Problematic video game use as an emotional coping strategy: Evidence from a sample of MMORPG gamers

Exploring Differences in Four Types of Online Activities Across Individuals with and without Problematic Smartphone Use

Studies on problematic online activities commonly focus on one type of online activity, such as social media. However, individuals often use their Smartphones for more than one online activity. This study examined four types of online activities (social networking, gaming, information acquisition, and short-form video viewing). Based on a combinatory assessment of problematic smartphone use and hours spent online, two groups were created from a larger sample (N = 642): a problematic smartphone user group (PSU; N = 230; F = 72%; Age = 24.99 ± 6.60) and a non-problematic smart phone user group (NPSU; N = 87; F = 62%; Age = 30.49 ± 10.22). As compared to the NPSU group, the PSU group engaged in more social networking, gaming, information acquisition, and short-form video seeing. The PSU group also scored higher on psychological distress, sleep disturbance, fear of missing out, metacognitions about Smartphone use (MSU), desire thinking (DT), and lower on satisfaction with life and cognitive reappraisal. Regression analyses were employed to probe correlates of each online activity among the PSU and NPSU groups. The findings are discussed in light of the metacognitive model of addictive behaviors and future directions are provided concerning the challenges of distinguishing individuals for problematic Internet-related behaviors.

Emotional regulation in Gaming Disorder: A systematic review

BACKGROUND AND OBJECTIVES

Problematic video game use is a source of concern. In addictions, difficulties with emotional regulation have become an important variable of interest. However, their study in relation to problematic video game use remains insufficient.

METHODS

A systematic review was conducted following PRISMA 2020 guidelines; 322 studies were screened, resulting in a final sample of k = 18 studies. The methodological quality of these studies was rated as moderate according to the McMaster Critical Review Form for Quantitative studies (CRF-Q).

RESULTS

There is evidence of relationship between different facets of emotional regulation and the presence of problematic video game use. Particularly, video games serve as escape strategy for suppressing emotional expression. There is no consensus regarding the nature of the relationship between emotional regulation, psychopathology, and problematic video game use, with various proposals suggesting moderation and mediation. There is also no consensus regarding the mediation of gender in the relationship between emotional dysregulation and problematic video game use. The level of certainty regarding the validity of the results was moderate.

DISCUSSION AND CONCLUSIONS

Emotional dysregulation plays a role in problematic video game use, especially through strategies as emotional suppression, and lack of abilities to understand and control emotions. It is important to consider emotional regulation as a potential target for research and intervention in clinical populations.

SCIENTIFIC SIGNIFICANCE

We review the largest sample of papers on problem gaming and emotion regulation to date. Our results highlight the importance of emotion regulation and, specially, emotional suppression, or negative escapism, on problematic video game use.

High immersion/escapism motivation makes gaming disorder risk less dependent of playtime among highly engaged male gamers

In the realm of gaming-related concerns, the relationship between gaming time (GT) and gaming disorder (GD) remains an intriguing and complex subject. Although increased GT is not a reliable predictor of GD risk, the circumstances under which this relationship strengthens or weakens remain relatively unknown. This study explores the roles of immersion/escapism motive (IEM) and GT in the context of GD among highly engaged gamers (N = 294), each dedicating a minimum of 20 hours weekly to gaming. The findings confirm that IEM significantly moderates the relationship between GT and GD in the male sample. Specifically, low and moderate levels of IEM result in a stronger relationship between GT and GD. In the case of women, the effect was not significant. These findings suggest the importance of comprehensive assessments of gaming motivations when addressing gaming-related issues, particularly in GD research. Moreover, they emphasize the value of adopting a complex approach to comprehending the development of problematic gaming behaviors.

The interconnection between social media addiction, alexithymia and empathy in medical students

Introduction

This study explores whether high alexithymia values correlate with low levels of empathy, while also trying to identify potential connections with social media addiction.

Methods

We hypothesized that alexithymia mediates the relationship between social media addiction and empathy levels in a sample of undergraduate students. The study population consisted of 649 medical students in the 4th/5th/6th University year, recruited between March and May 2021. For this assessment, we employed three psychometric instruments: the Toronto Empathy Questionnaire (TEQ), the Social Media Addiction Scale-Student Form (SMAS-SF), and the Toronto Alexithymia Scale (TAS-20). A pathway analysis investigated alexithymia as a mediator between social media addiction and the degree of empathy in medical undergraduates. Sobel's test and the Baron and Kenny approach were used for testing mediation.

Results

The TEQ total mean score was 48.76 ± 5.65, while the TAS-20 total mean score was 47.71 ± 11.49. Further analysis of the TAS-20 scale scores showed that 21.42% of students had possible alexithymia, while 14.02% had clear alexithymia. The SMAS-SF total mean score was 73.20 ± 14.59. None of the students reported levels consistent with major social media addiction. The mediated effect of the TAS-20 is about 1.3 times larger than the direct effect of the SMAS-SF on TEQ.

Discussion

We found a significant negative correlation between empathy and alexithymia in medical students. Alexithymia was a mediator between social media addiction and empathy. Therefore, we recommend further efforts to identify potential levels of alexithymia in medical students, in order to successfully develop tailored interventions aimed at increasing their emotional awareness.

Emotional dysregulation in relation to substance use and behavioral addictions: Findings from five separate meta-analyses

Background/objective

Emotional dysregulation (ED) is a transdiagnostic variable underlying various psychiatric disorders, including addictive behaviors (ABs). This meta-analysis examines the relationship between ED and ABs (alcohol, tobacco, cannabis, gambling, and gaming), and indicators of AB engagement (frequency, quantity/time of use, severity, and problems).

Method

Searches were conducted in PubMed, Scopus, WoS, and PsycINFO. Five separate meta-analysis were run using random-effects models. Moderators (age, sex, continental region, and sample type; community vs. clinical), and publication bias were evaluated.

Results

A total of 189 studies (N = 78,733; 51.29 % women) were identified. ED was significantly related to all ABs. Problems and severity indicators exhibited the largest effects (r's .118-.372, all p <.023). There were larger effect sizes for cannabis problems (r = .372), cannabis severity (r = .280), gaming severity (r = .280), gambling severity (r = .245), gambling problems (r = .131), alcohol problems (r = .237), alcohol severity (r = .204), and severity of nicotine dependence (r = .118). Lack of impulse control exhibited some of the largest effects in relation to ABs. Clinical samples of cannabis users vs. community-based exhibited larger magnitude of associations.

Conclusions

Interventions targeting ABs should address lack of strategies and impulsive behaviors as an emotion regulation strategy specifically, as it is a common risk factor for ABs.

Evaluation of Internet Addiction and Relational Variables Among Nursing Students in Turkey During the COVID-19 Pandemic

It is known that individuals use the internet more to escape from the psychological problems they encounter in daily life during the pandemic. Besides, it is also known that individuals with personality traits such as neuroticism and extraversion might be prone to internet addiction due to poor communication skills. It is important to determine the relationship between the internet usage characteristics and the mental state of nursing students so that students can provide better quality health services in their education and professional processes. The present study aimed to determine the relationship between internet addiction and personality traits, stress, and obsessive-compulsive symptoms among nursing students during the pandemic. This study includes 528 nursing students. The Young's Internet Addiction Test (YIAT), the Vancouver Obsessive-Compulsive Inventory (VOCI), the Eysenck Personality Inventory (EPI), and the Perceived Stress Scale (PSS) were used for data collection between August and October 2021. It was found that there was a statistically significant and positive correlation between the students' YIAT mean scores and the EPI neuroticism sub-dimension, VOCI all sub-dimensions, and PSS mean scores (p < .05). In addition, the mean scores of the PSS and EPI were predictors of the YIAT total score (R = .550, R2 = .233, p < .05). Considering these results, it is necessary to prevent the negative effects of the COVID-19 pandemic on the psychosocial health of individuals. Psychological counseling can be offered to provide protective factors during the pandemic period.

Problematic Internet Use Among Adolescent Male and Female Psychiatric Inpatients: A Gender Perspective

Problematic internet use (PIU) is of treatment interest in adolescent clinical samples. Gender specific differences in terms of personality traits and psychopathological symptoms remain unclear. In an adolescent clinical sample (n = 104; 69 girls) PIU, psychopathology, temperament and character traits as well as emotional and behavioral problems were assessed. 62% of the sample showed subthreshold PIU and 34% full PIU (fPIU). Boys reported more gaming whereas girls social networking. Sex specific analyses revealed gender differences: Girls with fPIU scored significantly higher on internalizing/externalizing problems/behavior, novelty seeking and transcendence, and lower on persistence, self-directedness, and cooperativeness than girls without fPIU. Boys with fPIU scored significantly higher on internalizing problems and self-transcendence and lower on harm avoidance than boys without fPIU. Gender plays an important role in PIU. Gender specific differences in both application use as well as symptomatic, temperament and character traits call for a gender specific approach in prevention and treatment integration.

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

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

The Role of Self-Esteem in Protecting Against Cyber-Victimization and Gaming Disorder Symptoms Among Adolescents: A Temporal Dynamics Analysis

Previous literature has suggested that victimization is linked to low self-esteem and increases the symptoms of gaming disorder. However, little is known about the intra-individual processes, and the temporal dynamics of cyber-victimization, self-esteem, and gaming disorder symptoms. To address this gap, a three-year longitudinal study was performed using data collected at six different time points from 4206 Chinese adolescents (aged 12-17 years; 50.4% boys). Results of random intercept cross-lagged panel models (RI-CLPMs) indicated that at the within-person level, the fluctuation in self-esteem weakly predicted late cyber-victimization, and the fluctuation of cyber-victimization also weakly predicted late self-esteem. Additionally, the current study identified an interactive effect between self-esteem and gaming disorder symptoms at the within-person level. Fluctuations in self-esteem negatively predicted late gaming disorder symptoms, and vice versa. However, when combining the three variables (i.e., cyber-victimization, self-esteem, and gaming disorder symptoms) into one RI-CLPM, the results did not support the mediation of self-esteem in the relationship between cyber-victimization and gaming disorder symptoms at the within-person level. Moreover, fluctuations in self-esteem negatively predicted late gaming disorder symptoms and cyber-victimization at the within-person level in the RI-CLPM. These findings emphasize the protective role of self-esteem developed against cyber-victimization and gaming disorder symptoms among adolescents.

The relationship of game genres, in-game purchases, and playing duration with probable gaming disorder in two independent, large-scale online surveys of Japanese adults

Background and aims

Game genres, availability on smartphones, in-game purchases, and playing duration, have been thought to influence Gaming Disorder (GD). However, little research has comprehensively examined their relationships with GD. Therefore, we examined the relationship between GD, in-game purchases, gaming duration via consoles and smartphones, and genres of smartphone games. Study 1 was based on self-reports, and Study 2 included objective data to clarify these associations.

Methods

We conducted two independent online surveys that collected sociodemographic data, game use patterns, and psychopathological assessment data, including GD severity (Study 1: N = 32,690; Study 2: N = 3,163). General mental illness scores and objective gaming time were also collected in Study 2.

Results

In Study 1, in-game purchases, several gaming genres, and subjective gaming duration were positively associated with probable GD. On the other hand, interactions between card games and loot box charges were negatively related to probable GD. In Study 2, objective gaming times of most game genres were not associated with GD. Although the correlation between subjective and objective gaming duration was moderate, their correlations with GD differed.

Discussion and conclusion

These results suggest the complexity of relationships between GD and in-game purchases, genres, and gaming duration. Results of this study suggest the importance of proper assessment of GD reflecting actual functional impairment in social life. Future studies should improve and update evaluation of assessments for gaming.

Emotion dysregulation and Internet gaming disorder in young people: Mediating effects of negative affect and metacognitions

BACKGROUND

Recent studies have found that emotion dysregulation, negative affect, and metacognitions about online gaming are risk factors for Internet gaming disorder (IGD). However, few studies investigated the mechanisms underlying these interactions. The present study aimed to explore the relationships between emotion dysregulation and IGD, and the mediating effects of negative affect and metacognitions about online gaming.

METHODS

An online survey was conducted with young people (aged 10-24 years) who played video games. 1768 participants were included in this study. Observed variables, including emotion dysregulation, IGD, depression, anxiety, and metacognitions, were measured with self-report scales. Structural equation modeling (SEM) was used to analyze the relationships among the variables.

RESULTS

The results showed that emotion dysregulation positively predicted IGD through a fully mediated model which included the independent mediating effects of negative affect and metacognitions about online gaming and their sequential mediating effect. The model explained 76.1 % of the variance in IGD.

LIMITATIONS

This was a cross-sectional study which could not infer causality.

CONCLUSIONS

This study emphasizes that negative affect and metacognitions about online gaming mediate the effect of emotion dysregulation on IGD; moreover, metacognition may be a proximal factor of IGD. Thus, improving emotional regulation and modifying maladaptive metacognitions in young people may improve the prevention and treatment of IGD.

Escaping through virtual gaming-what is the association with emotional, social, and mental health? A systematic review

Background

The realm of virtual games, video games, and e-sports has witnessed remarkable and substantial growth, captivating a diverse and global audience. However, some studies indicate that this surge is often linked to a desire to escape from real life, a phenomenon known as escapism. Much like substance abuse, escapism has been identified as a significant motivator, leading to adverse outcomes, including addiction. Therefore, it is crucial to comprehend the existing research on the connection between escapism and engagement in virtual gaming. This understanding can shed light on the reasons behind such practices and their potential impact on mental and public health.

Purpose

The objective of this systematic review is investigate the findings pertaining to association between escapism and the practice of virtual games, such as video-games and e-sport.

Methods

PUBMED and SCOPUS database were systematically searched. Six independent researchers screened articles for relevance. We extracted data regarding escapism-related measures, emotional/mental health-related measures and demographic information relevant to the review purpose.

Results

The search yielded 357 articles, 36 were included. Results showed that: (i) Escapist motivation (EM) is one of the main motives for playing virtual games; (ii) EM is related to negative clinical traits; (iii) EM predicts negative psychological/emotional/mental health outcomes; (iv) EM is associated with impaired/negative perception of the real-world life; (v) EM predicts non-adaptive real social life; and (vi) EM is associated with dysfunctional gaming practices in some cases. However, EM can have beneficial effects, fostering confidence, determination, a sense of belonging in virtual communities, and representation through avatars. Furthermore, the reviewed findings suggest that EM was positively linked to mitigating loneliness in anxious individuals and promoting social activities that preserved mental health among typical individuals during the pandemic.

Conclusion

Our review reinforces the evidence linking EM in the context of virtual games to poor mental health and non-adaptive social behavior. The ensuing discussion explores the intricate connection between escapism and mental health, alongside examining the broad implications of virtual gaming practices on underlying motivations for escapism in the realms of social cognition, health promotion, and public health.

Prevalence of internet gaming addiction and its association with sleep quality in medical students

Background

In Asia, there are approximately 2.3 billion internet users. Addiction to internet gaming takes a multifaceted toll on an individual's physical and mental well-being, casting a long shadow over their daily endeavors and also their sleep cycle.

Aim

To study the prevalence of internet gaming addiction and how it affects sleep quality in medical students.

Materials and Methods

A cross-sectional study was performed with a sample size (n = 112) in the Government Medical College, Datia (M.P.), and data were collected using a semi-structured proforma including the Internet Gaming Disorder Scale and Mini Sleep Questionnaire in the study population.

Results

In the study population with age group 18-28 years (mean age: 21 ± 1.7 years), the majority of them belong to the Hindu religion (91.1%), nuclear family (66.1%), and urban community (75.9%). Most students (n = 74) had mild to moderate sleep difficulty related to internet gaming addiction, that is, 65.1%. The most common response was "sometimes" on the Internet Gaming Disorder Scale. A significant association was observed between gaming disorder and parameters of sleep mainly in waking up too early, daytime sleepiness, snoring, feeling tired, and headache upon waking up with gaming disorder.

Conclusion

Among medical students, gaming addiction is significantly associated with poor sleep quality. Steps need to be taken to promote healthy internet use to improve sleep quality and mitigate negative effects to avoid long-term health impacts.

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.

Screen Media Use Affects Subcortical Structures, Resting-State Functional Connectivity, and Mental Health Problems in Early Adolescence

The association between excessive screen media use and mental health problems has attracted widespread attention. The literature to date has neglected the biological mechanisms underlying such a relationship and failed to distinguish between different types of screen media activities. A sample from the Adolescent Brain and Cognitive Development study was used in the present study to elucidate the longitudinal associations between specific types of screen media use, brain development, and diverse mental health problems. The results showed that different types of screen media use have differentiated associations with mental health problems, subcortical volume, and cortical-subcortical connectivity. Specifically, more passive media use was associated with increased rule-breaking behavior, while more video game playing was associated with increased withdrawn/depressed symptoms. In addition, more social media use was associated with a reduced volume of the hippocampus, caudate, and thalamus proper. More research is needed to examine the differential effects of screen media use on neurodevelopmental processes and mental health problems across adolescence.

Association between problematic Internet use and specific Internet activities and COVID-19- and earthquake-related stress, anxiety, and depression symptoms among Croatian young adults

Background

During the COVID-19 pandemic and concomitant earthquakes in Croatia in 2020, increased Internet use (IU) and Internet-based addictive behaviors were associated with decreasing mental well-being. We determined the changes in IU, problematic IU (PIU), and problematic specific Internet activities in young adults during the prolonged stress caused by the pandemic and earthquakes, age differences in PIU and differences in perceived source of stress (pandemic or earthquakes), and association between PIU and increase in specific Internet activities and stress, anxiety, and depression symptoms in young adults.

Methods

A cross-sectional online survey conducted from September 30, 2021 to October 17, 2021 included 353 young adults aged 22.6 ± 2.1 years, 382 early adults aged 32.1 ± 4.4 years, and 371 middle-aged adults aged 49.0 ± 6.5 years. Data on sociodemographic characteristics, stressors (without perceived stressors, only pandemic-related stressor, only earthquake-related stressor, and both pandemic and earthquake-related stressors), PIU and IU were collected with a self-report questionnaire. The Impact of Event Scale and the Hospital Anxiety Depression Scale were used to evaluate mental symptoms. PIU and problematic specific Internet activities were assessed using Tao et al.'s criteria. Data were anaylzed with paired-sample Wilcoxon test, McNemar's and Pearson's chi-square tests, and structural equation modeling.

Results

In 17% of young adults, we found increased PIU (OR = 5.15, 95% CI [2.82, 10.18]), problematic social media use (OR = 2.77, 95% CI [1.56, 5.14]), and uncontrolled online shopping (OR = 5.75, 95% CI [1.97, 22.87]) (p < 0.001 for all). PIU and problematic social media use were more common among young adults (60.8%), as well as problematic online gaming (25.9%). Problematic social media use was more frequent among young adults reporting pandemic stress than among those without perceived stress (69.9% vs. 43.2%). Increased online gaming predicted more severe avoidance symptoms (p = 0.041), increased social media use predicted more severe depression symptoms (p = 0.017), increased online shopping predicted more severe intrusion (p = 0.013) and anxiety symptoms (p = 0.001). PIU predicted more severe intrusion (p = 0.008), avoidance (p = 0.01), anxiety (p < 0.001), and depression (p = 0.012) symptoms.

Conclusion

Different effects of the pandemic and earthquakes on IU could reflect a different effect of various stressors on Internet behavior of young adults. Type of problematic Internet behavior may predict for the type of mental health problem.

Use and Acceptance of Digital Communication Technology by Older Adults for Social Connectedness During the COVID-19 Pandemic: Mixed Methods Study

BACKGROUND

Older adults are at higher risk for health issues, including mental health problems. This was especially apparent during the COVID-19 pandemic, where older adults were simultaneously more vulnerable to the disease and the mental health concerns created by social distancing. Subsequently, the use of digital communication technology (DCT) became a critical option for maintaining social connectedness in older adults. Prior to the pandemic, the low uptake and use of technology by older adults was an established problem, known as the digital divide. However, not much is known about how this may have changed as a result of the pandemic.

OBJECTIVE

This study aims to explore how older adults maintained social connectedness through DCT during the pandemic and to understand factors influencing the use and acceptance of DCT.

METHODS

A mixed methods explorative field study was set up, involving surveys and interviews of 25 community-dwelling older adults (65-88 years old) living in the United Kingdom. The surveys included the internet acceptance questionnaire (based on the Technology Acceptance Model [TAM]); COVID-19 dysfunctional anxiety was captured using the COVID-19 Anxiety Scale (CAS). Background information (demographics, use of technology) was gathered before conducting semistructured interviews. We hypothesized that CAS would affect constructs of TAM and that predictive constructs of TAM would have remained valid during the pandemic. We also posited that there would be unidentified themes outside TAM that impacted the acceptance and use of DCT. We used the quantitative data to guide the semistructured interviews, which were then analyzed through thematic analysis to identify additional themes.

RESULTS

Correlational analysis showed that CAS influences all constructs of TAM. We also saw that the predictive constructs of TAM, especially the perceived ease of use (PEU) and perceived usefulness (PU), remained valid during the pandemic. Common acceptance-influencing themes were encountered in both quantitative and qualitative analyses, with 3 matching the known constructs of TAM (PU, PEU, and behavioral intention). We identified 2 additional themes affecting acceptance, namely influence of the pandemic (situational context) and privacy and security concerns. DCT use (especially email and videoconferencing use) increased during the pandemic, but the results related to social networking sites were mixed.

CONCLUSIONS

The COVID-19 pandemic impacted technology acceptance and use by older adults, encouraging their use of certain DCT apps (email and videoconferencing apps, such as WhatsApp). These apps helped insulate them from adverse effects (social isolation and loneliness). Other social networking apps, however, exerted a negative influence, increasing anxiety and a general feeling of negativity. Future studies should maximize older adult agency related to design, privacy, security, and user requirements for development. We also recommend that when studying DCT acceptance for older adults, our additional identified themes should be considered alongside the existing TAM constructs.

COVID-19 Pandemic and Internet Addiction in Young Adults: A Pilot Study on Positive and Negative Psychosocial Correlates

Objective

During and after the lockdowns of the COVID-19 pandemic period, a strain was put on young adults who have taken refuge in the problematic use of internet, social media, gaming, and gambling. This paper aims to investigate possible correlates of Internet Addiction Disorder (IAD), hypothesizing anxiety, depression and perceived stress would promote addiction, while mindfulness skills, resilience and socialization would, conversely, hamper IAD, and promote, consequently, a more functional internet use.

Method

A pilot study was carried out with a sample of 31 young adults, recruited through a snowball sampling using social networks. Participants filled out an online questionnaire including the following measures: Internet Use, Abuse and Addiction (UADI), Beck Depression Inventory (BDI-II); State-Trait Anxiety Inventory (STAI-Y); Perceived Stress Scale (PSS); Five Facet Mindfulness Questionnaire (FFMQ); Mindfulness Attention and Awareness Scale (MAAS); Resilience Scale (RS-14). It was also administered an ad hoc questionnaire for the assessment of socialization behaviour (6 items) and gambling (2 items).

Results

All the measures, but socialization, showed adequate reliability. Our sample showed high levels of anxiety, stress, IA and gambling, while presenting low levels of resilience, the mindful skill of no-reactivity and socialization. The first hypothesis was confirmed, finding positive and significant correlations between Internet Addiction on one side and PSS, STAI-Y1, STAY-2, and BDI II on the other side. We also partially confirmed the second hypothesis about UADI negatively correlated with both RS-14 and Mindful Acting. Finally, no correlations were found between Gambling and IA.

Conclusions

In conclusion, the more one perceives an emotional overload with less stress-control, high anxiety, and depression, and the less one can leverage on the skills of mindful acting and resilience, the more one uses the internet as a strategy to escape from a threatening reality.

Functional MRI of inhibitory control processing in problematic mobile video gamers

With the development of mobile technology, mobile video games provide people with a more convenient way of entertainment, but problematic playing could also bring some negative consequences. Prior studies have indicated that Internet gaming addicts were accompanied by impaired inhibitory control. However, as a relatively new form of problematic game usage based on mobile devices, little is known about the neurobiological underpinnings of inhibitory control in problematic mobile video game (PMVG) users. Adopting an event-related fMRI Stroop task, the present study aimed to examine the different neural correlates of inhibitory control between PMVG and healthy control (HC) subjects. Compared with HC group, PMVG group showed greater brain activities in the right dorsolateral prefrontal cortex (DLPFC) during the Stroop process. Moreover, correlation analysis showed that brain activities extracted from the voxel in the DLPFC cluster had a significantly negative correlation with reward sensitivity. Our current findings may suggest the compensating effect in key brain regions of inhibitory control in problematic mobile video gamers relative to healthy controls.

Increased adolescent game usage and health-related risk behaviors during the COVID-19 pandemic

This study examines adolescent game usage and corresponding health-related risk behaviors during a period of limited social interaction and activity due to the COVID-19 pandemic. Participants included 225 middle- and 225 high-school students in Seoul who completed a survey online from October 1 to 30, 2021. The study measured participants' game usage level and the health-related risk behavior index. Findings showed that participants who engaged in excessive gaming showed higher levels of health-related risk behaviors. A multivariate analysis of variance was conducted to compare the health-related risk behaviors of students in the general, potential, and high-risk groups on excessive gaming. Results indicated that female students in the high-risk group showed higher stress levels and fatigue (f = 5.549, p < .01, Cohen's d = 0.016) than the males of the same group. However, male students showed higher physical inactivity levels (f = 3.195, p > .05, Cohen's d = 0.009) than females. The post hoc test indicated clear sex distinctions among the general, potential, and high-risk groups on excessive gaming (p < .001). Among the high-risk game usage group, female students displayed a higher level of risk behaviors than males. Adolescent gaming addiction should be considered an emotional and behavioral disorder for which parental guidance and support are needed, and counseling experts and professionals must come together to provide a cure and reform program.

Symptoms of internet gaming disorder and depression in Chinese adolescents: A network analysis

The current study aimed to investigate comorbidity among symptoms of depression and internet gaming disorder (IGD) utilizing symptom network analysis in a sample of Chinese adolescents. A total of 1,362 Chinese adolescents (Mean age = 15.19 ± 1.67; range 13-21; 39.79% female, 56.02% male, 4.19% not disclosed) were recruited from 11 local secondary schools between June and July 2020. Symptoms of depression and IGD were assessed by the 7-item DASS-21 depression subscale and the 9-item Internet Gaming Disorder Scale. We conducted network analysis to estimate network models and the most central symptoms of depression and IGD and computed a combined network model of both depression and IGD symptoms to find bridge symptoms and illustrate the comorbidity between depression and IGD. We found that feeling 'Worthless', 'Meaningless', and 'Down-hearted' were identified as the most central symptoms of depression, whereas 'Preoccupation' and 'Tolerance' were the two most central symptoms of IGD. The bridge symptoms in the combined network model were 'Gaming for escape or mood relief' from the IGD cluster and 'No initiative' and 'Down-hearted" from the depression cluster. The current study was the first to investigate the relationship between depression and IGD symptoms among adolescents utilizing a symptom network perspective. Also, it highlighted key bridge symptoms in understanding how IGD and depression contribute to each other.

Social anhedonia affects the trajectory of internet addiction in the college students: A latent growth curve analysis

BACKGROUND/AIM

There is growing awareness that anhedonia plays a critical role in the development of Internet Addictions (IA). However, anhedonia is a multidimensional construct and different aspects of anhedonia may exert different effects on IA. This study was designed to distinguish the effects of social anhedonia and physical anhedonia on the developmental trajectory of IA among college students.

METHODS

A total of 3577 Chinese college freshmen (M_age = 18.01, SD = 0.77; 65.4 % girls) participated in a 2-year, four waves longitudinal tracking study. The latent growth curve model (LGCM) was constructed to examine the impacts of different types of anhedonia on the developmental trajectories of IA. Gender was also added to the conditional LGCM as time-invariant variable.

RESULTS

The results of unconditional LGCM showed a U-shape developmental trajectory of IA. Social anhedonia significantly affected the intercept (β = 0.468, p < 0.001) and significantly affected the linear slope (β = -0.259, p < 0.05), but not the quadratic slope (β = 0.293, p > 0.05). Physical anhedonia was not significantly associated with intercept, linear slope and quadratic slope. There was no sex difference in both initial levels and change rate of IA.

CONCLUSIONS

Social anhedonia while not physical anhedonia has prediction effect on IA. College students with high levels of social anhedonia experienced high levels of IA at baseline, and performed a slower rate in downward trend of IA. The findings of the current study provide implications for prevention of IA in college students.

Problematic social networking sites use and online social anxiety: The role of attachment, emotion dysregulation and motives

Problematic Social Networking Sites Use (PSNSU) and social anxiety are associated. SNSs users may develop online social anxiety that may become a standalone problem. The present study aims to test the mediating role of emotion dysregulation and motives (coping, conformity, social, and enhancement) between attachment (anxiety and avoidance) and two outcomes (PSNSU and online social anxiety) in an integrated theory-driven model. Self-report questionnaires were completed by 756 SNSs users (50.4 % females; mean age = 28.74 years, SD = 8.00). Results of the path analysis supported the partial mediating role of emotion dysregulation in the association between attachment anxiety and both the outcomes and the serial mediating role via four and three motives in the association with PSNSU and online social anxiety, respectively. This study highlighted the role of several relational, emotional, and motivational factors that should be taken into account to tackle PSNSU and online social anxiety through clinical and prevention interventions.

The trajectories and associations of insomnia symptoms with addictive behaviours in adolescents: A two-year longitudinal study

Insomnia displays heterogeneous trajectories across adolescence, which may induce addictive behaviours, including internet gaming disorder and substance use. This study aimed to investigate the latent trajectory classes of insomnia symptoms over 2 years and to examine the associations between insomnia trajectories and these addictive behaviours. Participants were 910 adolescents from six middle schools in Shanghai, China (52.7% males; mean age = 13.17 years). The three-wave survey measured insomnia symptoms, internet gaming disorder, substance use, depressive symptoms, and sociodemographic characteristics from 7th to 9th grade. Latent class growth modelling was performed to identify the latent trajectory classes of insomnia symptoms. Then multivariable logistic regressions were conducted within the best-fitting latent class growth model to examine the associations of insomnia trajectories with internet gaming disorder and substance use. Two latent trajectory classes of insomnia symptoms were recognised: the non-insomnia group (71.8%) and the insomnia group (28.2%). In the multivariable analysis controlling for baseline demographic variables and depressive symptoms, the insomnia group had a higher risk of developing internet gaming disorder (OR = 2.203 [95% CI: 1.258-3.858]) and substance use (OR = 2.215 [95% CI: 1.324-3.705]) compared with the non-insomnia group. These findings add to a growing body of research on heterogeneous trajectories of insomnia symptoms during adolescence, suggesting that intervention strategies are needed to target the characteristics or developmental patterns of different insomnia subgroups. The ultimate goal is to mitigate the impact of insomnia symptoms on adolescent addictive behaviours.

The longitudinal association between internet addiction and depressive and anxiety symptoms among Chinese adolescents before and during the COVID-19 pandemic

Background

The COVID-19 pandemic and related prevention policies, such as home quarantine or online courses, could increase the risks of experiencing internet addiction and mental health problems among Chinese adolescents. There is a lack of longitudinal evidence to show the association between internet addiction symptoms and psychological consequences (e.g., depressive and anxiety symptoms).

Objective

This study aimed to explore the association between internet addiction and depressive and anxiety symptoms before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

An effective sample of 7,958 Chinese adolescents was recruited for this two-wave longitudinal survey conducted over a six-month interval. All participants completed two-wave surveys before and during the COVID-19 pandemic. A longitudinal cross-lagged path model was used to analyze the associations between internet addiction and depressive and anxiety symptoms after controlling for four covariates (i.e., age, sex, minority, and COVID-19 influence).

Results

Higher depressive and anxiety symptoms before COVID-19 significantly predicted severe internet addiction during COVID-19. Results showed a significant bidirectional relationship between internet addiction and depressive symptoms. Furthermore, the prevalence of internet addiction displayed an increasing trend over the two waves. Conversely, a reduced prevalence of anxiety and depressive symptoms was observed over the two waves.

Conclusion

This current study provided valuable evidence that psychological problems and internet addiction significantly influenced each other before and during the COVID-19 outbreak. Consequently, the presence of psychological problems before and during the COVID-19 outbreak could indicate internet addiction. Thus, depression- and anxiety-related psychotherapies should be developed to prevent internet addiction among Chinese adolescents.

A cross-sectional study on gaming intensity and social vulnerability in adolescents that have a chronic condition

Background

Adolescents growing up with a chronic condition might experience more social vulnerabilities compared to their healthy peers as an indirect result of their conditions. This can lead to a relatedness need frustration for these adolescents. Consequently, they might spend more time playing video games compared to their peers. Research shows that both social vulnerability and gaming intensity are predictors for problematic gaming. Therefore, we investigated if social vulnerability and gaming intensity are more pronounced in adolescents that have a chronic condition compared to the general population; and if these levels reflect the levels of a clinical group being treated for Internet Gaming Disorder (IGD).

Methods

Data on peer problems and gaming intensity were compared from three separate samples: a national representative sample of adolescents, a clinical sample of adolescents that are undergoing treatment for IGD, and a sample of adolescents diagnosed with a chronic condition.

Results

No differences were found on either peer problems or gaming intensity between the group of adolescents that have chronic conditions and the national representative group. The group with chronic conditions scored significantly lower on gaming intensity than the clinical group. No significant differences were found between these groups on peer problems. We repeated the analyses for boys only. Similar results were found for the group with chronic conditions compared to the national representative group. The group with chronic conditions now scored significantly lower on both peer problems and gaming intensity than the clinical group.

Conclusion

Adolescents growing up with a chronic condition appear similar in their gaming intensity and peer problems compared to their healthy peers.

Relationship of Gaming Disorder with parenting based on low affection-communication and personality trait of neuroticism in adolescents

Background

Gaming Disorder is increasingly common in adolescents. We aimed to evaluate the relationship between parenting, personality traits, and Gaming Disorder.

Methods

An observational and cross-sectional study in six secondary schools of Castelló, obtaining a final sample of 397 students.

Results

Adolescents with Gaming Disorder had lower scores in Adolescent Affection-Communication (F = 8.201; p < 0.001), Father's Warmth (F = 3.459; p = 0.028), and Father's Acceptance/Involvement (F = 5.467; p = 0.003), and higher scores in Mother's Revoking Privileges (F = 4.277; p = 0.034) and Father's Indifference (F = 7.868; p = 0.002) than healthy participants. Male sex was a risk factor for Gaming Disorder (OR = 12.221; p = 0.004), while Adolescent Affection-Communication (OR = 0.908; p = 0.001) and Agreeableness (OR = 0.903; p = 0.022) were protective factors. Data modeling described the protective effect that Adolescent Affection-Communication had on Gaming Disorder, which was both directly (B = -0.20; p < 0.001) and indirectly mediated by Neuroticism (B = -0.20; p < 0.001), while Neuroticism itself was a risk factor for Gaming Disorder (B = 0.50; p < 0.001).

Conclusion

These results reflect that Parental style with low affection and communication was directly and indirectly related to the Gaming Disorder, as well as male sex and personality trait of Neuroticism.

Neural activations to loss anticipation mediates the association between difficulties in emotion regulation and screen media activities among early adolescent youth: A moderating role for depression

BACKGROUND

Screen media activities (SMAs; e.g., watching videos, playing videogames) have become increasingly prevalent among youth as ways to alleviate or escape from negative emotional states. However, neural mechanisms underlying these processes in youth are incompletely understood.

METHOD

Seventy-nine youth aged 11-15 years completed a monetary incentive delay task during fMRI scanning. Neural correlates of reward/loss processing and their associations with SMAs were explored. Next, brain activations during reward/loss processing in regions implicated in the processing of emotions were examined as potential mediating factors between difficulties in emotion regulation (DER) and engagement in SMAs. Finally, a moderated mediation model tested the effects of depressive symptoms in such relationships.

RESULT

The emotional components associated with SMAs in reward/loss processing included activations in the left anterior insula (AI) and right dorsolateral prefrontal cortex (DLPFC) during anticipation of working to avoid losses. Activations in both the AI and DLPFC mediated the relationship between DER and SMAs. Moreover, depressive symptoms moderated the relationship between AI activation in response to loss anticipation and SMAs.

CONCLUSION

The current findings suggest that DER link to SMAs through loss-related brain activations implicated in the processing of emotions and motivational avoidance, particularly in youth with greater levels of depressive symptoms. The findings suggest the importance of enhancing emotion-regulation tendencies/abilities in youth and, in particular, their regulatory responses to negative emotional situations in order to guide moderate engagement in SMAs.

Between- and within-person associations of mobile gaming time and total screen time with sleep problems in young adults: Daily assessment study

OBJECTIVES

To explore associations of screen time (total, mobile gaming) with sleep problems in Chinese young adults.

METHODS

This was a 4-week daily morning (completion rate = 82.1%, 909/1107) and evening (completion rate = 92.4%, 1061/1148) assessment study in 41 university students (22 female, mean age = 22.3 [SD 4.2] years). Short sleep duration < 7 h, difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, and any of these three insomnia symptoms were self-reported in the morning. Mobile gaming time was self-reported in the evening, whilst total screen time was objectively tracked. Bayesian multilevel mixed-effects modeling disaggregated between- and within-person associations.

RESULTS

Between person, longer mobile gaming time predicted short sleep duration (adjusted odds ratio [AOR] = 1.90, 95% CI 1.39, 2.69), any insomnia symptoms (AOR = 1.59, 95% CI 1.20, 2.11), difficulty initiating sleep (AOR = 3.05, 95% CI 1.51, 6.24), and difficulty maintaining sleep (AOR = 2.19, 95% CI 1.18, 3.74). Short sleep duration (adjusted b = 0.99, 95% CI 0.05, 1.95), any insomnia symptoms (adjusted b = 1.19, 95% CI 0.24, 1.94), and difficulty initiating sleep (adjusted b = 1.72, 95% CI 0.11, 3.19) reversely increased mobile gaming time. Within person, any insomnia symptoms (adjusted b = 0.17, 95% CI 0.04, 0.31) and early morning awakening (adjusted b = 0.28, 95% CI 0.08, 0.48) increased next-day mobile gaming time. Total screen time was not associated with sleep problems both between and within person.

CONCLUSIONS

Bidirectional between-person associations of mobile gaming time with short sleep duration and insomnia symptoms informed multiple-health-behavior-change interventions. Unidirectional within-person associations of insomnia symptoms with next-day mobile gaming time informed just-in-time adaptive interventions addressing daily variations in insomnia symptoms. [250/250 word limits].

Exploring Addictive Online Behaviors in Patients with Narcolepsy Type 1

BACKGROUND

Narcolepsy type 1 (NT1) is a rare neurological sleep disorder caused by the loss of neurons that produce hypocretin-a peptide that plays a crucial role in addictive behaviors. We aimed to compare, for the first time, levels of problematic online gaming, problematic social media use, and compulsive Internet use between NT1 patients and healthy controls (HC), and to evaluate the association between anxiety, depression, and emotion dysregulation with addictive online behaviors in NT1 patients.

METHODS

A total of 43 patients with NT1 and 86 sex- and age-matched HC participated in an online cross-sectional survey.

RESULTS

NT1 patients did not differ from HC in terms of problematic social media use and compulsive Internet use but displayed higher levels of problematic online gaming compared to HC. Higher levels of emotion dysregulation were significantly associated with higher levels of problematic social media use and compulsive Internet use, while none of the tested factors were associated with problematic online gaming.

CONCLUSION

NT1 patients and HC had similar levels of problematic social media use and compulsive Internet use, but NT1 patients showed higher levels of problematic online gaming. Emotion dysregulation might be an intervention target for reducing compulsive Internet use and problematic social media use.

The Doctor Is In(ternet): The Mediating Role of Health Anxiety in the Relationship between Somatic Symptoms and Cyberchondria

Cyberchondria is a dysfunctional behavioral pattern characterized by an excessive and anxiety-amplifying engagement in searching for reassuring health information on the Internet. Research demonstrated that somatic symptoms and health anxiety might foster maladaptive health-related behaviors, such as cyberchondria. However, the relationships between somatic symptoms, health anxiety, and cyberchondria have been scarcely examined. Accordingly, this study aimed to test the mediating effect of health anxiety on the association between somatic symptoms and cyberchondria. Four hundred and thirty-one adults from the community (158 males, 36.66%), aged between 18 and 74, were recruited via an online survey. Participants completed self-report measures of somatic symptoms, health anxiety, and cyberchondria. A mediation analysis demonstrated that the severity of somatic symptoms predicted increased levels of cyberchondria and that health anxiety partially mediated this association. Therefore, interventions aimed at decreasing health anxiety may also play a role in decreasing the risk of developing cyberchondria.

Relationship between time spent playing internet gaming apps and behavioral problems, sleep problems, alexithymia, and emotion dysregulations in children: a multicentre study

BACKGROUND

Internet gaming addiction (IGA) is a serious condition that can significantly impact personal and social functioning. Many studies of IGA have been conducted in adolescents and young adults, but there are limited data available in children. We investigated the time spent using internet gaming apps in children and its association with behavioral problems, sleep problems, alexithymia, and emotional regulation.

METHODS

The research populations (N = 564) were categorized based on the number of hours spent using online gaming applications. The Strengths and Difficulties Questionnaire, the Children's Sleep Habits Questionnaire Abbreviated, the Children's Alexithymia Measure (CAM), and the Clinical Evaluation of Emotional Regulation-9 were used to assess all participants.

RESULTS

Compared to other groups, children who used internet gaming applications for more than 6 h had a higher proportion of abnormal responses on the emotional symptoms and hyperactivity scales. Children who used internet gaming applications for more than 6 h had the poorest sleep quality (75%), while children who used internet gaming applications for 1-2 h had the best (36.7%). Participants who used internet gaming apps for 1-2 h had significantly lower mean total scores on the emotional regulation scale and total CAM, whereas those using internet gaming apps for more than 6 h had the highest mean scores in the CAM.

CONCLUSIONS

Excessive use of internet gaming apps during childhood may be associated with hyperactivity, peer problems, high socioeconomic level, alexithymia concerns, shorter daytime sleep duration, and a delayed morning wake-up.

A comprehensive model to understand and assess the motivational background of video game use: The Gaming Motivation Inventory (GMI)

BACKGROUND AND AIMS

The popularity of video gaming has generated significant interest in research methods to examine motivations for gaming. Current measures of gaming motives are limited by lack of scope and/or their applicability to specific game genres only. We aimed to create a comprehensive motivation inventory applicable to any gaming genre and to evaluate its psychometric properties in a large sample of highly engaged video gamers.

METHODS

Stage 1 of this project involved a systematic review that generated the items for the Gaming Motivation Inventory (GMI). Stages 2-4 involved an evaluation of the psychometric properties of the GMI. A sample of 14,740 video gamers (89.3% male; mean age 24.1 years) were recruited via an online survey promoted by a popular gaming magazine.

RESULTS

In Stage 2, twenty-six gaming motives were identified, which clustered into six higher-order dimensions (Mastery, Immersion/Escapism, Competition, Stimulation, Social, Habit/Boredom). In Stage 3, construct validity of the six higher-order motives was assessed by associations with gaming-related, personality, and psychological variables. In Stage 4, the relationships between motives and depression symptoms and gaming disorder symptoms were explored. Although gaming motives had weak associations with gaming genres, they were moderately related to variables such as competitiveness, sociability, and positive and negative affect. Gaming disorder symptoms were directly predicted by depression symptoms and indirectly via Immersion/Escapism, Habit/Boredom, and Competition motives.

DISCUSSION AND CONCLUSIONS

These findings support the notion that motives are one of the primary causes of gaming behavior and play an important role in predicting its problematic nature. The GMI is a psychometrically valid tool that will be useful for gaining insights into factors underlying gaming behaviors.

Dominance or Integration? Influence of Sexual Dimorphism and Clothing Color on Judgments of Male and Female Targets' Attractiveness, Warmth, and Competence

The face is an important source of information in social interactions. Prior studies exploring the mechanism of face perception were consistent with either dominance or integration theory. Studies have shown that both sexually dimorphic features and background cues play essential roles in the formation of impressions and the perception of facial attractiveness. In this study, we conducted two experiments to examine 539 participants' appraisal of attractiveness, warmth, and competence of the target faces of masculine and feminine men and women dressed in red, blue, or white. The results showed that: (1) feminized male/female faces were considered to have a higher degree of attractiveness, warmth, and competence, (2) people rated feminine faces wearing red higher in terms of attractiveness perception, while there was no significant effect of red on attractiveness perception of masculine faces, (3) when evaluating the warmth of targets, the promotion effect of red was found for feminine faces but not for masculine faces. This study, conducted in a pathogen disgust environment, provides direct evidence to support the integration theory over the dominance theory. Feminized red preference found in this study matches Chinese collectivism and the red cultural heritage, which has an important value for people's daily impression management and consumption decisions.

Interpersonal Guilt and Problematic Online Behaviors: The Mediating Role of Emotion Dysregulation

OBJECTIVE

The positive association between problematic Internet use (PIU) and emotion dysregulation (ED) is well documented. Research has also found that interpersonal guilt is positively associated with ED. Nevertheless, the influence of interpersonal guilt on PIU has been scarcely examined. In the current study, we investigated the relationships among the three constructs, and tested if emotion dysregulation mediates the association between interpersonal guilt and different types of PIU, namely problematic online gaming, problematic social media use, and problematic online pornography use.

METHOD

A sample of 434 adult participants (210 males, 48.4%) aged between 18 and 69 years old completed self-reported measures on interpersonal guilt, ED, and PIU. A structural equation modeling (SEM) framework was used to test the mediation models.

RESULTS

SEM analyses showed that ED mediates the relationship between interpersonal guilt as antecedent, and problematic online gaming, problematic social media use, and problematic online pornography use as outcomes.

CONCLUSIONS

Our findings suggest that emotion dysregulation deriving from experiences of interpersonal guilt can amplify the risk of using gaming, social media, and online pornography in a problematic way. Implications for prevention and treatment of PIU are discussed.

Response to the Regulation of Video Games under the Youth Media Protection Act: A Public Health Perspective

The Swiss Youth and Media Act, which is about to enter into force, is an attempt to provide a legislative framework for video game use. Among other inclusions, the law intends to make providers more accountable by taking measures to protect minors from harm that can be caused by improper use of video games. However, it is a challenge to create a legal framework that can adequately regulate the evolving features of video games. Legislators must find a suitable regulatory approach which takes into account the fact that there is an increasing convergence between video games and gambling, particularly with the introduction of loot boxes. Moreover, there is a need for regulation, including the prohibition of misleading designs, the introduction of additional protection for minors, and the assurance of transparency of transactions. Appropriate policy legislation and consumer-protection measures are needed to protect people using these types of products, particularly children and adolescents. Further work should focus on assessing game characteristics to refine regulatory models to promote safe gaming. Based on experiences from the field of psychoactive substances as well as that of gambling, it is now a matter of developing a matrix of harm with elaborated categories: a tool that makes it possible to evaluate the potential harms of certain game design in an evidence-based manner.

Longitudinal Associations of Children’s Hyperactivity/Inattention, Peer Relationship Problems and Mobile Device Use

Children with emotional, behavioral or relationship problems may be more inclined to use mobile touchscreen devices (MTSDs: mobiles and tablets) to regulate their emotions or compensate for the lack of social relationships, which, in turn, may affect their symptoms. Bi-directional longitudinal associations between behavioral difficulties and MTSD use were analyzed. Participants were parents of children aged 4–6 years old at first data collection (n = 173), and 7–9 years old at second data collection (n = 98). They reported on their child’s MTSD use and behavioral difficulties at two time points (T1 and T2). It was analyzed whether T1 MTSD use predicts T2 behavioral difficulties (controlling for demographics and T1 behavioral difficulties); and whether T1 behavioral difficulties predict T2 MTSD use (controlling for demographics and T1 MTSD use). Additionally, cross-sectional associations between behavioral difficulties and MTSD use were analyzed. Children’s T1 hyperactivity/inattention score positively associated with T2 MTSD use, and peer relationship problems and MTSD use positively associated in T2. Pre-schoolers with more hyperactive inattentive symptoms may use MTSDs more to regulate their emotions. The association between peer relationship problems and MTSD use in T2 is consistent with poorer socio-cognitive skills in MTSD user children and may be bi-directional.

Influence of smartphone use motives on smartphone addiction during the COVID-19 epidemic in China: the moderating effect of age

With the development of science and technology, the phenomenon of smartphone addiction has become very common. However, smartphone addiction has adverse consequences. To date, few studies have examined psychological crises and smartphone use motives during the coronavirus disease 2019 (COVID-19) pandemic according to age. Therefore, this study aimed to examine the influences of different types of smartphone use motives on smartphone addiction and explore the moderating effect of age on adolescents and adults. A total of 1346 participants (600 adults and 746 adolescents) completed questionnaires on their motives for smartphone use and smartphone addiction. Results indicated significant positive correlations between smartphone use motives and smartphone addiction. In the moderation model, mood regulation, social relations, pastime, and conformity significantly and directly predicted smartphone addiction; however, perceived enjoyment did not. Age played a moderating role in the prediction of smartphone addiction. Teenagers and adults have different motives for smartphone use, and different motives have different effects on adolescents and adults. Adolescents have higher coping motivation and conformity motivation than adults, and for adolescents, perceived pleasure motivation has a significant impact on smartphone addiction. For adults, perceived pleasure and social relationship motivation have a significant impact on smartphone addiction. Therefore, interventions for smartphone addiction can be developed by investigating the motives of use among different people, and age should be considered when developing interventions for smartphone addiction.

Emotion Regulation Choice in Internet Addiction: Less Reappraisal, Lower Frontal Alpha Asymmetry

Individuals with internet addiction (IA) show difficulties in emotion regulation. However, they could effectively employ emotion regulation strategies when instructed. We speculate that this discrepancy might be caused by maladaptive emotion regulation choices. Recent studies indicated that decreased activity of the left frontal cortex could be a neural marker of reappraisal use. To address this problem, individuals with IA (n = 17, IA group) and healthy individuals (n = 23, healthy control [HC] group) were required to choose an emotion regulation strategy between reappraisal and distraction to regulate their emotions varying in emotional intensity and valence. We also compared the resting state frontal alpha asymmetry (FAA) of these 2 groups. The results replicated more choices of reappraisal in low- versus high-intensity emotional contexts across groups. More importantly, the IA group chose reappraisal less frequently compared with the HC group, irrespective of emotional intensity. Furthermore, we found individuals with IA have lower FAA than healthy controls, and FAA shows a positive correlation with the use of reappraisal. These findings suggest that IA alters individuals' patterns of emotion regulation choice and impairs frontal activities, causing difficulties in emotion regulation.

The relationship between adolescent emotion dysregulation and problematic technology use: Systematic review of the empirical literature

BACKGROUND AND AIMS

We aimed to systematically identify, evaluate and summarize the research on adolescent emotion dysregulation and problematic technology use. We critically appraise strengths and limitations and provide recommendations for future research.

METHODS

We followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and conducted a systematic review of published original reports on adolescent emotion dysregulation and problematic technology use published until March 1, 2022. A thorough search preceded the selection of studies matching prespecified criteria. Strengths and limitations of selected studies, regarding design and reporting, were identified based on current best practices.

RESULTS

39 studies met inclusion criteria. All of these studies provided on the relationship between adolescent emotion dysregulation and problematic technology use severity based on self-report data.

DISCUSSION

There was a positive correlation between adolescent emotion dysregulation and the severity of problematic technology use. Beyond this, other variables (such as anxiety, depression, self-esteem, etc.) were also closely related to emotion dysregulation and problematic technology use. Such studies are of importance to better understand cause-effect relations regarding both variables.

The Effects of Playing Video Games on Stress, Anxiety, Depression, Loneliness, and Gaming Disorder During the Early Stages of the COVID-19 Pandemic: PRISMA Systematic Review

During the initial phases of the COVID-19 pandemic, playing video games has been much more than just a pastime. Studies suggested that video games for many individuals have helped to cope with such difficult life experience. However, other research indicates that gaming may have had harmful effects. Within this context, this systematic review aimed to describe the literature on the effects of video games during the early stages of the COVID-19 crisis on stress, anxiety, depression, loneliness, and gaming disorder (GD), examining the study characteristics and outcomes. A systematic search of the literature was made following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. It was preregistered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY)-INPLASY202180053. The search databases were PsycINFO, Web of Science, and Medline. The search string was: [("video game*") OR ("computer game*") OR ("gaming")] AND [("COVID-19")]. Twenty-four studies met the inclusion criteria. Four research explored the effects of playing video games during the COVID-19 pandemic on stress, anxiety, and depression. Four studies investigated loneliness, while 18 research investigated game disorder. Video games, especially augmented reality and online multiplayer ones, mitigated stress, anxiety, depression, and loneliness among adolescents and young adults during stay-at-home restrictions. However, in the case of at-risk individuals (i.e., particularly male youths), playing video games had detrimental effects.

Developing an intense player-avatar relationship and feeling disconnected by the physical body: A pathway towards internet gaming disorder for people reporting empty feelings?

The literature suggests that alexithymia and emptiness could be risk factors for various addictive behaviors. The present study developed and tested a model that proposes a pathway leading from emptiness and difficulties in identifying emotions to Internet Gaming Disorder (IGD) symptoms via an intense gamer-avatar relationship and bodily dissociative experiences. A sample of 285 (64.2% M; mean age = 30.38 ± 7.53) online gamers using avatar-based videogames was recruited from gaming communities, and they were asked to complete a survey that included the Toronto Alexithymia Scale, the Subjective Emptiness scale, the Scale of Body Connection, the Self-Presence Questionnaire, and the Internet Gaming Disorder Scale-Short Form. The structural model evaluated produced a good fit to the data [χ2 = 175.14, df = 55, p < .001; RMSEA = 0.08 (90% C.I. =0.07–0.09), CFI = 0.96, SRMR = 0.08] explaining 28% of the total variance. Alexithymia was indirectly associated with IGD through the serial mediation of the gamer-avatar relationship and body dissociation. Emptiness was associated with IGD symptoms at the bivariate level, but did not predict IGD directly or indirectly. The current study identifies a potential pathway toward IGD by integrating different lines of research, showing the importance of considering aspects such as the difficulty in recognising and expressing one’s emotions, the gamer- avatar relationship, and the mind-body connection in the context of IGD.

Relationships Between Job Stress, Psychological Adaptation and Internet Gaming Disorder Among Migrant Factory Workers in China: The Mediation Role of Negative Affective States

Factory workers make up a large proportion of China's internal migrants and may be highly susceptible to job and adaptation stress, negative affective states (e.g., depression and anxiety), and Internet gaming disorder (IGD). This cross-sectional study investigated the relationships between job stress, psychological adaptation, negative affective states and IGD among 1,805 factory workers recruited by stratified multi-stage sampling between October and December 2019. Structural equation modeling (SEM) was conducted to test the proposed mediation model. Among the participants, 67.3% were male and 71.7% were aged 35 years old or below. The prevalence of probable depression, probable anxiety, and IGD was 39.3, 28.7, and 7.5%. Being male, younger age, and shorter duration of living in Shenzhen were associated with higher IGD scores. Job stress was significantly associated with IGD (β = 0.11, p = 0.01) but not with negative affective states (β = 0.01, p = 0.77). Psychological adaptation was significantly associated with negative affective states (β = -0.37, p < 0.001) but not with IGD (β = 0.09, p > 0.05). Negative affective states were positively associated with IGD (β = 0.27, p < 0.001). The indirect effect of psychological adaptation (β = -0.10, p = 0.004) but not job stress (β = 0.003, p = 0.77) on IGD through negative affective states was statistically significant. The observed psychological correlates and mechanisms are modifiable, and can inform the design of evidence-based prevention programs for depression, anxiety, and IGD in this population.

Altered effective connectivity from the pregenual anterior cingulate cortex to the laterobasal amygdala mediates the relationship between internet gaming disorder and loneliness

BACKGROUND

Individual with internet gaming disorder (IGD) often experience a high level of loneliness, and neuroimaging studies have demonstrated that amygdala function is associated with both IGD and loneliness. However, the neurobiological basis underlying these relationships remains unclear.

METHODS

In the current study, Granger causal analysis was performed to investigate amygdalar subdivision-based resting-state effective connectivity differences between 111 IGD subjects and 120 matched participants with recreational game use (RGUs). We further correlated neuroimaging findings with clinical measures. Mediation analysis was conducted to explore whether amygdalar subdivision-based effective connectivity mediated the relationship between IGD severity and loneliness.

RESULTS

Compared with RGUs, IGD subjects showed inhibitory effective connections from the left pregenual anterior cingulate cortex (pACC) to the left laterobasal amygdala (LBA) and from the right medial prefrontal cortex (mPFC) to the left LBA, as well as an excitatory effective connection from the left middle prefrontal gyrus (MFG) to the right superficial amygdala. Further analyses demonstrated that the left pACC-left LBA effective connection was negatively correlated with both Internet Addiction Test and UCLA Loneliness scores, and it mediated the relationship between the two.

CONCLUSION

IGD subjects and RGUs showed different connectivity patterns involving amygdalar subdivisions. These findings support a neurobiological mechanism for the relationship between IGD and loneliness, and suggest targets for therapeutic approaches that could be used to treat IGD.