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Lörsch F, Schmid AM, Thomas TA, Brand M, Müller A, Steins-Loeber S. The effect of individual differences on Pavlovian conditioning in specific Internet-use disorders. Behav Brain Res 2025; 476:115254. [PMID: 39307287 DOI: 10.1016/j.bbr.2024.115254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 09/16/2024] [Accepted: 09/17/2024] [Indexed: 09/30/2024]
Abstract
The I-PACE model suggests that Internet-use disorders result from the interplay of individual vulnerabilities and cognitive and affective processes. As in substance use disorders, Pavlovian conditioning processes are attributed a key role. However, and despite progress in identifying individual vulnerabilities, factors influencing appetitive conditioning remain poorly understood. We therefore conducted a Pavlovian conditioning experiment in which individuals with risky as well as non-problematic use of either gaming or buying-shopping applications learned to associate different abstract stimuli with either gaming or buying-shopping. Regression analyses were used to identify individual characteristics influencing awareness of the experimental contingencies, speed of acquisition of awareness and the magnitude of the conditioned emotional responses regarding pleasantness and arousal ratings of the stimuli. Results demonstrated successful Pavlovian conditioning and an attentional bias towards reward-predicting cues. Awareness of the experimental contingencies was linked solely to cognitive abilities, while the speed of acquisition of awareness and the magnitude of conditioned responses was influenced by specific personality characteristics, experiences of compensation from using the application and severity of problematic use. Importantly, certain characteristics specifically predicted the magnitude of the conditioned response towards gaming, while others specifically predicted the response towards buying-shopping, highlighting differing vulnerabilities. These findings underscore the importance of targeted interventions and prevention strategies tailored to these specific vulnerability factors. Further implications and limitations are discussed.
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Affiliation(s)
- Frank Lörsch
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany.
| | - Anna M Schmid
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Tobias A Thomas
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Matthias Brand
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
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2
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Elosua P, Abad FJ, Hernández A. Support of the Dimensionality and Internal Consistency of the Generalized Problematic Internet Use Scale-2: Systematic Review and Meta-Analysis. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2024. [PMID: 39588931 DOI: 10.1089/cyber.2024.0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2024]
Abstract
The field of problematic Internet use (PIU) has seen significant academic interest in recent years. In the absence of a universally accepted definition of PIU, a multitude of scales have been developed to evaluate it. Notably, the Generalized Problematic Internet Use Scale 2 (GPIUS-2), formulated on the cognitive-behavioral model by Caplan, emerges as a significant instrument in this domain. This research conducts a systematic review and meta-analysis of the GPIUS-2. The central aim is to assess its internal structure and reliability. This is achieved by a meta-analysis of the Cronbach's alpha and the factorial structure, which is carried out in the framework of the Meta-Analytic Structural Equation Modeling. The results reveal high internal consistency of the GPIUS-2, support the multidimensional nature of the scale, and provide evidence about the presence of a generalized factor supporting the use of a total scale value as indicator of GPIUS. In addition, the study delineates potential areas for future research aimed at further refining the validity of the GPIUS-2.
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Affiliation(s)
- Paula Elosua
- University of the Basque Country, San Sebastian, Spain
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Schmid AM, Thomas TA, Blümel S, Erdal NK, Müller SM, Merz CJ, Wolf OT, Brand M, Müller A, Steins-Loeber S. Transfer from goal-directed behavior to stimulus-response habits and its modulation by acute stress in individuals with risky gaming behavior. Sci Rep 2024; 14:26015. [PMID: 39472683 PMCID: PMC11522379 DOI: 10.1038/s41598-024-73899-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 09/23/2024] [Indexed: 11/02/2024] Open
Abstract
Habitual responses towards addiction-related cues play a relevant role in the development and maintenance of addictions. Such automatic responses may be more likely under stress, as stress has been shown to induce a shift from goal-directed to habitual behavior. The current study investigated these mechanisms in risky gaming behavior. Individuals with risky gaming behavior (n = 68), as established by a structured clinical interview, and a matched control group (n = 67) completed a Pavlovian-to-Instrumental Transfer (PIT) paradigm with gaming-related cues and rewards. After the Pavlovian training, participants underwent a stress (Trier Social Stress Test) or control condition before performing the instrumental training and the transfer phase of the PIT paradigm. To assess habitual behavior, the gaming-related rewards were devalued after half of the transfer phase. In both groups, gaming-related cues enhanced the choice of the gaming-related reward and this gaming PIT effect was reduced, however, not eliminated by the devaluation. Unexpectedly, stress did not significantly increase responding for the gaming-related reward in participants aware of the stimulus-outcome associations, however seemed to enhance habitual responding in unaware participants. Our findings underline the relevance of gaming-related cues in triggering habitual responses, which may undermine attempts to change a problematic gaming behavior.
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Affiliation(s)
- Anna M Schmid
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany.
| | - Tobias A Thomas
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Stefan Blümel
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Nicolas K Erdal
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Silke M Müller
- General Psychology: Cognition, Faculty of Computer Science, University of Duisburg-Essen, Duisburg, Germany
- Center for Behavioral Addiction Research (CeBAR), Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Christian J Merz
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Matthias Brand
- General Psychology: Cognition, Faculty of Computer Science, University of Duisburg-Essen, Duisburg, Germany
- Center for Behavioral Addiction Research (CeBAR), Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
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Chan GCK, Saunders JB, Stjepanović D, McClure-Thomas C, Connor J, Hides L, Wood A, King D, Siste K, Long J, Leung JK. The Gaming Disorder Identification Test (GADIT) - A screening tool for Gaming Disorder based on ICD-11. J Behav Addict 2024; 13:729-741. [PMID: 39088282 PMCID: PMC11457026 DOI: 10.1556/2006.2024.00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/26/2024] [Accepted: 06/16/2024] [Indexed: 08/03/2024] Open
Abstract
Background Gaming Disorder was included as an addictive disorder in the latest version of the International Classification of Diseases (ICD-11), published in 2022. The present study aimed to develop a screening tool for Gaming Disorder, the Gaming Disorder Identification Test (GADIT), based on the four ICD-11 diagnostic criteria: impaired control, increasing priority, continued gaming despite harm, and functional impairment. Method We reviewed 297 questionnaire items from 48 existing gaming addiction scales and selected 68 items based on content validity. Two datasets were collected: 1) an online panel (N = 803) from Australia, United States, United Kingdom and Canada, split into a development set (N = 589) and a validation dataset (N = 214); and 2) a university sample (N = 408) from Australia. Item response theory and confirmatory factor analyses were conducted to select eight items to form the GADIT. Validity was established by regressing the GADIT against known correlates of Gaming Disorder. Results Confirmatory factor analyses of the GADIT showed good model fit (RMSEA=<0.001-0.108; CFI = 0.98-1.00), and internal consistency was excellent (Cronbach's alphas = 0.77-0.92). GADIT scores were strongly associated with the Internet Gaming Disorder Test (IGDT-10), and significantly associated with gaming intensity, eye fatigue, hand pain, wrist pain, back or neck pain, and excessive in-game purchases, in both the validation and the university sample datasets. Conclusion The GADIT has strong psychometric properties in two independent samples from four English-speaking countries collected through different channels, and shown validity against existing scales and variables that are associated with Gaming Disorder. A cut-off of 5 is tentatively recommended for screening for Gaming Disorder.
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Affiliation(s)
- Gary C. K. Chan
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
- School of Psychology, The University of Queensland, St Lucia, Australia
| | - John B. Saunders
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
| | - Daniel Stjepanović
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
- School of Psychology, The University of Queensland, St Lucia, Australia
| | - Caitlin McClure-Thomas
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
- School of Psychology, The University of Queensland, St Lucia, Australia
| | - Jason Connor
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
- School of Psychology, The University of Queensland, St Lucia, Australia
- Discipline of Psychiatry, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Leanne Hides
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
- School of Psychology, The University of Queensland, St Lucia, Australia
| | - Andrew Wood
- School of Applied Psychology, Griffith University, Australia
| | - Daniel King
- College of Education, Psychology and Social Work, Flinders University, Australia
| | - Kristiana Siste
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Indonesia
- Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Jiang Long
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Janni K. Leung
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
- School of Psychology, The University of Queensland, St Lucia, Australia
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Ince C, Albertella L, Liu C, Tiego J, Fontenelle LF, Chamberlain SR, Yücel M, Rotaru K. Problematic pornography use and novel patterns of escalating use: A cross-sectional network analysis with two independent samples. Addict Behav 2024; 156:108048. [PMID: 38761685 PMCID: PMC7616041 DOI: 10.1016/j.addbeh.2024.108048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/09/2024] [Accepted: 04/30/2024] [Indexed: 05/20/2024]
Abstract
Modern internet pornography allows users to harness sexual novelty in numerous ways, which can be used to overcome desensitisation through increasing volume of use (quantitative tolerance), progressing to more stimulating genres (qualitative escalation), skipping between stimuli (tab-jumping), delaying orgasm ('edging'), and engaging in pornographic binges. However, existing research has not yet evaluated how these potentially reciprocal consumption patterns relate to problematic pornography use (PPU). To this end, we recruited two independent samples of male pornography users (N1 = 1,356, Mage = 36.86, SD = 11.26; N2 = 944, Mage = 38.69, SD = 12.26) and examined the relationships between these behavioural dimensions and self-reported difficulties in controlling one's pornography use. Data were analysed through the network analysis approach (using Gaussian graphical models). As hypothesised, i) quantitative tolerance was centrally placed within the overall network, and ii) acted as a statistical bridge node between other patterns of pornography use (e.g., pornographic binges), and all measured facets of PPU. Our results are consistent with other emerging literature suggesting that tolerance, pornographic binges, tab-jumping, and edging behaviours as relevant features ofPPU, and that upscaling overall usage may connect broader patterns of use with problematic engagement. Clinical and theoretical implications, as well as future research directions, are discussed.
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Affiliation(s)
- Campbell Ince
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia.
| | - Lucy Albertella
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Chang Liu
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Jeggan Tiego
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia; Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Clayton, VIC 3800, Australia
| | - Leonardo F Fontenelle
- Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia; Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil; D'Or Institute for Research and Education (IDOR), Brazil
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK
| | - Murat Yücel
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia; QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Kristian Rotaru
- School of Psychological Sciences, Monash University, Australia; Brain Park, Turner Institute for Brain and Mental Health, Monash University, Australia; Monash Business School, Monash University, Australia
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Vera Cruz G, Aboujaoude E, Liberacka-Dwojak M, Wiłkość-Dębczyńska M, Rochat L, Khan R, Khazaal Y. How much online pornography is too much? A comparison of two theoretically distinct assessment scales. Arch Public Health 2024; 82:79. [PMID: 38816773 PMCID: PMC11137999 DOI: 10.1186/s13690-024-01294-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/15/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Online pornography use, an ever more common activity, has raised myriad psychosocial and clinical concerns. While there is a need to screen for and measure its problematic dimension, there is a debate about the adequacy of existing assessment tools. OBJECTIVE The study compares two instruments for measuring pathological online pornography use (POPU) that are based on different theoretical frameworks-one in line with DSM-5 criteria and the six-component addiction model and one in line with ICD-11 criteria. METHODS An international sample of 1,823 adults (Mean age = 31.66, SD = 6.74) answered an online questionnaire that included the Short Version of the Problematic Pornography Consumption Scale (PPCS-6) and the Assessment of Criteria for Specific Internet-Use Disorders (ACSID-11). Factorial, correlational, and network analyses were conducted on the data. RESULTS Both tools adequately screened for online "addictive" behavior, but the ACSID-11 was superior in assessing the degree of clinical risk. CONCLUSION Depending on the specific aim of the assessment (screening vs. clinical diagnostics), both online pornography measurement tools may be useful.
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Affiliation(s)
- Germano Vera Cruz
- Department of Psychology, CRP-CPO, University of Picardie Jules Verne, Amiens, France.
| | - Elias Aboujaoude
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
- Program in Internet, Health and Society, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | | | | | - Lucien Rochat
- Department of Mental Health and Psychiatry, Specialized Facility in Behavioral Addiction ReConnecte, University Hospitals of Geneva, Geneva, Switzerland
| | - Riaz Khan
- Department of Mental Health and Psychiatry, Frontier Medical College Abbottabad, Bahria University Islamabad, Islamabad, Pakistan
| | - Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland.
- Research Centre, University Institute of Mental Health at Montreal and Department of Psychiatry and Addiction Montreal University, Montreal, Canada.
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7
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Ben Brahim F, Vera Cruz G, Courtois R, May J, Khazaal Y. Strength of Pornography Craving Experience (PCE-S): Psychometric properties of a new measure based on the elaborated intrusion theory of desire. Addict Behav 2024; 148:107858. [PMID: 37774528 DOI: 10.1016/j.addbeh.2023.107858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/11/2023] [Accepted: 09/06/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION Pornography use is a common sexual activity with potentially addictive use in some people. Even though craving is being recognized as an important characteristic of addictive behaviors, there is a lack of a specific validated instrument measuring the pornography craving experience. The present study aimed at adapting and validating an instrument measuring the users' strength of pornography craving experience (PCE-S) based on the Elaborated Intrusion theory of desire. METHODS Items from the "strength" form of the Craving Experience Questionnaire (CEQ) were adapted to pornography use and used to create the PCE-S. The PCE-S was then administered online to 1584 English-speaking cyberporn users aged 18-75 years old (M = 33.18; SD = 10.84]; 63.1 % male, 35.2 % female, and 1.7 % non-binary). All participants completed an assessment of compulsive cyberporn use (CIUS adapted for cyberporn). Confirmatory factorial analysis (CFA) was used to examine the construct structure validity; Cronbach alpha coefficient, corrected item-total correlation, regression, and discriminant analysis were used to assess the instrument's psychometric properties. RESULTS After using the modification indices to improve the initial model, a relatively good fit for the three-factor model was confirmed. Concurrent validity with the compulsive cyberporn use (CCU) measure was demonstrated. The PCE-S discriminated between participants with high CCU and those with low CCU scores. CONCLUSIONS A specific pornography craving experience instrument scale, based on the Elaborated Intrusion theory of desire seems to capture key constructs of the theory and correlate with measures of compulsive cyberporn use.
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Affiliation(s)
- Farah Ben Brahim
- University of Tours, QualiPsy, Tours, France; Lausanne University, Lausanne, Switzerland.
| | - Germano Vera Cruz
- Department of Psychology, UR 7273 CRP-CPO, University of Picardie Jules Verne, Amiens, France.
| | | | - Jon May
- School of Psychology (Faculty of Health), University of Plymouth, Plymouth, UK.
| | - Yasser Khazaal
- Addiction Medicine, Lausanne University Hospital, Switzerland; Lausanne University, Lausanne, Switzerland; Department of Psychiatry and Addictology, Montreal University, Canada.
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Ko CH, Király O, Demetrovics Z, Griffiths MD, Kato TA, Tateno M, Yen JY. Heterogeneity of gaming disorder: A clinically-based typology for developing personalized interventions. J Behav Addict 2023; 12:855-861. [PMID: 37934288 PMCID: PMC10786230 DOI: 10.1556/2006.2023.00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 08/29/2023] [Accepted: 10/07/2023] [Indexed: 11/08/2023] Open
Abstract
Background The eleventh revision of the International Classification of Diseases (ICD-11) defines the three key diagnostic criteria for gaming disorder (GD). These are loss of control over gaming, gaming as a priority over daily activities, and impaired functioning due to gaming. While this definition has implications for the prevention and treatment of GD, there is significant heterogeneity in the symptoms and etiology of GD among individuals, which results in different treatment needs. Cognitive control, emotional regulation, and reward sensitivity are three critical dimensions in the etiology model for GD. Aspects such as gender, comorbidity, motivation for gaming, stage or severity of GD, and risk factors all contribute to the heterogeneity of etiology among individuals with the disorder. Method On the basis of clinical symptoms and comorbidity characteristics among approximately 400 patients with gaming disorder, the present paper proposes a clinical typology of patients with GD based on the authors' clinical experience in treating individuals with GD. Results The findings indicated three common types of patients with GD: (i) impulsive male patients with attention deficit hyperactivity disorder (ADHD), (ii) dysphoria patients with dysfunctional coping skills, and (iii) isolated patients with social anxiety. The paper also discusses the presentation and treatment priority for these patients. Conclusion Personalized treatments for patients with GD should be developed to fit their individual needs. Future studies should examine the heterogeneity of GD and confirm these types, as well as obtain evidence-based information that can help in the development of personalized treatment. Treatment resources should be developed, and professionals should be trained to provide integrated individualized treatment.
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Affiliation(s)
- Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Mark D. Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Takahiro A. Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaru Tateno
- Department of Neuropsychiatry, School of Medicine, Sapporo Medical University, Sapporo, Japan
- Tokiwa Child Development Center, Tokiwa Hospital, Sapporo, Japan
| | - Ju-Yu Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
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Yang YN, Su JA, Pimsen A, Chen JS, Potenza MN, Pakpour AH, Chen JK, Poon WC, Nurmala I, Ruckwongpatr K, Lin CY. Validation of the Thai Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) among young adults. BMC Psychiatry 2023; 23:819. [PMID: 37940885 PMCID: PMC10633967 DOI: 10.1186/s12888-023-05210-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 09/21/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND The Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) is a consistent and comprehensive instrument to assess symptoms of specific internet-use disorders including those related to gaming, shopping, pornography use disorder, social networks use and gambling considering criteria in the eleventh revision of the International Classification of Diseases (ICD-11). However, to date, there is little evidence supporting instruments assessing major types of specific internet use disorders in Thailand. The aim of this present study was to assess the psychometric properties of the ACSID-11 among Thai young adults. METHODS A total of 612 participants were recruited. A confirmatory factor analysis (CFA) examined construct validity of the ACSID-11. Cronbach's α and McDonald's ω were used to assess reliability of the ACSID-11. Pearson correlations examined relationships between ACSID-11 domains and Internet Gaming Disorder Scale-Short Form (IGDS9-SF) scores. RESULTS The CFA supported validity of the Thai version of the ACSID-11 and a four-factor structure. Specific domains of the Thai ACSID-11, particularly gaming, were positively and significantly correlated with IGDS9-SF scores. CONCLUSIONS Data indicate that the Thai version of the ACSID-11 is a valid and reliable instrument to assess major types of specific internet use disorders. Additional studies are needed to further examine the validity and reliability of the Thai ACSID-11.
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Affiliation(s)
- Yung-Ning Yang
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Jian-An Su
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan
| | - Apiradee Pimsen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung, 824005, Taiwan
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, 300 George St., Suite 901, New Haven, CT, 06511, USA
- Connecticut Mental Health Center, 34 Park St, New Haven, CT, 06519, USA
- Connecticut Council On Problem Gambling, 100 Great Meadow Rd., Suite 704, Wethersfield, CT, 06109, USA
- Child Study Center, Yale School of Medicine, 350 George St, New Haven, CT, 06511, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, 200 South Frontage Rd., SHM C-303, New Haven, CT, 06510, USA
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Wai Chuen Poon
- Sunway Business School, Sunway University, Selangor, Malaysia
| | - Ira Nurmala
- Department of Epidemiology, Faculty of Public Health, Biostatistics, Population Studies and Health Promotion, Universitas Airlangga, Surabaya, Indonesia
| | - Kamolthip Ruckwongpatr
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- University of Religions and Denominations, Qom, Iran.
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
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10
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Diers M, Müller SM, Mallon L, Schmid AM, Thomas TA, Klein L, Krikova K, Stark R, Wegmann E, Steins-Loeber S, Brand M, Antons S. Cue-reactivity to distal cues in individuals at risk for gaming disorder. Compr Psychiatry 2023; 125:152399. [PMID: 37437451 DOI: 10.1016/j.comppsych.2023.152399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Gaming disorder (GD) is a disorder due to addictive behaviors (ICD-11). Cue-reactivity and craving are relevant mechanisms in the development and maintenance of addictive behaviors. When confronted with cues showing in-game content (proximal cues) individuals with higher symptom severity show increased cue-reactivity. Based on conditioning and addiction theories on incentive sensitization, cue-reactivity responses may generalize to more distal cues, e.g. when individuals at risk of developing a GD are confronted with a starting page of an online game. In cue-reactivity paradigms so far, only proximal gaming cues have been used. METHODS We investigated the effect of distal gaming cues compared to gaming-unrelated control cues on cue-reactivity and craving in 88 individuals with non-problematic use of online games (nPGU) and 69 individuals at risk for GD (rGD). The distal cues showed the use of an electronic device (e.g., desktop PC or smartphone) whose screen showed starting pages of either games (target cues), shopping- or pornography sites (control cues) from a first-person perspective. FINDINGS We found significantly higher urge and arousal ratings as well as longer viewing times for gaming-related compared to gaming-unrelated control cues in rGD compared to nPGU. Valence ratings did not differ between groups. INTERPRETATION The results demonstrate that already distal gaming-specific cues lead to cue-reactivity and craving in rGD. This finding indicates that based on conditioning processes, cue-reactivity and craving develop during the course of GD and generalize to cues that are only moderately related to the specific gaming activity.
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Affiliation(s)
- Martin Diers
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany.
| | - Silke M Müller
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Lukas Mallon
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Anna M Schmid
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich University of Bamberg, Bamberg, Germany
| | - Tobias A Thomas
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Lena Klein
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Kseniya Krikova
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, Giessen, Germany; Clinical Psychology and Psychotherapy, University Siegen, Siegen, Germany; Bender Institute for Neuroimaging, Justus Liebig University, Giessen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, Giessen, Germany; Bender Institute for Neuroimaging, Justus Liebig University, Giessen, Germany; Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Germany
| | - Elisa Wegmann
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich University of Bamberg, Bamberg, Germany
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Stephanie Antons
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
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Müller SM, Antons S. Decision making and executive functions in problematic pornography use. Front Psychiatry 2023; 14:1191297. [PMID: 37564242 PMCID: PMC10411905 DOI: 10.3389/fpsyt.2023.1191297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction Previous research on cognitive functions in Compulsive Sexual Behavior Disorder (CSBD) and problematic pornography use (PPU) reported inconsistent findings and mostly included sexual pictures in the used tasks. The role of general executive functions and cognitive competences (without the presence of appetitive stimuli) in the context of PPU is largely unexplored. Methods This study investigated differences between individuals with high versus low problem severity of PPU regarding decision making and executive functions. The sample of the laboratory study consisted of N = 102 male adults. Besides measures of trait impulsivity, we used standard neuropsychological tests (Trail Making Test and three-back working memory task) and an intertemporal risky choice paradigm, the Cards & Lottery Task (CLT). Results The results show heightened impulsivity (urgency and deficits in perseverance) in individuals with high PPU, but no differences regarding performance in the CLT and executive function tasks. Discussion The findings indicate that PPU might be associated with impulsive behavior when experiencing strong emotions (urgency) and deficient cognitive performance especially in the presence of sexual stimuli but not in general.
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Affiliation(s)
- Silke M. Müller
- Department of General Psychology, Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Stephanie Antons
- Department of General Psychology, Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
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12
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Brandtner A, Wegmann E. The fear in desire: linking desire thinking and fear of missing out in the social media context. BMC Psychol 2023; 11:176. [PMID: 37270492 DOI: 10.1186/s40359-023-01216-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 05/18/2023] [Indexed: 06/05/2023] Open
Abstract
According to the Elaborated Intrusion Theory of Desire, desire thinking and an associated deficit are fundamental factors to the emergence of craving. In the special case of problematic social networking sites (SNS) use, this experienced deficit could be constituted of an online-specific fear of missing out (FoMO). To test the interaction of these cognitions and their influence on problematic SNS use, we tested a serial mediation model on a sample of N = 193 individuals who use SNS (73% female, Mage = 28.3, SD = 9.29). We found that desire thinking predicted FoMO and both variables were only significant predictors of problematic SNS use when considered in interplay with craving. Ad hoc analyses revealed that the verbal subcomponent of desire thinking is more strongly associated with FoMO than imaginal prefiguration. Our results highlight that neither desire thinking nor FoMO are inherently dysfunctional but become problematic when they increase craving for potentially problematic SNS use.
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Affiliation(s)
- Annika Brandtner
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, LE220, 47057, Duisburg, Germany.
| | - Elisa Wegmann
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, LE220, 47057, Duisburg, Germany
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13
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Brandtner A, Verduyn P, Behrens S, Spada MM, Antons S. License to look? The role of permissive beliefs, desire thinking, and self-control in predicting the use of social networking sites. Addict Behav 2023; 139:107573. [PMID: 36608591 DOI: 10.1016/j.addbeh.2022.107573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/22/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
Permissive beliefs are considered the most proximal predictor of actual behavior. Whereas they have frequently been researched in substance-use disorders, the field of social networking sites (SNS) use is missing the investigation as to how relevant permissive beliefs might be in this context, what might be causal precursors of permissive beliefs (i.e., desire thinking), and which processes might influence the effect that permissive beliefs have on actual behavior (i.e., self-control). To answer these questions, 116 people who use SNS participated in an online survey that contained an experimental manipulation of desire thinking and questionnaires measuring permissive beliefs, self-control, and severity of problematic SNS use. In a one-week follow-up, 85 participants reported their SNS usage times. Results showed that the association between permissive beliefs and tendencies to use SNS problematically was not significant. The experimental manipulation led to a decrease in permissive beliefs in the control condition, but did not increase permissive beliefs in the desire thinking condition. Permissive beliefs predicted SNS use in the follow-up assessment, which was not moderated by self-control. The results suggest that permissive beliefs seem to be unrelated to addictive tendencies of SNS use, but are nevertheless associated with daily use. Desire thinking does not appear to activate permissive beliefs in this study, possibly because the use of social networks is less often experienced as conflicting. Due to its ubiquitous availability, the use of social networks itself might quickly resolve the conflict between desires and possible regulatory attempts, making good reasons for use unnecessary.
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Affiliation(s)
- Annika Brandtner
- University of Duisburg-Essen, Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), Duisburg, Germany.
| | - Philippe Verduyn
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
| | - Sofie Behrens
- University of Duisburg-Essen, Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), Duisburg, Germany.
| | | | - Stephanie Antons
- University of Duisburg-Essen, Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
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Kukafka R, Bottel L, Herpertz S, Timmesfeld N, Te Wildt BT, Wölfling K, Henningsen P, Neumann A, Beckers R, Pape M. Internet-Based Self-Assessment for Symptoms of Internet Use Disorder-Impact of Gender, Social Aspects, and Symptom Severity: German Cross-sectional Study. J Med Internet Res 2023; 25:e40121. [PMID: 36633897 PMCID: PMC9880811 DOI: 10.2196/40121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/23/2022] [Accepted: 10/24/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Internet use disorder (IUD) is a new type of behavioral addiction in the digital age. At the same time, internet applications and eHealth can also provide useful support in medical treatment. OBJECTIVE The purpose of this study is to examine if an internet-based eHealth service can reach individuals with IUD. In particular, it should be investigated whether both male and female individuals with more severe IUDs can be reached. METHODS Data were retrieved from the OMPRIS (online-based motivational intervention to reduce problematic internet use and promote treatment motivation in internet gaming disorder and internet use disorder) project (DRKS00019925), an internet-based motivational intervention to reduce problematic internet use and promote treatment motivation in internet gaming disorder and IUD. During the recruitment process (August 2020-March 2022), a total of 3007 individuals filled out the standardized scale for the assessment of internet and computer game addiction (AICA-S). The assessment was accessible via the project homepage. There was no preselection of participants at this stage of the study; however, the offer was addressed to people with hazardous internet use and IUDs. The web-based assessment was free and could be found via search engines, but attention was also drawn to the service via newspaper articles, radio reports, and podcasts. RESULTS Out of 3007 who participated in the web-based self-assessment, 1033 (34.4%) are female, 1740 (57.9%) are male, 67 (2.2%) are diverse individuals, and 167 (5.5%) did not disclose their gender. The IUD symptom severity score showed a wide range between the AICA-S extreme values of 0 and 27 points. On average, the total sample (mean 8.19, SD 5.47) was in the range of hazardous IUD behavior (AICA-S cutoff>7.0). Furthermore, 561 individuals (18.7% of the total sample; mean 17.42, SD 3.38) presented severe IUD (AICA-S cutoff>13.5). Focusing on female and male participants, 20.9% (363/1740) of the men and 14.9% (151/1033) of the women scored above 13.5 points, which can be considered pathological IUD behavior (χ22,2773=16.73, P<.001, effect size: Cramér V=0.078). Unemployment, being in vocational training or studying at a university, and being male were significantly associated with high IUD symptoms. CONCLUSIONS Using a large sample, the study showed that both mildly and severely IUD-affected individuals can be reached via the internet. An internet-based eHealth offer can thus be a good way to reach patients with IUD where they are addicted-on the internet. In addition, eHealth services increase the likelihood of reaching female patients, who hardly ever come to specialized outpatient clinics and hospitals. Since social problems, especially unemployment, have a strong association with disease severity, the integration of social counseling into treatment seems advisable in terms of a multidisciplinary approach. TRIAL REGISTRATION German Clinical Trials Register (DRKS) DRKS00019925; https://drks.de/search/de/trial/DRKS00019925.
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Affiliation(s)
| | - Laura Bottel
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Nina Timmesfeld
- Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Bochum, Germany
| | - Bert Theodor Te Wildt
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany.,Psychosomatic Hospital Diessen Monastery, Diessen, Germany
| | - Klaus Wölfling
- Outpatient Clinic for Behavioral Addictions, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University Munich, Munich, Germany
| | - Anja Neumann
- Institute for Health Care Management and Research, University Duisburg-Essen, Essen, Germany
| | - Rainer Beckers
- Competence Centre of Healthcare Telematics, Hagen, Germany
| | - Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
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