Cue-elicited craving-related lentiform activation during gaming deprivation is associated with the emergence of Internet gaming disorder

Neural mechanisms linked to treatment outcomes and recovery in substance-related and addictive disorders

The present review focuses on potential neural mechanisms underlying recovery from psychiatric conditions characterised by impaired impulse control, specifically substance use disorders, gambling disorder, and internet gaming disorder. Existing treatments (both pharmacological and psychological) for these addictions may impact brain processes, and these have been evaluated in neuroimaging studies. Medication challenge and short-term intervention administration will be considered with respect to treatment utility. Main models of addiction (e.g., dual process, reward deficiency syndrome) will be considered in the context of extant data. Additionally, advanced analytic approaches (e.g., machine-learning approaches) will be considered with respect to guiding treatment development efforts. Thus, this narrative review aims to provide directions for treatment development for addictive disorders.

Effective connectivity analysis of verbal working memory advantage across materials for pathological smartphone users by fNIRS

Previous studies have found working memory (WM) advantages of the pathological smartphone use (PSU) group, but most of which were emphasized in the network-related domain. Whether the advantages can transfer to other domains has yet to be confirmed. In particular, exploring from a brain mechanism perspective is necessary. Using the classical N-back paradigm, this study selected network-related words and neutral words as materials combined with fNIRS to probe the verbal WM characteristics of the PSU group. The results showed that β in channel 3, channel 4, and channel 5 were significantly lower in the PSU group than those in the control group The analysis of the region of interest revealed that the PSU group showed significantly lower β in the l-DLPFC and frontopolar. Granger Causality results showed that functional connectivity between frontopolar and R-DLPFC for the PSU group was significantly higher than for the control group in the network word condition. These results demonstrate that the PSU group has an advantage in WM, transferring from the network-related stimulus to the neutral stimulus. The advantages of network stimulus were related to bidirectional connectivity between frontopolar and R-DLPFC. Also, the l-DLPFC and frontopolar are associated with the cross-material consistency of WM.

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

Objectives

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

Methods

A narrative review was conducted.

Results

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

Conclusions

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

Cue-reactivity to distal cues in individuals at risk for gaming disorder

BACKGROUND

Gaming disorder (GD) is a disorder due to addictive behaviors (ICD-11). Cue-reactivity and craving are relevant mechanisms in the development and maintenance of addictive behaviors. When confronted with cues showing in-game content (proximal cues) individuals with higher symptom severity show increased cue-reactivity. Based on conditioning and addiction theories on incentive sensitization, cue-reactivity responses may generalize to more distal cues, e.g. when individuals at risk of developing a GD are confronted with a starting page of an online game. In cue-reactivity paradigms so far, only proximal gaming cues have been used.

METHODS

We investigated the effect of distal gaming cues compared to gaming-unrelated control cues on cue-reactivity and craving in 88 individuals with non-problematic use of online games (nPGU) and 69 individuals at risk for GD (rGD). The distal cues showed the use of an electronic device (e.g., desktop PC or smartphone) whose screen showed starting pages of either games (target cues), shopping- or pornography sites (control cues) from a first-person perspective.

FINDINGS

We found significantly higher urge and arousal ratings as well as longer viewing times for gaming-related compared to gaming-unrelated control cues in rGD compared to nPGU. Valence ratings did not differ between groups.

INTERPRETATION

The results demonstrate that already distal gaming-specific cues lead to cue-reactivity and craving in rGD. This finding indicates that based on conditioning processes, cue-reactivity and craving develop during the course of GD and generalize to cues that are only moderately related to the specific gaming activity.

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

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

Subgroups of internet gaming disorder based on addiction-related resting-state functional connectivity

AIMS

To identify subgroups of people with internet gaming disorder (IGD) based on addiction-related resting-state functional connectivity and how these subgroups show different clinical correlates and responses to treatment.

DESIGN

Secondary analysis of two functional magnetic resonance imaging (fMRI) data sets.

SETTING

Zhejiang province and Beijing, China.

PARTICIPANTS

One hundred and sixty-nine IGD and 147 control subjects.

MEASUREMENTS

k-Means algorithmic and support-vector machine-learning approaches were used to identify subgroups of IGD subjects. These groups were examined with respect to assessments of craving, behavioral activation and inhibition, emotional regulation, cue-reactivity and guessing-related measures.

FINDINGS

Two groups of subjects with IGD were identified and defined by distinct patterns of connectivity in brain networks previously implicated in addictions: subgroup 1 ('craving-related subgroup') and subgroup 2 ('mixed psychological subgroup'). Clustering IGD on this basis enabled the development of diagnostic classifiers with high sensitivity and specificity for IGD subgroups in 10-fold validation (n = 218) and out-of-sample replication (n = 98) data sets. Subgroup 1 is characterized by high craving scores, cue-reactivity during fMRI and responsiveness to a craving behavioral intervention therapy. Subgroup 2 is characterized by high craving, behavioral inhibition and activations scores, non-adaptive emotion-regulation strategies and guessing-task fMRI measures. Subgroups 1 and 2 showed largely opposite functional-connectivity patterns in overlapping networks.

CONCLUSIONS

There appear to be two subgroups of people with internet gaming disorder, each associated with differing patterns of brain functional connectivity and distinct clinical symptom profiles and gender compositions.

The involvement of spontaneous brain activity in natural recovery from internet gaming disorder: A resting-state fMRI study

OBJECTIVE

Internet gaming disorder (IGD) can seriously impair an individual's physical and mental health. However, unlike the majority of those suffering from substance addiction, individuals with IGD may recover without any professional intervention. Understanding the brain mechanisms of natural recovery from IGD may provide new insight into how to prevent addiction and implement more targeted interventions.

METHODS

Sixty individuals with IGD were scanned by using a resting-state fMRI to assess brain region changes associated with IGD. After 1 year, 19 individuals with IGD no longer met the IGD criteria and were considered recovered (RE-IGD), 23 individuals still met the IGD criteria (PER-IGD), and 18 individuals left the study. The brain activity in resting state between 19 RE-IGD individuals and 23 PER-IGD individuals was compared by using regional homogeneity (ReHo). Additionally, brain structure and cue-craving functional MRIs were collected to further support the results in the resting-state.

RESULTS

The resting-state fMRI results revealed that activity in brain regions responsible for reward and inhibitory control [including the orbitofrontal cortex (OFC), the precuneus and the dorsolateral prefrontal cortex (DLPFC)] was decreased in the PER-IGD individuals compared to RE-IGD individuals. In addition, significant positive correlations were found between mean ReHo values in the precuneus and self-reported craving scores for gaming, whether among the PER-IGD individuals or the RE-IGD individuals. Furthermore, we found similar results in that brain structure and cue-craving differences exist between the PER-IGD individuals and RE-IGD individuals, specifically in the brain regions associated with reward processing and inhibitory control (including the DLPFC, anterior cingulate gyrus, insula, OFC, precuneus, and superior frontal gyrus).

CONCLUSION

These findings indicate that the brain regions responsible for reward processing and inhibitory control are different in PER-IGD individuals, which may have consequences on natural recovery. Our present study provides neuroimaging evidence that spontaneous brain activity may influence natural recovery from IGD.

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

BACKGROUND AND AIMS

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

METHODS

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

RESULTS

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

DISCUSSIONS

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

The effect of creative expression program in neurocognitive networks performance measured by task and resting-state functional MRI

BACKGROUND

The current study examined the effects of a 16-week creative expression program on brain activity during a story creating task and resting-state functional network connectivity in mild cognitive impairment (MCI) adults.

METHOD

Thirty-six MCI adults were allocated to either the creative expression program (CrExp, n = 18) or control group (CG,n = 18). Before and after intervention, all participants were scanned with functional magnetic resonance imaging (fMRI) during story creating task performance and a resting state. The two-group comparison was calculated between the blood oxygenation level-dependent (BOLD) signal changes for each cluster to investigate the differences in fMRI activation and functional connectivity (FC) between two groups.

RESULTS

Task activation analyses showed an increase in the right anterior cingulate gyrus (ACG), right medial frontal gyrus (MFG), right lentiform nucleus (LN), left hippocampus (HIP), left middle occipital gyrus (MOG), and left cerebellum posterior lobe (CPL) (p < 0.05). Story creating performance improvements were associated with greater activation in the left HIP region. Resting-state functional connectivity (FC) between left HIP and certain other brain areas shown a significant interaction of creative expression group versus control group. Moreover, connectivity between the right angular gyrus (ANG), right inferior temporal gyrus (ITG), right superior occipital gyrus (SOG), left ANG, and left MFG were related to improved cognitive performance (p < 0.05).

CONCLUSION

These data extend current knowledge by indicating that the creative expression program can improve cognitive activation in MCI, and these enhancements may be related to the neurocognitive network plasticity changes induced by creative expression training.

Similarities and differences between internet gaming disorder and tobacco use disorder: A large-scale network study

Studies have shown that internet gaming disorder (IGD) has the potential to be a type of addiction; however, direct comparisons (similarities and differences) between IGD and traditional addictions remain scarce, especially at the neuroimaging level. Resting-state functional magnetic resonance imaging (fMRI) data were collected from 92 individuals with IGD, 96 individuals with tobacco use disorders (TUDs) and 107 individuals who served as healthy controls (HCs). Independent component analysis (ICA) was performed to explore the similarities and differences among these three groups; Granger causality analysis (GCA) was further performed based on the ICA results to determine potential neural features underlying the differences and similarities among the groups. The ICA results indicated significant differences in the subcortical network and cerebellar network. GCA results found that significant differences in bilateral caudate among three groups, and the efferents of dorsal frontostriatal circuit showed significant differences in insula among three groups, whereas efferents of ventral frontostriatal circuit showed significant differences in the medial prefrontal cortex (mPFC). Two kinds of addiction showed differences in thalamus and frontostriatal circuits, and similar changes found in cerebellum and mPFC regions. It suggested that addiction disorders have psychopathology features, and the craving and reward dysfunctions may be the key reasons. Although both substance addiction and behaviour addiction showed craving dysfunction in cerebellum, however, the key reward dysfunction of substance addiction was found in subcortical regions, whereas behaviour addiction located in cortical regions.

Weight Status Modulated Brain Regional Homogeneity in Long-Term Male Smokers

BACKGROUND

Tobacco smoking and being overweight could lead to adverse health effects, which remain an important public health problem worldwide. Research indicates that overlapping pathophysiology may contribute to tobacco addiction and being overweight, but the neurobiological interaction mechanism between the two factors is still unclear.

METHODS

The current study used a mixed sample design, including the following four groups: (i) overweight long-term smokers (n = 24); (ii) normal-weight smokers (n = 28); (iii) overweight non-smokers (n = 19), and (iv) normal-weight non-smokers (n = 28), for a total of 89 male subjects. All subjects underwent resting-state functional magnetic resonance imaging (rs-fMRI). Regional homogeneity (ReHo) was used to compare internal cerebral activity among the four groups. Interaction effects between tobacco addiction and weight status on ReHo were detected using a two-way analysis of variance, correcting for age, years of education, and head motion.

RESULTS

A significant interaction effect between tobacco addiction and weight status is shown in right superior frontal gyrus. Correlation analyses show that the strengthened ReHo value in the right superior frontal gyrus is positively associated with pack-year. Besides, the main effect of tobacco addiction is specially observed in the occipital lobe and cerebellum posterior lobe. As for the main effect of weight status, the right lentiform nucleus, left postcentral gyrus, and brain regions involved in default mode network (DMN) survived.

CONCLUSIONS

These results shed light on an antagonistic interaction on brain ReHo between tobacco addiction and weight status in the right superior frontal gyrus, which may be a clinical neuro-marker of comorbid tobacco addiction and overweight. Our findings may provide a potential target to develop effective treatments for the unique population of comorbid tobacco addiction and overweight people.

Neural classification of internet gaming disorder and prediction of treatment response using a cue-reactivity fMRI task in young men

BACKGROUND

Neural mechanisms underlying internet gaming disorder (IGD) are important for diagnostic considerations and treatment development. However, neurobiological underpinnings of IGD remain relatively poorly understood.

METHODS

We employed multi-voxel pattern analysis (MVPA), a machine-learning approach, to examine the potential of neural features to statistically predict IGD status and treatment outcome (percentage change in weekly gaming time) for IGD. Cue-reactivity fMRI-task data were collected from 40 male IGD subjects and 19 male healthy control (HC) subjects. 23 IGD subjects received 6 weeks of craving behavioral intervention (CBI) treatment. MVPA was applied to classify IGD subjects from HCs and statistically predict clinical outcomes.

RESULTS

MVPA displayed a high (92.37%) accuracy (sensitivity of 90.00% and specificity of 94.74%) in the classification of IGD and HC subjects. The most discriminative brain regions that contribute to classification were the bilateral middle frontal gyrus, precuneus, and posterior lobe of the right cerebellum. MVPA statistically predicted clinical outcomes in the craving behavioral intervention (CBI) group (r = 0.48, p = 0.0032). The most strongly implicated brain regions in the prediction model were the right middle frontal gyrus, superior frontal gyrus, supramarginal gyrus, anterior/posterior lobes of the cerebellum and left postcentral gyrus.

CONCLUSIONS

The findings about cue-reactivity neural correlates could help identify IGD subjects and predict CBI-related treatment outcomes provide mechanistic insight into IGD and its treatment and may help promote treatment development efforts.

Connectome-based prediction of craving for gaming in internet gaming disorder

BACKGROUND

Craving-related brain responses have been associated with the emergence and maintenance of addictions. However, little is known about brain network organizations underlying cravings in internet gaming disorder (IGD).

METHODS

Sixty-six IGD subjects and 61 matched individuals with recreational game use (RGU) were scanned while performing a cue-craving task. A recently developed whole-brain analysis approach, connectome-based predictive modelling (CPM) with leave-one-out cross-validation was conducted to identify networks that predicted craving responses in IGD. Then, the craving network was tested in different brain states (cue-craving under deprivation) to investigate replicability.

RESULTS

CPM identified an IGD craving network, as indicated by a significant correspondence between predicted and actual craving values (r = 0.49, p < 0.001), characterized by within-network default mode (DMN) connectivity and connectivity between canonical networks implicated in executive/cognitive control (frontoparietal, medial frontal, DMN) and reward responsiveness (subcortical, motor/sensory). Network strength in the cue-craving task during gaming deprivation also predicted IGD craving scores (r = 0.43, p = 0.017), indicating network replication across brain states.

CONCLUSIONS

The CPM results demonstrate that individual differences in cognitive, attention, and control network function can predict craving intensities in IGD subjects. These networks may be targets for potential interventions using brain modulation.

Imbalanced sensitivities to primary and secondary rewards in internet gaming disorder

BACKGROUND

Internet gaming disorder (IGD) is a type of behavioral addiction characterized by poorly controlled and interfering patterns of game playing. Studies have suggested that the IGD is usually accompanied by increased desire or craving for gaming, suggesting that secondary rewards related to gaming may become more salient than those for primary rewards like food. However, this hypothesis has not been formally tested and potential neural mechanisms remain unclear.

METHODS

This is a functional magnetic resonance imaging (fMRI) study. Twenty-one IGD subjects and 23 matched individuals with recreational game use (RGU) were scanned when exposed to gaming (secondary rewards), food (primary rewards) and neutral cues. Group-by-cue-type interaction analyses and subsequent within-group analyses for fMRI data were performed and seed-based functional connectivity (FC) analyses explored further potential neural features.

RESULTS

IGD subjects' subjective craving responses to gaming cues were higher than to food cues, while the opposite was observed in RGU subjects. Group-by-cue interaction effects implicated the precuneus and precuneus-caudate FC. Simple effect analysis showed that for IGD subjects, gaming-related cues elicited higher FC in precuneus-caudate relationships than did food-related cues. In the RGU subjects, the opposite was observed. Significant correlations were found between brain features and craving scores.

CONCLUSIONS

These results support the hypothesis regarding imbalances in sensitivities to different types of reward in IGD, and suggest neural mechanisms by which craving for gaming may make secondary rewards more salient than primary ones, thus promoting participation in addictive patterns of gaming.

Dorsal and ventral striatal functional connectivity shifts play a potential role in internet gaming disorder

Animal models suggest transitions from non-addictive to addictive behavioral engagement are associated with ventral-to-dorsal striatal shifts. However, few studies have examined such features in humans, especially in internet gaming disorder (IGD), a proposed behavioral addiction. We recruited 418 subjects (174 with IGD; 244 with recreational game use (RGU)). Resting-state fMRI data were collected and functional connectivity analyses were performed based on ventral and dorsal striatal seeds. Correlations and follow-up spectrum dynamic causal model (spDCM) analyses were performed to examine relationships between the ventral/dorsal striatum and middle frontal gyrus (MFG). Longitudinal data were also analysed to investigate changes over time. IGD relative to RGU subjects showed lower ventral-striatum-to-MFG (mostly involving supplementary motor area (SMA)) and higher dorsal-striatum-to-MFG functional connectivity. spDCM revealed that left dorsal-striatum-to-MFG connectivity was correlated with IGD severity. Longitudinal data within IGD and RGU groups found greater dorsal striatal connectivity with the MFG in IGD versus RGU subjects. These findings suggest similar ventral-to-dorsal striatal shifts may operate in IGD and traditional addictions.

In order to shed light on the underlying neural mechanisms of internet gaming disorder (IGD), Dong et al collected longitudinal resting-state fMRI data from participants with IGD or those who partake in recreational game use. They demonstrated that, consistent with animal models of addiction, dorsal and ventral striatal functional connectivity shifts appeared to play a potential mechanistic role in IGD.

Disrupted prefrontal regulation of striatum-related craving in Internet gaming disorder revealed by dynamic causal modeling: results from a cue-reactivity task

BACKGROUND

Studies of Internet gaming disorder (IGD) suggest an imbalanced relationship between cognitive control and reward processing in people with IGD. However, it remains unclear how these two systems interact with each other, and whether they could serve as neurobiological markers for IGD.

METHODS

Fifty IGD subjects and matched individuals with recreational game use (RGU) were selected and compared when they were performing a cue-craving task. Regions of interests [anterior cingulate cortex (ACC), lentiform nucleus] were selected based on the comparison between brain responses to gaming-related cues and neutral cues. Directional connectivities among these brain regions were determined using Bayesian estimation. We additionally examined the posterior cingulate cortex (PCC) in a separate analysis based on data implicating the PCC in craving in addiction.

RESULTS

During fixed-connectivity analyses, IGD subjects showed blunted ACC-to-lentiform and lentiform-to-ACC connectivity relative to RGU subjects, especially in the left hemisphere. When facing gaming cues, IGD subjects trended toward lower left-hemispheric modulatory effects in ACC-to-lentiform connectivity than RGU subjects. Self-reported cue-related craving prior to scanning correlated inversely with left-hemispheric modulatory effects in ACC-to-lentiform connectivity.

CONCLUSIONS

The results suggesting that prefrontal-to-lentiform connectivity is impaired in IGD provides a possible neurobiological mechanism for difficulties in controlling gaming-cue-elicited cravings. Reduced connectivity ACC-lentiform connectivity may be a useful neurobiological marker for IGD.

Reduced frontostriatal functional connectivity and associations with severity of Internet gaming disorder

Cognitive, functional, and structural brain factors involving frontal executive and striatal reward networks have been implicated in Internet gaming disorder (IGD). However, frontostriatal network connectivity and its association with addiction severity are poorly understood in IGD. Resting-state fMRI data from 337 subjects (130 with IGD, 207 with recreational game use [RGU]) were collected. Striatal-cortical communications were measured with resting-state functional connectivity (FC) using coherent spontaneous fluctuations in the blood-oxygenation-level-dependent fMRI signal. Correlations were calculated between FC measures and IGD-related assessments (addiction severity and craving scores). Decreased FC was predominantly observed in IGD subjects, with IGD subjects showing decreased FC between the putamen and superior frontal gyrus (SFG), middle frontal gyrus (MFG), and inferior frontal gyrus (IFG) and the ventral striatum and IFG, superior temporal gyrus, and MFG. Disorder severity and craving scores were negatively correlated with FC between striatal and frontal brain regions. Associations between diminished FC in corticostriatal circuitry and clinical features (IGD craving, severity) suggest potential therapeutic targets for neuromodulation treatments. The extent to which frontostriatal circuits involving executive control over reward processes may be altered to treat IGD warrants additional study.

Sex difference in neural responses to gaming cues in Internet gaming disorder: Implications for why males are more vulnerable to cue-induced cravings than females

BACKGROUND

Although drug addiction studies have shown that females are more likely to become addicted and sensitive to drug cues, this feature seems reversed in Internet gaming disorder (IGD), of which males are more likely to be sufferers. Given the prevalence of IGD in the male population, the current study was set to examine the potential effect of sex on IGD's craving using a cue reactivity task.

METHODS

Sixty-five (32 males) IGD subjects underwent fMRI scanning during exposure to visual gaming cues and neutral cues. Brain responses to gaming cues relative to neutral cues were examined within two groups separately. In addition, Granger causal analysis (GCA) was conducted to investigate how the effective connectivity patterns were altered in male and female IGD subjects.

RESULTS

When facing gaming cues, lower regions of brain activation were observed in males compared to females, including the left anterior cingulate cortex (ACC), the superior frontal gyrus and the posterior cingulate cortex (PCC); GCA results, using the PCC as the ROI, showed higher middle temporal gyrus-PCC-right ACC/parahippocampal gyrus effective connectivity in males as compared with females, when exposed to gaming cues.

CONCLUSION

The results indicate that gaming cues could more severely disturb male IGD subjects' inhibition control function over game-elicited cravings compared to females, which might make it hard for males to control their game cravings and stop their gaming behaviors. This conclusion is valuable in understanding why males are more vulnerable to IGD than females.

Altered modular segregation of brain networks during the cue-craving task contributes to the disrupted executive functions in internet gaming disorder

BACKGROUND

Previous studies have shown that gaming-related cues could induce gaming cravings and bring about changes in brain activities in subjects with Internet gaming disorder (IGD). However, little is known about the brain network organizations in IGD subjects during a cue-craving task and the relationship between this network organization and IGD severity.

METHODS

Sixty-one IGD subjects and 61 matched recreational game users (RGUs) were scanned while performing a cue-craving task. We calculated and compared the participation coefficient (PC) among brain network modules between IGD subjects and RGUs. Based on the results, further group comparison analyses were performed to explain the PC changes and to explore the relationship between PCs and IGD severity.

RESULTS

While performing a cue-craving task, compared with RGUs, IGD subjects showed significantly decreased PCs in the default-mode network (DMN) and the frontal-parietal network (FPN). Specifically, the number of connections between nodes in the ventromedial prefrontal cortex, anterior cingulate cortex, posterior cingulate cortex and other nodes in the DMN of IGD subjects was much larger than that in RGUs. Correlation results showed that the number of DMN intra-modular connections was positively correlated with addiction severity and craving degree.

CONCLUSIONS

These results provide neural evidence that can explain why cognitive control, emotion, attention and other functions are impaired in IGD subjects in the face of gaming cues, which leads to compulsive behavior toward games. These findings extend our understanding of the neural mechanism of IGD and have important implications for developing effective interventions to treat IGD subjects.

The Development of the Turkish Craving for Online Shopping Scale: A Validation Study

In the present study, the Turkish version of the Craving for Online Shopping Scale (TCOSS) was developed by modifying items on the Penn Alcohol Craving Scale (PACS). The sample comprised 475 adult volunteers (233 women and 242 men) from three different non-clinical samples recruited online. The structure validity of the TCOSS was examined utilizing exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and criterion validity testing. The EFA showed that the TCOSS had a unidimensional structure that explained 80% of the total variance. The five-item unidimensional structure of the TCOSS then underwent further testing using two different samples. First, the structure of the TCOSS was tested using CFA, which confirmed the unidimensional factor structure. Second, measurement invariance of the TCOSS was conducted through structural invariance, metric invariance, and scalar invariance across different samples. This demonstrated the TCOSS had measurement invariance across different samples (CFA and criterion validity samples). Criterion validity of the TCOSS was tested using the Internet Addiction Test-Short Form, Brief Self-Control Scale, Compulsive Online Shopping Scale, Positive and Negative Affect Schedule, and self-reported personal information. According to the criterion validity results, the TCOSS assessed the structure it targets. Cronbach’s α internal consistency coefficients of the TCOSS were .94 in the EFA sample, .94 in the CFA sample, and .96 in the criterion validity sample. When validity and reliability analysis of the TCOSS are considered as a whole, it is concluded that the TCOSS is a valid and reliable scale for assessing craving for online shopping among online shoppers.

Effect of Work Environment on Presenteeism among Aging American Workers: The Moderated Mediating Effect of Cynical Hostility

Cynical hostility in the workplace has been studied. However, there is still no complete study examining how cynical hostility affects work performance. We examined how work environment impacts presenteeism through the mediation of cynical hostility and how chronic work discrimination moderates the relationship between work environment and cynical hostility among ageing workforces. The psychosocial vulnerability model supplies theoretical support for our model. We analyzed data from a sample of 2926 aging workforces from the Health and Retirement Study. Structural equation modeling (SEM) was used to examine the relationships with a moderated mediation model. In the final SEM model, our results showed that work environment was directly negatively associated with presenteeism. Moreover, cynical hostility was significantly inversely correlated with work environment and positively correlated with presenteeism. We found that the significant indirect effect between work environment and presenteeism can be significantly mediated by cynical hostility. In addition, cynical hostility is more likely to be affected by work environment among ageing workforces with lower levels of chronic work discrimination than those with higher levels. Enterprise, government, and employees themselves should be aware of the impact of presenteeism on ageing workforces with high levels of cynical hostility.

Functional neural changes and altered cortical-subcortical connectivity associated with recovery from Internet gaming disorder

BACKGROUND AND AIMS

Although studies have suggested that individuals with Internet gaming disorder (IGD) may have impairments in cognitive functioning, the nature of the relationship is unclear given that the information is typically derived from cross-sectional studies.

METHODS

Individuals with active IGD (n = 154) and those individuals no longer meeting criteria (n = 29) after 1 year were examined longitudinally using functional magnetic resonance imaging during performance of cue-craving tasks. Subjective responses and neural correlates were contrasted at study onset and at 1 year.

RESULTS

Subjects' craving responses to gaming cues decreased significantly at 1 year relative to study onset. Decreased brain responses in the anterior cingulate cortex (ACC) and lentiform nucleus were observed at 1 year relative to onset. Significant positive correlations were observed between changes in brain activities in the lentiform nucleus and changes in self-reported cravings. Dynamic causal modeling analysis showed increased ACC-lentiform connectivity at 1 year relative to study onset.

CONCLUSIONS

After recovery from IGD, individuals appear less sensitive to gaming cues. This recovery may involve increased ACC-related control over lentiform-related motivations in the control over cravings. The extent to which cortical control over subcortical motivations may be targeted in treatments for IGD should be examined further.

Diagnostic and Classification Considerations Regarding Gaming Disorder: Neurocognitive and Neurobiological Features

Video gaming and Internet use have become a part of the everyday lives of many individuals, especially during adolescence. Given the health concerns related to problematic gaming behaviors, gaming disorder (GD) has been included in the version of the 11th edition of The International Classification of Diseases (ICD-11) ratified by the secretariat of the World Health Organization. Given these considerations and others (including debate regarding the most appropriate classification of GD and how best to prevent and treat the condition), there is a need for further research into GD. Specifically, we suggest that researching intermediate phenotypes focusing on cognitive and neurobiological function may help clarify GD's relationships to other addictive disorders and more accurately define their relationships with core and associated features of GD. Overlaps in neural activity, cognitive functioning, and other features suggest that GD shares similarities with gambling and substance-use disorders and may best be classified as an addictive disorder. Individuals with GD differ from those with regular game use (RGU) on neurocognitive levels. However, concerns have been raised with respect to the differences between GD and substance-use disorders in certain dimensional features, such as tolerance. Additionally, it has been argued that differences between GD and RGU may not be fully captured by nomenclature systems like the ICD-11. Nonetheless, individuals seek treatment for help with GD, despite the limited data available for effective treatments. As more data are gathered from investigations of GD, they should be translated into refining criteria for GD and optimizing interventions.