Based on a Decision Tree Model for Exploring the Risk Factors of Smartphone Addiction Among Children and Adolescents in China During the COVID-19 Pandemic

Similarities and differences in core symptoms of problematic smartphone use among Chinese students enrolled in grades 4 to 9: A large national cross-sectional study

Children and adolescents are highly susceptible to problematic smartphone usage. We employed network analysis to explore the similarities and differences in the core symptoms of problematic smartphone use across grades 4-9, using a large nationwide sample. This study included 8552 children and adolescents (Mage = 12.98, SD=1.51) who met the critical value for problematic smartphone use. The results showed that the core symptoms of problematic smartphone use exhibit both similarities and differences between grades 4 and 9. 'Withdrawal symptoms' and 'preoccupation symptoms' were the stable core symptoms of problematic smartphone use across grades 4 to 9, suggesting that problematic smartphone use begin to appear from earlier grades, such as grade 4. 'Feel impatient and fretful', 'never give up' and 'always thinking about' were the core symptoms in grades 4 and 5. 'Longer than I had intended' and 'hard to concentrate' emerged as additional core symptoms in grade 6, with the intensity indicators peaking in grades 8 and 9, suggesting that the issue of problematic smartphone use among Chinese children and adolescents has become intensified and intricate. Symptoms of problematic smartphone use vary across grades and exhibit both continuity and stage specificity. Consequently, to address this issue, the formulation of intervention measures should comprehensively consider both the grade levels and symptoms.

Post-COVID-19 internet addiction, depression, and pornography addiction among adolescents: Findings from a nationwide study in Bangladesh

Background and Aims

Regulations response to COVID-19 has increased internet addiction (IA), depression, and pornography addiction (PA) among adolescents worldwide. The objective of this nationwide study was to assess the current prevalence rate of IA, depression, and PA after the post-COVID-19 period among school-going adolescents in Bangladesh.

Methods

A total of 8832 male and female adolescents participated in this research. The cross-sectional study was conducted online using a simple random sampling method. Including the sociodemographic variables, Young's IA Test (IAT-20) Scale, Patient Health Questionnaire (PHQ-9), and Pornography Craving Questionnaire (PCQ-12) were used to measure IA, depression, and PA. By SPSS version 25.0, the prevalence and correlation between IA, depression, and PA were analyzed using the Chi-square test, binary logistic regression, and a bivariate co-relation matrix.

Results

Sixty-three percent, 76.6%, and 62.9% of the students were suffering from IA, depression, and PA respectively. Depressive and anxious symptoms were significantly associated with IA. Female students were more depressed than males. Males were more addicted to pornography than females. Students who utilized social media but didn't exercise had greater depression and PA. IA, depression, and PA were correlated.

Conclusion

The research emphasizes the need for comprehensive mental health treatments, digital literacy programs, and family and teacher participation to reduce IA, depression, and PA among adolescents post-COVID-19. Promotion of physical exercise and supporting policies to build safer online settings for adolescents are also encouraged.

A moderated chain mediation model examining the relation between smartphone addiction and intolerance of uncertainty among master's and PhD students

The theories of relational regulation and compensatory Internet use suggest that intolerance of uncertainty influences smartphone addiction (SPA), which in turn is influenced by other aspects. This study used previous results to examine how intolerance of uncertainty affects SPA in PhD and master's degree programs. A convenience sample comprising 1727 master's and PhD students (99.9 %; 50.7 % female; Mage = 27.71; SD = 3.80; range = 21-43) was recruited. Using established questionnaires, we measured SPA, anxiety, positive coping style, perceived social support, and intolerance of uncertainty. The results demonstrated that intolerance of uncertainty positively affects SPA in terms of predictive power. Furthermore, anxiety and positive coping style mediate that link in a cascade fashion. A greater SPA indicates that the individual is less likely to use a positive coping style, has a higher anxiety level, and has a lower tolerance for uncertainty. While thinking about how intolerance of uncertainty affects anxiety and positive coping style, perceived social support mediates the relationship. Intolerance of uncertainty has less impact on anxiety and positive coping style when perceived social support is high. These results indicate the possibility of examining SPA prevention and intervention from several angles. Therefore, emotional regulation, which modifies anxiety and the tendency to use a positive coping style, may reduce the impact of intolerance of uncertainty on SPA. Another successful strategy for reducing smartphone addiction is to provide social support from loved ones and the community at large.

Factors influencing smartphone overdependence among adolescents

Adolescents are particularly vulnerable to smartphone overdependence. Therefore, we identified the factors influencing smartphone overdependence and risk subgroups among adolescents. The current study is a secondary analysis of nationally representative data from the 2020 Korea Youth Risk Behavior Survey. The survey targeted middle- and high-school students in South Korea aged 12-18 using stratified, clustered, multistage probability sampling, and 53,457 students from 793 schools participated in this study. Complex sample data were analyzed considering the strata, clusters, and weights. Multiple logistic regression analysis revealed age, gender, household economic status, anxiety, loneliness, depressive symptoms, and experience of violent treatment as significant predictors of smartphone overdependence. Adolescents with severe anxiety were at a 3.326 times higher risk of smartphone overdependence than adolescents with minimal anxiety. Decision tree analysis showed that anxiety, gender, loneliness, and depressive symptoms were important in differentiating risk subgroups, with anxiety being the most significant factor. Group 13, comprising girls with severe anxiety, had the highest risk at 52.9%. Thus, early detection and prevention of issues such as anxiety, loneliness, and depressive symptoms, as well as treatment for violence, can prevent smartphone overdependence among adolescents. Additionally, more thorough interventions for anxiety are warranted to prevent smartphone overdependence.

Mobile phone addiction and suicide behaviors among Chinese adolescents: The mediation of poor sleep quality

Background and aims

Mobile phone addiction (MPA) is emerging among adolescents, especially during the COVID-19 pandemic. Nevertheless, there is a dearth of knowledge regarding the correlation between MPA and suicide behaviors and its mechanism. The objective of the current study is exploring the direct effect of MPA on suicide behaviors and the indirect effect through poor sleep quality.

Methods

A total of 18,900 Chinese adolescents aged 12 to 18 were recruited via a multi-stage cluster sampling method.

Results

The prevalence of MPA and poor sleep quality was 26.2 and 23.1%, respectively. During the past year, 24.4% participants were involved in suicide behaviors. Specifically, suicide ideators, suicide planners, and suicide attempters were 10.7, 8.4, and 5.3%, respectively. Particularly, rural females had the highest prevalence of suicide behaviors, MPA, and poor sleep quality. Logistic regression analysis showed that MPA was significantly associated with suicide ideators (OR = 1.22, 95% CI: 1.09-1.37, p < 0.001) and planners (OR = 1.18, 95% CI: 1.04-1.34, p < 0.05), but not for suicide attempters (p > 0.05). Structural equation modelling demonstrated that MPA had direct effect on suicide behaviors (β = 0.145, 95% CI = 0.127-0.160), and poor sleep quality partially mediated the relationship (the mediating ratio was 46.7%). The mediating ratio of poor sleep quality was the highest in urban males.

Conclusions

MPA has both direct and indirect effects on suicide behaviors. For suicide prevention, limited mobile phone use and improvement sleep quality may be practical for adolescents. Additionally, more efforts of intervention could give priority to rural girls.

The impact of long-term online learning on social anxiety and problematic smartphone use symptoms among secondary school students with different levels of fear of missing out: Evidence from a symptom network and longitudinal panel network analysis

Background

The advancement of communication technology and the impact of the COVID-19 pandemic have led to an increased reliance on online education. However, the effects of the long-term use of smart devices for online learning on students' social anxiety and problematic smartphone use (PSU) and the role of fear of missing out (FoMO) in this process have yet to be fully explored.

Methods

This study analysed longitudinal data from 2,356 high school students (female = 1,137 (48.26%), mean age = 13.84, SD age = 1.37) in China, divided into high- and low-FoMO groups based on their scores on the FoMO scale, to examine the impact of four months of online learning on social anxiety and PSU. The Social Anxiety Scale (SAS) and Mobile Phone Addiction Index (MPAI) were used to assess social anxiety and PSU symptoms.

Results

The undirected symptom networks revealed more bridge symptoms among the students in the high-FoMO group, although their overall symptom scores decreased. The results of the directed cross-lagged panel networks showed that "productivity loss" predicted other symptoms in the low-FoMO group but that "afraid of negative evaluation" was the predictor in the high-FoMO group. Meanwhile, "withdrawal/escape" and "productivity loss" were the symptoms that were most affected by other symptoms in the high-FoMO and low-FoMO groups, respectively.

Conclusions

The current study therefore sheds light on the changes in social anxiety and PSU symptoms among secondary school students during long-term online learning, as well as the moderating role of FoMO.

Associations of mobile phone addiction with suicide ideation and suicide attempt: findings from six universities in China

Background

Mobile phones are becoming indispensable for life and have changed various aspects of people's lives. The psychological impacts of excessive mobile phone use have emerged as an impressive problem among college students. However, little is known about the associations of mobile phone addiction with suicide ideation and suicide attempt.

Methods

A cross-sectional study was conducted with students from six universities in 2022. We collected the socio-demographic characteristics, suicide ideation, suicide attempt, psychosocial factors (depressive symptoms, social support, sleep quality), and health-related characteristics (smoking, drinking, body mass index). Mobile phone addiction was ascertained by the Mobile Phone Addiction Tendency Scale (MPATS). The associations of mobile phone addiction with suicide ideation and suicide attempt were estimated using binary logistic regression and restricted cubic splines regression.

Results

A total of 18,723 college students [6,531 males (34.9%) and 12,192 females (65.1%)] were included in the final analysis. Eleven percent of participants had a history of suicide ideation, and 1.8% of participants had engaged in suicide attempt. A total of 5,553 students (29.7%) met the criteria of mobile phone addiction (MPATS score ≥48), and the average score on the MPATS was 39.5 ± 13.0. After adjustment for potential covariates, mobile phone addiction was significantly associated with increased odds of suicide ideation (OR, 1.70; 95% CI, 1.53-1.88) and suicide attempt (OR, 1.48; 95% CI, 1.18-1.86). Gender did not affect the associations of mobile phone addiction with suicide ideation and suicide attempt (P for interaction > 0.05). The restricted cubic splines regression displayed a nonlinear dose-response association between MPATS score and risk of suicide ideation (P for non-linearity < 0.001), while a monotonically increasing risk of suicide attempt was found to be associated with an increasing MPATS score (P for non-linearity = 0.420).

Conclusions

Mobile phone addiction is associated with suicide ideation and suicide attempt among college students. The findings indicate that early examination, prevention, and intervention for mobile phone addiction may benefit the prevent and control of suicide.

Can restricting while-in-bed smartphone use improve sleep quality via decreasing pre-sleep cognitive arousal among Chinese undergraduates with problematic smartphone use? Longitudinal mediation analysis using parallel process latent growth curve modeling

BACKGROUND AND AIM

Problematic smartphone use (PSU) has become a global public health problem. Excessive while-in-bed smartphone use may result in poor sleep quality. The present study aimed to examine whether restricting while-in-bed smartphone use can improve sleep quality and the mediating role of pre-sleep cognitive arousal in this process.

METHODS

A total 152 Chinese undergraduates with symptoms of PSU (Smartphone Addiction Scale-Short Version [SAS-SV] > 31) were recruited and randomly assigned to the intervention group (N = 76) and the control group (N = 76) for a 4-week follow-up experiment. Sleep quality (assessed by the Pittsburgh Sleep Quality Index) and pre-sleep cognitive arousal (assessed by the Pre-sleep Arousal Scale-Cognitive Arousal) were measured at baselime, Week1, Week2, Week3, and Week4. The longitudinal mediation model was analyzed using parallel process latent growth curve modeling. The significance of indirect effect was tested by 95% biascorrected accelerated confidence intervals on the basis of 5000 bootstrap samples.

RESULTS

The initial level of sleep quality was positively associated with the initial level of pre-sleep cognitive arousal. The intervention decreased pre-sleep cognitive arousal and increased sleep quality. The slope of pre-sleep cognitive arousal was positively associated with the slope of sleep quality. The mediating effect of pre-sleep cognitive arousal was significant.

DISCUSSION

Restricting while-in-bed smartphone use can improve sleep quality via decreasing pre-sleep cognitive arousal among Chinese undergraduates with symptoms of PSU. These results suggests that restricting while-in-bed smartphone use is a potential remedy for sleep disturbance induced by PSU.

Development and validation of the while-in-bed-smartphone-use-induced sleep procrastination scale (WSPS) in Chinese undergraduates with/without problematic smartphone use

PURPOSE

Problematic smartphone use (PSU) has become a global public health problem. Excessive while-in-bed smartphone use may result in sleep procrastination and other negative outcomes. The present study aimed to develop and validate a new scale called WSPS to assess while-in-bed-smartphone-use-induced sleep procrastination among undergraduates.

METHODS

In total, 910 Chinese undergraduates completed the collection of WSPS, smartphone addiction scale-short version (SAS-SV), bedtime procrastination scale, Pittsburgh sleep quality index, and Zung self-rating depression scale. The whole sample were randomly splited in the exploratory factor analysis (EFA) sample (n = 455) and confirmatory factor analysis (CFA) sample (n = 455). 40 undergraduates with PSU (SAS-SV > 31) and 40 without PSU were asked to keep sleep diary for 2 weeks and complete the WSPS again.

RESULTS

EFA and CFA supported a six-item unidimensional structure of the WSPS. The WSPS demonstrated acceptable internal consistency among undergraduates. The WSPS showed good concurrent validity with other relevant variables including PSU, BP, sleep quality, and depression. Scalar invariance of the WSPS between undergraduates with/without PSU was supported, as well as scalar invariance across gender. The WSPS showed good convergent validity with self-report everyday while-in-bed smartphone use duration and good discriminant validity with sleep duration and sleep onset latency recorded by sleep diary. The WSPS also presented good test-retest reliability among undergraduates with/without PSU.

CONCLUSION

The WSPS is a reliable and valid measure of while-in-bed-smartphone-use-induced sleep procrastination in undergraduates with/without PSU.

Latent classes of smartphone dependency trajectories and predictors of classes among middle school students in South Korea

PURPOSE

With widespread use of smartphones, side effects of smartphone dependency among adolescents are emerging as a social problem. Screening high-risk groups is important for appropriate interventions to prevent smartphone dependency in early adolescence. This study thus aimed to identify latent classes of smartphone dependency trajectories and predictors of classes among South Korea's middle school students.

DESIGN AND METHODS

We used data from 2164 middle school students from the Korean Children and Youth Panel Survey (2018-2020). Latent growth curve modeling (LGCM) was performed to confirm the longitudinal trajectory, and latent class growth modeling (LCGM) was performed to identify latent classes of middle school students' smartphone dependency. Then, multinomial logistic regression analysis was conducted to explore predictors of the classes.

RESULTS

The LGCM showed that the trajectory of all middle school students' smartphone dependency increased (intercept 30.65, slope = 1.09). However, the LCGM identified three latent classes: (1) low-stable (intercept 23.01, nonsignificant slope), (2) medium-increasing (intercept 30.37, significant increasing slope), and (3) high-increasing (intercept 37.79, significant increasing slope). Predictors of each latent class included gender, aggressive behavior, self-esteem, parental smartphone dependency, parenting attitude, and negative peer relationships.

CONCLUSION

The results indicate that the smartphone dependency trajectory of all adolescents is not the same, and there are latent classes with different trajectory patterns.

PRACTICAL IMPLICATIONS

These findings may contribute to the development of nursing interventions for the smartphone dependency of adolescents. Such interventions should encourage positive factors and eliminate negative factors and, especially, involve parents.

Smartphone Addiction Among University Students' During the Post-COVID-19 Era: The Role of Emotional Intelligence and Future Anxiety

OBJECTIVE

Coronavirus disease-2019 (COVID-19) pandemic-related psychological symptoms can lead to smartphone addiction (SPA) risk and other behavioral disorders, thus impacting individuals' mental health and well-being. The present study aims to propose a mediation model to investigate the association between emotional intelligence (EI) and SPA, and the mediating role of future anxiety (FA) during the post-COVID-19 era.

METHODS

An online questionnaire including the Emotional Intelligence Scale, the Dark Future Scale, and the Smartphone Addiction Scale among university students from China, was conducted between September 14 and November 22, 2022. Finally, 1,154 valid questionnaires were collected. The reliability and confirmatory factor analysis results showed that all three scales had good reliability and validity.

RESULTS

Structural Equation Model demonstrated that EI significantly and negatively influenced SPA (β=0.211, p<0.001), university students' FA significantly and positively effected SPA (β=0.315, p<0.001), EI significantly predicted SPA in university students, and FA partially mediated the association between EI and SPA. The mediation effect of FA was 0.110, which accounted for 34.27% of the total effect. Bootstrap results furthermore tested the rigor of the mediating effect.

CONCLUSION

These findings broaden our understanding regarding the relationship between EI and SPA and the mediating role of FA, providing new sights for educators on how to reduce the risk of SPA when confronting the ongoing and possible future pandemics.

The relationship between loneliness and problematic smartphone use among adolescents during the COVID-19 pandemic: The mediating role of negative emotions and maladaptive coping

INTRODUCTION

Given the observed increased feelings of loneliness and problematic smartphone use among adolescents during the COVID-19 pandemic, further research was needed to determine whether and how the increased loneliness of adolescents during such major public health crisis events affects the risk of problematic smartphone use among adolescents. This study aimed to examine the relationship between loneliness and problematic smartphone use among Chinese adolescents (aged 10-16 years) during the COVID-19 pandemic and to investigate the possible mediating role of negative emotions and maladaptive coping.

METHODS

A total of 672 Chinese adolescents (Mage  = 13.05, SD = 1.51, 50.4% boys, 93.8% from rural areas, 22.5% of whom were only children) took part in this cross-sectional study in April 2022 by completing the Chinese adolescent version of the Loneliness Scale, the Positive and Negative Affect Scale (subscale), the Ways of Coping Questionnaire, and the Mobile Phone Addiction Index Scale.

RESULTS

The serial mediation model revealed that negative emotions and maladaptive coping independently mediated the relationship between adolescents' loneliness and problematic smartphone use. In addition, the mediation effects of "negative emotions-maladaptive coping" could also mediate the relationship between loneliness and problematic smartphone use.

CONCLUSIONS

Loneliness may be positively related to problematic smartphone use through negative emotions and maladaptive coping among adolescents during major public health crisis events, such as the COVID-19 pandemic.

The habitual characteristic of smart phone use under relevant cues among Chinese college students

Excessive smartphone use may be habitual behavior induced by cues associated with the phone. Habitual behavior occurs outside of awareness and is characterized by lack of control. It is not like problematic smartphone use (PSU) (Brand et al., 2016), which is used to either limit behavior or produce pleasure and relieve feelings of pain, stress, and failure despite significant harmful consequences. 62 college students participated in experiments to test the effects of visual cues and self-control, which are the important characteristic of habitual behavior in smartphone-related behavior. The results showed that a significantly larger amount of cue-related phone use behavior occurred in the setting where participants (a) had their smartphones in sight and (b) were given no instructions to exert self-control, compared to when neither of the two conditions was imposed. The habitual model is a useful framework for understanding PSU and can help people avoid it with less stress. The results provide substantial implications for reducing the frequency and duration of smartphone use among college populations.

Can limiting bedtime smartphone use improve next-day working memory among undergraduates with problematic smartphone use?

This study implemented a longitudinal self-control intervention experiment to examine whether limiting bedtime smartphone use can improve next-day working memory among individuals with problematic smartphone use (PSU). 156 Chinese undergraduates with PSU completed the 6-day experiment (3 nights for intervention condition and 2 nights for control condition). All participants were asked to complete N-back tests in the afternoon everyday during the experiment. The results indicated that limiting smartphone use in bed improved next-day working memory. Therefore, limiting smartphone use in bed is a potential remedy for daily cognitive impairments induced by PSU.

The experiences of counselors caring for children and adolescents with problematic smartphone use

This study examines field experts' experiences to ascertain the actual circumstances and strategies to increase the efficacy of intervention programs for children and adolescents with problematic smartphone use. Three focus group interviews were conducted via video conferencing. The data were grouped into three major themes: (1) the screening and inflow phase, which included the inaccuracy of the screening tests, barriers in the inflow process, and the importance of school cooperation; (2) the intervention phase, which included the necessity of developing a program tailored to the target audience, the importance of parental participation, and concerns about the vulnerable; and (3) the maintenance phase, which included the lack of a long-term strategy, the need to re-establish the purpose of the counseling/intervention programs, and the need for systematic maintenance of the system. To improve the reliability of the screening test for children and adolescents with problematic smartphone use, it is necessary to improve the measurement tools and environment. To increase parental involvement, education should be provided on perceiving the severity of problematic smartphone use, and program running hours should be varied. The findings offer information necessary for improving counseling and interventions for children and adolescents with problematic smartphone use.

The Relationship between Short Video Flow, Addiction, Serendipity, and Achievement Motivation among Chinese Vocational School Students: The Post-Epidemic Era Context

Since the COVID-19 outbreak, people have been spending more time in the online world because of restrictions on face-to-face communication due to epidemic prevention controls. This has also brought the issue of Internet addiction, including the overuse and negative effects of short videos, to the forefront of attention. Past research has found that Internet addiction has a negative impact on well-being. However, there is a special concept of positive emotion called "serendipity" (). Serendipity provides a small, fleeting but positive experience, yet it is often associated with negative perceptions from an outside perspective. However, the relationship between short video addiction and serendipity is not yet known. Based on this, a theoretical model was developed in the context of the I-PACE model. To understand the relationship between short video addiction and serendipity among college students, in this study, we conducted snowball sampling and distributed online questionnaires using the Wenjuanxing platform. The target population of the questionnaire distribution was vocational college students in China, of whom 985 valid study participants responded, yielding a valid return rate of 82.1%. Of the respondents, 410 (41.6%) were male and 575 (58.4%) were female. The results were as follows: a. short video flow had a positive relationship with serendipity, a negative relationship with achievement motivation, and a positive effect on short video addiction; b. short video addiction had a positive effect on serendipity and a negative effect on achievement motivation; and c. serendipity had a negative impact on achievement motivation. This shows that short video addiction, like other Internet addictions, can have a negative impact on students' learning.

A Systematic Overview of Adolescents’ Smartphone Habits and Internet Addiction During the COVID-19 Era

In order to prevent the spread of the virus during the Covid-19 epidemic period, measures such as maintaining social distance, quarantine practices, and keeping schools closed have been taken in many countries. In this process, individuals' internet use has also increased in order to restore interpersonal relationships that have decreased with staying at home. In addition, the transfer of educational activities, which are risky to be carried out face-to-face during the epidemic period, to online platforms, as in many countries, brought about an increase in the time spent on devices with internet providers in adolescents. For this reason, it is important to evaluate the results of studies examining the concepts of internet and smartphone addiction in relation to the use of the internet in the Covid-19 period. In this context, in this systematic review, "What is the status of adolescents' smartphone and internet addictions in the Covid-19 Era?" The question has been tried to be answered. As a result of the searches made in the databases, fourteen studies were reached and these studies were examined in depth. The findings showed that adolescents’ internet/smartphone addictions were higher than before the epidemic, the prevalence of internet/smartphone addictions increased in general, and internet/smartphone addictions were associated with adolescents' mental disorders and problems.

Adolescent resilience and mobile phone addiction in Henan Province of China: Impacts of chain mediating, coping style

BACKGROUND

As mobile phone use grows, so it brings benefits and risks. As an important part of adolescents healthy growth, resilience plays an indispensable role. Thus, it is important to identify when mobile phone use of an adolescent becomes an addiction. This study proposed to explore the effects of adolescent resilience on mobile phone addiction, and tested the mediating role of coping style and depression, anxiety, and stress (DASS) on phone addiction among 2,268 adolescents in the Henan province, China.

METHODS

The adolescents were surveyed via an online questionnaire, a mobile phone addiction index (MPAI), a depression, anxiety, and stress scale with 21 items (DASS-21), the Resilience Scale for Chinese Adolescents (RSCA), and the Simplified coping style questionnaire (SCSQ), and we used structural equation modeling to examine the correlations and moderation effects. All data analyses were performed using SPSS 26.0 and Amos 23.0.

RESULTS

The results show that adolescences resilience were negatively related to negative coping, DASS, and mobile phone addiction; both coping style and DASS could mediate the relationship between adolescent resilience and mobile phone addiction among Chinese adolescents. The relationship between adolescent resilience and mobile phone addiction in Chinese adolescents was mediated by the chain of coping styles and DASS.

CONCLUSIONS

There is a negative relationship which exists between resilience and mobile phone addiction in this population. In addition, stress, anxiety, depression, and coping style significantly influence the risk of adolescent mobile phone addiction and play an intermediary role in Chinese adolescent resilience and mobile phone addiction.

Tree-based, two-stage risk factor analysis for postoperative sepsis based on Sepsis-3 criteria in elderly patients: A retrospective cohort study

Background

Sepsis remains the leading cause of postoperative death in elderly patients and is defined as organ dysfunction with proven or suspected infection according to Sepsis-3 criteria. To better avoid potential non-linear associations between the risk factors, we firstly used a tree-based analytic methods to explore the putative risk factors of geriatric sepsis based on the criteria in the study.

Methods

Data of 7,302 surgical patients aged ≥ 65 years at the Third Affiliated Hospital of Sun Yat-sen University from January 2015 to September 2020 were collected. An analytic method that combined tree-based analysis with the method of Mantel-Haenszel and logistic regression was adopted to assess the association between 17 putative risk factors and postoperative sepsis defined by the Sepsis-3 guideline by controlling 16 potential confounding factors.

Results

Among the 16 potential covariates, six major confounders were statistically identified by the tree-based model, including cerebrovascular diseases, preoperative infusion of red blood cells, pneumonia, age ≥ 75, malignant tumor and diabetes. Our analysis indicated that emergency surgery increases the risk of postoperative sepsis in elderly patients by more than six times. The type of surgery is also a crucial risk factor for sepsis, particularly transplantation and neurosurgery. Other risk factors were duration of surgery > 120 min, administration of steroids, hypoalbuminemia, elevated creatinine, blood urea nitrogen, hematocrit, platelets, glucose, white blood cell count, abnormal neutrophil-to-lymphocyte ratio and elevated hsCRP-to-albumin ratio.

Conclusions

Our study uses an effective method to explore some risk factors for postoperative sepsis in elderly by adjusting many potential confounders and it can provide information for intervention design.

Estimation of Behavioral Addiction Prevalence During COVID-19 Pandemic: A Systematic Review and Meta-analysis

Purpose of Review

The COVID-19 pandemic changed people’s lifestyles and such changed lifestyles included the potential of increasing addictive behaviors. The present systematic review and meta-analysis aimed to estimate the prevalence of different behavioral addictions (i.e., internet addiction, smartphone addiction, gaming addiction, social media addiction, food addiction, exercise addiction, gambling addiction, and shopping addiction) both overall and separately.

Recent Findings

Four databases (PubMed, Scopus, ISI Web of Knowledge, and ProQuest) were searched. Peer-reviewed papers published in English between December 2019 and July 2022 were reviewed and analyzed. Search terms were selected using PECO-S criteria: population (no limitation in participants’ characteristics), exposure (COVID-19 pandemic), comparison (healthy populations), outcome (frequency or prevalence of behavioral addiction), and study design (observational study). A total of 94 studies with 237,657 participants from 40 different countries (mean age 25.02 years; 57.41% females). The overall prevalence of behavioral addiction irrespective of addiction type (after correcting for publication bias) was 11.1% (95% CI: 5.4 to 16.8%). The prevalence rates for each separate behavioral addiction (after correcting for publication bias) were 10.6% for internet addiction, 30.7% for smartphone addiction, 5.3% for gaming addiction, 15.1% for social media addiction, 21% for food addiction, 9.4% for sex addiction, 7% for exercise addiction, 7.2% for gambling addiction, and 7.2% for shopping addiction. In the lockdown periods, prevalence of food addiction, gaming addiction, and social media addiction was higher compared to non-lockdown periods. Smartphone and social media addiction was associated with methodological quality of studies (i.e., the higher the risk of boas, the higher the prevalence rate). Other associated factors of social media addiction were the percentage of female participants, mean age of participants, percentage of individuals using the internet in country, and developing status of country. The percentage of individuals in the population using the internet was associated with all the prevalence of behavioral addiction overall and the prevalence of sex addiction and gambling addiction. Gaming addiction prevalence was associated with data collection method (online vs. other methods) that is gaming addiction prevalence was much lower using online methods to collect the data.

Summary

Behavioral addictions appeared to be potential health issues during the COVID-19 pandemic. Healthcare providers and government authorities should foster some campaigns that assist people in coping with stress during COVID-19 pandemics to prevent them from developing behavioral addictions during COVID-19 and subsequent pandemics.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40429-022-00435-6.

Smartphone addiction risk, technology-related behaviors and attitudes, and psychological well-being during the COVID-19 pandemic

COVID-19 pandemic-related perceived risk of infection, illness fears, acute stress, emotional anxiety, exhaustion, and fatigue, psychological trauma and depressive symptoms, and sustained psychological distress can cause smartphone addiction risk and lead to technology-related cognitive, emotional, and behavioral disorders, thus impacting psychological well-being. Behavioral addiction of smartphone users can result in anxiety symptom severity, psychiatric symptoms, and depressive stress. We carried out a quantitative literature review of the Web of Science, Scopus, and ProQuest throughout June 2022, with search terms including "smartphone addiction + COVID-19" + "stress," "anxiety," "depression," "psychological distress," "screen time," and "fear." As we analyzed only articles published between 2020 and 2022, 288 papers met the eligibility criteria. By excluding sources with similar titles, having unclear findings or unsupported by replication, or displaying inconsistent content, we selected 64, mainly empirical, sources. We used layout algorithms (VOSviewer) and bibliometric mapping (Dimensions) as data visualization tools. Assessing the Methodological Quality of Systematic Reviews (AMSTAR), a systematic review and literature review software (Distiller SR), Mixed Methods Appraisal Tool (MMAT), and Systematic Review Data Repository (SRDR) were employed as methodological quality assessment tools. As limitations, we analyzed only articles published between 2020 and 2022 in scholarly outlets indexed in the Web of Science, Scopus, and ProQuest databases. The scope of our study also does not advance the inspection of sources covering vulnerable individuals suffering from certain diseases or specific generations. Subsequent analyses should develop on smartphone use and addiction among children and adolescents. Future research should thus investigate problematic smartphone use and addiction across generations Z and Alpha. Attention should be directed to their personality traits and psychopathological symptoms.

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

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

Internet Addiction, Phubbing, Psychological Variables and Self-Perception of Mathematical Competence in College Students

Internet Addiction (IA) and phubbing are prevalent, disruptive behaviours among university students. The aim of this study was to explore the relationship between IA and Phubbing with psychological variables (impulsiveness, self-esteem, and psychological distress), academic performance and self-perception of mathematical competence (SMC), as well as possible gender differences. Results showed (n = 715; Mean Age = 21.7) gender differences in lack of planning, emotional investment and somatisation and IA correlated positively with app addiction, mobile addiction, and psychopathology. A total of 26.3% of IA can be explained by a lack of self-control, time and performance management, mobile phone addiction, anxiety and psychological distress. Finally, 71% of students believe that the use of new technologies has worsened their SMC and this is correlated with impaired communication, obsession with mobile phones, IA (Total Phubbing Scale) and impulsiveness. Our results indicate the importance of taking into account psychological variables that affect the development of IA, phubbing, and SMC in the university population.

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

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

The Impact of Adolescent Resilience on Mobile Phone Addiction During COVID-19 Normalization and Flooding in China: A Chain Mediating

Natural disasters cause long-term psychological problems and increase substance use in some adults. However, it is unclear whether disasters also lead to these problems in adolescents. We hypothesized the influence of adolescent resilience on mobile phone addiction during the normalization of COVID-19 and flooding. We tested the mediating role of coping style and depression, anxiety, and stress (DASS) on phone addiction among 1,751 adolescents in the Henan Province in China. The adolescents were surveyed via an online questionnaire, and we used structural equation modeling to examine the correlations and moderation effects. The results show that coping style and DASS could mediate the relationship between adolescent resilience and mobile phone addiction among Chinese adolescents. A chain of coping styles and DASS mediated the relationship between adolescent resilience and mobile phone addiction in Chinese adolescents.

A Network Analysis of the Relationships Between Behavioral Inhibition/Activation Systems and Problematic Mobile Phone Use

Background

It is of great concern to society that individuals can be vulnerable to problematic mobile phone use (PMPU). However, there are a few studies in the field evaluating associations between behavioral inhibition/activation systems (BIS/BAS) and PMPU, and the results have been inconsistent. This study aimed to explore the relationships between BIS/BAS and PMPU by network analysis.

Methods

A total of 891 young adults participated in the study. BIS/BAS and PMPU were assessed by using the behavioral inhibition and activation systems scale and smartphone application-based addiction scale, respectively. The structure of the BIS/BAS-PMPU network was characterized using "strength," "closeness" and "betweenness" as centrality indices. Edge-weight accuracy and centrality stability were tested using a bootstrap procedure.

Results

The network analysis showed that "mood modification," "tolerance" and "withdrawal symptoms" had high centrality. In addition, the positive connection between BIS and "mood modification" or "tolerance" and between BAS-fun seeking and "mood modification" or "conflict" were also shown in the BIS/BAS-PMPU network.

Conclusion

These findings shed light on the central and bridge components between the BIS/BAS and PMPU communities, providing new evidence relevant to potential mechanisms that account for how high-BIS or high-BAS individuals develop PMPU, and inspiring component-based PMPU prevention or interventions.

Factors Associated with Smartphone Addiction during COVID-19 Pandemic Lockdown in Students of Faculty of Medicine in North Sumatera

Introduction: The popularity of cell phones among the younger generation has increased rapidly in a short period leading to the high prevalence of smartphone addiction among adolescents worldwide, especially during the Covid-19 pandemic lockdown period. This study aimed to investigate the factors associated with smartphone addiction measured by the Indonesian version of the Smartphone Addiction Scale-Short version (SAS-SV) score in both preclinical and clerkship students.  Methods: A cross-sectional study was conducted from November 2020 to December 2020 in preclinical and clerkship students of the Faculty of Medicine from the Universitas Sumatera Utara, North Sumatra Islamic University, Hospital of North Sumatra University, and Hospital of Haji Medan academic year of 2019-2020. The Indonesian version of the SAS-SV questionnaire was distributed to the study subjects through Google Form.  Results: Bivariate analysis showed all variables to be significantly associated with SAS-SV score (all p values were <0.05). Meanwhile, multivariate analysis showed all variables but the type of smartphone and the closest family members to be significantly associated with the SAS- SV score.  Conclusion: Age, gender, education level, monthly income, duration of smartphone use, sleep duration, parental educational background, monthly internet costs, and other uses of smartphones were found to be associated with smartphone addiction as measured by the Indonesian version of the SAS-SV score. Meanwhile, the type of smartphone and the closest family members were not associated with smartphone addiction as measured by the Indonesian version of the SAS-SV score.