Heavy Internet use and its associations with health risk and health-promoting behaviours among Thai university students

Prevalence of Internet Addiction and Its Association with Psychological Disorders Among Medical Students in Saudi Arabia

Background

Internet addiction is increasing worldwide. Internet addiction (IA) refers to excessive Internet usage in an uncontrolled and time-consuming manner, causing loss of time and disruption of daily life. However, the prevalence of IA may vary according to age, sex, and ethnicity, and is more prevalent among college students. There is a strong link between problematic Internet usage and an increased risk of developing Post Traumatic Stress Disorder PTSD and depression symptoms. Medical students were chosen for this study due to their unique stressors, including rigorous academic demands, extensive study hours, and clinical practice requirements. It is critical to address behavioral addictions and their psychological effects in this group, as they are linked to the future quality of healthcare provision compared with their non-medical peers.

Objective

To estimate the prevalence of Problematic Internet Use (PIU) in medical students and explore their correlation with the medical students' PTSD and Patient Health Questionnaire -9 (PHQ9) scores.

Methods

A cross-sectional online survey was conducted including 506 medical students in the second year of medical school up to internship year at Imam Abdulrahman bin Faisal University (IAU) between June 2021 and January 2022. The questionnaire consisted of consent forms, sociodemographic data, and screening tools for PTSD, the GPIU, and PHQ-9.

Results

The prevalence of problematic internet usage (PIU) was 30.6% in the sample group. Students with moderate-to-moderately severe PTSD were 1.7 times more likely to have PIU OR (95% CI): 1.7 (1.091, 2.879). Students with moderate to severe depression were 2.2 times more likely to have PIU OR (95% CI); 2.2 (1.333, 3.950).Having a Saudi nationality, lower income, and being single was significantly associated with PIU.

Conclusion

Single Saudi medical students with lower income are at risk of developing more problematic internet use. Especially those who score moderate to high on PTSD and PHQ-9 scales.

Decreased Serum Cocaine- and Amphetamine-Regulated Transcript Level in Internet Gaming Disorder

OBJECTIVE

Vulnerability to internet gaming disorder (IGD) has increased as internet gaming continues to grow. Cocaine- and amphetamine-regulated transcript (CART) is a hormone that plays a role in reward, anxiety, and stress. The purpose of this study was to identify the role of CART in the pathophysiology of IGD.

METHODS

The serum CART levels were measured by enzyme-linked immunosorbent assay, and the associations of the serum CART level with psychological variables were analyzed in patients with IGD (n=31) and healthy controls (HC) (n=42).

RESULTS

The serum CART level was significantly lower in the IGD than HC group. The IGD group scored significantly higher than the HC group on the psychological domains of depression, anxiety, the reward response in the Behavioral Activation System and Behavioral Inhibition System. There were no significant correlations between serum CART level and other psychological variables in the IGD group.

CONCLUSION

Our results indicate that a decrease in the expression of the serum CART level is associated with the vulnerability of developing IGD. This study supports the possibility that CART is a biomarker in the pathophysiology of IGD.

Relationship between Internet addiction and body mass index and the predictive role of emotion dysregulation

In recent years, the widespread use of the Internet has led to increasing concerns about problematic behaviors related to excessive Internet use and their potential consequences. This study aimed to investigate the relationship between Internet addiction (IA), body mass index (BMI), and emotion dysregulation (ED). Specifically, the study aimed to determine if IA significantly predicts obesity and if both Internet addiction and obesity can be significantly predicted by ED. 367 school-attending adolescents (Mage = 13.35; SD = 0.82; 49% girls) in Tekab participated in the study. Participants completed the Difficulties in Emotion Regulation Scale (DERS) and the Internet Addiction Test (IAT), while BMI was calculated using self-reported data to assess their obesity levels. The results indicated that ED significantly predicted both IA and increased BMI levels (p < 0.001). Furthermore, IA also significantly predicted elevated BMI levels (p < 0.001). Our findings showed that ED significantly predicted both higher IA and BMI values, while IA also significantly predicted elevated BMI levels These results have important implications for treatment. To address excessive Internet use or overeating behavior in individuals with either condition, it may be necessary to target the underlying emotional dysregulation that contributes to the problem.

Video game playing and oral health in school-age children: A cross-sectional study in Turkey

AIM

The aim of this study is to evaluate the relationship of video game playing with oral/dental health and harmful oral habits in school-age children.

METHODS

The daily video gamer (n = 77) and occasional video gamer (n = 77) children between 6 and 12 years old were included in the study. A questionnaire inquiring socio-demographic characteristics, video gaming and abnormal oral habits of the children was filled by parents. The children were examined intraorally and decayed-missing-filled tooth, the International Caries Detection and the Assessment-II System scores, dental plaque and gingival indices were recorded.

RESULTS

Of the children; 42.9% daily video gamers played video games for between 1 and 2 h and 57.1% played for ≥2 h while all of the occasional video gamers spent for between 1 and 2 h on video game per day. The daily video gamer and occasional video gamer children were not different in terms of socio-demographic characteristics, frequency of having daily tooth brushing habit, using children's toothpaste and having regular dental checkup (P > 0.05). No statistically significant difference was present between the groups in terms of frequencies of abnormal oral habits and having at least one abnormal oral habit (P > 0.05). Severe gingivitis and advanced caries lesions were more common in daily video gamer group (14.2% vs. 3.9%, P = 0.025 and 90.9% vs. 70.9%, P = 0.026, respectively). Daily video gaming time was weakly correlated with plaque index (r = 0.26, n = 77, P = 0.024). Daily video gaming for ≥2 h increased the risk for severe gingivitis (odds (95% confidence interval) = 4.53 (1.07-19.23), P = 0.041) while daily video gaming for between 1 and 2 h decreased the risk for having abnormal oral habit (odds (95% confidence interval) = 0.39 (0.16-0.93), P = 0.034).

CONCLUSION

In school age, daily video gaming may worsen oral and dental health compared with occasional video gaming. Particularly, an excessive video gaming time seems to be associated with poor oral health in school children.

Problematic media use is associated with poor oral health in Turkish school-age children: a pilot cross-sectional study

OBJECTIVES

In the recent years, problematic media use (PMU) has become a serious health concern for children. The precisely defined effects of PMU on children's oral health are unknown. It was aimed to investigate the relationship between the PMU and oral health and oral habits in school-age children.

METHODS

In this cross-sectional study, mothers and their healthy children aged 6-11 years who applied to pediatric dentistry outpatient clinic were enrolled. PMU was assessed using the parent-reported Problematic Media Use Measure Short Form (PMUM-SF). PMUM-SF scores were divided into 3 groups from the lowest to the highest tertile. Multivariable logistic regressions for PMU (moderate-high vs. low) were used to predict the odds of having good and parafunctional oral habits, poor oral hygiene, gingivitis and caries.

RESULTS

Totally 153 mother-child pairs participated in this study. Plaque index, gingival index, ICDAS-II (International Caries Detection and Evaluation System), DMFT and DMFS [decayed (D), missing (M), filled (F) tooth (T) /surfaces (S)] scores were significantly higher in children with moderate-high PMU (P < 0.05). After adjusting for potential confounders, moderate-high PMU decreased the probability of good oral habit of daily toothbrushing [Odds (95% CI) = 0.43 (0.20-0.94)] while it increased the risk of oral parafunctional habit of object sucking/biting [Odds (95% CI) = 3.34 (1.27-8.74)]. Moderate-high PMU increased the risk of moderate-severe gingivitis, moderate-extensive caries and the presence of DMFT [Odds (95% CI) = 2.13 (1.01-4.50); 4.54 (1.11-18.54) and 2.16 (1.07-4.36), respectively].

CONCLUSIONS

Turkish school-age children with a remarkable PMU were significantly more likely to have poor oral health and exhibit oral parafunctional habits Oral health screening seems to be needed for Turkish children experiencing PMU.

Substance use and adolescent injuries: a multi-country analysis of the association and mediating effect of interpersonal violence among 122,945 in-school paediatric populations in 29 countries

Background

Adolescent use of substances and injury experiences such as head injury have become increasingly prevalent. However, information regarding their association and the potential pathways linking them remains limited. This study examined the association between substance use and injuries, emphasizing the mediating role of interpersonal violence among adolescents.

Methods

We employed a multi-country analysis of Global School-based Health Surveys of 122,945 in-school adolescents aged 11-18 from 29 countries. This study was a cross-sectional school-based, nationally representative study developed by the World Health Organization and the United States Centers for Disease Control and Prevention, other United Nations allies, and country-specific institutions. Random-effects meta-analysis was performed to estimate the overall prevalence of injury and substance use and the I-square (I 2 ) statistic was used to investigate the between-country heterogeneity. Logistic regression models were fitted to examine the association between substance use and injuries. A path analysis was used to examine the potential mediation effect of interpersonal violence and employed decomposition of effects into total, direct, and indirect.

Results

Prevalence of substance use and injuries were 33.6% (95%CI = 28.5, 38.6%) and 41.7% (95%CI = 37.3, 46.1%), respectively. Substance use (37.8% vs. 29.4%, p = 0.001) and injuries (47.3% vs. 36.4%, p = 0.001) were significantly higher among male adolescents than females, respectively. After adjustment, substance users had 40% higher odds of injuries. The path analysis showed a mediation effect of perpetration of and victimization by interpersonal violence on the association of substance use with injuries, with total positive effects of perpetration [β = 0.18; 95%CI = 0.16, 0.19; p = 0.001] and victimization on injuries [β = 0.22; 95%CI = 0.21, 0.24; p = 0.001]. In a further subgroup analysis, tobacco users were 3.98 times more likely to sustain a gunshot wound whiles marijuana users had 2.81 times higher odds of sustaining gunshot wounds. Cigarette smokers had 45% lower odds of sustaining cut/stab wounds. Alcohol users were 53% more likely to sustain concussion/head injury and two and half times more likely to sustain gunshot wound.

Conclusion

A significant association exists between substance use and severe injuries among adolescents, mediated by interpersonal violence exposure. Our findings may have utility in informing substance use and interpersonal violence control policies and interventions to address adolescent injuries.

Internet Addiction in Socio-Demographic, Academic, and Psychological Profile of College Students During the COVID-19 Pandemic in the Czech Republic and Slovakia

Internet addiction is a serious problem among young adults that requires increased attention, especially at a time of distance learning during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to assess the relationships between internet addiction and selected socio-demographic, study-related, and psychological characteristics of college students. Internet addiction was measured using the Internet Addiction Test both overall and in its individual subscales (Salience, Excessive Use, Neglect Work, Anticipation, Lack of Control, and Neglect Social Life). The selected characteristics represented (1) socio-demographic profile (gender, age, residence, family), (2) academic profile (housing during the semester, form of study), and (3) psychological profile (depressive symptoms—the Patient Health Questionnaire, stress—the Perceived Stress Scale, anxiety symptoms—the Generalized Anxiety Disorder). Data collection took place during the first wave of the COVID-19 pandemic in 2020 at Czech and Slovak colleges, with 1,422 students from the Czech Republic and 1,677 students from Slovakia participating in the research. The analytical processes were carried out through descriptive analysis, non-parametric difference analysis, and multiple negative binomial regression. Mild internet addiction was found in 387 (27.2%) Czech and 452 (27.0%) Slovak students. Moderate internet addiction was identified in 49 (3.4%) students from the Czech Republic and in 100 (6.0%) students from Slovakia. Two (0.1%) Czech and three (0.2%) Slovak students reported severe internet addiction. Increased likelihood of internet addiction overall, as well as in most individual subscales, was found particularly among male students and students who lived away from home during the semester. Depressive symptoms and stress could also be considered significant predictors in both countries. These results are important for the development of effective strategies and prevention programs, as Internet addiction may be a serious problem in the future, given the current times. When assessing internet addiction among college students, it would also be appropriate to evaluate the individual internet addiction subscales and their specifics.

Problematic Internet Use, health behaviors, depression and eating disorders: a cross-sectional study among Polish medical school students

BACKGROUND

Problematic Internet Use is defined as a use of the Internet which leads to various difficulties. The aim of this study was to check whether Problematic Internet Use is associated with health risks, such as: anti-health behaviors, depressive symptoms, abnormal body weight or eating disorders.

METHODS

This cross-sectional study included 540 medical school students of Polish descent (83.5% females; 16.5% males), whose mean age was 22.49 years (SD = 5.20). The participants were asked to complete a questionnaire set, including the Problematic Internet Use Test, Juczyński's Health-Related Behavior Inventory, the Beck Depression Inventory, the Eating Attitudes Test and a self-designed demographic survey.

RESULTS

Increased Problematic Internet Use scores were observed in male, full-time students, persons who use the Internet on the computer (compared to those who mostly use it on the phone), and those who go online mainly for entertainment purposes (compared to those who indicated another main purpose of using the Internet). 47.6% of the sample reported poor health behaviors, while 27.1% met the criteria of a depressive episode and 6.9% of an eating disorder. High risk of Problematic Internet Use was observed in 2.8% of the sample, particularly those who reported having more free time during the day, engaged in fewer health protective behaviors, manifested more severe depressive symptoms and scored higher on the Eating Attitudes Test.

CONCLUSION

Such results indicate that students with Problematic Internet Use lead an unhealthy lifestyle and more often show symptoms of depression and eating disorders than students without Problematic Internet Use.

Association of problematic Internet use and oral health-related quality of life among medical and dental students

BACKGROUND

The Internet as a communication tool is an essential component of daily life. Nowadays, problematic Internet use (PIU) has led to various psychosocial problems that can indirectly lead to oral diseases due to neglect of healthy behaviors. Also, college students are a large proportion of Internet users. The present study aimed to determine the association between problematic Internet use and oral health-related quality of life (OHRQoL) among medical and dental students.

METHODS

A cross-sectional descriptive-analytical study was conducted on medical and dental students in the first and second years of education (basic sciences courses) at the Golestan University of Medical Sciences, Iran, between January and July 2020. The data collection process was carried out in the following sequence: questionnaire on demographic characteristics (age, gender, marital status, academic field, and year); Problematic Internet Use Questionnaire (PIUQ); and Oral Health Impact Profile (OHIP-14) questionnaire.

RESULTS

Among 268 medical and dental students, 171 students (63.81%) [95% confidence interval: 58.02%- 69.60%] had problematic Internet use. The mean PIU score in the first-year was significantly higher than the second-year students. In addition, 65% of single students and 25% of married subjects were dealing with PIU. The statistical difference between mean OHIP scores among PIU students (12.5 ± 2.9), with average Internet usage (7.39 ± 6.6), was significant. The Spearman correlation coefficient between PIU and OHIP was 0.309 and significant (P-value < 0.000001). It indicates that students with higher PIU showed higher OHIP scores.

CONCLUSION

The present study showed that problematic Internet use was significantly associated with oral health-related quality of life (OHRQoL) among first and second-year medical and dental students. Thus, the students with problematic Internet use experienced a poorer oral health-related quality of life than average Internet users. Furthermore, appropriate preventive and interventional strategies need to be developed to encourage rational use of the Internet to protect the users' oral health, especially among medical and dental students.

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

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

Internet Addiction, Oral Health Practices, Clinical Outcomes, and Self-Perceived Oral Health in Young Saudi Adults

The study assessed the relationship between Internet addiction and oral health practices and clinical outcomes and whether this was affected by oral health perception. In 2017, a cross-sectional study included university students in the Eastern Province of Saudi Arabia. Questionnaires assessed demographic background, oral health practices (consuming sugar, tobacco use, and oral hygiene), perceived oral health, and Internet addiction. Caries experience and gingivitis were assessed using the World Health Organization criteria. The multivariate general linear analysis assessed the relationship between dependent variables (oral health practices, DMFT, and gingivitis) and exposure (Internet addiction). Data were available for 919 participants, 75.4% females, mean age = 19.8 years, and 1.6% with significant Internet use problem. The mean percentage of teeth with gingivitis was 8.5% and mean DMFT was 2.9. Among those with good perception of oral health and compared with participants with significant Internet use problem, average Internet users had lower consumption of sugar and tobacco (B = -6.52, P = 0.03 and B = -2.04, P = 0.03), better oral hygiene practices (B = 2.07, P = 0.33), higher DMFT (B = 2.53, P = 0.10), and lesser gingivitis (B = -15.45, P = 0.06). Internet addiction was associated with negative oral health practices and poor clinical outcomes among young Saudis. Holistic health promotion approaches need to address the negative impact of Internet addiction on health and oral health status for this at-risk age group.

Is problematic Internet use associated with alcohol and cannabis use among youth? A systematic review

BACKGROUND

Problematic Internet use (PIU) is an important emerging public health problem. Among youth, the link between PIU and other risky behaviors needs to be defined. The objective of this systematic review is to explore the association between Internet use and substance use (alcohol, cannabis) among youth.

METHODS

Empirical studies meeting inclusion criteria were chosen from important databases and then reviewed. Quality assessment and narrative synthesis were executed. Forty-three studies were eligible.

SYNTHESIS

A majority of studies found a positive association between PIU and alcohol use, as well as between PIU and cannabis use. High heterogeneity in the assessment of alcohol and cannabis use made the synthesis a great challenge.

CONCLUSIONS

Current studies do not allow us to determine whether or not PIU and cannabis and alcohol use are linked. Prevention programs for youth addressing risky behavior should include PIU, an important emerging public health problem. Further studies are needed to assess the longitudinal impact of Internet use on substance use among youth. Validated measures for alcohol and cannabis use among youth should be more consistently used and this would certainly help future knowledge syntheses.

Internet Use in Relation to Overweight and Obesity: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

Although several studies have investigated the association between Internet use and odds of overweight and obesity, results are inconsistent. This systematic review and meta-analysis was performed to summarize evidence on the association between Internet use and odds of overweight and obesity. A systematic literature search was conducted in PubMed/Medline, Web of Science, Scopus, and Google Scholar up to February 2019 to identify relevant publications. Finally, 9 cross-sectional studies were considered in this systematic review and meta-analysis. Combining 11 effect sizes from 9 studies, we found a significant, positive association between the highest Internet use, compared to the lowest (ranged from ≥5 h/d to no use among studies), and odds of overweight and obesity (OR: 1.47; 95% CI: 1.21-1.78; I2, 69.6%; P < 0.001), such that Internet users had 47% greater odds of being overweight or obese. We also observed a significant, positive association between the highest Internet use, compared to the lowest (ranged from ≥5 h/d to no use among studies), and overweight/obesity (OR: 1.15; 95% CI: 1.06-1.25; I2, 0.0%; P = 0.426), obesity (OR: 2.58; 95% CI: 1.88-3.54; I2, 0.0%; P = 0.637), and overweight (OR: 1.38; 95% CI: 1.16-1.64; I2, 13.1%; P = 0.330). A linear dose-response meta-analysis revealed that each additional 1 h/d of Internet use was associated with 8% increased odds of overweight and obesity (OR: 1.08; 95% CI: 1.05-1.11; I2, 3.8%; P = 0.403). Findings of this systematic review and meta-analysis indicated that Internet use was positively associated with increased odds of being overweight and obese.

The Association between Various Lifestyle Patterns and the Body Mass Index in Adolescents

Objective: The study aims to analyze obesogenic behavioral patterns of adolescents living in Mureş County, Romania, as well as to establish a relationship between these behaviors and their Body Mass Index (BMI), in an attempt to provide effective prevention strategies for obesity.

Material and Methods: 153 students between 9th to 12th grade, aged between 14 and 19 years old, from the Vocational and Art Highschool of Târgu Mureş were included in the study. All the candidates filled out an evaluation questionnaire of lifestyle and risky behaviors. The analyzed data were sex, age, residence, BMI and risky eating behavior defined as the consumption of carbohydrates (bread, potatoes, sweets), sodas, junk food, alcohol (wine, distilled beverages, beer), beer separately, level of physical activity (school and extra-school sports activities), sedentary behaviors (≥2 hours/day in front of a screen: personal computer-PC and television-TV), and spending ≥2 hours/day separately on the PC and on the TV.

Results: A statistically significant association was observed between BMI and consumption of fast-food, tobacco, beer, sedentary behavior and spending ≥2 hours/day in front of the PC. Moreover, there was a statistically significant difference between the BMI values of adolescents presenting all studied risk behaviors compared to those who did not.

Conclusions: Obesity among adolescents from Mureş County is influenced by lifestyle choices like fast-food, tobacco, beer, sedentary behavior and spending ≥2 hours/day in front of the PC.

Excessive computer use as an oral health risk behaviour in 18-year-old youths from Poland: A cross-sectional study

Background

Many studies have indicated that the excessive use of computers (more than 3 hr/d) might be associated with an unhealthy life-style.

Aim

The aim of this study was to evaluate the relationship between excessive computer use with the condition of the teeth and periodontium and the oral health behaviour of 18-year-olds.

Design

Cross-sectional studies, using a questionnaire, were carried out on 1,611 18-year-olds from Poland. The questionnaire contained questions about socioeconomic status and information about health-related behaviour. The condition of their teeth and gingivae were clinically assessed.

Results

Excessive (>3 h/d) computer use was reported by 492 (31%) of participants, who had an increased frequency of unfilled cavities (1.97 vs. 2.27, p = .047) and a higher risk of oral hygiene neglect (e.g., using dental floss 41% vs. 34%, p = .009). Excessive computer use was also seen to be associated with poor dietary habits. Individuals who declared excessive computer use also had a higher risk of gingival bleeding (35% vs. 29%, p = .009).

Conclusion

In the group studied, excessive computer use by adolescents constituted a risk factor for neglect of oral hygiene, poor dietary choices, and failure to benefit from oral health care. Therefore, these aspects should be included in the risk assessment of oral disease and incorporated into educational programs that promote a healthy lifestyle.

Correlates of physical activity and sedentary behaviour in the Thai population: a systematic review

BACKGROUND

Given the importance of knowing the potential impediments and enablers for physical activity (PA) and sedentary behaviour (SB) in a specific population, the aim of this study was to systematically review and summarise evidence on individual, social, environmental, and policy correlates of PA and SB in the Thai population.

METHODS

A systematic review of articles written in Thai and English was conducted. Studies that reported at least one correlate for PA and/or SB in a healthy Thai population were selected independently by two authors. Data on 21 variables were extracted. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale.

RESULTS

A total of 25,007 records were screened and 167 studies were included. The studies reported associations with PA for a total of 261 variables, mostly for adults and older adults. For most of the variables, evidence was available from a limited number of studies. Consistent evidence was found for individual-level and social correlates of PA in children/adolescents and adults and for individual-level correlates of PA in older adults. Self-efficacy and perceived barriers were consistently associated with PA in all age groups. Other consistently identified individual-level correlates in adults and older adults included self-rated general health, mental health, perceived benefits, and attitudes towards PA. Consistent evidence was also found for social correlates of PA in adults, including social support, interpersonal influences, parent/family influences, and information support. The influence of friendship/companionship was identified as a correlate of PA only in children/adolescents. A limited number of studies examined SB correlates, especially in older adults. The studies reported associations with SB for a total of 41 variables. Consistent evidence of association with SB was only found for obesity in adults. Some evidence suggests that male adults engage more in SB than females.

CONCLUSIONS

More Thai studies are needed on (i) PA correlates, particularly among children/adolescents, and that focus on environment- and policy-related factors and (ii) SB correlates, particularly among older adults. Researchers are also encouraged to conduct longitudinal studies to provide evidence on prospective and causal relationships, and subject to feasibility, use device-based measures of PA and SB.

Correlates of sedentary behaviour in university students: A systematic review

High levels of sedentary behaviour are associated with negative health-related outcomes. However, there is limited evidence on the variables influencing sedentary behaviour in university students. The aim of this systematic review was to identify the intrapersonal, interpersonal, environmental, and time correlates of sedentary behaviour in university students. Records from 12 electronic databases were screened by two independent reviewers. Inclusion criteria included: (i) peer-reviewed articles written in English, Spanish, or French; (ii) studies including undergraduate or postgraduate university students; (iii) studies reporting on the association between sedentary behaviour and at least one variable. The protocol is registered in PROSPERO (CRD42017074198). A total of 126 studies published between 1994 and 2017 met the inclusion criteria. The primary measure of sedentary behaviour was self-reported screen time (61%), followed by total sitting time (28%). Most studies were cross-sectional (86%). After excluding high risk of bias studies (58%), only three intrapersonal variables were sufficiently investigated (≥4) to determine an association with sedentary behaviour: physical activity (negative association with sitting time), obesity markers (indeterminate associations with TV viewing), and gender - female (null associations with total sitting time and screen time). Overall, most of the reported correlates of sedentary behaviour were intrapersonal, non-modifiable factors. Further research on modifiable correlates covering all socio-ecologic levels is required to inform future intervention development. In addition, longitudinal studies are needed to enable the identification of determinants. Improvements in designing and reporting future studies are recommended to help strengthen the available evidence and facilitate future reviewing efforts.

Physical activity and sedentary behaviour research in Thailand: a systematic scoping review

BACKGROUND

The number of deaths per year attributed to non-communicable diseases is increasing in low- and middle-income countries, including Thailand. To facilitate the development of evidence-based public health programs and policies in Thailand, research on physical activity (PA) and sedentary behaviour (SB) is needed. The aims of this scoping review were to: (i) map all available evidence on PA and SB in Thailand; (ii) identify research gaps; and (iii) suggest directions for future research.

METHODS

A systematic literature search was conducted through 10 bibliographic databases. Additional articles were identified through secondary searches of reference lists, websites of relevant Thai health organisations, Google, and Google Scholar. Studies written in Thai or English were screened independently by two authors and included if they presented quantitative or qualitative data relevant to public health research on PA and/or SB.

RESULTS

Out of 25,007 screened articles, a total of 564 studies were included in the review. Most studies included PA only (80%), 6.7% included SB only, and 13.3% included both PA and SB. The most common research focus was correlates (58.9%), followed by outcomes of PA/SB (22.2%), prevalence of PA/SB (12.4%), and instrument validation (3.2%). Most PA/SB research was cross-sectional (69.3%), while interventions (19.7%) and longitudinal studies (2.8%) were less represented. Most studies (94%) used self-reports of PA/SB, and few (2.5%) used device-based measures. Both sexes were examined in most studies (82.5%). Adults were the main target population group (51.1%), followed by older adults (26.9%), adolescents (15.7%), and children (6.3%). Clinical populations were investigated in the context of PA/SB in a relatively large number of studies (15.3%), most frequently those with cardiovascular disease, diabetes, and hypertension (22%, 21%, and 21% respectively).

CONCLUSIONS

The number of Thai papers on PA published per year has been increasing, indicating a growing interest in this research area. More studies using population-representative samples are needed, particularly among children and adolescents, and investigating SB as a health risk factor. To provide stronger evidence on determinants and outcomes of PA/SB, longitudinal studies using standardised measures of PA and SB are required.

Pathological Internet Use-An Important Comorbidity in Child and Adolescent Psychiatry: Prevalence and Correlation Patterns in a Naturalistic Sample of Adolescent Inpatients

Background

Few studies have examined the prevalence of problematic internet use (PIU) in young people undergoing inpatient treatment in child and adolescent psychiatry centers. The aims of our study were thus (a) to assess the frequency of comorbid PIU in a sample of adolescent psychiatric inpatients and compare it with a control group of nonreferred adolescents and (b) to gain insights into correlations between PIU and psychiatric comorbidities.

Methods

111 child and adolescent psychiatry inpatients (CAP-IP, mean age 15.1 ± 1.4 years; female : male 72.4% : 27.6%) undergoing routine psychodiagnostics were screened for the presence of PIU. The widely used Compulsive Internet Use Scale (CIUS) was chosen for this purpose. Prevalence rates of PIU were then compared to matched nonreferred control subjects from a school sample. Additionally, comorbidities of inpatients with PIU were compared to inpatients without PIU.

Results

Our inpatient sample showed a much higher prevalence of PIU than that found in previous populational samples of young people. Compared with a matched school sample, addictive internet use was 7.8 times higher and problematic internet use 3.3 times higher among our adolescent sample. PIU was significantly associated with characteristic patterns of psychopathology, that is, suicidality, difficulties in establishing stable and consolidated identity, and peer victimization.

Conclusion

PIU among adolescents undergoing inpatient psychiatric treatment is much more frequent than among their peers in the general population and is associated with specific patterns of psychopathology.

Associations of Internet Use with Oral Hygiene Based on National Youth Risk Behavior Survey

Objectives

To investigate the association of problematic Internet use with oral health behaviors and oral health status in a nationally representative sample of Korean adolescents.

Methods

Data from the 2010 Korea Youth Risk Behavior Web-based Survey (73238 Korean adolescents; mean age 15.06±1.75 years; age range, 12-18 years) were used. Problematic Internet use was measured using the Korean Internet Addiction Proneness Scale for Youth-Short Form. Self-report questionnaires were used to assess oral health behaviors and oral health status of adolescents.

Results

Problematic Internet users were less likely to brush their teeth frequently [adjusted odds ratio (AOR)=0.59; 95% confidence interval (CI)=0.56-0.63] and at school after lunch (AOR=0.89; 95% CI=0.83-0.94) as well as more likely to perceive their oral health to be poorer (AOR=1.63, 95% CI=1.54-1.72) and experience oral symptoms (AOR=1.75, 95% CI=1.65-1.86) compared to usual Internet users.

Conclusion

The study results indicate that problematic Internet use may adversely affect the oral health of Korean adolescents. Thus, oral health screening and Internet-based education are needed for adolescents experiencing problematic Internet use.

Correlates of sedentary behaviour in adults: a systematic review

OBJECTIVE

The objective of this study was to systematically review evidence to identify intrapersonal, social environmental, physical environmental and policy correlates of sedentary behaviour (SB) among adults.

METHODS

Six databases were searched to identify studies that reported on intrapersonal, social, physical environmental and/or policy correlates of SB across domains (i.e. occupational, leisure and transportation) in adults (mean ≥ 18 years old). Subgroup differences (sex, age, disease status, publication status and date, weekdays vs. weekend) were examined. Risk of bias was assessed, and a qualitative synthesis completed.

PROSPERO

CRD42014009814 RESULTS: Searching identified 22,779 articles; 257 were used in the analysis. Most studies used self-reported SB and were cross-sectional. The most studied domain of SB and correlate was leisure and intrapersonal, respectively. Consistent evidence found positive relationships between full-time employment and higher transportation and lower leisure SB; higher income/socioeconomic status and greater transportation and occupation SB; living in more urban areas and greater sitting time and total SB; ownership of televisions and greater leisure SB; and, active workstations and lower occupational SB.

CONCLUSIONS

The review identifies the need for longitudinal studies, as well as further research on factors in the physical, social and policy environments. The review also recognizes the need to standardize methodology for collecting, defining and reporting SB and correlates.

Changes of quality of life and cognitive function in individuals with Internet gaming disorder: A 6-month follow-up

Internet gaming disorder (IGD) contributes to poor quality of life (QOL) and cognitive dysfunction and is increasingly recognized as a social problem in various countries. However, no evidence exists to determine whether QOL and cognitive dysfunction stabilize after appropriate management. The present study addressed improvement in QOL and cognitive functioning associated with changes in addiction symptoms following outpatient management for IGD. A total of 84 young males (IGD group: N = 44, mean age: 19.159 ± 5.216 years; healthy control group: N = 40, mean age: 21.375 ± 6.307 years) participated in this study. We administered self-report questionnaires at baseline to assess clinical and psychological characteristics, and conducted traditional and computerized neuropsychological tests. Nineteen patients with IGD completed follow-up tests in the same manner after 6 months of outpatient treatment, which included pharmacotherapy with selective serotonin reuptake inhibitors. A baseline comparison of patients with IGD against the healthy control group showed that the IGD patients had more symptoms of depression and anxiety, higher degrees of impulsiveness and anger/aggression, higher levels of distress, poorer QOL, and impaired response inhibition. After 6 months of treatment, patients with IGD showed significant improvements in the severity of IGD, as well as in QOL, response inhibition, and executive functioning. Additionally, a stepwise multiple regression analysis revealed a favorable prognosis for IGD patients with low working memory functioning and high executive functioning at baseline. These results provide evidence regarding longitudinal changes in QOL and cognitive function following psychiatric intervention for IGD. Furthermore, it appears that response inhibition may be an objective state marker underlying the pathophysiology of IGD.

Pathological Internet Use and Risk-Behaviors among European Adolescents

Risk-behaviors are a major contributor to the leading causes of morbidity among adolescents and young people; however, their association with pathological Internet use (PIU) is relatively unexplored, particularly within the European context. The main objective of this study is to investigate the association between risk-behaviors and PIU in European adolescents. This cross-sectional study was conducted within the framework of the FP7 European Union project: Saving and Empowering Young Lives in Europe (SEYLE). Data on adolescents were collected from randomized schools within study sites across eleven European countries. PIU was measured using Young's Diagnostic Questionnaire (YDQ). Risk-behaviors were assessed using questions procured from the Global School-Based Student Health Survey (GSHS). A total of 11,931 adolescents were included in the analyses: 43.4% male and 56.6% female (M/F: 5179/6752), with a mean age of 14.89 ± 0.87 years. Adolescents reporting poor sleeping habits and risk-taking actions showed the strongest associations with PIU, followed by tobacco use, poor nutrition and physical inactivity. Among adolescents in the PIU group, 89.9% were characterized as having multiple risk-behaviors. The significant association observed between PIU and risk-behaviors, combined with a high rate of co-occurrence, underlines the importance of considering PIU when screening, treating or preventing high-risk behaviors among adolescents.

A cognitive-behavioral model of Internet gaming disorder: theoretical underpinnings and clinical implications

Cognitive contributions to the behaviors observed in substance and non-substance addictions have been investigated and characterized. Based on models of drug addictions and the extant literature on Internet gaming disorder (IGD), we propose a cognitive-behavioral model for conceptualizing IGD. The model focuses on three domains and their roles in addictive behaviors. The three domains include motivational drives related to reward-seeking and stress-reduction, behavioral control relating to executive inhibition, and decision-making that involves weighing the pros and cons of engaging in motivated behaviors. Based on this model, we propose how behavioral therapies might target these domains in the treatment of IGD.

Nocturnal sleep problems among university students from 26 countries

BACKGROUND

The aim of this study is to estimate the prevalence of nocturnal sleeping problems and its associated factors among university students in mainly low- and middle-income countries.

METHODS

A cross-sectional survey was conducted with 20,222 undergraduate university students (mean age, 20.8; SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas.

RESULTS

Overall, 10.4% reported severe or extreme nocturnal sleeping problems (male, 10.2%; female, 10.5%) in the past month. Noctural sleeping problems differed by country, from 32.9% in Indonesia to 3.0 % in Thailand among Asian countries, from 13.7% in Mauritius to 7.5% in South Africa, and from 11.8% in Jamaica to 6.1% in Columbia in the Americas. In multivariate logistic regression analysis, coming from a poor family background, staying off campus (on their own or with parents or guardians), stress (history of child sexual abuse), poor mental health (depression and PTSD symptoms), health risk behaviour (tobacco use, heavy internet use, gambling, skipping breakfast and having sustained an injury), lack of social support and poor academic performance were associated with nocturnal sleeping problems.

CONCLUSIONS

A significant prevalence of past-month nocturnal sleeping problems was found. Potential factors associated with the risk of reporting sleeping complaints were identified, which may assist in prevention strategies to promote a better quality of sleep.