is an effective treatment of Internet addiction, including Internet gaming disorder (IGD). However, the neural mechanisms underlying its efficacy remain unclear. Cortical-ventral striatum (VS) circuitry is a common target of psychobehavioral interventions in drug addiction, and cortical-VS dysfunction has been reported in IGD; hence, the primary aim of the study was to investigate how the VS circuitry responds to psychobehavioral interventions in IGD. In a cross-sectional study, we examined resting-state functional connectivity of the VS in 74 IGD subjects (IGDs) and 41 healthy controls (HCs). In a follow-up craving behavioral intervention (CBI) study, of the 74 IGD subjects, 20 IGD subjects received CBI (CBI+) and 16 IGD subjects did not (CBI-). All participants were scanned twice with similar time interval to assess the effects of CBI. IGD subjects showed greater resting-state functional connectivity of the VS to left inferior parietal lobule (lIPL), right inferior frontal gyrus and left middle frontal gyrus, in positive association with the severity of IGD. Moreover, compared with CBI-, CBI+ showed significantly greater decrease in VS-lIPL connectivity, along with amelioration in addiction severity following the intervention. These findings demonstrated that functional connectivity between VS and lIPL, each presumably mediating gaming craving and attentional bias, may be a potential biomarker of the efficacy of psychobehavioral intervention. These results also suggested that non-invasive techniques such as transcranial magnetic or direct current stimulation targeting the VS-IPL circuitry may be used in the treatment of Internet gaming disorders.

Circulating MicroRNA Expression Levels Associated With Internet Gaming Disorder

BACKGROUND

Addictive use of the Internet and online games is a potential psychiatric disorder termed Internet gaming disorder (IGD). Altered microRNA (miRNA) expression profiles have been reported in blood and brain tissue of patients with certain psychiatric disorders and suggested as biomarkers. However, there have been no reports on blood miRNA profiles in IGD.

METHODS

To discover IGD-associated miRNAs, we analyzed the miRNA expression profiles of 51 samples (25 IGD and 26 controls) using the TaqMan Low Density miRNA Array. For validation, we performed quantitative reverse transcription PCR with 36 independent samples (20 IGD and 16 controls).

RESULTS

Through discovery and independent validation, we identified three miRNAs (hsa-miR-200c-3p, hsa-miR-26b-5p, hsa-miR-652-3p) that were significantly downregulated in the IGD group. Individuals with all three miRNA alterations had a much higher risk of IGD than those with no alteration [odds ratio (OR) 22, 95% CI 2.29-211.11], and the ORs increased dose dependently with number of altered miRNAs. The predicted target genes of the three miRNAs were associated with neural pathways. We explored the protein expression of the three downstream target genes by western blot and confirmed that expression of GABRB2 and DPYSL2 was significantly higher in the IGD group.

CONCLUSION

We observed that expressions of hsa-miR-200c-3p, hsa-miR-26b-5p, and hsa-miR-652-3p were downregulated in the IGD patients. Our results will be helpful to understand the pathophysiology of IGD.

Risk Factors for Internet Gaming Disorder: Psychological Factors and Internet Gaming Characteristics

Background: Understanding the risk factors associated with Internet gaming disorder (IGD) is important to predict and diagnose the condition. The purpose of this study is to identify risk factors that predict IGD based on psychological factors and Internet gaming characteristics; Methods: Online surveys were conducted between 26 November and 26 December 2014. There were 3568 Korean Internet game users among a total of 5003 respondents. We identified 481 IGD gamers and 3087 normal Internet gamers, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria. Logistic regression analysis was applied to identify significant risk factors for IGD; Results: The following eight risk factors were found to be significantly associated with IGD: functional and dysfunctional impulsivity (odds ratio: 1.138), belief self-control (1.034), anxiety (1.086), pursuit of desired appetitive goals (1.105), money spent on gaming (1.005), weekday game time (1.081), offline community meeting attendance (2.060), and game community membership (1.393; p < 0.05 for all eight risk factors); Conclusions: These risk factors allow for the prediction and diagnosis of IGD. In the future, these risk factors could also be used to inform clinical services for IGD diagnosis and treatment.

Assessment of the Italian Version of the Internet Disorder Scale (IDS-15)

Much research has focused on the validation of psychometric tools assessing Internet addiction. One of the newest measures is the Internet Disorder Scale (IDS-15) based on the modified IGD criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This study aimed at investigating the psychometric properties of the Italian version of the IDS-15 by examining the construct and the concurrent and the criterion-related validity and by identifying the taxonomy and the patterns of Internet users. A sample of 471 participants (M_age = 24.72 years, SD = 8.66; 256 males) was recruited from secondary schools, universities, and gaming halls. Confirmatory factor analyses supported the four-dimensional second-order structure and the three levels of the measurement invariance across gender. The reliability and the validity of the scale were confirmed, and the LPAs provided four classes of Internet users on the basis of the scores obtained in all four dimensions of the scale. The psychometric robustness of the Italian version of the IDS-15 was clearly demonstrated. Cross-cultural research should expand and generalize the present findings.

Internet Gaming Disorder as a formative construct: Implications for conceptualization and measurement

Some people have serious problems controlling their Internet and video game use. The DSM-5 now includes a proposal for 'Internet Gaming Disorder' (IGD) as a condition in need of further study. Various studies aim to validate the proposed diagnostic criteria for IGD and multiple new scales have been introduced that cover the suggested criteria. Using a structured approach, we demonstrate that IGD might be better interpreted as a formative construct, as opposed to the current practice of conceptualizing it as a reflective construct. Incorrectly approaching a formative construct as a reflective one causes serious problems in scale development, including: (i) incorrect reliance on item-to-total scale correlation to exclude items and incorrectly relying on indices of inter-item reliability that do not fit the measurement model (e.g., Cronbach's α); (ii) incorrect interpretation of composite or mean scores that assume all items are equal in contributing value to a sum score; and (iii) biased estimation of model parameters in statistical models. We show that these issues are impacting current validation efforts through two recent examples. A reinterpretation of IGD as a formative construct has broad consequences for current validation efforts and provides opportunities to reanalyze existing data. We discuss three broad implications for current research: (i) composite latent constructs should be defined and used in models; (ii) item exclusion and selection should not rely on item-to-total scale correlations; and (iii) existing definitions of IGD should be enriched further.

The development and psychometric evaluation of the Internet Disorder Scale (IDS-15)

INTRODUCTION

Previously published research suggests that improvement in the assessment of Internet addiction (IA) is paramount in advancing the field. However, little has been done to address inconsistencies in the assessment of IA using a more updated framework. The aim of the present study was to develop a new instrument to assess IA based on a modification of the nine Internet Gaming Disorder (IGD) criteria as suggested by the American Psychiatric Association in the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and to provide a taxonomy of the potential risk of IA risk among participants.

METHODS

A heterogeneous sample of Internet users (n=1105) was recruited online (61.3% males, mean age 33years). Construct validity of the new instrument - Internet Disorder Scale (IDS-15) - was assessed by means of factorial, convergent, and discriminant validity. Criterion-related validity and reliability were also investigated. Additionally, latent profile analysis (LPA) was carried out to differentiate and characterize Internet users based on their potential IA risk.

RESULTS

The construct and criterion-related validity of the IDS-15 were both warranted. The IDS-15 proved to be a valid and reliable tool. Using the LPA, participants were classed as "low addiction risk" (n=183, 18.2%), "medium addiction risk" (n=456, 41.1%), and "high addiction risk" (n=455, 40.77%). Furthermore, key differences emerged among these classes in terms of age, relationship status, cigarette consumption, weekly Internet usage, age of Internet use initiation, and IDS-15 total scores.

CONCLUSIONS

The present findings support the viability of using adapted IGD criteria as a framework to assess IA.

Prevalence of Internet Addiction and Its Association With Psychological Distress and Coping Strategies Among University Students in Jordan

PURPOSE

The purpose of this study was to measure the prevalence of Internet addiction (IA) and its association with psychological distress and coping strategies among university students in Jordan.

DESIGN AND METHODS

A descriptive, cross-sectional, correlational design was used with a random sample of 587 university students in Jordan. The Perceived Stress Scale, Coping Behavior Inventory, and Internet Addiction Test were used.

FINDINGS

The prevalence of IA was 40%. IA was associated with high mental distress among the students. Students who used problem solving were more likely to experience a lower level of IA.

PRACTICE IMPLICATIONS

This study should raise awareness in nurses and other healthcare providers that IA is a potential problem for this population.

Characteristics and Psychiatric Symptoms of Internet Gaming Disorder among Adults Using Self-Reported DSM-5 Criteria

OBJECTIVE

The Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) proposed nine diagnostic criteria and five cut-point criteria for Internet Gaming Disorder (IGD). We aimed to examine the efficacy of such criteria.

METHODS

Adults (n=3041, men: 1824, women: 1217) who engaged in internet gaming within last 6 months completed a self-report online survey using the suggested wordings of the criteria in DSM-5. Major characteristics, gaming behavior, and psychiatric symptoms of IGD were analyzed using ANOVA, chi-square, and correlation analyses.

RESULTS

The sociodemographic variables were not statistically significant between the healthy controls and the risk group. Among the participants, 419 (13.8%) were identified and labeled as the IGD risk group. The IGD risk group scored significantly higher on all motivation subscales (p<0.001). The IGD risk group showed significantly higher scores than healthy controls in all nine psychiatric symptom dimensions, i.e., somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism (p<0.001).

CONCLUSION

The IGD risk group showed differential psychopathological manifestations according to DSM-5 IGD diagnostic criteria. Further studies are needed to evaluate the reliability and validity of the specific criteria, especially for developing screening instruments.

Reliability and Validity of the Behavioral Addiction Measure for Video Gaming

Most tests of video game addiction have weak construct validity and limited ability to correctly identify people in denial. The purpose of the present research was to investigate the reliability and validity of a new test of video game addiction (Behavioral Addiction Measure-Video Gaming [BAM-VG]) that was developed in part to address these deficiencies. Regular adult video gamers (n = 506) were recruited from a Canadian online panel and completed a survey containing three measures of excessive video gaming (BAM-VG; DSM-5 criteria for Internet Gaming Disorder [IGD]; and the IGD-20), as well as questions concerning extensiveness of video game involvement and self-report of problems associated with video gaming. One month later, they were reassessed for the purposes of establishing test-retest reliability. The BAM-VG demonstrated good internal consistency as well as 1 month test-retest reliability. Criterion-related validity was demonstrated by significant correlations with the following: time spent playing, self-identification of video game problems, and scores on other instruments designed to assess video game addiction (DSM-5 IGD, IGD-20). Consistent with the theory, principal component analysis identified two components underlying the BAM-VG that roughly correspond with impaired control and significant negative consequences deriving from this impaired control. Together with its excellent construct validity and other technical features, the BAM-VG represents a reliable and valid test of video game addiction.

Psychometrische Eigenschaften und Normierung der deutschen Version der Compulsive Internet Use Scale (CIUS)

Zusammenfassung. Die epidemiologische Beschreibung von Internetabhängigkeit und die Entwicklung von Interventionen erfordern eine reliable und ökonomische Erfassungsmethode von Internetabhängigkeit. Die Compulsive Internet Use Scale (CIUS) erfasst die Kernelemente von Internetabhängigkeit mit 14 Items, allerdings fehlten bisher bevölkerungsrepräsentative Normwerte für die deutsche Version der CIUS. In der vorliegenden Studie werden nun teststatistische Kennwerte und Normwerte für die deutsche Version der CIUS vorgelegt. 8 132 Personen aus der Allgemeinbevölkerung (14 – 64 Jahren) mit einer durchschnittlichen privaten Internetnutzung von einer Stunde oder länger, an mindestens einem Tag in der Woche oder am Wochenende beantworteten die CIUS. Insgesamt weist die CIUS gute psychometrische Eigenschaften auf und die vorgelegten Normwerte bieten die Möglichkeit für Vergleiche von individuellen Werten mit denen der internetnutzenden Bevölkerung.

Resting-state regional homogeneity as a biological marker for patients with Internet gaming disorder: A comparison with patients with alcohol use disorder and healthy controls

OBJECTIVE

Internet gaming disorder (IGD) shares core clinical features with other addictive disorders, such as gambling disorder and substance use disorder. Designation of IGD as a formal disorder requires elucidation of its neurobiological features and comparison of these with those of other addictive disorders. The aims of the present study were to identify the neurobiological features of the resting-state brain of patients with IGD, alcohol use disorder (AUD), and healthy controls, and to examine brain regions related to the clinical characteristics of IGD.

METHOD

Functional magnetic resonance imaging was performed on 16 subjects with IGD, 14 subjects with AUD, and 15 healthy controls during the resting-state. We computed regional homogeneity (ReHo) measures to identify intrinsic local connectivity and to explore associations with clinical status and impulsivity.

RESULTS

We found significantly increased ReHo in the posterior cingulate cortex (PCC) of the IGD and AUD groups, and decreased ReHo in the right superior temporal gyrus (STG) of those with IGD, compared with the AUD and HC groups. We also found decreased ReHo in the anterior cingulate cortex of patients with AUD. Scores on Internet addiction severity were positively correlated with ReHo in the medial frontal cortex, precuneus/PCC, and left inferior temporal cortex (ITC) among those with IGD. Furthermore, impulsivity scores were negatively correlated with that in the left ITC in individuals with IGD.

CONCLUSION

Our results provide evidence of distinctive functional changes in the resting-state of patients with IGD and demonstrate that increased ReHo in the PCC may be a common neurobiological feature of IGD and AUD and that reduced ReHo in the STG may be a candidate neurobiological marker for IGD, differentiating individuals with this disorder from those with AUD and healthy controls.

Factor Structure of the Internet Addiction Test in Online Gamers and Poker Players

BACKGROUND

The Internet Addiction Test (IAT) is the most widely used questionnaire to screen for problematic Internet use. Nevertheless, its factorial structure is still debated, which complicates comparisons among existing studies. Most previous studies were performed with students or community samples despite the probability of there being more problematic Internet use among users of specific applications, such as online gaming or gambling.

OBJECTIVE

To assess the factorial structure of a modified version of the IAT that addresses specific applications, such as video games and online poker.

METHODS

Two adult samples-one sample of Internet gamers (n=920) and one sample of online poker players (n=214)-were recruited and completed an online version of the modified IAT. Both samples were split into two subsamples. Two principal component analyses (PCAs) followed by two confirmatory factor analyses (CFAs) were run separately.

RESULTS

The results of principal component analysis indicated that a one-factor model fit the data well across both samples. In consideration of the weakness of some IAT items, a 17-item modified version of the IAT was proposed.

CONCLUSIONS

This study assessed, for the first time, the factorial structure of a modified version of an Internet-administered IAT on a sample of Internet gamers and a sample of online poker players. The scale seems appropriate for the assessment of such online behaviors. Further studies on the modified 17-item IAT version are needed.

The factor structure of the internet addiction tool with university students in Jordan

Internet addiction is a growing phenomenon affecting people in varying ways around the globe. This study examined the factor structure and internal reliability of the Internet Addiction Test (IAT) with a heterogeneous sample of university students in Jordan. The study used a cross-sectional design, and all the questionnaires were completed in classrooms. A sample of 587 students from seven universities in Jordan was obtained. The exploratory and confirmatory factor analyses of the 20-item IAT revealed that a four-factor solution offered the most parsimonious explanation of the data. The IAT reliably assesses distinct domains of Internet addiction. These domains are Excessive Use, Loss/Suffer, Attached To, and Impaired Social Relations. Thus, it is recommended to use the obtained four factors when assessing Internet addiction among a similar population.

Similarities and differences among Internet gaming disorder, gambling disorder and alcohol use disorder: a focus on impulsivity and compulsivity

BACKGROUND AND AIMS

The aim of the present study was to test the impulsivities and compulsivities of behavioral addictions, including Internet gaming disorder (IGD) and gambling disorder (GD), by directly comparing them with alcohol use disorder (AUD) and a healthy control (HC) group.

METHODS

We enrolled male patients who were diagnosed with IGD, GD or AUD, with 15 patients per group, as well as 15 HCs. Trait impulsivity was measured using the Barratt Impulsiveness Scale version 11 (BIS-11). The stop-signal test (SST) from the Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess the patients’ abilities to inhibit prepotent responses. Compulsivity was measured using the intra–extra dimensional set shift (IED) test from the CANTAB. The Trail Making Test (TMT) was also used in this study.

RESULTS

The IGD and AUD groups scored significantly higher on the BIS-11 as a whole than did the HC group (p = 0.001 and p = 0.001, respectively). The IGD and AUD groups also scored significantly higher on the BIS-11 as a whole than did the GD group (p = 0.006 and p = 0.001, respectively). In addition, the GDgroup made significantly more errors (p = 0.017 and p = 0.022, respectively) and more individuals failed to achieve criterion on the IED test compared with the IGD and HC groups (p = 0.018 and p = 0.017, respectively). Discussion: These findings may aid in the understanding of not only the differences in categorical aspects between individuals with IGD and GD but also in impulsivity–compulsivity dimensional domains.

CONCLUSION

Additional studies are needed to elucidate the neurocognitive characteristics of behavioral addictive disorders in terms of impulsivity and compulsivity.

Video game addiction in gambling disorder: clinical, psychopathological, and personality correlates

OBJECTIVE

We studied the prevalences of video game use (VGU) and addiction (VGA) in gambling disorder (GD) patients and compared them with subjects with non-video game use (non-VGU) in relation to their gambling behavior, psychopathology, and personality characteristics.

METHOD

A sample of 193 GD patients (121 non-VGU, 43 VGU, and 29 VGA) consecutively admitted to our pathological gambling unit participated in the study. Assessment. Measures included the video game dependency test (VDT), symptom checklist-90-revised, and the temperament and character inventory-revised, as well as a number of other GD indices.

RESULTS

In GD, the observed prevalence of VG (use or addiction) was 37.3% (95% CI :30.7% ÷ 44.3),VGU 22.3% (95% CI :17.0% ÷ 28.7), and VGA 15% (95% CI :10.7% ÷ 20.7). Orthogonal polynomial contrast into logistic regression showed positive linear trends for VG level and GD severity and other measures of general psychopathology. After structural equation modeling, higher VG total scores were associated with younger age, general psychopathology, and specific personality traits, but not with GD severity. Patients' sex and age were involved in the mediational pathways between personality traits and VG impairment.

CONCLUSIONS

GD patients with VG are younger and present more dysfunctional personality traits, and more general psychopathology. The presence of VG did not affect the severity of GD.