Attachment and behavioral addictions in adolescents: The mediating and moderating role of coping strategies

Coping Tendency as a Mediator in the Relationship Between Psychological Resilience and Health Problems Among College Students

Purpose

The study aimed to explore the status of four common health problems (ie, smoking, internet addiction, physical inactivity, psychological disorder) among college students and analyze the relationship between psychological resilience, coping tendency and health problems.

Participants and Methods

The convenience sampling method was used to recruit 500 college students from four universities. The General Information Questionnaire, Adolescent Psychological Resilience Scale, Simplified Coping Style Questionnaire and Health Risk Behavior Questionnaire were used for survey.

Results

Among the students, there were 71 smokers (15.4%) and 61 internet addicts (13.2%). Over a third of the students reported physical inactivity (35.9%) and a minority had psychological disorder (6.3%). The psychological resilience score differed between students who smoked, had internet addiction, physical inactivity, psychological disorder and those without these health-risk behaviors. Logistic regression analysis showed that negative coping tendency was the common contributing factor of physical inactivity, internet addiction and psychological disorder. Coping tendency played a partial mediating effect in the relationship between psychological resilience and health problems, with a mediating effect of 37.93%.

Conclusion

Psychological resilience can not only affect health problems directly but also influence health problems indirectly through coping tendency. Educators and administrators in universities can apply effective measures to improve psychological resilience and positive coping to prevent or reduce health problems among undergraduates.

The Associations Between Attachment Insecurity and Compulsive Sexual Behavior Disorder or Problematic Pornography Use: The Mediating Role of Emotion Regulation Difficulties

Compulsive sexual behavior disorder (CSBD) was previously considered an attachment disorder, while emotion dysregulation was thought to potentially be a key characteristic of it. However, this theoretical model was not tested in previous empirical research. In our cross-sectional study, we tested whether emotional regulation (ER) difficulties can be adopted as an explanatory mechanism for the relationships between attachment avoidance and anxiety, as well as CSBD and its most prevalent behavioral presentation-problematic pornography use (PPU). Participants (n = 1002; Mage = 50.49 years, SD = 13.32; men: 50.2%) completed an online survey regarding the investigated variables. In mediation analyses, attachment avoidance and anxiety were treated as simultaneous predictors, ER difficulties as a mediating variable, with CSBD/PPU severity as dependent variables. Emotion regulation difficulties and attachment anxiety had a direct positive effect on both CSBD and PPU. The direct effect of attachment avoidance on PPU was non-significant, and significant for CSBD depending on the measure used. Moreover, all the relationships between both insecure attachment dimensions and CSBD/PPU symptom severity were at least partially mediated by ER difficulties. Our results corroborate the theoretical claim that ER difficulties may be a useful framework for explaining the impact of attachment insecurity on CSBD/PPU. Theoretical and practical implications of the findings are discussed.

Parental attachment security and problematic internet use in children: The mediating role of maladaptive cognitive emotion regulation strategies

Problematic Internet Use (PIU) is a growing problem among children. Insecure attachment has been associated with PIU and emotion dysregulation. Furthermore, there is evidence suggesting that maladaptive Cognitive Emotion Regulation Strategies (CERS), such as Self-blame, Rumination, Catastrophizing and Other-blame, lead to PIU, nevertheless, the mediating role of CERS between attachment and PIU has not been explored. A sample of 641 children (M = 10.15; SD = .89) participated in the study. The findings showed that there were significant differences between problematic and non-problematic users in terms of secure attachment and emotion dysregulation. Results show a negative association between attachment security and PIU and a negative association between attachment and maladaptive CERS, whilst maladaptive CERS were positively related with PIU. Finally, maladaptive CERS, particularly Rumination, were found to mediate the relationship between attachment security and PIU. However, Catastrophizing and Other Blame partially mediated the relationship between maternal attachment, but not the relationship between Father attachment and PIU. Limitations and implications are discussed, motivating the promotion of prevention and intervention programs.

Press Play to Feel: The Role of Attachment Styles and Alexithymic Features in Problematic Gaming

Problematic gaming has been consistently associated with insecure attachment styles and alexithymia. However, there is limited knowledge regarding the impact of specific alexithymic features and insecure attachment styles on problematic gaming. The study included a sample of 358 online game players (242 males, 67.6%) between the ages of 18 and 59 (M = 28.46; SD = 8.76) who were recruited from online gaming communities. The participants completed a sociodemographic schedule and measures on attachment styles, alexithymia, and problematic gaming. The results provide evidence for a positive prediction of problematic gaming by dismissing attachment style and the alexithymic factors concerning the difficulty identifying feelings and externally oriented thinking, even when controlling for potentially confounding factors, such as age, sex, education, marital status, and self-reported time devoted to online games. Additionally, the analysis revealed a significant interaction effect between externally oriented thinking and dismissing attachment style in the prediction of problematic gaming. The interaction implies that the alexithymia factors pertaining to externally oriented thinking hold significant relevance in predicting problematic gaming behaviors, especially in cases where dismissive attachment levels are moderately to highly present. These findings emphasize the significance of considering specific insecure attachment styles and alexithymic features when studying problematic gaming behaviors.

Mediating role of splitting in relation to attachment styles and shopping addiction

Introduction

Shopping can provide a sense of satisfaction and pleasure; however, if a person's excessive involvement in this behavior starts to negatively impact other aspects of their life, similar to other addictive behaviors like excessive internet use, gaming, and gambling, it may be classified as pathological. Given the lack of agreement regarding the classification of excessive shopping tendencies as a separate mental health condition or addictive behavior, taking a socio-emotional approach to explore the psychological factors that precede this behavior, may offer a better comprehension of it.

Methods

The purpose of this study was to examine the relationship between attachment styles and excessive shopping behavior, as well as to investigate the potential mediating effect of defense mechanisms like splitting on this relationship. Using convenience sampling, a group of 457 stock market employees (116 female, 341 male) between the ages of 24 and 60 were recruited. The researchers utilized a set of validated psychological questionnaires to assess the employees attachment styles, shopping addiction, and splitting tendencies.

Results

The results obtained from both the mediation model and path analysis suggest that attachment styles do not have a direct relationship with shopping addiction. Nonetheless, the study supports the impact of insecure anxious and avoidan attachment styles on splitting. Furthermore, the findings confirm that splitting has a mediating effect on the relationship between attachment styles and splitting.

Discussion

The present study enhanced our comprehension of the subconscious mechanisms underlying shopping tendencies. Specifically, the findings suggest that excessive tendencies towards shopping can be considered a maladaptive response resulting from insecure attachment styles and the unconscious utilization of the splitting defense mechanism.

Gambling: Exploring the Role of Gambling Motives, Attachment and Addictive Behaviours Among Adolescents and Young Women

There is a growing body of research that seeks to understand the aetiology, consequences and risk factors associated with addictive behaviours in youths. However, research examining the specific profile of adolescent females is very limited. Therefore, the objectives of the present study were, firstly, to explore the differences between attachment, gambling motives (social enhancement and coping), positive and negative affect, and addictive behaviours (gambling, drugs, spending, alcohol and video games) in female adolescents with and without risk of gambling problems. Secondly, the relationships between attachment, gambling motives, positive and negative affect and addictive behaviours were analysed in the subsample of female adolescents with problem gambling Thirdly, we examine the predictive role of positive and negative affect, gambling motives, and attachment in the aforementioned addictive behaviours. The sample was composed of 351 adolescents and young women, of which 312 had no risk of gambling and 39 had gambling problems. The results obtained revealed higher scores in drugs, spending, maternal attachment, and all gambling motives in the group of gambling problems. Likewise, analyses showed that the relevance of the predictor variables (attachment, gambling motives, and affect) varied according to the addiction that was taken as a reference point (i.e., gambling, drugs, spending, alcohol and video games).Consequently, the identification of the possible vulnerability factors for each addiction could be useful in the design of prevention and treatment approaches. In addition, the need for integrated and holistic health- and social- care programmes are suggested in terms of sex and age.

Problematic Gambling Behavior in a Sample with Substance Use Disorder: The Role of Attachment Style and Alexithymia

Gambling disorder is a high comorbid disorder in substance abusers which conjunct appearance is related to worse symptomatology and evolution. Nevertheless, the research on the risk factors that may explain this comorbidity is scarce. We build of the self-regulation theory of attachment and addiction to examine if insecure attachment is related to gambling comorbidity in substance abuse disorder and the mediating role of alexithymia in this process. A cross-sectional study was carried out with 369 clinical patients with substance use disorder of which 69 presented comorbid gambling disorder diagnosed with the DSM-5 criteria. Results showed that insecure attachment was more prevalent in the group with comorbid gambling. In this group, the alexithymia levels were also higher and mediated the relationship in between attachment and gambling disorder comorbidity even controlling for several sociodemographic variables. This research indicates that insecure attachment enhances the risk of gambling comorbidity on substance abusers due to the detrimental effect on the self-regulation of emotion. Thus, interventions directed to increase the identification, expression and awareness of emotions might help to reduce comorbidity of gambling of substance use disorders.

Understanding the relationship between distress intolerance and problematic Internet use: The mediating role of coping motives and the moderating role of need frustration

INTRODUCTION

There is emerging research interest in exploring the relationship between distress intolerance and problematic Internet use, yet most of the existing studies are limited by cross-sectional design, convenience sampling method, and poor understanding of the potential mediating and moderating factors involved. Based on the distress intolerance theory of addictive behavior and the theory of compensatory internet use, this study investigated a moderated mediation model to explain the impact of distress intolerance on problematic Internet use in adolescents.

METHODS

A three-wave longitudinal survey was conducted with 709 adolescents in Shanghai, China. The gender distribution was even, 50.2% were boys and 49.8% were girls. The mean age at T1 was 14.79 years (SD = 2.87).

RESULTS

Distress intolerance at Time 1 was found to positively predict problematic Internet use at Time 3. This prospective relation was mediated by adolescents' coping motives for Internet use at Time 2. Further, the mediation effect of coping motives for Internet use was moderated by need frustration at Time 2. The moderated mediation model was statistically equivalent for both genders.

CONCLUSIONS

Findings of this study contribute to new knowledge and have practical implications for prevention and intervention of adolescent problematic Internet use.

The Impact of Peer Attachment on Left-Behind Children's Pathological Internet Use: A Moderated Mediating Effect Model

The aim of this study was to determine how left-behind children’s perceived personal rejection and emotional intelligence impact on the relationship between their peer attachment and pathological Internet use in China. Using the cluster random sampling method, a total of 406 left-behind children (aging 12.76 ± 2.13) from six rural primary and secondary schools in mainland China were recruited for the study (202 males and 204 females). The results of the analysis indicated that peer attachment negatively predicted left-behind children’s pathological Internet use. Perceived personal rejection had a mediating effect on the relationship between peer attachment and pathological Internet use, whereas emotional intelligence had a moderating effect on the relationships between peer attachment and perceived personal rejection and between peer attachment and pathological Internet use among these children. Moreover, peer attachment had a greater negative impact on the perceived personal rejection and pathological Internet use of left-behind children with high emotional intelligence compared with those of students with low emotional intelligence. These findings reveal the need for more support and interventions aimed at strengthening peer attachment and emotional intelligence of left-behind primary and secondary children and reducing their perceptions of personal rejection, which, in turn, reduces their pathological Internet use.

Positive psychological intervention for anxiety, depression and coping in subjects addicted to online games

BACKGROUND

Addiction to online games is not uncommon. The patients usually refuse to take medications and present with affective symptoms such as anxiety, depression and negative coping styles. Psychological intervention based on positive psychology is a promising treatment for such patients.

AIM

To evaluate the effect of positive psychological intervention on anxiety, depression and coping in people addicted to online games.

METHODS

This self-controlled study included 89 people addicted to online games, who received treatment at Hangzhou Seventh People’s Hospital, Hangzhou, China in 2019. The Hamilton Anxiety Scale, Hamilton Depression Scale and Trait Coping Style Questionnaire were administered to evaluate the anxiety, depression and coping style among these people. Psychological intervention based on positive psychology was provided for 6 wk followed by another evaluation. The results were compared against those from the previous evaluation.

RESULTS

After 6 wk of psychological intervention, 89 people achieved a significant improvement in the Hamilton Anxiety Scale and Hamilton Depression Scale-24 scales. The score for positive coping style in Trait Coping Style Questionnaire was significantly improved, while that of the negative coping style decreased significantly (P < 0.05).

CONCLUSION

Psychological intervention based on positive psychology alleviated affective symptoms, such as anxiety and depression, in subjects addicted to online games. Psychological intervention corrected negative coping style, thereby improving mental health.

Coping associated with compulsive buying tendency

Research on general coping is limited within compulsive buying (CB) literature. Nevertheless, other behavioural addictions and hoarding might provide insights into coping in CB. One-hundred and ninety-nine participants (M age = 52.72, SD = 16.06; 50.3% female, 1% unknown sex) completed online questionnaires. Mental and behavioural disengagements were hypothesized to predict greater self-reported CB tendency. Whilst these relationships were found in the correlations, a regression analysis indicated that only mental disengagement significantly predicted CB tendency. Additionally, the exploration of denial and substance use identified that denial was an important predictor of CB tendency coping. The relationship between CB tendency and substance use could not be explored given the large degree of participants reporting minimal scores. CB tendency is associated with maladaptive mental disengagement, denial and lack of acceptance coping strategies, which could be useful to consider in therapy.

Attitudes, Risk Factors, and Behaviours of Gambling among Adolescents and Young People: A Literature Review and Gap Analysis

Gambling is occurring in a rapidly changing landscape, with new trends and technologies affecting gambling behaviour and problem gambling across a range of populations. Gambling activity among adolescents and young people has received considerable research attention due to a high prevalence of gambling reported among these groups in recent years. Despite legislation worldwide to constrain gambling among adolescents and young people, modern technology, such as online gaming apps and online gambling venues, has significantly increased their exposure to the risks of problem gambling. It is important, therefore, to have up to date information about what is currently known about gambling and to explore gaps in our knowledge. This gap analysis presents the results of a systematic approach to reviewing the current literature on gambling behaviour, attitudes, and associated risk factors for gambling and problem gambling among adolescents and young adults (aged 10-25 years). The review included studies published between January 2015 and August 2020 and included 85 studies for final synthesis. Findings reveal further research is needed on the implications for young people of emerging technologies and new trends in gambling in the digital age. The current gap analysis reveals that this should include more research on the development and impact of both treatment and intervention strategies, and policy and regulatory frameworks from a public health perspective.

Managing Game-Related Conflict With Parents of Young Adults With Internet Gaming Disorder: Development and Feasibility Study of a Virtual Reality App

BACKGROUND

Individuals with internet gaming disorder (IGD) report facing family conflicts repeatedly because of their excessive internet gaming. With recent advancements in virtual reality (VR) technology, VR therapy has emerged as a promising method for the management of various psychiatric disorders, including IGD. Given that several risk and protective factors for young people with addiction can be influenced by their interpersonal context, the potential utility of VR-based apps for managing family conflicts needs to be examined with reference to IGD management. However, few studies have evaluated potential treatment modules related to interpersonal conflict management, such as emotion regulation and taking the perspective of others.

OBJECTIVE

This preliminary study aims to examine the potential use of a VR-based app in the management of game-related conflicts with parents of young adults with IGD and matched controls.

METHODS

In total, 50 young male adults (24 with IGD and 26 controls) were recruited to participate in the study. We developed a virtual room where game-related family conflicts arise. Using this room, participants completed 2 VR tasks that required them to express anger and then implement coping skills (ie, risk/benefit assessment of stopping a game and taking parents' perspective) to deal with negative emotions in interpersonal conflict situations and to decrease one's gaming behavior.

RESULTS

The results showed that immersion in our VR app tended to provoke negative emotions in individuals with IGD. In addition, after a risk/benefit assessment of stopping a game, the response of stopping a game immediately increased significantly in the IGD group, suggesting that patients' gaming behavior could be changed using our VR program. Furthermore, in individuals with IGD, longer gaming hours were associated with a lower level of perceived usefulness of the coping skills training.

CONCLUSIONS

The findings of this study indicate that our VR app may be useful for implementing more desirable behaviors and managing gaming-related family conflicts in individuals with IGD. Our VR app may offer an alternative for individuals with IGD to learn how a vicious cycle of conflicts is developed and to easily and safely assess their dysfunctional thoughts behind the conflicts (ie, perceived unreasonable risks of stopping a game and thoughts acting as a barrier to taking the perspective of others).

Profiles of Mobile Phone Use, Cyberbullying, and Emotional Intelligence in Adolescents

The use of mobile phones has great benefits for communication. However, evidence has shown that problematic use, such as cyberbullying, can also be associated with mobile phones. In this sense, emotional regulation plays an important role. The objective of this study was to identify different groups that varied in terms of conflicts related to problematic mobile phone use (namely, maladaptive communication and emotional patterns). Furthermore, the study aimed to examine whether there were significant differences in the dimensions of emotional intelligence and cyberbullying between adolescents with a mobile phone use problem. The study participants were 810 students aged between 12 and 16 years. The Emotional Coefficient Inventory questionnaire about cyberbullying and a questionnaire on experiences related to mobile phones were used. The cluster analysis identified three different types of mobile phone use: A group displaying no problematic use, a group displaying moderately problematic use, and a group displaying problematic use. The study results motivate carrying out stress management programs, emotional re-education, and other actions that reinforce emotional intelligence.

Profiles of Problematic Internet Use in Bullying and Cyberbullying among Adolescents

The rise of technology has increased risks such as problematic internet use or cyberbullying. Data show that there is problematic use of the internet, which has important repercussions academically, personally, socially and for health. The objective of this study was to identify different profiles that vary according to intra- and interpersonal conflicts related to internet use. In addition, this study aimed to examine whether there are significant differences in bullying and cyberbullying among adolescents with a conflict related to internet use. The study participants were 810 students of Compulsory Secondary Education (M = 13.99, SD = 1.32). The Questionnaire on School Violence and the Questionnaire of Experiences Related to Internet was use. The latent profile analysis identified four different types of conflicts related to internet use: (a) high levels in intra- and interpersonal conflicts; (b) low levels intra- and interpersonal conflicts; (c) moderate intra- and interpersonal conflicts and (d) very high levels in intra- and interpersonal conflicts. The results of the study indicated that there were significant differences in the manifestations of school violence between the profiles. This study assists in educational programs to prevent conflicts related to internet use and school violence through emotional adjustment.

Attachment style and addictions (alcohol, cigarette, waterpipe and internet) among Lebanese adolescents: a national study

Background

The prevalence in the Lebanese general population of cigarette and waterpipe smoking, alcohol drinking and internet use seems to be increasing lately. So far, no study was done relating the above to attachment styles in Lebanese adolescents. Consequently, the objective of our study was to assess the relationship between attachment styles (secure, preoccupied, fearful, and dismissing) and addictions (cigarettes, water pipes, alcohol, and internet) among this population.

Methods

It is a cross-sectional study that took place between January and May 2019. Two thousand questionnaires were distributed out of which 1810 (90.5%) were completed and collected back. A proportionate random sample of schools from all Lebanese Mohafazat was used as recruitment method.

Results

A secure attachment style was significantly associated with lower addiction to alcohol, cigarette, and waterpipe, whereas insecure attachment styles (preoccupied, dismissing and fearful) were significantly associated with higher addiction to cigarette, waterpipe, alcohol, and internet.

Conclusion

Lebanese adolescents with insecure attachment had higher rates of addiction to cigarette, waterpipe, alcohol, and internet. They should be closely monitored in order to reduce the risk of future substance use disorder and/or behavioral addiction development.