Affective and cognitive processes involved in behavioral addictions

Symptoms and functional impairments in patients with Internet Use Disorders participating in an online short-term therapy

BACKGROUND

Internet use disorders (IUD) have been recognized as a serious mental health concern. In order to promote consensus on core features of IUD, further studies involving clinical samples are required.

AIMS

A clinical evaluation of patients with IUD was conducted as part of the scientific monitoring of a novel online short-term therapy, embedded in the randomized controlled trial Stepped Care Approach for Problematic Internet use Treatment (SCAPIT; ID: DRKS00025994).

METHODS

An online diagnostic and a clinical assessment were performed at the baseline measurement of the online intervention. The self-report version of the Assessment of Internet and Computer Game Addiction (AICA-S) was applied to assess symptom severity of IUD. The impact of psychopathological symptoms and impairments of functioning on IUD symptomatology was examined in the sample of patients. Based on a dichotomous classification of the symptom severity of IUD, differences among participants presenting moderate compared to severe addictive Internet behavior were analyzed.

RESULTS

The sample of this an analysis consisted of 57 patients (57.9% males, mean age of 29.12 years) participating in the online short-term therapy for IUD. Based on the AICA-S sum score (M = 11.60; SD = 3.30) participants exhibited moderate (n = 44; 77.2%) to severe (n = 13; 22.8%) symptoms of addictive Internet use. Psychopathological symptoms and impairments of psychosocial functioning had an effect on symptom severity of IUD. Participants with severe symptoms of IUD showed higher psychopathological strains compared to patients with moderate addictive Internet behavior.

CONCLUSIONS

The clinical evaluation of patients participating in a novel online short-term therapy for IUD indicated that psychopathological symptoms and impairments of functioning have an impact on addictive Internet behaviors and consequently, need to be addressed in the treatment of IUD. Based on the results, further implications for clinical practice and research on addictive Internet behavior are derived.

Early maladaptive schemas and addictive behaviours: A systematic review and meta-analysis

BACKGROUND

Recently, early maladaptive schemas have been increasingly focused as the underlying factor of several psychopathologies. The primary objective is to systematically review and meta-analytically analyse the evidence on the relationship between early maladaptive schemas and types of addictive behaviours. Additionally, the secondary objective was to examine potential moderators of the effect sizes.

METHODS

The systematic search was conducted on three databases including 'Scopus', 'Web of Science' and 'PubMed'. They were searched for quantitative studies investigating the relationship between early maladaptive schemas and addictive behaviours. The studies that were non-English and had insufficient information to calculate effect sizes were excluded. The random-effect model was utilized to estimate the pool effect sizes, and the meta-regression was used for moderation analysis.

RESULTS

Thirty-three studies with 12,577 participants were included for analyses. Most of included studies were conducted in the United States (k = 12, 36.36%). The mean ages of participants varied from 13.32 to 46.09 years. The findings indicated that all of early maladaptive schemas and schema domains positively correlated with addictive behaviours. The disconnection and rejection, impaired limits and impaired autonomy were the domains with the highest association with substance addictions (pool r = 0.338, 3.26 and 3.16, respectively). Furthermore, disconnection and rejection and impaired autonomy were the schema domains with the highest association with behavioural addictions (0.310 and 0.304, respectively). The moderation analysis demonstrated that study design was the factor affecting the effect sizes between schema domain and addictive behaviours.

LIMITATION

All included studies were from peer-reviewed journals in English. Moreover, the number of research examining the relationship between early maladaptive schemas and behavioural addictions was limited.

CONCLUSION

The findings provide evidence supporting the idea that substance addictions and behavioural addictions have shared risk factors, supporting the validity of the schema model, which can be applied for targeting and preventing addictive behaviours.

Emotion dysregulation factors associated with problematic smartphone use severity: The mediating role of fear of missing out

Based on current theoretical frameworks, there has been increasing research examining psychopathology leading to problematic smartphone use (PSU). However, less is known about the affective and cognitive processes linked to PSU. The present study aimed at analyzing the fear of missing out (FoMO) as a mediator in the association between emotion dysregulation and PSU severity. Participants were 343 U.S. undergraduate students (64.7  % female, Mage = 19.3, SD = 2.51) who completed online measures of emotion dysregulation, FoMO and PSU. A fully latent structural equation model was analyzed. Results indicate greater impulse control dysregulation was associated with heightened PSU via increased FoMO. Our findings present evidence suggesting emotion dysregulation and FoMO as affective and cognitive mechanisms associated with PSU, with FoMO serving a mediating role between impulse control and PSU severity. Clinical implications are discussed.

Impaired Control Over Gaming Scale (ICOGS): Development, confirmatory factor validation, and psychometric evaluation

Background and aims

The concept of impaired control is central to addictive disorders, including gaming disorder in the DSM-5 and ICD-11. Impaired control refers to the recurrent inability to resist impulses to engage in certain activities or behaviours and the failure to limit or stop this engagement. Although numerous screening tools for gaming disorder symptoms have been developed, these instruments have limited capacity for measuring the nature and extent of impaired control. To address this limitation, the present study reports on the creation of the Impaired Control Over Gaming Scale (ICOGS), an 8-item screening tool to assess gaming-related impaired control.

Methods

A total of 513 gamers, including 125 gamers (24.3%) who met the DSM-5 criteria for gaming disorder, were recruited from Prolific, an online crowd-sourcing platform.

Results

The ICOGS demonstrated promising psychometric properties. Exploratory and confirmatory factor analysis using two samples provided robust support for a 2-factor model and high internal consistency of the scale. ICOGS scores were significantly and positively associated with gaming disorder symptoms, gaming-related harms, gaming frequency, psychological distress, and neuroticism. Using receiver operating characteristic analysis, the ICOGS differentiated between non-problem gamers and those who met the criteria for GD.

Discussion and conclusions

Overall, the ICOGS appears to be a valid and reliable scale for use in studies of problem gaming, and may be useful for assessing outcomes of GD interventions that employ self-regulation and stopping techniques to reduce or eliminate problem gaming behavior.

Concept of Affective Dependence and Validation of an Affective Dependence Scale

Background

There is a degree of affective interdependence that is considered normal and only becomes pathological if it causes excessive suffering, both for the subject and for those close to them. Our objective was to introduce and psychometrically validate a short and effective affective dependency scale, the Affective Dependence Scale (ADS-9).

Methods

We used a sample of 762 participants (clinical: emotional dependent subjects n = 212, comparison: non-emotionally-dependent addicted subjects n = 272, and general population n = 278) to assess the factor structure, the psychological construct validity and the measurement invariance for the ADS-9 by means of independent exploratory factor analyses for each sample group and subsequent multigroup confirmatory factor analyses.

Results

Our results confirm that ADS-9 is a psychometrically consistent instrument, with construct and clinical validity, as well as configural, metric and scalar invariance across different sample groups (clinical, comparison and general population). A hypothesized two-dimensional structure was confirmed by means of factor analyses. Both sub-scales of this abbreviated form, Submission and Craving, showed a good agreement with the previously validated Relationships and Sentimental Dependencies Inventory (IRIDS-100).

Conclusion

The ADS-9 is a brief instrument that appears to reliably detect the dependent and pathological components of affective dependence. It consists of two sub-scales, describing Submission (adaptation, accommodation, and subjugation) and Craving (imperative need for the other with the presence of disturbing states). We suggest that it is a versatile scale that may be useful for clinicians and researchers.

How Theoretical Models Can Inspire Advances in Research and Clinical Practice: The Example of Behavioral Addictions

Abstract. Aims: In this narrative position paper, we will summarize some examples of theoretical models of behavioral addictions. We will then make some suggestions for how theoretical models may inspire both research and clinical practice in the context of behavioral addictions. Results: Current theoretical models typically distinguish between general and specific risk factors. It is commonly argued that based on conditioning processes, affective responses to specific stimuli (cue-reactivity and craving) develop within the course of behavioral addictions. Diminished control over the behavior is reflected in reductions in inhibitory control and executive functioning. Cognitive distortions, attentional biases, and behavior-related expectancies are also considerable mechanisms. Theoretical models have been used to inspire advances not only in research but also in clinical practice. For example, theoretical models have inspired the development of standardized treatment protocols. Conclusions: If theoretical models contributed more consistently to scientific studies, a better understanding of the processes underlying specific mental disorders could be facilitated, which could then promote updates and modifications of the theoretical models and improvements in clinical practice. Close connections and stimulating discussions between theorists and therapists are very important and beneficial for advances over time.

Regulation/Non-Regulation/Dys-Regulation of Health Behavior, Psychological Reactance, and Health of University Undergraduate Students

The Self-Regulation vs. External-Regulation Theory (2017) has postulated a continuum of regulation/non-regulation/dys-regulation that is present both in the individual and in the individual’s context. This gives rise to a behavioral heuristic that can predict and explain other health-related variables, such as psychological reactance and student health. On a voluntary basis, 269 university students completed validated questionnaires on variables of regulation, reactance and health. Using an ex post facto design, we performed correlational analysis and structural linear regression to build a structural equations model (SEM) with acceptable statistical values. The results showed various predicted relationships: self-regulation was associated with and positively predicted self-regulated health behavior; external health-regulating contexts were associated with and positively predicted self-regulated health behavior; non-regulatory and dysregulatory contexts negatively predicted self-regulated health behavior and students’ health itself, as well as positively predicting psychological reactance behavior. Implications are established for explaining variability in general and health-related self-regulation, as well as for intervening in these variables in health programs.