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Al-Ameri M, Abu-Shaikh H, Mansour M, Al-Habahbeh S, Weshah F, Ennab W, Binsaleh AY, Shilbayeh SAR, Gammoh O. Attention-Deficit Hyperactivity Disorder Symptoms in Adults Diagnosed with Multiple Sclerosis: Prevalence and Correlates. J Clin Med 2024; 13:3844. [PMID: 38999410 PMCID: PMC11242620 DOI: 10.3390/jcm13133844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
Background: The relationship between adult ADHD symptoms in People with Multiple Sclerosis (PwMS) is understudied. This study aimed to answer two questions: are PwMS more likely to experience higher ADHD symptoms versus healthy subjects? And what are the correlates of severe ADHD symptoms in PwMS? Methods: This study followed a cross-sectional design with predefined inclusion criteria. The Adult ADHD Self-Report Scale-V1.1 (ASRS) was used to assess the ADHD symptoms severity. Results: Data were analyzed from 171 PwMS and 200 controls. Regression analysis revealed that PwMS were at a significantly (B = 3.05, t = 2.24, 95% CI = 0.37-5.73, p = 0.02) higher risk to report higher ADHD scores versus controls. In addition, PwMS with relapses in the last 6 months and PwMS reporting smartphone addiction were at a significantly higher risk for severe ADHD (B = 7.19, t = 269, 95% CI = 1.91-12.48, p = 0.008) and (B = 9.18, t = 3.47, 95% CI = 3.97-14.41, p = 0.001), respectively. In conclusion, diagnosis with MS in our study was identified as a risk for higher ADHD symptoms. Conclusions: Further research is required to establish this relationship, and holistic medical and psychological interventions are required to improve the cognitive status of PwMS.
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Affiliation(s)
- Mariam Al-Ameri
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid 21163, Jordan;
| | | | - Mohammad Mansour
- Department of Neurology, Al-Bashir Hospital, Amman 11151, Jordan; (M.M.); (S.A.-H.); (F.W.); (W.E.)
| | - Suha Al-Habahbeh
- Department of Neurology, Al-Bashir Hospital, Amman 11151, Jordan; (M.M.); (S.A.-H.); (F.W.); (W.E.)
| | - Feras Weshah
- Department of Neurology, Al-Bashir Hospital, Amman 11151, Jordan; (M.M.); (S.A.-H.); (F.W.); (W.E.)
| | - Wail Ennab
- Department of Neurology, Al-Bashir Hospital, Amman 11151, Jordan; (M.M.); (S.A.-H.); (F.W.); (W.E.)
| | - Ammena Y. Binsaleh
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (A.Y.B.); (S.A.R.S.)
| | - Sireen Abdul Rahim Shilbayeh
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (A.Y.B.); (S.A.R.S.)
| | - Omar Gammoh
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid 21163, Jordan;
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Dong W, Tang H, Wu S, Lu G, Shang Y, Chen C. The effect of social anxiety on teenagers' internet addiction: the mediating role of loneliness and coping styles. BMC Psychiatry 2024; 24:395. [PMID: 38802784 PMCID: PMC11129444 DOI: 10.1186/s12888-024-05854-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 05/17/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND & AIM There is a lack of understanding of how social anxiety may affect Internet addiction among adolescents. Based on several theories, the purpose of this study was to investigate the multiple mediating roles of loneliness and coping styles in the association between social anxiety and Internet addiction in Chinese adolescents. METHODS This study used the Social Anxiety Scale, Internet Addiction Test, Loneliness Scale, and Simple Coping Style Questionnaire to investigate 1188 students in two junior high schools and senior high schools in Henan Province, China. We adopted Pearson's correlation analysis and the PROCESS Macro Model 81 in regression analysis to explore the relationships among social anxiety, loneliness, coping styles, and Internet addiction. RESULTS We found that social anxiety not only directly affects teenagers' Internet addiction, but also affects teenagers' Internet addiction through loneliness and coping styles. CONCLUSIONS These results emphasize the importance of improving social anxiety to reduce Internet addiction among adolescents. At the same time, it also emphasizes the need to reduce adolescents' loneliness and cultivating positive coping styles. In addition, this study has certain theoretical significance for teenagers' mental health and intervention studies on Internet addiction.
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Affiliation(s)
- Wanglin Dong
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Henan, Kaifeng, China
| | - Haishan Tang
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Henan, Kaifeng, China
| | - Sijia Wu
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Henan, Kaifeng, China
| | - Guangli Lu
- Institute of Business Administration, School of Business, Henan University, Jinming Avenue, Henan, Kaifeng, 475004, China
| | - Yanqing Shang
- School of Basic Medical Science, Henan University, Jinming Avenue, Henan, Kaifeng, 475004, China.
| | - Chaoran Chen
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Henan, Kaifeng, China.
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Jong A, Odoi CM, Lau J, J.Hollocks M. Loneliness in Young People with ADHD: A Systematic Review and Meta-Analysis. J Atten Disord 2024; 28:1063-1081. [PMID: 38400533 PMCID: PMC11016212 DOI: 10.1177/10870547241229096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Many studies focus on problematic peer functioning in attention deficit/hyperactivity disorder (ADHD) but loneliness has been studied less. This paper examined (1) The loneliness level differences between young people (below 25 years old) with ADHD and those without ADHD, and (2) The association between loneliness and mental health difficulties in young people with ADHD. Six electronic databases were searched and 20 studies were included. A random effects meta-analysis was carried out in RStudio using the metafor package for the first question, while a narrative synthesis summarized the findings for the second question. The meta-analysis (n = 15) found that young people with ADHD reported significantly higher loneliness than those without ADHD, with a small-to-medium weighted pool effect (Hedges' g = 0.41) and high heterogeneity (I2 = 75.1%). For the second question (n = 8), associations between loneliness and mental health difficulties in ADHD was found (r = 0.05-0.68). Targeted research and interventions on loneliness in young people with ADHD is needed.
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Affiliation(s)
- Angelina Jong
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
| | - Clarissa Mary Odoi
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
| | - Jennifer Lau
- Queen Mary University of London Wolfson Institute of Population Health, London, UK
| | - Matthew J.Hollocks
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
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Jin E, Hwang SSH. A preliminary study on the neurocognitive deficits associated with loneliness in young adults. Front Public Health 2024; 12:1371063. [PMID: 38680939 PMCID: PMC11046705 DOI: 10.3389/fpubh.2024.1371063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/01/2024] [Indexed: 05/01/2024] Open
Abstract
The experience of loneliness is universal and may have an adverse effect on neurocognitive functioning even at a younger age. Using a comprehensive neurocognitive functioning test (NCFT) battery, we examined the possible negative effects of loneliness on neurocognitive functioning in young adults. The high-loneliness and low-loneliness groups were screened using the UCLA Loneliness Scale v. 3, and measures pertaining to the domains of intelligence, attention, memory, executive function, and psychomotor functioning were tested and compared. As depression and anxiety were significantly higher in the high-loneliness group, an analysis of covariance was conducted. As a result, the high-loneliness group showed significantly poor performance on measures of executive function and attention prior to controlling for depression and anxiety, and executive function retained its significance even after controlling for these variables. Additional analysis showed that depression and anxiety did not significantly mediate the relationship between loneliness and neurocognitive functioning. Such results suggest that loneliness is likely to negatively affect executive functioning and attention in early adulthood and then progressively spread to other domains of cognitive functioning, as reported in the older adult population. The limitations and implications of the present study were considered and addressed.
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Wang Y, Zeng Y. Relationship between loneliness and internet addiction: a meta-analysis. BMC Public Health 2024; 24:858. [PMID: 38504216 PMCID: PMC10953128 DOI: 10.1186/s12889-024-18366-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 03/15/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND In the digital age, the Internet has become integrated into all aspects of people's work, study, entertainment, and other activities, leading to a dramatic increase in the frequency of Internet use. However, excessive Internet use has negative effects on the body, psychology, and many other aspects. This study aims to systematically analyze the research findings on the relationship between loneliness and Internet addiction to obtain a more objective, comprehensive effect size. METHODS This study employed a comprehensive meta-analysis of empirical research conducted over the past two decades to investigate the relationship between loneliness and Internet addiction, with a focus on the moderating variables influencing this relationship. This meta-analysis adopted a unique approach by categorizing moderating variables into two distinct groups: the objective characteristics of research subjects and the subjective characteristics of researchers. It sheds light on the multifaceted factors that influence the relationship between loneliness and Internet addiction. RESULTS A literature search in web of science yielded 32 independent effect sizes involving 35,623 subjects. Heterogeneity testing indicated that a random effects model was appropriate. A funnel plot and Begg and Mazumdar's rank correlation test revealed no publication bias in this meta-analysis. Following the effect size test, it was evident that loneliness was significantly and positively correlated with Internet addiction (r = 0.291, p < 0.001). The moderating effect analysis showed that objective characteristics significantly affected the relationship. However, subjective characteristics did not affect the relationship. CONCLUSIONS The study revealed a moderately positive correlation between loneliness and Internet addiction. Moreover, this correlation's strength was found to be influenced by various factors, including gender, age, grade, and the region of the subjects. However, it was not affected by variables such as the measurement tool, research design, or research year (whether before or after COVID-19).
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Affiliation(s)
- Yue Wang
- Department of Education, Liaoning Normal University, 116000, Dalian, China
| | - Youlai Zeng
- Department of Education, Liaoning Normal University, 116000, Dalian, China.
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Koncz P, Demetrovics Z, Takacs ZK, Griffiths MD, Nagy T, Király O. The emerging evidence on the association between symptoms of ADHD and gaming disorder: A systematic review and meta-analysis. Clin Psychol Rev 2023; 106:102343. [PMID: 37883910 DOI: 10.1016/j.cpr.2023.102343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 06/27/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023]
Abstract
The co-existence of gaming disorder (GD) with other mental health problems has been widely reported. Despite the growing research interest in the comorbidity of GD with attention-deficit/hyperactivity disorder (ADHD), to date, no quantitative synthesis has been performed. The present study comprised a systematic literature search using Scopus, Science Direct, Web of Science, and PubMed databases. Three types of studies were included in the analyses: studies reporting (i) correlation coefficients between the symptoms of GD and ADHD, (ii) means, and standard deviations for comparison of GD severity between ADHD/non-ADHD individuals, and (iii) comparison of ADHD severity between GD/non-GD individuals. The results indicated a moderate relationship between GD and ADHD symptom severity when both subdomains of ADHD were combined (r = 0.296), and also when only inattention (r = 0.306) or hyperactivity (r = 0.266) symptoms were analyzed, which was also confirmed in a structural equation model meta-analysis. Studies showed a large average difference comparing the GD symptom severity of ADHD and non-ADHD individuals (g = 0.693), or ADHD symptom severity of GD and non-GD individuals (g = 0.854). In some cases, higher estimates of association were reported among studies that (i) had a higher proportion of males, (ii) assessed problematic internet use among predominantly videogame player samples rather than assessing only GD, and (iii) had been more recently published. The present review shows that this is an emerging field demonstrating significant results in cross-sectional correlational studies. However, future research should apply more rigorous methodologies to investigate the relationship further (e.g., longitudinal studies and studies using professional/clinical ratings and diagnosis). These results suggest that screening and treatment for ADHD among individuals with gaming disorder is necessary, and individuals with ADHD should be made aware of their higher susceptibility to gaming disorder.
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Affiliation(s)
- Patrik Koncz
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar.
| | - Zsofia K Takacs
- School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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Augner C, Vlasak T, Barth A. The relationship between problematic internet use and attention deficit, hyperactivity and impulsivity: A meta-analysis. J Psychiatr Res 2023; 168:1-12. [PMID: 37866293 DOI: 10.1016/j.jpsychires.2023.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 09/11/2023] [Accepted: 10/14/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE This study aimed to investigate the relationship between problematic internet use (PIU) and ADHD-related symptoms of attention deficit, impulsivity and hyperactivity. METHODS We chose a meta-analytical approach and searched for relevant studies in different databases (Pubmed, PsycInfo, Google scholar). We identified 24 studies with 18 859 participants (mean age = 18.40 (SD = 5.51)) published between 2004 and 2021 which were applicable for our research. We calculated 21, 7, and 9 effect sizes for attention deficit, hyperactivity and impulsivity, respectively. RESULTS We found significant associations between PIU and attention deficit (r = 0.36, 95% confidence interval = [0.28 to 0.43]), hyperactivity (r = 0.44, 95% confidence interval = [0.33 to 0.53]), and impulsivity (r = 0.41, 95% confidence interval = [0.30 to 0.51]), p < .001 for all three. The effect sizes of attention deficit and hyperactivity were significantly higher in male compared to female participants. Additionally, higher attention deficit effects were found in adults compared to children/adolescents. CONCLUSIONS Our meta-analysis indicates that ADHD-related symptoms are associated with PIU. Although cross-sectional analyses cannot explain cause-and-effect relationships, we hypothesize that attention deficit, hyperactivity and impulsivity constitute a vulnerability towards PIU.
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Affiliation(s)
- Christoph Augner
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria; Institute for Human Resources Research in Health Care, University Clinics of Paracelsus Medical University, Salzburg, Austria.
| | - Thomas Vlasak
- Institute for Psychology, Sigmund Freud University Linz, Austria
| | - Alfred Barth
- Institute for Psychology, Sigmund Freud University Linz, Austria
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Lin HT, Tai YM, Gau SSF. Autistic Traits and Cyberbullying Involvement Mediated by Psychopathologies and School Functions in a Nationally Representative Child Sample. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023; 26:706-716. [PMID: 37477877 DOI: 10.1089/cyber.2022.0309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Cyberbullying has become an international concern among youth with autistic traits in the digital age. It draws the attention of professionals in mental health and education due to its potentially severe psychosocial and academic impacts. However, there is limited knowledge about the mediators for these associations. This study investigated whether school dysfunction and comorbid psychopathologies mediated the link between autistic traits and cyberbullying. We used a nationally representative sample of 9,483 students (9-14 years of age). The instruments included the Social Responsiveness Scale for autistic traits; the Cyberbullying Experiences Questionnaire for cyberbullying victimization and perpetration; the Swanson, Nolan, and Pelham, version IV for inattention, hyperactivity/impulsivity, and oppositional behaviors; the Child Behavior Checklist for anxiety/depression; and the Social Adjustment Inventory for Children and Adolescents for impaired school functions. Multiple mediation models were used for statistical analyses. The results showed that the 1-year prevalence rates of pure victims, pure perpetrators, and bully-victims of cyberbullying were 7.9 percent, 2.4 percent, and 5.7 percent, respectively. Cyberbullying victimization and perpetration were positively associated with autistic traits, school dysfunction, and comorbid psychopathologies. The associations between autistic traits and cyberbullying victims and bully-victims were significantly mediated by school dysfunction and hyperactivity/impulsivity (only for bully-victims), independent of sex and age. Our results suggest that early identification and intervention of these difficulties may mitigate the risks of cyberbullying. ClinicalTrials.gov ID: NCT02707848.
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Affiliation(s)
- Hai-Ti Lin
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yueh-Ming Tai
- Department of Psychiatry, Beitou Branch, Tri-Service Hospital, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
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El Archi S, Barrault S, Garcia M, Branger S, Maugé D, Ballon N, Brunault P. Adult ADHD Diagnosis, Symptoms of Impulsivity, and Emotional Dysregulation in a Clinical Sample of Outpatients Consulting for a Behavioral Addiction. J Atten Disord 2023; 27:731-742. [PMID: 36945199 DOI: 10.1177/10870547231161336] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE This study aimed to investigate ADHD in adult outpatients seeking treatment for a behavioral addiction and to identify the specificity of psychopathological features if the behavioral addiction cooccurs with adult ADHD. METHOD Sixty-five outpatients consulting for a behavioral addiction were assessed for ADHD (DIVA-5), addictive disorder (alcohol, tobacco, cannabis, gambling, gaming, food, and sex), impulsivity (UPPS-P), and emotion dysregulation (DERS-36). RESULTS In our sample of outpatients seeking treatment for a behavioral addiction, adult ADHD was independently associated with higher compulsive sexual behavior disorder severity, "sensation seeking," "positive urgency," difficulties in "goal-directed behavior," "impulse control," and use of "emotion regulation strategies" in the context of intense emotions. A 19% of the sample was diagnosed for adult ADHD. CONCLUSION The association of adult ADHD with specific dimensions of impulsivity and emotion dysregulation, pave the way for future clinical and research perspectives.
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Affiliation(s)
| | - Servane Barrault
- Qualipsy, EE1901, Université de Tours, Tours, France
- Centre de Soins d'Accompagnement et de Prévention en Addictologie (CSAPA-37), Tours, France
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne-Billancourt, France
| | - Manuel Garcia
- Centre de Soins d'Accompagnement et de Prévention en Addictologie (CSAPA-37), Tours, France
- Équipe de Liaison et de Soins en Addictologie, Tours, France
| | - Stéphanie Branger
- Centre de Soins d'Accompagnement et de Prévention en Addictologie (CSAPA-37), Tours, France
| | - Damien Maugé
- Centre de Soins d'Accompagnement et de Prévention en Addictologie (CSAPA-37), Tours, France
| | - Nicolas Ballon
- Équipe de Liaison et de Soins en Addictologie, Tours, France
- UMR 1253, iBrain, INSERM, Université de Tours, Tours, France
| | - Paul Brunault
- Qualipsy, EE1901, Université de Tours, Tours, France
- Équipe de Liaison et de Soins en Addictologie, Tours, France
- UMR 1253, iBrain, INSERM, Université de Tours, Tours, France
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Internet addiction and loneliness among school-going adolescents in Bangladesh in the context of the COVID-19 pandemic: Findings from a cross-sectional study. Heliyon 2023; 9:e13340. [PMID: 36743850 PMCID: PMC9889277 DOI: 10.1016/j.heliyon.2023.e13340] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 01/16/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
Internet addiction (IA) by children and adolescents is a concern for parents. The intensity of this problem has increased in the context of COVID-19 pandemic across the world. Here we aimed to evaluate internet usage patterns, addiction to internet use, and mental health among Bangladeshi school-going adolescents during the COVID-19 pandemic. We conducted this cross-sectional study among 502 school-going adolescents. Pre-structured questionnaire was used to collect information related to demographics and the internet usage pattern. We assessed the prevalence of IA and loneliness using the internet addiction test (IAT) scale and UCLA-3 loneliness scale. The prevalence of IA and loneliness among Bangladeshi school-going adolescents were 88.25% and 72.51%, respectively. Individuals with English-medium education, higher classes, high economic status, mobile internet connection, online gaming habits, and living without family showed significantly higher levels of IA. Moreover, a high proportion of loneliness was observed among individuals with high financial conditions, mobile internet connection, and who watch movies on the internet. The present study findings suggest a strong association between demographics, internet usage patterns, IA, and the mental health of adolescents. These results would have practical inferences in clinical psychology, psychotherapy, and related fields. Based on this finding, the healthcare authorities and professionals can develop an inclusive interventional approach for adolescents who suffer from IA and mental health disorders.
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Structural Equation Modeling (SEM): Gaming Disorder Leading Untreated Attention-Deficit/Hyperactivity Disorder to Disruptive Mood Dysregulation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116648. [PMID: 35682233 PMCID: PMC9179962 DOI: 10.3390/ijerph19116648] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 12/04/2022]
Abstract
(1) Background: Internet gaming disorder (IGD) in youths likely leads to disruptive mood dysregulation, especially among those with attention-deficit/hyperactivity disorder (ADHD). Whether IGD mediates the pathways leading ADHD to disruptive emotional dysfunction remains unclear. This study aims to elucidate the direct or indirect influence of IGD on ADHD; (2) Method: The Swanson, Nolan, and Pelham Version IV questionnaire was used to evaluate symptoms of ADHD and oppositional defiant disorder, and the Chen gaming disorder scale was used to measure IGD. A psychiatrist diagnosed ADHD, IGD, and disruptive mood dysregulation disorder (DMDD)-like symptoms. Structural equation modeling was applied to evaluate the role of IGD in mediating ADHD progression to disruptive mood dysregulation; (3) Results: Among a total of 102 ADHD youths, 53 (52%) of them with IGD were significantly more likely to have poor interpersonal relationships (p < 0.01) and DMDD-like symptoms (p < 0.01) than ADHD youths without IGD. IGD played a mediating role in increasing the risk of disruptive mood dysregulation in ADHD youths; (4) Conclusions: The findings suggest that IGD mediates ADHD’s progression to disruptive mood dysregulation. Intensive biopsychosocial interventions are warranted for ADHD youths with IGD. More children and adolescents became mood-dysregulated after excessive gaming during the COVID-19 pandemic; this study’s results suggest that child mental health experts develop earlier detection and prevention strategies for children and adolescents hidden behind internet addiction.
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Khatcherian E, Zullino D, De Leo D, Achab S. Feelings of Loneliness: Understanding the Risk of Suicidal Ideation in Adolescents with Internet Addiction. A Theoretical Model to Answer to a Systematic Literature Review, without Results. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042012. [PMID: 35206200 PMCID: PMC8872550 DOI: 10.3390/ijerph19042012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/04/2022]
Abstract
The Internet has become an essential tool for adolescents. It is part of their social integration within peers and supports their identity construction. The Internet can also become a source of addiction, especially when used as a coping strategy towards unpleasant life situations. Addiction to the Internet is often linked with an increase in the feeling of loneliness. The feeling of loneliness is an emotion present during adolescence. However, in excess, it can lead to suicidal ideation. Addiction to the Internet is also linked to an increased suicide risk. We questioned ourselves on the impact of the feeling of loneliness on the link between an excessive use of the Internet by adolescents and the risks of suicidal ideation. We attempted to find an answer to this question by performing a systematic review of the literature. We found no result matching our search criteria. We noted the absence of studies with regards to the interaction between the feeling of loneliness, addiction to the Internet and the risk of suicidal ideation amongst adolescents. We established a theoretical model which could be used as a lead for future research. We insist on the importance that studies need to be conducted in this domain, in order to enable us to establish efficient preventive measures for the risks of suicidal ideation amongst adolescents.
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Affiliation(s)
- Eugénie Khatcherian
- Addiction Division, Department of Psychiatry, University Hospitals of Geneva,1202 Geneva, Switzerland; (E.K.); (D.Z.)
| | - Daniele Zullino
- Addiction Division, Department of Psychiatry, University Hospitals of Geneva,1202 Geneva, Switzerland; (E.K.); (D.Z.)
- Department of Psychiatry, Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland
| | - Diego De Leo
- Department of Psychology, Primorska University, 6000 Koper, Slovenia;
- AISRAP, Griffith University, Mt Gravatt Campus, Mount Gravatt, QLD 4122, Australia
- De Leo Fund, 35137 Padua, Italy
| | - Sophia Achab
- Addiction Division, Department of Psychiatry, University Hospitals of Geneva,1202 Geneva, Switzerland; (E.K.); (D.Z.)
- Department of Psychiatry, Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland
- Correspondence:
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Association between internet addiction and loneliness across the world: A meta-analysis and systematic review. SSM Popul Health 2021; 16:100948. [PMID: 34754896 PMCID: PMC8563346 DOI: 10.1016/j.ssmph.2021.100948] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 11/24/2022] Open
Abstract
There might be an association between Internet addiction (IA) and loneliness; however, inconsistent evidence suggests that the severity of this association remains unclear. This study was conducted to assess the association between IA and loneliness. A systematic literature search was conducted in four online databases, including PubMed (MESH terms), Web of Science, Scopus, and Embase. Observational studies measuring the association between IA and loneliness were screened and included in this review. A meta-analysis was conducted using the Stata software. Twenty-six articles with a total sample size of 16496 subjects were included in the analysis. A moderate positive association (r = 0.15 (95% CI: 0.13, 0.16)) was found between IA and loneliness. The individuals with IA had significantly higher scores of loneliness. According to this meta-analysis, we need more attention to the early symptoms of loneliness in individuals with IA. Longitudinal studies are needed to determine the temporality of this association considering adjustment for time varying confounders.
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Wongpakaran N, Wongpakaran T, Pinyopornpanish M, Simcharoen S, Kuntawong P. Loneliness and problematic internet use: testing the role of interpersonal problems and motivation for internet use. BMC Psychiatry 2021; 21:447. [PMID: 34507556 PMCID: PMC8431860 DOI: 10.1186/s12888-021-03457-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/01/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND A number of factors have been demonstrated to be associated with Problematic Internet Use (PIU); otherwise known as Internet Addiction), which is mostly concerned with psychological problems such as loneliness. This study aimed to examine how and in what way loneliness influenced PIU. METHODS A self-report measurement on loneliness, the Internet addiction test (IAT) and instruments on interpersonal problems were administered to 318 medical students (57% females); mean age totaled 20.88 years (SD = 1.8). We performed a mediation analysis to evaluate direct effects of loneliness on IAT, as well as indirect effects mediated by interpersonal problems. In addition, motivation for internet use was added to the mediation model and tested whether it acted as the second mediator (serial mediation model) or a moderator (moderated mediation model). RESULTS After controlling for sex and age, socially inhibited problems exhibited full mediation whereas the remainder showed partial mediation effects, with the exception that intrusive and cold interpersonal problems indicated no mediating role. Negative motivation and motivation for being accepted had mediation effects for all types of interpersonal problems. Motivation for working was found to be a significant mediator and moderator of the most interpersonal problems. Intrusive and cold styles became a mediator only when some motivation variables were added to the model, implying that not only psychological problems should be included when analyzing PIU, but also other variables such motivation for internet use. The percent of variance explained, by IAT score, increased from 13% in the mediation model to 33% by the moderated mediation model, and 43% using the serial mediation model. CONCLUSION The study suggested the crucial role of loneliness and interpersonal problems on PIU, for which motivation for internet use explained how each interpersonal problem would be associated. This may provide some insight regarding the pathological characteristics of those using the internet as a coping strategy.
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Affiliation(s)
- Nahathai Wongpakaran
- grid.7132.70000 0000 9039 7662Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200 Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand.
| | - Manee Pinyopornpanish
- grid.7132.70000 0000 9039 7662Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200 Thailand
| | | | - Pimolpun Kuntawong
- grid.7132.70000 0000 9039 7662Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200 Thailand
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Perpetration of and Victimization in Cyberbullying and Traditional Bullying in Adolescents with Attention-Deficit/Hyperactivity Disorder: Roles of Impulsivity, Frustration Intolerance, and Hostility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136872. [PMID: 34206834 PMCID: PMC8297231 DOI: 10.3390/ijerph18136872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/20/2021] [Accepted: 06/24/2021] [Indexed: 01/23/2023]
Abstract
Victimization and perpetration of cyberbullying and traditional bullying are prevalent among adolescents with attention-deficit/hyperactivity disorder (ADHD). This study examined the associations of impulsivity, frustration discomfort, and hostility with victimization and with the perpetration of cyberbullying and traditional bullying in adolescents with ADHD. Self-reported involvement in cyberbullying and traditional bullying was assessed in 195 adolescents with a clinical diagnosis of ADHD. Adolescents also completed questionnaires for impulsivity, frustration discomfort, and hostility. Caregivers completed the Child Behavior Checklist for adolescents’ ADHD, internalization, oppositional defiance, and problems with conduct. The associations of impulsivity, frustration discomfort, and hostility with victimization and perpetration of cyberbullying and traditional bullying were examined using logistic regression analysis. The results demonstrated that after the effects of demographic characteristics and behavioral problems were controlled for, frustration intolerance increased the risks of being cyberbullying victims and perpetrators whereas hostility increased the risks of being the victims and perpetrators of traditional bullying. Impulsivity was not significantly associated with any type of bullying involvement. Prevention and intervention programs should alleviate frustration intolerance and hostility among adolescents with ADHD.
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Alavi SS, Ghanizadeh M, Mohammadi MR, Jannatifard F, Esmaili Alamuti S, Farahani M. The effects of cognitive-behavioral group therapy for reducing symptoms of internet addiction disorder and promoting quality of life and mental health. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2021; 43:47-56. [PMID: 33681908 PMCID: PMC7932042 DOI: 10.47626/2237-6089-2020-0010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/24/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Internet addiction disorder has reportedly become an important cause of health and social problems. The aim of this study was to investigate the effectiveness of cognitive-behavioral group therapy for internet addiction symptoms, quality of life, and mental health of students with internet addiction. METHODS This was a quasi-experimental study with pretest-posttest measures and a control group. The statistical population of the study consisted of all students at Tehran universities in the academic year of 2018-19. The target group was selected through an internet addiction test and a clinical interview using a targeted sampling method and was divided into experimental and control groups by randomization. The experimental group participated in fifteen 90-minute cognitive-behavioral group therapy sessions. Before, immediately after, and 3 months after the treatment, the internet addiction symptoms of both groups were evaluated to assess mental health with the IAT, quality of life (QOL), and SCL-90-R questionnaires. Data were analyzed with ANCOVA analysis using SPSS Statistics 20 software. RESULTS After treatment, cognitive-behavioral therapy groups showed reductions in internet addiction scores (p < 0.05). Results showed that the cognitive-behavioral group therapy was effective for improving quality of life (p < 0.05) and mental illnesses (p < 0.05) in students with internet addiction. CONCLUSIONS Cognitive-behavioral group therapy can enhance awareness and mental health of students with internet addiction. Therefore, this intervention can be used as a beneficial treatment to reduce internet addiction symptoms and improve the condition of people with behavioral addictions such as internet dependency.
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Affiliation(s)
- Seyyed Salman Alavi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Malihe Farahani
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Duong XL, Liaw SY, Augustin JLPM. How has Internet Addiction been Tracked Over the Last Decade? A Literature Review and 3C Paradigm for Future Research. Int J Prev Med 2021; 11:175. [PMID: 33456731 PMCID: PMC7804875 DOI: 10.4103/ijpvm.ijpvm_212_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/04/2020] [Indexed: 12/25/2022] Open
Abstract
Background: The popularity of the internet aggravated by its excessive and uncontrolled use has resulted in psychological impairment or addiction. Internet addiction is hypothesized as an impulse-control disorder of internet use having detrimental impacts on daily life functions, family relationships, and emotional stability. The goal of this review is to provide an exhaustive overview of the empirical evidence on internet addiction and draw attention to future research themes. Methods: We performed a literature search on ScienceDirect and PubMed to review original research articles with empirical evidence published on peer-reviewed international journals from 2010 to 2019. Eight hundred and 26 articles were eligible for analysis. Frequency and descriptive statistics were calculated by Microsoft Excel. Results: A substantial contribution has been coming from researchers from China, Turkey, Korea, Germany, and Taiwan respectively. Despite controversies regarding its definition and diagnostic procedures, internet addiction has become the focal point of a myriad of studies that investigated this particular phenomenon from different exposures. Given observed literature review data regarding research design, data acquisition, and data analysis strategies, we proposed the 3C paradigm which emphasizes the necessity of research incorporating cross-disciplinary investigation conducted on cross-cultural settings with conscientious cross-validation considerations to gain a better comprehension of internet addiction. Conclusions: The findings of the present literature review will serve both academics and practitioners to develop new solutions for better characterize internet addiction.
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Affiliation(s)
- Xuan-Lam Duong
- Faculty of Economics and Rural Development, Thai Nguyen University of Agriculture and Forestry, Thai Nguyen Province, Vietnam.,Department of Tropical Agriculture and International Cooperation, National Pingtung University of Science and Technology, Pingtung City, Taiwan
| | - Shu-Yi Liaw
- Management College, Computer Centre, National Pingtung University of Science and Technology, Pingtung City, Taiwan
| | - Jean-Luc Pradel Mathurin Augustin
- Department of Tropical Agriculture and International Cooperation, National Pingtung University of Science and Technology, Pingtung City, Taiwan
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Lee M, Chung SJ, Lee Y, Park S, Kwon JG, Kim DJ, Lee D, Choi JS. Investigation of Correlated Internet and Smartphone Addiction in Adolescents: Copula Regression Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165806. [PMID: 32796609 PMCID: PMC7460171 DOI: 10.3390/ijerph17165806] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/31/2020] [Accepted: 08/06/2020] [Indexed: 01/31/2023]
Abstract
Internet and smartphone addiction have become important social issues. Various studies have demonstrated their association with clinical and psychological factors, including depression, anxiety, aggression, anger expression, and behavioral inhibition, and behavioral activation systems. However, these two addictions are also highly correlated with each other, so the consideration of the relationship between internet and smartphone addiction can enhance the analysis. In this study, we considered the copula regression model to regress the bivariate addictions on clinical and psychological factors. Real data analysis with 555 students (age range: 14-15 years; males, N = 295; females, N = 265) from South Korean public middle schools is illustrated. By fitting the copula regression model, we investigated the dependency between internet and smartphone addiction and determined the risk factors associated with the two addictions. Furthermore, by comparing the model fits of the copula model with linear regression and generalized linear models, the best copula model was proposed in terms of goodness of fit. Our findings revealed that internet and smartphone addiction are not separate problems, and that associations between them should be considered. Psychological factors, such as anxiety, the behavioral inhibition system, and aggression were also significantly associated with both addictions, while ADHD symptoms were related to internet addiction only. We emphasize the need to establish policies on the prevention, management, and education of addiction.
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Affiliation(s)
- Minji Lee
- Department of Statistics, Ewha Womans University, Seoul 03760, Korea;
| | - Sun Ju Chung
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea;
| | - Youngjo Lee
- Department of Statistics, Seoul National University, Seoul 08826, Korea;
| | - Sera Park
- I Will Center, Seoul Metropolitan Boramae Youth Center, Seoul 07062, Korea; (S.P.); (J.-G.K.)
| | - Jun-Gun Kwon
- I Will Center, Seoul Metropolitan Boramae Youth Center, Seoul 07062, Korea; (S.P.); (J.-G.K.)
| | - Dai Jin Kim
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Donghwan Lee
- Department of Statistics, Ewha Womans University, Seoul 03760, Korea;
- Correspondence: (D.L.); (J.-S.C.)
| | - Jung-Seok Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea;
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul 03080, Korea
- Correspondence: (D.L.); (J.-S.C.)
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19
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Moretta T, Buodo G. Problematic Internet Use and Loneliness: How Complex Is the Relationship? A Short Literature Review. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00305-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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20
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Zheng X, Chen J, Guo Y, Xiong Q, Hu Y, Shi S, Li C, Yu Q. The buffer effect of physical activity: Why does parental marital satisfaction affect adolescents' problematic Internet use. Addict Behav Rep 2020; 11:100271. [PMID: 32300636 PMCID: PMC7152658 DOI: 10.1016/j.abrep.2020.100271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/16/2020] [Accepted: 03/25/2020] [Indexed: 01/15/2023] Open
Abstract
Marital satisfaction negatively predicted adolescents' problematic internet use (PIU). Depression mediated the relationship between marital satisfaction and PIU. The mediating effect was significant for individuals with low physical activity. The mediating effect was not significant for individuals with high physical activity.
Introduction To explore the moderating effect of physical activity and the mediating effect of depression on the relationship between marital satisfaction and adolescents’ problematic internet use (PIU). Methods This study adopted a sample of 288 adolescents and their parents, and measured adolescents’ depression, PIU, physical activity, and parents’ marital satisfaction. Results These results showed that parental marital satisfaction negatively predicted adolescents' PIU. Adolescents’ depression played a mediating role between parental marital satisfaction and adolescents’ PIU. Further mediated moderation effect analysis showed that the interaction between marital satisfaction and adolescents' physical activity affected the PIU through adolescents’ depression. Specifically, for individuals with lower physical activity, the marital satisfaction affected the PIU through adolescents' depression. However, for the group with higher physical activity, physical activity weakened the effects of marital satisfaction on adolescents' depression, and the mediating effect of depression did not reach a significant level. Conclusion These results are of theoretical and practical significance in understanding and intervening to address adolescents' PIU.
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Affiliation(s)
- Xintong Zheng
- Graduate School of Education, Huazhong University of Science and Technology, No 1037 Luoyu Rd, Hongshan District, Wuhan, Hubei 430074, China
| | - Jianwen Chen
- Graduate School of Education, Huazhong University of Science and Technology, No 1037 Luoyu Rd, Hongshan District, Wuhan, Hubei 430074, China
| | - Yafei Guo
- Department of Business Administration, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Qing Xiong
- Jiangxi University of Finance and Economics, China
| | - Yiqiu Hu
- School of Educational Science, Hunan Normal University, No 36. Lushan Road, Yuelu District, Changsha 410081, China
| | - Shuping Shi
- RDFZ Chaoyang Branch School, No. 8 Taiyanggong Nanlin st, Chaoyang District, Beijing 100020, China
| | - Congcong Li
- School of Psychology, Central China Normal University, No 152 Luoyu Rd, Hongshan District Wuhan, Hubei 430079, China
| | - Quanlei Yu
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, School of Psychology, Central China Normal University, Central China Normal University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality, No 152 Luoyu Rd, Hongshan District Wuhan, Hubei 430079, China
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Toro R, García-García J, Zaldívar-Basurto F. Factorial Structure and Invariance Analysis of the BIS–BAS Scale, IPIP-R Version. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2020. [DOI: 10.1007/s10942-020-00345-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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22
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Wongpakaran N, Wongpakaran T, Pinyopornpanish M, Simcharoen S, Suradom C, Varnado P, Kuntawong P. Development and validation of a 6-item Revised UCLA Loneliness Scale (RULS-6) using Rasch analysis. Br J Health Psychol 2020; 25:233-256. [PMID: 31999891 DOI: 10.1111/bjhp.12404] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 01/06/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The UCLA Loneliness Scale, containing 20 items, is one of the commonly used loneliness scales. Some shorter versions have been developed using factor analysis. The study aimed to shorten the UCLA Loneliness Scale using Rasch and factor analysis methods and test the psychometric properties of the new scale. METHODS The full sample of the study included 719 respondents, divided into three subsamples (205, 324, and 190 for samples 1-3, respectively). The original, 20-item Revised UCLA Loneliness Scale (R-ULS) was shortened using 205 students (sample 1); the shortened scale was then validated for construct and concurrent validity with 324 students (sample 2) and 190 clinical participants (sample 3). Confirmatory factor analysis and Rasch analysis were used for construct validity. Convergent, discriminant, and concurrent validity were assessed by exploring the correlation with other psychological measurements. RESULTS In sample 1, the R-ULS was shortened to a 6-item scale (RULS-6) that fits the Rasch model. The RULS-6 met the criteria of unidimensionality and local independence without differential item functioning due to age and sex, and good targeting the clinical sample. Person Separation Index (PSI) reflected that reliability from the Rasch perspective was acceptable. However, collapsing categories 2 (sometime) and 3 (rarely) may be required in a clinical sample. When tested in samples 2 and 3, the RULS-6 fits the Rasch measurement model. Convergent and discriminant validity were demonstrated with interpersonal problems and attachment scales. As expected, a positive correlation was found between RULS-6 and anxiety, depression subscale, interpersonal difficulties, and somatization subscales denoting concurrent validity. Cronbach's alpha of the RULS-6 was good (.83). CONCLUSION Using Rasch analysis, the proposed RULS-6 constituted a 70% reduction of the number of original items, yet preserved the psychometric properties in independent samples of students and psychiatric outpatients. Statement of contribution What is already known on this subject? The UCLA Loneliness Scale is a common instrument used to gauge loneliness levels. The 20-item revised scale (R-ULS) has acceptable psychometric properties but its construct varies. Due to the length of the questionnaire, administration of R-ULS is not always practical. Short versions vary in items and were developed with classic test theory (e.g., factor analysis). Rasch analysis - providing more accuracy based on measurement theory - could be used instead. What does this study add? Using a Rasch analysis approach, a 6-item scale of loneliness (RULS-6) was created. The RULS-6 was tested in student and clinical samples, meeting Rasch measurement model criteria. The RULS-6 showed promising psychometrics to be used in both non-clinical and clinical samples.
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Affiliation(s)
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand
| | | | | | - Chawisa Suradom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand
| | - Pairada Varnado
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand
| | - Pimolpun Kuntawong
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand
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Assari S. Sex Differences in the Association between Cortical Thickness and Children's Behavioral Inhibition. JOURNAL OF PSYCHOLOGY & BEHAVIOR RESEARCH 2020; 2:49-64. [PMID: 33241229 DOI: 10.22158/jpbr.v2n2p49] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM To investigate sex differences in the association between cortical thickness and behavioral inhibition of 9-10 years old American children. MATERIALS AND METHODS This cross-sectional investigation used data from the Adolescent Brain Cognitive Development (ABCD) study. Baseline ABCD data of 10249 American children between ages 9 and 10 were analyzed. The independent variable was cortical thickness measured by structural brain magnetic resonance imaging (sMRI). The primary outcome, behavioral inhibition, was measured based on the behavioral inhibition system (BIS), and behavioral approach system (BAS). Sex was the moderator. Age, race, ethnicity, socioeconomic status indicators, and intracranial volume were covariates. RESULTS In the overall sample, high cortical thickness was not associated with behavioral inhibition in children. Sex showed a statistically significant interaction with cortical thickness's effect on children's behavioral inhibition, net of all confounders. The interaction indicated a statistically stronger positive effect of high cortical thickness on male behavioral inhibition compared to female children. CONCLUSION Cortical thickness is a determinant of behavioral inhibition for male but not female American children. Male but not female children show better behavioral inhabitation at higher levels of cortical thickness.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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Li Q, Dai W, Zhong Y, Wang L, Dai B, Liu X. The Mediating Role of Coping Styles on Impulsivity, Behavioral Inhibition/Approach System, and Internet Addiction in Adolescents From a Gender Perspective. Front Psychol 2019; 10:2402. [PMID: 31708840 PMCID: PMC6821786 DOI: 10.3389/fpsyg.2019.02402] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 10/08/2019] [Indexed: 01/13/2023] Open
Abstract
Previous findings have shown that impulsivity and Behavioral Inhibition/Approach System (BIS/BAS) have substantial effects on adolescents’ Internet addiction, but the mechanisms underlying these associations and gender differences in these effects have received little attention. We examined the mediating effects of coping styles from impulsivity, and BIS/BAS to Internet addiction as well as gender differences in these associations. A total of 416 Chinese adolescents were examined using a cross-sectional survey involving Young’s Diagnostic Questionnaire for Internet Addiction, Barratt Impulsiveness Scale, BIS/BAS scales, and Coping Style Scale for Middle School Students. The data were analyzed using the independent sample t-test, chi-square test, Pearson correlation, and structure equation modeling. The results from the multiple-group (by adolescent gender) structural model analysis revealed that both impulsivity (p < 0.001) and BIS (p = 0.001) directly predicted positive Internet addiction in girls, while both impulsivity (p = 0.011) and BAS (p = 0.048) directly predicted positive Internet addiction in boys. Furthermore, emotion-focused coping mediated the relationship between impulsivity and Internet addiction (β = 0.080, 95% CI: 0.023–0.168) and the relationship between BIS and Internet addiction (β = 0.064, 95% CI: 0.013–0.153) in girls, while in boys, problem-focused coping and emotion-focused coping mediated the association between impulsivity and Internet addiction (β = 0.118, 95% CI: 0.031–0.251; β = 0.065, 95% CI: 0.010–0.160, respectively) and problem-focused coping mediated the association between BAS and Internet addiction [β = −0.058, 95% CI: (−0.142)–(−0.003)]. These findings extend our insight into the mechanisms underlying the associations among impulsivity, BIS/BAS, and Internet addiction in adolescents and suggest that gender-sensitive training approaches to decrease adolescents’ Internet addiction are indispensable. These interventions should focus on the different gender predictors of adolescent Internet addiction and on the development of specific coping styles for boys and girls respectively.
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Affiliation(s)
- Qi Li
- Chinese Academy of Sciences, Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Weine Dai
- Chinese Academy of Sciences, Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Center of Functionally Integrative Neuroscience and Positron Emission Tomography Center, Aarhus University, Aarhus, Denmark.,Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China.,Sino-Danish Center for Education and Research, Beijing, China
| | - Yang Zhong
- Chinese Academy of Sciences, Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Lingxiao Wang
- Chinese Academy of Sciences, Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Bibing Dai
- Institute of Psychology, Tianjin Medical University, Tianjin, China
| | - Xun Liu
- Chinese Academy of Sciences, Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Ko CH, Liu TL, Su CH, Lee JI. The reinforcement sensitivity of male adults with attention-deficit/hyperactivity disorder: The association with internet addiction. TAIWANESE JOURNAL OF PSYCHIATRY 2019. [DOI: 10.4103/tpsy.tpsy_7_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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26
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Lu WH, Chou WJ, Hsiao RC, Hu HF, Yen CF. Correlations of Internet Addiction Severity With Reinforcement Sensitivity and Frustration Intolerance in Adolescents With Attention-Deficit/Hyperactivity Disorder: The Moderating Effect of Medications. Front Psychiatry 2019; 10:268. [PMID: 31105605 PMCID: PMC6498759 DOI: 10.3389/fpsyt.2019.00268] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 04/08/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Deviations in reinforcement sensitivity and frustration-related reactions have been proposed as components of the biopsychosocial mechanisms, which explained the high vulnerability to internet addiction (IA) among individuals with attention-deficit/hyperactivity disorder (ADHD). There is currently limited knowledge on the relationship of IA symptoms with reinforcement sensitivity and frustration intolerance, as well as factors moderating those correlations in this population. Objective: The aims of this study were (1) to examine the associations of IA symptoms severity with reinforcement sensitivity and frustration intolerance and (2) identify the moderators of these associations among adolescents diagnosed with ADHD in Taiwan. Methods: A total of 300 adolescents aged between 11 and 18 years who had been diagnosed with ADHD participated in this study. Their levels of IA severity, reinforcement sensitivity, and frustration intolerance were assessed using the Chen Internet Addiction Scale, behavioral inhibition system (BIS) and behavioral approach system (BAS), and Frustration Discomfort Scale, respectively. The associations of IA severity with reinforcement sensitivity and frustration intolerance were examined using multiple regression analysis. Possible moderators, including medications for ADHD, were tested using the standard criteria. Results: Higher fun seeking on the BAS (p = .003) and higher frustration intolerance (p = .003) were associated with more severe IA symptoms. Receiving medication for treating ADHD moderated the association between fun seeking on the BAS and severity of IA symptoms. Conclusion: Fun seeking on the BAS and frustration intolerance should be considered as targets in prevention and intervention programs for IA among adolescents with ADHD.
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Affiliation(s)
- Wei-Hsin Lu
- Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center and College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| | - Ray C Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States.,Department of Psychiatry, Children's Hospital and Regional Medical Center, Seattle, WA, United States
| | - Huei-Fan Hu
- Department of Psychiatry, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Neelapaijit A, Pinyopornpanish M, Simcharoen S, Kuntawong P, Wongpakaran N, Wongpakaran T. Psychometric properties of a Thai version internet addiction test. BMC Res Notes 2018; 11:69. [PMID: 29361970 PMCID: PMC5781275 DOI: 10.1186/s13104-018-3187-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 01/17/2018] [Indexed: 11/17/2022] Open
Abstract
Objective The aim was to assess the reliability and validity of a Thai version internet addiction test. Results Cronbach’s alpha for the Thai version of the internet addiction test was 0.89. A three-factor model showed the best fit with the data for the whole sample, whereas the hypothesized six-factor model, as well as a unidimensional model of the internet addiction test, failed to demonstrate acceptable fit with the data. Three factors, namely functional impairment, withdrawal symptoms and loss of control, exhibited Cronbach’s alphas of 0.81, 0.81, and 0.70, respectively. Item 4, ‘to form new relationships with online users’, yielded the lowest loading coefficient of all items. Positive correlations between the internet addiction test and UCLA loneliness scores were found. The Thai version of the internet addiction test was considered reliable and valid, and has sufficient unidimensionality to calculate for total score in screening for excessive internet use. Electronic supplementary material The online version of this article (10.1186/s13104-018-3187-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adam Neelapaijit
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand
| | - Manee Pinyopornpanish
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand
| | - Sutapat Simcharoen
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand
| | - Pimolpun Kuntawong
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, 50200, Thailand.
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Simcharoen S, Pinyopornpanish M, Haoprom P, Kuntawong P, Wongpakaran N, Wongpakaran T. Prevalence, associated factors and impact of loneliness and interpersonal problems on internet addiction: A study in Chiang Mai medical students. Asian J Psychiatr 2018; 31:2-7. [PMID: 29306727 DOI: 10.1016/j.ajp.2017.12.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/05/2017] [Accepted: 12/26/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Internet addiction is common among medical students, and the prevalence is higher than the general population. Identifying and creating solutions for this problem is important. The aim of this study was to examine the prevalence and associated factors, particularly loneliness and interpersonal problems among Chiang Mai medical students. MATERIALS AND METHODS Of 324 first to sixth year medical students, 56.8% comprised females with a mean age of 20.88 (SD 1.8). All completed questionnaires related to the objectives and activities of internet use, the Young Internet Addiction Test, the UCLA loneliness scale, and the Interpersonal Problems Inventory were employed to identify internet addiction. RESULTS In all, 36.7% of the subjects exhibited internet addiction, mostly at mild level. Amount of time used daily, loneliness and interpersonal problems were strong predictors (beta = 0.441, p < 0.05, beta = 0.219, p < 0.001 and beta = 0.203 p < 0.001, respectively), whereas age and sex were not. All objectives of using internet contributed to the variance of internet addiction score. For internet activities, only non-academic or studying contributed. The final model accounted for 42.8% of total variance of the internet addiction score. CONCLUSION Even though most addiction was at a mild level, careful strategies should be applied to better understand the situation. Along with a screening for potential internet addiction among medical students, attention should be paid to identifying those who experience loneliness and interpersonal problems, because both are strong predictors that can be improved by a variety of appropriate intervention.
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Affiliation(s)
- Sutapat Simcharoen
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Manee Pinyopornpanish
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Pimolpun Kuntawong
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Effects of Group Counseling Programs, Cognitive Behavioral Therapy, and Sports Intervention on Internet Addiction in East Asia: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121470. [PMID: 29182549 PMCID: PMC5750889 DOI: 10.3390/ijerph14121470] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 11/21/2017] [Accepted: 11/21/2017] [Indexed: 11/16/2022]
Abstract
To evaluate the effects of group counseling programs, cognitive behavioral therapy (CBT), and sports intervention on Internet addiction (IA), a systematic search in ten databases was performed to identify eligible studies without language restrictions up to January 2017. A meta-analysis and trial sequential analysis (TSA) was performed, respectively. A total of 58 randomized controlled trials (RCTs), which included 2871 participants, were incorporated into our meta-analysis. The results showed that group counseling programs, CBT, and sports intervention could significantly reduce IA levels (group counseling program: standardized mean difference (SMD), -1.37; 95% confidence interval (CI), -1.89 to -0.85; CBT: SMD, -1.88; 95% CI, -2.53 to -1.23; sports intervention: SMD, -1.70; 95% CI, -2.14 to -1.26). For group counseling programs, this treatment was more effective in four dimensions of IA, including time management, interpersonal and health issues, tolerance, and compulsive Internet use. For CBT, this treatment yielded a positive change in depression, anxiousness, aggressiveness, somatization, social insecurity, phobic anxiety, paranoid ideation, and psychoticism. For sports intervention, the significant effects were also observed in all dimensions of the IA scale. Each of group counseling programs, cognitive behavioral therapy, and sports intervention had a significant effect on IA and psychopathological symptoms. Sports intervention could improve withdrawal symptoms especially.
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Young adults' internet addiction: Prediction by the interaction of parental marital conflict and respiratory sinus arrhythmia. Int J Psychophysiol 2017; 120:148-156. [PMID: 28800963 DOI: 10.1016/j.ijpsycho.2017.08.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 08/08/2017] [Accepted: 08/08/2017] [Indexed: 12/26/2022]
Abstract
The aim of the current study was to address the potential moderating roles of respiratory sinus arrhythmia (RSA; baseline and suppression) and participant sex in the relation between parents' marital conflict and young adults' internet addiction. Participants included 105 (65 men) Chinese young adults who reported on their internet addiction and their parents' marital conflict. Marital conflict interacted with RSA suppression to predict internet addiction. Specifically, high RSA suppression was associated with low internet addiction, regardless of parental marital conflict; however, for participants with low RSA suppression, a positive relation between marital conflict and internet addiction was found. Internet addiction also was predicted by a significant three-way interaction among baseline RSA, marital conflict, and participant sex. Specifically, for men, marital conflict positively predicted internet addiction under conditions of low (but not high) baseline RSA. For women, marital conflict positively predicted internet addiction under conditions of high (but not low) baseline RSA. Findings highlight the importance of simultaneous consideration of physiological factors, in conjunction with family factors, in the prediction of young adults' internet addiction.
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Liu SI, Huang YH, Wu YH, Huang KY, Huang HC, Sun FJ, Huang CR, Sung MR, Huang YP. Temperament traits in suicidal and non-suicidal mood disorder patients in Taiwan. Psychiatry Res 2017; 253:260-266. [PMID: 28407557 DOI: 10.1016/j.psychres.2017.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 02/27/2017] [Accepted: 04/02/2017] [Indexed: 12/13/2022]
Abstract
Suicide is a major social and clinical problem in Asia. Although studies have suggested that personality traits are possible risk factors for suicide, no study has been conducted among Chinese to compare the temperament traits of suicidal and non-suicidal mood disorder patients with those of healthy controls. This study compared temperament traits of two patient groups, those with a mood disorder who have attempted suicide (n=204), and those with a mood disorder who have not attempted suicide (n=160), and compared the traits of these patients to those of healthy controls (n=178), assessed by Cloninger's Tridimensional Personality Questionnaire and the Brown-Goodwin Aggression Inventory. Patients with suicidal attempts had significantly higher novelty seeking and aggression scores than healthy controls and patients without suicidal attempts. Two groups of patients with mood disorder had significantly higher harm avoidance scores than the healthy controls. However, patients with suicidal attempts did not have higher harm avoidance scores than patients without suicidal attempts. This study confirms findings that harm avoidance and mood disorder are related, and extends them by suggesting that those with a mood disorder and suicide attempts have higher novelty seeking and lifetime aggression scores than those without suicidal attempt, either patients or healthy controls.
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Affiliation(s)
- Shen-Ing Liu
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
| | - Yu-Hsin Huang
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Ying-Hui Wu
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Kuo-Yang Huang
- Department of Psychiatry, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Hui-Chun Huang
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Fang-Ju Sun
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Chiu-Ron Huang
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ming-Ru Sung
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yo-Ping Huang
- Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
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