Attachment Style and Internet Addiction: An Online Survey

Social media addiction: associations with attachment style, mental distress, and personality

BACKGROUND

Social media bring not only benefits but also downsides, such as addictive behavior. While an ambivalent closed insecure attachment style has been prominently linked with internet and smartphone addiction, a similar analysis for social media addiction is still pending. This study aims to explore social media addiction, focusing on variations in attachment style, mental distress, and personality between students with and without problematic social media use. Additionally, it investigates whether a specific attachment style is connected to social media addiction.

METHODS

Data were collected from 571 college students (mean age = 23.61, SD = 5.00, 65.5% female; response rate = 20.06%) via an online survey administered to all enrolled students of Sigmund Freud PrivatUniversity Vienna. The Bergen Social Media Addiction Scale (BSMAS) differentiated between students addicted and not addicted to social media. Attachment style was gauged using the Bielefeld Partnership Expectations Questionnaire (BFPE), mental distress by the Brief Symptom Inventory (BSI-18), and personality by the Big Five Inventory (BFI-10).

RESULTS

Of the total sample, 22.7% of students were identified as addicted to social media. For personality, it was demonstrated that socially media addicted (SMA) students reported significantly higher values on the neuroticism dimension compared to not socially media addicted (NSMA) students. SMA also scored higher across all mental health dimensions-depressiveness, anxiety, and somatization. SMA more frequently exhibited an insecure attachment style than NSMA, specifically, an ambivalent closed attachment style. A two-step cluster analysis validated the initial findings, uncovering three clusters: (1) secure attachment, primarily linked with fewer occurrences of social media addiction and a lower incidence of mental health problems; (2) ambivalent closed attachment, generally associated with a higher rate of social media addiction and increased levels of mental health problems; and (3) ambivalent clingy attachment, manifesting a medium prevalence of social media addiction and a relatively equitable mental health profile.

CONCLUSIONS

The outcomes are aligned with previous research on internet and smartphone addiction, pointing out the relevance of an ambivalent closed attachment style in all three contexts. Therapeutic interventions for social media addiction should be developed and implemented considering these findings.

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.

Attachment anxiety and cyberbullying victimization in college students: the mediating role of social media self-disclosure and the moderating role of gender

Backgrounds and purpose

Cyberbullying is a globally prevalent social problem that threatens the wellbeing of young people. Despite a rising call for more research focused on cyberbullying victims, our understanding of the psychological and behavioral risk factors associated with cyberbullying victimization (CV) remains limited, especially among the Chinese population. However, such information is crucial for identifying potential victims and planning targeted educational and protective interventions. In this paper, we report an empirical investigation into how attachment anxiety (AA), social media self-disclosure (SMSD), and gender interplay with each other to influence CV.

Methods

Cross-sectional survey data from 845 Chinese college students (Female = 635, Mage = 18.7) were analyzed in SPSS PROCESS using Haye's macro with the bootstrap method.

Results

Our data support a moderated mediation model. First, SMSD partially mediates the positive relationship between AA and CV, which suggests individuals with high AA tend to engage in risky and excessive self-disclosure behavior on social media, which, in turn, expose them to an increased risk of cyberbullying. Second, gender moderates the direct AA-CV path and the second stage of the mediation path, making the effect of AA on CV appear more direct in males (i.e., not mediated by SMSD) and more indirect (i.e., fully mediated through SMSD) in females.

Conclusion

The results contribute to an ongoing endeavor to better understand the psychological and behavioral mechanisms underlying CV and develop effective strategies to identify and protect vulnerable individuals.

The associations between attachment, self-esteem, fear of missing out, daily time expenditure, and problematic social media use: A path analysis model

The present study investigated the factors that may be associated with a dysfunctional use of social media use, by exploring the association between adult attachment patterns and problematic social media use and analyzing the sequential mediation of self-esteem, fear of missing out (FoMO), and time spent on social media. A sample of 470 social media users (M_age = 33.76 years; SD = 14.267; 70 % women) completed the Bergen Social Media Addiction Scale, Fear of Missing Out Scale, Rosenberg Self-Esteem Scale, and Relationship Questionnaire. Results showed a path analysis model providing an excellent fit to the data (χ² = 2.939, p = 0.230; GFI = 0.998, TLI = 0.987, CFI = 0.998, RMSEA = 0.032, SRMR = 0.016). A significant and positive total effect in the associations between preoccupied and fearful attachment patterns and problematic social media use emerged. Both preoccupied and fearful attachment patterns were also related to self-esteem, FoMO, and time spent on social media, which were sequentially associated and were, in turn, significantly related to problematic social media use. Finally, when self-esteem, FoMO, and time spent on social media were added into the model, they totally mediated the relationships between preoccupied and fearful attachment patterns and problematic social media use, suggesting a full multiple mediation model (R² = 0.33). Such data may provide useful information for clinical practice to develop tailored interventions and prevention programs to address the compensatory and problematic use of social media.

Inferiority feelings and internet addiction among Turkish University students in the context of COVID-19: The mediating role of emotion dysregulation

Emotion dysregulation is a major predictor of increased internet addiction. However, the psychological experiences linked to increased internet addiction through higher emotion dysregulation are poorly understood. The aim of this study was to investigate if inferiority feelings, an Adlerian construct theorized to be rooted in childhood, are associated with increased Internet addiction through emotion dysregulation. Another objective of the study was to determine if the internet use characteristics of young adults changed during the pandemic. A conceptual model was validated statistically using the PROCESS macro with a survey method involving 443 university students living in different regions of Turkey. The results support the significance of all three effects of inferiority feelings on internet addiction, namely the total (B = 0.30, CI = [0.24, 0.35]), the direct (B = 0.22, BootCI = [0.15, 0.29]), and the indirect (B = 0.08, BootCI = [0.04, 0.12]). In other words, inferiority feelings are associated with a greater level of internet addiction both directly and indirectly through greater emotion dysregulation. Moreover, the overall prevalence of Internet addiction was 45.8% among the participants and that of severe Internet addiction was 22.1%. Almost 90% of the participants reported an increase in their recreational Internet use during the pandemic, with an average daily increase of 2.58 h (SD = 1.49), the significance of which was supported by the t-test results. The results provide important insights for parents, practitioners, and researchers on addressing the internet addiction problem among young adults living in Turkey or other countries that are similar to Turkey.

Escapism and Excessive Online Behaviors: A Three-Wave Longitudinal Study in Finland during the COVID-19 Pandemic

Excessive online behaviors refer to harmful or disproportionate use of digital network applications. Such behaviors are likely to be associated with escapist motives. Our aim was to analyze whether escapism predicts excessive gambling, excessive gaming, and excessive internet use over time. A longitudinal sample of Finnish residents aged 18-75 years (n = 1022, 51.27% male) was surveyed at three time points during the COVID-19 pandemic in 6-month intervals: April 2021 (Time 1), October-November 2021 (Time 2), and April-May 2022 (Time 3). Of the original Time 1 respondents, 66.80% took part in the surveys at both Time 2 and Time 3. All surveys included measures for excessive gambling (Problem Gambling Severity Index), excessive gaming (Internet Gaming Disorder Test), and excessive internet use (Compulsive Internet Use Scale). Three escapism-specific questions were used to construct a dedicated escapism variable. Socio-demographic variables, alcohol consumption, and psychological distress were used as controls. The study was conducted with multilevel regression analyses using hybrid models. Our research showed that escapism had strong within-person effects on excessive gambling, B = 0.18, p = 0.003; excessive gaming, B = 0.50, p < 0.001; and excessive internet use, B = 0.77, p < 0.001 over time. The between-person effect of escapism was demonstrated on excessive gaming B = 0.91, p < 0.001, and excessive internet use B = 0.61, p = 0.036. Adverse societal events and uncertain times can manifest in excessive online behaviors motivated by escapism, highlighting a need to focus prevention efforts on healthy coping methods.

The Relationship Between Being Bullied and Addictive Internet Use Among Chinese Rural Adolescents: The Mediating Effect of Adult Attachment

Internet addiction among adolescents is an emerging public health issue. The aim of this study was to examine the relationship between being bullied and internet addiction, and further to test the mediating effect of adult attachments on this relationship among Chinese rural adolescents. A total of 1,270 adolescents from three high schools in Henan province were recruited as subjects. Internet addiction was measured by Young's internet addiction scale. This study showed that the prevalence of being bullied and addictive internet use among the recruited Chinese rural adolescents were 41.97% and 11.34%, respectively. Being bullied was significantly associated with internet addition. Adult attachment was found to mediate the association between being bullied and internet addiction. Higher anxiety attachment and lower close-dependent attachment partially explained the higher risk of internet addiction among the Chinese rural adolescents being bullied. This study suggests that the experience of being bullied can increase the risk of addictive internet use and that this risk can be mediated through adult attachments. This discovery supports the adoption of effective prevention programs to decrease school bullying and to improve adult attachments for adolescents in China and other countries.

The Mediator Role of Fear of Missing Out in the Parent-Adolescent Relationship Quality and Problematic Internet Use

The aim of the research is to examine the direct and indirect relationship between parent-adolescent relationship quality, problematic internet use, and fear of missing out. The sample consists of 547 university students (67% female and 33% male) aged between 17 and 23 (X = 22.15, SD = 2.86). Parent-Adolescent Relationship Quality Scale, Fear of Missing Developments Scale, Problematic Internet Use Scale, and Personal Information Form were used to collect the study data. Research hypotheses were tested using Structural Equation Modeling (SEM). The results of the analysis supported the research hypothesis and showed that the fear of missing out developments had a partial mediating effect on the relationship between the parent-individual relationship quality and problematic internet use. Research analysis showed that negative interaction with parents and creating a negative atmosphere can increase FoMO experiences among adolescents, which might increase their problematic internet use. Limitations, conclusions, and directions for future research are discussed.

The prevalence and psychological relation of problem shopping: data from a large-scale sample from Turkey

BACKGROUND

The purpose of the present study was to comprehensively examine the measurement aspects, the prevalence, and the psychological correlates of problem shopping among a large-scale national sample of Turkish adults.

RESULT

Participants (N = 24,380, 50% men, M age = 31.79 years, age range = 18-81 years) completed a questionnaire that comprised the Shopping Addiction Risk Questionnaire, the Brief Symptom Inventory, the Positive and Negative Affect Schedule, and the Experiences in Close Relationships-Revised. Results showed that 1.8% of the participants had probable shopping addiction. Being female, being younger, psychiatric distress, positive affect, negative affect, anxious attachment, and avoidant attachment were positive correlates of problem shopping.

CONCLUSION

The results of this large sample size study suggest that shopping addiction is not a rare condition in Turkey. Further research is needed to understand different motives that underlie the problematic shopping behavior in the young and female population in comparison to older and male populations. Preventive programs or any interventions for people with PSB needs to address regulation difficulties and development of healthy strategies to cope with psychiatric distress.

Internet Addiction: The Role of Parental Care and Mental Health in Adolescence

Internet addiction in adolescence is a social issue which is being increasingly discussed worldwide. Hence, deepening the knowledge of its development is necessary to prevent short- and long-term negative outcomes. This study involving 266 adolescents (mean age = 16.1 years, SD = 1.4) aimed at analyzing the relationship between quality of parental care, Internet addiction and adolescents’ mental health, by means of the following self-report tools: the Parental Bonding Instrument, the Internet Addiction Test, and the Strengths and Difficulties Questionnaire. The findings, collected through structural equation model analyses, showed that perceived care from both father and mother had significant indirect effects on Internet addiction problems through adolescents’ mental health problems. Furthermore, Internet addiction problems were demonstrated to be negatively associated with maternal care but not with paternal care. The study provides empirical support to the need of family-based prevention and intervention programs to take care of Internet addiction.

Early parent-child interactions and substance use disorder: An attachment perspective on a biopsychosocial entanglement

This review aims to elucidate environmental and genetic factors, as well as their epigenetic and neuroendocrine moderators, that may underlie the association between early childhood experiences and Substance Use Disorders (SUD), through the lens of parental attachment. Here we review those attachment-related studies that examined the monoaminergic systems, the hypothalamic pituitary adrenal stress response system, the oxytoninergic system, and the endogenous opioid system from a genetic, epigenetic, and neuroendocrine perspective. Overall, the selected studies point to a moderating effect of insecure attachment between genetic vulnerability and SUD, reasonably through epigenetic modifications. Preliminary evidence suggests that vulnerability to SUDs is related with hypo-methylation (e.g. hyper-expression) of high-risk polymorphisms on the monoaminergic and hypothalamic pituitary adrenal system and hyper-methylation (e.g. hypo-expressions) of protective polymorphisms on the opioid and oxytocin system. These epigenetic modifications may induce a cascade of neuroendocrine changes contributing to the subclinical and behavioural manifestations that precede the clinical onset of SUD. Protective and supportive parenting could hence represent a key therapeutic target to prevent addiction and moderate insecure attachment.

Loneliness and problematic internet use: testing the role of interpersonal problems and motivation for internet use

BACKGROUND

A number of factors have been demonstrated to be associated with Problematic Internet Use (PIU); otherwise known as Internet Addiction), which is mostly concerned with psychological problems such as loneliness. This study aimed to examine how and in what way loneliness influenced PIU.

METHODS

A self-report measurement on loneliness, the Internet addiction test (IAT) and instruments on interpersonal problems were administered to 318 medical students (57% females); mean age totaled 20.88 years (SD = 1.8). We performed a mediation analysis to evaluate direct effects of loneliness on IAT, as well as indirect effects mediated by interpersonal problems. In addition, motivation for internet use was added to the mediation model and tested whether it acted as the second mediator (serial mediation model) or a moderator (moderated mediation model).

RESULTS

After controlling for sex and age, socially inhibited problems exhibited full mediation whereas the remainder showed partial mediation effects, with the exception that intrusive and cold interpersonal problems indicated no mediating role. Negative motivation and motivation for being accepted had mediation effects for all types of interpersonal problems. Motivation for working was found to be a significant mediator and moderator of the most interpersonal problems. Intrusive and cold styles became a mediator only when some motivation variables were added to the model, implying that not only psychological problems should be included when analyzing PIU, but also other variables such motivation for internet use. The percent of variance explained, by IAT score, increased from 13% in the mediation model to 33% by the moderated mediation model, and 43% using the serial mediation model.

CONCLUSION

The study suggested the crucial role of loneliness and interpersonal problems on PIU, for which motivation for internet use explained how each interpersonal problem would be associated. This may provide some insight regarding the pathological characteristics of those using the internet as a coping strategy.

People-centered care for psoriasis and urticaria: Are we overlooking Internet addiction while only considering patients and physician settings?

Psoriasis and chronic urticaria (CU) are chronic skin diseases with a high impact on individuals' life and mental health. Some studies indicate a high prevalence of Internet addiction and many affected individuals seem not to utilize healthcare, but rather search for health-related information online. The aims of the study were to assess Internet addiction as a potential comorbidity in both diseases as well as identify differences in healthcare utilization between individuals with psoriasis and CU. This cross-sectional study is based on self-reported data from individuals with psoriasis and CU living throughout Germany using the framework of an online survey from 12/2018 to 01/2019. Advertisements on Google and Facebook were used to address Internet users who searched online for information on psoriasis or CU. The study questionnaire comprised questions on demographics, current contact with physicians, and disease history as well as validated screening tools for well-being and Internet addiction. Overall, 1686 participants (74.0% female, 38.5% psoriasis) with a mean age of 36.9 ± 12.9 years were analyzed. Participants with CU were more likely female (89.2% vs 49.8%, P < 0.001) and not in medical care compared to participants with psoriasis (60.3% vs 45.9%, P < 0.001). Sixteen percent of the participants overall were screened positive for Internet addiction. Furthermore, not utilizing medical care showed a significant association with being screened positive for Internet addiction in participants with CU (adjusted odds ratio [aOR] = 1.49, 95% confidence interval [CI] 1.10-2.02), but not in those with psoriasis. The study revealed a high proportion of affected individuals not being in medical care and a high prevalence of Internet addiction, with individuals with CU not utilizing medical resources having a higher chance of being screened positive for Internet addiction. This underlines the approach of people-centered care and highlights its importance for further research.

Always Online? Internet Addiction and Social Impairment in Psoriasis across Germany

With the World Health Organization (WHO) demanding further investigation of the social impairment and psychosocial burden of psoriasis, a first study identified a high prevalence of Internet addiction. The aim of this study was to assess social impairment and estimate the occurrence of Internet addiction along with depression, cigarette smoking, and alcohol dependency in individuals with psoriasis recruited online in a people-centered care approach. A cross-sectional online survey was carried out across Germany between March 2019 and June 2019. The questionnaire contained information on social impairment, smoking habits, as well as validated questionnaires on Internet addiction, depression, and alcohol dependency. Overall, 460 individuals (62.4% female; mean age: 45.9 ± 13.7 years) with psoriasis were included. Of those, 406 (88.3%) stated to be at least rarely socially impaired. The positive screening rate for Internet addiction was 8.5%. Furthermore, 40.0% had positive screenings for depression, 17.1% for alcohol dependency, and 32.6% for daily smoking. Positive screenings for Internet addiction and alcohol dependency were substantially more frequent in individuals with psoriasis than in the German general population. In order to meet the demands of the WHO, Internet addiction could be considered as a potential comorbidity in psoriasis and a focus on people-centered care is advisable for further research.

A partial mediation effect of father-child attachment and self-esteem between parental marital conflict and subsequent features of internet gaming disorder in children: a 12-month follow-up study

Background

This study evaluated whether parent-child attachment and self-esteem may mediate the relationship between parental marital conflict and increases in features of internet gaming disorder (IGD) in children at 1 year.

Methods

The baseline and one-year follow-up data for 268 pre-teens aged between 9 and 10 from the Internet User Cohort for Unbiased Recognition of Gaming Disorder in Early Adolescence (iCURE) study were collected. The students were children at low risk for IGD in the initial self-reported assessment, anyone living with both parents, current game user at baseline, and those who completed a 12-month follow-up assessment. The Internet Game Use-Elicited Symptom Screen (IGUESS) was used to identify increases in IGD features at 12 months. To examine a potential mediation effect, structural equation modeling was performed.

Results

The direct effect was statistically significant, and parental marital conflict at baseline significantly predicted the increases in IGD features in children at the 12-month follow-up after adjusting for gender, sex, socioeconomic status, and baseline IGUESS score (ß = 0.206, P = 0.003). The indirect effect showed that attachment to fathers through self-esteem was a significant mediating effect (ß = 0.078, P = 0.045). Parental marital conflicts were associated with increases in IGD features in children through poor father-child attachment, and in turn, the lower levels of self-esteem in the children.

Conclusions

Parents, especially fathers, should make an effort to bond with their children to reduce the risk of their children’s developing the IGD features.

Measurement, Profiles, Prevalence, and Psychological Risk Factors of Problematic Gaming Among the Turkish Community: A Large-scale National Study

The present study investigated the prevalence, the potential different profiles, and the associated psychological factors of disordered gaming using data from a large-scale epidemiological study (TURBAHAR [Turkey’s Addiction and Mental Health Risk Profile Map Project]) carried out in Turkey in 2018 with 24,494 participants aged 18–81 years. Participants completed a comprehensive survey comprising a demographic questionnaire, Gaming Addiction Risk Questionnaire, Brief Symptom Inventory, Personal Well-Being Index Adult Form, Positive and Negative Affect Schedule, Toronto Alexithymia Scale, and Experiences in Close Relationships-Revised Scale. Latent class analysis showed the existence of eight different game profiles, which differed in relation to the intensity and specific features of the behavior. Results showed that 1.6% of the participants were problematic gamers. Being male, being younger, lower education level, being single, using alcohol and cigarettes, psychiatric distress, positive and negative affect, and anxious adult attachment were positively associated with problematic gaming.

Treatment Efficacy of Internet Gaming Disorder With Attention Deficit Hyperactivity Disorder and Emotional Dysregulaton

BACKGROUND

Recent youth with Attention Deficit Hyperactivity Disorder (ADHD) noticed emotional dysregulation if they had Internet Gaming Disorder (IGD). This study aims to understand the treatment efficacy of IGD with ADHD and emotional dysregulaton.

METHOD

A total of 101 ADHD youths were recruited. We used the Chen Internet Addiction Scale and IGD criteria of the diagnotsic statistical manual (DSM)-5 to confirm IGD. The Swanson, Nolan, and Pelham questionnaire Version IV was used for symptoms of ADHD and oppositional defiant disorder. Disruptive mood dysregulation disorder was assessed by psychiatrist.

RESULTS

There is a new phenomenon that emotional dysregulation has been frequently noticed in severely gaming-addicted ADHD youth. Treatment efficacy of IGD is good when the underlying symptom of ADHD is controlled. Symptom scores of disruptive mood dysregulation (DMDD) were significantly reduced by 71.9%, 74.8%, and 84.4% at week 2, 3, and 4, respectively (P ≤ .001) after adjusting baseline symptom severity.

CONCLUSION

IGD may strongly arouse emotional dysregulation. Future DSM criteria could consider these gaming-addicted youth as a specific subclass of ADHD.

Long-term effects of parental divorce on mental health - A meta-analysis

The aim of this study was to estimate the long-term effects of parental divorce on their offspring's mental health as well as substance-based addiction. We performed a systematic literature search on PubMed, Medline, PsyINFO, PsyARTICLES and PsycNET for the time period from 1990 until March 2018 in English language. In total 54 studies were included in the meta-analysis resulting in 117 effect sizes as well as a total sample of 506,299 participants. A significant association between parental divorce and every aspect of mental health was found with the following pooled ORs (95% CIs): Depression 1.29 (1.23-1.35), anxiety 1.12 (1.04-1.12), suicide attempt 1.35 (1.26-1.44), suicidal ideation 1.48 (1.43-1.54), distress 1.48 (1.37-1.6), alcohol 1.43 (1.34-1.53), smoking 1.64 (1.57-1.72) and drugs 1.45 (1.44-1.46) could be estimated. There was significant association between the effect sizes and the publication date specifically for distress (r = -0.995, p = .005). The results of the meta-analysis show a consistent direction of influence regarding the long-term effect of parental divorce on their children. Individuals affected by parental divorce have a higher risk of developing a variety of mental health conditions, although the effect sizes decreased from 1990 to 2017. Further research should focus on developing programmes to promote the resilience of children affected by divorce.

Internet Interpersonal Connection Mediates the Association between Personality and Internet Addiction

Backgrounds: The development of the Internet has changed interpersonal interactions, so that people no longer need to physically meet each other. However, some people are more vulnerable to becoming addicted to Internet activities, something to which the ease of Internet access and usage has contributed. In this study, we examined the association between personality traits and feelings about online interpersonal interactions to predict Internet addiction. This was accomplished using an online advertisement that asked participants to complete the questionnaires in the laboratory. Methods: Two hundred and twenty-three participants with a mean age of 22.50 years were recruited for this study and asked to complete the following questionnaires: the Beck Depressive Inventory (BDI), the Beck Anxiety Inventory (BAI), the Chen Internet Addiction Scale (CIAS), the Eysenck Personality Questionnaire (EPQ), the Internet Usage Questionnaire (IUQ) and the Feelings of Internet Interpersonal Interaction Questionnaire (FIIIQ). Results: The results showed that people with a neurotic personality and anxious feelings about Internet interpersonal interactions are more likely to become addicted to the Internet. In addition, people with neuroticism and who are more anxious about Internet interpersonal relationships are more likely to develop Internet addiction. Conclusions: People who tend to develop new interpersonal relationships via the Internet and be anxious about online interpersonal relationships are more vulnerable to becoming addicted to the Internet. The individuals who are more anxious about Internet interpersonal interaction and tend to develop new interpersonal relationships via the Internet are more likely to develop Internet addiction.

Sexual Desire, Mood, Attachment Style, Impulsivity, and Self-Esteem as Predictive Factors for Addictive Cybersex

BACKGROUND

An increasing number of studies are concerned with various aspects of cybersex addiction, the difficulty some persons have in limiting cybersex use despite a negative impact on everyday life.

OBJECTIVE

The aim of this study was to assess potential links between the outcome variable cybersex addiction, assessed with the Compulsive Internet Use Scale (CIUS) adapted for cybersex use, and several psychological and psychopathological factors, including sexual desire, mood, attachment style, impulsivity, and self-esteem, by taking into account the age, sex, and sexual orientation of cybersex users.

METHODS

A Web-based survey was conducted in which participants were assessed for sociodemographic variables and with the following instruments: CIUS adapted for cybersex use, Sexual Desire Inventory, and Short Depression-Happiness Scale. Moreover, attachment style was assessed with the Experiences in Close Relationships-Revised questionnaire (Anxiety and Avoidance subscales). Impulsivity was measured by using the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency Impulsive Behavior Scale. Global self-esteem was assessed with the 1-item Self-Esteem Scale.

RESULTS

A sample of 145 subjects completed the study. Addictive cybersex use was associated with higher levels of sexual desire, depressive mood, avoidant attachment style, and male gender but not with impulsivity.

CONCLUSIONS

Addictive cybersex use is a function of sexual desire, depressive mood, and avoidant attachment.

Comparison of Students With and Without Problematic Smartphone Use in Light of Attachment Style

Background: Nowadays, media addictions are especially of high relevance to psychotherapeutic practice. More recently, this particularly includes excessive smartphone usage. Even though a growing number of scientific literature and also mainstream media highlight problematic smartphone use as a serious health problem, there is only little research on this issue. Objective: The aim of this study was to examine this phenomenon with a focus on attachment-specific differences between students with and without problematic smartphone use. Method: A survey was carried out on all enrolled students of the Sigmund Freud University Vienna. The Smartphone Addiction Scale (SPAS) was used to differentiate between students with and without problematic smartphone use. The attachment style was assessed using the Bielefeld Partnership Expectations Questionnaire (BFPE). Results: Of the total sample, 75 of the students (15.1%) showed a problematic smartphone use. A positive correlation between excessive smartphone usage and an insecure attachment style was found. Discussion: Therapy for problematic smartphone use should be carried out in light of patient's attachment style. Further research into other factors of mental stress and personality is needed to better understand problematic smartphone use.

Effects of Equine-Assisted Activities and Therapies on the Affective Network of Adolescents with Internet Gaming Disorder

OBJECTIVES

Internet gaming disorder (IGD) has been suggested to be a mental health disorder. Attachment and emotional status in IGD patients are important for understanding the etiology and progression of IGD because both parameters are considered to be associated with the affective network. Equine-assisted activities and therapies (EAAT) have been reported to improve emotional status and attachment in subjects. We hypothesized that EAAT would improve attachment in IGD adolescents with insecure attachment issues and increase functional connectivity (FC) within the affective network.

DESIGN

Subjects completed a demographic questionnaire, the Korean Experiences in Close Relationships Scale Revised version (K-ECRS), the Child Depression Inventory, Young's Internet Addiction Scale, the Korean Attention-Deficit Hyperactivity Disorder Rating Scale, and resting-state functional magnetic resonance imaging at baseline at the end of EAAT.

SUBJECTS

Fifteen IGD adolescents with insecure attachment issues and 15 healthy comparison adolescents with secure attachment agreed to participate in this study.

RESULTS

After 7 days of EAAT, K-ECRS avoidance and anxiety scores improved in all adolescents. K-ECRS avoidance scores of the IGD group showed marked improvement compared with those of the healthy group. In all participants, FC from the left amygdala to the left parahippocampal gyrus, left medial frontal gyrus, and left inferior frontal gyrus, as well as from the right amygdala to the left caudate, right claustrum, and left inferior frontal gyrus increased. In IGD adolescents, FC from the left amygdala to the left frontal orbital gyrus, as well as from the right amygdala to the right corpus callosum also increased.

CONCLUSION

These findings suggested that EAAT improves attachment, which could lead to a decrease in the severity of IGD symptoms in IGD patients with insecure attachment issues. In addition, EAAT increases FC within the affective network, which was associated with attachment not only in healthy adolescents but also in adolescents with IGD.

Internet and Video Game Addictions: Diagnosis, Epidemiology, and Neurobiology

In the past 2 decades, there has been substantial increase in availability and use of digital technologies, including the Internet, computer games, smart phones, and social media. Behavioral addiction to use of technologies spawned a body of related research. The recent inclusion of Internet gaming disorder as a condition for further study in the DSM-V invigorated a new wave of researchers, thereby expanding our understanding of these conditions. This article reviews current research, theory, and practice regarding the diagnosis, epidemiology, and neurobiology of Internet and video game addictions.

Adolescent Internet Abuse: A Study on the Role of Attachment to Parents and Peers in a Large Community Sample

Adolescents are the main users of new technologies and their main purpose of use is social interaction. Although new technologies are useful to teenagers, in addressing their developmental tasks, recent studies have shown that they may be an obstacle in their growth. Research shows that teenagers with Internet addiction experience lower quality in their relationships with parents and more individual difficulties. However, limited research is available on the role played by adolescents' attachment to parents and peers, considering their psychological profiles. We evaluated in a large community sample of adolescents (N = 1105) the Internet use/abuse, the adolescents' attachment to parents and peers, and their psychological profiles. Hierarchical regression analyses were conducted to verify the influence of parental and peer attachment on Internet use/abuse, considering the moderating effect of adolescents' psychopathological risk. Results showed that adolescents' attachment to parents had a significant effect on Internet use. Adolescents' psychopathological risk had a moderating effect on the relationship between attachment to mothers and Internet use. Our study shows that further research is needed, taking into account both individual and family variables.

Gender Differences in and the Relationships Between Social Anxiety and Problematic Internet Use: Canonical Analysis

Background

The cognitive-behavioral model of problematic Internet use (PIU) proposes that psychological well-being is associated with specific thoughts and behaviors on the Internet. Hence, there is growing concern that PIU is associated with psychological impairments.

Objective

Given the proposal of gender schema theory and social role theory, men and women are predisposed to experience social anxiety and engage in Internet use differently. Thus, an investigation of gender differences in these areas is warranted. According to the cognitive-behavioral model of PIU, social anxiety is associated with specific cognitions and behaviors on the Internet. Thus, an investigation of the association between social anxiety and PIU is essential. In addition, research that takes into account the multidimensional nature of social anxiety and PIU is lacking. Therefore, this study aimed to explore multivariate gender differences in and the relationships between social anxiety and PIU.

Methods

Participants included 505 college students, of whom 241 (47.7%) were women and 264 (52.3%) were men. Participants’ ages ranged from 18 to 22 years, with a mean age of 20.34 (SD=1.16). The Social Anxiety Scale and Problematic Internet Use Scale were used in data collection. Multivariate analysis of variance (MANOVA) and canonical correlation analysis were used.

Results

Mean differences between men and women were not statistically significant in social anxiety (λ=.02, F3,501=2.47, P=.06). In all three PIU dimensions, men scored higher than women, and MANOVA shows that multivariate difference was statistically significant (λ=.94, F3,501=10.69, P<.001). Of the canonical correlation functions computed for men, only the first was significant (Rc=.43, λ=.78, χ29=64.7, P<.001) and accounted for 19% of the overlapping variance. Similarly, only the first canonical function was significant for women (Rc=.36, λ=.87, χ29=33.9, P<.001), which accounted for 13% of the overlapping variance.

Conclusions

On the basis of the findings, we conclude that enhanced educational opportunities for women and their increasing role in the society have led women to become more active and thus closed the gap in social anxiety levels between men and women. We found that men showed more difficulties than women in terms of running away from personal problems (ie, social benefit), used the Internet more excessively, and experienced more interpersonal problems with significant others due to Internet use. We conclude that men are under a greater risk of social impairments due to PIU. Our overall conclusion is that there is a substantial amount of association between social anxiety and PIU and the association is stronger for men than it is for women. We advise that future research continue to investigate PIU and social anxiety as multidimensional constructs.

Prevalence, associated factors and impact of loneliness and interpersonal problems on internet addiction: A study in Chiang Mai medical students

INTRODUCTION

Internet addiction is common among medical students, and the prevalence is higher than the general population. Identifying and creating solutions for this problem is important. The aim of this study was to examine the prevalence and associated factors, particularly loneliness and interpersonal problems among Chiang Mai medical students.

MATERIALS AND METHODS

Of 324 first to sixth year medical students, 56.8% comprised females with a mean age of 20.88 (SD 1.8). All completed questionnaires related to the objectives and activities of internet use, the Young Internet Addiction Test, the UCLA loneliness scale, and the Interpersonal Problems Inventory were employed to identify internet addiction.

RESULTS

In all, 36.7% of the subjects exhibited internet addiction, mostly at mild level. Amount of time used daily, loneliness and interpersonal problems were strong predictors (beta = 0.441, p < 0.05, beta = 0.219, p < 0.001 and beta = 0.203 p < 0.001, respectively), whereas age and sex were not. All objectives of using internet contributed to the variance of internet addiction score. For internet activities, only non-academic or studying contributed. The final model accounted for 42.8% of total variance of the internet addiction score.

CONCLUSION

Even though most addiction was at a mild level, careful strategies should be applied to better understand the situation. Along with a screening for potential internet addiction among medical students, attention should be paid to identifying those who experience loneliness and interpersonal problems, because both are strong predictors that can be improved by a variety of appropriate intervention.

Individual Differences in the Relationship Between Attachment and Nomophobia Among College Students: The Mediating Role of Mindfulness

Background

There is a growing interest in nomophobia, which is defined as the fear of being out of cellular phone contact, or "feelings of discomfort or anxiety experienced by individuals when they are unable to use their mobile phones or utilize the affordances these devices provide”. However, only limited research can be found in terms of its determinants at present. Contemporary literature suggests that the relationships among attachment styles, mindfulness, and nomophobia have not been investigated.

Objective

This study aims to investigate the mediating effect of mindfulness on the relationship between attachment and nomophobia. In addition, the study also focuses on gender differences in attachment, mindfulness, and nomophobia. A theory-based structural model was tested to understand the essentials of the associations between the constructs.

Methods

The Experiences in Close Relationships Scale, Nomophobia Questionnaire, and Mindful Attention Awareness Scale were used to collect data from undergraduate students (N=450; 70.9% women [319/450]; mean age=21.94 years [SD 3.61]). Two measurement models (ie, attachment and mindfulness) and a structural model were specified, estimated, and evaluated.

Results

The structural equation model shows that the positive direct effects of avoidant (.13, P=.03) and anxious attachment (.48, P<.001) on nomophobia were significant. The negative direct effects of avoidant (−.18, P=.01) and anxious attachment (−.33, P<.001) on mindfulness were also significant. Moreover, mindfulness has a significant negative effect on nomophobia for women only (−.13, P=.03). Finally, the Sobel test showed that the indirect effects of avoidant and anxious attachment on nomophobia via mindfulness were significant (P<.001). The direct and indirect effects of anxious attachment, avoidant attachment, and mindfulness altogether accounted for 33% of the total variance in nomophobia. Gender comparison results show that there is a significant difference in attachment based on gender (F_2,447=6.97, P=.01, Wilk λ=.97, partial η²=.03). Women (mean 68.46 [SD 16.96]) scored significantly higher than men (mean 63.59 [SD 15.97]) in anxious attachment (F₁=7.93, P=.01, partial η²=.02). Gender differences in mindfulness were not significant (F_4,448=3.45, P=.69). On the other hand, results do show significant gender differences in nomophobia (F_4,445=2.71, P=.03, Wilk λ=.98, partial η²=.02) where women scored significantly higher than men.

Conclusions

In general, individuals who are emotionally more dependent and crave more closeness and attention in the relationship tend to display higher levels of fear or discomfort when they have no access to their mobile phones. However, gender has a differential impact on the relationship between avoidant attachment and nomophobia. This study establishes the impact of mindfulness on nomophobia for women; therefore, future studies should test the effectiveness of mindfulness-based therapy approaches and confirm whether they are effective and efficient. On the basis of significant gender difference in nomophobia and attachment, we conclude that gender should be taken into account in mindfulness-based treatments dealing with nomophobia.