Child maltreatment, alexithymia, and problematic internet use in young adulthood

Rates and psychological stress predictors of problematic internet use (PIU) during the COVID-19 pandemic in a racially diverse sample of young adults

BACKGROUND

Problematic internet use (PIU), which includes social media misuse (SMM) and gaming misuse (GM), is uncontrollable and associated with significant psychological impairment. PIU is a coping behavior for COVID-19-related stress. We explored distress-related predictors of PIU in a young adult racially diverse sample during the pandemic.

METHODS

Analyses used cross-sectional survey data (N = 1956). Psychological diagnoses, financial distress, COVID-19-related emotions, psychological distress, distress tolerance, social support, loneliness, SMM and GM were measured. Hierarchical multiple regressions identified predictors of PIU. Race-stratified exploratory analyses sought to understand if predictors held true across racial groups.

RESULTS

Low distress tolerance was associated with SMM and GM, as were depression symptoms, with racial differences observed. SMM was associated with younger age, and GM was associated with male gender. PTSD symptoms predicted more GM. SMM and GM rates varied between racial groups. COVID-19-related adjustment challenges and stress predicted SMM and GM respectively, with racial differences observed.

CONCLUSION

Individual psychological distress and low distress tolerance markedly increased PIU risk. Clinicians should screen for stress-related PIU risk factors and bolster distress tolerance in vulnerable patients. Comparing PIU to different forms of coping in a larger sample would further clarify groups differences in stress coping behaviors.

The Association Between Child Abuse and Internet Addiction: A Three-Level Meta-Analysis

Child abuse is an important factor for Internet addiction. Despite numerous researches had observed there was a positive correlation between child abuse and Internet addiction, the strength of this association differed considerably in the previous studies. This study aims to obtain reliable estimates for effect sizes and investigate the potential moderator of the association between child abuse and Internet addiction. Thirty-one studies reported the association between child abuse and Internet addiction (273 effect sizes and 55,585 participants) through a systematic literature search. Based on Preferred Reporting Items for Systematic Review and Meta-Analysis approach, a three-level model was employed to conduct a three-level meta-analysis. The current meta-analysis found that child abuse was significantly positively correlated with Internet addiction. Besides, the study found that the type of child abuse and publication year had significant moderating effects on the association between child abuse and Internet addiction. This study suggested child abuse was a risk factor for Internet addiction. Moreover, child abuse is an essential factor should be considered when strengthening interventions for individuals' Internet addiction.

Adverse childhood experience and young adult's problematic Internet use: The role of hostility and loneliness

BACKGROUND

Few studies have explored the relationship between adverse childhood experiences (ACEs) and problematic Internet use (PIU) during young adulthood. Moreover, even fewer studies have explored the roles of loneliness (social and emotional) and hostility in this relationship.

METHODS

This study used data from the Taiwan Youth Project (2011-2017). The analytical sample included 1885 participants (mean age = 31.3 years). PIU was measured using the short form of Chen's Internet Addiction Scale (2017). ACEs were assessed at the baseline of the adolescent phase (mean age = 14.3 years); this indicator has undergone recent revision. Hostility (three items from the Symptom Checklist-90-Revised) and loneliness (six items from the De Jong Gierveld scale) were measured in 2011 and 2014, respectively.

RESULTS

ACEs were associated with hostility and loneliness (emotional and social). Additionally, hostility (β = 0.62, p < .01) and emotional loneliness (β = 0.44, p < .01) were significantly associated with PIU. Most mediating paths (e.g., ACE → hostility → PIU) were significant, based on the bootstrapping results.

CONCLUSIONS

This study suggests that ACEs have a long-term shadow effect on PIU in young adults. ACEs show an indirect association with PIU through both hostility and loneliness, as well as involving the relationship between them.

Role of Alexithymia in the Association Between Childhood Abuse and Risk Perception for Sexual Victimization in College Women

Sexual victimization is prevalent among college women with a history of childhood abuse (CA), which some research suggests is linked to impaired risk perception for sexual victimization or difficulties identifying and responding to unwanted sexual advances. Alexithymia is one construct yet to be examined in the association between CA and risk perception for sexual victimization. The purpose of this study was to elucidate the associations between CA, alexithymia, and risk perception for sexual victimization in a sample of college women with a history of CA. Participants included 294 undergraduate women with a history of childhood emotional, physical, and/or sexual abuse (Mage = 20.6, 80.6% White). An a priori path analysis was conducted to examine whether alexithymia indirectly explains the association between CA and risk perception for sexual victimization (i.e., comprising two related constructs, including threat detection and behavioral response to threat). Supplementary analyses were conducted post hoc to examine potential differences across CA subtypes (emotional, physical, and sexual). Alexithymia indirectly explained the relationship between CA and threat detection, and behavioral response to threat. However, indirect effects were negative, suggesting that undergraduate women with more severe CA and alexithymia identify sexual assault threat cues and intentions to "leave" a hypothetical sexual assault scenario sooner rather than later. The same pattern of results was observed for emotional and physical (but not sexual) CA when examining their indirect effects on threat detection, and for emotional CA when examining behavioral response to threat. Findings contribute to the literature on sexual victimization by clarifying the role of alexithymia in risk perception for sexual victimization. Results also highlight the potential utility of increasing emotional literacy among college women with a history of CA (and especially emotional abuse) to facilitate adaptive responding to unwanted sexual advances.

The Effect of Internet Addiction and Emotion Regulation on Trauma Reactions During the COVID-19 Pandemic in Adolescents With Anxiety Disorder

ABSTRACT

In this study, we examined the relationship among trauma reactions, anxiety severity, Internet addiction (IA), and emotion regulation difficulties during the COVID-19 pandemic in adolescents with anxiety disorders. The sample of study consisted of 63 adolescents aged 12 to 18 years who were diagnosed with AD and their parents. IA scores and emotional regulation difficulties were significantly higher in the group with pathological trauma reactions than the group exhibiting nonpathological trauma reactions. The trauma scores of adolescents with AD were correlated with IA, emotional regulation difficulties, and anxiety scores. The results of mediation analysis found that IA was the full mediating factor in the relationship between anxiety and trauma scores and a partial mediating factor in the relationship between emotional regulation difficulties and trauma scores. As a result, monitoring adolescents' Internet use not exceeding healthy levels and developing and strengthening emotion regulation skills can help protect against trauma during the COVID-19 pandemic.

Sex and national differences in internet addiction in Egypt and Saudi Arabia

BACKGROUND

Understanding individual differences in psychology, and how they relate to specific addictions, may allow society to better identify those at most risk and even enact policies to ameliorate them. Internet addiction is a growing health concern, a research focus of which is to understand individual differences and the psychology of those most susceptible to developing it. Western countries are strongly overrepresented in this regard.

METHOD

Here, sex and national differences in internet addiction are measured, using Young's 'Internet Addiction Test,' in two non-Western countries, Egypt and Saudi Arabia. >800 students aged 18 and 35 years (M = 20.65, SD = 1.48) completed a multidimensional internet addiction instrument. The instrument measures traits such as Withdrawal and Social Problems, Time Management and Performance and Reality Substitute.

RESULTS

Analyses revealed that males scored higher than females and Saudis higher than Egyptians on nearly all scales, including the total score. Factor analysis of the 20-item instrument revealed three factors, all exhibiting sex and culture differences.

CONCLUSIONS

These findings add to the body of evidence that males are higher than females in problematic internet use, as they are in addictive behaviors in general. Our findings may also imply that restrictions on male-female interaction, which are more pronounced in Saudi Arabia, may elevate the prevalence of internet addiction. The internet is also easier and cheaper to access in Saudi Arabia than in Egypt.

The smartphone as a "significant other": interpersonal dependency and attachment in maladaptive smartphone and social networks use

Smartphones are increasingly widespread throughout the world and, although smartphones provide various benefits, excessive and maladaptive use is often reported. Given the penetration of smartphones in the individual's daily life, it is relevant to identify the mechanisms sustaining their use, including the affective bond that the owner may develop with the device. The aim of the current study is to test a novel model to explain smartphone and Social Network Sites (SNS) use from an interpersonal perspective. We hypothesized that adult attachment style and interpersonal patterns (i.e., features of interpersonal dependency) generalize to the emotional bond with the mobile device, interacting with psychological correlates and background factors to predict smartphone and SNS consumption. 341 nonclinical adults (57.2% females; age M = 35.5, SD = 14.6) completed a battery consisting of the Attachment Style Questionnaire, the Relationship Profile Test, the Rosenberg Self-Esteem Scale, the Toronto Alexithymia Scale, the Young Adult Attachment to Phone Scale, and the Social Network Intensity and Social Network Access via Mobile phone Applications. A multi-mediation model supported the hypothesis regarding the influence of interpersonal style in the relationship of the individual with their smartphone and use of SNS. A parallel between attachment style and the emotional bond with the smartphone emerged, with anxious attachment style and destructive overdependence being potential risk factors for maladaptive smartphone use especially in individuals involved in a romantic relationship. Findings are discussed in terms of theoretical implications and intervention strategies towards smartphone dependency.

Parental neglect and short-form video application addiction in Chinese adolescents: The mediating role of alexithymia and the moderating role of refusal self-efficacy

BACKGROUND

The phenomenon of short-form video application addiction among Chinese adolescents is noteworthy. More research has focused on the influencing factors of internet addiction, but research on specifically exploring the antecedents and influencing mechanisms of short-form video application addiction (a subcategory of internet addiction) among adolescents is insufficient.

OBJECTIVES

This study aimed to investigate the relation between parental neglect and short-form video application addiction among Chinese adolescents and examine the mediating effect of alexithymia and the moderating role of refusal self-efficacy.

METHODS

A total of 1203 Chinese adolescents were assigned to complete scales regarding parental neglect, alexithymia, refusal self-efficacy and short-form video application addiction.

RESULTS

Parental neglect was positively related to short-form video application addiction among Chinese adolescents, and alexithymia mediated this link. Furthermore, refusal self-efficacy moderated the direct connection between parental neglect and short-form video application addiction. Specifically, the link between parental neglect and short-form video application addiction became weaker as adolescents' refusal self-efficacy increased.

CONCLUSION

The experiences of parental neglect are closely related to higher levels of short-form video application addiction among Chinese adolescents. Parental neglect is associated with higher level of short-form video application addiction through stronger alexithymia, and the relationship between parental neglect and short-form video application addiction is attenuated when adolescents have high refusal self-efficacy.

Associations between adverse childhood experiences and early adolescent problematic screen use in the United States

BACKGROUND

Problematic screen use, defined as an inability to control use despite private, social, and professional life consequences, is increasingly common among adolescents and can have significant mental and physical health consequences. Adverse Childhood Experiences (ACEs) are important risk factors in the development of addictive behaviors and may play an important role in the development of problematic screen use.

METHODS

Prospective data from the Adolescent Brain Cognitive Development Study (Baseline and Year 2; 2018-2020; N = 9,673, participants who did not use screens were excluded) were analyzed in 2023. Generalized logistic mixed effects models were used to determine associations with ACEs and the presence of problematic use among adolescents who used screens based on cutoff scores. Secondary analyses used generalized linear mixed effects models to determine associations between ACEs and adolescent-reported problematic use scores of video games (Video Game Addiction Questionnaire), social media (Social Media Addiction Questionnaire), and mobile phones (Mobile Phone Involvement Questionnaire). Analyses were adjusted for potential confounders including age, sex, race/ethnicity, highest parent education, household income, adolescent anxiety, depression, and attention-deficit symptoms, study site, and participants who were twins.

RESULTS

The 9,673 screen-using adolescents ages 11-12 years old (mean age 12.0) were racially and ethnically diverse (52.9% White, 17.4% Latino/Hispanic, 19.4% Black, 5.8% Asian, 3.7% Native American, 0.9% Other). Problematic screen use rates among adolescents were identified to be 7.0% (video game), 3.5% (social media), and 21.8% (mobile phone). ACEs were associated with higher problematic video game and mobile phone use in both unadjusted and adjusted models, though problematic social media use was associated with mobile screen use in the unadjusted model only. Adolescents exposed to 4 or more ACEs experienced 3.1 times higher odds of reported problematic video game use and 1.6 times higher odds of problematic mobile phone use compared to peers with no ACEs.

CONCLUSIONS

Given the significant associations between adolescent ACE exposure and rates of problematic video and mobile phone screen use among adolescents who use screens, public health programming for trauma-exposed youth should explore video game, social media, and mobile phone use among this population and implement interventions focused on supporting healthy digital habits.

Childhood trauma and problematic internet use: A meta-analysis based on students in mainland China

Background

In recent years, the relationship between childhood trauma and problematic Internet use has been widely studied by scholars, but the research conclusions on the relationship between them are not consistent. Some studies report that childhood trauma and problematic Internet use are significantly correlated. However, others believe that there is a weak correlation between them. So the relationship between them needs to be studied further. The aim of this study is to explore the relationship between childhood trauma and problematic Internet use, and the effects of some moderating variables on both for students in Mainland China.

Methods

This study followed the requirements of Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statement for literature screening. We searched the related studies on childhood trauma and problematic Internet use in Mainland China from January 2009 to November 2022 from CNKI, Wanfang Data, Chongqing VIP Information Co., Ltd. (VIP), Baidu scholar, ProQuest dissertations, SAGE Online Journals, Elsevier SDOL, Taylor &amp; Francis, Springer, Web of Science, Google Scholar, EBSCO, Medline, Scopus Database, PubMed Central, Embase, The Cochrane Library, PsycINFO, CMA 3.0 was used to analyse the overall effect and test the moderating effect.

Results

Among the papers included in the meta-analysis in this study, 31 papers reflected the relationship between childhood trauma and problematic Internet use, involving 52,503 subjects, and the sample size ranged from 388 to 16,130. This relationship between childhood trauma and problematic Internet use can be considered as a moderate correlation (r = 0.281, 95%CI[0.221, 0.338], p &lt; 0.001). The results showed that the relationship between childhood trauma and problematic Internet use was affected by different problematic Internet use measures. Meanwhile, meta-regression demonstrated that the relationship between childhood trauma and problematic Internet use was moderated by survey’s year. Specifically, the correlation coefficient between childhood trauma and problematic Internet use also increases with increasing year. However, the relationship between childhood trauma and problematic Internet use was not affected by the region, grade, childhood trauma measures, publication source.

Conclusion

Childhood trauma is closely related to problematic Internet use. In order to reduce problematic Internet use, corresponding prevention and intervention measures should be taken.

Relationship between adverse childhood experiences and problematic internet use among young adults: The role of the feeling of loneliness trajectory

BACKGROUNDS AND AIMS

Given problematic Internet usage's (PIU) negative impact on individual health, this study evaluates how adverse childhood experiences (ACEs) affect young adults' PIU and the possible underlying mechanism of the "feeling of loneliness" (FOL) trajectory.

METHODS

Analyzing a retrospective cohort sample from the Taiwan Youth Project, 2,393 adolescents were interviewed from the average ages of 14-28. We constructed ACE in 2000 using six categories (e.g., abuse and low family socioeconomic status) and 5-item PIU in 2017 from Chen's Internet Addiction Scale. FOL trajectories measured eight times, at average ages 14, 16, 17, 18, 20, 22, 25, 28 years-old.

RESULTS

Overall, 12.65% of the participants did not have ACEs, and 12.78% exhibited PIU. FOL trajectory analyses yielded three groups: "constant low" (reference group: 53.25%); "moderate decline" (36.81%); and "increasing" (9.94%). Regression models showed a dose-response association between ACE and young adults' PIU (adjusted odds ratio = 1.12; 95% confidence interval [CI] = 1.02-1.23) and the two risky loneliness groups (moderate decline: relative risk ratio [RRR] = 1.42, 95% CI = 1.32-1.54; increasing: RRR = 1.52, 95% CI = 1.37-1.71). Structural equation modeling further found that ACEs increase young adults' risk of being in the increasing group, and consequently, the risk of PIU.

DISCUSSION AND CONCLUSIONS

We demonstrated that ACE may be associated with 1) adults' PIU, 2) FOL from adolescence to emerging adulthood, and 3) young adults' PIU through its association with FOL trajectories.

Childhood Sexual Abuse and Exposure to Peer Bullying Victimization

Females exposed to child sexual abuse (CSA) are at an increased risk of experiencing further victimization in adolescence. Associations between CSA and several forms of cyber and in-person peer bullying victimization were assessed in a prospective, longitudinal study. Females exposed to substantiated CSA and a matched comparison group (N = 422) were followed over a two-year period. Bullying experiences were assessed in both survey and qualitative interviews. Qualitative data were coded and used to describe the types (e.g., cyber, physical, verbal), and foci (e.g., threats, physical appearance) of bullying victimization. Logistic regression was used to assess the odds that CSA was associated with subsequent bullying victimization, adjusted for demographics, social networking use, and prior bullying. CSA-exposed females were at an increased risk of multiple forms of bullying victimization with a persistent risk of bullying victimization over time. Specifically, they had 2.6 times higher odds of experiencing any bullying at follow-up, 2.9 times higher odds of experiencing cyberbullying at follow-up, and 2 times higher odds of experiencing combined cyber/in-person bullying at follow-up. CSA-exposed females were more likely than comparison females to experience bullying regarding their appearance/weight and dating relationships. Findings provide further insight into the unique circumstances of the cyberbullying and in-person bullying experienced by CSA-exposed females. Females exposed to child sexual abuse (CSA) are at an increased risk of experiencing bullying victimization, specifically cyberbullying and combined cyber/in-person bullying, as well as bullying about their appearance and dating relationships. These findings indicate that bullying prevention needs to include trauma-focused components to target these uniquely vulnerable females.

Cumulative childhood trauma and cybervictimization among Chinese college students: Internet addiction as a mediator and roommate relationships as a moderator

Existing studies have found that childhood trauma is a risk predictor of cybervictimization, but few studies have explored the relationship between cumulative childhood trauma and college students' cybervictimization. This study explored the relationship and the roles of Internet addiction and Internet victimization between them. A total of 854 college students (568 females, M age = 18.92 years, SD = 0.86) completed a survey including the Short Form of Childhood Trauma Questionnaire, the Cyberbullying Inventory, the Young's Internet Addiction Scale, and the revised Roommate Relationships Questionnaire. The results showed that: (1) cumulative childhood trauma was significantly positively associated with cybervictimization; (2) Internet addiction played a mediating role between cumulative childhood trauma and cybervictimization; and (3) roommate relationships played a moderating role between cumulative childhood trauma and cybervictimization, as well as Internet addiction and cybervictimization. The research findings provide a theoretical and practical basis for the prevention and intervention of college students' cybervictimization.

Interpersonal Guilt and Problematic Online Behaviors: The Mediating Role of Emotion Dysregulation

OBJECTIVE

The positive association between problematic Internet use (PIU) and emotion dysregulation (ED) is well documented. Research has also found that interpersonal guilt is positively associated with ED. Nevertheless, the influence of interpersonal guilt on PIU has been scarcely examined. In the current study, we investigated the relationships among the three constructs, and tested if emotion dysregulation mediates the association between interpersonal guilt and different types of PIU, namely problematic online gaming, problematic social media use, and problematic online pornography use.

METHOD

A sample of 434 adult participants (210 males, 48.4%) aged between 18 and 69 years old completed self-reported measures on interpersonal guilt, ED, and PIU. A structural equation modeling (SEM) framework was used to test the mediation models.

RESULTS

SEM analyses showed that ED mediates the relationship between interpersonal guilt as antecedent, and problematic online gaming, problematic social media use, and problematic online pornography use as outcomes.

CONCLUSIONS

Our findings suggest that emotion dysregulation deriving from experiences of interpersonal guilt can amplify the risk of using gaming, social media, and online pornography in a problematic way. Implications for prevention and treatment of PIU are discussed.

Inconsistent Media Mediation and Problematic Smartphone Use in Preschoolers: Maternal Conflict Resolution Styles as Moderators

Previous studies suggest that inconsistent parenting leads to undesired consequences, such as a child’s defiant reactance or parent–child conflicts. In light of this, we examined whether mothers’ inconsistent smartphone mediation strategies would influence their children’s problematic smartphone use during early childhood. Furthermore, given that harsh parenting often escalates a child’s behavioral problems, we focused on parent–child conflict resolution tactics as moderators. One hundred fifty-four mothers (ages 25–48 years; M = 35.58 years) of preschoolers (ages 42–77 months) reported their media mediation and parent–child conflict resolution tactics and their child’s problematic smartphone use. We found that the positive association between the mother’s inconsistent mediation and their child’s problematic smartphone use was more pronounced when mothers relied on negative parent–child resolution tactics—i.e., psychological aggression and physical assault. Our findings provide vital theoretical and empirical insights into mother–child relational characteristics for the child’s problematic smartphone use.

Characteristics of online behavior and structure of consumed content in Abakan adolescents of different age, groups and ethnicity

Background. The study of the prevalence and structure of various types of online behavior, the characteristics of the content consumed by adolescents of different age, sex and ethnic groups is an important area of scientific research.

The aim. To study the features of online behavior and the structure of content consumed in Abakan adolescents of various age and sex groups and ethnicity (Russians and Khakasses).

Materials and methods. 1400 adolescents of the city of Abakan (Republic of Khakassia) aged 12–18 were examined: 962 (68.7 %) Russians, 438  (31.3  %) Khakasses, 678 (48.4 %) boys and 722 (51.6 %) girls, aged 12–14 years – 39.8 % and 15–18 years – 60.2 %. The type of online behavior was verified using the Chen scale (CIAS). Emotional and behavioral disorders were diagnosed using the SDQ questionnaire. The indicators were compared in groups formed by sex, age and ethnicity. The data were processed using the Statistica 12.0 program (StatSoft Inc., USA).

Results. It has been established that the prevalence and structure of online behavior among adolescents in Abakan depends on gender, age and ethnicity. Pathological Internet use (PIU) is more common among Khakasses, more often in the older age group. Regardless of ethnicity, maladaptive online behavior (pathological and maladaptive Internet use) is recorded more often among girls. In the structure of consumed content, gaming addiction prevails, social network addiction is in second place, and the proportion of mixed and undifferentiated Internet addiction is less. Dependence on online games prevails in boys, while dependence on social networks and undifferentiated internet addiction prevail in girls.

Conclusion. One of the reasons for the greater prevalence of maladaptive online behavior among Khakasses may be the association of maladaptive Internet use with the presence of emotional disorders and behavioral problems that reach the borderline level and are causally significant factors in the development of Internet addiction. Adolescents with maladaptive online behavior, who have not yet reached the level of formed Internet addiction, are the target group requiring medical and psychological assistance.

Depression Mediates the Relationship between Childhood Trauma and Internet Addiction in Female but Not Male Chinese Adolescents and Young Adults

Internet addiction is associated with a range of psychological risk factors such as childhood trauma and depression. Studies have also suggested sex differences in internet and other behavioral addictions. However, it remains unclear how childhood trauma, depression and internet addiction inter-relate differently between the sexes. A total of 1749 adolescents and young adults aged 12–27 participated in a survey of sociodemographic characteristics and standardized assessments to evaluate internet addiction (Internet Addiction Test), childhood trauma (Childhood Trauma Questionnaire) and depression (Beck Depression Inventory). Mediation and path analyses were used to examine the relationship between childhood trauma, depression and internet addiction. Internet-addicted females relative to males showed more severe depression but the control participants showed the opposite. Childhood trauma was associated with depression for both internet-addicted males and females; however, internet-addicted females but not males showed significant associations between depression and the severity of internet addiction as well as between childhood trauma and the severity of internet addiction. Further, in females, depression mediated the correlations between all types of childhood trauma and the severity of internet addiction. A path analysis suggested that sexual abuse and emotional neglect contributed most significantly to internet addiction when all types of childhood trauma were examined in one model. The findings suggest sex differences in the relationship between childhood trauma, depression and internet addiction. Childhood trauma contributes to internet addiction through depression only in females. The findings may guide future prevention and intervention strategies of internet addiction.

There Are Predictors of Eating Disorders among Internet Use Characteristics-A Cross-Sectional Study on the Relationship between Problematic Internet Use and Eating Disorders

The aims of this cross-sectional study were: (i) to establish the prevalence of problematic Internet use (PIU) and eating disorders (EDs) among Polish students; (ii) to investigate potential correlations between the two phenomena; and (iii) to identify predictors of eating disorders among socio-demographic and Internet use characteristics in this population. To this end, a total of 1008 Polish students aged 18-40, completed the Problematic Internet Use Test (TPIU22), the Eating Attitudes Test (EAT-26) and a self-designed Socio-demographic and Internet Use Survey. Men received more PIU scores (p < 0.001), while women received more EAT-26 scores (p < 0.05) with a significant correlation observed between those variables (rho = 0.212; p < 0.001). The strongest predictors of EDs were as follows: preoccupation with the Internet, neglect of sleep in favor of Internet use, alleviation of negative feelings while online, higher mean number of hours spent online on weekends for academic and work-related purposes, extracurricular activity, lower height and higher BMI. An association has been demonstrated between problematic internet use and eating disorders. Somewhat surprisingly, our results suggest that people at risk of EDs use the Internet primarily to fulfill their routine duties. Nevertheless, further research is needed to establish the causality of EDs and PIU.

The Relationship of Smartphone Addiction and Alexithymia

OBJECTIVE

This study aims to evaluate whether smartphone addiction (SA) is associated with social media use and alexithymia levels in university students.

METHODS

A group of 935 students aged between 18 and 45 years (509 females and 426 males) was recruited from different universities in Istanbul. SAs, alexithymia and social media use were assessed using the Smartphone Addiction Scale Short Version (SAS-SV), Toronto Alexithymia Scale-20 (TAS-20), and ad-hoc questions regarding social media use.

RESULTS

The mean age of participants was 21.89±3.27 years and 509 of participants were female (54.4%). 455 (48.6%) participants were placed in the "SA" and 198 (21.2%) in the "alexithymia" categories. The study found a high level of positive correlation (p<0.001) between both subscale and total TAS-20 scores and SAS-SV scores. Gender (OR=1.496, 95% CI 1.117-2.002, p=0.007) and number of social media by participants (OR=1.221, 95% CI 1.134-1.315, p<0.001) and TAS (OR=1.074, 95% CI 1.059-1.090, p<0.001) were found to be an independent predictors for SA.

CONCLUSION

The study revealed a positive correlation between alexithymia and smartphone use severity, and alexithymia was a significant predictor of SA. Future studies focusing on the causal aspect of this relationship will be useful in planning strategies for treatment.

Adverse Childhood Experiences and Problematic Media Use: Perceptions of Caregivers of High-Risk Youth

Youth with a history of adverse childhood experiences (ACEs) are more likely to develop risky health behaviors. With the increase of media use in the general population, it is likely that these high-risk youth are developing maladaptive behaviors associated with media use (i.e., problematic media use). The goals of this article are (1) to describe symptoms of problematic media use in high-risk youth and (2) to determine whether ACEs are related to problematic media use in this population. Data were collected through online questionnaires from 348 parents or legal guardians of children ages 5 to 18 years, the majority of whom had been adopted. Parents and guardians reported on the child's history of ACEs and completed the Problematic Media Use Measure-Short Form (PMUM-SF). Almost half of the participants reported that their child had a history of four or more ACEs (48.9%). Caregivers of foster or adopted children reported more symptoms of problematic media use than those reporting on their biological children. After adjusting for covariates, the number of ACEs predicted problematic media use above and beyond variance explained by demographic factors or screen time amount. Children with a history of ACEs had higher problematic media use compared to children without ACEs.

Can Adverse Childhood Experiences Heighten Risk for Problematic Internet and Smartphone Use? Findings from a College Sample

Background: College students are among the heaviest users of smartphones and the Internet, and there is growing concern regarding problematic Internet (PIU) and smartphone use (PSU). A subset of adverse childhood experiences, household dysfunction [(HHD) e.g.; parental substance use, mental illness, incarceration, suicide, intimate partner violence, separation/divorce, homelessness], are robust predictors of behavioral disorders; however, few studies have investigated the link between HHD and PIU and PSU and potential protective factors, such as social support, among students. Methods: Data are from a diverse California student sample (N = 1027). The Smartphone Addiction Scale—Short Version and Internet Addiction Test assessed dimensions of addiction. Regression models tested associations between students’ level of HHD (No HHD, 1–3 HHD, ≥4 HHD) and PSU and PIU, and the role of extrafamilial social support in these relationships, adjusting for age, gender, ethnicity, SES, employment loss due to COVID-19, and depression. Results: Compared to students reporting no HHD, students with ≥4 HHD had twice the odds (AOR: 2.03, 95% CI: 1.21–3.40) of meeting criteria for PSU, while students with 1–3 HHD and ≥4 HHD had three and six times the odds of moderate to severe PIU (AORs: 2.03–2.46, CI:1.21–3.96) after adjusting for covariates. Extrafamilial social support was inversely associated with PIU and moderated the HHD–PSU association for students with 1–3 HHD. Conclusion: Students exposed to HHD may be especially vulnerable to developing behavioral addictions such as PSU and PIU. Extrafamilial social support offset the negative effects of HHD for PSU among the moderate risk group; implications for prevention efforts are discussed.

Measuring Problematic Internet Use, Internet Gaming Disorder and Social Media Addiction in young adults: A cross-sectional study

Background

Digital technology use is nearly ubiquitous among young adults; this use provides both benefits and risks. The risks of technology use include maladaptive technology use or technology addiction. Several conceptualizations of these addictions have emerged, each with its own assessment tools. These conditions include problematic internet use (PIU), internet gaming disorder (IGD), and social media addiction (SMA). These conditions have been associated with health outcomes such as problematic alcohol use, sleep disorders, and mental illness. These maladaptive technology conditions have been most commonly studied in isolation from each other.

Objective

The aim of this study is to examine PIU, IGD, and SMA together to better inform future research approaches and provider screening practices for young adults.

Methods

This cross-sectional survey study was conducted using Qualtrics panel-based recruitment and survey hosting. We recruited US young adults aged 18-25 years. The survey assessed PIU, IGD, and SMA. Survey measures also included assessments of problematic alcohol use, sleep, depression, and anxiety. We evaluated the frequency of and overlap in positive screening scores among PIU, IGD, and SMA and modeled each condition using multivariate logistic regression. Finally, we calculated sensitivity and specificity, as well as the positive predictive value and negative predictive value of the screening tools using the most prevalent maladaptive technology type.

Results

Our 6000 participants had an average age of 21.7 (SD 2.5) years. Of these 6000 participants, 3062 (51.03%) were female, 3431 (57.18%) were Caucasian, 1686 (28.1%) were in a 4-year college program, and 2319 (38.65%) worked full time. The mean PIU score was 3.5 (SD 3.1), and 53.58% (3215/6000) of participants met the criteria for PIU. The mean IGD score was 2.7 (SD 2.6), and 24.33% (1460/6000) of participants met the criteria for IGD. The mean SMA score was 7.5 (SD 5.7), and 3.42% (205/6000) met the criteria for SMA. Across all 3 maladaptive technology use diagnoses, there were varied associations with demographic variables and similar overlap with health outcomes. The sensitivity of PIU screening to detect IGD was 82% and to detect SMA was 93%, whereas the specificity and positive predictive value were much lower (37%-54% specificity; 6%-37% positive predictive value).

Conclusions

This cross-sectional survey screened a large national sample of adolescents and young adults for PIU, IGD, and SMA to determine prevalence and overlap, demographic associations with each, and associations between these technology-related conditions and health outcomes. There was overlap across PIU, IGD, and SMA in some associated demographic variables and health outcomes. However, the patterns in the associated variables demonstrated unique qualities of each of these conditions.

Mediators of the longitudinal relationship between childhood adversity and late adolescent psychopathology

BACKGROUND

Childhood adversity (CA) is commonly associated with an increased risk of subsequent psychopathology. It is important to identify potential mediators of this relationship which can allow for the development of interventions. In a large population-based cohort study we investigated the relationship between CA and late adolescent psychopathology and early adolescent candidate mediators of this relationship.

METHODS

We used data from three waves (n = 6039) of Cohort 98' of the Growing up in Ireland Study (age 9, 13 and 17). We used doubly robust counterfactual analyses to investigate the relationship between CA (reported at age-9) with psychopathology (internalizing and externalizing problems), measured using the Strengths and Difficulties Questionnaire at age-17. Counterfactual and traditional mediation was used to investigate the mediating effects of the parent-child relationship, peer relations, self-concept, computer usage and physical activity.

RESULTS

CA was associated with an increased risk of internalizing and externalizing problems at age-17. Parent-child conflict mediated 35 and 42% of the relationship between CA and late adolescent externalizing problems and internalizing problems, respectively. Self-concept and physical activity mediated an additional proportion of the relationship between CA and internalizing problems. These results were robust to unmeasured confounding.

CONCLUSIONS

Parent-child conflict explains more than a third of the relationship between CA and later psychopathology. Self-concept and physical activity explain the additional proportion of the relationship between CA and internalizing problems. This suggests that these factors may be good targets for intervention in young people who have experienced CA to prevent subsequent psychopathology.

Oxytocin Receptor Gene Polymorphisms and Early Parental Bonding Interact in Shaping Instagram Social Behavior

Human beings engage in multiple social interactions daily, both in person and online. There are, however, individual differences in the frequency and quality of these interactions. This exploratory study focuses on online interactions and aims to model these differences by looking at potential environmental and genetic factors. The environmental factor is the childhood parental relationship, as reported by the participants in the dimensions of the Parental Bonding Instrument (N = 57, 41 females). At a genetic level, buccal mucosa cell samples were collected to assess participants' genetic susceptibility, and OXTr regions rs2254298 (G/G homozygotes vs. A-carriers) and rs53576 (A/A homozygotes vs. G-carriers) were analyzed. To capture participants' online activity, Instagram was probed. The number of people that the individual follows ("followings"), followers, and posts were used as a proxy for the quantity of interaction, and a Social Desirability Index (SDI) was computed as the ratio of followers to followings. An interaction between OXTr groups and parental bonding scores on the number of followings and posts was hypothesized. A gene-environment interaction for OXTr/rs2254298 on the number of Instagram posts was identified. In line with the hypothesis, participants with a genetic risk factor (A-carriers) and a history of low paternal care showed fewer Instagram posts than those without this risk factor (G/G genotype). Moreover, an interaction effect between maternal overprotection and OXTr/rs2254298 on the Instagram SDI was detected. These findings could represent an indirect pathway through which genes and parental behavior interact to shape social interactions on Instagram.

INTERNET ADDICTION AMONG ADOLESCENTS IN A WESTERN BRAZILIAN AMAZONIAN CITY

Objective:

Analyze the prevalence and factors associated with internet addiction in a sample of high school adolescents in Acre, a state in northern Brazil.

Methods:

A population-based cross-sectional study was conducted with 1,387 adolescents between 14 and 18 years old enrolled in high schools in the city of Rio Branco, Acre. A structured questionnaire with questions about demographics, family and behavioral patterns was applied. Internet addiction was verified using the Internet Addiction Test (IAT), with a cutoff equal to or greater than 70 points. The associated factors were identified by multiple logistic regression analyses.

Results:

The overall prevalence of Internet addiction was 10.6%. Higher dependence was observed in females. The factors associated with Internet addiction were being female, using the computer for more than two hours a day during weekdays and on the weekend, not practicing physical activities and going out to dance at nightclubs and concerts at least once a month. A protective association of reading habits in relation to Internet dependence was observed.

Conclusions:

The present study showed a high prevalence of Internet dependence, with female adolescents being more susceptible. Behavioral aspects were associated with internet dependence in a sample of adolescents from Rio Branco, Acre.

Cross-National Associations Among Cyberbullying Victimization, Self-Esteem, and Internet Addiction: Direct and Indirect Effects of Alexithymia

The relationship among cyberbullying victimization, lower self-esteem, and internet addiction has been well-established. Yet, little research exists that explains the nature of these associations, and no previous work has considered the inability to identify or describe one’s emotions, namely, alexithymia, as a potential mediator of these links. The present study sought to investigate the indirect effects of cyberbullying victimization on self-esteem and internet addiction, mediated by alexithymia. The sample consisted of 1,442 participants between 12 and 17 years (M_age = 14.17, SD = 1.38, 51.5% male) from Germany, the Netherlands, and the United States. Results showed a direct relationship between cyberbullying victimization and self-esteem and an indirect association mediated by alexithymia in the Dutch sample. However, in the German and U.S. samples, only an indirect relationship via alexithymia, but not a direct effect of cyberbullying victimization on self-esteem, was found. Consistent across the three country samples, cyberbullying victimization and internet addiction were directly and also indirectly associated via alexithymia. In sum, findings indicate that alexithymia might help better understand which detrimental effects cyberbullying victimization has on adolescent psychological health. Thus, cyberbullying prevention programs should consider implementing elements that educate adolescents on the ability to identify and describe their own emotions.

The relationship between childhood trauma and Internet gaming disorder among college students: A structural equation model

BACKGROUND

The aim of this study was to investigate the mechanisms of Internet gaming disorder (IGD) and the associated interaction effects of childhood trauma, depression and anxiety in college students.

METHODS

Participants were enrolled full-time as freshmen at a University in the Hunan province, China. All participants reported their socio-demographic characteristics and undertook a standardized assessment on childhood trauma, anxiety, depression and IGD. The effect of childhood trauma on university students' internet gaming behaviour mediated by anxiety and depression was analysed using structural equation modelling (SEM) using R 3.6.1.

RESULTS

In total, 922 freshmen participated in the study, with an approximately even male-to-female ratio. A mediation model with anxiety and depression as the mediators between childhood trauma and internet gaming behaviour allowing anxiety and depression to be correlated was tested using SEM. The SEM analysis revealed that a standardised total effect of childhood trauma on Internet gaming was 0.18, (Z = 5.60, 95% CI [0.02, 0.05], P < 0.001), with the direct effects of childhood trauma on Internet gaming being 0.11 (Z = 3.41, 95% CI [0.01, 0.03], P = 0.001), and the indirect effects being 0.02 (Z = 2.32, 95% CI [0.00, 0.01], P = 0.020) in the pathway of childhood trauma-depression-internet gaming; and 0.05 (Z = 3.67, 95% CI [0.00, 0.02], P < 0.001) in the pathway of childhood trauma-anxiety-Internet gaming. In addition, the two mediators anxiety and depression were significantly correlated (r = 0.50, Z = 13.54, 95% CI [3.50, 5.05], P < 0.001).

CONCLUSIONS

The study revealed that childhood trauma had a significant impact on adolescents' Internet gaming behaviours among college students. Anxiety and depression both significantly mediated the relationship between childhood trauma and internet gaming and augmented its negative influence. Discussion of the need to understand the subtypes of childhood traumatic experience in relationship to addictive behaviours is included.

Development and Validation of a Short-Form Internet Overuse Screening Questionnaire for Adults

AIMS

The aim of the current study was to develop and validate a short-form of the internet overuse screening questionnaire (IOS-Qs).

METHODS

A total of 571 adults were recruited from a representative, stratified, and multistage cluster sample. Among participants, 188 and 383 were used in the development and validation of the IOS-Qs, respectively.

RESULTS

Experts' ratings and Rasch model analyses led to the selection of 8 items from the IOS-Qs; latent-class analysis using these 8 items revealed an estimated prevalence of 8.6% (33 out of 383) of problematic internet over-users. Problematic internet over-users were positively associated with a 1-year prevalence rate of any mental disorder (OR 3.08, p = 0.008), mood disorder (OR 7.11, p = 0.003), and depressive disorder (OR 5.22, p = 0.016). The receiver operating characteristic curves identified an optimal cutoff score of 9.5 for differentiating problematic internet over-users from unproblematic internet users with 94% sensitivity and 94% specificity.

CONCLUSION

The results suggest that the IOS-Qs was valid, and items including social isolation were crucial to the brief distinction of at-risk internet users. Because of its brevity, the questionnaire can be effectively administered as a large-scale survey.

The prediction of alexithymia as a state or trait characteristic in patients with substance use disorders and PTSD

Alexithymia is common in patients with a substance use disorder (SUD) and is possibly a negative prognostic factor in their treatment. The aim of this study was twofold. First, we explored whether SUD patients with posttraumatic stress disorder (PTSD) are more alexithymic than SUD patients without PTSD. Next, we explored whether trait and state-related parts of alexithymia could be differentiated in these patients. This phenomenon was studied in 197 SUD patients with the Toronto Alexithymia Scale-20 (TAS-20); Clinician Administered PTSD Scale; Self-Report Inventory for PTSD; Traumatic Experiences Checklist; European Addiction Severity Index; and the Depression, Anxiety and Stress Scale in a cross-sectional design. SUD patients with current PTSD showed more alexithymic characteristics than patients without PTSD or with previous lifetime/not current PTSD. The severity of PTSD complaints; alcohol addiction; and the combination of depression, anxiety and stress symptoms, all of which are more related to alexithymia as a state, explained 38.1% of the TAS-20. In conclusion, we advise that SUD patients be assessed for alexithymia and that its degree is taken into account. We also tentatively assume that a considerable part of alexithymia is more state- than trait-related in these patients.

Association between mothers' problematic Internet use and maternal recognition of child abuse

BACKGROUND

There are few studies about mothers' problematic Internet use (PIU). Mothers' PIU may lead to inadequate parenting and child abuse.

OBJECTIVE

This cross-sectional study aimed to clarify the association between mothers' PIU and their recognition of child abuse.

PARTICIPANTS AND SETTING

We analyzed data collected of health examinations of children aged 4 months, 1.5 years, and 3 years which were carried out in Matsue City, Shimane Prefecture, Japan between April 2016 and March 2017. The number of the subjects were 1685, 1729, 1674, respectively.

METHODS

We used logistic regression analysis to clarify the association between mothers' PIU (Young's Diagnostic Questionnaire for Internet Addiction score: ≥5) and their recognition of child abuse (selecting < True of me > for < I sometimes think that I am abusing my child > on a questionnaire survey), which was adjusted for covariates such as maternal age, number of children, daytime caretaker, social support, postpartum depression, and current smoking status of the parents.

RESULTS

Based on the multivariate logistic regression analysis, the mothers' PIU was significantly correlated with their recognition of child abuse for children aged 4 months, 1.5 years, or 3 years [odds ratio (OR): 13.30, 95% confidence interval (CI): 1.26-139.98, OR: 7.02, 95% CI: 1.28-38.55, and OR: 28.06, 2.48-317.93, respectively].

CONCLUSION

This study revealed the possibility that mothers with PIU recognize child abuse more than mothers without PIU. However, further studies should be conducted to increase reliability and validity.

Predicting effects of borderline personality symptoms and self-concept and identity disturbances on internet addiction, depression, and suicidality in college students: A prospective study

The aims of this study were to evaluate the predicting effects of borderline personality symptoms and self-concept and identity disturbances on internet addiction, significant depression, and suicidality among college students at follow-up assessments conducted 1 year later. A sample of 500 college students aged between 20 and 30 years participated in this study. Their levels of borderline personality symptoms, self-concept and identity disturbances, internet addiction, depression, and suicidality at baseline and at follow-up interviews were assessed through the Borderline Symptoms List, Self-concept and Identity Measure, Chen Internet Addiction Scale, Beck Depression Inventory-II, and questions related to suicidality from the Epidemiological version of the Kiddie Schedule for Affective Disorders and Schizophrenia, respectively. A total of 324 college students received follow-up assessments 1 year later. Among them, 15.4%, 27.5%, and 17% had internet addiction, significant depression, and suicidality, respectively. Our result revealed the severity of borderline symptoms, disturbed identity, unconsolidated identity, and lack of identity at initial assessment increased the occurrence of internet addiction, significant depression, and suicidality at follow-up assessment except for the predictive effect of unconsolidated identity on internet addiction. The results indicated that self-concept and identity and borderline symptoms may have a significant role in the risk of mental health problems in college students.

Neurobiological Risk Factors for the Development of Internet Addiction in Adolescents

The sudden appearance and spread of Internet addiction in adolescent populations, in association with the rapid escalation of consumed Internet content and the broad availability of smartphones and tablets with Internet access, is posing a new challenge for classical addictology which requires urgent solutions. Like the majority of other psychopathological conditions, pathological Internet addiction depends upon a group of multifactor polygenic conditions. For each specific case, there is a unique combination of inherited characteristics (nervous tissue structure, secretion, degradation, and reception of neuromediators), and many are extra-environment factors (family-related, social, and ethnic-cultural). One of the main challenges in the development of the bio-psychosocial model of Internet addiction is to determine which genes and neuromediators are responsible for increased addiction susceptibility. This information will herald the start of a search for new therapeutic targets and the development of early prevention strategies, including the assessment of genetic risk levels. This review summarizes the literature and currently available knowledge related to neurobiological risk factors regarding Internet addiction in adolescents. Genetic, neurochemical and neuroimaging data are presented with links to actual pathogenetic hypotheses according to the bio-psychosocial model of IA forming.

Mindfulness, Compulsive Mobile Social Media Use, and Derived Stress: The Mediating Roles of Self-Esteem and Social Anxiety

There is growing concern over the emergence of damaging compulsive use patterns among some users of social networking sites (SNSs), in particular of mobile social media. Although previous studies argue that mindfulness has a protective effect on compulsive behaviors, to date, no study has analyzed the underlying mechanisms by which mindfulness reduces compulsive SNS usage. This study addresses this gap by examining the relationship between mindfulness, self-esteem, social anxiety, compulsive mobile SNS usage, and derived stress in the context of the use of the mobile social media application, WhatsApp™. Mediation analysis supported the roles of self-esteem and social anxiety as mediators of the beneficial (lowering) effect of mindfulness on compulsive mobile SNS usage. Moreover, the results confirmed that compulsive mobile SNS use induces stress and that mindfulness has also lowering effects on stress derived from such compulsive behavior, mediated by the former variables. This research, therefore, provides a process explanation for the beneficial effect of mindfulness on stress derived from mobile social media use. Further theoretical and practical implications, as well as future research avenues, are discussed.

College Students and Problematic Internet Use: A Pilot Study Assessing Self-Appraisal and Independent Behavior Change

PURPOSE

Problematic Internet Use (PIU) is a growing health concern; universal screening and validated interventions remain elusive. This pilot study's purpose was to assess participants' self-appraisal of PIU risk, and the subsequent frequency and outcome of behavior change after validated PIU screening.

METHODS

In this 3-year study, college student participants reported yearly self-appraised PIU risk, and then completed a problematic and risky internet use screening scale. At Time 3, participants reported behavior change based on Time 2 screening.

RESULTS

Our 283 participants were 57% female and 75% Caucasian. Participants' self-appraisal of PIU risk had a sensitivity of 23%-39%. Of 29 participants at risk at Time 2, six (20.6%) reported attempted behavior change at Time 3, though 83.3% remained at risk.

CONCLUSIONS

College students have varied capacity to assess and implement effective behavior change regarding PIU. The role of providers in identification and intervention for PIU remains critical.

Childhood maltreatment and problematic social media use: The role of attachment and depression

Childhood maltreatment is associated with many maladaptive outcomes. This study sought to examine the association between childhood maltreatment and problematic social media use using a cross-sectional sample of young adults aged 17-25 years (n = 1029). Specifically, we studied whether the relationship is mediated through (i) attachment anxiety, (ii) attachment avoidance, or (iii) both attachment dimensions operating in series with depressive symptoms. Results revealed that a history of childhood maltreatment was significantly associated with more problematic social media use. Both anxious and avoidant attachment dimensions independently mediated the relationship between childhood maltreatment and problematic use of social media, but in opposing directions. Avoidant attachment was associated with less problematic social media use, whilst anxious attachment was associated with more problematic social media use. Avoidant attachment and depressive symptoms in series accounted for part of the relationship between childhood maltreatment and problematic social media use. Anxious attachment and depressive symptoms in series fully mediated the relationship between childhood maltreatment and problematic social media use. The results suggest that childhood maltreatment may influence social media use directly, but also indirectly. People experiencing depressive symptoms may overuse social media in an attempt to alleviate their distress. However, causality cannot be established with the current design.

Association of Internet addiction and alexithymia - A scoping review

It has been hypothesized that individuals with alexithymia who have difficulty in identifying, expressing, and communicating emotions may overuse Internet as a tool of social interaction to better regulate their emotions and to fulfill their unmet social needs. Similarly, an increasing body of evidence suggests that alexithymia may also play an essential role in the etiopathogenesis of addictive disorders. We conducted a scoping review of questionnaire-based studies of problematic Internet use/Internet addiction and alexithymia. From initial 51 studies, all of the final 12 included studies demonstrated a significant positive association between scores of alexithymia and severity of Internet addiction. However, the causal direction of the association is not clear because the interplay of numerous other variables that could affect the relation has not been studied. There are limitations in the methodology of the studies conducted. Hence, we emphasise the need for longitudinal studies with stronger methodologies.

Differences in the relationship between traumatic experiences, self-esteem, negative cognition, and Internet addiction symptoms among North Korean adolescent defectors and South Korean adolescents: A preliminary study

North Korean adolescent defectors experience adaptation difficulties along with a wide range of psychosocial problems, but no study has yet examined their Internet addiction symptoms. We compared early traumatic experiences, self-esteem, negative cognition, and Internet addiction symptoms, as well as the relationships between these variables, between North Korean adolescent defectors and South Korean adolescents. Fifty-six North Korean adolescent defectors and 112 age- and sex- matched South Korean adolescents participated. The analyses examined the relationship between traumatic experiences and Internet addiction symptoms, with negative automatic thoughts or low self-esteem as mediators of these relations. North Korean adolescent defectors tended to have higher levels of negative automatic thoughts and more severe Internet addiction symptoms, as well as better self-esteem, than did South Korean adolescents. Furthermore, only among North Korean adolescent defectors, traumatic experiences were positively associated with Internet addition symptoms via increasing negative automatic thoughts. North Korean adolescent defectors are more susceptible to Internet addiction, negative cognitions, and early traumatic experiences compared to South Korean adolescents. However, the cross-sectional design of this study precludes consideration of the causality of these relationships. Interventions aiming to correct negative cognitions and increase self-esteem may be helpful for North Korean adolescent defectors with problematic Internet use.

Cross-sectional and longitudinal epidemiological studies of Internet gaming disorder: A systematic review of the literature

AIM

The diagnostic criteria of Internet gaming disorder (IGD) have been included in section III of DSM-5. This study aims to systematically review both cross-sectional and longitudinal epidemiological studies of IGD.

METHODS

All publications included in PubMed and PsychINFO up to May 2016 were systematically searched to identify cross-sectional studies on prevalence and longitudinal studies of IGD. In the process of identification, articles in non-English languages and studies focusing solely on the use of gaming were excluded, and those meeting the methodological requirements set by this review were included. As a result, 37 cross-sectional and 13 longitudinal studies were selected for review.

RESULTS

The prevalence of IGD in the total samples ranged from 0.7% to 27.5%. The prevalence was higher among males than females in the vast majority of studies and tended to be higher among younger rather than older people in some studies. Geographical region made little difference to prevalence. Factors associated with IGD were reported in 28 of 37 cross-sectional studies. These were diverse and covered gaming, demographic and familial factors, interpersonal relations, social and school functioning, personality, psychiatric comorbidity, and physical health conditions. Longitudinal studies identified risk and protective factors, and health and social consequences of IGD. The natural course of IGD was diverse but tended to be more stable among adolescents compared to adults.

CONCLUSION

Although existing epidemiological studies have provided useful data, differences in methodologies make it difficult to compare the findings of these studies when drawing consensus. Future international studies using reliable and uniform methods are warranted.

Abnormal illness behavior and Internet addiction severity: The role of disease conviction, irritability, and alexithymia

Background and aims While the association between health anxiety and maladaptive Internet use is a well-established finding, no studies have been performed to examine the possible effect of abnormal illness behavior (AIB). AIB is a maladaptive manner of experiencing, evaluating, or acting in response to health and illness that is disproportionate to evident pathology. The aim of this study was to investigate the association between AIB and Internet addiction (IA) severity in a sample of Italian University students. The possible effect of alexithymia, anxiety, and depression was also taken into account. Methods Participants were 115 men and 163 women (mean age = 23.62 ± 4.38 years); AIB was measured via the Illness Behavior Questionnaire (IBQ), and IA severity by the Internet Addiction Test (IAT). Results The most powerful IBQ factor predicting IA severity scores was disease conviction. Irritability was the only emotional IBQ factor associated with IA severity. Nevertheless, disease conviction and alexithymia remained the only significant predictors of IAT scores when hierarchical regression analysis was executed. Discussion and conclusions Our results support previous findings showing that those characterized by health anxiety are more prone to an excessive and maladaptive use of Internet. Moreover, this study showed that irritability was the only emotional aspect of AIB predicting IA severity. This finding is consistent with the cognitive model of hypochondria, which states that cognitive factors (dysfunctional beliefs and assumptions) play a major role in the explanation of this psychopathological condition.

Stress vulnerability in male youth with Internet Gaming Disorder

Internet Gaming Disorder [IGD] was introduced as new behavioral addiction in DSM-5 Section 3. Vulnerability to stress is a potential predisposing factor for IGD. Given a lack of preexisting empirical data, the study investigated differences in the psychological and neurobiological response to acute stress in patients with IGD. 24 young men (mean age 18.38 years; range 13-25 years) fulfilling DSM-5 criteria for IGD and 25 matched controls underwent the Trier Social Stress Test [TSST]. Participants provided hair samples for the analysis of basal hypothalamic-pituitary-adrenal [HPA] axis activity and clinical interviews were conducted to assess psychopathology. During the experiment, participants reported on their subjective stress experience and momentary affect, provided samples of salivary cortisol and their heart rate was continuously recorded. Patients with IGD reported greater everyday and chronic stress, as well as psychopathological comorbidity. No differences were found on measures of hair cortisol. Compared to controls, IGD patients showed an attenuated cortisol response (χ²₍₇₎=25.75, p<0.001) and greater negative affect (χ²₍₇₎=17.25, p=0.016) in response to acute stress. Heart rate (χ²₍₁₎=5.49, p=0.019), negative affect (χ²₍₁₎=5.60, p=0.018) and subjective stress (χ²₍₁₎=5.55, p=0.019) were transiently increased in IGD patients. After adjusting for sportive activities, IGD patients showed transiently decreased cortisol (χ²₍₁₎=5.20, p=0.022), potentially indicating general HPA-axis dysfunction beyond altered reactivity. Stress reactivity showed correlations with IGD symptom severity. Findings illustrate differences in acute psychological and neurobiological stress reactivity in patients with IGD. Alterations of the stress response system may be involved in the development and maintenance of IGD.