The link between problematic internet use, problematic gaming, and psychological distress: does sleep quality matter?

Impact of Social Media Addiction and Internet Gaming Disorder on Sleep Quality: Serial Mediation Analyses

Poor sleep quality is a concerning and prevalent consequence of social media addiction (SMA) and internet gaming disorder (IGD). Due to the lack of research examining how SMA and IGD lead to poor sleep quality, the current study aimed to understand the relationship between SMA and sleep quality, as well as that between IGD and sleep quality, through impulse control and bedtime procrastination. The study tested the hypotheses that higher levels of SMA and IGD would predict lower levels of impulse control, which would then predict higher levels of bedtime procrastination, leading to poorer sleep quality. A serial mediation analysis was performed with a sample of 221 participants (63.3% females, 34.4% males, and 2.3% prefer not to say) aged 18 to 53 years (M = 23.64, SD = 5.72). Participants completed questionnaires that assessed for social media addiction, internet gaming disorder, impulse control factor, bedtime procrastination, and sleep quality. There was a full serial mediation of impulse control and bedtime procrastination in the relationship between SMA and sleep quality, as well as that between IGD and sleep quality, providing support for the hypotheses. The findings provide the knowledge needed to develop and implement strategies that target impulse control issues and reduce bedtime procrastination to improve sleep quality.

University Students' Gaming and Gambling Behaviors, Related Factors, and the Relationship Between Gaming and Gambling

The purpose of this study was to investigate university students' gaming and gambling behaviors, the factors that relate to these behaviors, and the connection between gaming and gambling behaviors. The study was designed as survey research, which is one of the quantitative research methods. The sample for the study consists of 232 students who are continuing their education at a state university in Turkey. The data of the research were collected through the Student Information Form, the Game Addiction Scale, and the South Oaks Gambling Screen. While the rate of students with problematic gambling behavior was 9.1% (n = 21), the rate of students with problematic gambling behavior was 14.2% (n = 33). Gaming behavior showed significant differences according to gender, age, the feeling of success, leisure time sufficiency, sleep proficiency, smoking, and alcohol use. Gambling behavior showed significant differences according to gender, family type, family income, the feeling of success, level of happiness, the experience of psychological distress, social relationship satisfaction, smoking, and alcohol use, and the presence of an addicted person in the social environment. Gender, perception of success, leisure proficiency, and alcohol use were variables associated with both gambling and gaming. There was a positive and significant relationship between gaming and gambling behavior (r = .264, p < .001). As a result, it is seen that the variables related to gaming and gambling behavior differ rather than partnership. Considering the weak relationship between gaming and gambling behavior, it is difficult to put forward sharp views on the relationship between gaming and gambling.

Biopsychosocial factors of gaming disorder: a systematic review employing screening tools with well-defined psychometric properties

Background and aims

Considering the growing number of gamers worldwide and increasing public concerns regarding the negative consequences of problematic gaming, the aim of the present systematic review was to provide a comprehensive overview of gaming disorder (GD) by identifying empirical studies that investigate biological, psychological, and social factors of GD using screening tools with well-defined psychometric properties.

Materials and methods

A systematic literature search was conducted through PsycINFO, PubMed, RISS, and KISS, and papers published up to January 2022 were included. Studies were screened based on the GD diagnostic tool usage, and only five scales with well-established psychometric properties were included. A total of 93 studies were included in the synthesis, and the results were classified into three groups based on biological, psychological, and social factors.

Results

Biological factors (n = 8) included reward, self-concept, brain structure, and functional connectivity. Psychological factors (n = 67) included psychiatric symptoms, psychological health, emotion regulation, personality traits, and other dimensions. Social factors (n = 29) included family, social interaction, culture, school, and social support.

Discussion

When the excess amount of assessment tools with varying psychometric properties were controlled for, mixed results were observed with regards to impulsivity, social relations, and family-related factors, and some domains suffered from a lack of study results to confirm any relevant patterns.

Conclusion

More longitudinal and neurobiological studies, consensus on a diagnostic tool with well-defined psychometric properties, and an in-depth understanding of gaming-related factors should be established to settle the debate regarding psychometric weaknesses of the current diagnostic system and for GD to gain greater legitimacy in the field of behavioral addiction.

The mediating role of sleep quality on the relationship between internet gaming disorder and perceived stress and suicidal behaviour among Indian medical students

Background

In the recent digital era, individuals with internet gaming disorder (IGD) have reported a much higher prevalence of poor sleep quality, perceived stress and suicidal behaviour. However, the underlying mechanisms for these psychological problems remain unknown.

Aims

The primary aims of this study were to explore the mediating role of sleep quality on the relationship between IGD and the health outcomes of perceived stress and suicidal behaviour and to assess the prevalence and risk factors for IGD among medical students.

Methods

A cross-sectional study enrolling 795 medical students from two medical colleges in a rural area of North India was conducted from April to May 2022. The study participants were chosen using a stratified random sampling approach. A self-administered questionnaire was used to collect data, including sociodemographic and personal information and gaming characteristics. The study also included the Gaming Disorder and Hazardous Gaming Scale, the Pittsburgh Sleep Quality Index, the Perceived Stress Scale-10 and the Suicide Behaviors Questionnaire-Revised to measure IGD, sleep quality, perceived stress and suicidal behaviour, respectively. Multiple logistic regression for the risk factors and Pearson's correlation test for the relationship between variables were used. Hayes' PROCESS macro for SPSS was employed to carry out mediation analysis.

Results

Among the 348 gamers with a mean age of 21.03 (SD 3.27) years, the prevalence of IGD was 15.23% (95% confidence interval: 11.6% to 19.4%). In the correlational analysis, small to large (r: 0.32-0.72) significant relationships between scores of IGD and other health outcomes were established. The indirect effect (B=0.300) via sleep quality accounted for 30.62% of the total effect (B=0.982) of IGD on perceived stress (partially mediated), while sleep quality (B=0.174) accounted for 27.93% of the total effect (B=0.623) of IGD on suicidal behaviour (partially mediated). The factors of being male, living in a single-parent family, using the internet for other than academic purposes (1-3 hours and more than 3 hours/day), playing games for more than 3 hours/day and playing games with violent content were associated with IGD symptoms.

Conclusions

Using a dimensional measure, the results specified the relationship between IGD and perceived stress and suicidal behaviour by demonstrating that sleep quality meditated them. This modifiable mediating factor can be addressed by psychotherapy to mitigate the risk of perceived stress and suicidal behaviour among the future medical workforce.

Analysis of the determinants of sleep quality in a Spanish population: a study protocol for a cross-sectional study

INTRODUCTION

Sleep problems are a growing public health concern being related, among others, to an increased risk of cardiovascular diseases or worse cognitive functioning. In addition, they can affect aspects related to personal motivation and quality of life. However, very few studies have analysed the possible determinants of sleep quality in the adult population as a whole, establishing patterns based on these determinants.The objectives are to evaluate the determinants of sleep quality in a representative sample of the general adult population between 25 and 65 years old, and to establish patterns of sleep quality based on lifestyles, psychological factors, morbidities, sociodemographic variables, biological markers and other possible determinants.

METHODS AND ANALYSIS

Descriptive observational cross-sectional study. The study population will include a representative sample of 500 people between 25 and 65 years old from the cities of Salamanca and Ávila (Spain) selected by random sampling stratified by age groups and sex. A 90-minute visit will be performed, during which sleep quality will be assessed. The variables collected will be: morbidity, lifestyles (physical activity, diet, toxic habits), psychological factors (depression, stress, occupational stress and anxiety), socioeconomic and work-related variables, habitability conditions of the habitual residence and rest area, screen time, relaxation techniques and melatonin as a biological marker related to sleep quality.

DISCUSSION

With the results of this work, improved interventions for behaviour modification could be designed, as well as intervention and education programmes or other research aimed at improving sleep quality.

ETHICS AND DISSEMINATION

This study has a favourable opinion from the Ethics Committee for Drug Research of the Health Areas of Salamanca and Ávila (CEim Code: PI 2021 07 815). The results of this study will be published in international impact journals of different specialties.

TRIAL REGISTRATION NUMBER

NCT05324267.

The Psychometric Properties of the DASS-21 and Its Association with Problematic Internet Use among Chinese College Freshmen

During transitional periods, college freshmen may experience mental health issues. The Depression, Anxiety, and Stress Scale-21-item version (DASS-21) is commonly used for mental health assessment in China. However, evidence is lacking regarding its applicability with freshmen as a demographic. Debates also exist regarding its factor structure. This study aimed to evaluate the DASS-21's psychometric properties with Chinese college freshmen and investigate its association with three kinds of problematic Internet use. A convenience sampling method was used to recruit two samples of freshmen-one of 364 (female 248; mean age 18.17 years) and the other of 956 (female 499; mean age 18.38 years) participants. McDonald's ω and confirmatory factor analysis were conducted to evaluate both the scale's internal reliability and construct validity. The results indicated acceptable reliability, with a one-factor structure inferior to a three-factor structure in terms of model fit. Furthermore, it was demonstrated that problematic Internet use was significantly and positively associated with depression, anxiety, and stress among Chinese college freshmen. Based on the prerequisite of measurement equivalence across two samples, the study also found that freshmen's problematic Internet use and psychological distress were likely to be affected by the strict measures put in place during the COVID-19 pandemic.

The relationship between social anxiety and academic engagement among Chinese college students: A serial mediation model

BACKGROUND

Few studies have elucidated the mechanisms linking social anxiety and academic engagement. This study aimed to explore the link between social anxiety and academic engagement through a series of mediating effects of social media addiction and sleep quality among college students.

METHODS

2661 college students completed the Liebowitz Social Anxiety Scale, the Bergen Social Media Addiction Scale, the Pittsburgh Sleep Quality Index, and the Utrecht Work Engagement Scale for Student. The serial mediation analysis was conducted using Hayes' PROCESS macro (Model 6).

RESULTS

Social anxiety had a significantly direct effect on academic engagement (c = -0.162, p < 0.001) and through three significantly indirect pathways: (1) through social media addiction (B = -0.019, 95% CI: -0.027 to -0.011), accounting for 11.7% of the total effect; (2) through poor sleep quality (B = -0.043, 95% CI: -0.052 to-0.034), accounting for 26.5% of the total effect; and (3) through the serial mediators involving in social media addiction and poor sleep quality (B = -0.007, 95% CI: -0.009 to -0.005), accounting for 4.3% of the total effect. The total mediating effect was 42.6%.

LIMITATIONS

This cross-sectional study prevented us from establishing causality.

CONCLUSIONS

This study highlights the serial mediating role of social media addiction and sleep quality, the behavior and lifestyle factors, in the relationship between social anxiety and academic engagement. Therefore, social media addiction and sleep quality interventions for college students with social anxiety have the potential to improve their academic engagement.

The More Internet Access, the More Mental Symptoms Students Got, the More Problematic Internet Use They Suffered: a Meta-analysis of Mainland Chinese Adolescents and Young Adults

The traditional view is that mental symptoms and problematic Internet use are positively related. Still, other researchers have questioned this view, and they believe that mental symptoms are negatively associated with problematic Internet use. Since then, this controversy has continued yet. The current study attempts to use meta-analysis to explore the relationship between mental symptoms and problematic Internet use in mainland Chinese students to provide a reliable basis for resolving this dispute. Sixty-three articles were included in this study, including 66 sample sizes and 47,968 subjects. It found that mental symptoms are positively correlated with problematic Internet use (r = .288, 95% confidence interval [.255, .320]). The correlation is affected by regions. Compared with coastal areas, problematic Internet users in the non-coastal areas are more likely to be affected by mental symptoms. In addition, gender differences also significantly affect the relationship between mental symptoms and problematic Internet use. The correlation coefficient between mental symptoms and problematic Internet use of girls is significantly higher than that of boys. Moreover, year also significantly affects the relationship between mental symptoms and problematic Internet use-the correlation increases by growing years.

Prevalence of Problematic Internet Use during the COVID-19 Pandemic

The present paper reviews recent studies on problematic Internet use (PIU) prevalence before and during the coronavirus disease 2019 (COVID-19) pandemic. Several pre-pandemic meta-analyses reported PIU prevalence estimates ranging from 6% to 9.7%. Experts in the field of online addictions speculated that PIU would increase during the pandemic because of increased time spent on the Internet. However, it is still unclear if increased time on the Internet resulted in higher PIU prevalence estimates during the pandemic. Prevalence estimates differed greatly across studies during the COVID-19 pandemic. Possible inconsistencies are outlined together with future directions for PIU prevalence studies.

The association of problematic use of social media and online videogames with aggression is mediated by insomnia severity: A cross-sectional study in a sample of 18- to 24-year-old individuals

One of the worrying concomitants of problematic use of Internet (PUI) is aggression. Although the mechanisms underlying such link have not been completely clarified, it has been suggested that problematic use of social media and online videogames (i.e., two common forms of PUI among young adults) lead to increased sleep disturbances which, in turn, represent a relevant trigger for aggression. We have tested this hypothesis in a sample (N = 480) of young individuals (351 females and 129 males; mean age: 21.76 ± 1.92 years; range: 18-24). Self-report measures investigating symptoms related to social media addiction (SMA), Internet gaming disorder (IGD), insomnia severity, and aggression were used. Mediational models analyzing the direct and indirect associations of SMA- and IGD-related symptoms on aggression severity through insomnia-related symptoms were performed controlling for confounding factors. The models showed that the total effects of SMA-related symptoms (B = 0.018; p = .010) and of IGD-related symptoms (B = 0.018; p = .041) on aggression severity were significant and that these associations were mediated by insomnia-related symptoms (respectively, p < .001 and p = .003). Our findings support the potential mediating role of insomnia severity in the association of SMA- and IGD-related disturbances with levels of aggression.

Gaming Behaviors and the Association with Sleep Duration, Social Jetlag, and Difficulties Falling Asleep among Norwegian Adolescents

The relationship between gaming and sleep is mostly informed by studies of addictive gaming behavior, thus limiting our understanding of sleep in the context of nonproblematic engaged gaming. The present study investigated whether addicted, problem, and engaged gaming behavior was associated with sleep duration, social jetlag, and difficulties falling asleep. The sample consisted of 13- and 16-year-old Norwegian adolescents (n = 3228) participating in the Health Behavior in School-Aged Children (HBSC) survey in 2018. Participants were categorized into addicted, problem, engaged, and normal/non-gaming behavior groups according to which GAS-7 criteria they fulfilled. Robust generalized linear mixed models with a random intercept for class ID were used to examine the association between the sleep variables and gaming behavior. Addicted gaming behavior was unfavorably associated with all sleep parameters. The findings for engaged gaming and problem gaming behavior were somewhat mixed. Engaged gamers slept less on weekends, less on weekdays for those aged 16, and experienced greater social jetlag compared to the normal/non-gaming group. Problem gamers experienced greater social jetlag and had higher odds of experiencing difficulties falling asleep. Overall, the results suggest that all types of gaming behaviors might harm sleep health, but to a greater extent for the addicted gamers.