Lifetime depressive and current social anxiety are associated with problematic internet use in adolescents with ADHD: a cross-sectional study

The emerging evidence on the association between symptoms of ADHD and gaming disorder: A systematic review and meta-analysis

The co-existence of gaming disorder (GD) with other mental health problems has been widely reported. Despite the growing research interest in the comorbidity of GD with attention-deficit/hyperactivity disorder (ADHD), to date, no quantitative synthesis has been performed. The present study comprised a systematic literature search using Scopus, Science Direct, Web of Science, and PubMed databases. Three types of studies were included in the analyses: studies reporting (i) correlation coefficients between the symptoms of GD and ADHD, (ii) means, and standard deviations for comparison of GD severity between ADHD/non-ADHD individuals, and (iii) comparison of ADHD severity between GD/non-GD individuals. The results indicated a moderate relationship between GD and ADHD symptom severity when both subdomains of ADHD were combined (r = 0.296), and also when only inattention (r = 0.306) or hyperactivity (r = 0.266) symptoms were analyzed, which was also confirmed in a structural equation model meta-analysis. Studies showed a large average difference comparing the GD symptom severity of ADHD and non-ADHD individuals (g = 0.693), or ADHD symptom severity of GD and non-GD individuals (g = 0.854). In some cases, higher estimates of association were reported among studies that (i) had a higher proportion of males, (ii) assessed problematic internet use among predominantly videogame player samples rather than assessing only GD, and (iii) had been more recently published. The present review shows that this is an emerging field demonstrating significant results in cross-sectional correlational studies. However, future research should apply more rigorous methodologies to investigate the relationship further (e.g., longitudinal studies and studies using professional/clinical ratings and diagnosis). These results suggest that screening and treatment for ADHD among individuals with gaming disorder is necessary, and individuals with ADHD should be made aware of their higher susceptibility to gaming disorder.

Unpacking the relation between children's use of digital technologies and children's well-being: A scoping review

Over the last decade, a substantial number of studies have addressed children's use of technologies and their impact on well-being. Nonetheless, there is still a lack of clarity on the operationalisation of technology use, well-being, and the relation between the two. This scoping review intended to shed lights on Digital Technologies Use, its operationalisation, and the relation between Digital Technologies Negative Use (DTNU) and children's well-being. For the scope of the special issue we focused on negative use. Results showed two conceptualisations of DTNU: compulsive/addictive use of devices and the Internet (e.g., Internet addiction) and negative online experiences/risky behaviours (e.g., cyberbullying). Well-being in relation to DTNU was mainly studied in terms of psycho/social dimensions (e.g., depression), and a gap in cognitive well-being studies was identified. Study designs were largely quantitative, and, in most studies, well-being was considered as a predictor of DTNU. Also, research with children under 12 years was lacking. Future research on DTNU should look at: how dimensions of addiction and negative online experiences relate; provide more evidence on cognitive well-being; explore the interplay of well-being multiple components relying on integrative conceptual frameworks. The recent notion of digital well-being should also be explored considering the results of this review.

Does the Internet Bring People Closer Together or Further Apart? The Impact of Internet Usage on Interpersonal Communications

The complementarity interference (CI) model suggests that the Internet may either inhibit or facilitate interpersonal communications. This paper empirically examines the impact of Internet usage on interpersonal interactions, using a micro dataset from China to answer whether the Internet brings people closer together or further apart. The empirical results demonstrate, first, that Internet usage significantly increases both the time and frequency of people’s communications with their family and friends, rather than causing them to feel more disconnected and isolated. Holding other factors constant, for each one-standard-deviation increase in Internet usage, weekly communications with family members increases by an average of 102.150 min, while there is an average increase of 54.838 min in interactions with friends. These findings as to its positive effects are robust when using other regression models and interpersonal contact measures, as well as the instrumental variable method. Second, Internet usage also contributes to decreased loneliness; it exerts this effect primarily by improving people’s interactions with their family members. However, communications with friends do not significantly mediate such impacts. Third, the positive role of Internet usage on communications is more prominent for people with more frequent online socialization and self-presentation, better online skills, younger age, higher educational level, and who are living in urban areas. In addition, the beneficial effects of Internet usage are larger for communications with family members in the case of migrants. Therefore, in the context of the rapid development of information technology, the network infrastructure should be improved to make better use of the Internet to facilitate interpersonal communications and promote people’s wellness.

A mixed-methods study of problematic social media use, attention dysregulation, and social media use motives

Problematic social media use (PSMU) refers to excessive uncontrolled use of social media which impacts upon daily functioning (Blackwell et al., 2017). Self-regulation is central to the development and experience of PSMU, and conceptually interrelates with individual usage motivations (Reinecke et al., 2022). While there is a growing body of research on social media use motivations, how usage motivations and self-regulation combined influence PSMU is not well understood. There are also persistent questions around the effectiveness of addiction-based measures of PSMU. The quantitative component of this nested mixed-methods study (N = 607) employed hierarchical regression and structural equation modelling, principally identifying that impulsive social media usage mediates the pathway between perceived executive/attentional functioning and the Bergen Social Media Addiction Scale (BSMAS, Andreassen et al., 2012, 2016), a popular tool used to measure PSMU. In contrast, social-engagement motivations had a negative influence on the BSMAS. The qualitative component, comprising interview/open-ended questionnaire, explored individual experiences self-regulating social media use. Participants (N = 24) were recruited from the survey study, based on meeting screening criteria for executive dysfunction (Adult Self-Report ADHD Scale, Kessler et al., 2005), with sub-groups defined by top and bottom quartile BSMAS scores (evenly grouped). Thematic analysis found that most individuals with attention dysregulation, regardless of their BSMAS category, perceive self-regulation of social media use as highly challenging and effortful, describing broadly problematic relationship with social media. They also described rich combination of motivations and context of using social media, and strategies for managing use. This research questions the effectiveness of the BSMAS as a measure of general PSMU (lacking a formed self-regulation component), especially in individuals with attentional dysregulation. Future research investigating self-regulation strategies and focusing on characteristics of positive social media use is needed.

Challenges of children and adolescents with attention-deficit/hyperactivity disorder during the COVID-19 pandemic

OBJECTIVE

We aimed to understand the challenging effect of the pandemic on children and adolescents with ADHD.

METHODS

100 children and adolescents with ADHD aged 7-18 years were included in the study. They were evaluated in terms of internet addiction diagnostic criteria. Symptom severity was assessed using the CBCL, CPRS, and SNAP-IV.

RESULTS

We found that 42% spent less time outdoors, and 26% spent more time watching TV. 57% had increased internet use and 28% were diagnosed as having internet addiction. There was a significant difference in terms of symptom severity between the groups depending on whether the children took part in sports activity before the pandemic.

CONCLUSIONS

Children and adolescents with ADHD have experienced challenges in many areas, especially internet use in the pandemic. The positive long-term effects of exercise in children with ADHD are thought to be protective in terms of symptom management during the COVID-19 pandemic.

Co-occurrence of Adult ADHD Symptoms and Problematic Internet Use and Its Links With Impulsivity, Emotion Regulation, Anxiety, and Depression

The co-occurrence of attention-deficit/hyperactivity disorder (ADHD) and problematic Internet use (PIU) is associated with increased severity of PIU and poorer treatment outcomes. The main objective of this study was to examine the association between PIU and adult ADHD symptoms and determine whether adult ADHD symptoms were a predictor of PIU in the general adult population. We also examined the potential mediating role of the dimensional psychopathological factors, including anxiety, depression, impulsivity, and emotion regulation, in this relationship. To achieve these aims, we recruited 532 regular Internet users online from the general adult population. The participants completed an online questionnaire assessing PIU (Internet Addiction Test), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), adult ADHD symptoms (Adult ADHD Self-Report Scale-V1.1), emotion regulation (Emotion Regulation Questionnaire), and impulsivity (UPPS-P Impulsive Behavior Scale). We conducted a multiple regression analysis to determine the predictors of PIU and mediation analyses to identify the psychopathological mediators of the association between adult ADHD symptoms and PIU. PIU was observed in 17.9% of our sample. A significantly higher proportion of respondents with PIU screened positive for adult ADHD symptoms compared to respondents without PIU (50.5 vs. 21.7%; p < 0.001). Individuals with PIU reported significantly higher scores than those without PIU for anxiety and depressive symptoms, impulsivity, and the emotion regulation strategy of expressive suppression. Additionally, they had significantly lower scores than those without PIU on cognitive reappraisal than non-problematic Internet users. In addition to adult ADHD symptoms, the multiple regression analysis revealed that PIU was also positively predicted by depressive symptoms, positive urgency, lack of perseverance, and expressive suppression, and is negatively predicted by cognitive reappraisal and negative urgency. The mediation analysis showed that lack of perseverance, positive urgency, and depressive and anxiety symptoms were partial mediators of the relationship between adult ADHD symptoms and PIU. Our results highlight the significant co-occurrence of PIU and adult ADHD symptoms. This study also provides support for a theoretical model in which impulsivity dimensions, emotion regulation strategies, as well as the tendency to anxiety and depressive symptoms, may play a mediating role in this co-occurrence. In summary, the findings emphasize the need to assess these psychological characteristics in problematic Internet users, as they can be a factor of clinical complexity, as well as the importance of targeting them as part of integrated interventions for both adult ADHD symptoms and PIU.

Associations between Internet Addiction, Psychiatric Comorbidity, and Maternal Depression and Anxiety in Clinically Referred Children and Adolescents

PURPOSE

Internet addiction (IA) has become a global problem and is one of the most common reasons for children to be referred for intervention because IA results in social and educational dysfunction and conflict with parents. IA is associated with various comorbid psychiatric disorders, with notable association between IA and family factors. However, little is known about parental psychopathology. This study aimed to examine the prevalence of IA and association between IA and maternal depression and anxiety in clinical samples after adjusting for comorbidities.

PATIENTS AND METHODS

A cross-sectional study was conducted between April 2020 and August 2021 at the Department of Neuropsychiatry of Osaka Metropolitan University Hospital in Japan. A total of 218 clinically referred children and adolescents (aged 8 to 15 years) were assessed using the Internet Addiction Test, which is one of the most popular questionnaires to evaluate IA, the Child Behavior Checklist (CBCL), and The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. IA was defined as a total score on the Internet Addiction Test ≥ 50. Of those, for the evaluation of maternal depression and anxiety, the 132 mothers of the children who were referred after January 2021 completed K6 as well.

RESULTS

A total of 68 participants (31.2%) presented with IA and had higher total and externalizing scores of CBCL, social anxiety disorder, and oppositional defiant disorder compared to those without IA. IA was associated with the six-item Kessler scale scores of mothers, being raised by single parents, and anxiety disorders after adjusting for age, sex, and family income (95% CI: 1.023-1.215).

CONCLUSION

Maternal depression and anxiety may be one of the risk factors for children and adolescents to develop IA. Care for maternal depression and anxiety may contribute to intervention for children and adolescents with IA.