Psychometric Evaluation of the Nine-Item Problematic Internet Use Questionnaire (PIUQ-9) in Nine European Samples of Internet Users

Factors associated with problematic internet use among University of Gondar undergraduate students, Northwest Ethiopia: Structural equation modeling

BACKGROUND

For young adults and adolescents, excessive internet use has become a serious public health concern due to its negative impact on their health. It has been associated with detrimental effects on both physical and mental health. Negative academic outcomes were observed in the students, including missing classes, lower grades, and academic dismissal. Therefore, the purpose of the current study was to identify factors associated with PIU among undergraduate students at the University of Gondar.

METHOD

A cross-sectional study was conducted at the University of Gondar among 1514 undergraduate students from June 1-20, 2022. The study participants were selected using a stratified simple random selection procedure. Using structural equation modeling, the degree of relationship was ascertained. A p-value of less than 0.05 and an adjusted regression coefficient with a 95% confidence interval (CI) were used to interpret the data.

RESULTS

In our study, being from non-health departments [β = 0.11, 95% CI: 0.037, 0.181], current alcohol use [β = 0.12, 95% CI: 0.061, 0.187], depressive symptoms [β = 0.23, 95% CI: 0.175, 0.291], insomnia symptoms [β = 0.12, 95% CI: 0.060, 0.196], and ADHD symptoms [β = 0.11, 95% CI: 0.049, 0.166] had a significant positive effect on PIU, while having a history of head injury had a significant negative effect [β = -0.12, 95% CI: -0.226, -0.021] on PIU.

CONCLUSION AND RECOMMENDATION

Factors such as current alcohol use, non-health department type, depressive symptoms, insomnia, and ADHD symptoms were positively associated with PIU. However, a history of head injuries was negatively associated with PIU. Therefore, strategies aimed at the early identification of PIU may lead to an improvement in the psychosocial health of university students.

The Dual Systems Model-Impulsivity and Narcissism as the Reflexive System and Self-Regulation as the Reflective System-of Smartphone Addiction

The exploration of underlying mechanisms leading to the development of smartphone addiction has been limited, with only a few studies incorporating theories to provide explanations. Drawing upon the Dual Systems Model, this study tested the hypothesis that the reflective system of self-regulation would mediate the relation between the reflexive system of impulsivity and narcissism, and smartphone addiction in a sample of 298 undergraduate students. Participants completed a self-administrated web-based questionnaire containing measures of impulsivity (the Barratt Impulsiveness Scale), narcissism (the Narcissistic Personality Inventory), self-regulation (the Self-Regulation Scale), and smartphone addiction (the Smartphone Addiction Inventory). The findings from structural equation modeling revealed that self-regulation served as a significant mediator between impulsivity and smartphone addiction, as well as between narcissism and smartphone addiction. These findings offer insights that can contribute to the development of interventions and strategies that target impulsivity and narcissism by enhancing self-regulation skills.

Problematic Use of the Internet and Well-Being among Youth from a Global Perspective: A Mediated-Moderated Model of Socio-Emotional Factors

Problematic Use of the Internet (PUI) is characterized as the inability to control one's internet use or as an excessive use of the internet that may result in social, psychological, and emotional difficulties (Fernandes et al., 2019). It is regarded nowadays as an increasingly worrisome public heath issue, especially among youth. This study explored the contexts in which youth PUI occurs and its associations with socio-emotional functioning that may lead to a decrease in one's sense of well-being. We conducted this exploration among 783 middle school students from the US (425 students; 54.27%) and Israel (358 students; 45.73%). The overall age of both samples ranged between 12 and 16 (M = 13.94, SD = 1.59). In the Israeli sample, 49.1% of the students were girls and 50.9% were boys, whereas in the US sample, 48.8% were girls and 51.2% were boys. The study examined the role of depressive mood, loneliness, resilience, self-control, and school engagement in mediating the relationship between PUI and well-being, and how country of origin might moderate these relationships. Results indicate PUI was related to lower well-being only for the US sample. Yet, for both samples, higher loneliness was related to lower well-being, and higher school engagement was related to higher well-being. A moderated mediation analysis revealed the socio-emotional variables were all mediators in these associations, but differently for each country sample. The study results are discussed according to key factors required for developing intervention programs for coping with youth PUI behaviors.

Magnitude, relationship and determinants of attention deficit hyperactivity disorder and depression among University of Gondar undergraduate students, Northwest Ethiopia, 2022: Non-recursive structural equation modeling

BACKGROUND

Up to 80% of adults with attention deficit hyperactivity disorder (ADHD) may have a concomitant psychiatric disorder. ADHD and depression, combined with the demands of University life, can pose serious challenges for students. However, there are limited studies conducted on this topic in our country. Therefore, the current study assessed the magnitude, relationship, and determinants of ADHD and depressive symptoms among students at the University of Gondar.

METHOD

An institution-based cross-sectional study was employed among 1514 undergraduate students at the University of Gondar from June 1-20, 2022. A stratified, simple random sampling technique was applied. Structural equation modeling was employed. The degree of relationship was interpreted based on the adjusted regression coefficient with 95% confidence interval (CI) and p-value (<0.05).

RESULT

In our study, 37.6% [CI: 35.2-40.1%] and 20.01% [CI: 18.1-22.1%] of the participants had depressive and ADHD symptoms, respectively. Chronic illness [β = 0.19, CI; 0.09, 0.30], alcohol use [β = 0.10, CI; 0.03, 0.17], social support [β = -0.23, CI; -0.29, -0.17], problematic internet use (PIU) [β = 0.23, CI; 0.18, 0.27], and insomnia [β = 0.24, CI; 0.17, 0.30] had a direct relationship with depressive symptoms. Mother education level [β = -0.09, CI; -0.13, -0.06], birth order [β = -0.09, CI; -0.11, -0.07], chat chewing [β = 0.18, CI; 0.06, 0.30], and depressive symptoms [β = 0.73, CI; 0.62, 0.86] had a direct relationship with ADHD. Chronic illness [β = 0.14, CI; 0.06, 0.22], PIU [β = 0.16, CI; 0.13, 0.21], social support [β = -0.16, CI; -0.22, -0.12], and insomnia [β = 0.17, CI; 0.13, 0.23] had an indirect effect on ADHD.

CONCLUSION AND RECOMMENDATION

The prevalence of ADHD and depressive symptoms was high. Chronic disease, alcohol use, social support, PIU, and insomnia had a direct effect on depressive symptoms and an indirect effect on ADHD. Mother education, birth order, chat chewing, and depressive symptoms had a direct effect on ADHD. Our study provided useful clues for clinical treatment and school-based interventions that aim to improve college students' mental well-being. It is better to design school-based intervention and prevention programs to achieve timely diagnosis and treatment of these disorders among university students.

A cross-sectional study: family communication, anxiety, and depression in adolescents: the mediating role of family violence and problematic internet use

OBJECTIVE

The objective of this study is to explore the relationship between family communication, family violence, problematic internet use, anxiety, and depression and validate their potential mediating role.

METHODS

The study population consisted of Chinese adolescents aged 12 to 18 years, and a cross-sectional survey was conducted in 2022. Structural equation models were constructed using AMOS 25.0 software to examine the factors that influence adolescent anxiety and depression and the mediating effects of problematic internet use and family violence.

RESULTS

The results indicate that family communication was significantly and negatively related to family violence (β = -.494, p < 0.001), problematic internet use (β = -.056, p < .05), depression (β = -.076, p < .01), and anxiety (β = -.071, p < .05). And the finds also indicate that family violence mediated the relationships between family communication and depression (β = -.143, CI: -.198 -.080), and between family communication and anxiety (β = -.141; CI: -.198 -.074). Chain indirect effects between family communication and depression (β = -.051; CI: -.081 -.030) or anxiety (β = -.046; CI: -.080 -.043) via family violence and then through problematic internet use were also found in the present study.

CONCLUSIONS

In conclusion, positive family communication is crucial in reducing anxiety and depression in adolescents. Moreover, problematic internet use and family violence mediate the effects of positive family communication on anxiety and depression. Therefore, improving family communication and promoting interventions aimed at reducing family violence and problematic internet use can help reduce anxiety and depression in adolescents, thus promoting their healthy development.

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.

Compulsive Internet Use Scale for assessment of self-reported problematic internet use in primary school-aged children

Introduction

The tremendous growth of internet use during past few decades has been primarily led by young people. Despite a plenitude of studies reporting the pros and cons of excessive internet use by adolescents, the internet use of primary school-aged children is under-researched. First, there is lack of reliable and valid cultural invariant self-report instruments for children younger than 11-years-old. Secondly, there is no consensus on whether primary school-aged children can reliably report on their internet use. This study aimed to examine the psychometric properties of the Compulsive Internet Use Scale (CIUS) as reported by primary school-aged children in three different countries/regions.

Methods

Paper-pencil format CIUS questionnaires were completed by a total of 691 children aged 8 to 10 years old, 236 of them Latvian, 207 Lithuanian, and 248 Taiwanese, as well as by one of their parents, at two-time points, separated by a one-year interval. The parents also reported on the child's emotional and behavioral difficulties.

Methods

Confirmatory factor analysis indicated that for the child self-report, a 10-item CIUS showed the best fit and good psychometric properties: solid structural validity; very good internal consistency; appropriate stability and predictive validity after 1 year; as well as sound sensitivity and specificity when compared to the 14-item CIUS parent-report form. Child self-report CIUS ratings correlated with time online reported by the child and parent and with emotional and behavioral problems reported by the parent.

Discussion

This study indicates that children as young as 8-10 years old can reliably and consistently provide valuable information on their problematic use of the internet.

Internet severity and activities addiction questionnaire (ISAAQ): Psychometrics of item response theory and clustering of online activities

BACKGROUND

Problematic usage of the internet (PUI) is an umbrella term, referring to a variety of maladaptive online behaviors linked to functional impairment. There is ongoing need for the development of instruments capturing not only PUI severity, but also the online activity types. The Internet Severity and Activities Questionnaire (ISAAQ), previously developed to address this need, required further refinement and validation.

METHODS

Cross-sectional data was gathered in two separate samples (South Africa n = 3275, USA-UK n = 943) using the Internet Severity and Activities Addiction Questionnaire (ISAAQ). Item Response Theory (IRT) was used to examine the properties of the scale (Part A of the ISAAQ) and differential item functioning against demographic parameters. The severity scale of the ISAAQ was optimized by eliminating the poorest performing items using an iterative approach and examining validity metrics. Cluster analyses was used to examine internet activities and commonalities across samples (Part B of the ISAAQ).

RESULTS

Optimization of ISAAQ using IRT yielded a refined 10-item version (ISAAQ-10), with less differential item functioning and a robust unidimensional factor structure. The ISAAQ-10 severity score correlated strongly with established measures of internet addiction (Compulsive Internet Use Scale [Person's r = 0.86] and the Internet Addiction Test-10 [r = 0.75]). Combined with gaming activity score it correlated moderately strongly with the established Internet Gaming Disorder Test (r = 0.65). Exploratory cluster analyses in both samples identified two groups, one of "low-PUI" [98.1-98.5%], and one of "high-PUI" [1.5-1.9%]. Multiple facets of internet activity appeared elevated in the high-PUI cluster.

DISCUSSION

The ISAAQ-10 supersedes the earlier longer version of the ISAAQ, and provides a useful, psychometrically robust measure of PUI severity (Part A), and captures the extent of engagement in a wide gamut of online specific internet activities (Part B). ISAAQ-10 constitutes a valuable objective measurement tool for future studies.

Problematic Internet Use, Anxiety, Depression, and Stress Symptoms in Adults with COVID-19 Pandemic and Earthquake Experience: Insights from Croatian Online Survey

In 2020, Croatia was hit by the COVID-19 pandemic and two earthquakes. As previous research showed that Internet use (IU) increased during the COVID-19 pandemic, we carried out an online survey to determine the levels of problematic Internet use (PIU) and problematic specific Internet activities before and during the prolonged stress caused by the COVID-19 pandemic as well as earthquakes. We also determined the correlation between the PIU and specific Internet activities and anxiety, depression, and stress symptoms. According to the responses of 1,118 participants from all Croatian regions, PIU increased by 14.1 percent (odds ratio [OR] 6.2), problematic social media use by 12.6 percent (OR 4.8), and uncontrolled online shopping by 5.3 percent (OR 5.8) in comparison with presurvey period. The PIU increase was significantly higher in participants reporting only pandemic-related stress than in those reporting both pandemic- and earthquake-related stress. Problematic social media use increased in those reporting only pandemic-related stress and both pandemic- and earthquake-related stress. The strongest correlation between PIU and problematic social media use and anxiety, depression, intrusion, and avoidance symptoms was found among those reporting both pandemic- and earthquake-related stress. The correlation between psychiatric measures and PIU and problematic specific Internet activities varied depending on the source of experienced or perceived stress. Our findings show the relationship between the problematic stress-related Internet behaviors, different types of stressors, and their impact on the overall PIU and problematic specific Internet activities in situations of prolonged stress.

Difficulties in impulse control in adolescents with problematic use of the internet and self-injurious behaviors

Problematic use of the internet (PUI) and self-injurious behaviors (SIB) associate in adolescents and both relate to impulsivity. However, studies have not examined whether difficulties in impulse control are shared in adolescents with PUI and SIB, and how PUI relates to SIB frequency and impairment. Here, exploratory factor analysis was performed on a PUI questionnaire based on the Minnesota Impulse Disorder Interview, using survey data from 2,912 Connecticut high-school students. Regression analyses evaluated relationships between PUI factor scores and correlates of SIB. Moderation analyses examined impulsivity and sensation-seeking in relationship to PUI factors and SIB. Two PUI factors were extracted. The first PUI factor was associated with lifetime SIB, frequency, severity, urges, rising tension, and self-perceived problems with SIB. The second factor was associated with lifetime SIB and attempts to reduce SIB. Impulsivity and sensation-seeking associated with PUI factors and SIB, but did not moderate relationships between PUI and SIB. Findings suggest that PUI and SIB are related by difficulties in impulse control, and poor control over internet use is associated with more impairing SIB in adolescents who self-injure. Further research should investigate possible interventions targeting impulsivity and sensation-seeking to prevent PUI and SIB in youth.

The Relationship between Depressive Symptoms, Loneliness, Self-Control, and Gaming Disorder among Polish Male and Female Gamers: The Indirect Effects of Gaming Motives

The present study analyzed the relationship between gaming disorder (GD), motives for gaming, and psychological problems in daily life (i.e., depression, loneliness, and self-control deficits) among Polish gamers. More specifically, the purpose of the present study was to analyze the indirect effects between GD and psychological problems in daily life via motives for gaming among male and female gamers. Additionally, the present study examined gender differences in motives for gaming and the relationship between the analyzed variables. The sample comprised 652 gamers (233 females; M = 28.77 years; SD = 7.18; age range: 18-48 years). The nine-item Internet Gaming Disorder Scale-Short Version (IGDS9-SF) was used to assess GD. The motives for gaming were assessed using the Motives for Online Gaming Questionnaire (MOGQ). The nine-item Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms, and the Brief Self-Control Scale (BSCS) was used to assess self-control. Loneliness was assessed using the De Jong Gierveld Loneliness Scale. In order to examine the relationship between the study variables, path analysis and indirect effects analysis were performed among both male and female gamers. The present study showed that depressive symptoms and self-control exerted a significant indirect effect on GD via escape and fantasy motives for gaming. Additionally, there was an indirect effect between depressive symptoms and GD via social motives for gaming. However, these indirect effects were found among male gamers only. The present study also showed gender differences in all analyzed gaming motives except escape (males scoring higher on all of them) and in the relationship between depressive symptoms and escape. These findings contribute to a better understanding of GD development mechanisms, which are associated with psychological problems in daily life.

Preference of online friends over face-to-face friends: Effect of interpersonal fears on online relationship building preference

The emergence of online social networking has increased development of exclusively online friendships. Individuals in online environments are willing to invest considerable time and effort to develop and maintain relationships as they would in other gathering spaces. In some cases, individuals find it preferable to make friends via the internet over more traditional means of relationship formation. The current study examines preference for online friends over face-to-face friends. Initially, we developed a brief, one-dimensional, 11-item questionnaire assessing online friendship preference based on semi-structured interviews. Confirmatory factor analysis showed support for a one-factor model. Internal consistency was established using inter-item correlation, corrected item-total correlation, and Cronbach’s α. Subsequently, we examined the psychological determinants and consequences of preference for online friendship formation. Participants who reported higher fear of intimacy and perceived relationship vulnerability reported greater preference for online friends over face-to-face friends. Preference for online friendship was related to increased risk of problematic internet use. The findings suggest that interpersonal fears, combined with attributes of online communication (e.g., reduced social cues and more personal control) motivate some individuals to prefer online intimacies over face-to-face friendships, thereby increasing time spent online.

The Digital Divide of Know-How and Use of Digital Technologies in Higher Education: The Case of a College in Latin America in the COVID-19 Era

To determine whether or not digital inequalities exist, the frequency, duration, satisfaction, importance, and perceived competence of eighteen groups of digital tools during the COVID-19 pandemic confinement were examined. An online survey was administered to 2882 Latin American university students (49% female; M = 21.3 years). The following items are checked: (1) increased digital inequalities during the pandemic; (2) adequate reliability and validity of the Digital Technology Survey (DTS) instrument; (3) patterns of digital inequalities to the detriment of men, lower strata and unemployed people; and (4) evidence that the importance of digital activities as a causal factor on satisfaction with such digital activities as an outcome is mediated by the purpose of use and communication recipients, but not by strata or employment status, nor moderated by gender. The results are discussed in the light of previous studies, the limitations of the study and future perspectives.

The Self-perception of Text message Dependence Scale (STDS): A Brazilian-Portuguese validation and expansion of its psychometric properties

Text messaging is the primary form of technology-mediated interpersonal contact and the most carried out activity on cell phones. Despite its advantages, text messaging is not exempt from risks. The present paper aimed to validate and expand the psychometric properties of the Self-perception of Text-message Dependency Scale (STDS) in a Brazilian sample of adult internet users. In this cross-sectional study, we recruited a convenience sample of Brazilian internet users aged 18 and over. A total of 1,642 (M age = 38.6, SD = 13.5; 73% female) participants completed the STDS, the Mobile Phone Problem Usage Scale-27 (MPPUS), and the Problematic Internet Use Questionnaire - Short form - 9 questionnaires (PIUQ-SF-9). Multigroup confirmatory factor analysis showed measurement invariance for gender and age. Internal consistency was high when accessed by both McDonalds' Omega and Cronbach's alpha. Network Analysis provided insights into the core symptoms of problematic text messaging. Convergent validity of the STDS was demonstrated by the subscale's correlation with MPPUS and PIUQ-SF-9. Due to its expanded psychometric properties and brevity, the STDS can be used in more comprehensive investigations about other excessive technology-related behaviors, such as problematic smartphone and internet use, allowing a better understanding of the mechanisms involved in problematic technology use.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-02957-8.

Social Networks Addiction (SNA-6) - Short: Validity of Measurement in Mexican Youths

The excessive use of social networks needs to be addressed, and this phenomenon needs to be measured for the purpose of evaluation, prevention, and intervention among adolescents and young people. The objective of the study was to adapt and psychometrically validate the Brief Scale of Addiction to Social Networks (SNA-6) among Mexican adolescents and young adults. The participating sample consisted of 2,789 students from 6 public educational campuses in Cuernavaca (Morelos, Mexico). Data collection was carried out through a web platform to strictly maintain anonymity, voluntary participation, and confidentiality. Data analysis first focused on the detection of possible response biases (random intercept model and careless/insufficient effort), the quality of the response structure partial credit model (PCM), dimensionality (CFA and invariance), and the relationship with external variables. It was found that when the range of efficient response options was limited to less than five, reliability was high (0.91), and unidimensionality was maintained. Response biases slightly affected the dimensional structure of the instrument. Measurement invariance reached scalar invariance in the sex, age, and campus groups. The association with sensation seeking and depression, controlling for sex and age covariates, was statistically significant, small, and theoretically consistent. Implications of the results are discussed.

Validation of the Digital Eye Strain Questionnaire and pilot application to online gaming addicts

INTRODUCTION

'Digital eye strain' (DES) is a clinical syndrome with eyesight symptoms related to continuous engagement in front of a screen-enabled digital device. With use of these devices constantly on the rise, the related symptoms have become prominent, even in younger ages. This study describes the process of validating the Digital Eye Strain Questionnaire (DESQ), a thirteen-item self-report scale in a yes-no format designed to offer a measure of complaints related to digital eye strain syndrome (DES).

METHODS

The validation process included 150 outpatients with no long-standing eye disease who were examined for various eye complaints and 50 outpatients who were diagnosed with gaming addiction according to WHO ICD-11 clinical criteria. All participants filled in a demographics questionnaire, the DESQ, the Computer Vision Syndrome Questionnaire (CVS-Q) and the Problematic Internet Use Questionnaire-9 (PIUQ-9).

RESULTS

Principal component analysis of categorical variables confirmed the proposed three-factor DES structure with a total of 61.02% of explained variance and Cronbach's alpha equal to.94. Concurrent validity was assessed by comparing the results of the DESQ to the CVS-Q while convergent validity was assessed by examining correlations of the DESQ with results from the PIUQ-9 questionnaire. In all cases the DESQ demonstrated excellent reliability and validity.

CONCLUSIONS

Results indicate that the DESQ questionnaire can be employed to reliably measure the symptomatology of digital eye strain in clinical populations who present either with eye issues or with excessive use of the gaming and screen-enabled devices in general.

Problematic use of the internet during the COVID-19 pandemic: Good practices and mental health recommendations

With the onset of the COVID-19 pandemic and the accelerated spread of the SARS-CoV-2 virus came jurisdictional limitations on mobility of citizens and distinct alterations in their daily routines. Confined to their homes, many people increased their overall internet use, with problematic use of the internet (PUI) becoming a potential reason for increased mental health concerns. Our narrative review summarizes information on the extent of PUI during the pandemic, by focusing on three types: online gaming, gambling and pornography viewing. We conclude by providing guidance for mental health professionals and those affected by PUI (with an outline of immediate research priorities and best therapeutic approaches), as well as for the general public (with an overview of safe and preventative practices).

COVID-19 Pandemic and the Burden of Internet Addiction in the United States

Despite the extensive usage of the internet, little is known about internet addiction among Americans during the pandemic. A valid and reliable questionnaire was deployed online via MTurk to recruit a national sample of adult Americans to understand the nature and extent of internet addiction. A total of 1305 individuals participated in the study where the majority were males (64%), whites (78%), non-Hispanic (70%), married (72%), 18–35 years old (57%), employed full time (86%), and with a Bachelor’s degree or higher (83%). The prevalence of internet addiction was distributed as no addiction (45%), probable addiction or risk of addiction (41%), and definite or severe addiction (14%). More than a fourth of the population had depression (28%) or anxiety (25%). Despite adjusting for sociodemographic characteristics, definite/severe internet addiction was strongly predictive of depression, anxiety, and psychological distress in multiple regression analyses. Those who were probably addicted or at risk of addiction were also more likely to have depression or anxiety. Compared to estimates before the pandemic, this study suggests an increase in internet addiction among U.S. adults during the COVID-19 pandemic. Population-based interventions and mental health promotion strategies should focus on a reduction in internet consumption and screen time.

Validation of the Greek version of the Problematic Internet Use Questionnaire - Short Form (PIUQ-SF-6)

Internet is a necessary tool of everyday routine, however, concerns about the development of abnormal behaviours in relation to its use by adolescents are constantly growing. The need of brief screening tools for problematic internet use in teenagers in Greece is imperative. The purpose of this study was to validate the 6-item short form of the Problematic Internet Use Questionnaire (PIUQ-SF-6) in a Greek sample of adolescents. The sample consisted of 200 adolescents (55.0% males, 61.6% high school students, 38.4% junior high school students) who completed the study’s questionnaires i.e., a demographic questionnaire, the PIUQ-SF-6, the Young’s Diagnostic Questionnaire (YDQ) and the Adolescent Computer Addiction Test (ACAT). The internal consistency of the Greek version of PIUQ-SF-6 was sufficient and acceptable (Cronbach’s alpha coefficient a = 0.80). Confirmatory Factor Analysis was significant, and goodness-of-fit was adequate. For establishing convergent validity, Pearson’s and Spearman’s correlation coefficients were calculated between the PIUQ-SF-6 and ACAT scales and Receiver Operating Characteristic (ROC) analysis (between PIUQ-SF-6 and YDQ) indicated an excellent accuracy. The Greek version of the PIUQ-SF-6 demonstrated satisfactory psychometric properties (reliability and validity) and is recommended as a reliable screening tool for problematic internet use in Greek adolescents.

Compulsive Internet Use Scale: Psychometric Properties and Associations With Sleeping Patterns, Mental Health, and Well-Being in Lithuanian Medical Students During the Coronavirus Disease 2019 Pandemic

Background: The increase in problematic Internet use (PIU) among medical students and resident doctors during the coronavirus disease 2019 (COVID-19) pandemic may be leading to significant impairments in everyday functioning, including sleeping patterns, anxiety, depressive symptoms, and overall well-being. The Compulsive Internet Use Scale (CIUS) has been developed to assess the severity of PIU, however, it has not been elucidated whether this scale is also applicable to medical students and resident doctors. The first aim of this study was to explore the psychometric properties of the Lithuanian version of the CIUS. The second aim was to examine associations between subjectively reported mental health symptoms and PIU during the COVID-19 pandemic. Methods: A total of 524 medical students and resident doctors (78.60% women, mean age 24 [SD 3] years old) participated in an online survey between December 2020 and February 2021. Participants completed the CIUS, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder Assessment-7 (GAD-7), and the WHO-Five Well-Being Index questionnaire (WHO-5). Results: The confirmatory factor analysis (CFA) suggested brief versions (CIUS-5, CIUS-7, and CIUS-9) rather than the original (CIUS-14) version of the CIUS questionnaire as reliable and structurally stable instruments that can be used to measure compulsive Internet use severity in the sample of medical students and resident doctors. The most prevalent online behaviors were social media use (90.1%), online shopping (15.6%), and online gaming/gambling (11.3%). Students with higher CIUS scores reported significantly lower academic achievements during the 6 months (r = 0.12-0.13; p < 0.006), as well as more severe depressive and anxiety symptoms, worsened sleep quality, and lower sense of well-being (r = 0.21-0.41; p's < 0.001). Both, during workdays (d = 0.87) and weekend (d = 0.33), students spent more time online than resident doctors (p's < 0.001). Conclusion: The brief, 5-, 7-, and 9-item versions of the Lithuanian CIUS are reliable and valid self-report screening instruments for evaluating the severity of PIU symptoms among the medical student population. Symptoms of PIU during the COVID-19 period were associated with worsened self-reported mental health and everyday functioning.

Problematic Internet Usage and Self-Esteem in Chinese Undergraduate Students: The Mediation Effects of Individual Affect and Relationship Satisfaction

The aim of this cross-sectional study was to examine the mediating effects of individual affect and relationship satisfaction on the relationship between self-esteem and Problematic Internet Use (PIU). Affect was measured using the Positive and Negative Affect Schedule (PANAS), relationship satisfaction was assessed using a positive and negative semantic dimension scale, self-esteem was measured using the Rosenberg Self-Esteem Scale, and PIU was measured using the Problematic Internet Use scale with a sample of 507 Chinese university students (Mage = 20.41 years, SD = 2.49). The relationships between the variables were tested using structural equation modelling with a multiple mediation model. The results revealed that negative affect and the negative semantic dimensions of relationship satisfaction mediated the relationship between self-esteem and PIU. The implications of the results and the study’s theoretical contributions are discussed.

Heterogeneous Association of Chinese Adolescents' Engaged Living With Problematic Internet Use: A Mixture Regression Analysis

The present study explored heterogeneity in the association between engaged living (i.e., social integration and absorption) and problematic Internet use (PIU). This study included 641 adolescents from four junior-senior high schools of Guangzhou, China. Besides the standard linear regression analysis, mixture regression analysis was conducted to detect certain subgroups of adolescents, based on their divergent association between engaged living and PIU. Sex, age, and psychological need were further compared among the latent subgroups. The results showed that a mixture regression model could account for more variance of PIU than a traditional linear regression model, and identified three subgroups based on their class-specific regression of PIU to engaged living. For the High-PIU class, lower social integration and higher absorption were associated with increased PIU; for the Medium-PIU class, only high social integration was linked with the increase of PIU. For the Low-PIU class, no relation between engaged living and PIU were found. Additionally, being male or having a lower level of satisfied psychological needs increased the link between engaged living and PIU. The results indicated a heterogeneous relationship between engaged living and PIU among adolescents, and prevention or intervention programs should be tailored specifically to subgroups with moderate or high levels of PIU and to those with lower levels of psychological needs’ satisfaction, as identified by the mixture regression model.

Impulsivity Mediates Associations Between Problematic Internet Use, Anxiety, and Depressive Symptoms in Students: A Cross-Sectional COVID-19 Study

Background: Problematic internet use (PIU) is a serious global mental health issue that especially manifested during the Coronavirus disease (COVID-19) pandemic. Engagement in PIU as an impulsive coping with mental distress may pose a long-lasting threat to develop anxiety and depressive disorders. The first aim of our study was to investigate the prevalence of PIU and mental distress symptoms during the COVID-19 pandemic among university students in Lithuania. The second aim was to test the hypothesis that PIU affects anxiety and depressive symptoms through the mediating role of impulsivity. Methods: The cross-sectional study was comprised of 619 university students (92.9% females and 7.1% males) with a mean age of 22 ± 3 years who participated in an online survey from May to November, 2020. Participants completed the following scales: the Problematic Internet Use Questionnaire-9, the Generalized Anxiety Disorder Questionnaire-7, the Patient Health Questionnaire-9, and the Barratt Impulsiveness Scale-11. K-means cluster analysis and one-way multivariate analysis of variance were used for group comparison in terms of internet use time and habit change during COVID-19 pandemic. Structural equation modeling was applied to examine the mediating effect of impulsivity in association between PIU and mental distress, while controlling for age. Results: In sum, 45.1% of the participants reported PIU and 38.1% had markedly expressed symptoms of anxiety while 43.6% of the students reported moderate to severe depressive symptoms. During the COVID-19 pandemic 76% of the students reported at least moderate increase in their internet use time. Anxiety and depressive symptoms were significantly higher in the group of frequent internet users. The results of the structural equational modeling analysis showed a statistically significant effect of PIU on subjective anxiety symptoms and the statistically significant effect of PIU on subjective depression symptoms, both mediated via impulsivity. Conclusions: During COVID-19 pandemic, PIU, anxiety and depression symptoms are highly prevalent among students. Findings also suggest that relationships between PIU, anxiety and depressive symptoms are mediated via impulsivity. These results underscore the importance of the inclusion of impulsivity factor in the studies analyzing longitudinal effects of PIU on mental distress during COVID-19 pandemic.

A Case-Control Study on Behavioral Addictions and Neurocognition: Description of the BANCO and BANCO2 Protocols

INTRODUCTION

Only two behavioral addictions (BAs) are currently recognized in international classifications (gambling disorder: GbD; gaming disorder: GmD), while some of them await further investigation (food addiction: FA; sexual addiction: SA). Neurocognitive functioning is considered a risk factor for BAs. Research is quite abundant for GbD and highlights specific deficits in several cognitive functions. Nevertheless, grey areas still exist. The aim of this research programme is to investigate the neurocognitive profiles of patients presenting with various BAs and to establish parallels between different forms of BA to achieve a common addiction concept.

METHODS AND ANALYSIS

This research program is composed of two studies sharing the same methodology but focusing on different samples: the BANCO study aims to include 30 individuals with a GbD, whereas the BANCO2 study aims to include 30 individuals with a GmD, 30 with a SA, and 30 with a FA. Moreover, for each BA group, 30 healthy controls will be recruited, matched by sex, age and education level. Several cognitive tasks will be completed by participants. Cue reactivity and physiological responses, as well as clinical data regarding addiction characteristics and personality, will also be investigated. A composite score based on the cognitive tasks will be computed using principal component analysis (PCA). Overall cognitive performance and detailed performance on the different cognitive tasks will be compared between individuals with BAs and their matched healthy controls using linear models with random effects. Comparisons will also be made between BA groups to investigate specific alterations associated with each disorder.

DISCUSSION

The results of this research programme will impact both research and clinical areas by (i) providing new knowledge for discussions regarding the inclusion of BAs under the spectrum of addictive disorders; (ii) improving understanding of addiction mechanisms in general; (iii) providing clarity in the grey areas in neurocognitive research on BAs and improving the understanding of less studied BAs, (iv) guiding clinicians to propose therapeutic alternatives and complementary programmes.

TRIAL REGISTRATION

BANCO study (ClinicalTrials.gov NCT03202290); BANCO2 study (ClinicalTrials.gov NCT03967418).

Psychometric Properties of the Nine-Item Problematic Internet Use Questionnaire in a Brazilian General Population Sample

Objective: The goal of the study is to adapt and examine the psychometric properties of the Brazilian version of the nine-item Problematic Internet Use Questionnaire (PIUQ-SF-9). Methods: A convenience sample of Brazilian internet users aged between 18 and 89 years (72.7% female, mean age 38.7 years ± 13.5) was recruited online from September 2018 to July 2019 (test sample = 1,525; retest sample = 237). Participants responded to the adapted version of the PIUQ-SF-9, as well as the Center for Epidemiologic Studies-Depression Scale (CES-D-10) and sociodemographic questions. Results: A bifactor model with one general factor and three specific dimensions (obsession, neglect and control disorder) yielded the best fit indices [χ² = 67.66, df = 15, CFI = 0.99, TLI = 0.99, RMSEA = 0.048 (0.037-0.060), RMSEA p close = 0.587 and SRMR = 0.01]. McDonald's hierarchical omega coefficient was 0.76 for the general factor and varied between 0.16 and 0.33 for the specific dimensions. The intraclass correlation coefficient was 0.73 for the general factor and varied between 0.64 and 0.72 for the specific dimensions. The MIMIC model supported the scale's construct validity as the relationship of the predictors (age, time spent online, self-perception of problematic internet use, and depression symptoms) with the PIUQ-SF-9 factors was in line with the assumptions based on the literature. Conclusion: PIUQ-SF-9 seems to be a brief and culturally validated instrument with sound psychometric properties to be used in future studies on problematic internet use in the Brazilian population.

Problematic Internet Use among Youths

Problematic Internet Use (PIU) has of late come to the major attention of researchers of risky behaviours. For parents and teachers in turn, the various pathological forms of Internet use have become more and more noticeable. In recent years, the operationalisation of the term PIU has also been discussed and attempts to measure its various phenomena have been made. In our study, we used the quantitative method—a diagnostic survey designed on the basis of a tool of the Supreme Audit Office and Scientific and Academic Computer Network (Naukowa i Akademicka Sieć Kompureowa NASK), The survey was conducted in the first half of 2017 in Poland, among 3569 adolescents (median 16, SD = 1.28). The purpose of the research was to investigate the scale of PIU among Polish youths. For most young people, PIU is a major social problem. The majority also declare that more than half of their friends have problems with using electronic media (smartphones and the Internet in particular). On the basis of the data collected, it is estimated that 60% of adolescents use media in a functional way, whereas 40% of young electronic media users show visible PIU symptoms, of which 5% do so at a destructive level (all symptoms). Gender does not co-occur with PIU; however, family structure (where both parents are present), the setting of rules for the use of electronic media, and the place of residence are all protective factors. There is a need for constantly improved tools for measuring PIU, as well as preventive programs focused on developing self-control and helping young people understand their own emotions.

A review of recent research in problematic internet use: gender and cultural differences

The present study reviewed current trends in the literature on problematic Internet use. The review included a total of 48 studies published within the last two years and covered by the Web of Science and Scopus databases. Despite frequently investigated in the literature, results of the studies suggest that there is still much to be unveiled regarding problematic Internet use and its relation to gender and cultural differences. In terms of gender, although more studies show that men are further vulnerable to problematic Internet use symptoms, results differ regarding the moderator effect(s) or differences in various cultural settings. Recent studies mostly employed quantitative methods; but, it is also noted that problematic Internet use studies increasingly focus on meta-analysis and literature reviews. Research also tends to investigate large-sample cross-cultural groups, but their results are far from achieving consensus. Studies mostly used cross-sectional approaches with self-report instruments and focused on adolescents and young adults who were students.

Co-occurrences of substance use and other potentially addictive behaviors: Epidemiological results from the Psychological and Genetic Factors of the Addictive Behaviors (PGA) Study

BACKGROUND AND AIMS

Changes in the nomenclature of addictions suggest a significant shift in the conceptualization of addictions, where non-substance related behaviors can also be classified as addictions. A large amount of data provides empirical evidence that there are overlaps of different types of addictive behaviors in etiology, phenomenology, and in the underlying psychological and biological mechanisms. Our aim was to investigate the co-occurrences of a wide range of substance use and behavioral addictions.

METHODS

The present epidemiological analysis was carried out as part of the Psychological and Genetic Factors of the Addictive Behaviors (PGA) Study, where data were collected from 3,003 adolescents and young adults (42.6% males; mean age 21 years). Addictions to psychoactive substances and behaviors were rigorously assessed.

RESULTS

Data is provided on lifetime occurrences of the assessed substance uses, their co-occurrences, the prevalence estimates of specific behavioral addictions, and co-occurrences of different substance use and potentially addictive behaviors. Associations were found between (i) smoking and problematic Internet use, exercising, eating disorders, and gambling (ii) alcohol consumption and problematic Internet use, problematic online gaming, gambling, and eating disorders, and (iii) cannabis use and problematic online gaming and gambling.

CONCLUSIONS

The results suggest a large overlap between the occurrence of these addictions and behaviors and underlies the importance of investigating the possible common psychological, genetic and neural pathways. These data further support concepts such as the Reward Deficiency Syndrome and the component model of addictions that propose a common phenomenological and etiological background of different addictive and related behaviors.

Problematic Internet Use, Psychopathology, Defense Mechanisms, and Coping Strategies: a Cross-Sectional Study from the United Arab Emirates

A number of studies point to a demonstrated relationship between problematic Internet use (PIU) and psychopathological variables. However, explorations of PIU in relation to defense mechanisms and coping strategies remain rare. The present study sought to determine the extent of PIU among a sample of college-aged young adults resident in the United Arab Emirates. The relationship of PIU to two psychopathological variables (depression and low self-esteem) and two psychological variables (defense mechanisms and coping strategies) were examined. A sample of 697 Emirati participants aged between 18 and 33 years of age completed assessments of PIU, socio-demographic, psychopathological, and psychological variables. A total of 67.3% exhibited PIU. Problematic users produced higher scores for maladaptive coping strategies and for the use of immature, neurotic, and autistic fantasy defenses. Regression analyses revealed that PIU was predicted by the mature, immature, and autistic fantasy defenses as well as, negatively by adaptive coping, and positively by maladaptive coping. These differed when the analyses were repeated on gender-stratified samples. Given that this initial prevalence estimation suggests that PIU may be a substantial issue in this region of the world, future research should examine the mental health risk factors related to PIU, particularly their causal relationships.

Psychometric Properties of the Nine-Item Problematic Internet Use Questionnaire (PIUQ-9) in a Lithuanian Sample of Students

Objectives: To date, there is no reliable instrument which could be used to assess problematic Internet use (PIU) in Lithuania. The nine-item Problematic Internet Use Questionnaire (PIUQ-9) previously validated in multiple countries, could be a potential tool for measuring PIU severity. The main objective of the present study was to explore the psychometric properties of the Lithuanian version of the questionnaire. Methods: A total of 272 students (17% men, mean age 27 ± 9 years) completed the PIUQ-9, the Patient Health Questionnaire (PHQ) and answered questions about the impairment of daily functioning caused by PIU in an online survey. Results: A confirmatory factor analysis indicated that a bi-factor model with one general factor "general problem" and two-specific factors "obsession" and "neglect + control disorder" fitted the data well. The presence of a strong global factor was supported by the common variance index in the bi-factor model indicating that the "general problem" factor explained 67.7% of common variance. The multiple indicators multiple causes (MIMIC) model showed that psychiatric symptoms (β = 0.25) had a moderate, while impairment due to PIU (β = 0.41) had a moderate-to-strong direct effect on the factor "general problem" supporting the construct validity of the scale. Conclusion: The Lithuanian version of the PIUQ-9 has appropriate psychometric properties to be used in measuring PIU severity in student samples.