Excessive and pathological Internet use - Risk-behavior or psychopathology?

Exploring the relationship between media use and depressive symptoms among gender diverse youth: findings of the Mental Health Days Study

BACKGROUND

Over the past decades, media use has become a key aspect of young people's daily lives, significantly shaping their social interactions, learning processes, and recreational pursuits. At the same time, healthcare professionals and researchers are increasingly concerned about the impact of media use on young people's mental health. This concern is particularly relevant for gender diverse youth who may have distinct experiences with media that could impact their mental health uniquely compared to their peers, such as increased exposure to cyberbullying and negative content regarding their gender identity. This study aims to explore the associations between media use and depressive symptoms among youth and examine if gender moderates this association.

METHODS

This study utilized a cross-sectional design involving a school-based sample of 8158 participants (Mage = 14.05 years, SD = 2.45, Ndiverse = 144) from Austria. Participants completed a survey assessing their media use and depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Media use was measured by asking participants to report their daily usage in hours and minutes across various categories, including smartphone use, streaming services, social networks, and other media types. Multiple regression analyses were conducted to examine relationships between different forms of media use and depressive symptoms. Moderation analyses were performed using the PROCESS macro for SPSS to explore the role of gender.

RESULTS

For gender diverse youth, multiple regression analysis identified streaming services (β = 0.265, p = .005) and social networks (β = 0.189, p = .037) as significant predictors of depressive symptoms in gender diverse youth. Moderation analyses conducted with the entire sample showed that gender moderates the relationship between depressive symptoms and smartphone use (B = - 0.008, p = .014), with the effect being the most negative for gender diverse individuals.

CONCLUSION

The findings underscore the complex relationship between media use and depressive symptoms among gender diverse youth, emphasizing the moderating role of gender. These results underline the need for gender-sensitive approaches in media literacy and mental health interventions. Stakeholders should be aware of risks and benefits of different media types to foster healthy media engagement.

Relationship between Problematic Internet Use and Depression in Young Latin American College Students

(1) Problematic Internet use (PIU) in young people is a topic of great interest both in the field of addictions and mental health, but scientific evidence is limited in Latin America. The aim was to analyze the relationship between PIU and depression in Latin American college students. (2) Methods: The sample consisted of 1828 college students (63.7% women), aged between 18-30 years (M = 21.64 years). (3) Results: PIU was detected in 40.2% of cases, and severe or moderately severe depression in 31.7%. Rates of severe depression in students with PIU were 3.02 times higher than in those without PIU (χ2(3) = 168.443; p < 0.000). The presence of PIU was also statistically significantly higher among youth with depressive symptoms. Linear and logistic regression models for predicting PIU, show how the depression level constitutes a risk factor for PIU: seven times higher for severe depression; more than five times higher for moderate depression; and more than two times for mild depression. (4) Conclusions: There is a clear association between depression and PIU, suggesting that a higher level of depression would act as a predictor of PIU. However, this finding is exploratory. Future studies should clarify the directionality of the relationship between both variables.

Risk-taking and self-harm behaviors as markers of adolescent borderline personality disorder

Adolescence is a critical period for early identification and intervention of borderline personality disorder (BPD). Risk-taking and self-harm behaviors (RSB) have been identified as promising early markers of BPD and correlates of depression in school-based samples. The present study aimed, first, to examine the association between RSB and BPD in a clinical sample of adolescents and, second, to examine whether RSB are also linked to depression. N = 405 participants (82.7% female) were recruited from an outpatient clinic for adolescents with RSB. RSB assessed included truancy, excessive media use, alcohol, tobacco, and illicit drug use, sexual risk-taking, and self-harm behavior. Regression analyses and generalized linear models were performed to examine the associations between individual RSB or patterns of RSB (identified using latent class analysis, LCA) and a diagnosis and severity of BPD or depression. All RSB (except excessive media use) were positively associated with BPD diagnosis and severity. In contrast, only non-suicidal self-injury (NSSI) and suicide attempts were positively associated with depression diagnosis and severity, while illicit drug use was negatively associated with depression severity. The LCA yielded two classes differing in the occurrence of RSB. The high RSB class was more likely to have a BPD diagnosis and greater BPD severity than the low RSB class. Classes did not differ regarding depression diagnosis or severity. As NSSI and suicide attempts were associated with both BPD and depression, the presence of additional RSB, besides self-harm behavior, may represent a specific risk marker for BPD in adolescents.

[Anxiety and depression in adolescents]

Anxiety and depression among young people had already increased in the years before the COVID-19 pandemic and then experienced a significant increase again during the pandemic. In this article the different clinical forms of expression of these emotional syndromes are presented in detail and the developmental paths of a combination of both disorders are also explained. Even subclinical forms of anxiety and depression already have clear clinical implications and impair the developmental tasks of adolescence. The "avolitional depression" (depression with severe drive disorders) is mentioned as a special form. Pathogenetic building blocks-from genetic vulnerability to psychosocial stressors-come up for discussion in light of the fact that anxiety and depression are about twice as common in adolescent females as in males. The embedding of the disorders in current events shows the special importance of the self-reflective emotion of shame in the adolescent development process. The scarcity and dysfunctionality of emotional dialogue between significant caregivers and children must be cautioned against. Its role in adolescents' self-regulation and affect regulation should not be underestimated. Finally, an overview of the most important therapeutic measures for anxiety and depression in adolescence is presented.

Video games and disability-a risk and benefit analysis

Purpose

Over the past decades, video games have become a substantial part of the entertainment industry. While ubiquitous, video game participation remains low among people with disabilities amid potential negative effects. This article analyzes the risks and benefits that video games may present to individuals with disabilities.

Methodology

In this conceptual article, we explored the literature pertaining to video games and disability. To better understand the impact of video games on individuals with disabilities, we focused on the unique features of video games through the lens of the Self-Determination Theory.

Findings

Our findings show that individuals with disabilities are most at risk from excessive video game use, leading to increased aggression, sedentary behavior, and negative impact on academic performance. Identified benefits include promoting physical rehabilitation and psychological well-being, improving cognitive abilities and emotional regulation, and utility in promoting exercises, and managing chronic pain.

Originality

This article presents a number of strategies and resources to help guide individuals with disabilities, educators, practitioners, and researchers in maximizing the benefits of video games while controlling the risks.

Social media addiction, escapism and coping strategies are associated with the problematic internet use of adolescents in Türkiye: a multi-center study

Introduction

The literature highlighted that problematic internet use can have detrimental consequences on individuals' well-being. Social media addiction, escapism and coping skills are closely related to problematic internet use. However, no study has currently examined the relationship between problematic internet use and social media use, escapism and coping skills.

Method

This multicenter cross-sectional designed study evaluated the relationships between problematic internet use and social media addiction, escapism, and coping skills in 508 adolescents (319 female) aged 14-18 years. In order to collect data, sociodemographic data form, Internet Addiction Scale, Social Media Addiction Scale, Escapism Scale and Kidcope Adolescent Version have been used. First, adolescents who scored ≥50 on the Internet Addiction Test were classified as the problematic internet use group; adolescents who scored <50 were classified as the control group. Then, the relationships between problematic internet use and social media addiction, escapism and coping skills were evaluated.

Results

The results showed that problematic internet use was associated with duration of social media use, impairment in social media-related functionality, preferring virtual life, and virtual pleasure, escapism, avoidant and negative coping strategies.

Conclusion

These findings may provide an empirical basis for problematic internet use prevention and intervention in adolescence.

The effects of self-esteem and parental phubbing on adolescent internet addiction and the moderating role of the classroom environment: a hierarchical linear model analysis

BACKGROUND

With the advent of the new media era, the understanding of adolescent internet addiction needs to be enriched. It is also necessary to distinguish the related factors of adolescent internet addiction at different levels to clarify the mechanisms of this phenomenon.

METHODS

This study used hierarchical linear model analysis to explore the effects of student-level factors and school-level factors on adolescent internet addiction, along with cross-level moderating effects. A total of 1,912 students between the 4th and 8th grades in China participated in the study. Participants completed the Self-Esteem Scale, Parents Phubbing Scale, Classroom Environment Scale, and the Diagnostic Questionnaire of Internet Addiction.

RESULTS

Correlational analyses revealed that internet addiction was found to be negatively correlated with both self-esteem and the teacher-student relationship (p < 0.01), while father phubbing, mother phubbing, and learning burden were shown to positively correlate with internet addiction (p < 0.01). Hierarchical linear model analysis suggested that student-level variables, including self-esteem, and mother phubbing, were significant predictors of internet addiction (β = -0.077, p < 0.001 and β = 0.028, p < 0.01, respectively). At the school level, learning burden significantly and negatively predicted internet addiction (β = 0.073, p < 0.05). Furthermore, the relationship between self-esteem and internet addiction was significantly moderated by learning burden (β = -0.007, p < 0.05). Meanwhile, the teacher-student relationship also had a significant moderating effect on the association between mother phubbing and internet addiction (β = -0.005, p < 0.01).

CONCLUSIONS

This study revealed the relationships between self-esteem, parental phubbing, and classroom environment with adolescent internet addiction, and these findings could provide insights into reducing adolescent internet addiction from the perspective of individuals, families, and schools.

The Mediating Role of Procrastination in the Relationship between Fear of Missing Out and Internet Addiction in University Students

This study aims to examine the potential mediating role of procrastination in the relationship between fear of missing out and internet addiction. Employing a cross-sectional research design, this study utilized a paper-pencil form to collect data from 315 students (65.4% undergraduate and 66.3% females) between 18 and 32 (Mage = 22.43; SD = 3.81) studying at a state university in Türkiye. Data were collected through the convenience sampling method. The study was designed as a survey model. This design was tested via mediation analysis. The participants completed self-report assessments using the Fear of Missing Out Scale (FoMOs), General Procrastination Scale (GPS-9), and Young Internet Addiction Scale (short form). The findings showed that FoMO had a significant positive direct effect on both procrastination (R2 = 0.13) and internet addiction (R2 = 0.33). Procrastination also had a significant positive direct effect on internet addiction (R2 = 0.34). Additionally, procrastination mediated the relationship between the fear of missing out and internet addiction (β = 0.156, p < 0.001). These findings not only extend the scope of existing research but also hold practical implications for the development of sustainable interventions. It is believed that the findings will contribute to the consideration of procrastination when preparing psychoeducation or group guidance programs for internet addiction. These interventions can effectively address the process through which fear of missing out leads to internet addiction by considering the significant role of procrastination in students. Findings typically suggest that procrastination behavior is a key factor in explaining the association between FoMO and internet addiction.

Media Influences on Children and Advice for Parents to Reduce Harmful Exposure to Firearm Violence in Media

Firearm violence is now the leading cause of youth fatalities in the United States. This article outlines the various ways that entertainment media glorify the use of firearms and how this content can influence youth interest and use of guns. Social media are also increasingly serving as a source of risk for exposure to firearms. Counseling parents about the impact of media exposure to firearms on their children's health, and how to mitigate these risks, can be effective in promoting their children's health and safety.

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.

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

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

Hyperfocus symptom and internet addiction in individuals with attention-deficit/hyperactivity disorder trait

Background

Hyperfocus symptom is the intense concentration on a certain object. It is a common but often overlooked symptom in those with attention-deficit/hyperactivity disorder (ADHD). Hyperfocus disrupts attention control and results in a focus on inappropriate behaviors. It allows individuals to focus on internet use and make them use internet excessively. This excessive internet use can lead to an addiction. This study investigated the status of IA and hyperfocus, the mediation effect of hyperfocus in relation to IA, and the relationship between ADHD subtypes and hyperfocus in those with ADHD symptoms.

Methods

This web-based cross-sectional study included 3,500 Japanese adults who completed internet-based questionnaires, which included the Adult ADHD Self-Report Scale (ASRS), Internet Addiction Test (IAT), and Hyperfocus Scale (HFS) to assess ADHD symptoms, internet dependence, and hyperfocus symptoms, respectively. The mediating role of HFS in the relationship between ASRS and IAT was assessed by mediation analysis. To analyze the relationship between hyperfocus symptoms and ADHD subtypes, we compared the correlation of HFS with the Inattention and Hyperactive Scores of ASRS.

Results

ADHD traits were associated with higher IAT scores (p &lt; 0.001) and higher HFS scores (p &lt; 0.001). Mediation analysis and bootstrap testing showed that HFS significantly mediated the association between ASRS and IAT. Analyses of ADHD subtypes demonstrated that HFS was significantly correlated with the Inattention (R = 0.597, p &lt; 0.001) and Hyperactive (R = 0.523, p &lt; 0.001) Scores. The correlation between HFS and the Inattention Score was significantly higher than that between HFS and the Hyperactive Score (p &lt; 0.001).

Conclusion

Our findings suggest that hyperfocus may play an important role in addictive behavior in ADHD as a manifestation of attentional control malfunction.

Longitudinal Effects of Screen Time on Depressive Symptoms among Swedish Adolescents: The Moderating and Mediating Role of Coping Engagement Behavior

Studies suggest that hourly digital screen time increases adolescents' depressive symptoms and emotional regulation difficulties. However, causal mechanisms behind such associations remain unclear. We hypothesized that problem-focused and/or emotion-focused engagement coping moderates and possibly mediates this association over time. Questionnaire data were collected in three waves from a representative sample of Swedish adolescents (0, 3 and 12 months; n = 4793; 51% boys; 99% aged 13-15). Generalized Estimating Equations estimated the main effects and moderation effects, and structural regression estimated the mediation pathways. The results showed that problem-focused coping had a main effect on future depression (b = 0.030; p < 0.001) and moderated the effect of screen time (b = 0.009; p < 0.01). The effect size of this moderation was maximum 3.4 BDI-II scores. The mediation results corroborated the finding that future depression was only indirectly correlated with baseline screen time, conditional upon intermittent problem-coping interference (C'-path: Std. beta = 0.001; p = 0.018). The data did not support direct effects, emotion-focused coping effects, or reversed causality. We conclude that hourly screen time can increase depressive symptoms in adolescent populations through interferences with problem-focused coping and other emotional regulation behaviors. Preventive programs could target coping interferences to improve public health. We discuss psychological models of why screen time may interfere with coping, including displacement effects and echo chamber phenomena.

Has the "Double Reduction" policy relieved stress? A follow-up study on Chinese adolescents

PURPOSE

"Double Reduction" Policy requires schools to reduce the burden of excessive homework and off-campus training for Chinese students to reduce their academic stress and promote mental health. We conducted a study in compulsory education students before and after the "Double Reduction" Policy to explore changes in mental health problems and relevant influential factors.

METHODS

A total of 28,398 elementary and junior high school students completed both waves of the survey through electronic questionnaires. Depressive symptoms were assessed using the Patient Heath Questionnaire (PHQ-9), and anxiety symptoms were assessed using the Generalized Anxiety Disorder Scale (GDA-7). Demographic information was evaluated at baseline, and "Double Reduction" related factors and negative life events were measured at follow up.

RESULTS

The overall depression and anxiety levels significantly decreased after the "Double Reduction" Policy. Girls, poor parental marital quality, chronic physical illness, and psychiatric family history were related to increased occurrence of mental health. Sleep duration > 8 h/night, reduced homework, more extracurricular activities more time with parents, and reduced academic stress were protective factors against mental health problems.

CONCLUSIONS

The "Double Reduction" Policy has improved the mental health symptoms of students to a certain extent. Appropriately increasing sleep time, participating in more extracurricular activities and parental involvement, and reducing the burden of homework are effective ways to promote the development of students' mental health.

Study protocol for a randomised controlled trial of an e-health stepped care approach for the treatment of internet use disorders versus a placebo condition: the SCAPIT study

INTRODUCTION

Excessive internet use can lead to problems for some individuals. The WHO has introduced Gaming Disorder in the International Classification of Diseases-11 (ICD-11). Previous research has shown that other internet applications can cause serious mental health problems as well. It is important to provide measures of prevention, early intervention and therapy for internet use disorders (IUDs).

METHODS AND ANALYSIS

The study 'Stepped Care Approach for Problematic Internet use Treatment' is a randomised, two-arm, parallel-group, observer-blind trial. The aim of the study is to investigate if a stepped care approach is effective to reduce symptom severity for IUD. The sample is primarily recruited online with a focus on employees in companies with support of health insurances. After screening, the stepped care approach depends on the success of the previous step-that is, the successful reduction of criteria-and comprise: (1) app-intervention with questionnaires and feedback, (2) two telephone counsellings (duration: 50 min) based on motivational interviewing, (3) online therapy over 17 weeks (15 weekly group sessions, eight individual sessions) based on cognitive-behavioural therapy. A follow-up is conducted after 6 months. A total of 860 participants will be randomised. Hierarchical testing procedure is used to test the coprimary endpoints number of Diagnostic and Statistical Manual of Mental Disorders, fifth edition and ICD-11 criteria. Primary analysis will be performed with a sequential logit model.

ETHICS AND DISSEMINATION

The study has been approved by the Ethics Committees of the Universities of Lübeck (file number: 21-068), Mainz (file number: 2021-15907) and Berlin (file number: 015.2021). Results will be reported in accordance to the CONSORT statement. If the approach is superior to the control condition, it may serve as part of treatment for IUD.

TRIAL REGISTRATION NUMBER

DRKS00025994.

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

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