Special Issue "Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (31 May 2020).

Special Issue Editor

Dr. Olatz Lopez-Fernandez
Website
Guest Editor
Senior Lecturer, Turning Point, Eastern Health Clinical School, Monash University, 110 Church Street, Richmond VIC 3121, Australia
Interests: addictive behaviours; behavioural addictions; general online addictive behaviours (e.g., internet addiction; problem mobile phone use); specific online addictive behaviours (e.g., gaming, social networking, cybersex); gender issues (e.g., female, male); lifespan issues (e.g., children, elderly); educational technology (e.g., educative innovations; higher education; online learning and teaching; ePortfolios); e-health (e.g., healthcare practices for behavioural addictions, mhealth, serious games)
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

The previous Special Issue "Internet and Mobile Phone Addiction: Health and Educational Effects" (2017-2018) was a successful achievement, which can be found at https://www.mdpi.com/journal/ijerph/special_issues/internet_addiction. The second edition relies on recent developments in internet and smartphone use-related addiction health problems.

The focus will be in its treatment, education and research, as the Special Issue will collect papers that will cover one (or more) of the health problems under study or under the clinical scope.

First, we invite studies on how these problems are being diagnosed, the profiling of these patients, the usual comorbidity, treatments applied, and their prognosis. Second, we want to know how these problems could be tackled from an educational and preventive perspective, if any policy options have been applied and the consequences, if any educational intervention is undertaken, even as a preventive action, or on how education has developed on these health problems. Third, any research focused on the role of the internet in different fixed or mobile technologies is expected. However, the primary interest is in empirical papers and reviews or new theoretical developments are welcome, even if they are focussed on not formally recognised behavioural addictions (i.e., cybersex, online shopping). Other behavioural addictions where the technology has a role which is not primarily the most important (e.g., food addiction, exercise addiction) will also be considered. Thus, contributions should offer new knowledge about how these health problems are evolving worldwide.

Dr. Olatz Lopez-Fernandez
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Internet addiction
  • Mobile phone (or smartphone) addiction
  • Internet use-related addiction health problems: Gaming, disordered social networking, cybersex, emotional dependence, online shopping, etc.
  • Other behavioural addictions which use the technology as a complement: Food addiction, exercise addiction, work addiction, etc.
  • Diagnosis, dual pathology, comorbidity, treatments, psychotherapy, prognosis
  • Public health, eHealth, mHealth, etc.
  • Educational, intervention, prevention, psycho-sociological effects studies

Published Papers (39 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Jump to: Review

Open AccessArticle
Empirical Relationships between Problematic Alcohol Use and a Problematic Use of Video Games, Social Media and the Internet and Their Associations to Mental Health in Adolescence
Int. J. Environ. Res. Public Health 2020, 17(17), 6098; https://doi.org/10.3390/ijerph17176098 - 21 Aug 2020
Abstract
Adolescents frequently show risky behavior, and these problematic behavior patterns often do not occur in isolation, but together. Problematic alcohol use is widespread among youth, as is problematic use of the Internet and of specific online applications (video games or social media). However, [...] Read more.
Adolescents frequently show risky behavior, and these problematic behavior patterns often do not occur in isolation, but together. Problematic alcohol use is widespread among youth, as is problematic use of the Internet and of specific online applications (video games or social media). However, there is still a lack of findings for minors regarding the relations between these behavioral patterns (particularly between problematic alcohol use and problematic gaming or problematic social media use). Standardized instruments were used to survey problematic alcohol use, problematic gaming, problematic social media use, problematic Internet use and mental health among 633 adolescents (mean age: 15.79 years). Bivariate correlation and multivariable linear regression analyses were conducted. The correlation analyses showed statistically significant positive bivariate relationships between all four behavioral patterns each. Antisocial behavior was related to all problematic behavioral patterns. Whereas, emotional distress, self-esteem problems and hyperactivity/inattention were associated with substance-unrelated problematic behavior patterns only. Anger control problems were related to problematic alcohol use and problematic gaming. In adolescence, the findings revealed small effect sizes between substance-related and substance-unrelated problematic behavior patterns, but moderate to large effect sizes within substance-unrelated behavioral patterns. Similarities and differences were found in the relations between the behavioral patterns and mental health. Full article
Open AccessArticle
Assessing the Psychometric Properties of the Internet Addiction Test in Peruvian University Students
Int. J. Environ. Res. Public Health 2020, 17(16), 5782; https://doi.org/10.3390/ijerph17165782 - 10 Aug 2020
Abstract
The use of the Internet has been gradually and unstoppably gaining ground in all areas of life, from recreational activities to how social relations are established. However, the existence of clinical cases indicates that the addictive use of the Internet is a problem [...] Read more.
The use of the Internet has been gradually and unstoppably gaining ground in all areas of life, from recreational activities to how social relations are established. However, the existence of clinical cases indicates that the addictive use of the Internet is a problem that seriously affects some people. Among the instruments that measure this construct, the Internet Addiction Test (IAT) stands out. However, instrumental studies of this test are scarce in Latin America. The present study sought to analyze the psychometric properties of the IAT in a sample of 227 Peruvian undergraduate university students. Confirmatory factor analysis was used to provide validity evidence based on the internal structure, and evidence based on the relationship with other variables was also provided. Reliability was estimated through the ordinal alpha coefficient. The results indicated that the IAT adequately fits a bifactor model (with two specific factors, time/control and stress/compensate), obtaining good levels of reliability. Additionally, the IAT scores correlate significantly with the average number of hours per day on the internet and social skills. The results lead to the conclusion that the scores in the IAT have evidence of validity and reliability for its use. Full article
Show Figures

Figure 1

Open AccessArticle
Problematic Relationships with Smartphones of Spanish and Colombian University Students
Int. J. Environ. Res. Public Health 2020, 17(15), 5370; https://doi.org/10.3390/ijerph17155370 - 25 Jul 2020
Abstract
The presence of smartphones in the lives of the population in general, and of youth in particular, is evident, and is derived from elements such as the diversity of prices as well as the ease of access of all the resources that can [...] Read more.
The presence of smartphones in the lives of the population in general, and of youth in particular, is evident, and is derived from elements such as the diversity of prices as well as the ease of access of all the resources that can be reached through the internet. With the use of a descriptive approach using a quantitative poll, the objective of the present study was to discover the opinions of university students in Spain and Colombia about smartphone use, as well as the consequences of its use, and if this use could derive into so-called problematic smartphone use (PSU). For gathering the information, the Mobile Phone Problematic Use Scale (MPPUSA) was utilized, with a sample size n = 4009. The main result reached was that the model obtained is structured around six factors that determined the elements in light of PSU. The initial conclusion found was that the model applied can be utilized with Colombian students, with young Spanish women and students in the macro area of Social Sciences, the ones who had problematic behavior with the devices, as compared to the Health Sciences students who did not have it. Full article
Open AccessArticle
Autonomy Need Dissatisfaction in Daily Life and Problematic Mobile Phone Use: The Mediating Roles of Boredom Proneness and Mobile Phone Gaming
Int. J. Environ. Res. Public Health 2020, 17(15), 5305; https://doi.org/10.3390/ijerph17155305 - 23 Jul 2020
Cited by 1
Abstract
Psychological needs dissatisfaction has been identified as hindering adaptive development, in which autonomy need dissatisfaction, as one core component, may be associated with adolescents’ maladaptive online behaviors. Sporadic research has examined the association between autonomy need dissatisfaction and problematic mobile phone use (PMPU). [...] Read more.
Psychological needs dissatisfaction has been identified as hindering adaptive development, in which autonomy need dissatisfaction, as one core component, may be associated with adolescents’ maladaptive online behaviors. Sporadic research has examined the association between autonomy need dissatisfaction and problematic mobile phone use (PMPU). Boredom proneness and mobile phone gaming were suggested to be linked to this association. This study aimed to examine the mediating effects of boredom proneness and mobile phone gaming in the association between autonomy need dissatisfaction and PMPU. A total of 358 secondary school students completed questionnaires at three waves; autonomy need dissatisfaction was measured in time 1 (T1); boredom proneness and mobile phone gaming were measured one year later (time 2, T2); PMPU was measured two years later (time 3, T3). The structural equation model results showed that T1 autonomy need dissatisfaction not only directly predicted T3 PMPU, but also exerted effects via the mediating role of T2 boredom proneness and the chain mediating role of T2 boredom proneness and T2 mobile phone gaming. These findings reveal the unique role of specific psychological need in engaging PMPU, which provides support to targeted interventions, such that promoting autonomy need satisfaction may be an instrumental procedure to prevent adolescents from addiction-like online behaviors. Full article
Show Figures

Figure 1

Open AccessFeature PaperArticle
Mind over Matter: Testing the Efficacy of an Online Randomized Controlled Trial to Reduce Distraction from Smartphone Use
Int. J. Environ. Res. Public Health 2020, 17(13), 4842; https://doi.org/10.3390/ijerph17134842 - 05 Jul 2020
Abstract
Evidence suggests a growing call for the prevention of excessive smartphone and social media use and the ensuing distraction that arises affecting academic achievement and productivity. A ten-day online randomized controlled trial with the use of smartphone apps, engaging participants in mindfulness exercises, [...] Read more.
Evidence suggests a growing call for the prevention of excessive smartphone and social media use and the ensuing distraction that arises affecting academic achievement and productivity. A ten-day online randomized controlled trial with the use of smartphone apps, engaging participants in mindfulness exercises, self-monitoring and mood tracking, was implemented amongst UK university students (n = 143). Participants were asked to complete online pre- and post-intervention assessments. Results indicated high effect sizes in reduction of smartphone distraction and improvement scores on a number of self-reported secondary psychological outcomes. The intervention was not effective in reducing habitual behaviours, nomophobia, or time spent on social media. Mediation analyses demonstrated that: (i) emotional self-awareness but not mindful attention mediated the relationship between intervention effects and smartphone distraction, and (ii) online vigilance mediated the relationship between smartphone distraction and problematic social media use. The present study provides preliminary evidence of the efficacy of an intervention for decreased smartphone distraction and highlights psychological processes involved in this emergent phenomenon in the smartphone literature. Online interventions may serve as complementary strategies to reduce distraction levels and promote insight into online engagement. More research is required to elucidate the mechanisms of digital distraction and assess its implications in problematic use. Full article
Show Figures

Figure 1

Open AccessArticle
Relationship between Difficulty in Emotion Regulation and Internet Addiction in College Students: A One-Year Prospective Study
Int. J. Environ. Res. Public Health 2020, 17(13), 4766; https://doi.org/10.3390/ijerph17134766 - 02 Jul 2020
Abstract
This prospective study evaluated the predictive effect of difficulty in emotion regulation on the occurrence and remission of Internet addiction (IA) and determined whether IA has a role in changing emotion regulation among college students during a follow-up period of 1 year. A [...] Read more.
This prospective study evaluated the predictive effect of difficulty in emotion regulation on the occurrence and remission of Internet addiction (IA) and determined whether IA has a role in changing emotion regulation among college students during a follow-up period of 1 year. A total of 500 college students (262 women and 238 men) were recruited. In baseline and follow-up investigations, the levels of IA and difficulty in emotion regulation were evaluated using the Chen Internet Addiction Scale and the Difficulties in Emotion Regulation Scale (DERS), respectively. The results indicated that the subscale of impulse control difficulties on the DERS predicted the incidence of IA during the follow-up period of 1 year in male participants (t = −2.875, p = 0.005), whereas no subscale on the DERS predicted the remission of IA. IA did not predict the change in difficulties in emotion regulation. The subscale of impulse control difficulties on the DERS predicted the occurrence of IA in the college students and warrants early intervention. Full article
Show Figures

Figure 1

Open AccessArticle
The Matthew Effect in Recovery from Smartphone Addiction in a 6-Month Longitudinal Study of Children and Adolescents
Int. J. Environ. Res. Public Health 2020, 17(13), 4751; https://doi.org/10.3390/ijerph17134751 - 01 Jul 2020
Abstract
The clinical course of problematic smartphone use (PSU) remains largely unknown due to a lack of longitudinal studies. We recruited 193 subjects with smartphone addiction problems for the present study. After providing informed consent, the subjects completed surveys and underwent comprehensive interviews regarding [...] Read more.
The clinical course of problematic smartphone use (PSU) remains largely unknown due to a lack of longitudinal studies. We recruited 193 subjects with smartphone addiction problems for the present study. After providing informed consent, the subjects completed surveys and underwent comprehensive interviews regarding smartphone usage. A total of 56 subjects among the 193 initially recruited subjects were followed up for six months. We compared baseline characteristics between persistent addicted users and recovered users at the end of the 6-month follow-up. Persistent problematic smartphone users displayed higher baseline smartphone addiction severity and were more prone to develop mental health problems at the follow-up. However, baseline depressive or anxiety status did not significantly influence the course of PSU. PSU behaved more like an addictive disorder rather than a secondary psychiatric disorder. Harm avoidance, impulsivity, higher Internet use, and less conversation time with mothers were identified as poor prognostic factors in PSU. Lower quality of life, low perceived happiness, and goal instability also contributed to persistent PSU, while recovery increased these scores as well as measures of self-esteem. These findings suggest that the Matthew effect is found in the recovery of PSU with better premorbid psychosocial adjustment leading to a more successful recovery. Greater clinical resources are required for interventions in vulnerable populations to modify the course of this increasingly prevalent problematic behavior worldwide. Full article
Show Figures

Figure 1

Open AccessArticle
Psychological Risk Factors that Predict Social Networking and Internet Addiction in Adolescents
Int. J. Environ. Res. Public Health 2020, 17(12), 4598; https://doi.org/10.3390/ijerph17124598 - 26 Jun 2020
Cited by 2
Abstract
Adolescents’ addictive use of social media and the internet is an increasing concern among parents, teachers, researchers and society. The purpose was to examine the contribution of body self-esteem, personality traits, and demographic factors in the prediction of adolescents’ addictive use of social [...] Read more.
Adolescents’ addictive use of social media and the internet is an increasing concern among parents, teachers, researchers and society. The purpose was to examine the contribution of body self-esteem, personality traits, and demographic factors in the prediction of adolescents’ addictive use of social media and the internet. The participants were 447 Spanish adolescents aged 13−16 years (M = 14.90, SD = 0.81, 56.2% women). We measured gender, age, body self-esteem (body satisfaction and physical attractiveness), personality traits (extraversion, neuroticism, disinhibition and narcissism) and social networking and internet addiction (internet addiction symptoms, social media use, geek behaviour, and nomophobia). The effects of gender, age, body self-esteem and personality on the different dimensions of internet addiction were estimated, conducting hierarchical linear multiple regression analysis and a fuzzy-set qualitative comparative analysis (fsQCA). The results evidenced different pathways explaining four types of adolescents’ internet addiction: gender and disinhibition were the most relevant predictors of addiction symptoms; gender combined with physical attractiveness best explained social media use; narcissism and neuroticism appear to be the most relevant predictors of geek behaviour; and narcissism was the variable that best explained nomophobia. Furthermore, the advantages and differences between both methodologies (regressions vs. QCA) were discussed. Full article
Open AccessArticle
Stakeholders’ Consensus on Strategies for Self- and Other-Regulation of Video Game Play: A Mixed Methods Study
Int. J. Environ. Res. Public Health 2020, 17(11), 3846; https://doi.org/10.3390/ijerph17113846 - 28 May 2020
Abstract
Background: Little is known about strategies or mechanics to improve self-regulation of video game play that could be developed into novel interventions. This study used a participatory approach with the gaming community to uncover insider knowledge about techniques to promote healthy play and [...] Read more.
Background: Little is known about strategies or mechanics to improve self-regulation of video game play that could be developed into novel interventions. This study used a participatory approach with the gaming community to uncover insider knowledge about techniques to promote healthy play and prevent gaming disorder. Methods: We used a pragmatic approach to conduct a convergent-design mixed-methods study with participants attending a science fiction and education convention. Six participants answered questions about gaming engagement and self- or game-based regulation of gaming which were then categorized into pre-determined (a priori) themes by the presenters during the presentation. The categorized themes and examples from participant responses were presented back to participants for review and discussion. Seven participants ranked their top choices of themes for each question. The rankings were analyzed using a nonparametric approach to show consensus around specific themes. Results: Participants suggested several novel potential targets for preventive interventions including specific types of social (e.g., play with others in a group) or self-regulation processes (e.g., set timers or alarms). Suggestions for game mechanics that could help included clear break points and short missions, but loot boxes were not mentioned. Conclusions: Our consensus development approach produced many specific suggestions that could be implemented by game developers or tested as public health interventions, such as encouraging breaks through game mechanics, alarms or other limit setting; encouraging group gaming; and discussing and supporting setting appropriate time or activity goals around gaming (e.g., three quests, one hour). As some suggestions here have not been addressed previously as potential interventions, this suggests the importance of including gamers as stakeholders in research on the prevention of gaming disorder and the promotion of healthy gaming. A large-scale, online approach using these methods with multiple stakeholder groups could make effective use of players’ in-depth knowledge and help speed discovery and translation of possible preventive interventions into practice and policy. Full article
Show Figures

Figure 1

Open AccessArticle
Self-Perception of Dependence as an Indicator of Smartphone Addiction—Establishment of a Cutoff Point in the SPAI–Spain Inventory
Int. J. Environ. Res. Public Health 2020, 17(11), 3838; https://doi.org/10.3390/ijerph17113838 - 28 May 2020
Abstract
Background: In recent years, the abusive use of the smartphone has reached a situation that could be considered pathological. In this sense, different instruments to assess this problematic use or addiction to the smartphone are used. One of these instruments is the Smartphone [...] Read more.
Background: In recent years, the abusive use of the smartphone has reached a situation that could be considered pathological. In this sense, different instruments to assess this problematic use or addiction to the smartphone are used. One of these instruments is the Smartphone Addition Inventory (SPAI), which has been validated in the Spanish language (SPAI-Spain). The main difficulty of these scales is to establish a cut-off point that determines such mobile addiction. On the other hand, self-perception was used in different addictions as a predictor of the problem. Aim: The objective of this study was to establish the cut-off point in the scores of the SPAI-Spain, using as a reference the self-perception of addiction values. Methods: A receiver operating characteristics (ROC) analysis was carried out, establishing as the cut-off point the one that presented a higher value of Youden J, indicative of its sensitivity and specificity. Results: 2958 participants from the university community completed the SPAI–Spain questionnaire. Differences in SPAI–Spain scores were found among age groups and gender, even though not all of them were statistically significant. When using the self-perception of smartphone addiction as the benchmark value, a score of 44 was established as the cutting point of the SPAI-Spain questionnaire, with a Youden J corresponding to 0.416. Conclusions: The implementation of a cut-off point of the SPAI-Spain questionnaire makes it an instrument that allows early identification of those individuals at risk of addiction, as well as the establishment of preventive and/or intervention measures. Full article
Show Figures

Figure 1

Open AccessArticle
Confirmatory Factor Analysis of the Malay Version of the Smartphone Addiction Scale among Medical Students in Malaysia
Int. J. Environ. Res. Public Health 2020, 17(11), 3820; https://doi.org/10.3390/ijerph17113820 - 28 May 2020
Abstract
Background: At present, the validity and reliability evidence of the Malay version of the Smartphone Addiction Scale (SAS-M) is only available by exploratory factor analysis (EFA). The aim of this study is to validate and determine the psychometric properties of the SAS-M by [...] Read more.
Background: At present, the validity and reliability evidence of the Malay version of the Smartphone Addiction Scale (SAS-M) is only available by exploratory factor analysis (EFA). The aim of this study is to validate and determine the psychometric properties of the SAS-M by confirmatory factor analysis (CFA). Methods: A cross-sectional study was conducted among 323 medical students in Universiti Sains Malaysia. The students were given questionnaire forms consisting of socio-demographic information, the SAS-M and the Malay version of the Internet Addiction Test (MVIAT). The CFA was conducted using robust maximum likelihood estimator. The internal consistency reliability was determined by Raykov’s rho coefficient. The concurrent validity was assessed by the Pearson’s correlations between the factor scores of the SAS-M and the MVIAT. Results: The analysis showed the five-factor model of the SAS-M has an acceptable model fit after the inclusion of 12 correlated errors (SRMR = 0.067, RMSEA 0.059 (90% CI: 0.054, 0.065), CFI = 0.895, TLI = 0.882). The factor loadings ranged from 0.320 to 0.875. The internal consistency reliability was good (Raykov’s rho = 0.713 to 0.858) and it showed good concurrent validity with the MVIAT. Conclusions: The CFA showed that the SAS-M is a valid and reliable self-administered questionnaire to measure the level of smartphone addiction among medical students. Full article
Open AccessArticle
Aligning the “Manifesto for a European Research Network into Problematic Usage of the Internet” with the Diverse Needs of the Professional and Consumer Communities Affected by Problematic Usage of Pornography
Int. J. Environ. Res. Public Health 2020, 17(10), 3462; https://doi.org/10.3390/ijerph17103462 - 15 May 2020
Abstract
The Manifesto for a European research network into Problematic Usage of the Internet was published in May 2018. It was written from the perspective of the COST Action Network, a programme of the European Cooperation in Science and Technology CA16207 and is expected [...] Read more.
The Manifesto for a European research network into Problematic Usage of the Internet was published in May 2018. It was written from the perspective of the COST Action Network, a programme of the European Cooperation in Science and Technology CA16207 and is expected to have significant influence on research funding priorities over the next decade. The Manifesto identified nine key research priorities to advance understanding in the field. Our analysis shows that while at the most general level it identified problematic usage of pornography (PUP) as a key research priority, it then barely mentioned it again within the body of the report. This paper uses the Manifesto’s framework to suggest research areas into the problematic usage of pornography which are of particular relevance to clinicians and other professionals working in the field who want to develop approaches to assist individuals and target groups affected by PUP. It also looks at potential research opportunities inspired by the lived-experience of users withdrawing from PUP. A large number of opportunities are identified for new work on PUP across all nine key research areas of the Manifesto. Full article
Open AccessArticle
The Association of Problematic Internet Shopping with Dissociation among South Korean Internet Users
Int. J. Environ. Res. Public Health 2020, 17(9), 3235; https://doi.org/10.3390/ijerph17093235 - 06 May 2020
Abstract
Background: This study examined patterns of problematic shopping behavior by South Korean internet users to investigate the association between problematic internet shopping (PIS) and dissociative experiences.; Methods: Five hundred and ninety eight participants from 20–69 years old were recruited through an [...] Read more.
Background: This study examined patterns of problematic shopping behavior by South Korean internet users to investigate the association between problematic internet shopping (PIS) and dissociative experiences.; Methods: Five hundred and ninety eight participants from 20–69 years old were recruited through an online panel survey. We gathered information about sociodemographic characteristics, alcohol use, caffeine intake, and online shopping behaviors. Psychopathological assessments included Korean version of dissociative experience scale (DES-K), Canadian Problem Gambling Index (CPGI-K), the modified Stress Response Inventory (SRI-MF), the Barratt Impulsive Scale-11-Revised (BIS-K). We used multiple logistic regression analysis with the Richmond compulsive buying scale (RCBS-K) as the dependent variable.; Results: The prevalence of shoppers with internet-based problem shopping was 12.5%. The amount of time spent on online shopping was correlated with PIS severity (OR = 1.008, p < 0.01). The risk of PIS was related to an increased tendency toward dissociation (OR = 1.044, p < 0.001) and impulsivity (OR = 1.046, p < 0.05). Conclusions: PIS participants with dissociation showed higher levels of perceived stress, gambling problems, and impulsivity than did PIS participants without dissociation. This study suggests that dissociation was associated with a higher burden of PIS as it was connected to poor mental health problems. Full article
Open AccessArticle
Adolescents’ Addictive Phone Use: Associations with Eating Behaviors and Adiposity
Int. J. Environ. Res. Public Health 2020, 17(8), 2861; https://doi.org/10.3390/ijerph17082861 - 21 Apr 2020
Abstract
Concerns have been raised about excessive or “addictive” phone use among adolescents, and the impact that addictive phone use (APU) can have on adolescent development and health. Most research on the physical health correlates of smartphone use has been limited to sleep health, [...] Read more.
Concerns have been raised about excessive or “addictive” phone use among adolescents, and the impact that addictive phone use (APU) can have on adolescent development and health. Most research on the physical health correlates of smartphone use has been limited to sleep health, whereas other outcomes, such as eating behaviors and obesity risk have not received as much attention. To address this gap in the literature, we examined the association between APU and emotion regulation difficulties, impulsivity, maladaptive eating behaviors, and adiposity in a sample of 111 adolescents. We found that APU is associated with greater emotion regulation difficulties, dysregulated eating, restrained eating, food addiction, and higher percent body fat. Further, we found that emotion regulation difficulties mediated the association between APU and dysregulated eating, restrained eating, and food addiction. Findings suggest that addictive phone use may confer increased risk for obesogenic eating behaviors and food addiction via challenges in regulating emotions. Full article
Open AccessArticle
The Effect of Solution-Focused Group Counseling Intervention on College Students’ Internet Addiction: A Pilot Study
Int. J. Environ. Res. Public Health 2020, 17(7), 2519; https://doi.org/10.3390/ijerph17072519 - 07 Apr 2020
Abstract
This pilot study aimed to explore the effect of solution-focused group counseling intervention on Internet addiction among college students. Eighteen college students participated in this study, out of which nine subjects were assigned into the experimental group and the rest (n = [...] Read more.
This pilot study aimed to explore the effect of solution-focused group counseling intervention on Internet addiction among college students. Eighteen college students participated in this study, out of which nine subjects were assigned into the experimental group and the rest (n = 9) to a control group. The experimental group received group counseling for five weeks, while the control group did not receive any intervention. The revised version of the Chinese Internet Addiction Scale (CIAS-R) was used to capture pre-test and post-test excessive use in the two groups. The experimental group was also subjected to a follow-up test and self-reported Internet addiction scores six months after the end of group counseling. Results showed that after the five-week solution-focused group counseling, the scores of four dimensions of the CIAS-R in the experimental group had CIAS-R decreased, and the reduction trend of the total score of CIAS-R was similar across all subjects in this group. The treatment effect was larger than the placebo reduction in the control group in two dimensions: compulsive and withdrawal (Sym-C & Sym-W) and tolerance (Sym-T) symptoms. Qualitative research confirmed the conclusions from the quantitative data, showing that the experimental group reduced its Internet addiction symptoms. Overall, the findings suggested that solution-focused group counseling had positive intervention effects on Internet addiction. Full article
Show Figures

Figure 1

Open AccessArticle
Problematic Social-Networks-Use in German Children and Adolescents—The Interaction of Need to Belong, Online Self-Regulative Competences, and Age
Int. J. Environ. Res. Public Health 2020, 17(7), 2518; https://doi.org/10.3390/ijerph17072518 - 07 Apr 2020
Cited by 2
Abstract
Adolescents nowadays spend much time communicating via social networks. Recent investigations also report a noticeable proportion showing a problematic usage behavior, underlining the importance of better understanding its development and maintenance in young individuals. Theoretical views on Internet-use disorders assume that specific predispositions [...] Read more.
Adolescents nowadays spend much time communicating via social networks. Recent investigations also report a noticeable proportion showing a problematic usage behavior, underlining the importance of better understanding its development and maintenance in young individuals. Theoretical views on Internet-use disorders assume that specific predispositions and needs can contribute to addictive behaviors in interaction with further aspects including Internet-related cognitive biases. This study focuses on vulnerable individuals due to their age and investigates interactions between possible risk (need to belong, NTB) and protective factors (online self-regulative competences, OSRC). Participants (N = 466) between 10 and 17 years answered questionnaires assessing social-networks-use disorder symptoms, NTB, and OSRC. Moderated regression analysis revealed significant effects of age, NTB, and OSRC. Three-way interaction was also significant (potentially mainly caused by females), with highest social-networks-use disorder symptoms found for individuals with high NTB and low OSRC, especially when older. With high OSRC, symptoms were significantly lower for both younger and older individuals having high NTB. However, even if NTB was low, older individuals showed high social-networks-use disorder symptoms if their OSRC were low. The results highlight the importance of improving specific competences to prevent problematic usage behaviors, which should be considered in youth-tailored prevention and intervention programs. Full article
Show Figures

Figure 1

Open AccessArticle
A Marketing Approach to a Psychological Problem: Problematic Smartphone Use on Adolescents
Int. J. Environ. Res. Public Health 2020, 17(7), 2471; https://doi.org/10.3390/ijerph17072471 - 04 Apr 2020
Cited by 1
Abstract
Background: Smartphones have become an indispensable part of the daily lives of adolescents in the 21st century, which is characterized by a highly digitized modern world. Besides their many advantages, smartphones might pave the way to compulsive usage and addictive experiences. To remedy [...] Read more.
Background: Smartphones have become an indispensable part of the daily lives of adolescents in the 21st century, which is characterized by a highly digitized modern world. Besides their many advantages, smartphones might pave the way to compulsive usage and addictive experiences. To remedy this problem, this study proposes an authentic approach which integrates consumer behavior theories and techniques such as unhook and gamification. An education program has been designed based on these approaches to decrease the problematic smartphone use. Method: The participants of the education program consisted of 305 students (48.2% girls and 51.8% boys) with a mean age of 14.57 (SD = 0.74). The Demographic Form and Smartphone Addiction Scale for Adolescents (SASA) were conducted before the education program and three weeks after the education. Results: The results of the paired sample t-test analysis before and after the education program revealed that the SASA total scores decreased significantly (p < 0.01). There are significant differences in terms of gender, mothers’ education and class levels. Conclusion: This research emphasizes the role of an interdisciplinary approach to the addiction problem. The content used in the education program includes strategies that originally aimed at increasing consumption. The effectiveness of the program can be enhanced further in the future along with self-regulatory additions. Full article
Open AccessArticle
Psychological Characteristics and Addiction Propensity According to Content Type of Smartphone Use
Int. J. Environ. Res. Public Health 2020, 17(7), 2292; https://doi.org/10.3390/ijerph17072292 - 29 Mar 2020
Abstract
The aim of this study was to evaluate the association between content type of smartphone use and psychological characteristics and addiction propensity, including the average time of smartphone use and problematic smartphone use. Data were obtained from the 2017 Korea Youth Risk Behavior [...] Read more.
The aim of this study was to evaluate the association between content type of smartphone use and psychological characteristics and addiction propensity, including the average time of smartphone use and problematic smartphone use. Data were obtained from the 2017 Korea Youth Risk Behavior Web-Based Survey, a nationally representative survey of middle- and high-school students (n = 62,276). The content type of smartphone use was divided into four categories: (1) Study, (2) Social-Networking Services (SNS), (3) Game, and (4) Entertainment. The association of depressive mood and suicidal ideation with content type of smartphone use was analyzed, using multiple and binary logistic regression analyses, respectively. The relationship between content type of smartphone use and time spent on smartphone use and problematic smartphone use was analyzed by using multiple logistic regression, adjusted for related covariables. The results of this study revealed that depressive mood and suicidal ideation were significantly associated with the SNS smartphone use group, compared with the other groups. Our results also indicate that the SNS group showed higher addiction propensity, such as overuse and experiencing adverse consequences of smartphone use. Full article
Open AccessArticle
Pathological Traits Associated to Facebook and Twitter among French Users
Int. J. Environ. Res. Public Health 2020, 17(7), 2242; https://doi.org/10.3390/ijerph17072242 - 26 Mar 2020
Cited by 2
Abstract
Background: With a growing number of users, social networking sites have been the subject of numerous recent studies, but little investigation has been given to their problematic use. Objectives: Our main objective was to study the relationship between psychopathological variables (i.e., personality traits, [...] Read more.
Background: With a growing number of users, social networking sites have been the subject of numerous recent studies, but little investigation has been given to their problematic use. Objectives: Our main objective was to study the relationship between psychopathological variables (i.e., personality traits, depressive and anxiety symptoms, and stress) and problematic Facebook and Twitter use. Participants and method: A sample of 1068 Internet users (Mage = 26.64; SD = 9.5) has been recruited online. Participants completed scales exploring problematic Facebook and Twitter use, and psychopathological variables. Results: Problematic Facebook and Twitter use were predicted by different pathological personality traits, regrouped in clusters in our study. Depressive and anxiety symptoms were also predictive of problematic Facebook and Twitter use but only stress explained problematic Facebook use. Gender differences have been observed. Discussion: This study highlights the relationship between depression, anxiety, stress, pathological personality traits, and problematic Facebook and Twitter use. Significant differences have been retrieved between these two uses and their relationship to psychopathology. Future research should also explore the causal relationship between social networking sites use and psychopathology and consider gender. Full article
Open AccessArticle
Relationships between Severity of Internet Gaming Disorder, Severity of Problematic Social Media Use, Sleep Quality and Psychological Distress
Int. J. Environ. Res. Public Health 2020, 17(6), 1879; https://doi.org/10.3390/ijerph17061879 - 13 Mar 2020
Cited by 10
Abstract
Internet gaming and social media use are prevalent and integral to many people’s lives. However, excessive engagement in either could lead to negative health impacts. This study aimed to investigate relationships between severities of internet gaming disorder (IGD) and problematic social media use [...] Read more.
Internet gaming and social media use are prevalent and integral to many people’s lives. However, excessive engagement in either could lead to negative health impacts. This study aimed to investigate relationships between severities of internet gaming disorder (IGD) and problematic social media use (operationalized as social media addiction; SMA) with sleep quality and psychological distress among young adults. A cross-sectional study with snowball sampling was conducted among Hong Kong university students in 2019. All participants (n = 300; mean (SD) age = 20.89 (1.48); 122 males (40.67%)) responded to an online survey that included Chinese versions of the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), Bergen Social Media Addiction Scale (BSMAS), Pittsburgh Sleep Quality Index (PSQI), and Depression Anxiety Stress Scales (DASS-21). Multiple linear regressions demonstrated that IGDS-SF9 scores demonstrated associations with psychological distress measures (standardized coefficient (β) = 0.295 for depression, 0.325 for anxiety, 0.339 for stress, all p < 0.001). BSMAS scores showed similar albeit numerically less robust associations (β = 0.235 for depression, p < 0.001; 0.219 for anxiety, p = 0.001; 0.262 for stress, p < 0.001). BSMAS scores demonstrated associations with poorer sleep quality (β = 0.292; p < 0.001) and IGDS9-SF scores (β = 0.157; p = 0.024) showed a significantly less robust association (p = 0.01 for comparing the two βs). These findings suggest that both severities of IGD and SMA associate with more psychological distress and poorer sleep quality, although the strengths of associations may differ. Full article
Open AccessArticle
The Associations between Family-Related Factors and Excessive Internet Use in Adolescents
Int. J. Environ. Res. Public Health 2020, 17(5), 1754; https://doi.org/10.3390/ijerph17051754 - 08 Mar 2020
Cited by 4
Abstract
This study examined the relationship between Excessive Internet Use (EIU) in adolescents and their family environment, namely the family type, the family economic status, the effect of parental care, the level of parental control, the amount of parental monitoring, the quality of communication, [...] Read more.
This study examined the relationship between Excessive Internet Use (EIU) in adolescents and their family environment, namely the family type, the family economic status, the effect of parental care, the level of parental control, the amount of parental monitoring, the quality of communication, and the time spent together. The study was based on data from an international survey, Health Behaviour in School Aged Children (HBSC), conducted in Slovakia. The sample representative for adolescents included 2547 participants (51% boys) aged 13–15. Multiple-step linear regression revealed that higher parental care and parental monitoring predicted lower EIU, while higher parental overprotection and lower socioeconomic status predicted higher EIU. The results suggest that both so-called optimal parenting (i.e., the balance of emotional warmth and protection) and the adolescent′s autonomy lower the risk of EIU. Family factors explained about 14% of the variance, which suggests that aside from personal, cognitive and affective factors, a close social environment also plays an important role in adolescence EIU. Full article
Open AccessArticle
Spanish Validation of the Internet Gaming Disorder Scale–Short Form (IGDS9-SF): Prevalence and Relationship with Online Gambling and Quality of Life
Int. J. Environ. Res. Public Health 2020, 17(5), 1562; https://doi.org/10.3390/ijerph17051562 - 28 Feb 2020
Cited by 6
Abstract
Online gaming is a very common form of leisure among adolescents and young people, although its excessive and/or compulsive use is associated with psychological impairments in a minority of gamers. The latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders [...] Read more.
Online gaming is a very common form of leisure among adolescents and young people, although its excessive and/or compulsive use is associated with psychological impairments in a minority of gamers. The latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, Section III) tentatively introduced Internet Gaming Disorder (IGD). Since then, a number of evaluation tools using the DSM-5 criteria have been developed, including the Internet Gaming Disorder Scale–Short Form (IGDS9-SF). The main objective of this study was to translate and adapt the IGDS9-SF into Spanish, as well as to obtain indicators relating to its validity and reliability. The Spanish version of four scales were administered: IGDS9-SF, Mobile Phone-Related Experiences Questionnaire (CERM), Online Gambling Disorder Questionnaire (OGD-Q), and KIDSCREEN-27. The sample comprised 535 Vocational Training students (mean age 18.35 years; SD±2.13; 78.5% males) who reported playing video games in the past 12 months. Confirmatory factor analysis yielded a one-dimensional model with a good fit while the reliability indicators were satisfactory. Findings indicated that 1.9% of gamers were classified with IGD (meeting five or more criteria for more than 12 months). Additionally, another 1.9% were considered gamers ‘at-risk’ because they endorsed four criteria. Positive and significant relationships were found between the IGDS9-SF, the CERM, and the OGD-Q. Participants classified with IGD had poorer health-related quality of life. In conclusion, the Spanish IGDS9-SF is a valid and reliable instrument to assess IGD according to the DSM-5. Full article
Open AccessEditor’s ChoiceArticle
Internet Gaming Disorder Clustering Based on Personality Traits in Adolescents, and Its Relation with Comorbid Psychological Symptoms
Int. J. Environ. Res. Public Health 2020, 17(5), 1516; https://doi.org/10.3390/ijerph17051516 - 26 Feb 2020
Cited by 3
Abstract
In recent years, the evidence regarding Internet Gaming Disorder (IGD) suggests that some personality traits are important risk factors for developing this problem. The heterogeneity involved in problematic online gaming and differences found in the literature regarding the comorbid psychopathology associated with the [...] Read more.
In recent years, the evidence regarding Internet Gaming Disorder (IGD) suggests that some personality traits are important risk factors for developing this problem. The heterogeneity involved in problematic online gaming and differences found in the literature regarding the comorbid psychopathology associated with the problem could be explained through different types of gamers. Clustering analysis can allow organization of a collection of personality traits into clusters based on similarity. The objectives of this study were: (1) to obtain an empirical classification of IGD patients according to personality variables and (2) to describe the resultant groups in terms of clinical and sociodemographic variables. The sample included 66 IGD adolescent patients who were consecutive referrals at a mental health center in Barcelona, Spain. A Gaussian mixture model cluster analysis was used in order to classify the subjects based on their personality. Two clusters based on personality traits were detected: type I “higher comorbid symptoms” (n = 24), and type II “lower comorbid symptoms” (n = 42). The type I included higher scores in introversive, inhibited, doleful, unruly, forceful, oppositional, self-demeaning and borderline tendency traits, and lower scores in histrionic, egotistic and conforming traits. The type I obtained higher scores on all the Symptom Check List-90 items-Revised, all the State-Trait Anxiety Index scales, and on the DSM-5 IGD criteria. Differences in personality can be useful in determining clusters with different types of dysfunctionality. Full article
Show Figures

Figure 1

Open AccessArticle
Parental Monitoring and Adolescent Problematic Mobile Phone Use: The Mediating Role of Escape Motivation and the Moderating Role of Shyness
Int. J. Environ. Res. Public Health 2020, 17(5), 1487; https://doi.org/10.3390/ijerph17051487 - 25 Feb 2020
Cited by 1
Abstract
In an attempt to reduce the negative consequences of adolescent media use, parents often monitor their children’s online activities. However, research suggests that parental monitoring often does not reduce children’s problematic mobile phone use as expected. Based on the results of a survey [...] Read more.
In an attempt to reduce the negative consequences of adolescent media use, parents often monitor their children’s online activities. However, research suggests that parental monitoring often does not reduce children’s problematic mobile phone use as expected. Based on the results of a survey of 584 Chinese adolescents, we found that parental monitoring positively predicted children’s problematic mobile phone use (PMPU) within a Chinese cultural context. The results also showed that children’s escape motivation partially mediated this relationship, while their level of shyness moderated both the mediated path and the direct impact of parental monitoring on children’s PMPU. The findings suggested that a higher level of shyness increased the likelihood that parental monitoring would increase the child’s escape motivation and PMPU. The study results provide guidelines for parents and educators regarding interventions for adolescents’ problematic phone use. Full article
Show Figures

Figure 1

Open AccessArticle
Problematic Smartphone Use and Mental Health in Chinese Adults: A Population-Based Study
Int. J. Environ. Res. Public Health 2020, 17(3), 844; https://doi.org/10.3390/ijerph17030844 - 29 Jan 2020
Cited by 2
Abstract
Problematic smartphone use (PSU) has been associated with anxiety and depression, but few explored its mental well-being correlates that could co-occur with or be independent of mental symptoms. We studied the associations of PSU with anxiety, depression, and mental well-being in Hong Kong [...] Read more.
Problematic smartphone use (PSU) has been associated with anxiety and depression, but few explored its mental well-being correlates that could co-occur with or be independent of mental symptoms. We studied the associations of PSU with anxiety, depression, and mental well-being in Hong Kong Chinese adults in a probability-based survey (N = 4054; 55.0% females; mean age ± SD 48.3 ± 18.3 years). PSU was measured using Smartphone Addiction Scale-Short Version. Anxiety and depression symptoms were evaluated using General Anxiety Disorder screener-2 (GAD-2) and Patient Health Questionnaire-2 (PHQ-2). Mental well-being was measured using Subjective Happiness Scale (SHS) and Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). Multivariable regression analyzed associations adjusting for sociodemographic and lifestyle-related variables. Associations of PSU with mental well-being were stratified by symptom severity of anxiety (GAD-2 cutoff of 3) and depression (PHQ-2 cutoff of 3). We found that PSU was associated with higher odds of anxiety and depression symptom severity and lower scores of SHS and SWEMWBS. Associations of PSU with lower SHS and SWEMWBS scores remained in respondents who screened negative for anxiety or depression symptoms. To conclude, PSU was associated with anxiety, depression, and impaired mental well-being. Associations of PSU with impaired mental well-being could be independent of anxiety or depression symptoms. Full article
Open AccessArticle
Problematic Internet Use, Non-Medical Use of Prescription Drugs, and Depressive Symptoms among Adolescents: A Large-Scale Study in China
Int. J. Environ. Res. Public Health 2020, 17(3), 774; https://doi.org/10.3390/ijerph17030774 - 26 Jan 2020
Cited by 1
Abstract
This large-scale study aimed to test, among Chinese adolescents, the association between problematic Internet use (PIU), non-medical use of prescription drugs (NMUPD), and depressive symptoms, as well as the mediating effects of NMUPD on the associations above. This study used the data from [...] Read more.
This large-scale study aimed to test, among Chinese adolescents, the association between problematic Internet use (PIU), non-medical use of prescription drugs (NMUPD), and depressive symptoms, as well as the mediating effects of NMUPD on the associations above. This study used the data from the 2017 National School-based Chinese Adolescents Health Survey, and 24,345 students’ questionnaires qualified for the analyses. Generalized linear mixed models and path models were performed. In the models without mediation, PIU was associated with depressive symptoms (unstandardized β estimate = 0.26, 95% CI = 0.25–0.27); frequent use of opioid or sedative was also related to depressive symptoms (unstandardized β estimate for opioid = 2.77, 95% CI = 1.90–3.63; unstandardized β estimate for sedative = 4.45, 95% CI = 3.02–5.88). Additionally, the results of the path models indicated that opioid misuse partially mediated the association between PIU and depressive symptoms. PIU and opioid/sedative misuse were related to the increased risk of depressive symptoms, respectively. The association above might be complicated, and PIU may elevate the risk of opioid or sedative misuse and depressive symptoms, which in turn could worsen the situation of PIU and vice versa. Multidisciplinary health intervention programs to prevent adolescents involving in PIU, as well as NMPUD, are recommended to be provided. Full article
Show Figures

Figure 1

Open AccessArticle
The Assessment of Problematic Internet Pornography Use: A Comparison of Three Scales with Mixed Methods
Int. J. Environ. Res. Public Health 2020, 17(2), 488; https://doi.org/10.3390/ijerph17020488 - 12 Jan 2020
Cited by 3
Abstract
The primary aim of this study was to compare different screening tools for problematic internet pornography use (IPU) and identify the most accurate measure. The reliability and validity of three scales, namely, the Problematic Pornography Consumption Scale (PPCS), Problematic Pornography Use Scale (PPUS), [...] Read more.
The primary aim of this study was to compare different screening tools for problematic internet pornography use (IPU) and identify the most accurate measure. The reliability and validity of three scales, namely, the Problematic Pornography Consumption Scale (PPCS), Problematic Pornography Use Scale (PPUS), and Short Internet Addiction Test Adapted to Online Sexual Activities(s-IAT-sex), were examined using three homogeneous groups, respectively. A total of 972 adults (mean age = 24.8) from 28 provinces/regions in China participated in the quantitative part (QUAN). The Brief Pornography Screener served as the reference standard. The PPCS demonstrated stronger reliability and validity, including criterion validity, as well as greater sensitivity and acceptable specificity; therefore, it was considered to be the more accurate screening instrument. In the qualitative part (QUAL), we interviewed 22 volunteers and 11 therapists (who had worked with individuals with problematic IPU) to examine their perspectives on the core features of problematic IPU and dimensions of the PPCS. Almost all the interviewees endorsed the structure of the PPCS. These findings encourage the use of the PPCS in future research studies and underscore its screening applications because of its ability to classify IPU as problematic or nonproblematic. Full article
Show Figures

Figure 1

Open AccessArticle
Comparison of Behavioral Changes and Brain Activity between Adolescents with Internet Gaming Disorder and Student Pro-Gamers
Int. J. Environ. Res. Public Health 2020, 17(2), 441; https://doi.org/10.3390/ijerph17020441 - 09 Jan 2020
Abstract
While pro-gamers play according to defined living habits and planned schedules, adolescents with internet gaming disorder (IGD) exhibit irregular lifestyles and unregulated impulsive gaming behavior. Fourteen IGD adolescents and 12 pro-gaming students participated in this study. At baseline and after one year, demographic [...] Read more.
While pro-gamers play according to defined living habits and planned schedules, adolescents with internet gaming disorder (IGD) exhibit irregular lifestyles and unregulated impulsive gaming behavior. Fourteen IGD adolescents and 12 pro-gaming students participated in this study. At baseline and after one year, demographic data, the Child Behavior Check List (CBCL), depressed mood, anxiety, and resting-state functional magnetic resonance imaging were assessed. Over the year, IGD adolescents played games as per their usual schedule, while pro-gamer students played according to their school’s team schedule. After one year, the pro-gamers’ scores had decreased in the CBCL-total (total problematic behaviors), CBCL-externalizing (under-controlled behavior, like impulsivity and aggression), and CBCL-internalizing (over-controlled behavior like depression and anxiety) compared to those of the IGD adolescents. Both groups displayed increased brain activity in the parietal lobe (a component of the attention network) over the years. Compared to pro-gamers, IGD adolescents showed higher brain activity within the left orbitofrontal cortex. Brain activity within the orbitofrontal cortex was associated with CBCL-externalizing scores. These results suggest that gaming had increased the attention network’s brain activity, but a well-organized support system could lead to different results, in terms of improved behaviors and suppressing brain activity within the orbitofrontal cortex. Full article
Show Figures

Figure 1

Open AccessArticle
The Prevalence of E-Gambling and of Problem E-Gambling in Poland
Int. J. Environ. Res. Public Health 2020, 17(2), 404; https://doi.org/10.3390/ijerph17020404 - 08 Jan 2020
Abstract
This study estimated the levels of involvement in e-gambling and problem e-gambling in Poland and identified selected sociodemographic variables associated with e-gambling activities. The study was conducted using a representative sample of the adult inhabitants of Poland (n = 2000). The survey [...] Read more.
This study estimated the levels of involvement in e-gambling and problem e-gambling in Poland and identified selected sociodemographic variables associated with e-gambling activities. The study was conducted using a representative sample of the adult inhabitants of Poland (n = 2000). The survey contained questions measuring three aspects of gambling (involvement in e-gambling, types of e-gambling activity, and problematic e-gambling). Results suggested that 4.1% of respondents were involved in e-gambling and 26.8% of them could be classified as problem gamblers. The most popular e-gambling games were lotteries and sports betting. Gender, age, size of city of residence, level of education, and income were identified as significant predictors of involvement in e-gambling. The results indicated that men, younger people, and people who earnt less were more often involved in e-gambling. Having children, playing online scratch cards, and online sport betting—but not online lotteries—turned out to be typical for problem online gamblers. The prevalence of problem gambling among Polish e-gamblers suggests that extended research in this area is needed. Full article
Open AccessArticle
Personal Factors, Internet Characteristics, and Environmental Factors Contributing to Adolescent Internet Addiction: A Public Health Perspective
Int. J. Environ. Res. Public Health 2019, 16(23), 4635; https://doi.org/10.3390/ijerph16234635 - 21 Nov 2019
Cited by 5
Abstract
Individual characteristics, family- and school-related variables, and environmental variables have equal importance in understanding Internet addiction. Most previous studies on Internet addiction have focused on individual factors; those that considered environmental influence typically only examined the proximal environment. Effective prevention and intervention of [...] Read more.
Individual characteristics, family- and school-related variables, and environmental variables have equal importance in understanding Internet addiction. Most previous studies on Internet addiction have focused on individual factors; those that considered environmental influence typically only examined the proximal environment. Effective prevention and intervention of Internet addiction require a framework that integrates individual- and environmental-level factors. This study examined the relationships between personal factors, family/school factors, perceived Internet characteristics, and environmental variables as they contribute to Internet addiction among adolescents based on the public health model. A representative sample of 1628 junior high school students from 56 regions in Seoul and Gyeonggi-do participated in the study via questionnaires with the cooperation of the Ministry of Health and Welfare and the district office of education. The study analyzed psychological factors, family cohesion, attitudes toward academic activities, Internet characteristics, accessibility to PC cafés, and exposure to Internet game advertising. About 6% of the adolescents were categorized as being in the severely addicted group. Between-group comparisons showed that the addicted group had started using the Internet earlier; had higher levels of depression, compulsivity, and aggressiveness as well as lower family cohesion; and reported higher accessibility to PC cafés and exposure to Internet game advertising. Multiple logistic regression indicated that for adolescents, environmental factors had a greater influence than family or school-related factors. Policy implications for prevention and intervention are discussed. Full article
Open AccessArticle
Self-Exclusion among Online Poker Gamblers: Effects on Expenditure in Time and Money as Compared to Matched Controls
Int. J. Environ. Res. Public Health 2019, 16(22), 4399; https://doi.org/10.3390/ijerph16224399 - 11 Nov 2019
Abstract
Background: No comparative data is available to report on the effect of online self-exclusion. The aim of this study was to assess the effect of self-exclusion in online poker gambling as compared to matched controls, after the end of the self-exclusion period. Methods: [...] Read more.
Background: No comparative data is available to report on the effect of online self-exclusion. The aim of this study was to assess the effect of self-exclusion in online poker gambling as compared to matched controls, after the end of the self-exclusion period. Methods: We included all gamblers who were first-time self-excluders over a 7-year period (n = 4887) on a poker website, and gamblers matched for gender, age and account duration (n = 4451). We report the effects over time of self-exclusion after it ended, on money (net losses) and time spent (session duration) using an analysis of variance procedure between mixed models with and without the interaction of time and self-exclusion. Analyzes were performed on the whole sample, on the sub-groups that were the most heavily involved in terms of time or money (higher quartiles) and among short-duration self-excluders (<3 months). Results: Significant effects of self-exclusion and short-duration self-exclusion were found for money and time spent over 12 months. Among the gamblers that were the most heavily involved financially, no significant effect on the amount spent was found. Among the gamblers who were the most heavily involved in terms of time, a significant effect was found on time spent. Short-duration self-exclusions showed no significant effect on the most heavily involved gamblers. Conclusions: Self-exclusion seems efficient in the long term. However, the effect on money spent of self-exclusions and of short-duration self-exclusions should be further explored among the most heavily involved gamblers. Full article
Show Figures

Figure 1

Open AccessArticle
Social Exclusion, Surveillance Use, and Facebook Addiction: The Moderating Role of Narcissistic Grandiosity
Int. J. Environ. Res. Public Health 2019, 16(20), 3813; https://doi.org/10.3390/ijerph16203813 - 10 Oct 2019
Cited by 1
Abstract
One hundred and eighty-eight participants completed the online questionnaire with items on demographics (age and gender), social exclusion, surveillance use, Facebook addiction, and narcissistic grandiosity. The findings showed that social exclusion was positively associated with Facebook addiction (B = 0.237, p < 0.001) [...] Read more.
One hundred and eighty-eight participants completed the online questionnaire with items on demographics (age and gender), social exclusion, surveillance use, Facebook addiction, and narcissistic grandiosity. The findings showed that social exclusion was positively associated with Facebook addiction (B = 0.237, p < 0.001) and surveillance use was significantly positively associated with Facebook addiction (B = 0.211, p < 0.01). The surveillance use of Facebook was found to be a significant mediator between the risk of social exclusion on Facebook and Facebook addiction (B = 0.054, CI [0.20, 0.113]). Narcissistic grandiosity significantly moderated the associations between social exclusion and Facebook addiction (B = 0.079, p = 0.012). These findings suggest that the risk of social exclusion could serve as facilitator of Facebook addiction depending on narcissistic grandiosity. Full article
Show Figures

Figure 1

Open AccessArticle
Relationship between Self-Identity Confusion and Internet Addiction among College Students: The Mediating Effects of Psychological Inflexibility and Experiential Avoidance
Int. J. Environ. Res. Public Health 2019, 16(17), 3225; https://doi.org/10.3390/ijerph16173225 - 03 Sep 2019
Cited by 3
Abstract
Internet addiction (IA) has become a major public health problem among college students. The aim of this study was to examine the relationship between self-identity confusion and IA and the mediating effects of psychological inflexibility and experiential avoidance (PI/EA) indicators in college students. [...] Read more.
Internet addiction (IA) has become a major public health problem among college students. The aim of this study was to examine the relationship between self-identity confusion and IA and the mediating effects of psychological inflexibility and experiential avoidance (PI/EA) indicators in college students. A total of 500 college students (262 women and 238 men) were recruited. Their levels of self-identity were evaluated using the Self-Concept and Identity Measure. Their levels of PI/EA were examined using the Acceptance and Action Questionnaire-II. The severity of IA was assessed using the Chen Internet Addiction Scale. The relationships among self- identity, PI/EA, and IA were examined using structural equation modeling. The severity of self-identity confusion was positively associated with both the severity of PI/EA and the severity of IA. In addition, the severity of PI/EA indicators was positively associated with the severity of IA. These results demonstrated that the severity of self-identity confusion was related to the severity of IA, either directly or indirectly. The indirect relationship was mediated by the severity of PI/EA. Self-identity confusion and PI/EA should be taken into consideration by the community of professionals working on IA. Early detection and intervention of self-identity confusion and PI/EA should be the objectives for programs aiming to lower the risk of IA. Full article
Show Figures

Figure 1

Open AccessArticle
Associations Among Resilience, Stress, Depression, and Internet Gaming Disorder in Young Adults
Int. J. Environ. Res. Public Health 2019, 16(17), 3181; https://doi.org/10.3390/ijerph16173181 - 31 Aug 2019
Cited by 11
Abstract
Background and Aims: Using gaming to escape emotional difficulty has been suggested to be a candidate mechanism contributing to Internet gaming disorder (IGD). This study evaluated the associations among resilience, perceived stress, depression, and IGD. Methods: A total of 87 participants [...] Read more.
Background and Aims: Using gaming to escape emotional difficulty has been suggested to be a candidate mechanism contributing to Internet gaming disorder (IGD). This study evaluated the associations among resilience, perceived stress, depression, and IGD. Methods: A total of 87 participants in an IGD group and 87 participants in a control group were recruited into this study. IGD was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders. Stress levels, resilience, and depression were measured by a self-reported questionnaire. Results: The IGD group had a lower resilience, higher perceived stress, and depression than the control group. Hierarchical regression analysis demonstrated that resilience was associated with IGD when perceived stress was controlled. After depression was controlled, resilience and perceived stress were not associated with IGD. Among the IGD group, those with low resilience had higher depression. Furthermore, discipline was the resilience characteristic associated with IGD. Conclusions: Low resilience was associated with a higher risk of IGD. IGD individuals with low resilience had higher depression. Depression was more associated with IGD than resilience. Depression assessments and stress coping interventions should be provided for individuals with IGD who exhibit low resilience or high stress. Full article
Open AccessArticle
Development and Validation of the Parental Smartphone Use Management Scale (PSUMS): Parents’ Perceived Self-Efficacy with Adolescents with Attention Deficit Hyperactivity Disorder
Int. J. Environ. Res. Public Health 2019, 16(8), 1423; https://doi.org/10.3390/ijerph16081423 - 21 Apr 2019
Cited by 4
Abstract
The psychometric properties of the Parental Smartphone Use Management Scale (PSUMS) and its prospective relationships with symptoms of smartphone addiction and attention deficit hyperactivity disorder (ADHD) were studies in a sample of parents of adolescents with ADHD. This is a scale to measure [...] Read more.
The psychometric properties of the Parental Smartphone Use Management Scale (PSUMS) and its prospective relationships with symptoms of smartphone addiction and attention deficit hyperactivity disorder (ADHD) were studies in a sample of parents of adolescents with ADHD. This is a scale to measure parents’ perceived self-efficacy on managing their children’s smartphone use. Construct validity (exploratory factor analysis and confirmatory factor analysis), criterion-related validity (known-group validity and concurrent validity), and reliability (Cronbach’s alpha) were performed for data analyses. The results showed that the PSUMS had good factorials validity and high reliabilities, with Cronbach’s alphas ranging between 0.93 and 0.95. The 17-item PSUMS accounted for 78.58% of the total variance and contains three theoretically and statistically appropriate subscales: reactive management, proactive management, and monitoring. Strong relationships were found between parental smartphone use management and symptoms of smartphone addiction and ADHD in expected directions. Moreover, parents of children with smartphone addiction yielded lower scores on all three PSUMS subscales than parents of children without smartphone addiction. The PSUMS is considered a valuable and reliable tool in the study of parental management on their adolescent children’s smartphone use, while providing us with important targets for intervention. Full article

Review

Jump to: Research

Open AccessReview
Preventing Harmful Internet Use-Related Addiction Problems in Europe: A Literature Review and Policy Options
Int. J. Environ. Res. Public Health 2020, 17(11), 3797; https://doi.org/10.3390/ijerph17113797 - 27 May 2020
Cited by 1
Abstract
Internet use-related addiction problems are increasingly being recognized on a European scale due to international health organizations considering gaming addiction. In April 2013, the American Psychiatric Association recognized Internet Gaming Disorder in the fifth Diagnostic and Statistical Manual of Mental Disorders, and in [...] Read more.
Internet use-related addiction problems are increasingly being recognized on a European scale due to international health organizations considering gaming addiction. In April 2013, the American Psychiatric Association recognized Internet Gaming Disorder in the fifth Diagnostic and Statistical Manual of Mental Disorders, and in April 2018, the World Health Organization included Gaming Disorder in the eleventh International Classification of Diseases. However, findings on these problems within this period are lacking in Europe, and a preventive approach is missing globally. A detailed critical literature review was conducted using PsycINFO and Web of Science in this five-year period. A total of 19 studies were reviewed and problems identified were: generalized Internet addiction and online gaming and gambling addictions across seven European countries (i.e., Spain, Germany, France, Italy, Greece, The Netherlands, and Denmark). The individuals with problematic use were found to be educated adolescents, usually young males with comorbid disorders, and gaming and gambling disorders were implicated in the most severe cases. Cognitive behavioral therapy was the main treatment, sometimes combined with a systemic approach for adolescents. Prevalence, high-risk populations, and factors contributing to these addiction problems are discussed, and a set of policy options are developed for this region. The implications for early detection, diagnosis, treatment, and prevention in Europe are considered. Full article
Show Figures

Figure 1

Open AccessReview
Internet Addiction in the Web of Science Database: A Review of the Literature with Scientific Mapping
Int. J. Environ. Res. Public Health 2020, 17(8), 2753; https://doi.org/10.3390/ijerph17082753 - 16 Apr 2020
Cited by 8
Abstract
Information and communication technologies (ICT) is a major element of today’s society with great potential that can offer both advantages and disadvantages. Addiction to the Internet and social networks is a growing problem in all age groups. Education is the context in which [...] Read more.
Information and communication technologies (ICT) is a major element of today’s society with great potential that can offer both advantages and disadvantages. Addiction to the Internet and social networks is a growing problem in all age groups. Education is the context in which to work and train in the correct use of these media. The objective of the study focuses on knowing the scientific production and the performance of the concepts “addiction” and “internet” (ADIN). A bibliometric methodology complemented with the scientific mapping technique was followed. Different processes related to the quantification, analysis, evaluation, and estimation of scientific documents were carried out. The literature was analyzed by specific programs such as SciMAT, Analyze Results, and Creation Citation Report. The unit of analysis was specified in 5644 scientific publications extracted from Web of Science (WoS), belonging to the period of years between 1996 and 2019. The results showed that the evolution in the study of the addiction to the Internet is constant and continuous, with articles in English being the most used means to present the information on the part of the investigators. In addition, the subject of study was based on time, given that the coincidence of key words between the periods analyzed was high. In conclusion, the importance of promoting healthy living habits that include responsible use of the Internet are discussed. Full article
Show Figures

Figure 1

Open AccessReview
Does Smartphone Addiction Fall on a Continuum of Addictive Behaviors?
Int. J. Environ. Res. Public Health 2020, 17(2), 422; https://doi.org/10.3390/ijerph17020422 - 08 Jan 2020
Cited by 8
Abstract
Due to the high accessibility and mobility of smartphones, widespread and pervasive smartphone use has become the social norm, exposing users to various health and other risk factors. There is, however, a debate on whether addiction to smartphone use is a valid behavioral [...] Read more.
Due to the high accessibility and mobility of smartphones, widespread and pervasive smartphone use has become the social norm, exposing users to various health and other risk factors. There is, however, a debate on whether addiction to smartphone use is a valid behavioral addiction that is distinct from similar conditions, such as Internet and gaming addiction. The goal of this review is to gather and integrate up-to-date research on measures of smartphone addiction (SA) and problematic smartphone use (PSU) to better understand (a) if they are distinct from other addictions that merely use the smartphone as a medium, and (b) how the disorder(s) may fall on a continuum of addictive behaviors that at some point could be considered an addiction. A systematic literature search adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was conducted to find all relevant articles on SA and PSU published between 2017 and 2019. A total of 108 articles were included in the current review. Most studies neither distinguished SA from other technological addictions nor clarified whether SA was an addiction to the actual smartphone device or to the features that the device offers. Most studies also did not directly base their research on a theory to explain the etiologic origins or causal pathways of SA and its associations. Suggestions are made regarding how to address SA as an emerging behavioral addiction. Full article
Show Figures

Figure 1

Open AccessReview
Addictive Features of Social Media/Messenger Platforms and Freemium Games against the Background of Psychological and Economic Theories
Int. J. Environ. Res. Public Health 2019, 16(14), 2612; https://doi.org/10.3390/ijerph16142612 - 23 Jul 2019
Cited by 16
Abstract
Currently about 2.71 billion humans use a smartphone worldwide. Although smartphone technology has brought many advances, a growing number of scientists discuss potential detrimental effects due to excessive smartphone use. Of importance, the likely culprit to understand over-usage is not the smartphone itself, [...] Read more.
Currently about 2.71 billion humans use a smartphone worldwide. Although smartphone technology has brought many advances, a growing number of scientists discuss potential detrimental effects due to excessive smartphone use. Of importance, the likely culprit to understand over-usage is not the smartphone itself, but the excessive use of applications installed on smartphones. As the current business model of many app-developers foresees an exchange of personal data for allowance to use an app, it is not surprising that many design elements can be found in social media apps and Freemium games prolonging app usage. It is the aim of the present work to analyze several prominent smartphone apps to carve out such elements. As a result of the analysis, a total of six different mechanisms are highlighted to illustrate the prevailing business model in smartphone app development. First, these app-elements are described and second linked to classic psychological/economic theories such as the mere-exposure effect, endowment effect, and Zeigarnik effect, but also to psychological mechanisms triggering social comparison. It is concluded that many of the here presented app-elements on smartphones are able to prolong usage time, but it is very hard to understand such an effect on the level of a single element. A systematic analysis would require insights into app data usually only being available for the app-designers, but not for independent scientists. Nevertheless, the present work supports the notion that it is time to critically reflect on the prevailing business model of ‘user data in exchange for app-use allowance’. Instead of using a service in exchange for data, it ultimately might be better to ban or regulate certain design elements in apps to come up with less addictive products. Instead, users could pay a reasonable fee for an app service. Full article
Back to TopTop