Family factors in adolescent problematic Internet gaming: A systematic review

Exploring parent-child relationships in a Swedish child and adolescent psychiatry - cohort of adolescents with internet gaming disorder

BACKGROUND

While recent studies suggest a high prevalence of Internet gaming disorder (IGD) in child and adolescent psychiatry (CAP) clinics, little is known about the factors contributing to problematic gaming among these patients. Given the well-established role of parenting and parent-child relationships in the development of problem behaviors, this study aimed to explore parent-child relationships within a Swedish cohort of CAP patients with IGD.

METHODS

A total of 72 adolescents from CAP clinics in Skane, Sweden, diagnosed with IGD based on DSM-V criteria (73% boys), aged 13 to 18 years were included in the study. The adolescents completed the Game Addiction Scale for Adolescents (GASA) and reported on aspects of parent-child communication, such as parental control and adolescent disclosure and secrecy, and family climate. Adolescents were categorized as engaged, problem or addicted gamers based on core approach. Independent sample t-tests, Pearsons's correlations, and multivariate regression analyses were used to address the study goals.

RESULTS

Independent sample t-tests revealed that girls showed lower levels of parental knowledge than boys. Bivariate correlation analyses showed that IGD-symptoms were related to lower levels of child disclosure, while multivariate regression analyses revealed that higher IGD-symptoms were predicted by high levels of child secrecy and low child disclosure.

CONCLUSION

Parent-child relationships, in particular adolescent information management to parents, plays an important role for the level of IGD-symptoms in a clinical sample of adolescents. We suggest that therapeutic interventions for IGD should integrate family-focused strategies, such as parent training programs fostering open communication between parents and their children.

Influence of Gender, Parental Control, Academic Performance and Physical Activity Level on the Characteristics of Video Game Use and Associated Psychosocial Problems in Adolescents

Previous research has determined the relevance of video games for adolescents; however, it has not been possible to establish differences in usage patterns and certain psychological variables according to gender, parental control, academic performance, physical activity level or game type, nor the relationship between these variables. For this reason, the aims of this research were as follows: (a) to determine the differences in the gaming variables and the psychological variables related to video games according to gender, the closest environment, the academic performance and the level of physical activity; and (b) to determine which gaming variables and behavioral variables influence psychological variables in adolescents. A descriptive, cross-sectional study was carried out involving 2567 adolescents (mean age: 15.06 ± 2.81 years). Participants completed eight questionnaires on the study variables. The results showed that males play more video games than females; play different types of games and on different platforms; and have more psychological problems than females. Having separated parents and having a greater parental control over video game use is associated with more time spent playing video games. Poorer academic performance is related to playing shooters and open-world games, as well as with a more negative emotional response. However, playing shooters and sport and racing games is related to more physical activity. Playing online games, mainly with strangers, is related to higher addictive and problematic uses. In addition, the times of use during the week and on weekends, especially on weekends, stand out as predictors of most psychological variables related to video games in adolescents. This study provides further scientific evidence on the role of certain behavioral and game-related variables in the relationship between video games and well-being. In addition, it highlights the importance of analyzing in the future those video game players who do not have a problematic or addictive use of video games, but who play frequently without any associated problem. From a practical perspective, the promotion of video games with social and cooperative components, or those that promote physical activity, could be related to social and psychological benefits.

The Relationship Between Family Communication and Adolescent Problematic Internet Use: The Chain Mediation Effects of Loneliness and Depression

Introduction

Problematic internet use (PIU) is a significant issue during adolescence. It is recognized as a condition for further study in the DSM-5 and may also be a consequence of underlying psychopathologies, as suggested by previous studies. Poor family communication is an important predictor of adolescent PIU. However, it remains unclear how family communication impacts adolescent PIU from the perspective of underlying psychopathologies. This study tested the chain mediating effect of loneliness and depression as well as the moderating effect of developmental stage in this chain mediation model to uncover the mechanisms underlying this association.

Methods

This cross-sectional study recruited a total of 1,377 participants (53% male) from 23 provinces across China, all aged 12 to 17. Family communication was assessed using the FCS-10, which measures aspects such as openness, emotional expression, and problem-solving abilities within family interactions. PIU was assessed using the PIUQ-SF-6, loneliness was measured by the T-ILS, and depression was assessed using the PHQ-9. The chain mediating effects were tested using bias-corrected percentile bootstrap (sample = 5000).

Results

The results indicated that (a) poor family communication was positively associated with adolescent PIU; (b) loneliness and depression mediated the link between family communication and adolescent PIU; (c) loneliness and depression sequentially mediated the link between family communication and adolescent PIU; (d) the developmental stage of adolescence (early vs late) moderated the relationship between depression and PIU in the chain mediation model.

Conclusion

This study reveals that depression, as a potential underlying psychopathology, may precede PIU. It also establishes a link between family communication and PIU, showing that loneliness resulting from poor family communication contributes to the development of depression in adolescents. The connection between depression and PIU is particularly pronounced in late adolescence. These findings highlight the importance of addressing underlying psychopathologies when screening and treating adolescent PIU.

Parent-Adolescent Conflict, Peer Victimization, and Internet Gaming Disorder Among Chinese Adolescents: The Moderating Effect of OXTR Gene rs53576 Polymorphism

Despite growing evidence that parent-adolescent conflict positively correlates with Internet gaming disorder (IGD) among adolescents, its underlying mediating and moderating mechanisms have yet to be thoroughly examined. Based on the social development model and gene-environment interaction perspective, this study investigates whether the indirect association of parent-adolescent conflict, which impacts adolescent IGD through peer victimization, was moderated by the oxytocin receptor (OXTR) gene rs53576 polymorphism. Overall, 673 Chinese adolescents (Meanage = 12.81 years; SD = 0.48 years; 54% boys) were included in this study. The participants completed questionnaires concerning parent-adolescent conflict, peer victimization, and IGD, and genomic DNA was extracted from each participant's saliva and buccal cells. The findings indicated that peer victimization mediated the link between parent-adolescent conflict and IGD among adolescents. The OXTR gene rs53576 polymorphism also moderated this indirect link. Specifically, the indirect effect of parent-adolescent conflict on adolescent IGD through peer victimization was significant for adolescents with AA homozygotes. However, it was non-significant for adolescents with GA and GG genotypes. This research simultaneously considers the roles of family, peers, and genetics in adolescent IGD. Furthermore, it provides beneficial information to customize interventions for adolescent IGD prevention.

Influence of parental mediation and social skills on adolescents' use of online video games for escapism: A cross-sectional study

The widespread use of video games among adolescents has raised concerns about their impact on psychological and social development. This study aimed to assess the effects of different types of parental mediation on adolescents' tendency to use video games to avoid negative emotions and determine the relationship between adolescents' interpersonal skills and their reliance on online video games for escapism. Participants were 452 adolescents from 15 middle and high schools. Data on sociodemographic information, gaming habits, parental control of online gaming, interpersonal skills, and reasons for playing online games were also collected. Hierarchical multiple regression was used to analyze the data, with online video game escapism as the dependent variable. Results supported the study's hypothesis that both parental mediation and adolescent interpersonal skills significantly predict the use of online video games for escapism. Higher levels of parental monitoring were associated with a lower tendency of adolescents to use video games to escape negative emotions, while parental mediation supporting autonomy showed a similar but weaker protective effect. At the same time, parental monitoring was also found to be associated with lower interpersonal skills, notably higher impulsivity, narcissism, and stress in social situations. In addition, adolescents with higher levels of impulsivity were more likely to use video games for escapism. These findings highlight the importance of balanced parental involvement and the development of adolescents' social skills to mitigate the risks of problematic online gaming. Interventions should promote effective parental mediation strategies and enhance adolescents' interpersonal skills to reduce their tendency to use video games as a coping mechanism for real-life challenges. Effective parental mediation and improved interpersonal skills are critical for promoting healthier gaming habits and reducing adolescent escapism.

The association between digital addiction and interpersonal relationships: A systematic review and meta-analysis

Digital addiction (DA) has been identified as an emerging public health problem worldwide. However, the extent and direction of the association between DA and interpersonal relationships (IRs) are unknown. Does DA have adverse effects on IRs, and how credible is the evidence for this association in published analyses of real-world data? Using the PRISMA method, we conducted a meta-analysis to quantitatively synthesize the results of the relevant studies and obtain reliable effect size estimates and performed an analysis of moderating factors. A systematic literature search identified 98 studies involving 134,593 participants and 99 effect sizes. A significant negative association was observed between DA and IRs. Importantly, our meta-analysis revealed that the DA subtype has no significant moderating effect on IRs, suggesting that combining numerous categories of DA rather than focusing on specific forms of DA may be appropriate for understanding the relationship between DA and IRs. Relative to the IR subtype, the association between DA and offline relationships is significant and negative, whereas the association between DA and online relationships is significant and positive. The strength of the relationship is also influenced by the participants' sex ratio, educational level, and measurement tools. These results may help resolve the disagreement over the magnitude and direction of the association between DA and IRs and have potential implications for the treatment of DA.

The prevalence of suboptimal health status among Chinese secondary school students and its relationship with family health: the mediating role of perceived stress and problematic internet use

BACKGROUND

The health status of secondary school students has received widespread attention, and family plays an extremely important role in protecting and promoting their health. However, the relationship between family health and suboptimal health status (SHS) among secondary school students and its underlying mechanisms are unclear. This study aims to understand the prevalence of SHS among Chinese secondary school students and analyze the relationship between family health and SHS, and examine the mediating roles of perceived stress and problematic internet use.

METHODS

The 2,094 secondary school students (52.6% boys, 47.4% girls, Mage ± SD = 15.74 ± 1.78) of this study came from "2022 Psychology and Behavior Investigation of Chinese Residents, PBICR". The chi-square test and t-test were used to analyze the prevalence of SHS in secondary school students with different characteristics. The SPSS PROCESS macro software was used to explore the relationship between family health and SHS and the mediating effects of perceived stress and problematic internet use.

RESULTS

The prevalence of SHS among Chinese secondary school students was 40.7%, and older students, girls, non-only child, high school students, smokers, drinkers, and students living in the Northeast region of China had higher prevalence. Family health, SHS, perceived stress, and problematic internet use were significantly related (P < 0.001). Family health had a negative effect on SHS (β = -0.127, 95% CI: -0.173 to -0.080). At the same time, perceived stress mediated the relationship between family health and SHS (chain mediation model 1: β = -0.109, 95% CI: -0.133 to -0.087; chain mediation model 2: β = -0.098, 95% CI: -0.120 to -0.078) and problematic internet use also mediated their relationship (chain mediation model 1: β = -0.034, 95% CI: -0.056 to -0.014; chain mediation model 2: β = -0.077, 95% CI: -0.099 to -0.055). The chain mediating effect of perceived stress and problematic internet use was also found in this study and the chain path from family health to perceived stress to problematic internet use to SHS was superior (β = -0.043, 95% CI: -0.054 to -0.033).

CONCLUSIONS

Many secondary school students are experiencing SHS. Improving family health, such as strengthening parent-child communication and fostering positive parenting practice, is critical to improving their health. Helping secondary school students relieve perceived stress and reduce their problematic internet use is key to implementing family-oriented health interventions.

The impact of video game playing on Chinese adolescents' academic achievement: Evidence from a moderated multi-mediation model

Internet access for adolescents is becoming more prevalent around the world. Although video game playing has been verified to be negatively related to adolescent academic achievement, the mechanisms underlying this relationship are also unknown. Using a nationally representative sample of adolescents from the China Education Panel Survey (2014-2015), this study aims to explore the parallel mediation roles of self-educational expectation and learning attitude in the link between video game playing and academic achievement, and whether the direct and indirect effects are moderated by parent-child relationship. The results indicate that video game playing in adolescents is both directly and indirectly related to their academic achievement, and self-educational expectation and learning attitude partially mediate this association. Moreover, the results reveal that parent-child relationship moderates the direct association between video game playing and academic achievement as well as the indirect association of video game playing on academic achievement via self-educational expectation, respectively. By showing empirical evidence for the usefulness of social cognitive theory to adolescents' academics in the Internet Age, our research provides a supplement to existing literature.

The impact of stress on sleep quality: a mediation analysis based on longitudinal data

Objective

This study evaluates the potential mechanisms through which stress affects sleep quality and examines the mediating roles of rumination, social anxiety, emotion-focused coping strategies, and smartphone dependence in the relationship between stress and sleep quality.

Methods

From October 2023 to April 2024, we conducted three surveys with 426 university students and utilized structural equation modeling to explore the mechanisms by which stress impacts sleep quality.

Results

Stress not only significantly predicts sleep quality but also significantly affects sleep quality through rumination, emotion-focused coping strategies, and smartphone dependence as independent mediators. Additionally, stress influences sleep quality through both dual-mediation and triple-mediation paths.

Conclusion

Stress has a significant direct and indirect impact on sleep quality. This study reveals the complex mechanisms through which stress affects sleep quality. Improving individuals' sleep quality requires not only considering the influence of real-life stressors but also examining the intersecting effects between stress and factors such as ruminative thinking, social anxiety, smartphone dependency, and emotion-focused coping strategies. The intense social competition in Chinese society exacerbates the decline in sleep quality, highlighting the need for the government to implement more policies aimed at maintaining the physical and mental health of the population to alleviate the increasingly severe sleep issues and mental health crisis.

The relationship between childhood trauma and mental health status among Chinese vocational high school adolescents: the mediating effect of poor self-control and internet addiction

BACKGROUND

Mental health problems among adolescents are a common concern globally. However, its relationship with childhood trauma is not clearly understood from the existing studies. Therefore, this study aims to explore the relationships among childhood trauma, mental health, self-control, and internet addiction in Chinese vocational high school students.

METHODS

A cross-sectional survey was conducted among vocational high school students in China from October 2020 to December 2020. Standardized questionnaires were used to collect basic information regarding childhood trauma, self-control, psychological state, and social demographics. A structural equation model was used to study the relationships among internet addiction, self-control, childhood trauma, and mental health.

RESULTS

A total of 3368 individuals participated in the study. The results revealed the mediating effects of poor self-control and internet addiction on the association between childhood trauma and mental health.

CONCLUSIONS

Internet addiction and low self-control play mediating roles in childhood trauma and mental health. Clarifying these relationships will help formulate better-targeted interventions to improve the mental health of Chinese vocational high school students and aid in interventions to treat and prevent mental health problems.

Who has the greatest influence on adolescent gaming disorder: parents, teachers, or peers? An interpersonal relationships network model of gaming disorder

Introduction

Gaming disorder (GD) in adolescents is associated with impaired interpersonal relationships, including those with parents, teachers and peers. However, the interpersonal relationships most strongly associated with GD-related maladaptive behaviors are not well established. This study aimed to investigate the associations between these three types of relationships and the manifestation of GD in adolescents.

Methods

In this cross-sectional study, 1920 Chinese adolescents participated in a survey that assessed interpersonal relationships (parent-child, teacher-student, and peer relationships) and demographic variables (e.g., gender, grade, duration of gaming), and 1414 participants were ultimately included. A network analysis approach was utilized to evaluate the key network metrics of edge weight and node centrality.

Results

The findings revealed that peer fear and inferiority (r = 0.12) and teacher-student conflict were most strongly correlated with GD, followed by parent-child conflict (r = 0.09). Peer fear and inferiority exhibited the highest strength centrality (0.84), followed by teacher-student conflict (0.83) and parent-child conflict (0.35). Moreover, the duration of gaming was significantly and positively correlated with GD (r = 0.19).

Conclusions

The present study underscores the significant role of conflict and rejection within interpersonal relationships, particularly among peers, in the manifestation of GD-related behaviors in Chinese adolescents.

Problematic gaming, psychiatric comorbidities, and adolescence: A systematic review of the literature

Problematic gaming is particularly prevalent in adolescent and young adult populations. While numerous studies have investigated the psychiatric comorbidities of Internet Gaming Disorder in young adults, few have focused specifically on adolescents who might be especially at risk because developmental particularities related to this developmental period. Here, we conducted a review of the literature, in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, in order to highlight the types of psychiatric comorbidities found in adolescents with problematic gaming.. We selected and analyzed 30 cross-sectional and longitudinal studies which correspond to 3683 adolescents (63,27% of boys) worldwide with problematic gaming. Our results highlight the high prevalence of Attention Deficit Hyperactivity Disorder (ADHD) in adolescents with problematic gaming and the links between this addiction and inattention, anxiety, depression, behavioural and emotional problems. These psychiatric comorbidities interact with problematic gaming and predict it throughout the adolescent's development. Moreover, this interaction involves personality profile and environment, including parental education. The complexity of this interaction argues in favor of the multi-level assessment that we are promoting.

Investigating Parental Factors for Adolescent Problematic Gaming and Social Media Use - A Cross-sectional and Longitudinal Approach

PURPOSE

Increasing concern has been raised on the addictive potential of digital games and socialmedia platforms, especially in adolescent users. Hence, investigating the etiology of problematic gaming (PG) and problematic social-media use (PSMU) is of great scientific and clinical interest. Parental factors have not been sufficiently addressed yet. Therefore, this study aims to investigate the predictive values of parental demographic, psychological, parenting, and role model factors for adolescent PG/PSMU.

METHODS

In a representative parent-child (10-17 years) sample parental factors and adolescent PG/PSMU were assessed cross-sectionally (Ndyads = 1221) and longitudinally (Ndyads = 659) using online-questionnaires at two measurement points 14 months apart. Parental factors included parental media-use patterns, sociodemographic aspects, (digital) emotion regulation, stress perception, (digital) parental self-efficacy, and media rules. Best subset linear regression models were estimated to identify parental factors with greatest predictive values. These were included in prospective linear regression analyses.

RESULTS

At the cross-sectional level, 18% of model variance predicting PG and 24% predicting PSMU could be explained by parental media-use patterns, media rules, and (digital) parental self-efficacy after controlling for adolescent age. Longitudinally, 33% of variance in the PG model and 34% of variance of the PSMU model could be explained by parental media-use patterns and parental self-efficacy after controlling for adolescent age and baseline PG/PSMU.

DISCUSSION

This study is the first to differentially investigate parental factors in the context of adolescent PG/PSMU in a prospective representative parent-child study. Aspects of digital parental role modeling and parenting could be identified as promising anchors for prevention and treatment.

Family factors related to adolescent screen media use and mental health outcomes: A systematic review and recommendation for practices

INTRODUCTION

Screen media serves an essential role in adolescents' lives, posing growth opportunities and mental health challenges. Family plays a crucial role in mitigating these challenges. This systematic review offers a comprehensive analysis of the family factors related to adolescent screen media use and mental health.

METHODS

A systematic search was conducted in PubMed, CINAHL, PsycINFO, Scopus, and Embase, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the following inclusion criteria: English, peer-reviewed, observational design, and published since 2013; adolescent samples aged 10-17 years; and examining screen media use, family factors, and internalizing problems. The role of family factors as predictors, moderators, and mediators was also examined.

RESULTS

Of the 3587 records, 32 met the inclusion criteria. These studies, primarily cross-sectional, presented a global perspective of 14 countries. A heterogeneous range of family factors, screen media use, and mental health outcomes were examined, revealing significant associations between elevated screen media use and internalizing problems. Positive family processes and democratic media-specific parenting mitigate such association. A few studies underscored family socioeconomic status (SES), noting elevated screen media use and mental health risks among adolescents in families of low SES.

CONCLUSIONS

Accumulating evidence supports the important role of positive family contexts in fostering balanced screen media use and mental health in adolescents, accentuating the need for professional screening and education to promote positive screen media use among adolescents and families. Further research requires refinement in measurement and methodology to better capture the intricate relationship between family dynamics, screen media use, and adolescent mental health.

Sociodemographic Factors Associated with Video Game Addiction in Schoolchildren from the South-Central Region of Chile

Video game addiction is a worldwide concern, particularly in schoolchildren where it has impact on academic, social, and emotional spheres. The objective of this study was to determine the sociodemographic factors associated with video game addiction in schoolchildren from the south-central region of Chile. Methods: An analytical cross-sectional study that included a sample of 308 schoolchildren was performed. Sociodemographic factors were analyzed and levels of video game addiction was assessed using the Video Game Addiction Test (VAT) developed by Chóliz and Marco. A general linear regression model (ANCOVA) (α = 0.05) was applied (STATA v16). The prevalence of video game use was 82.7%, while addiction reached 10%. Risk factors associated with the increased risk of addiction were as follows: being male (β = 13.99; p < 0.001); being in the care of another relative (β = 11.1; p < 0.001); a higher number of people in the household (β = 11.2; p < 0.001); the caregiver in employment (β = 12.8; p < 0.001); and not performing extracurricular physical activity (β = 9.9; p < 0.001).

Effectiveness and Acceptability of Cognitive Behavioral Therapy and Family Therapy for Gaming Disorder: Protocol for a Nonrandomized Intervention Study of a Novel Psychological Treatment

BACKGROUND

Gaming disorder (GD) is a new official diagnosis in the International Classification of Diseases, 11th Revision, and with its recognition, the need to offer treatment for the condition has become apparent. More knowledge is needed about the type of treatment needed for this group of patients.

OBJECTIVE

This study aims to evaluate the effectiveness and acceptability of a novel module-based psychological treatment for GD based on cognitive behavioral therapy and family therapy.

METHODS

This study is a nonrandomized intervention study, with a pretest, posttest, and 3-month follow-up design. It will assess changes in GD symptoms, psychological distress, and gaming time, alongside treatment satisfaction, working alliance, and a qualitative exploration of patients' and relatives' experiences of the treatment.

RESULTS

This study started in March 2022 and the recruitment is expected to close in August 2024.

CONCLUSIONS

This study evaluates the effectiveness and acceptability of a psychological treatment for patients with problematic gaming behavior and GD. It is an effectiveness trial and will be conducted in routine care. This study will have high external validity and ensure that the results are relevant for a diverse clinical population with psychiatric comorbidity.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06018922; https://clinicaltrials.gov/study/NCT06018922.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/56315.

Cognitive, Metacognitive, Motivational, and Emotional Predictors of the Intensity of Internet Gaming Disorder among Adolescents

Internet gaming disorder (IGD) is multifaceted and can have significant negative consequences. The present study examined the contribution of cognitive, metacognitive, motivational, and emotional factors as predictors for IGD severity. In a cross-sectional study, 703 Iranian adolescents (36.8% females, mean age = 16.98 years [SD = 1.23]) completed an online survey. Hierarchical regression analysis showed that the cognitive, metacognitive, motivational, and emotional factors predicted 7.8%, 17.4%, 1.4%, and 1.9% of the variance in IGD symptoms, respectively. The findings indicated that the cognitive factors including some maladaptive cognitions, such as cognitive salience, regret, and perfectionism, and metacognitive factors including some maladaptive metacognitions (negative metacognitions regarding the uncontrollability of online gaming and negative metacognitions regarding the dangers of online gaming) were significant predictors of IGD severity, highlighting their importance in understanding and predicting problematic gaming behaviors. Although contributing to the variance in IGD, motivational factors (escape, coping, and skill development) and emotional factors including emotion regulation (especially reappraisal) played relatively smaller roles compared to cognitive and metacognitive factors. Of the examined predictive factors, metacognitions were the most important predictor of IGD severity. Exploratory moderator analyses showed significant interactions between three predictors of IGD (reappraisal, negative metacognitions, and cognitive salience) with loneliness, stress, anxiety, and depressive symptoms. Reappraisal was the most frequent predictor and had a significant interaction with these variables. Other predictors independently impacted IGD irrespective of the level of loneliness, stress, anxiety, or depressive symptoms. Based on these findings, special attention to metacognitive, cognitive, emotional, and motivational factors is suggested in the treatment of IGD.

Family-based therapy for internet addiction among adolescents and young adults: A meta-analysis

Background and aims

Internet addiction (IA) has been identified as a major public health problem that is more prominent in adolescents and young adults. Some researchers have indicated certain advantages of family-based therapy over other treatments in participants with IA, but no conclusive evaluation has been reported. The present meta-analysis aims to review the efficacy of family-based therapy on Internet addiction in adolescents and young adults.

Methods

Relevant articles published from 1996 to February 15th, 2024, were searched from 14 databases, including three Chinese databases. A total of 19,590 articles were identified using a combination of three sets of search terms (Internet addiction, family therapy, and adolescents). Only RCTs and nonrandomized controlled trials were included.

Results

18 studies, most of which were conducted in Asian countries, were included in the final data analysis. The overall severity of Internet addiction in the family-based therapy group was significantly lower than that in the control group. However, significant heterogeneity was detected. Subgroup analysis showed a beneficial effect of family-based therapy when compared with non-intervention and when added to another psychological or behavioural therapy in psychiatric patients with co-medication. Few studies have examined secondary outcomes or follow-up effects.

Discussion and Conclusions

Family-based therapy is most effective in reducing the severity of Internet addiction when combined with other therapies, especially medication treatments in psychiatric patients. It might also be helpful to relieve depression and enhance family functions, which needs further evidence. More studies following up on the post-intervention effects are recommended in the future.

Examining the association of family environment and children emotional/behavioral difficulties in the relationship between parental anxiety and internet addiction in youth

Introduction

Associations between parental anxiety and adolescent internet addiction have been documented in the literature; however, few studies have analyzed the role of the family environment in this relationship. This study aims to explore the relationship between parental anxiety and adolescent internet addiction while also investigating the indirect relationships involving multiple dimensions of the family environment and child emotional behavior issues.

Methods

Surveys were conducted among 6,296 parent-child pairs. We administered SDQ, CIAS-R, and FES-CV to assess adolescents' issues and internet addiction, and evaluate family environment. Additionally, parents completed GAD-7 to assess parental anxiety levels.Results: Correlation analysis revealed that the family environment and adolescent emotional behavior issues played an indirect relationship in the link between parental anxiety and internet addiction.

Discussion

The findings emphasize the importance of addressing parental anxiety and fostering a positive family environment as effective measures to alleviate adolescent emotional behavior problems and reduce the risk of internet addiction.

Impact of intergenerational conflict on young people and interventions to mitigate its effects: a scoping review

BACKGROUND

Intergenerational conflicts with parents or grandparents have been shown to have adverse effects on young people. Inevitably these conflicts influence the mental health and well-being of young people.

AIMS

The scoping review aimed to identify the extent of existing literature related to intergenerational conflicts in a familial context, including the factors associated with those conflicts and the interventions addressing intergenerational issues.

METHOD

Articles across OVID, PubMed, and ERIC databases on intergenerational conflicts involving youth (10-24), parents, and/or grandparents were identified. The review is reported adhering to PRISMA-ScR guidelines.

RESULTS

From 185 database articles, 43 studies met eligibility criteria, and 4 more were added via cross-referencing, totalling 47. They were grouped into pre-COVID, COVID-related studies, and intervention studies. Parent-child conflict significantly impacted youth mental health, particularly internalising and externalising behaviours. Besides examining the associations, the review addresses the intergenerational conflict in the purview of Gender and cultural differences. Also, a focus on Interventions designed to enhance intergenerational relationships and resolve conflicts was discussed.

CONCLUSIONS

This review illuminates the detrimental impact of intergenerational conflicts within familial dynamics on the mental well-being of young individuals. It also encompasses the distinct landscape of intergenerational conflicts during the COVID-19 pandemic.

The association between anxiety and internet addiction among left-behind secondary school students: the moderating effect of social support and family types

BACKGROUND

The left-behind children (LBC), children and adolescents aged 0-18 whose parents have migrated for economic purposes for extended periods exceeding three months, present a unique social concern. These children remain in their place of household registration, often under the guardianship of relatives, while receiving compulsory education. LBC with growing Internet addiction (IA) have made it urgent to take a close look at the mechanisms and effective interventions for them. Anxiety has been proven to be correlated with IA in adolescents; however, the mechanisms of addiction in this population are less well-fully grasped. Based on the current theories and empirical results, the study examined whether and how social support (SS) and family types moderated the associations between anxiety and IA among left-behind secondary students.

METHODS

Stratified cluster sampling survey. A questionnaire was administered to 5290 secondary school children (2553 classified as left-behind) to explore the relationships between anxiety, IA, left-behind types, family types, and social support. This cross-sectional study employed a stratified cluster sampling survey of students in the ethnic areas of southeast Chongqing. The study sought to appraise the relationships between anxiety and IA in different types of left-behind children and to assess the potential moderating effect of SS on the relationship among the population and its family types differences.

RESULTS

The relationship between anxiety and IA was moderated significantly by social support and family types. Notably, the impact of social support on the moderating effect between IA and anxiety varied among students from both family types. For students from families where both parents had migrated, social support weakened the association between IA and anxiety. Conversely, for students from single-parent families where the parent had migrated, social support seemed to strengthen the relationships between these two issues.

CONCLUSIONS

The moderating effects of SS on the relationship between anxiety and IA differs based on family type among various groups of left-behind secondary students. Gaining insights into the IA mechanisms can guide the development of targeted intervention strategies aimed at minimizing IA among diverse groups of left-behind students.

Parent-adolescent conflict and problematic internet use among Chinese adolescents: the mediating role of depression and the moderating role of school climate

BACKGROUND

Problematic Internet use (PIU) may lead adolescents to physical, emotional, social, or functional impairment due to the risky, excessive, or impulsive internet use manner. How do the experiences of adolescents influence them using the internet in a problematic manner? The answer to this question is the key to preventing and intervening PIU of adolescents. To address this question, we focus on the interactions among family (parent-adolescent conflict), school (school climate), and individual factors (PIU, depression), exploring the influence factors of PIU.

METHODS

A moderated mediation model was constructed to explore the relationship between variables. Using a two-wave longitudinal design with a six-month interval between timepoints, this study collected data from 801 Chinese adolescents (411 boys, Mage = 14.68) by questionnaires. Path analysis was employed to test the model and participants' age, sex and baseline were controlled.

RESULTS

Parent-adolescent conflict at Time 1 (T1) was positively related to PIU at Time 2 (T2) in adolescents. Depression at T2 mediated the relationship between parent-adolescent conflict at T1 and PIU at T2. School climate at T2 significantly moderated the mediation effect of depression on the relationship between parent-adolescent conflict at T1 and PIU at T2. Specifically, positive school climate could significantly weaken the negative effect of depression on PIU for adolescents with low level of depression.

CONCLUSIONS

The present study reveals that parent-adolescent conflict leads to PIU in adolescents through depression whilst the school climate moderates the impacts of depression on PIU. This adds further evidence regarding the significance of systematically and consistently incorporating family and school in the alleviating of problem behaviors displayed by teens.

Personality Traits and Internet Addiction among Adolescent Students: The Moderating Role of Family Functioning

Objectives: Internet addiction is a behavioral addiction characterized by excessive and compulsive use of the internet. The risk of internet addiction among adolescents has risen recently due to an increase in technological advancement and globalization. However, previous studies have focused on the precipitating factors triggering the internet addiction without looking at the exogenous factors and boundary conditions, such as family functioning, that can either sustain or weaken such behavior. Thus, the present study aimed to examine the moderating role of family functioning in the relationship between personality traits and internet addiction among adolescents. Methods: This study is a cross-sectional study consisting of 3150 adolescent students in the grade/class level of JSS1-SS3 who were assessed with standardized measures of the Big-Five Personality Inventory, Internet Addictive Test, and Family APGAR Index. Pearson correlation was used to explore the bivariate relationships between the demographic variable and other variables of interest, while Hayes regression-based PROCESS macro for SPSS was used to test the Hypotheses. Results: (1) Openness to experience, conscientiousness, extraversion, and neuroticism positively correlated with internet addiction, whereas agreeableness was negatively associated with internet addiction. (2) Positive family functioning correlated negatively with internet addiction. (3) Positive family functioning moderated the relationships of extraversion and agreeableness with internet addiction but not on openness to experience, conscientiousness, and neuroticism with internet addiction. Conclusions: Positive family functioning correlated negatively with internet addiction among adolescents, suggesting that improving family functioning would be a valuable tactic for reducing adolescents' susceptibility to personality-related internet addiction.

Problematic usage of the internet among Hungarian elementary school children: a cross-sectional study

INTRODUCTION

Problematic usage of the internet (PUI) is perhaps one of the most frequently studied phenomena of the 21st century receiving increasing attention in both scientific literature and the media. Despite intensive research there have been relatively few meaningful studies among elementary school students in Hungary and worldwide, who may be considered as a high-risk population with regard to problematic internet use. The aim of our study was to carry out a complex research focusing on the prevalence and risk factors of PUI among elementary school children aged 10-15 years (Grade 5-8).

METHODS

Demographics included were gender, age, place of stay, type of residence, family type, parental education, start of internet use, used devices, daily internet use, purpose of internet use, internet accounts, ways of keeping in touch with friends and sporting activities. PUI was evaluated using the paper-based version of the Potentially Problematic Use of the Internet Questionnaire.

RESULTS

Overall, 2000 paper-based questionnaires were successfully delivered and the final analysis included 1168 responses (overall response rate 58.4%). Mean age was 12.55 ± 1.24 years. Female gender (OR = 2.760, p = 0,006, CI 95% 0.065 to 0.384), younger age (11-12 years) (OR = 3.812, p < 0.001, 95% CI: 1.747-4.731), early exposure to the internet (OR = 3.466, p = 0.001, 95% CI 1.535-5.446), living in a small village (OR = 1.081, p = 0.002, 95% CI 1.041-1.186) urgency to answer online (OR = 4.677, p < 0.001, 95% CI: 2.714-6.639), decreased frequency of personal contact with friends (OR = 2.897, p = 0.004, 95% CI: 1.037-1.681), spending more than 6 h online (OR = 12.913, p < 0.001, 95% CI: 10.798-14.892), morning and nighttime internet use (OR = 3.846, p < 0.001, CI 95% 1.886-5.810) and never doing any sports (OR = 2.016, p = 0.044, 95% CI: 1.050-3.354) were independently associated with problematic internet use.

CONCLUSIONS

Based on the results of our questionnaire survey more than 10% seemed to be problematic users in our study population, which is a relatively high rate. Early exposure to the internet as well as younger age were strongly related to this phenomenon. Duration of being online as well as daily time interval of internet use are important predisposing factors. Scarcely studied social factors such as being online at the expense of personal relationships and the lack of physical activity should be payed more attention to prevent the development of PUI.

Intergenerational Transmission of Mental Health Literacy and Its Mechanism: The Mediating Effect of Parent-Child Relationship and the Moderating Effect of School Mental Health Service

Background

Adolescents' mental health literacy is a topic of growing interest and studies have begun to explore the factors that influence adolescents' mental health literacy. This study investigated the relationship between parents' mental health literacy and adolescents' mental health literacy, as well as the mediating roles of parent-child relationship, and the moderating roles of school mental health service.

Methods

Questionnaires were distributed to adolescents and their parents at two time points with an interval of one month. In the first survey, 835 parents completed a mental health literacy scale and a parent-child relationship scale. In the second, 841 adolescents completed a school mental health service questionnaire and an adolescent mental health literacy assessment questionnaire. A total of 617 paired data points were matched (parents' age: M = 40.47, SD = 5.10; adolescents' age: M = 13.34, SD = 0.99).

Results

Bootstrapping results showed that parents' mental health literacy was positively associated with adolescents' mental health literacy. In addition, parent-child intimacy mediated the relationship between parents' mental health literacy and adolescents' mental health literacy. School mental health service moderated the relationship between parents' mental health literacy and parent-child intimacy and adolescents' mental health literacy.

Conclusion

Intergenerational transmission of mental health literacy from parents to adolescents and its conditions were revealed. These findings provide new insights for the intervention of adolescents' mental health literacy, and may lead future research to investigate the role of parents within the family context, as well as the influence of home-school cooperation on adolescents' mental health literacy.

Measurement Invariance of the Lemmens Internet Gaming Disorder Scale-9 Across Age, Gender, and Respondents

Although Internet gaming disorder (IGD) has gained increased attention in scientific, clinical, and community contexts, there is still a lack of consensus regarding the best assessment tools (i.e., self-report or other reports) for assessing its symptoms. The present study aimed to investigate the reliability, validity, and measurement invariance of both versions (youth and parent) of The Lemmens Internet Gaming Disorder Scale-9. To achieve this goal, we recruited between June and October 2019 from five Romanian highschools a total of 697 adolescents (11-19 years old) and one of their parents (N = 391). The internal consistency was good in both versions of the instrument (α = 0.772 for the youth version and α = 0.781 for the parent version). Construct validity assessed through confirmatory factor analysis showed support for the one factor structure of the scales, while multigroup confirmatory factor analysis endorsed the invariance across age, gender, and respondents (i.e., parent vs. youth report). The current research identifies both IGD scales to be reliable and valid, arguing for their utility for assessing IGD symptomatology among adolescents. Implications for theory, assessment, and future directions are discussed.

The Effects of Equine-Assisted Learning on Adolescents with Internet Gaming Disorder

During the COVID-19 pandemic, internet gaming became more popular as a way to cope with stress, but excessive gaming can lead to mental health issues like internet gaming disorder (IGD). IGD has serious consequences, especially among children and young adults, and the gaming industry's profits continue to grow. This study aims to understand the mental and behavioral health of adolescents with IGD participating in an equine-assisted learning (EAL) program and assess the changes in their addiction tendencies and emotional and behavioral problems. The results showed that the participants' tendency towards internet gaming addiction and emotional and behavioral problems decreased immediately after the EAL program, but they rose again a month later. This suggests the importance of ongoing program involvement. As COVID-19 restrictions ease worldwide, this study highlights the increasing risk of IGD. It suggests that EAL could be a valuable approach to treating behavioral addictions, including gaming addiction. While prior research has shown the effectiveness of EAL in treating substance addiction, more research is needed to explore its potential in treating various types of addictions, such as gambling or gaming addictions.

The vicious cycle of family dysfunction and problematic gaming and the mediating role of self-concept clarity among early adolescents: A within-person analysis using random intercept cross-lagged panel modeling

Backgrounds and aims

Family dysfunction is a significant risk factor for adolescent problematic gaming, yet few studies have investigated the bidirectional relations between changes in family dysfunction and adolescent problematic gaming and potential mediating mechanisms. This study thus examined the bidirectional relations between family dysfunction and adolescent problematic gaming and the mediating role of self-concept clarity within this relation.

Methods

Participants included 4,731 Chinese early adolescents (44.9% girls; M age = 10.91 years, SD = 0.72) who were surveyed at four time points 6 months apart.

Results

Random intercept cross-lagged panel modeling found (a) family dysfunction directly predicts increased problematic gaming, (b) adolescent problematic gaming directly predicts increased experience of family dysfunction, (c) family dysfunction indirectly predicts problematic gaming via self-concept clarity, and (d) adolescent problematic gaming indirectly predicts family dysfunction via self-concept clarity.

Discussion and conclusions

The present study suggests that adolescents may be trapped in a vicious cycle between family dysfunction and problematic gaming either directly or indirectly through impairing their self-concept clarity. Findings indicate fostering youth self-concept clarity is essential to break the vicious circle between dysfunctional experiences in the family and problematic gaming among adolescents.

How does parents' psychological distress relate to adolescents' problematic gaming? The roles of parent-adolescent relationship and adolescents' emotion regulation

Background and Aims

Emerging research has identified parents' psychological distress as a potential risk factor that increases adolescents' vulnerability to problematic gaming. This study attempted to address "why" from a relational perspective. We hypothesized that parents' psychological distress may link to adolescents' problematic gaming through the mediation of parent-child relationship quality, while the mediating effects of parent-child relationship quality may vary depending on adolescents' emotion regulation.

Methods

We collected data from 4,835 parent-child dyads in China (parental age = 41.45 ± 4.53 years; adolescent age = 13.50 ± 1.00 years). Structural Equation Modeling (SEM) was utilized to analyze the relationships among the variables under study.

Results

Parent-reported parental depression/anxiety was related to worse adolescent-reported parent-child relationship, which in turn related to more severe adolescent-reported problematic gaming. Moreover, the mediating effects of parent-child relationship quality were weaker when adolescents used more expressive suppression (but not cognitive reappraisal).

Discussion and Conclusions

The findings of this study highlight the need to consider both parent-child relationships and adolescents' active role in their own emotion regulation in order to understand parental influence on adolescent problematic gaming.

Cognitive Patterns and Problematic Use of Video Games in Adolescents: A Cluster Analysis

BACKGROUND

Video game playing (VGP) is an increasingly common leisure activity among children and adolescents, although in some cases, it is accompanied by problems due to misuse.

METHOD

A sample of 2884 children and adolescents aged between 12 and 20, representative of the Community of Madrid (Spain), were studied using a cluster analysis to explore the existence of cognitive patterns associated with engagement, attitudes, and concurrent cognitions. We also explored the relationship between these patterns and problematic VGP, using the 2173 gamers as a reference.

RESULTS

The concurrent cognitions were not qualitatively different between the problematic users and the others. High engagement and high activation of concurrent cognitions (intensity and frequency) showed the greatest relationship with problematic VGP.

CONCLUSIONS

The results suggest the existence of different groups of gamers and the relevance to include psycho-educational aspects in intervention programs, as well as the training of specific skills, especially those related with the control of activation. Limitations related to the sample size and potential supplementary analyses are acknowledged.

Parental rejection and control: Potential risks for excessive Internet usage among adolescents

BACKGROUND

Internet addiction is an emergent health hazard among adolescents, especially after COVID19. Parenting factors in a family environment specifically, have potential roles in either causing excessive internet usage, or in protecting teenagers from internet addiction.

AIM

The aim of the study was to understand factors in parent-adolescent relationship that determine low and excessive internet usage.

METHODS

A total of 102 adolescents within the age group of 13 to 18 years from two different schools in urban Bengaluru, India were recruited. Data was collected using three instruments namely semi structured tool to assess socio-demographic characteristics, Young's internet addiction test for internet usage and parental bonding instrument for adolescent perception about parenting dimensions.

RESULTS

Half of the participants were found to have mild to severe levels of internet addiction, and the remaining half had normal levels of internet usage. The results showed that decreased care and increased control from the mother, high autonomy from father and increased rejection from both parents as risk factors associated with adolescent internet excessive use. No other significant associations were found between adolescents' demographic, academic, peer and school profile and their internet addiction.

CONCLUSION

As internet has become an inevitable part of our life, parent-adolescent relationship forms an essential moderating factor in adolescents' internet usage.

The epidemiology and effects of video game addiction: A systematic review and meta-analysis

With the increasing popularity and accessibility of video games, the public concern about their effects - positive and negative - has also increased. In this regard, this systematic review sought to identify and thematically analyze recent studies (in the last five years) and report on video games' epidemiological characteristics and outcomes. A systematic database search was done on ScienceDirect, APA PsycINFO, Emerald, and Scopus databases for articles published from January 1, 2017, to April 1, 2022. The Meta XL software - an add-in for Microsoft Excel - was used to calculate the pooled prevalence level of video game addiction. The database search yielded a total of 693 non-duplicate articles. After applying the inclusion and exclusion criteria, 27 articles were selected to be included in the systematic review. Along with this, 12 articles were considered for the final meta-analysis. The pooled prevalence level of gaming addiction was 5.0 % (95 % CI, 2.1-8.8 %). The I2 value was 99.297 with a p-value of 0.000. The factors that accompanied addictive video gaming were psychological, social, and personal. An addictive gaming behavior was characterized by spending an above-average time on gaming, doing most of the gaming online, and gaming activities interfering with sleep patterns. Some predictors of addictive gaming were emotional dependence, social detachment, increased gaming time, preference for playing online than offline, and increased emotional and psychological stress. Engaging in addictive gaming led to adverse outcomes such as lower academic scores, depression, and anxiety, as well as decreased self-esteem, life satisfaction, and social support. From the collected findings it could be concluded that extreme playing of video games can be classified as addictive. Following the identification of risk factors, appropriate corrective or interventional measures should be developed and applied coherently to newer statistical data.

Assessment and Diagnostic Classification Using DC:0-5 in Early Childhood Mental Health Clinics: The Protocol for the Developmental Psychiatry Diagnostic Challenges Study (DePsy)

Mental health problems in early childhood are common, but there is a lack of psychiatric research on this age group. DC:0-5 is a multiaxial classification system for mental disorders in early childhood, providing a framework for standardizing clinical practice and research. However, research on the validity of DC:0-5 is scarce. The Developmental Psychiatry Diagnostic Challenges Study (DePsy) is a multi-site, prospective clinical study including six German early childhood mental health (ECMH) clinics. The main objective of the study is to contribute to the validation of Axis I and Axis II of DC:0-5. A second aim of the study is to describe the population of the participating clinics regarding diagnoses, family context, and treatment outcomes. Additionally, the impact of environmental risk factors, including parental Adverse Childhood Experiences (ACEs) and media use, on child psychopathology and caregiver-child relationships will be examined. Over two years, patients aged 0.0-5.9 years old will be enrolled in the study. Assessments include ICD-10 and DC:0-5 diagnoses, developmental tests, video-based observations of caregiver-child interactions, and questionnaires on child psychopathology, media use, parental stress, and treatment satisfaction. Study results will promote the standardization of assessment and treatment in ECMH clinics aiming to improve the development of patients and their families.

Investigating the Effectiveness of Modifying the Parent-Child Interaction Pattern Based on Filial Play Therapy on Internet Addiction, Sleep Quality, and Self-efficacy in 9-12-Year-Old Children

Background

Despite all the positive features of the internet, the risk of addiction threatens users. Sleep disorders and the negative effects on self-efficacy are important risks of this technology. Accordingly, the present study aimed to investigate the effectiveness of modifying the parent-child interaction pattern based on play therapy (filial therapy) on internet addiction, sleep quality, and self-efficacy in 9-12-year-old children.

Methods

This quasi-experimental study was conducted using a pre-test-post-test design with a control group. The statistical population of the study consisted of all 3617 boys and girls aged 9-12 years studying in selected schools in Kerman, Iran (12 elementary schools) in the academic year 2020-2021. A total of 72 students were randomly selected from among the children who met the benchmark score of internet addiction and were not under medical and psychological treatment. The participants were divided into two experimental and control groups (36 students each). A demographic information questionnaire, the Internet Addiction Scale (YIAS), the Self-Efficacy Questionnaire for Children (SEQ-C), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. Data were analyzed using SPSS software.

Findings

The mean scores of internet addiction in the pre-test and post-test were 86.67 and 86.23 in the control group and 88.14 and 75.14 in the experimental group, respectively, which showed a decrease in internet addiction. The scores of sleep quality in the pre-test and post-test were 1.81 and 1.78 in the control group and 1.75 and 0.5 in the experimental group, respectively. Moreover, the overall scores of self-efficacy in the pre-test and post-test were 63.64 and 63.94 in the control group and 62.08 and 81.75 in the experimental group, respectively. The results indicated an improvement in the overall quality of sleep and selfefficacy.

Conclusion

The results showed that the severity of internet addiction in children decreased after the treatment based on modifying the parent-child interaction, and this treatment was also effective on self-efficacy and sleep disorders.

Association Between Family Atmosphere and Internet Addiction Among Adolescents: The Mediating Role of Self-Esteem and Negative Emotions

Objectives: Family atmosphere is a significant predictor of internet addiction in adolescents. Based on the vulnerability model of emotion and the compensatory internet use theory, this study examined whether self-esteem and negative emotions (anxiety, depression) mediated the relationship between family atmosphere and internet addiction in parallel and sequence. Methods: A total of 3,065 Chinese middle school and high school students (1,524 females, mean age = 13.63 years, SD = 4.24) participated. They provided self-reported data on demographic variables, family atmosphere, self-esteem, anxiety, depression, and internet addiction through the Scale of Systemic Family Dynamic, Self-Esteem Scale, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Internet Addiction Test, respectively. We employed Hayes PROCESS macro for the SPSS program to scrutinize the suggested mediation model. Results: It revealed that self-esteem, anxiety, and depression mediated the relationship between family atmosphere and internet addiction in parallel and sequence. The pathway of family atmosphere-self-esteem-internet addiction played a more important role than others. Conclusion: The present study confirmed the mediating role of self-esteem and negative emotions between family atmosphere and internet addiction, providing intervention studies with important targeting factors.

Development and validation of the resource loss due to reduction in gaming time scale among adolescent internet gamers in China

BACKGROUND

Adolescent internet gaming disorder (IGD) is prevalent and positively associated with gaming time, a reduction of which is a common means of IGD prevention/treatment. Personal/interpersonal resource losses due to the reduction in gaming time (RL-RGT) are plausible. According to the Conservation of Resource (COR) theory, RL-RGT may cause mental distress and maladaptive behaviors. No study has investigated such relationships, partially due to the lack of validated tools assessing RL-RGT. This study aimed to develop and validate such a scale (RL-RGTS).

METHODS

A cross-sectional survey was conducted in four secondary schools in Guangzhou, China (October to December 2019). Secondary school students who had played internet games in the last 12 months participated in this study (n = 944), irrespective of their IGD status and intention to reduce gaming time. Using a deductive approach, an expert panel generated the 19 scale items. The half-split method was used to conduct exploratory and confirmatory factor analyses.

RESULTS

The prevalence of IGD and intention to reduce gaming time were 10.9% and 74.2%, respectively. The exploratory and confirmatory factor analyses identified a 2-factor model (personal loss and interpersonal loss). Psychometric properties (internal consistency, no ceiling effect, and concurrent validity) were satisfactory, but noticeable floor effects were observed.

CONCLUSIONS

The RL-RGTS could be applied to understand potential side effects and obstacles regarding interventions reducing IGD through reducing gaming time. The findings support the COR theory and extend its applications to internet gaming research. Validations in other populations are warranted.

"I have no control over how much time I play" the metacognitions about online gaming scale: Evidence from a cross-cultural validation among Israeli adolescents

In the current study we evaluated the psychometric properties of the Metacognitions about Online Gaming Scale (MOGS), including its factor structure, reliability, and predictive validity among Israeli adolescents in a six-month prospective study. We also examined the usefulness of the MOGS as a mediator of the effect of attachment patterns on Internet Gaming Disorder (IGD), the preference for online social interactions, and the motives for online gaming. The study population included 1,056 Israeli adolescents (610 males and 446 females, M = 15.77, standard deviation (SD) = 1.43) with an age range of 13-18 years. The participants completed the translated Hebrew version of the MOGS and measures on attachment style, IGD, preference for online social interactions, emotion regulation, and motives for online gaming. The analyses indicated that the factorial structure of the Hebrew MOGS comprised the expected two factors at T1 and T2 (a six-month follow-up). We also found that positive and negative metacognitions significantly mediated the effect of attachment styles on IGD, the preference for online social interactions, and the motives for online gaming. The findings provide evidence that the Hebrew MOGS among Israeli adolescents appears psychometrically appropriate for use by researchers and practitioners dealing with the prevention and treatment of IGD.

Masters of Media: A longitudinal study of parental media efficacy, media monitoring, and child problematic media use across early childhood in the United States

The development of problematic media use in early childhood is not well understood. The current study examined long-term associations between parental media efficacy, parental media monitoring, and problematic media use across a three-year period of time during early childhood. Participants included 432 parents who reported on their own parenting and their child's use of problematic media once a year for three years (M age of child at Wave 1 = 29.68 months, SD = 3.73 months). Results revealed that early parental media efficacy predicted lower levels of child problematic media use over time. Restrictive media monitoring was also related to lower levels of child problematic media use over time. Additionally, general parental efficacy was related to parental media efficacy and lower child problematic media use, both at the cross-sectional and longitudinal levels. Discussion focuses on encouraging early parental media efficacy (and exploring other potential mechanisms) as a way to mitigate the development of problematic media use over time.

Association between the Internet Gaming Disorder and Anxiety and Depression among University Students during COVID-19 Pandemic

Introduction: Internet gaming is now a major concern since its overuse has had a detrimental impact on people's well-being. This study aims to investigate the association between Internet Gaming Disorder and depression, anxiety, and stress, as well as gaming elements during the COVID-19 pandemic, among university students. Methods: The cross-sectional study involved 213 students from two different institutions who were randomly selected. The participants were required to complete three sets of online questionnaires via Google Forms. The online questionnaire consists of the Internet Gaming Disorder Scale-Short Form (IGD9-SF) and the Depression, Anxiety, and Stress Scale (DASS-21). Results: The prevalence rate of IGD among university students during the COVID-19 pandemic was 9.86%. Bivariate analysis revealed biological sex (p-value = 0.011), preferred gaming platforms (p-value = <0.001), game gameplay (p-value = 0.03), history of substance use (p-value = <0.001), and stress (p-value = <0.001) to be associated with IGD. Meanwhile, binary logistic regression demonstrated that males have a higher risk of developing IGD compared with females (adjusted odds ratio (AOR) = 3.426, p-value 0.015, CI = 1.27-9.21). Students who used consoles as their preferred gaming platform were 13 times more likely to develop IGD in comparison to another platform (AOR = 13.031, p-value = 0.010, 95% CI = 1.87-91.02). Extensive gaming duration of more than 4 h a day showed a higher risk of developing IGD (AOR = 8.929, p-value 0.011, CI = 1.659-48.050). High-stress levels significantly increased the risk of IGD (AOR = 13.729, p-value = 0.001, 95% CI = 2.81-67.1). Conclusion: The prevalence of IGD among university students was high during the COVID-19 pandemic. Thus, interventions for reducing stress among university students should be implemented to reduce the risk of IGD.

Gaming disorder: A summary of its characteristics and aetiology

The emergence, development, and maintenance of gaming disorder (GD) is the result of an interplay between gaming-related factors, individual factors, and environmental factors. None of these alone are sufficient to cause a disordered state, but it is the interactive co-occurrence of all these factors, which in some cases leads to GD. The goal of the present paper is to discuss in detail these three factors based on relevant and recent findings of the literature. Among gaming-related factors, we discuss online vs. offline videogames, the role of game genres, structural characteristics, game design elements, as well as some important monetization techniques. Among individual factors demographic risk factors, personality traits, motivational factors, comorbid psychopathology, genetic predisposition, and neurobiological processes are considered. Finally, among environmental factors we discuss family factors, early life experiences, the role of peers and school-related factors, as well as the broader context of culture including the popularity of esports.

Impact of Coding Educational Programs (CEP) on Digital Media Problematic Use (DMPU) and on Its Relationship with Psychological Dependence and Emotional Dysregulation

Alongside the positive effects linked to the introduction of digital technologies into our lives, particular dysfunctional behaviors in the use of digital tools have appeared, through which the expression of conditions such as addiction, difficulties in affective and behavioral self-regulation and mental health problems have been channeled. The present study aims to investigate, in a sample of young students aged m = 12.91 (ds = 0.56) years, whether Coding Educational Programs (CEP), deployed to 44.9% of the sample, is effective in psychological dependence, emotional self-regulation and Digital Media Problematic Use (DMPU), as self-assessed through questionnaires (DERS, DSRS, IAT, MPIQ and MPPUS). CEP had no effect on emotional dysregulation or on DMPU. They were effective in the time management of mobile phone use, with students rescheduling from daytime use on working days to daytime use on the weekend. Moreover, people who attended CEP more frequently used smartphones for orienting themselves and for obtaining information. In conclusion, CEP are effective in achieving a more functional and important use of smartphones and better time management. It is possible that CEP effect on metacognition could reduce DMPU if alternative ways to regulate emotions are available.

Adverse childhood experiences and sleep disorders among Tunisian adolescents: The mediating role of internet addiction

BACKGROUND

Adverse childhood experiences (ACEs) are a prevalent health problem worldwide. Different side effects have been linked to this issue such as sleep disorders. This matter is well known. However, its influencing mechanisms are not well investigated in literature.

OBJECTIVE

To investigate the mediating role of internet addiction in the relation between adverse childhood experiences (ACEs) and sleep disorders among a population of high-school students in the region of Gafsa (Tunisia).

PARTICIPANTS AND SETTING

We performed a cross-sectional study, in February 2020, including adolescents registered in all secondary schools of Gafsa city.

METHODS

Sleep disorders were evaluated via the Pittsburgh Sleep Quality Index, internet addiction via the Internet Addiction Test and adverse childhood experiences via the Adverse Childhood Experiences-International Questionnaire.

RESULTS

A total of 414 students were enrolled in our study with a mean age of 17.18 ± 1.5 years. Exposure to intra-familial violence was more reported than social adversities with 99.1 % and 84 % respectively. Males showed higher rates of internet addiction (82.9 % vs 78.3 %, p < 0.001). Sleep disorders were reported in 94 % of students, predominantly among females (95.4 % vs 91 %, p < 0.001). Our results revealed that ACEs predict sleep disturbances through internet addiction (% mediation =18.3 %, p = 0.005). More particularly, an important mediation effect of internet addiction on the relationship between ACEs and sleep disorders was found among females (% mediation =30 %).

CONCLUSION

Internet addiction was found to be a mediating factor in the relation between ACEs and sleep disturbances among Gafsa high school students.

The Relationship Between Digital Game Addiction and Loneliness and Social Dissatisfaction in Adolescents

Background In this study, it was aimed to examine digital addiction, loneliness and social dissatisfaction among adolescents studying in Adıyaman, Turkey, and to determine the relationship with each other. Methodology Digital Game Addiction Scale for Children (DGASFC) and Loneliness and Social Dissatisfaction Questionnaire (LSDQ) were administered to 634 middle and high school students. A questionnaire form was used as a data collection tool. Results DGASFC scores and LSDQ scores were found to be higher in males, in high school students, in those whose parents' education level was high school or above, in those whose parents lived separately, in those with good economic status, in those who were younger, and in those who were not restricted by their families. A significant positive correlation was found between DGASFC and LSDQ scores. Conclusions Digital addiction should be followed closely in terms of accompanying disorders or pathologies that predispose to it. In our study, it was found that digital game addiction, loneliness and social dissatisfaction decreased with age. However, this applies separately to middle school and high school groups. Because, despite their older age, high school adolescents have been found to be more digitally dependent, lonely and socially dissatisfied than secondary school students. Contrary to the studies in the literature, the risk of digital addiction, loneliness and social dissatisfaction was found to be low in those with low economic status.

The effect of solution-focussed education and counselling on problematic internet usage, sleep quality and school achievement: A randomized controlled trial

AIM

The aim of this study was to determine the effects of solution-focussed education and counselling on problematic internet usage, sleep quality and school achievement.

METHODS

This randomized controlled trial was conducted between January - December 2016 with 44 adolescents who participated in a solution-focussed intervention to address their problematic internet usage and poor sleep quality. After the intervention, the teens were followed up for 6 months to measure problematic Internet usage, sleep quality and school achievement using the Internet Addiction Test, Pittsburg Sleep Quality Index, Parent-Child Internet Addiction Scale and the students' end-of-term school grades. Data were analysed in Statistical Package for the Social Sciences programme using Chi-square test, Independent t test, Man-Whitney U test, Friedman test and Spearman correlation analysis.

RESULTS

The median Internet Addiction Test and Pittsburg Sleep Quality Index scores of the adolescents in the intervention group were significantly lower than those of the controls (P < 0.05), and there was a positive and moderate association between problematic Internet usage and sleep quality in both groups after the follow-up (r = 0.537, P = 0.010; r = 0.576 P = 0.005).

CONCLUSION

The education and counselling intervention decreased problematic Internet usage and increased sleep quality. There was also an improvement in school achievement, but the difference was not significant.

Prevalence and Possible Predictors of Gambling Disorder in a Sample of Students in the Healthcare Professions

The Italian version of the South Oaks Gambling Screen questionnaire (SOGS) and a socio-demographic questionnaire were administered to a sample of 275 healthcare professions students aged 19 to 58 years (mean age = 22.17; females = 81.1%) to address the research objectives: to examine the prevalence and correlates of problem gambling in a population of university healthcare professions students in Italy. Among the sample, 8.7% (n = 24) of participants showed problem gambling and 1.5% (n = 4) pathologic gambling. Lottery and scratch cards were the most frequent type of gambling in the sample, followed by cards and bingo. Compared to females, males tend to be more involved in problem gambling and pathological gambling. Males tend to be more involved than females in different types of gambling (such as cards, sports bets, gambling at the casino). Pathological gambling is positively associated with gender, being students lagging behind the regular schedule of exams and parents' level of education. These findings have important implications in terms of prevention and intervention on gambling and pathological gambling. Universities should make available educational programs and counselling services to address this issue.

Children's mobile-gaming preferences, online risks, and mental health

This study examined the relationships between children's mobile gaming preferences, online risks, and mental health. Data were obtained from a sample of 2,702 third and fourth grade students from 16 elementary schools in Taiwan and 9 schools in China. A self-administered questionnaire was used. The mental state of the children who participated in the study was assessed using the Strengths and Difficulties Questionnaire (SDQ), while mobile gaming addiction was assessed using the short form of the Internet Gaming Disorders Scale (IGDS9-SF). The results showed that about 54% of children played mobile games with others (multi-player), while 31% played mobile games alone, and 15% did not play mobile games. Multiple logistic regression results indicated that behaviors such as participating in multi-player games, playing violent games, a poor parent-child relationship, and living in a rural area were associated with a greater risk of mobile gaming addiction. Involvement in multi-player games, playing violent games, mobile gaming addiction, and exposure to mobile violence/pornography were associated with greater risks of cyber aggression/victimization. Multiple regression results showed that being a multi-player, playing violent games, mobile gaming addiction, exposure to violence/pornography, exposure to cyber aggression/victimization, and having a poor parent-child relationship were associated with emotional and behavioral problems.

Psychological treatments for excessive gaming: a systematic review and meta-analysis

Despite widespread public interest in problematic gaming interventions, questions regarding the empirical status of treatment efficacy persist. We conducted pairwise and network meta-analyses based on 17 psychological intervention studies on excessive gaming (n = 745 participants). The pairwise meta-analysis showed that psychological interventions reduce excessive gaming more than the inactive control (standardized mean difference [SMD] = 1.70, 95% confidence interval [CI] 1.27 to 2.12) and active control (SMD = 0.88, 95% CI 0.21 to 1.56). The network meta-analysis showed that a combined treatment of Cognitive Behavioral Therapy (CBT) and Mindfulness was the most effective intervention in reducing excessive gaming, followed by a combined CBT and Family intervention, Mindfulness, and then CBT as a standalone treatment. Due to the limited number of included studies and resulting identified methodological concerns, the current results should be interpreted as preliminary to help support future research focused on excessive gaming interventions. Recommendations for improving the methodological rigor are also discussed.