COVID-19 pandemic related excessive electronic media exposure and mental health in Saudi Arabia

OBJECTIVE

Due to the continued spread of COVID-19 and the emergence of novel mutated viral variants, families all over the world are experiencing wide-ranging stressors that threaten not only their financial well-being but also their physical and mental health. The present study assessed the association between excessive electronic media exposure of pandemic-related news and mental health of the residents of Ha'il Province, Saudi Arabia. The present study also assessed the prevalence of perceived stress, fear of COVID-19, anxiety, depression, and loneliness due to COVID-19-related restrictions in the same population.

MATERIALS AND METHODS

A total of 490 residents of Ha'il Province participated in a cross-sectional online survey during a two-month period (March to April 2021). A validated 38-item self-report survey was used to collect the data.

RESULTS

Significant associations were reported between excessive electronic media exposure and the prevalence of perceived stress (χ2=140.56; p<.001), generalized anxiety (χ2=74.55; p<.001), depression (χ2=71.58; p<.001), COVID-19-related fear (χ2=24.54; p<.001), and loneliness (χ2=11.46; p<.001). It was also found that participants without depressive symptoms were 0.28 times less likely to have been exposed to excessive electronic media exposure (AOR: 0.28; C.I. 0.16-0.48; p<.001). Similarly, participants with no stress/mild stress were 0.32 times less likely to have been exposed to excessive electronic media exposure (AOR: 0.32; C.I. 0.19-0.52; p<.001).

CONCLUSIONS

The findings of the present study suggest an urgent need for educational resilience programs (online and in-person) for susceptible individuals (females, unemployed, urban residents, etc.). Such programs would help them to develop skills to cope with the psychological impact of the COVID-19 pandemic.

Assessing whether COVID-19 patients will benefit from critical care, and an objective approach to capacity challenges during a pandemic: An Intensive Care Society clinical guideline

This national professional society guidance lays out operational and ethical principles for decision-making during a pandemic, in the immediate context of COVID-19 in the early 2020 surge iteration but with potential ongoing relevance. It identifies the different phases of a pandemic and the implications for capacity and mutual aid within a national healthcare system, and introduces a revised CRITCON-PANDEMIC framework for shared operational responsibilities and clinical decision-making. Usual legal and ethical frameworks should continue to apply while capacity and mutual aid are available (CRITCON-PANDEMIC levels 0-3); clinicians should focus on current clinical needs and should not treat patients differently because of anticipated future pressures. In conditions of resource limitation (CRITCON-PANDEMIC 4), a structured and equitable approach is necessary and an objective Decision Support Aid is proposed. In producing this guidance, we emphasise that all patients must be treated with respect and without discrimination, because everyone is of equal value. The guidance has been put together with input from patient and public groups and aims to provide standards that are fair to everyone. We acknowledge that COVID-19 is a new disease with a partial and evolving knowledge base, and aim to provide an objective clinical decision-making framework based on the best available information. It is recognised that a factual assessment of likely benefit may take into account age, frailty and comorbidities, but the guidance emphasises that every assessment must be individualised on a balanced, case by case, basis and may inform clinical judgement but not replace it. The effects of a comorbidity on someone's ability to benefit from critical care should be individually assessed. Measures of frailty should be used with care, and should not disadvantage those with stable disability.

Internet addiction: a systematic review of epidemiological research for the last decade

In the last decade, Internet usage has grown tremendously on a global scale. The increasing popularity and frequency of Internet use has led to an increasing number of reports highlighting the potential negative consequences of overuse. Over the last decade, research into Internet addiction has proliferated. This paper reviews the existing 68 epidemiological studies of Internet addiction that (i) contain quantitative empirical data, (ii) have been published after 2000, (iii) include an analysis relating to Internet addiction, (iv) include a minimum of 1000 participants, and (v) provide a full-text article published in English using the database Web of Science. Assessment tools and conceptualisations, prevalence, and associated factors in adolescents and adults are scrutinised. The results reveal the following. First, no gold standard of Internet addiction classification exists as 21 different assessment instruments have been identified. They adopt official criteria for substance use disorders or pathological gambling, no or few criteria relevant for an addiction diagnosis, time spent online, or resulting problems. Second, reported prevalence rates differ as a consequence of different assessment tools and cut-offs, ranging from 0.8% in Italy to 26.7% in Hong Kong. Third, Internet addiction is associated with a number of sociodemographic, Internet use, and psychosocial factors, as well as comorbid symptoms and disorder in adolescents and adults. The results indicate that a number of core symptoms (i.e., compulsive use, negative outcomes and salience) appear relevant for diagnosis, which assimilates Internet addiction and other addictive disorders and also differentiates them, implying a conceptualisation as syndrome with similar etiology and components, but different expressions of addictions. Limitations include the exclusion of studies with smaller sample sizes and studies focusing on specific online behaviours. Conclusively, there is a need for nosological precision so that ultimately those in need can be helped by translating the scientific evidence established in the context of Internet addiction into actual clinical practice.

Excessive Computer Game Playing: Evidence for Addiction and Aggression?

Computer games have become an ever-increasing part of many adolescents' day-to-day lives. Coupled with this phenomenon, reports of excessive gaming (computer game playing) denominated as "computer/video game addiction" have been discussed in the popular press as well as in recent scientific research. The aim of the present study was the investigation of the addictive potential of gaming as well as the relationship between excessive gaming and aggressive attitudes and behavior. A sample comprising of 7069 gamers answered two questionnaires online. Data revealed that 11.9% of participants (840 gamers) fulfilled diagnostic criteria of addiction concerning their gaming behavior, while there is only weak evidence for the assumption that aggressive behavior is interrelated with excessive gaming in general. Results of this study contribute to the assumption that also playing games without monetary reward meets criteria of addiction. Hence, an addictive potential of gaming should be taken into consideration regarding prevention and intervention.

The exercise addiction inventory: a quick and easy screening tool for health practitioners

BACKGROUND

Exercise addiction is not routinely screened for probably because available instruments take a long time to administer, their scoring may be complicated, and their interpretation is not always obvious. A new psychometric instrument has been developed that is capable of identifying people affected by, or at risk of, exercise addiction: the exercise addiction inventory (EAI). A preliminary report showed the EAI had good reliability and validity.

OBJECTIVES

To test further the EAI's psychometric properties and show that it would be quick and simple to administer by general practitioners.

METHODS

A sample of 200 habitual exercisers were given the EAI and two existing exercise addiction scales (obligatory exercise questionnaire; exercise dependence scale). Two weeks later, another sample of 79 exercisers were administered the EAI to determine the test-retest reliability of the questionnaire.

RESULTS

The original data from the preliminary report were reanalysed to determine the split half correlation of the EAI. This was found to be 0.84 (Guttman split-half coefficient). A correlation between weekly frequency of exercising and EAI scores was also determined, and it was found that the two variables shared 29% of the variance (r2 = 0.29). The test-retest reliability of the scale was found to be very good (0.85).

CONCLUSIONS

The EAI is a valid and reliable tool which would be capable of helping general practitioners to quickly and easily identify people affected by, or at risk of, exercise addiction.

Online computer gaming: a comparison of adolescent and adult gamers

Despite the growing popularity of online game playing, there have been no surveys comparing adolescent and adult players. Therefore, an online questionnaire survey was used to examine various factors of online computer game players (n = 540) who played the most popular online game Everquest. The survey examined basic demographic information, playing frequency (i.e. amount of time spent playing the game a week), playing history (i.e. how long they had been playing the game, who they played the game with, whether they had ever gender swapped their game character, the favourite and least favourite aspects of playing the game, and what they sacrifice (if anything) to play the game. Results showed that adolescent gamers were significantly more likely to be male, significantly less likely to gender swap their characters, and significantly more likely to sacrifice their education or work. In relation to favourite aspects of game play, the biggest difference between the groups was that significantly more adolescents than adults claimed their favourite aspect of playing was violence. Results also showed that in general, the younger the player, the longer they spent each week playing.

The acquisition, development and maintenance of lottery and scratchcard gambling in adolescence

The U.K. National Lottery and instant scratchcards are now well established yet there is still little empirical research on the players. This study was an exploratory investigation of the psychosocial effects of these forms of gambling among adolescents (n=1195; aged 11- to 15-years-old). Using a questionnaire, it was shown that large numbers of adolescents were taking part in these activities. There was a significant link between parental and child gambling with most lottery tickets and scratchcards being bought for the adolescents by their parents. Results showed that many adolescents thought they would win lots of money on these activities and that these activities were in general not perceived to be forms of gambling. Six per cent of adolescents fulfiled the DSM-IV-J criteria for pathological gambling, the majority of which were males.

Dependence on computer games by adolescents

As computer game playing is a popular activity among adolescents, a questionnaire study was undertaken with 387 adolescents (12-16 years of age) to establish their "dependence" using a scale adapted from the DSM-III-R criteria for pathological gambling. Analysis indicated that one in five adolescents were currently "dependent" upon computer games. Boys played significantly more regularly than girls and were more likely to be classified as "dependent." The earlier children began playing computer games it appeared the more likely they were to be playing at "dependent" levels. These and other results are discussed in relation to research on other gaming dependencies.

A caecal diaphragm in cystic fibrosis

A right iliac fossa mass may be a difficult diagnostic problem in a patient with cystic fibrosis. We present a patient with such a mass who was thought to have a non-obstructing intussusception on clinical and radiological grounds. However, at laparotomy she was found to have a pathology not previously described in cystic fibrosis. She had a partial diaphragm almost blocking the lumen to her appendix. The differential diagnosis of a right iliac fossa mass is considered and the cause of her pathology discussed.

The effect of type A personality on physiological arousal while playing computer games

Despite the widespread use of computer games, there is a lack of systematic research in the area--particularly on their "addictiveness" potential. Anecdotal evidence suggests that computer game addiction may be due to arousal properties of computer games, although other factors may be important. This study examined the relationship between Type A personality and arousal in computer-game play. It was hypothesised that, during computer-game play, Type A and Type B subjects would have significantly higher heart rates as compared with baseline levels and that Type A subjects would experience a significantly greater increase in arousal when playing a computer game than Type B subjects. These hypotheses were both supported and the results are discussed in relation to arousal, personality, and addiction.

Fetal vesicoureteral reflux: outcome following conservative postnatal management

Of 222 infants with a urinary tract abnormality detected antenatally 30 male and 9 female patients (64 renal units) were found to have primary vesicoureteral reflux. Grade of reflux was predominantly severe, with grade III or higher noted in 83% of the patients. Prenatal and postnatal ultrasound failed to detect any abnormality in 29 refluxing units (45%) discovered contralateral to the known abnormal system, although 19 had grade III or higher reflux. Of the 64 refluxing units 8 underwent primary ureteral reimplantation, 12 were lost to followup and 44 were managed conservatively for a mean of 3.3 years. Reflux ceased in 61% of the cases, improved in 14% and remained unchanged in 23%. In only 1 unit did the grade of reflux increase. Documented urinary tract infection occurred in 6 of the 39 reflux patients. Dimercaptosuccinic acid renography performed in 21 infection-free patients demonstrated global reduction in renal parenchyma in 4 units, focal parenchymal defects in 3 and normal function in 14. Conservative postnatal management of fetal vesicoureteral reflux is justified. Global and focal parenchymal changes can occur in the kidneys of infants with reflux despite the absence of urinary tract infection.

Pinball wizard: the case of a pinball machine addict

This is a description of a young man who is addicted to playing pinball machines. The subject's playing history and playing pathology are outlined using an adapted version of the DSM-III-R criteria for pathological gambling. Such an adaptation of these criteria is proposed as beneficial in monitoring and recording objective measures of all gaming-machine addictions.

Amusement machine playing in childhood and adolescence: a comparative analysis of video games and fruit machines

The introduction of video games has met with mixed reviews. In the US, an ongoing debate focusing on the potential problems of video game playing has been taken up by parents, politicians and social scientists. A number of the concerns that have been raised about the playing of video games in the US are very similar to the concerns raised about the playing of fruit machines (slot machines) in the UK. This paper attempts to put the on-going US and UK amusement machine debates into an empirical perspective and attempts a comparative analysis of video games and fruit machines by examining: incidence of play, sex differences and psychological characteristics of machine players, observational findings in arcade setting, the alleged negative consequences of amusement machine playing (i.e. increased aggression and addiction), and an appraisal of amusement machines' positive aspects. Future directions and an expanded version of Brown's (1989) developmental model of a pathology of man-machine relationships are also discussed.

Ideational conditioning: bridging the cognitive-behaviourist divide

Classical conditioning has traditionally been referred to as a 'dumb form of learning'; however, psychological activity can be redefined in terms of the conditioned reflex by considering other more complex forms of conditioning, i.e., configural or semantic conditioning. In this paper it is argued that conditioning may underpin both human perception and consciousness and previous experiments involving perceptual conditioning are outlined. Recent experiments which involve a new paradigm of ideational conditioning have shown that cognitions can play a part in conditioning processes. It is shown here that ideational conditioning demonstrates unequivocally that thoughts alone are adequate stimuli for acquisition of behavioural responses and that these experiments may help to bridge the cognitive-behaviourist divide.

Virilizing adrenal adenoma in a 2-year-old girl

A 2-year-old girl with virilization had an adrenal tumor that produced testosterone with little evidence of excessive urinary androgen excretion. Plasma testosterone concentration was 407 ng/dL and urinary 17-ketosteroid (17KS) levels were 3 and 2 mg/day. Excretion of 17KS decreased to 1.8 mg/day after suppression of dexamethasone therapy, but urinary 17-hydroxycorticosteroid excretion did not change from 1.0 to 0.7 mg/day after administration of dexamethasone. She had a blunted response to administration of metyrapone and insulin and a small diurnal variation in cortisol concentration suggesting suppression of corticotropin secretion, even though the plasma cortisol concentration was in the normal range and there were no clinical signs of cortisol excess. High-performance liquid chromatography was used to analyze the steroid content of tumor tissue. Those portions of the tumor that were rich in steroids contained predominantly testosterone.