Early substance consumption and problematic use of video games in adolescence

Microaggressions, perceptions of campus climate, mental health, and alcohol use among first-year college students of color

Depressive and anxiety symptoms are increasingly common, and problematic alcohol use remains prevalent in college. To expand on prior research on mostly white samples, we surveyed first-year students of color from our predominately white university (Southeastern US) to identify risk factors for mental health symptoms and potentially co-occurring problematic alcohol use. Results showed significant associations between microaggressions and poor campus climate (hypothetical predictors) with depressive, anxiety, somatic symptoms (hypothetical outcomes) that were indirectly linked through perceived stress, poor sleep, and academic burnout (hypothetical mediators). Poor campus climate, academic burnout, and using alcohol to cope were the most relevant to alcohol use disorder symptoms. Results support efforts to address and reduce racial microaggressions and promote a positive campus climate for all.

Prevalence of Internet gaming disorder and its association with psychiatric comorbidities among a sample of adults in three Arab countries

Abstract

Background

As Internet gaming became publicly available over the past 25 years, Internet gaming disorder emerged as a new diagnostic entity and became established in psychiatric diagnostic systems as a form of addiction. Given the recency of its advent, reliable data on the epidemiology and psychiatric comorbidity of this disorder in specific geographic regions are scarce and dearly needed for appropriate treatment.

Results

A total sample of number = 1332 participants completed the questionnaire. Four-hundred twenty-three of them were gamers; in this cohort, the prevalence of Internet gaming disorder was 6.1%. A strong association between Internet gaming and several psychiatric disorders (attention deficit, hyperactivity, depression, and anxiety) was found.

Conclusions

Internet gaming disorder is frequent in adults from Arab countries. It is associated with psychiatric comorbidities in this current sample; the nature of this association needs to be properly investigated.

Development and Psychometric Validation of a Novel Self-Report Measure of ICD-11 Gaming Disorder

Video game use is associated with addiction-like behaviors in 6 to 15.6 percent of video game players. There were no formal diagnostic criteria for video game addiction until gaming disorder (GD) was added to the International Classification of Diseases 11th Edition (ICD-11), and there are no published instruments designed to diagnose GD. The aims of the current study were to develop a self-report measure of GD (using the Lee Morrell Gaming Disorder Questionnaire [LMGDQ]) and test its factor structure, reliability, validity, and relationships with participant demographic characteristics. Participants included 3,481 adult video game players (M = 25.08, SD = 7.02; 79.8 percent cisgender male; 77.4 percent Caucasian) who completed an online survey. Factor analyses suggested retaining 14 items and indicated the presence of two factors. The scale had excellent reliability (α = 0.919), and LMGDQ scores were positively correlated with existing scales measuring problematic video game use as well as video game use and age, p values <0.01. Participants who were Asian and Asian American, cisgender men, single and dating, unemployed, had completed some high school or their GED, and who played massively multiplayer online role-playing games the most reported significantly greater LMGDQ scores, p values <0.05. Results suggest that the LMGDQ is a psychometrically sound and valid measure of GD.

Dual Diagnosis in Adolescents with Problematic Use of Video Games: Beyond Substances

The technological revolution has led to the birth of new diagnoses, such as gaming disorder. When any addiction, including this one, is associated with other mental disorders, it is considered a dual diagnosis. The objectives of this current work were to estimate the prevalence of dual diagnoses in the adolescent general population while also considering the problematic use of video games and substance addiction and assessing its psychosocial risk factors. Thus, we carried out a cross-sectional study with a sample of 397 adolescents; 16.4% presented problematic videogame use and 3% presented a dual diagnosis. Male gender increased the probability of both a dual diagnosis (OR [95% CI] = 7.119 [1.132, 44.785]; p = 0.036) and problematic video game use (OR [95% CI] = 9.85 [4.08, 23.77]; p < 0.001). Regarding personality, low conscientiousness, openness, and agreeableness scores were predictors of a dual diagnosis and problematic videogame use, while emotional stability predicted a dual diagnosis (OR [95% CI] = 1.116 [1.030, 1.209]; p = 0.008). Regarding family dynamics, low affection and communication increased both the probability of a dual diagnosis (OR [95% CI] = 0.927 [0.891, 0.965]; p < 0.001) and problematic video game use (OR [95% CI] = 0.968 [0.945, 0.992]; p = 0.009). Regarding academic performance, bad school grades increased the probability of a dual diagnosis. In summary, male gender, certain personality traits, poor communication, and poor affective family dynamics should be interpreted as red flags that indicate an increased risk of a dual diagnosis in adolescents, which could require early intervention through specific detection programs.

Assessing the Association Between Internet Addiction Disorder and Health Risk Behaviors Among Adolescents and Young Adults: A Systematic Review and Meta-Analysis

Background

Internet addiction disorder (IAD) is a global issue that has resulted in a slew of physical and emotional consequences. Studies have indicated that health risk behaviors might be the risk factors for IAD. The published literature on the correlation between the two is lacking. Therefore, we conducted a comprehensive analysis to understand better the link between IAD and health risk behaviors among adolescents and young adults.

Methods

We searched ten electronic databases for relevant articles. Data were extracted based on IAD and health risk behaviors ( alcohol, smoking, suicidal, gambling and drug abuse). We calculated odds ratios (ORs), a pooled correlation coefficient (r) and 95% confidence intervals (CIs). A fixed-effect model was applied to summarize the pooled effects. Heterogeneity was examined using I2 statistics and Cochran's Q statistics. All analyses were conducted by using Stata version 15.0.

Results

A total of 16 studies and 61,823 participants were included in this study. Meta-analysis showed that IAD was positively correlated with drinking (r = 0.35; 95% CI 0.32–0.37) and smoking (r = 0.12; 95%CI 0.10–0.15), and was associated with an increased risk of suicidal behavior (OR= 1.95; 95% CI 1.65–2.30), drinking (OR= 1.75; 95% CI 1.65–1.85), and smoking (OR= 1.63; 95% CI 1.54–1.72) among adolescents.

Conclusion

We found significantly increased risks of suicidal behavior, drinking, and smoking in adolescents and young adults with IAD. These findings are important to expand our understanding of IAD and have great guiding significance for preventing health risk behaviors of adolescents and young adults.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021257729, identifier: PROSPERO CRD42021257729.

Polysubstance Use Is Positively Associated with Gaming Disorder Symptom Severity: A Latent Class Analytical Study

INTRODUCTION

The link between gaming disorder (GD) and substance use amongst adolescents is not clear. Some studies reported positive associations, whereas others suggested that alcohol and illicit drug use are not related to GD severity.

OBJECTIVES

The present study aimed to identify empirically based latent classes of alcohol and illicit drug use amongst adolescents and explore their associations with GD symptom severity and whether endorsement of specific criteria of GD is linked to the membership of latent classes of alcohol and illicit drug use.

METHODS

Data of the national sample of Hungarian adolescents from the Health Behaviour in School-aged Children survey (N = 2,768; females: 52.08%; mean age: 16.73 years) were analysed. Measures for frequency of alcohol and illicit drug use, gaming, GD symptom severity, and life satisfaction were included in the analyses.

RESULTS

Latent class analysis discriminated 4 subgroups of alcohol and illicit drug use: polysubstance users, high-risk alcohol users, moderate alcohol users, and infrequent substance users. Polysubstance users presented significantly higher levels of GD symptom severity and higher odds for endorsement of criteria of "giving up other activities" and "negative consequences."

CONCLUSIONS

Positive associations were shown between higher GD severity and the polysubstance using class. The roles of criteria of "giving up other activities" and "negative consequences" were highlighted in more severe substance use patterns. However, GD severity and criteria did not differ as a function of the level of alcohol use. These findings may imply common roots of GD and illicit drug use in adolescents.

Mental health and behavioral problems associated with video game playing among Brazilian adolescents

BACKGROUND

The problematic use of video games is linked to mental health and behavioral problems among adolescents. World reported averages for problematic use range from 1.3% to 19.3%. This is the first study to investigate these problems among Brazilian adolescents.

OBJECTIVES

This study aimed to describe the prevalence of the non-problematic and problematic use of video games among Brazilian adolescents, and to assess mental health and behavioral problems associated with both types of use.

METHODS

This study used the baseline data of a cluster randomized controlled trial that evaluated the effectiveness of the school-based program #Tamojunto2.0. The sample included 3,939 eighth-grade students who answered an anonymous self-report questionnaire. Video game use was investigated through a question, and problematic use was assessed using a scale. Weighted logistic regressions were used to investigate the associated factors.

RESULTS

The results show that 85.85% of the children reported playing video games in the past year, 28.17% fulfilled our criteria for problematic use. Non-problematic video game use is associated with being male, younger ages, and bullying perpetration. Problematic video game use is associated with being male, tobacco and alcohol use, bullying perpetrators, and bullying victims, with abnormal levels of hyperactivity/inattention, social behavior problems, conduct problems, peer relationship problems, and emotional symptoms.

CONCLUSION

Brazilian adolescents' self-reported use of video games is compatible with the world average, but the percentage of those who showed problematic use is higher than the world average. This study demonstrates the need for investigating how to prevent and intervene in this situation.

Emotional Dysregulation in Preschool Age Predicts Later Media Use and Gaming Disorder Symptoms in Childhood

Background: The aim of this study was to evaluate the role of early Emotional Dysregulation (ED) at preschool age as a risk factor or predictor of later media use behavior and Gaming Disorder (GD) in school age. Methods: 80 patients (63.7% male; mean age = 4.2, SD = 1.23) who had attended a special outpatient program for preschoolers at measuring point time t1 were contacted at measuring point time t2 (mean age = 9.2, SD = 2.03). At t1, the comprehensive clinical assessment comprised Child Behavior Checklist-Dysregulation Profile (CBCL-DP). At t2, parents completed a questionnaire on their children's media availability, usage times, and GD. Results: ED predicts a more intense use of digital media in the future. The daily average screen-use time at t2 varies significantly between the groups (148 min for children with ED at t1 and 85 min for children without ED at t1). The intensity of media use can be considered a significant predictor for the presence of a GD in dimensional assessment. When GD is classified categorically, according to the DSM-5 criteria, there is no significant correlation between ED and later GD diagnosis, neither between screen-use time and GD diagnosis. However, at dimensional level, preschool children with ED show significantly higher GD symptom scores at 9 years of age. Conclusion: ED at preschool age is strongly associated with time spent video gaming and GD symptoms 5 years later. Our results strongly indicate that emotion dysregulation in preschool children is a risk factor for later problematic video game playing behavior. This strengthens the concept of ED in the etiology of media use and provides potential targets for early GD prevention.

Internet use and adolescent drinking: Does it matter what young people do online?

BACKGROUND

In this study we examine whether the association between internet use and drinking could be different for different types of internet activities among adolescents. We also adjust for a number of theoretically relevant factors such as peer influence, unstructured activities, impulsivity and parental monitoring.

METHOD

The data are drawn from four cross-sectional surveys from the years 2016-2019 in eight municipalities in southern Sweden. The sample consist of 3733 adolescents in year 9 of compulsory education, aged 14-15.

RESULTS

The results show that there is an association between internet activities and drinking and that there are differences depending on what young people do online. Self-presentation and online sociality are both positively associated with drinking, whereas news consumption and playing games are negatively associated with drinking. The results also show that the association between the different internet activities and drinking becomes weaker when adjusting for the control variables.

CONCLUSION

This study suggests that more research is needed to examine the correlations between different forms of internet activities and drinking among adolescents in more detail.

Examining the association between exposure to various screen time sedentary behaviours and cannabis use among youth in the COMPASS study

Background

Canadian youth are among the top users of cannabis globally. The Canadian federal government identified protecting youth from cannabis-related harms as a key public health objective aligned with the legalization and strict regulation of cannabis. While there are well-established associations between screen time sedentary behaviour (STSB) and alcohol and tobacco use, the association with cannabis use is understudied. The purpose of this study is to examine the association between various types of STSBs and cannabis use in a large sample of Canadian youth.

Methods

Using cross-sectional data from 46,957 grade 9 to 12 students participating in year 5 of the COMPASS host study (2016–2017), four gender-stratified ordinal logistic regression models were used to examine how total STSB and four different types of STSBs (watching/streaming TV shows/movies, playing video games, Internet use, emailing/messaging/texting) are associated with frequency of cannabis use.

Results

One-quarter of participants (24.9%) reported using cannabis in past 12 months; the largest proportion of this group (37.9%) reported rare/sporadic use. Overall, participants spent an average 7.45 ( ±5.26) hours/day on STSBs. Total STSB was positively associated with more frequent cannabis use, and when separated by type, internet use and messaging were significant. Playing video games and watching TV/movies were also significantly associated with more frequent cannabis use, but only for females.

Conclusions

The associations between frequency of cannabis use and various measures of STSBs suggest that screen time may be a risk factor for cannabis use among youth. This association may be mediated by youths’ mental wellbeing, given emerging evidence that STSB is a risk factor for poor mental health, and the tendency for individuals to use substances as a coping mechanism. Further, the ubiquity of pro-substance use content on the internet may also contribute to increased exposure to and normalization of cannabis, further promoting its use.

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Youth average of overall STSBs was 7.48 h per day.

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Greater hours of overall STSB increased likelihood of higher frequency cannabis use.

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Internet use and messaging STSBs were both positively associated with cannabis use.

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Gender differences present for TV watching and video gaming STSBs.

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Cyber-bullying victims show increased likelihood for higher frequency cannabis use.

The increased trend of non-drinking alcohol among adolescents: what role do internet activities have?

Background

Recently, an increased trend toward non-drinking among adolescents has been observed in several countries. The aim of the present study is to evaluate a common suggestion in literature, that adolescents do not drink alcohol because they spend more time on the internet, monitored at home, by examining associations between internet activities (social media/chatting and computer gaming) and non-drinking.

Methods

A health questionnaire was distributed to all 9th graders (15-16 years) in a mid-sized Swedish county in 2008, 2010 and 2012. In total, 7089 students returned the questionnaire.

Results

In contrast to the suggestion, no association was found between total time spent on computers and non-drinking. Social media/chatting was robustly associated with a decreased probability of non-drinking across the three survey years. On the other hand, computer gaming during weekends only (OR = 1.74, CI = 1.13-2.69) or both on weekdays and weekends increased the probability of non-drinking (OR = 1.82, CI = 1.31-2.54) in 2012 only. However, neither social media/chatting nor computer gaming was associated with the increased trend of non-drinking from 2008 to 2012.

Conclusions

Internet activities were in general not associated with non-drinking among adolescents aged 15-16 years in Sweden. Although, a weak positive association between computer gaming and non-drinking was found in 2012, this effect benefited the vast majority of the boys. The larger alcohol use among those with extensive social media use/chatting may indicate that these online platforms are arenas where adolescents are exposed for positive alcohol preferences and alcohol advertising without parental supervision.

Little video-gaming in adolescents can be protective, but too much is associated with increased substance use

BACKGROUND

Studies have demonstrated inconsistent results regarding the association between video gaming time and substance use in teenagers. Understating intricacies of this association can help with substance use reduction in teenagers.

OBJECTIVES

This study aimed to untangle this complex relationship by theorizing and examining a U-shaped association.

METHODS

We analyzed two large samples (n₁ = 7313 [52.5% female] and n₂ = 8079 [51.6% female]) of 8th and 10th graders in the United States. Substance use was operationalized as the sum of self-reported number of lifetime use instances of 14 unprescribed substances. Video game use time (hours per week) was self-reported on a 1 (none) to 9 (40+) scale. Common covariates/risk factors were included.

RESULTS

Consistently across datasets, partial-correlation between squared video gaming time and substance use (r = .10, p < .001 in 2014 and r = .08, p < .001 in 2015) supported the hypothesized u-shaped association. Analysis of covariance revealed that teenagers playing video games for 1-5 h a week report on significantly fewer instances of substance use compared with non-gamers (p < .001-.007). Post hoc analyses revealed that those who play at least 30 h per week report on significantly (p < .001) more instances of substance use (3.92 in 2014 and 3.38 in 2015) compared with teenagers playing video games for 1-5 h a week (2.17 in 2015 and 1.96 in 2015).

CONCLUSIONS

Video gaming time and substance use follow a u-shaped association; light video gaming can be protective in terms of substance use, while too much video gaming is associated with increased substance use.

Smoking, ADHD, and Problematic Video Game Use: A Structural Modeling Approach

Problematic video game use (PVGU), or addiction-like use of video games, is associated with physical and mental health problems and problems in social and occupational functioning. Possible correlates of PVGU include frequency of play, cigarette smoking, and attention deficit hyperactivity disorder (ADHD). The aim of the current study was to explore simultaneously the relationships among these variables as well as test whether two separate measures of PVGU measure the same construct, using a structural modeling approach. Secondary data analysis was conducted on 2,801 video game users (M_age = 22.43 years, standard deviation [SD]_age = 4.7; 93 percent male) who completed an online survey. The full model fit the data well: χ² (2) = 2.017, p > 0.05; root mean square error of approximation (RMSEA) = 0.002 (90% CI [0.000-0.038]); comparative fit index (CFI) = 1.000; standardized root mean square residual (SRMR) = 0.004; and all standardized residuals <|0.1|. All freely estimated paths were statistically significant. ADHD symptomatology, smoking behavior, and hours of video game use explained 41.8 percent of variance in PVGU. Tracking these variables may be useful for PVGU prevention and assessment. Young's Internet Addiction Scale, adapted for video game use, and the Problem Videogame Playing Scale both loaded strongly onto a PVGU factor, suggesting that they measure the same construct, that studies using either measure may be compared to each other, and that both measures may be used as a screener of PVGU.

Problem Gaming: A Short Primer

As the popularity of video games has risen so too has the worry about the problems associated with playing them. The authors review the research concerning problem gaming, its similarity to some clinical addictions like gambling and drug and alcohol abuse, and current treatment options. They conclude that, regardless of how researchers and medical professionals assess the nature of a gaming disorder, few who play video games experience negative consequences from doing so and, at best, only a small subset of players might be considered to suffer from an addiction to it.

Cross-sectional and longitudinal epidemiological studies of Internet gaming disorder: A systematic review of the literature

AIM

The diagnostic criteria of Internet gaming disorder (IGD) have been included in section III of DSM-5. This study aims to systematically review both cross-sectional and longitudinal epidemiological studies of IGD.

METHODS

All publications included in PubMed and PsychINFO up to May 2016 were systematically searched to identify cross-sectional studies on prevalence and longitudinal studies of IGD. In the process of identification, articles in non-English languages and studies focusing solely on the use of gaming were excluded, and those meeting the methodological requirements set by this review were included. As a result, 37 cross-sectional and 13 longitudinal studies were selected for review.

RESULTS

The prevalence of IGD in the total samples ranged from 0.7% to 27.5%. The prevalence was higher among males than females in the vast majority of studies and tended to be higher among younger rather than older people in some studies. Geographical region made little difference to prevalence. Factors associated with IGD were reported in 28 of 37 cross-sectional studies. These were diverse and covered gaming, demographic and familial factors, interpersonal relations, social and school functioning, personality, psychiatric comorbidity, and physical health conditions. Longitudinal studies identified risk and protective factors, and health and social consequences of IGD. The natural course of IGD was diverse but tended to be more stable among adolescents compared to adults.

CONCLUSION

Although existing epidemiological studies have provided useful data, differences in methodologies make it difficult to compare the findings of these studies when drawing consensus. Future international studies using reliable and uniform methods are warranted.

Definitions of Risky and Problematic Cannabis Use: A Systematic Review

Although cannabis is widely used, it remains unclear which consumption patterns are more likely to produce future consequences (risky/hazardous use) or current damage (problematic/harmful use). This unresolved issue contributes to cannabis public health implications. In order to facilitate further consensus, this review analyzes previously used definitions in the literature.

METHODS

This systematic review was performed following the PRISMA guidelines. Articles published before October 2015 in the Medline, Scopus-Elsevier, ISI-Web of Knowledge and Cochrane databases and fulfilling a-priori decided criteria were retrieved. Definitions in preselected websites of national and international organizations addressing drug problems were also included.

RESULTS

Definitions identified in articles (n = 46) and official websites (n = 3) widely varied from each other. Weekly cannabis use was mostly considered risky. Problematic cannabis use was mostly described with the Cannabis Abuse and Screening Test. Evidence-based definitions as well as information on quantities consumed, time-frames and special considerations for risky groups were very limited.

CONCLUSIONS

Working on official definitions is highly necessary as criteria used remain incomplete, leading to increased confusion in the field. Recommendations to improve existing definitions are given.

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research

This commentary supports the argument that there is an increasing tendency to subsume a range of excessive daily behaviors under the rubric of non-substance related behavioral addictions. The concept of behavioral addictions gained momentum in the 1990s with the recent reclassification of pathological gambling as a non-substance behavioral addiction in DSM-5 accelerating this process. The propensity to label a host of normal behaviors carried out to excess as pathological based simply on phenomenological similarities to addictive disorders will ultimately undermine the credibility of behavioral addiction as a valid construct. From a scientific perspective, anecdotal observation followed by the subsequent modification of the wording of existing substance dependence diagnostic criteria, and then searching for biopsychosocial correlates to justify classifying an excessive behavior resulting in harm as an addiction falls far short of accepted taxonomic standards. The differentiation of normal from non-substance addictive behaviors ought to be grounded in sound conceptual, theoretical and empirical methodologies. There are other more parsimonious explanations accounting for such behaviors. Consideration needs to be given to excluding the possibility that excessive behaviors are due to situational environmental/social factors, or symptomatic of an existing affective disorder such as depression or personality traits characteristic of cluster B personalities (namely, impulsivity) rather than the advocating for the establishment of new disorders.