New developments in brain research of internet and gaming disorder

Effect of Screen Time and Sugar Consumption Reduction on Sleep Bruxism in Children: A Randomised Clinical Trial

OBJECTIVE

Sleep bruxism (SB) is associated with alterations in dopamine and serotonin, which are related to increased consumption of added sugar and overuse of screens. The aim of this study was to compare the effect of the interventions 'Food, Fun and Family' (FFF) and Counselling and Education (CE) on the frequency of SB in children.

METHODS

A randomised clinical trial was conducted. Forty-eight participants aged between 4 and 8 years, attending the paediatric clinics of Universidad CES (Colombia) and Hospital Elina de la Serna (Argentina) participated in the study. Subjects were randomised into the FFF (experimental) and CE (regular intervention) groups. The frequency of SB was reported with the Children's Sleep Habits Questionnaire (CSHQ), the consumption of added sugar from items with the HBSC-FFQ and the time of use of screens through a diary in baseline (before starting the intervention), at Week 6 and Week 12. Data were analysed with Kruskal-Wallis test followed by Dunn's post hoc, Mann-Whitney test, a linear mixed model and logistic ordinal regression analyses.

RESULTS

The FFF group had a more significant reduction in consumption of added sugar and screen time compared to the CE group (p < 0.05), especially from Week 6 to baseline. Regression analysis showed that reducing TV watching and consumption of added sugar were associated with a decrease in SB frequency, especially in the FFF group (OR < 1, p < 0.05), and the results were consistent across different study environments.

CONCLUSION

The FFF intervention was more effective in reducing the screen time and sugar consumption and thus decreased the frequency of SB, when compared with the CE intervention.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT05310162.

The impact of screen time and social media on youth self-harm behaviour and suicide: A protocol for a systematic reviews

INTRODUCTION

Social media, gaming, and other types of screen time have been associated with a number of child and adolescent mental health concerns, including NSSI, suicidal ideation, suicide attempts and suicides. However, findings have been complicated by a quickly changing technological landscape and the COVID-19 pandemic. Inconsistent findings may be related to the dissimilar impacts of different screen time types on different age groups. The aim of this systematic review is to explore the pattern of impact of different screen time types on children and adolescents, investigating age groups of particular risk, and synthesising outcomes, recommendations, and strategies described to inform future studies and guidelines.

METHODS AND ANALYSIS

A systematic review will be conducted of all study types, and reported using the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) guidelines. The following databases will be searched for relevant publications: CINAHL, PubMed, Embase, PsycINFO, PsychArticles, Scopus, and Web of Science. Searches will be limited by language (English). Article selection, quality evaluation, and data extraction will be conducted independently by two reviewers. Quality assessment will be conducted using Joanna Briggs Institute (JBI) checklists for the appropriate study type.

ETHICS AND DISSEMINATION

Ethics approval is not required since we are not using patient data. Findings will be published in a peer-reviewed journal article, and disseminated via conference presentations.

PROSPERO REGISTRATION NUMBER

CRD42023493058.

Scoping review of withdrawal's role in contemporary gaming disorder research: Conceptualizations and operationalizations

The global gaming community now exceeds 3 billion players, prompting increased attention from social and medical sciences regarding gaming-related disorders. Internet Gaming Disorder (IGD) was incorporated into DSM-5 in 2013, and Gaming Disorder (GD) found its place in ICD-11 in 2019. A contentious criterion in IGD, not present in GD, revolves around withdrawal symptoms. This paper offers a theoretical foundation on gaming withdrawal symptoms in gaming-related disorders and conducts a scoping review of withdrawal operationalization and conceptualization in 40 selected studies, following PRISMA-ScR guidelines. Most studies employed a correlation framework, relying on convenience samples and self-assessment questionnaires. A smaller portion focused on clinical samples and case studies. Withdrawal was predominantly conceptualized in terms of affective components, with less emphasis on behavioural, cognitive, physical, or neurological aspects. The prevailing terminology for gaming-related disorders was IGD, with only three studies referencing GD as defined in ICD-11. Notably, just six experimental studies included abstinence control. We advocate for an expansion of research on withdrawal symptoms, particularly through experimental studies that implement abstinence within experimental groups and offer alternative operationalizations beyond dominant self-assessment measures.

Connectivity in the Dorsal Visual Stream Is Enhanced in Action Video Game Players

Action video games foster competitive environments that demand rapid spatial navigation and decision-making. Action video gamers often exhibit faster response times and slightly improved accuracy in vision-based sensorimotor tasks. Background/Objectives: However, the underlying functional and structural changes in the two visual streams of the brain that may be contributing to these cognitive improvements have been unclear. Methods: Using functional and diffusion MRI data, this study investigated the differences in connectivity between gamers who play action video games and nongamers in the dorsal and ventral visual streams. Results: We found that action video gamers have enhanced functional and structural connectivity, especially in the dorsal visual stream. Specifically, there is heightened functional connectivity-both undirected and directed-between the left superior occipital gyrus and the left superior parietal lobule during a moving-dot discrimination decision-making task. This increased connectivity correlates with response time in gamers. The structural connectivity in the dorsal stream, as quantified by diffusion fractional anisotropy and quantitative anisotropy measures of the axonal fiber pathways, was also enhanced for gamers compared to nongamers. Conclusions: These findings provide valuable insights into how action video gaming can induce targeted improvements in structural and functional connectivity between specific brain regions in the visual processing pathways. These connectivity changes in the dorsal visual stream underpin the superior performance of action video gamers compared to nongamers in tasks requiring rapid and accurate vision-based decision-making.

Alterations of gray matter asymmetry in internet gaming disorder

Structural asymmetry is a subtle but pervasive property of the human brain, which has been found altered in various psychiatric and neurocognitive disorders. However, little is known regarding potential alterations of structural asymmetry underlying internet gaming disorder (IGD). Therefore, this study aimed to investigate the structural features of gray matter asymmetry in IGD. High-resolution structural magnetic resonance imaging data were collected from 104 individuals with IGD and 104 recreational game users (RGUs). We applied a whole-brain voxel-based asymmetry (VBA) approach to determine the asymmetrical aberrations of gray matter in relation to IGD. Furthermore, the local abnormalities of structural asymmetry were employed as features to examine the effect of classification using a support vector machine (SVM). The results indicated that individuals with IGD as compared to RGUs showed asymmetrical alterations of gray matter in the medial prefrontal cortex (mPFC), orbitofrontal cortex, precuneus, middle temporal gyrus, superior parietal lobule and inferior temporal gyrus, regions implicated in hedonic motivation, self-reflection, information integration and visuospatial attention processing. Moreover, these atypical asymmetrical features can distinguish IGD subjects from RGUs with high accuracy. These results suggested that disrupted structural asymmetry of motivational reward, visuospatial and default mode circuits might be potential biomarkers for identifying pathological gaming dependence. These findings extended our understanding of structural underpinnings of IGD and provided new insights for developing effective interventions to alleviate compulsive gaming usage.

Neurophysiological characteristics of reward processing in individuals at different levels of gaming

Altered reward processing has been repeatedly reported in Internet gaming disorder (IGD). However, it remains unclear whether these changes are linked to the severity of addictive symptoms or the extent of gaming experience. This study examined the neurophysiological responses regarding reward anticipation and consummation in individuals at different levels of gaming (including 22 casual gamers, 31 regular gamers, and 27 individuals with IGD) through a monetary incentive delay task. Three event-related potential components during reward anticipation-cue-related P300 (Cue-P3), contingent negative variation, and stimulus-preceding negativity (SPN)-and two during reward consummation-feedback-related negativity and feedback-related P300 (FB-P3)-were measured. We found that IGD individuals exhibited greater Cue-P3 but lower SPN amplitude compared to casual gamers, while regular gamers fell between the two without significant differences. Regressions indicated that more extensive gaming experience, rather than the severity of the symptoms, primarily contributed to the increased Cue-P3 in IGD. No group differences were found during reward consummation. Our results highlight disrupted reward anticipation processing in IGD, characterized by increased attention bias toward reward cues (Cue-P3) but diminished cognitive resources for reward anticipation (SPN) and emphasize the role of gaming experience in increased attention bias in IGD.

Internet addiction: the Czech and Slovak adolescent population

BACKGROUND

Adolescence is often seen as an important period for further personality development. In today's world, it is therefore important to keep track of current trends in adolescents. One of them is addictive behaviour in the context of the online environment. Spending too much time online can have a negative impact on the quality of life of adolescents. It is therefore important to pay increased attention to this phenomenon and to respond adequately to the current situation.

METHODS

Our study focuses on the prevalence of Internet addiction among Czech and Slovak adolescents. In total, 3,741 respondents participated in the project (N = 2,642 CZ; N = 1,099 SK); their ages ranged from 11 to 19 years (M = 14.38; SD ± 2.27). The research addressed differences among individual types of schools and between sexes in relation to Internet addiction. The research focused on adolescents attending secondary schools (ISCED 2 and 3) between the ages of 11 and 19 in the Czech and Slovak Republics. A questionnaire battery consisting of a sociodemographic questionnaire and the Internet Addiction Test (IAT) questionnaire was used for data collection.

RESULTS

In relation to the category of Internet use, girls did not score higher than boys either in the Czech group F(1, 2112) = .089, p = .765, or in the Slovak group F(1, 927) < .001 p = .994. There is a significant effect of school type both in the Czech group F(4, 2100) = 11.483, p < .001, and in the Slovak group F(4, 859) = 2.859, p = .023.

CONCLUSIONS

Our research indicates that some adolescents, particularly boys, face issues with excessive Internet use, affecting social interactions. Further studies in the Czech Republic could explore the link between psychosocial factors and adolescent Internet use. This highlights the need to raise awareness among professionals about Internet addiction in Czech and Slovak adolescents.

Multimodal analysis of cortical activation in young male adults with internet gaming disorder: A resting state EEG-fNIRS study

BACKGROUND

Internet gaming disorder (IGD) has become increasingly prevalent worldwide and is recognized as a significant public health concern because of its negative consequences on individuals mental and physical health, social relationships, academic performance and overall well-being. While research on IGD has gained significant momentum in the past decade, the neural substrates underlying this disorder remains unclear. This study aims to investigate resting-state cortical activation in male subjects with IGD using a concurrent functional near infrared spectroscopy (fNIRS) and electroencephalography (EEG) hybrid system.

METHODS

Twenty-two male individuals with IGD (18-23 years old) and twenty-two male healthy, age-matched healthy controls were included in the study. Mean oxygenation of the prefrontal cortex (PFC) and whole head neural activity were measured using fNIRS and EEG respectively, during eyes-open and eyes-closed conditions at the resting state. EEG signals were decomposed into distinct frequency sub-bands with wavelet transform, followed by the analysis of the power spectral density within each band. Mean oxygenation of PFC is measured using a multichannel fNIRS system.

RESULTS

Results revealed that the individuals with IGD had significantly higher beta power in the frontal region compared to the control group. Individuals with IGD showed significantly increased PFC oxygenation compared to healthy controls. Additionally, both frontal beta power and PFC oxygenation were significantly correlated with IGD severity. However, there were no significant correlations observed between oxygenation and beta powers.

CONCLUSION

This study is the first to examine resting-state cortical activation using multimodal EEG-fNIRS system in young adults with IGD. Moreover, it provides an important contribution to the understanding of the underlying neural mechanisms of IGD and offer new insights for the diagnosis and intervention of the disorder using multimodal EEG-fNIRS system. Further studies should aim to replicate the findings of this study using a larger and more culturally diverse sample to support the neurophysiological basis of IGD.

Neuropsychological Deficits in Disordered Screen Use Behaviours: A Systematic Review and Meta-analysis

Over the last few decades, excessive and disordered screen use has become more prevalent, prompting investigations into its associated consequences. The extent to which disordered screen use behaviours impact neuropsychological functioning has been reportedly mixed and at times inconsistent. This review sought to synthesise the literature and estimate the magnitude of overall cognitive impairment across a wide range of disordered screen use behaviours. We also sought to determine the cognitive domains most impacted, and whether the observed impairments were moderated by the classification of screen-related behaviours (i.e., Internet or gaming) or the format of cognitive test administration (i.e., paper-and-pencil or computerised). A systematic search of databases (Embase, PsycINFO, MEDLINE) identified 43 cross-sectional articles that assessed neuropsychological performance in disordered screen use populations, 34 of which were included in the meta-analysis. A random-effects meta-analysis revealed significant small/medium (g = .38) cognitive deficits for individuals with disordered screen use behaviours relative to controls. The most affected cognitive domain with a significant medium effect size (g = .50) was attention and focus followed by a significant reduction in executive functioning (g = .31). The classification of disordered screen use behaviours into Internet or gaming categories or the format of cognitive testing did not moderate these deficits. Additionally, excluding disordered social media use in an exploratory analysis had little effect on the observed outcomes. This study highlights a number of methodological considerations that may have contributed to disparate findings and shows that disordered screen use can significantly impact cognitive performance. Recommendations for future research are also discussed. Data for this study can be found at https://osf.io/upeha/ .

Learning and memory processes in behavioural addiction: A systematic review

Similar to addictive substances, addictive behaviours such as gambling and gaming are associated with maladaptive modulation of key brain areas and functional networks implicated in learning and memory. Therefore, this review sought to understand how different learning and memory processes relate to behavioural addictions and to unravel their underlying neural mechanisms. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched four databases - PsycINFO, PubMed, Scopus, and Web of Science using the agreed-upon search string. Findings suggest altered executive function-dependent learning processes and enhanced habit learning in behavioural addiction. Whereas the relationship between working memory and behavioural addiction is influenced by addiction type, working memory aspect, and task nature. Additionally, long-term memory is incoherent in individuals with addictive behaviours. Consistently, neurophysiological evidence indicates alterations in brain areas and networks implicated in learning and memory processes in behavioural addictions. Overall, the present review argues that, like substance use disorders, alteration in learning and memory processes may underlie the development and maintenance of behavioural addictions.

Psychometric properties of the Turkish version of the gaming disorder scale for adolescents (GADIS-A)

PURPOSE

This methodological study established the Turkish validity and reliability of the Gaming Disorder Scale for Adolescents (GADIS-A).

METHODS

The study was conducted with 378 adolescents studying in primary and secondary education institutions in the central districts of a province in Turkey affiliated with the Provincial Directorate of National Education. Data were collected using an adolescent information form and GADIS-A. An ethics committee approved the study, and permission was obtained from the institution.

RESULTS

Confirmatory Factor Analysis (CFA) showed that the scale had factor loadings of 0.511 to 0.768, the Goodness of Fit indices of >0.87, and the RMSEA index of <0.10. The total scale had a Cronbach's alpha of 0.860.

CONCLUSION

The results show that GADIS-A is a valid and reliable measure for the Turkish sample.

IMPLICATIONS TO PRACTICE

GADIS-A, a highly valid and reliable scale, can be used as a measurement tool in national and international screening programs.

Large-scale network abnormality in behavioral addiction

BACKGROUND

Researchers have endeavored to ascertain the network dysfunction associated with behavioral addiction (BA) through the utilization of resting-state functional connectivity (rsFC). Nevertheless, the identification of aberrant patterns within large-scale networks pertaining to BA has proven to be challenging.

METHODS

Whole-brain seed-based rsFC studies comparing subjects with BA and healthy controls (HC) were collected from multiple databases. Multilevel kernel density analysis was employed to ascertain brain networks in which BA was linked to hyper-connectivity or hypo-connectivity with each prior network.

RESULTS

Fifty-six seed-based rsFC publications (1755 individuals with BA and 1828 HC) were included in the meta-analysis. The present study indicate that individuals with BAs exhibit (1) hypo-connectivity within the fronto-parietal network (FN) and hypo- and hyper-connectivity within the ventral attention network (VAN); (2) hypo-connectivity between the FN and regions of the VAN, hypo-connectivity between the VAN and regions of the FN and default mode network (DMN), hyper-connectivity between the DMN and regions of the FN; (3) hypo-connectivity between the reward system and regions of the sensorimotor network (SS), DMN and VAN; (4) hypo-connectivity between the FN and regions of the SS, hyper-connectivity between the VAN and regions of the SS.

CONCLUSIONS

These findings provide impetus for a conceptual framework positing a model of BA characterized by disconnected functional coordination among large-scale networks.

Comparative efficacy of different interventions on executive function in adolescents with internet use disorder

BACKGROUND

The formation and relapse of Internet use disorder (IUD) are related to the decline in executive function. Previous studies have indicated that exercise intervention and high-definition transcranial direct current stimulation (HD-tDCS) can improve the cognitive abilities of adolescents with IUD. However, the combined intervention's impact on executive function in these adolescents remains unclear. Therefore, this study aims to explore the effects and differences of multimodal exercise, HD-tDCS intervention, and combined intervention on the executive function of adolescents with IUD.

METHODS

Forty-eight adolescents with IUD were randomly assigned to the multimodal exercise group, HD-tDCS intervention group, combined intervention group, and control group. The intervention groups received 4 weeks of moderate-intensity multimodal exercise, HD-tDCS intervention (2 mA, 20min/session, 3 times/week), or combined multimodal exercise with HD-tDCS intervention. The control group received conventional educational learning. Executive function measurements were taken before intervention, after intervention, and 2 weeks post-intervention.

RESULTS

Compared to pre-intervention, different interventions effectively improved the behavioral performance of adolescents with IUD in executive function tasks. In comparison to single interventions, the combined intervention significantly outperformed multimodal exercise and HD-tDCS intervention in influencing the executive function (especially inhibitory control and working memory) in adolescents with IUD.

CONCLUSION

Combined multimodal exercise with HD-tDCS intervention proves to be an effective means of enhancing executive function in adolescents with IUD, particularly contributing to the improvement of explicit behavioral performance related to executive function.

Screened realities: a Grounded Theory exploration of gaming disorder dynamics among Iranian male adolescents

Introduction

The increasing prevalence of gaming Disorder (GD) among adolescents has become a global concern. Despite the rising number of studies investigating GD, the cultural and socio-economic factors influencing GD with a qualitative approach are scarce. This study aims to explore the underlying factors, processes, and consequences of GD among Iranian male adolescents and contextual factors related to GD within Iran's unique socio-cultural and psychological tapestry.

Methods

The study used a qualitative design based on the Grounded Theory Method (GTM). The researchers conducted semi-structured interviews with 13 male adolescents aged 15-18 who Dignasoed according to DSM-5 and ICD-11 criteria. The interviews were transcribed and analyzed using the GTM approach, which involves open, axial, and selective coding.

Results

The study revealed nine main themes and a core category: (1) interaction seeking, (2) encounter and familiarize with games, (3) games attraction, (4) Socialization, (5) game careerism, (6) dexterity, (7) lack and compensation, (8) physical harm, territorial-cultural barrier, (9) second life, and ''life crafting'' as the core category.

Discussion

The study's findings provide valuable insights into the cultural and socio-economic factors influencing GD among Iranian male adolescents. For example, Iran's economic conditions make adolescents choose gaming as their job and try to earn money in this way, which makes them more dependent on gaming. On the other hand, communities related to games play an essential role in the identity development of adolescents with GD.

Internet addiction and health-related quality of life in adolescents: The mediating role of sleep disturbance

BACKGROUND

Internet addiction (IA) has emerged as a recognized risk factor associated with impaired health-related quality of life (HRQOL) in adolescents. However, the role of sleep disturbance in this association remains unclear. This study aimed to investigate the association of IA with HRQOL in Chinese adolescents and to evaluate the potential mediating role of sleep disturbance.

METHODS

A cross-sectional study was conducted among adolescents attending six randomly selected middle schools in Guangzhou, China. Adolescents self-reported their internet use using the Young Diagnostic Questionnaire. HRQOL and sleep disturbance were assessed by the Pediatric Quality of Life Inventory version 4.0 and the Pittsburgh Sleep Quality Index, respectively. Multivariate linear regression analysis was employed to assess the association between IA and HRQOL. Baron and Kenny's causal steps method was used to examine the possible mediating role of sleep disturbance.

RESULTS

Of the 6473 adolescents included, 23.5% had maladaptive internet use (MIU) and 16.6% had pathological internet use (PIU). Compared to adolescents with adaptive internet use (AIU), those with IA had significantly lower scores across all HRQOL dimensions and summary scales. Mediation analysis revealed that sleep disturbance was a significant mediator. Specifically, sleep disturbance mediated 34.55% of the effects of MIU and 34.06% of the effects of PIU on the HRQOL total scale score , respectively.

CONCLUSIONS

IA was associated with poorer HRQOL, indicating the needs of preventing IA in Chinese adolescents. Additionally, our findings underscored the importance of enhancing sleep quality to mitigate the adverse impact of IA on adolescents' well-being.

Video game addiction is associated with early stage of inhibitory control problems: An event-related potential study using cued Go/NoGo task

Video game addiction (VGA) is associated with cognitive problems, particularly deficits in inhibitory control. The present study aimed to investigate behavioural responses and event-related potential associated with specific response inhibition using the cued Go/NoGo task to examine the effects of VGA on brain activity related to response inhibition. Twenty-five individuals addicted to video games (action video games) and 25 matched healthy controls participated in the study. The results showed that the VGA group had significantly more commission error in the NoGo trials and faster reaction time in the Go trials compared with the control group. The event-related potential analyses revealed significant reductions in amplitudes of N2 cue and N2 NoGo in the VGA group. While there was no significant difference between the N2 amplitudes of the Go and NoGo trials in the VGA group, the control group had a larger N2 amplitude in the NoGo trials. These results indicate that VGA subjects have difficulties in the early stages of response inhibition, as well as some level of impairment in proactive cognitive control.

Digital Media and Developing Brains: Concerns and Opportunities

Purpose of Review

The incorporation of digital technologies and their use in youth's everyday lives has been increasing rapidly over the past several decades with possible impacts on youth development and mental health. This narrative review aimed to consider how the use of digital technologies may be influencing brain development underlying adaptive and maladaptive screen-related behaviors.

Recent Findings

To explore and provide direction for further scientific inquiry, an international group of experts considered what is known, important gaps in knowledge, and how a research agenda might be pursued regarding relationships between screen media activity and neurodevelopment from infancy through childhood and adolescence. While an understanding of brain-behavior relationships involving screen media activity has been emerging, significant gaps exist that have important implications for the health of developing youth.

Summary

Specific considerations regarding brain-behavior relationships involving screen media activity exist for infancy, toddlerhood, and early childhood; middle childhood; and adolescence. Transdiagnostic frameworks may provide a foundation for guiding future research efforts. Translating knowledge gained into better interventions and policy to promote healthy development is important in a rapidly changing digital technology environment.

Higher striatal glutamate in male youth with internet gaming disorder

Internet gaming disorder (IGD) was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a research diagnosis, but little is known about its pathophysiology. Alterations in frontostriatal circuits appear to play a critical role in the development of addiction. Glutamate is considered an essential excitatory neurotransmitter in addictive disorders. This study's aim was to investigate striatal glutamate in youth with IGD compared to healthy controls (HC). Using a cross-sectional design, 25 adolescent male subjects fulfilling DSM-5 criteria for IGD and 26 HC, matched in age, education, handedness and smoking, were included in the analysis. A structural MPRAGE T1 sequence followed by a single-voxel magnetic resonance spectroscopy MEGA-PRESS sequence (TR = 1500 ms, TE = 68 ms, 208 averages) with a voxel size of 20 mm3 were recorded on 3 T Siemens Magnetom Prisma scanner. The voxel was placed in the left striatum. Group comparison of the relative glutamate and glutamine (Glx) was calculated using regression analysis. IGD subjects met an average of 6.5 of 9 DSM-5 IGD criteria and reported an average of 29 h of weekly gaming. Regression analysis showed a significant group effect for Glx, with higher Glx levels in IGD as compared to HC (coef. = .086, t (50) = 2.17, p = .035). Our study is the first to show higher levels of Glx in the striatum in youth with IGD. The elevation of Glx in the striatum may indicate hyperactivation of the reward system in IGD. Thus, results confirm that neurochemical alterations can be identified in early stages of behavioral addictions.

Impulsivity and aggression as risk factors for internet gaming disorder among university students

Internet gaming addiction is a global problem, especially among young individuals. Exhibiting characteristics similar to other addictions, Internet Gaming Disorder (IGD) is linked to adverse mental health outcomes. Identified as risk factors for dependence behaviors, the association of impulsivity and aggression with IGD is relatively under-researched in the student population. The present sample of 350 university students (Mage = 21.30 years, SDage = 4.96 years) from Najran university in Saudi Arabia completed an online questionnaire that included the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), the Buss-Perry Aggression Questionnaire-Short Form, and the Barratt Impulsiveness Scale (BIS-15). Results indicated that impulsivity and aggression were positively associated with IGD severity and both personality traits explained 34.6% of the variance in IGD scores. Further bivariate analyses suggested that individuals spending 7 or more hours on internet gaming were more likely to exhibit high impulsivity and aggression, and had a relatively higher severity of IGD. These results suggest that individuals with these personality traits may be more vulnerable to developing an addiction to internet gaming. These findings need to be confirmed in future more robust studies; however, this exploratory study provides insights for potential programs to prevent IGD among young individuals.

Explicit and implicit effects of gaming content on social media on the behavior of young adults

Excessive gameplay can have negative effects on both mental and physical health, especially among young people. Nowadays, social media platforms are bombarding users with gaming-related content daily. Understanding the effect of this content on people's behavior is essential to gain insight into problematic gaming habits. However, this issue is yet to be studied extensively. In this study, we examined how gaming-related content on social media affects young adults explicitly and implicitly. We studied 25 healthy young adults (average age 21.5 ± 2.2) who played online games casually and asked them to report their gaming desire. We also conducted an implicit association test (IAT) to measure their implicit attitudes toward gaming-related content. We also investigated the relationship between these measures and various psychological factors, such as personality traits, self-efficacy, impulsiveness, and cognitive flexibility. The results revealed that participants had a higher explicit gaming desire when exposed to gaming-related cues on social media than neutral cues. They also had a robust positive implicit attitude toward gaming-related content on social media. Explicit gaming desire was positively correlated with neuroticism levels. Furthermore, the IAT effect was negatively correlated with self-efficacy and cognitive flexibility levels. However, there were no significant correlations between explicit gaming desire/IAT effect and impulsiveness levels. These findings suggest that gaming-related content on social media can affect young adults' behavior both explicitly and implicitly, highlighting the need for further research to prevent gaming addiction in vulnerable individuals.

Association between gaming disorder and regional homogeneity in highly involved male adult gamers: A pilot resting-state fMRI study

BACKGROUND

Gaming behavior can induce cerebral changes that may be related to the neurobiological features of gaming disorder (GD). Additionally, individuals with higher levels of depression or impulsivity are more likely to experience GD. Therefore, the present pilot study explored potential neurobiological correlates of GD in the context of depression and impulsivity, after accounting for video gaming behavior.

METHODS

Using resting-state functional magnetic resonance imaging (fMRI), a cross-sectional study was conducted with 35 highly involved male adult gamers to examine potential associations between GD severity and regional homogeneity (ReHo) in the entire brain. A mediation model was used to test the role of ReHo in the possible links between depression/impulsivity and GD severity.

RESULTS

Individuals with greater GD severity showed increased ReHo in the right Heschl's gyrus and decreased ReHo in the right hippocampus (rHip). Furthermore, depression and impulsivity were negatively correlated with ReHo in the rHip, respectively. More importantly, ReHo in the rHip was found to mediate the associations between depression/impulsivity and GD.

CONCLUSIONS

These preliminary findings suggest that GD severity is related to ReHo in brain regions associated with learning/memory/mood and auditory function. Higher levels of depression or impulsivity may potentiate GD through the functional activity of the hippocampus. Our findings advance our understanding of the neurobiological differences behind GD symptoms in highly involved gamers.

The relationship between internet gaming disorder and psychotic experiences: cyberbullying and insomnia severity as mediators

BACKGROUND

The nature of the relationship between Internet Gaming Disorder (IGD) and psychosis is unclear so far. There is evidence that greater time spent in playing video games may expose players to both insomnia and a toxic online environment with widespread cyberbullying. These two possible consequences of IGD may, in turn, be associated with greater psychotic experiences (PE). Based on this theoretical framework, the present study proposed to contribute the body of the knowledge in this area, by testing the possible indirect effects of insomnia severity, cyber-victimization and cyberbullying in the cross-sectional association between IGD and PE in a sample of Tunisian university students.

METHOD

We conducted a cross-sectional study over 4 months (February-May 2022). The Arabic versions of the Brief Symptom Inventory, the Internet Gaming disorder-20 Test, the Insomnia Severity Index, and the Revised Cyber Bullying Inventory-II were administered to a total of 851 students (mean age = 21.26 ± 1.68 years, 53.7% females).

RESULTS

We found that 25% of students were at risk of IGD, and 1.8% had an IGD. The results of the mediation analysis showed that insomnia severity fully mediated the association between IGD and paranoid ideation. Higher IGD was significantly associated with more insomnia severity, which was, in turn, significantly associated with more paranoid ideation. Cyberbullying partly mediated the association between IGD and psychoticism. Higher IGD scores were significantly associated with more cyberbullying, which was, in turn, significantly associated with more psychoticism. Finally, greater IGD was significantly and directly associated with higher psychoticism.

CONCLUSION

Our findings suggest that insomnia and cyberbullying may be regarded as potential targets for youth mental health promotion, as well as community-focused prevention and early intervention in psychosis. More particular attention should be devoted to the huge potential for engaging in cyberbullying among online gamers. Sleep deprivation should be prevented, assessed and treated in heavy gamers.

Neuroimaging correlates of internet gaming disorder: Can we achieve the promise of translating understandings of brain functioning into clinical advances?

Objectives

Here we aimed to consider the neural factors associated with internet gaming disorder (IGD), as well as the associations between these factors and existing treatments for the disorder.

Methods

A narrative review was conducted.

Results

Pharmacological as well as psychological treatments for IGD may be associated with specific changes in multiple brain areas and circuits. In particular, fronto-striatal and subcortical regions and pathways appear relevant to IGD and its treatment.

Conclusions

Neuroimaging holds promise for identifying specific mechanisms underlying IGD interventions. However, to date, firm conclusions are difficult to draw and more research examining neural mechanisms of empirically supported treatments for IGD is needed.

Correlation Between Attention Deficit Hyperactivity Disorder, Internet Gaming Disorder or Gaming Disorder

OBJECTIVE

Individuals with internet gaming disorder (IGD) or gaming disorder (GD) had a higher prevalence of ADHD than individuals without IGD or GD. The overpathologizing of excessive gaming behaviors may be associated with the functional impairment due to ADHD in individuals with GD.

METHODS

The present study was designed to compare the gaming patterns, accompanying psychopathology, and co-occurring psychiatric disorders, especially ADHD, between clinical and general gamer samples (17-29 years old).

RESULTS

Out of the nine IGD criteria, the item "functional impairment" had low diagnostic accuracy in participants with IGD or GD. The IGD (GD) group had a higher prevalence of ADHD compared to the general gamer group. Conversely, there was a higher prevalence of IGD (GD) in the ADHD group compared to the non-ADHD group.

DISCUSSION

The possibility of ADHD should be considered when IGD or GD is diagnosed in patients with problematic Internet gaming.

Circadian typologies and insomnia in individuals with internet gaming disorder comorbid with attention deficit/hyperactivity disorder

The alteration in circadian typology and insomnia were prevalent among both Individuals with IGD and those with attention deficit hyperactivity disorder (ADHD), the most comorbid psychiatric disorder of IGD. This study aimed to evaluate the relationships between circadian typologies, insomnia, and internet gaming disorder (IGD) and how ADHD affects this relationship. We recruited three groups of 69 young adults: an IGD group, a control group comprising age- and sex-matched nongamers, and a group of gamers without IGD through diagnostic interviews. The participants with IGD exhibited lower composite scale of morningness (CSM) scores and thus a higher eveningness preference In addition, the score of Pittsburgh insomnia rating scale-20-item version (PIRS_20) was significantly higher among those with IGD. The participants with IGD and ADHD exhibited lower CSM scores but higher PRIS_20 scores than the participants with IGD but without ADHD. The present findings indicate that participants with IGD exhibited a tendency of eveningness preference and experienced more severe insomnia. ADHD exacerbated the eveningness preference and insomnia of individuals with IGD. Close attention should be paid to sleep problems in individuals with IGD, particularly to those with ADHD.

White matter microstructural changes in internet addiction disorder: A systematic review of diffusion tensor imaging studies

Diffusion tensor imaging (DTI) is a kind of magnetic resonance imaging (MRI) modality that helps designate tracts with brain microstructural changes. Internet gaming disorder (IGD) is an internet addiction that can cause many social and personality problems, such as problems in social communication, anxiety, and depression. There are several pieces of evidence showing the impact of this condition on brain regions, and many studies have investigated DTI measurements in these individuals. Therefore, we decided to systematically review the studies that have reported DTI parameters in IGD individuals. We searched the PubMed and Scopus databases to find relevant articles. Two reviewers separately screened the studies, and finally, 14 articles, including diffusion and network studies, were found eligible for our systematic review. Most of the studies reported findings on FA, showing an increase in the thalamus, anterior thalamic radiation, corticospinal tract, and inferior longitudinal fasciculus (ILF), while other regions mentioned in the studies demonstrated inconsistent findings. Moreover, in network studies, IGD individuals showed a decrease in nodal and global efficiencies. In conclusion, our study illuminates the neuropsychological basis of this condition and suggests that internet gaming can correlate with microstructural abnormalities in the central nervous system. Some correlate with the characteristics of online gaming, the addiction state, and the illness's duration.

Biopsychosocial factors of gaming disorder: a systematic review employing screening tools with well-defined psychometric properties

Background and aims

Considering the growing number of gamers worldwide and increasing public concerns regarding the negative consequences of problematic gaming, the aim of the present systematic review was to provide a comprehensive overview of gaming disorder (GD) by identifying empirical studies that investigate biological, psychological, and social factors of GD using screening tools with well-defined psychometric properties.

Materials and methods

A systematic literature search was conducted through PsycINFO, PubMed, RISS, and KISS, and papers published up to January 2022 were included. Studies were screened based on the GD diagnostic tool usage, and only five scales with well-established psychometric properties were included. A total of 93 studies were included in the synthesis, and the results were classified into three groups based on biological, psychological, and social factors.

Results

Biological factors (n = 8) included reward, self-concept, brain structure, and functional connectivity. Psychological factors (n = 67) included psychiatric symptoms, psychological health, emotion regulation, personality traits, and other dimensions. Social factors (n = 29) included family, social interaction, culture, school, and social support.

Discussion

When the excess amount of assessment tools with varying psychometric properties were controlled for, mixed results were observed with regards to impulsivity, social relations, and family-related factors, and some domains suffered from a lack of study results to confirm any relevant patterns.

Conclusion

More longitudinal and neurobiological studies, consensus on a diagnostic tool with well-defined psychometric properties, and an in-depth understanding of gaming-related factors should be established to settle the debate regarding psychometric weaknesses of the current diagnostic system and for GD to gain greater legitimacy in the field of behavioral addiction.

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.

Effects of Transcranial Electrical Stimulation on Gambling and Gaming: A Systematic Review of Studies on Healthy Controls, Participants with Gambling/Gaming Disorder, and Substance Use Disorder

Gambling disorder (GD) and internet gaming disorder (IGD) are formally recognized behavioral addictions with a rapidly growing prevalence and limited treatment options. Recently, transcranial electrical stimulation (tES) techniques have emerged as potentially promising interventions for improving treatment outcomes by ameliorating cognitive functions implicated in addictive behaviors. To systematize the current state of evidence and better understand whether and how tES can influence gambling and gaming-related cognitive processes, we conducted a PRISMA-guided systematic review of the literature, focusing on tES effects on gaming and gambling in a diverse range of population samples, including healthy participants, participants with GD and IGD, as well as participants with substance abuse addictions. Following the literature search in three bibliographic databases (PubMed, Web of Science, and Scopus), 40 publications were included in this review, with 26 conducted on healthy participants, 6 focusing on GD and IGD patients, and 8 including participants with other addictions. Most of the studies targeted the dorsolateral prefrontal cortex, using transcranial direct current stimulation (tDCS), and assessed the effects on cognition, using gaming and gambling computerized cognitive tasks measuring risk taking and decision making, e.g., balloon analogue risk task, Iowa gambling task, Cambridge gambling task, etc. The results indicated that tES could change gambling and gaming task performances and positively influence GD and IGD symptoms, with 70% of studies showing neuromodulatory effects. However, the results varied considerably depending on the stimulation parameters, sample characteristics, as well as outcome measures used. We discuss the sources of this variability and provide further directions for the use of tES in the context of GD and IGD treatment.

Sleep bruxism in children, from evidence to the clinic. A systematic review

Objectives

The present paper aims to systematically review the literature published from 2015 to 2023 on bruxism in children with the aim to compilate the best available evidence.

Materials and Methods

A systematic search in the National Library of Medicine's PubMed, Medline (EBSCO), SCOPUS, and Google Scholar databases was performed to identify all studies on humans assessing genetic, biopsychosocial, and sleep factors assessed with any different approach for sleep bruxism (SB) in children and its interventions. The selected articles were assessed independently by the two authors according to a structured reading of the article's format (PICO). The quality of the articles was evaluated using Quality Assessments Tool for Experimental Bruxism Studies (Qu-ATEBS) and the JBI critical appraisal tools.

Results

A total of 16 articles were included for discussion in the review and grouped into questionnaire/parental-report (n = 7), SB assessment through parental report of SB and clinical examination (n = 4), and instrumental assessment (n = 5) studies. The total quality scores evaluated with STROBE and Qu-ATEBS were high for all included papers. However, in general, there was no control of bias strategies and there was no control group in the intervention studies.

Conclusions

Investigations based on self-report, clinical, and instrumental bruxism assessment showed a positive association with genetics, quality of life aspects (school and emotional functions and overuse of screen-time), mother anxiety and family conformation, diet, alteration in sleep behaviors and architecture, and sleep breathing disorders. Additionally, the literature presents options to increase airway patency and, thus, reduce the occurrence of SB. Tooth wear was not found to be a major sign of SB in children. However, methods of SB assessment are heterogeneous and hamper a reliable comparison of the results.

Functional MRI of inhibitory control processing in problematic mobile video gamers

With the development of mobile technology, mobile video games provide people with a more convenient way of entertainment, but problematic playing could also bring some negative consequences. Prior studies have indicated that Internet gaming addicts were accompanied by impaired inhibitory control. However, as a relatively new form of problematic game usage based on mobile devices, little is known about the neurobiological underpinnings of inhibitory control in problematic mobile video game (PMVG) users. Adopting an event-related fMRI Stroop task, the present study aimed to examine the different neural correlates of inhibitory control between PMVG and healthy control (HC) subjects. Compared with HC group, PMVG group showed greater brain activities in the right dorsolateral prefrontal cortex (DLPFC) during the Stroop process. Moreover, correlation analysis showed that brain activities extracted from the voxel in the DLPFC cluster had a significantly negative correlation with reward sensitivity. Our current findings may suggest the compensating effect in key brain regions of inhibitory control in problematic mobile video gamers relative to healthy controls.

Gaming disorder: A summary of its characteristics and aetiology

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

The role of the orbitofrontal cortex in exercise addiction and exercise motivation: A brain imaging study based on multimodal magnetic resonance imaging

BACKGROUND

Excessive exercise may also lead to exercise addiction (EXA), which is harmful to people's physical and mental health. Behavioral and neuroimaging studies have demonstrated that addictive disorders are essentially motivational problems. However, little is known about the neuropsychological mechanism of EXA and the effects of motivation on EXA.

METHODS

We investigated 130 regularly exercised participants with EXA symptoms to explore the neurobiological basis of EXA and its association with motivation. The correlation between EXA and gray matter volume (GMV) was evaluated by whole-brain regression analysis based on voxel-based morphometry. Then, regional brain function was extracted and the relationship between brain structure-function-EXA was analyzed. Finally, mediation analysis was performed to further detect the relationship between the brain, motivation, and EXA.

RESULTS

Whole-brain correlation analyses showed that the GMV of the right orbitofrontal cortex (OFC) was negatively correlated with EXA. The function of the right OFC played an indirect role in EXA and affected EXA via the GMV of the OFC. Importantly, the GMV of the right OFC played a mediating role in the relationship between ability motivation and EXA. These results remain significant even when adjusting for sex, age, body mass index, family socioeconomic status, general intelligence, total intracranial volume, and head motion.

LIMITATION

The results should be interpreted carefully because only the people with EXA symptoms were included.

CONCLUSION

This study provided evidence for the underlying neuropsychological mechanism of the important role of the right OFC in EXA and revealed that there may be a decrease in executive control function in EXA.

Internet addiction-induced brain structure and function alterations: a systematic review and meta-analysis of voxel-based morphometry and resting-state functional connectivity studies

Internet addiction (IA) is a growing social concern and has been intensively studied in recent years. Previous imaging studies have shown that IA may impair brain structure and function, but with no robust conclusions. We conducted a systematic review and meta-analysis of neuroimaging studies in IA. Two separate meta-analyses were conducted for voxel-based morphometry (VBM) studies and resting-state functional connectivity (rsFC) studies. All meta-analyses were performed using two analysis methods activation likelihood estimation (ALE) and seed-based d mapping with permutation of subject images (SDM-PSI). The ALE analysis of VBM studies revealed less gray matter volume (GMV) in the supplementary motor area (SMA) (1176 mm³), anterior cingulate cortex (ACC) (one cluster size is 744 mm³ and the other is 688 mm³), and orbitofrontal cortex (OFC) (624 mm³) in subjects with IA. The SDM-PSI analysis showed less GMV in the ACC (56 voxels). The ALE analysis of rsFC studies showed stronger rsFC from posterior cingulate cortex (PCC) (880 mm³) or insula (712 mm³) to the whole brain in subjects with IA; however, the SDM-PSI analysis revealed no obvious rsFC alteration. These changes may underlie the core symptoms of IA, which include emotional regulation disorder, distraction, and impaired executive control. Our results reflect the common features of neuroimaging studies related to IA in recent years and may potentially help inform the development of more effective diagnostic and treatment approaches.

Internet Gaming Disorders and Early Onset Psychosis in Young People: A Case Study and Clinical Observations

BACKGROUND

Over the last ten years, the video game industry has grown exponentially, involving about 2.5 billion young adults in the world. The estimated global prevalence of gaming addiction has been reported to be 3.5% ranging from 0.21% to 57.5% in the general population. Moreover, during the recent COVID-19 pandemic period, school closures and stay-at-home measures have also further increased the opportunities for prolonged and intensified playing of video games. Little is known about the relationship between IGD and psychosis, and the literature is still scarce. Some characteristics of patients with psychosis, particularly those with a first-episode psychosis (FEP), may suggest that these individuals would be particularly liable to develop IGD.

CASE PRESENTATION

We report two cases of young patients with to Internet gaming disorder, experiencing early onset psychosis treated with antipsychotic therapy.

CONCLUSION

Although it is difficult to show the specific mechanisms underlying the psychopathological alterations in IGD, it is clear that excessive exposure to video games could be a risk factor for precipitating psychosis especially in a vulnerable age group such as adolescence. Clinicians should be aware of the possibility of a higher risk of psychotic onset associated specifically with gaming disorders in very young people.

Possible sleep bruxism and biological rhythm in school children

OBJECTIVE

To verify whether children with possible sleep bruxism (PSB) had alterations in biological rhythm and to explore the possible factors involved, such as sleep characteristics, screen time, breathing, sugary food consumption, and clenching teeth during wakefulness reported by parents/guardians.

METHODOLOGY

Data were collected through online interviews with 178 parents/guardians of students aged 6 to14 years from Piracicaba, SP, BR, when the BRIAN-K scale was answered, which is composed of four domains (1) sleep; (2) daily routine activities; (3) social behavior; (4) eating; questions about predominant rhythms (willingness, concentration, and change day to night). Three groups were formed: (1) without PSB (WPSB), (2) with PSB sometimes (PSBS), and (3) with PSB frequently (PSBF).

RESULTS

Sociodemographic variables were similar between groups (P > 0.05); the total value of the BRIAN-K was significantly higher for the PSBF group (P < 0.05); the first domain (sleep) presented significantly higher values for the PSB groups (P < 0.05); no significant difference for other domains and predominant rhythms occurred (P > 0.05). The involved factor that differed between groups was clenching teeth, as the number of children with PSBS was significantly higher (χ2, P = 0.005). The first domain of the BRIAN-K (P = 0.003; OR = 1.20), and clenching teeth (P = 0.048; OR = 2.04) were positively associated with PSB.

CONCLUSION

Difficulties in maintaining sleep rhythm and clenching teeth during wakefulness reported by parents/guardians may determine a greater chance to increase the frequency of PSB.

CLINICAL RELEVANCE

Good sleep seems to be important to maintain a regular biological rhythm and may reduce the frequency of PSB in the 6-14 age group.

Effective interventions for gaming disorder: A systematic review of randomized control trials

Objective

To identify effective intervention methods for gaming disorder (GD) through a rigorous assessment of existing literature.

Methods

We conducted a search of six databases (PubMed, Embase, PsycINFO, CNKI, WanFang, and VIP) to identify randomized controlled trials (RCTs) that tested GD interventions, published from database inception to December 31, 2021. Standardized mean differences with 95% confidence intervals were calculated using a random effects model. Risk of bias was assessed with the Risk of Bias 2 (RoB 2) tool.

Results

Seven studies met the inclusion criteria. Five interventions were tested in these studies: group counseling, craving behavioral intervention (CBI), transcranial direct current stimulation (tDCS), the acceptance and cognitive restructuring intervention program (ACRIP), and short-term cognitive behavior therapy (CBT). Four of the five interventions (the tDCS was excluded) were found to have a significant effect on GD. The results of the quality assessment showed that the included studies had a medium to high risk in the randomization process and a medium to high risk of overall bias.

Conclusion

Rigorous screening identified that four interventions are effective for GD: group counseling, CBI, ACRIP, and short-term CBT. Additionally, a comprehensive review of the literature revealed that improvements could be made in the conceptualization of GD, experimental design, sample representativeness, and reporting quality. It is recommended that future studies have more rigorous research designs and be based on established standards to provide more credible evidence to inform the development of GD interventions.

Potential Biological Markers and Treatment Implications for Binge Eating Disorder and Behavioral Addictions

The reward system is highly relevant to behavioral addictions such as gambling disorder (GD), internet gaming disorder (IGD), and food addiction/binge eating disorder (FA/BED). Among other brain regions, the ventral striatum (VS) has been implicated in reward processing. The main objective of the present state-of-the-art review was to explore in depth the specific role of the VS in GD, IGD and FA/BED, understanding it as a possible biomarker of these conditions. Studies analyzing brain changes following interventions for these disorders, and especially those that had explored possible treatment-related changes in VS, are discussed. More evidence is needed on how existing treatments (both pharmacological and psychobehavioral) for behavioral addictions affect the activation of the VS and related circuitry.

Graph analysis of diffusion tensor imaging-based connectome in young men with internet gaming disorder

Although recent evidence suggests that dysfunctional brain organization is associated with internet gaming disorder (IGD), the neuroanatomical alterations related to IGD remain unclear. In this diffusion tensor imaging (DTI) study, we aimed to examine alterations in white matter (WM) structural connectomes and their association with IGD characteristics in 47 young men with IGD and in 34 well-matched healthy controls. Two approaches [namely, network-based statistics (NBS) and graph theoretical measures] were applied to assess differences in the specific topological features of the networks and to identify the potential changes in the topological properties, respectively. Furthermore, we explored the association between the alterations and the severity of internet addiction. An NBS analysis revealed widespread alterations of the cortico-limbic-striatal structural connectivity networks in young people with IGD: (1) an increased subnet1 comprising the insula and the regions responsible for visual, auditory, and sensorimotor functions and (2) two decreased subnet2 and subnet3 comprising the insula, striatum, and limbic regions. Additional correlation analysis showed a significant positive association between the mean fractional anisotropy- (FA-) weighted connectivity strength of subnet1 and internet addiction test (IAT) scores in the IGD group. The present study extends our knowledge of the neuroanatomical correlates in IGD and highlights the role of the cortico-limbic-striatal network in understanding the neurobiological mechanisms underlying this disorder.

Reward, motivation and brain imaging in human healthy participants - A narrative review

Over the past 20 years there has been an increasing number of brain imaging studies on the mechanisms underlying reward motivation in humans. This narrative review describes studies on the neural mechanisms associated with reward motivation and their relationships with cognitive function in healthy human participants. The brain's meso-limbic dopamine reward circuitry in humans is known to control reward-motivated behavior in humans. The medial and lateral Pre-Frontal Cortex (PFC) integrate motivation and cognitive control during decision-making and the dorsolateral PFC (dlPFC) integrates and transmits signals of reward to the mesolimbic and meso-cortical dopamine circuits and initiates motivated behavior. The thalamus and insula influence incentive processing in humans and the motor system plays a role in response to action control. There are reciprocal relationships between reward motivation, learning, memory, imagery, working memory, and attention. The most common method of assessing reward motivation is the monetary incentive delay task (DMRT) and there are several meta-analyses of this paradigm. Genetics modulates motivation reward, and dopamine provides the basis for the interaction between motivational and cognitive control. There is some evidence that male adolescents take more risky decisions than female adolescents and that the lateralization of reward-related DA release in the ventral striatum is confined to men. These studies have implications for our understanding of natural reward and psychiatric conditions like addiction, depression and ADHD. Furthermore, the association between reward and memory can help develop treatment techniques for drug addiction that interfere with consolidation of memory. Finally, there is a lack of research on reward motivation, genetics and sex differences and this can improve our understanding of the relationships between reward, motivation and the brain.

Changes of internet behavior of adolescents across the period of COVID-19 pandemic in China

During the COVID-19 pandemic, internet use and gaming of adolescents had been elevated. On the one hand, internet use and gaming in the period was a good approach to killing quarantined time. However, the increased use of the internet and game of adolescents may also increase the risk of internet addiction. This study aimed to describe the internet behavior changes of adolescents and to understand the impact of clinical features on internet addiction after the adolescents back to school in COVID-19 period. We conducted a cross-sectional cohort study using data collected through online investigation in China. Six hundred and twenty-five adolescents completed the online survey. Results indicated that internet addiction, having gaming use behaviors, Strengths and Difficulties Questionnaire (SDQ) Conduct subscale scores and the SDQ Prosocial subscale scores before the COVID-19 outbreak were significant in predicting the internet addiction after the adolescents back to school. The proportion of internet addiction and gaming behaviors among adolescents in China was changed across the COVID-19 pandemic. Clinical features before the COVID-19 pandemic could predict Internet addiction risk after the adolescents back to school.

Misalignment of Reward Response With Healthful Behavior: An Underappreciated Driver of Population Health Deficits and Health Disparities?

Socioeconomic status-related (SES-related) health disparities are worsening across resource-rich environments, despite increased knowledge about health determinants and inducements for healthful behavior change. We ask whether insights from addiction science and evolutionary biology may assist understanding and counteracting SES-related health disparities. It is known that a mismatch between evolved traits and behaviors that conserve energy drives many health deficits. We posit that this energy mismatch is one manifestation of a more expansive mismatch in levels of reward activation, between environments more versus less manipulated by human activity. This larger mismatch explains why SES-related health disparities arise not only from overeating and excessive sedentism, but also from alcohol, nicotine, other substances, and mood disorders. Lower SES persons are more likely to have lower baseline reward activation, which leads to higher prioritization of reward elevating activities, and at the same time are less likely to act on knowledge about unhealthfulness of behaviors.

Considering gender differences in the study and treatment of internet gaming disorder

BACKGROUND AND AIMS

Internet gaming disorder (IGD) is a multifaceted and complex addictive disorder characterized by poor impulse control and altered reward sensitivities, among other features. IGD is a male-predominant condition, and gender-related differences may contribute importantly to the development and maintenance of, and recovery from, IGD.

METHODS

The current manuscript proposes a framework that incorporates gender-related considerations at different stages of IGD and proposes potential strategies for the prevention and treatment of IGD.

RESULTS

At the development stage, high impulsivity, impaired inhibitory control, and aggressive behaviors have been more frequently observed among males than females, suggesting potential risk factors for the development of IGD. Loneliness and other emotional dysregulation have been more frequently noted among females (than among males) with IGD. At the maintenance stage, males may be more sensitive to gaming-related rewards than females, and acute gaming behaviors may elicit higher cravings among males than among females and thus weaken their inhibitory control. In recovery, females with IGD have reported more negative mood states than males, and females' gaming behaviors have been linked with affective disorders.

DISCUSSIONS

The model proposed here highlights gender-related differences in modulating the behavioral and neural systems that contribute to a three-stage framework of IGD. Additional investigation into gender-related differences in IGD may further advance the field by uncovering complex relationships that may underlie vulnerability and provide insights into the development of gender-specific prevention and treatment strategies.

Psychometric properties of the Farsi version of the gaming disorder scale for adolescents (GADIS-A)

BACKGROUND

Gaming disorder was added to the 11th version of the international classification of disease by the world health organization in early 2019. Adolescents are the most vulnerable group in this area. Thus, a screening tool for this age range is essential. This study aims to examine the psychometric properties of the gaming disorder scale for adolescents (GADIS-A) in an Iranian male sample.

METHODS

260 male students-7th to 12th grade-from Isfahan city in the academic year 2020-2021 were selected using convenience sampling. The participants responded to the Farsi version of the GADIS-A and problematic online game questionnaire (POGQ). Thirty participants answered the scale again to assess the validity of the retest. Pearson's correlation analysis, Cronbach's alpha, and confirmatory factor analysis were used. The data were analyzed by SPSS version 24 and R software packages psych and lavaan.

RESULTS

Confirmatory factor analysis revealed that the two-factor model, which included cognitive-behavioral symptoms and negative consequences, had good fitness indices. The GADIS-A convergent validity is confirmed by the scale's significant correlation with the POGQ. Cronbach's alpha coefficient was used to determine the scale's validity, which was 0.85 for the full scale and 0.70 and 0.75 for two factors. The validity of the retest after two weeks also showed a correlation of 0.88.

CONCLUSION

The Farsi version of the gaming disorder scale for adolescents has a two-factor structure and is valid for use in Iran.

Brain structural covariation linked to screen media activity and externalizing behaviors in children

Background and Aims

Screen media activity (SMA) may impact neurodevelopment in youth. Cross-sectionally, SMA has been linked to brain structural patterns including cortical thinning in children. However, it remains unclear whether specific brain structural co-variation patterns are related to SMA and other clinically relevant measures such as psychopathology, cognition and sleep in children.

Methods

Adolescent Brain Cognitive Development (ABCD) participants with useable baseline structural imaging (N = 10,691; 5,107 girls) were analyzed. We first used the Joint and Individual Variation Explained (JIVE) approach to identify cortical and subcortical covariation pattern(s) among a set of 221 brain features (i.e., surface area, thickness, or cortical and subcortical gray matter (GM) volumes). Then, the identified structural covariation pattern was used as a predictor in linear mixed-effect models to investigate its associations with SMA, psychopathology, and cognitive and sleep measures.

Results

A thalamus-prefrontal cortex (PFC)-brainstem structural co-variation pattern (circuit) was identified. The pattern suggests brainstem and bilateral thalamus proper GM volumes covary more strongly with GM volume and/or surface area in bilateral superior frontal gyral, rostral middle frontal, inferior parietal, and inferior temporal regions. This covariation pattern highly resembled one previously linked to alcohol use initiation prior to adulthood and was consistent in girls and boys. Subsequent regression analyses showed that this co-variation pattern associated with SMA (β = 0.107, P = 0.002) and externalizing psychopathology (β = 0.117, P = 0.002), respectively.

Discussion and Conclusions

Findings linking SMA-related structural covariation to externalizing psychopathology in youth resonate with prior studies of alcohol-use initiation and suggest a potential neurodevelopmental mechanism underlying addiction vulnerability.

Digital Addiction and Sleep

In 2020, the World Health Organization formally recognized addiction to digital technology (connected devices) as a worldwide problem, where excessive online activity and internet use lead to inability to manage time, energy, and attention during daytime and produce disturbed sleep patterns or insomnia during nighttime. Recent studies have shown that the problem has increased in magnitude worldwide during the COVID-19 pandemic. The extent to which dysfunctional sleep is a consequence of altered motivation, memory function, mood, diet, and other lifestyle variables or results from excess of blue-light exposure when looking at digital device screens for long hours at day and night is one of many still unresolved questions. This article offers a narrative overview of some of the most recent literature on this topic. The analysis provided offers a conceptual basis for understanding digital addiction as one of the major reasons why people, and adolescents in particular, sleep less and less well in the digital age. It discusses definitions as well as mechanistic model accounts in context. Digital addiction is identified as functionally equivalent to all addictions, characterized by the compulsive, habitual, and uncontrolled use of digital devices and an excessively repeated engagement in a particular online behavior. Once the urge to be online has become uncontrollable, it is always accompanied by severe sleep loss, emotional distress, depression, and memory dysfunction. In extreme cases, it may lead to suicide. The syndrome has been linked to the known chronic effects of all drugs, producing disturbances in cellular and molecular mechanisms of the GABAergic and glutamatergic neurotransmitter systems. Dopamine and serotonin synaptic plasticity, essential for impulse control, memory, and sleep function, are measurably altered. The full spectrum of behavioral symptoms in digital addicts include eating disorders and withdrawal from outdoor and social life. Evidence pointing towards dysfunctional melatonin and vitamin D metabolism in digital addicts should be taken into account for carving out perspectives for treatment. The conclusions offer a holistic account for digital addiction, where sleep deficit is one of the key factors.

Relation between internet gaming addiction and comorbid psychiatric disorders and emotion avoidance among adolescents: A cross-sectional study

INTRODUCTION

Internet Gaming Disorder has been a controversial subject. Even though internet addiction has been studied among adolescents, there is a lack of evidence regarding Internet Gaming Disorder. The purpose of this study was to assess the prevalence rate of Internet Gaming Disorder and the relationship between Internet Gaming Disorder, comorbid psychiatric disorders, and emotion avoidance among adolescents.

METHODS

Four hundred seven adolescents aged 11 to 18 years old were recruited. Participants were divided into two groups based on the internet gaming addiction scale-Adolescents with IGA (N = 40) and adolescents without IGA (N = 367). All participants were evaluated for demographic data, the Strengths and Difficulties Questionnaire (SDQ), socioeconomic scale, and the Emotional Avoidance Strategy Inventory for Adolescents (EASI-A).

RESULTS

The adolescent with IGA had a higher mean of the number of hours and devices using Internet gaming apps than an adolescent without IGA. Regarding SDQ, adolescents with IGA had a significantly higher mean value for all subscales of SDQ except the prosocial scale and all subscales of EASI-A compared with adolescents without IGA.

CONCLUSIONS

Adolescents with IGA had more hours and devices using Internet gaming apps; more comorbid psychiatric disorders and problems in emotional expression inform of using avoidance techniques than adolescents without IGA.

Proactive and reactive inhibitory control are differently affected by video game addiction: An event-related potential study

INTRODUCTION

Video game addiction (VGA) is associated with physical and mental disorders, one of which is problem in executive function, particularly inhibitory control. The present study aimed to investigate reactive and proactive inhibitory controls by event-related potential (ERP).

METHODS

Thirty video game (action video games)-addicted subjects and 30 matched healthy controls participated in the study, who were tested by the selective stop-signal task.

RESULTS

The main results revealed that the VGA group had significantly more problems in preparatory processes and proactive stop trials, showing that VGA has a negative effect on proactive inhibition.

CONCLUSION

Finding the problem in proactive inhibitory control might be helpful in developing new treatments and rehabilitation methods in these fields.