Digital Addiction and Sleep

Digital traps: How technology fuels nomophobia and insomnia in Taiwanese college students

This study investigates the relationship between maladaptive digital technology use, which arises from nomophobia, and insomnia among young adults. It specifically focuses on problematic gaming (PG), problematic social media use (PSMU), and problematic YouTube use (PYTU) as significant forms of digital behavior contributing to this contemporary health concern. Adolescents and young adults, being the first generation raised in a highly digitized environment, encounter unique challenges, including the emergence of behavioral addictions. Our findings indicate a strong association between nomophobia and problematic digital behaviors, with PSMU identified as the most prevalent form of maladaptive use. Additionally, PG and PSMU are recognized as substantial contributors to the development of nomophobia. The interaction of cognitive overstimulation, emotional dysregulation, blue light exposure, time displacement, and reward-driven dependency on these digital platforms promotes compulsive behaviors, which subsequently lead to the onset of insomnia. Utilizing Structural Equation Modeling (SEM), the study illustrates that nomophobia precipitates problematic digital behavior, which in turn results in sleep disturbances, thereby elucidating a clear pathway from digital dependency to insomnia. The limitations of this study include its cross-sectional design and reliance on self-reported data, which may introduce potential biases. Despite these limitations, our findings underscore the critical role of nomophobia in triggering insomnia through various maladaptive digital behaviors. This highlights the urgent need for targeted prevention and intervention strategies aimed at fostering healthier digital habits and alleviating the adverse health effects of excessive technology use, ultimately enhancing well-being in an increasingly interconnected society.

Role of conscious awareness and Big Five in predicting the digital addiction

Introduction

Digital addiction is discussed in the literature as a type of addiction that negatively affects the personal, social, and societal lives of individuals. Digital addiction is a behavioral addiction that occurs as a result of the problematic and unconscious use of digital tools with features such as compulsive, excessive, impulsivity, and includes human-machine interaction. What is meant to be expressed with conscious awareness is to accept the facts and experiences as they are without judgment, and to be aware of them. With awareness, it is aimed to contribute to individuals to evaluate their past experiences more objectively, to get rid of automatic behavioral and emotional patterns, and to show more moderate reactions by avoiding aggressive reactions. In this context, this study examines the Big Five and Mindfulness as predictive variables for digital addiction, focusing on them as a cause and a solution variable that can be used in interventions for digital addiction. Given its prevalence and negative effects, it is important to identify and analyze the relationship patterns between digital addiction and related variables in order to define and resolve the problem. In this context, the present study aims to determine the levels of conscious awareness and digital addiction among university students and to examine the predictive effect of conscious awareness levels and Big Five variables on predicting digital addiction behaviors.

Methods

The present study is designed to employ the survey method. Data were collected from 1,664 university students selected by using the convenience sampling method, and the data obtained were analyzed by using descriptive statistics and structural equation modeling. The SPSS 25 and LISREL 8.8 software packages were used in the analysis process.

Results and discussion

The results achieved in this study revealed that university students have a moderate level of conscious awareness and that the overall level of digital addiction is generally moderate. The results achieved from the structural equation modeling for the measurement model constructed for the relationships between variables confirmed the validity of the proposed model. It was determined that the model had a good fit with the latent variables, which represent the indicator variables, and also other latent variables. In conclusion, it was found that Big Five and the level of conscious awareness have a reducing effect on digital addiction and serve a protective function against this negativity among university students.

Disconnect to Reconnect: Practical Approaches to Managing Social Media's Impact on Pediatric Mental Health

INTRODUCTION

The pediatric mental health crisis has intensified, especially during the COVID-19 pandemic. Social media and electronic use have been significant contributors to this issue.

METHODS

This paper explores existing literature and clinical guidelines to assess the impact of electronic overuse on pediatric mental health, focusing on practical interventions for healthcare providers.

RESULTS

Studies show that increased screen time correlates with heightened levels of anxiety, depression, and suicidal ideation, particularly among vulnerable populations such as racial minorities and LGBTQ+ youth.

DISCUSSION

Healthcare providers, especially nurse practitioners, are in prime position to address these issues through evidence-based screening tools, setting boundaries for electronic use, and supporting caregivers. Proactive, holistic interventions are key to mitigating the long-term effects of social media on adolescent mental health.

Influence of Lifestyle Factors on Ocular Surface Parameters in Relation to Age

PURPOSE

To evaluate how Video Display Terminal (VDT) use, Contact Lens (CL) wear, and eyedrop use affect ocular surface parameters in participants with ocular discomfort and how these factors may vary across different age groups.

METHODS

The current cross-sectional study initially involved a total of 252 participants who completed a self-administered survey to collect information about ocular discomfort and lifestyle factors. This online survey was composed of an Ocular Surface Disease Index (OSDI) questionnaire and three extra questions regarding lifestyle factors (VDT use, CL wear, and eyedrop use). Only 185 symptomatic participants, those with OSDI values > 12, were scheduled to undergo a comprehensive ocular examination that included tear film osmolarity, Fluorescein Break-Up Time (FBUT), Maximum Blink Interval (MBI), and corneal staining.

RESULTS

Differences in ocular parameters and lifestyle factors across age groups (<40 years, 40-60 years, >60 years) were analyzed, along with their correlations and regression. Significant age group differences were found in OSDI, osmolarity, FBUT, and MBI (One-way ANOVA, all p ≤ 0.029). Correlations were observed between CL wear and osmolarity and MBI (Pearson's correlation, both p ≤ 0.049). Multiple regression confirmed age associations with OSDI, osmolarity, FBUT, and MBI (Multiple linear regression, all p ≤ 0.040) and found links between VDT use and osmolarity and MBI (Multiple linear regression, both p ≤ 0.038) and between eyedrop use and OSDI (Multiple linear regression, p = 0.040).

CONCLUSION

Aging is a primary factor affecting ocular homeostasis, with older adults showing lower FBUT and MBI values and higher osmolarity. Prolonged use of VDTs exacerbates this effect, further contributing to ocular discomfort and destabilized tear film. No associations between CL wear and any of the ocular parameters were found. Eyedrop use shows varied effects on ocular comfort across age groups, emphasizing the need for age-specific ocular care. Overall, these findings confirm that aging and extended VDT use play a significant role in ocular surface discomfort.

The role of digital device use on the risk of migraine: a univariable and multivariable Mendelian randomization study

Background

The pervasive integration of digital devices into daily life has raised concerns about their potential health impacts. This study aimed to explore the causal relationships between digital device use and the risk of migraine using Mendelian randomization (MR).

Methods

Genetic data on digital device use and migraines were sourced from large-scale genome-wide association studies conducted by the UK Biobank, the FinnGen study, and the International Headache Genetics Consortium. Univariable MR (UVMR), meta-analysis, and multivariable MR (MVMR) approaches were conducted to explore and verify the causal effects of digital device use (including mobile phone use, computer use, playing computer games, and watching television) on migraine risk. Sensitivity analyses were conducted using Cochran's Q, MR-Egger intercept test, MR pleiotropy residual sum and outlier, MR Radial, MR Steiger, and leave-one-out methods.

Results

UVMR analyses revealed that genetically predicted mobile phone use was significantly associated with an increased risk of overall migraine (odds ratio [OR] = 2.39, p = 9.78e-5) and migraine without aura (MO) (OR = 2.25, p = 0.024). Additionally, there were significant positive associations between genetically predicted television watching and the risk of overall migraine (OR = 1.63, p = 2.12e-5) and MO (OR = 2.10, p = 4.98e-5). These results were further supported by the meta-analysis and MVMR analysis. Sensitivity analysis indicated no heterogeneity or pleiotropy.

Conclusion

This comprehensive MR study provides preliminary evidence for the causal impact of mobile phone use and television watching on the risk of migraines. Further studies are needed to explore these associations across different populations.

Sleep patterns and quality during summer and academic year among female university students

OBJECTIVES

To measure sleep patterns and quality during summer vacation and weeks 1-4 of the academic year among female university students.

METHODS

This retrospective prospective cohort study included female students at a university in Riyadh, Saudi Arabia. Participants were recruited with convenience sampling and completed questionnaires online. The questionnaire asked about 5 occasions using the Sleep Quality Scale (SQS) and about their sleep schedule during summer vacation and weeks 1-4 of the academic year.

RESULTS

There were 385 participants. The number of students who slept before midnight increased over time from n=127 (32.9%) students during vacation to n=172 (44.6%) students in week 4 (p<0.001). The average sleep hours decreased from 8.97 (standard deviation (SD)=2.6) hours during summer to 7.01 (p<0.001, SD=2.7) hours in week 4. Students reported poorer sleep quality during the academic year, particularly in week 1 (p=0.023), than summer. Students reported higher satisfaction with sleep during summer vacation (n=97; 25.2%) than week 1 (n=38; 9.9%) and week 4 (n=36; 9.4%) (p<0.001). Students experienced daytime fatigue and tiredness (n=79; 20.5%; p=0.002) and low concentration in week 4 (n=79; 20.5%; p<0.001) compared to summer.

CONCLUSION

In the studied population, multiple sclerosis was the most prevalent cause of ON. Women were more likely to have ON. The prognosis for eyesight was substantially connected with the length of ON.

The Bidirectional Association between Internet Use, Sleep Quality and Eating Behavior: A Cross-Sectional Study in Northwestern Thrace Region in Türkiye

OBJECTIVE

This study aimed to examine the complex associations between Internet addiction, sleep disturbances, and disordered eating behaviors.

METHODS

This cross-sectional study included 646 students from 17 high schools in Edirne, Türkiye between December 2023 and May 2024. A face-to-face questionnaire was administered to assess demographic characteristics, Internet addiction (YIAT), sleep quality (PSQI), and eating behavior (TFEQ-R21).

RESULTS

In total, 644 students completed the study. The prevalence of Internet addiction among adolescents was 16.3%, with a similar prevalence among male and female adolescents. The prevalence of poor sleep quality among adolescents was 6.4%, and this trend was more pronounced in male adolescents, with an incidence of 13.0%. A weak positive correlation was observed between Internet addiction and disordered eating behavior. Additionally, a moderate positive correlation was observed between poor sleep quality and disordered eating behavior. Gender, maternal education level, Internet addiction, and poor sleep quality were significant predictors of eating disorders in adolescents.

CONCLUSION

The findings of our study are of significant value in providing insights into the development of programs designed to prevent undesired eating behaviors.

Internet, App-Based, and Casino Gambling: Associations Between Modality, Problem Gambling, and Substance Use

Technology-based gambling prevalence is not well understood since relevant questions are not included in health and disease surveillance studies. The current study sought to estimate the prevalence of internet-based and smartphone app-based gambling, along with casino gambling, in a sample of U.S. young adults and determine if gambling modality was associated with problem gambling symptoms or substance use. The 2022 Rhode Island Young Adult Survey included N = 1,022 students between the ages of 18 to 25 years old who had lived in Rhode Island, with n = 414 lifetime gamblers (40.5%) included in this study. Odds of gambling via a smartphone app and on the internet, respectively, were greater in heterosexual cis-males compared to heterosexual cis-females (OR[95%CI] = 3.14 [1.25,7.91]; OR[95%CI] = 6.30 [2.05,19.3]). Internet gambling amongst employed students was less common than among those who were not a student and not employed (OR[95%CI] = 0.25 [0.06,1.00]). Odds of problem gambling symptoms were higher among those who gambled via a smartphone app (OR[95%CI] = 3.23 [1.21,8.60]). All forms of gambling were associated with alcohol consumption, although the strength of the association was stronger in app and internet gamblers. Casino gamblers were more likely to be high risk marijuana and illicit drug users. The rising availability of app gambling coupled with its social, psychological, and cultural context may presents an alternative pathway to problem gambling. Bans on internet gambling and/or strict guidelines on the frequency of wagers and cash placed per wager, should be considered as viable methods to mitigate associated consequences.

The relationship between adolescents' physical activity, circadian rhythms, and sleep

Objective

To explore the correlation between physical activity, circadian rhythms, and sleep in adolescents, and analyze the influencing factors of sleep quality in this population.

Methods

A total of 381 high school students were selected through cluster sampling in a specific high school. The Pittsburgh Sleep Quality Index (PSQI) was employed to categorize the participants into a good sleep quality group (n=199) and a poor sleep quality group (n=182). Comprehensive assessments were conducted using the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), PSQI, Morningness-Eveningness Questionnaire-5 (MEQ-5), and International Physical Activity Questionnaire Short Form (IPAQ-SF).

Results

The prevalence of poor sleep quality is 47.8%. The BMI in the poor sleep quality group is higher than that in the good sleep quality group, and the male ratio is lower than that in the good sleep quality group. The poor sleep quality group exhibits significantly higher levels of depression, anxiety, evening chronotype, and low physical activity compared to the good sleep quality group.Spearman rank correlation analysis revealed a positive correlation between the PSQI total score and HAMA and HAMD scores, and a negative correlation with physical activity and MEQ-5 scores. Binary logistic stepwise regression analysis identified lack of physical activity, eveningness chronotype, anxiety, and depression as risk factors for poor sleep quality.

Conclusion

Adolescent sleep quality is correlated with gender, BMI, anxiety, depression, chronotype, and physical activity levels. The findings highlight the importance of considering these factors in interventions aimed at improving sleep health in adolescents.

Suicide Risk Factors in High School Students

In Mexico, suicide has become an important public health problem, representing the third leading cause of death in the adolescent population. Suicidal behavior in adolescents is associated with the interaction of complex relationships between personal, interpersonal, and sociocultural factors. Through a quantitative, descriptive, and correlational cross-sectional study, the present study aimed to analyze the prevalence and risk factors associated with suicidal ideation among adolescents from different high schools of the high school system (SEMS) of the University of Guadalajara, in response to the psychosocial impact of the COVID-19 pandemic. A descriptive statistical analysis was carried out on the data obtained from the 3583 students surveyed, followed by a principal component analysis (PCA) to identify closely related social, emotional, and behavioral variables. The PCA yielded eight principal components, which together represent 75.42% of the variance across psychometric tests. A multiple linear regression analysis was used, with a regression value (R2) of 0.4811, indicating that the explanatory model can predict 48.1% of the variability in suicidal ideation, with a statistical significance level of 0.05. According to the studies conducted, 19% (688 students) showed indicators of high suicide risk and 26.8% (960 students) showed moderate risk. Depression, mental health, health-related quality of life, physical and psychological well-being, and mood and emotions are the most influential factors in suicidal ideation.

Recognition, prevention and management of 'digital harm'

The digital world continues to evolve and is apparent in all aspects of daily life. For children and young people, their online life is as real to them as their in-person life. Health professionals urgently need to update their knowledge and awareness of the positive and negative impacts of the myriad of online content and how this is viewed and used by children and young people. Digital harm can contribute to multiple clinical presentations and paediatricians must ask about online life in consultations and be able to provide holistic digital safety advice, while recognising serious digital harm requiring safeguarding input.This article will introduce the main areas of harm and how to include assessment in routine clinical practice. It will equip paediatricians to offer advice and safeguard children and young people and offer resources and links to further learning.

Addressing cortex dysregulation in youth through brain health check coaching and prophylactic brain development

The Carter Center has estimated that the addiction crisis in the United States (US), if continues to worsen at the same rate, may cost the country approximately 16 trillion dollars by 2030. In recent years, the well-being of youth has been compromised by not only the coronavirus disease 2019 pandemic but also the alarming global opioid crisis, particularly in the US. Each year, deadly opioid drugs claim hundreds of thousands of lives, contributing to an ever-rising death toll. In addition, maternal usage of opioids and other drugs during pregnancy could compromise the neurodevelopment of children. A high rate of DNA polymorphic antecedents compounds the occurrence of epigenetic insults involving methylation of specific essential genes related to normal brain function. These genetic antecedent insults affect healthy DNA and mRNA transcription, leading to a loss of proteins required for normal brain development and function in youth. Myelination in the frontal cortex, a process known to extend until the late 20s, delays the development of proficient executive function and decision-making abilities. Understanding this delay in brain development, along with the presence of potential high-risk antecedent polymorphic variants or alleles and generational epigenetics, provides a clear rationale for embracing the Brain Research Commission's suggestion to mimic fitness programs with an adaptable brain health check (BHC). Implementing the BHC within the educational systems in the US and other countries could serve as an effective initiative for proactive therapies aimed at reducing juvenile mental health problems and eventually criminal activities, addiction, and other behaviors associated with reward deficiency syndrome.

The role of the GABAergic system on insomnia

Sleep is an essential activity for the survival of mammals. Good sleep quality helps promote the performance of daily functions. In contrast, insufficient sleep reduces the efficiency of daily activities, causes various chronic diseases like Alzheimer's disease, and increases the risk of having accidents. The GABAergic system is the primary inhibitory neurotransmitter system in the central nervous system. It transits the gamma-aminobutyric acid (GABA) neurotransmitter via GABAA and GABAB receptors to counterbalance excitatory neurotransmitters, such as glutamate, noradrenaline, serotonin, acetylcholine, orexin, and dopamine, which release and increase arousal activities during sleep. Several studies emphasized that dysfunction of the GABAergic system is related to insomnia, the most prevalent sleep-related disorder. The GABAergic system comprises the GABA neurotransmitter, GABA receptors, GABA synthesis, and degradation. Many studies have demonstrated that GABA levels correlate with sleep quality, suggesting that modulating the GABAergic system may be a promising therapeutic approach for insomnia. In this article, we highlight the significance of sleep, the classification and pathology of insomnia, and the impact of the GABAergic system changes on sleep. In addition, we also review the medications that target the GABAergic systems for insomnia, including benzodiazepines (BZDs), non-BZDs, barbiturates, GABA supplements, and Chinese herbal medicines.

Hooked on technology: examining the co-occurrence of nomophobia and impulsive sensation seeking among nursing students

BACKGROUND

Nomophobia, the crippling fear of being disconnected from mobile devices, is a burgeoning global concern. Given the critical nature of the profession of nursing students, understanding nomophobia's prevalence and potential impacts on patient care and professional conductors becomes even more crucial.

AIM

This study explores the relationship between nomophobia and impulsive sensation-seeking among nursing students in Egypt.

DESIGN AND METHODS

A multicenter cross-sectional survey was conducted with 1626 nursing students randomly selected from three universities across Egypt.

TOOLS

The Arabic versions of the Nomophobia and Impulsive Sensation Seeking Questionnaires were employed to gather data.

RESULTS

Our findings revealed that 40.3% of the surveyed nursing students exhibited severe nomophobia, indicating a substantial dependence on their mobile devices. Notably, this high prevalence was accompanied by a strong tendency towards impulsive sensation-seeking behaviors. Furthermore, a stepwise regression analysis identified several significant predictors of nomophobia (p < 0.001). Impulsive sensation-seeking, year of study, average daily smartphone usage, and age emerged as key factors, explaining 27.5% of the variability in nomophobia scores.

CONCLUSION

The prevalence of nomophobia among Egyptian nursing students is undeniable, highlighting their substantial reliance on mobile devices. A significant association with impulsive sensation-seeking behavior further compounds this dependence. Factors such as impulsive sensation seeking, year of study, average daily smartphone usage, and age were identified as significant predictors of nomophobia. Recognizing these factors as key predictors of nomophobia is crucial for designing effective interventions and psychotherapies. Prioritizing such interventions can promote future nurses' well-being and ensure they deliver the highest quality care to their patients.

Mediating effect of sleep in the association between social media use and mental health among French adolescents during the COVID-19 sanitary crisis

OBJECTIVE/BACKGROUND

Social media use could have deleterious effects on mental health through short sleep duration and poor sleep quality among adolescents. This study aimed to investigate the mediating role of both sleep duration and sleep quality in the association between social media use and mental health among adolescents.

PATIENTS/METHODS

We used cross-sectional data collected from adolescents in the EXIST pilot project conducted during COVID-19 pandemic. Adolescents self-reported wellbeing (WEMWBS), anxiety and depression (HADS) as mental health outcomes. We used ad-hoc questionnaires to assess social media use during weekdays and weekend days, and sleep duration and quality. Mediation analyses were carried out following Baron and Kenny's method, using adjusted linear regression models.

RESULTS

A total of 340 adolescents (13.5 ± 0.6 years, 45.3 % girls) were included. Greater social media use, poorer sleep quality, and shorter sleep duration were associated with poorer mental health. Greater social media use was associated with poorer sleep quality only during the weekend days. The total effect of social media use during weekend days on anxiety (β = 2.54; 95%CI [-1.59; 6.68]) was significantly conveyed through sleep quality (β = 1.22; 95%CI [0.17; 2.62]; mediated proportion = 48.0 %) and duration (mediated proportion = 46.8 %). Mediated proportions ranged from 12.5 % to 20.6 % for wellbeing and depression. Mediating effects were not evident during weekdays.

CONCLUSIONS

Sleep duration and quality mediated the association between social media use and mental health among adolescents during weekend days but not weekdays. Our findings highlight the importance of promoting healthy social media habits, especially during periods of increased reliance on digital platforms, such as COVID-19 pandemic.

A Holistic Investigation of the Relationship between Digital Addiction and Academic Achievement among Students

Digital addiction (DA), an umbrella term referring to addiction to any type of digital media, such as the internet, smartphone, digital games, and social media, is a significant factor influencing students' academic achievement (AA). Many scholars have contributed to this line of research from around the world. Nevertheless, the literature lacks a holistic investigation of how the DA-AA research field evolved, which could guide future studies. The current study aims to address this void and conducts a combined bibliometric and science mapping analysis of research addressing the relationship between DA and AA. Data were retrieved from the WoS database, considered one of the optimal databases for such studies with its comprehensive coverage of quality journals. One hundred eighteen articles were included in the final dataset and were analyzed using the SciMAT software, which allowed analysis over three consecutive periods and yielded comparable results regarding the conceptual and thematic evolution of the DA-AA domain. The results indicated an increased research interest in the topic, especially during the last five years. The science mapping analysis showed that the most-studied types of addiction were smartphone addiction for the first two periods and social media addiction for the last. Research in the DA-AA domain which focused on understanding the addictive use of smartphones during the first period, evolved to address factors such as self-efficacy or life satisfaction leading to smartphone addiction and lower grades. During the third period, the number of factors addressed gained significant variety and covered family-related and personal factors.

From Reward to Anhedonia-Dopamine Function in the Global Mental Health Context

When "hijacked" by compulsive behaviors that affect the reward and stress centers of the brain, functional changes in the dopamine circuitry occur as the consequence of pathological brain adaptation. As a brain correlate of mental health, dopamine has a central functional role in behavioral regulation from healthy reward-seeking to pathological adaptation to stress in response to adversity. This narrative review offers a spotlight view of the transition from healthy reward function, under the control of dopamine, to the progressive deregulation of this function in interactions with other brain centers and circuits, producing what may be called an anti-reward brain state. How such deregulation is linked to specific health-relevant behaviors is then explained and linked to pandemic-related adversities and the stresses they engendered. The long lockdown periods where people in social isolation had to rely on drink, food, and digital rewards via the internet may be seen as the major triggers of changes in motivation and reward-seeking behavior worldwide. The pathological adaptation of dopamine-mediated reward circuitry in the brain is discussed. It is argued that, when pushed by fate and circumstance into a physiological brain state of anti-reward, human behavior changes and mental health is affected, depending on individual vulnerabilities. A unified conceptual account that places dopamine function at the centre of the current global mental health context is proposed.

Association Between Daily Internet Use and Incidence of Chronic Diseases Among Older Adults: Prospective Cohort Study

BACKGROUND

Chronic disease incidence among the elderly is increasing, which is correlated with the acceleration of population aging. Evolving internet technologies may help prevent and provide interventions for chronic diseases in an accelerating aging process. However, the impact of daily internet use on the incidence of chronic diseases is not well understood.

OBJECTIVE

This study aims to investigate whether daily internet use by middle-aged and older adults may inhibit or promote the occurrence of chronic diseases.

METHODS

We included participants from the China Health and Retirement Longitudinal Study (CHARLS), a longitudinal survey of Chinese residents aged ≥45 years. We assessed 8-year data from wave 1 (June 2011-March 2012) to wave 4 (July-September 2018) in CHARLS. Data from wave 4 were used for a cross-sectional study, and data from all 4 waves were used for a longitudinal study. Self-reported data were used to track variables, including internet use, use frequency, and the incidence of different chronic diseases. Cox proportional hazards modeling was applied in the longitudinal study to examine the relationship between daily internet use and chronic diseases among middle-aged and older adults, while adjusting for sociodemographic characteristics and health behaviors. In addition, longitudinal data were used to analyze internet usage trends, and cross-sectional data were used to analyze the factors influencing internet use.

RESULTS

Among the 20,113 participants included in the longitudinal analyses, internet use increased significantly, from 2% to 12.3%, between 2011 and 2018. The adjusted model found statistically significant relationships between daily internet use and a lower incidence of the following chronic diseases: hypertension (hazard ratio [HR] 0.78, 95% CI 0.65-0.95, P=.01), chronic lung disease (HR 0.74, 95% CI 0.57-0.97, P=.03), stroke (HR 0.69, 95% CI 0.50-0.94, P=.02), digestive disease (HR 0.73, 95% CI 0.58-0.91, P=.005), memory-related disorders (HR 0.58, 95% CI 0.37-0.91, P=.02), arthritis or rheumatism (HR 0.60, 95% CI 0.48-0.76, P<.001), asthma (HR 0.52, 95% CI 0.33-0.84, P=.007), depression (HR 0.80, 95% CI 0.71-0.89, P<.001), and vision impairment (HR 0.83, 95% CI 0.74-0.93, P=.004). Moreover, our study also showed that with increasing frequency of internet use, the risk of some chronic diseases decreases.

CONCLUSIONS

This study found that middle-aged and older adults who use the internet have a reduced risk of developing chronic diseases versus those who do not use the internet. The increasing prevalence of daily internet use among middle-aged and older adults may stimulate contemplation of the potential role of internet platforms in future research on chronic disease prevention.

Socialization, Relaxation, and Leisure across the Day by Social Determinants of Health: Results from the American Time Use Survey, 2014-2016

This study used the American Time Use Survey (ATUS) to examine socialization, relaxation, and leisure activities throughout the day as related to social determinants of health (SDOH). The study population was adults aged 25 years and older who participated in the ATUS in 2014-2016, the most recent years for collecting SDOH. Descriptive analyses provide characteristics of the study population. Graphical analyses display socialization by SDOH across the hours of the day based on adjusted regression models. Quasi-binomial models analyzed the association between the numbers of minutes of various activities and SDOH. Associations between SDOH and sleeplessness (yes or no) were explored using logistic regression. For much of the day, being female, having less education, living in poverty, and having food insecurity were associated with more time socializing and relaxing. The major activities under socializing and relaxation are watching television and movies. Having a college degree was strongly associated with increased minutes of sports activity, whereas living in poverty and food insecurity were associated with fewer minutes. Less education, living in poverty, and having food insecurity were associated with sleeplessness. A possible mechanism of the effects of SODH on health is by its altering of the patterns of daily life.

Impact of COVID-19 Confinement on Mental Health in Youth and Vulnerable Populations: An Extensive Narrative Review

The objective of this narrative review is to analyze the impact of COVID-19 on the mental health of particularly vulnerable groups. This information will allow a better understanding of the determining factors that influence the appearance and/or maintenance of mood disorders. To achieve the main objective of this study, a critical review was carried out in which primary sources such as scientific articles, secondary sources such as databases, and other appropriate reference indexes were considered. The results indicated that there was an increase in the diagnosis of mood disorders and the use of medication associated with these disorders, mainly during the period of reclusion that was declared worldwide in March 2020. In addition, risk factors such as loneliness, a lack of resilience, and a lack of adequate coping strategies negatively impacted these groups. The future consequences of this may be reflected over many years thereafter, and it is important that all data obtained from this point forward be considered by mental health professionals and the general population. This review can be a starting point for looking directly at the most vulnerable populations and considering both the resources available to them and the possible aftermath of a traumatic period in everyone’s lives.

Mobile phone use addiction, insomnia, and depressive symptoms in adolescents from ethnic minority areas in China: A latent variable mediation model

BACKGROUND AND AIMS

Although previous studies have discussed the association between mobile phone use addiction (MPUA) and depressive symptoms in adolescents, studies on Chinese adolescents are limited, with no studies being reported on adolescents from ethnic minority areas within Yunnan. This study aimed to explore the mediating mechanism of insomnia in the association between MPUA and depressive symptoms among Yunnan college students.

METHODS

A sample survey was conducted among 10,121 college students from four colleges in Yunnan province, China, from November to December 2021 via cluster sampling. Insomnia was assessed using the Insomnia Severity Index Scale, MPUA was assessed using the Self-Rating Questionnaire for Adolescent Problematic Mobile Phone Use, and depressive symptoms were assessed using the Patient Health Questionnaire-9 items. A generalized linear model was used to analyze the association between MPUA, insomnia, and depressive symptoms. The structural equation model was used to analyze the mediating effect of insomnia.

RESULTS

The positive rates of depressive symptoms, MPUA, and insomnia were 39.2 %, 30.8 %, and 22.3 %, respectively. After adjusting for the demographic and confounding variables, MPUA (β = 0.14, 95 % CI: 0.13-0.15, P < 0.01) and insomnia (β = 0.44, 95 % CI: 0.43-0.46, P < 0.01) were associated with depressive symptoms (P < 0.05). The mediating effect of insomnia accounted for 34.7 % of the total effect in the mediating model of MPUA associated with depressive symptoms.

CONCLUSION

Our findings suggest that insomnia partially mediates the association between MPUA and depressive symptoms among Yunnan college students.

The Potential of N-acetyl Cysteine in Behavioral Addictions and Related Compulsive and Impulsive Behaviors and Disorders: a Scoping Review

Purpose of Review

Behavioral addictions (also termed disorders due to addictive behaviors) contain impulsive and compulsive features and have been shown to involve glutamate dysregulation. N-acetylcysteine (NAC), a well-tolerated cysteine pro-drug and antioxidant, may reduce addictive behaviors by restoring glutamate homeostasis. The current review details and discusses the use of NAC in behavioral addictions and related impulsive and compulsive behaviors, including gambling disorder, problematic use of the internet, problematic video gaming, compulsive sexual behavior, problematic shopping/buying, problematic stealing, repetitive self-injurious behavior, and binge eating disorder.

Recent Findings

Preliminary results have indicated the usefulness of NAC in gambling disorder, self-injurious behaviors, and compulsive sexual behaviors. Preclinical studies indicate that NAC is effective in improving binge eating behavior, but clinical trials are limited to a small open-label trial and case report. Studies are lacking on the efficacy of NAC in problematic use of the internet, problematic video gaming, problematic stealing, and problematic shopping/buying.

Summary

NAC demonstrates potential for use in behavioral addictions and compulsive behaviors, particularly in gambling disorder and self-injury. However, more studies are needed to assess the effectiveness of NAC in other behavioral addictions and the mechanisms by which NAC improves these conditions.

Revealing the Intellectual Structure and Evolution of Digital Addiction Research: An Integrated Bibliometric and Science Mapping Approach

The current study uses "digital addiction" as an umbrella term to refer to addiction to the Internet, social media, smartphones, digital devices, video games, or similar digital technologies. The study aims to investigate the scientific landscape of the digital addiction research field through combining bibliometric and science mapping analysis and to facilitate insight into the development and evolution of this knowledge base. Data for the analysis were extracted from the Scopus database, which covers a wide range of journal articles, with 429 articles addressing digital addiction included in the analysis. The science mapping analysis was performed over three consecutive time periods using SciMAT software to observe the thematic evolution. The results indicated that addictive behavior was the most significant theme across the three time periods. Cross-sectional studies addressing the risk factors or outcomes of addiction among adults and different sexes were prevalent during the first period (1997-2012), while interest moved to the addictive behavior of adolescents and students during the second period (2013-2017). Research during the third period (2018-2022) was driven by smartphone and social media addiction, and resilience as a preventive factor garnered more research interest than previously studied risk factors, which may indicate a perspective change by researchers. Implications are suggested for future investigations of digital addiction.

Analyzing the changing relationship between personal consumption and suicide mortality during COVID-19 pandemic in Japan, using governmental and personal consumption transaction databases

During the early stages of the ongoing COVID-19 pandemic, suicides did not increase in most countries/regions. Japan, however, was an exception to this, reporting increased numbers of female suicides with no changes in male suicide. To explore the trends of increasing suicides, the fluctuations of personal consumption (as an indicator of lifestyle) and standardized suicide death rate (SDR) disaggregated by age, sex, and prefecture, were determined using a linear mixed-effect model. Additionally, fixed effects of personal consumption on SDR during the pandemic were also analyzed using hierarchical linear regression models with robust standard errors. During the first wave of the pandemic, SDR for both sexes decreased slightly but increased during the second half of 2020. SDR of females younger than 70 years old and males younger than 40 years old continued to increase throughout 2021, whereas SDR for other ages of both sexes did not increase. Personal consumption expenditures on out-of-home recreations (travel agencies, pubs, and hotels) and internet/mobile communication expenses decreased, but expenditures on home-based recreations (contents distribution) increased during the pandemic. Increased expenditures on internet/mobile communication were related to increasing SDR of both sexes. Increasing expenditures on content distributions were related to increasing females' SDR without affecting that of males. Decreasing expenditures on pubs were related to increasing SDR of both sexes in the non-metropolitan region. These findings suggest that transformed individual lifestyles, extended time at home with a decreased outing for contact with others, contributed to the progression of isolation as a risk of suicide. Unexpectedly, increasing compensatory contact with others using internet/mobile communication enhanced isolation resulting in increased suicide risk.