This cross-sectional study aimed to explore specific online behaviours and their association with a range of underlying psychological and other behavioural factors during the COVID-19 pandemic. Eight countries (Italy, Spain, the United Kingdom, Lithuania, Portugal, Japan, Hungary, and Brazil) participated in an international investigation involving 2223 participants (M = 33 years old; SD = 11), 70% of whom were females. Participants were surveyed for specific type of Internet use severity, appearance anxiety, self-compassion, and image and use of performance-enhancing drugs (IPEDs). Results were compared cross-culturally. The mean time spent online was 5 h (SD = 3) of daily browsing during the pandemic. The most commonly performed activities included social networking, streaming, and general surfing. A strong association between these online behaviours and appearance anxiety, self-compassion, and IPEDs use was found after adjustment for possible confounders, with higher scores being associated with specific online activities. Significant crosscultural differences also emerged in terms of the amount of time spent online during the initial stages of the COVID-19 pandemic.
The present paper reviews recent studies on problematic internet use (PIU) prevalence before and during the COVID-19 pandemic. Several pre-pandemic meta-analyses reported PIU prevalence estimates ranging from 6% to 9.7%. Experts in the field of online addictions speculated that PIU would increase during the pandemic because of increased time spent on the internet. However, it is still unclear if increased time on the internet resulted in higher PIU prevalence estimates during the pandemic. Prevalence estimates differed greatly across studies during the COVID-19 pandemic. Possible inconsistencies are outlined together with future directions for PIU prevalence studies.
Background The coronavirus disease 2019 (COVID-19) pandemic has had a negative effect on mental health and subjective psychological wellbeing. One of the most affected population is medical students, reporting higher levels of depression, anxiety, sleep difficulties, and overall poorer wellbeing. However, the relationship between depression, anxiety, and sleep difficulties, and subjective psychological wellbeing has not been extensively researched in medical students in the context of COVID-19 pandemic. The aim of this study was to investigate the associations between depression, anxiety, and sleep quality, and subjective psychological wellbeing.Methods In total, 524 medical students and resident doctors (78.6% female, mean age 24 ± 3 years old) participated in an online survey between December 2020 and February 2021. Participants completed the WHO—Five Wellbeing Index Questionnaire, the Pittsburgh Sleep Quality Index questionnaire, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder Assessment-7.ResultsMultivariable logistic regression analysis showed that female participants’ worse subjective psychological wellbeing was associated with sleep difficulties [odds ratio (OR) = 2.39, 95% CI = 1.37–4.18, p = 0.002], higher depression (OR = 6.13, 95% CI = 3.46–10.88, p < 0.001), and anxiety symptoms (OR = 2.95, 95% CI = 1.66–5.22, p < 0.001). In male participants, analysis revealed an association between worse subjective psychological wellbeing and higher depression scores (OR = 9.94, 95% CI = 3.29–30.03, p < 0.001).Conclusion Sex differences are an important factor to consider when evaluating subjective psychological wellbeing. Clinicians should be aware of significant contributors, such as sleep patterns anxiety, and depression, to subjective psychological wellbeing.
In this current opinions article we synthesize recent evidence exploring neurocognitive deficits in problematic usage of the internet, which support the notion that inhibitory control and decision making deficits occur in problematic usage versus controls, strengthening its theoretical conceptualization. Potential confounders, notably IQ and the presence of comorbidities from the impulsive/compulsive spectrum may account for some of these identified deficits. Most studies focused on gaming, whereas other facets remain relatively understudied. The literature has high levels of methodological issues, such as using non-validated thresholds/instruments, examining only a narrow range of cognitive domains, and overlooking potentially confounding comorbid disorders. Longitudinal studies with rigorous methodologies are needed to address whether cognitive problems associated with problematic internet use play a role in vulnerability, chronicity, or both.
With the onset of the COVID-19 pandemic and the accelerated spread of the SARS-CoV-2 virus came jurisdictional limitations on mobility of citizens and distinct alterations in their daily routines. Confined to their homes, many people increased their overall internet use, with problematic use of the internet (PUI) becoming a potential reason for increased mental health concerns. Our narrative review summarizes information on the extent of PUI during the pandemic, by focusing on three types: online gaming, gambling and pornography viewing. We conclude by providing guidance for mental health professionals and those affected by PUI (with an outline of immediate research priorities and best therapeutic approaches), as well as for the general public (with an overview of safe and preventative practices).
Background: The increase in problematic Internet use (PIU) among medical students and resident doctors during the coronavirus disease 2019 (COVID-19) pandemic may be leading to significant impairments in everyday functioning, including sleeping patterns, anxiety, depressive symptoms, and overall well-being. The Compulsive Internet Use Scale (CIUS) has been developed to assess the severity of PIU, however, it has not been elucidated whether this scale is also applicable to medical students and resident doctors. The first aim of this study was to explore the psychometric properties of the Lithuanian version of the CIUS. The second aim was to examine associations between subjectively reported mental health symptoms and PIU during the COVID-19 pandemic. Methods: A total of 524 medical students and resident doctors (78.60% women, mean age 24 [SD 3] years old) participated in an online survey between December 2020 and February 2021. Participants completed the CIUS, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder Assessment-7 (GAD-7), and the WHO—Five Well-Being Index questionnaire (WHO-5). Results: The confirmatory factor analysis (CFA) suggested brief versions (CIUS-5, CIUS-7, and CIUS-9) rather than the original (CIUS-14) version of the CIUS questionnaire as reliable and structurally stable instruments that can be used to measure compulsive Internet use severity in the sample of medical students and resident doctors. The most prevalent online behaviors were social media use (90.1%), online shopping (15.6%), and online gaming/gambling (11.3%). Students with higher CIUS scores reported significantly lower academic achievements during the 6 months ( r = 0.12–0.13; p < 0.006), as well as more severe depressive and anxiety symptoms, worsened sleep quality, and lower sense of well-being ( r = 0.21–0.41; p 's < 0.001). Both, during workdays ( d = 0.87) and weekend ( d = 0.33), students spent more time online than resident doctors ( p 's < 0.001). Conclusion: The brief, 5-, 7-, and 9-item versions of the Lithuanian CIUS are reliable and valid self-report screening instruments for evaluating the severity of PIU symptoms among the medical student population. Symptoms of PIU during the COVID-19 period were associated with worsened self-reported mental health and everyday functioning.
Fear Of Missing Out (FOMO) continues to be an under-researched phenomenon and is a form of problematic use of the Internet (commonly mistaken for Internet addiction). FOMO is a behaviour connected with the avalanche of information and the development of new digital technologies. Young people in particular are exposed to FOMO. Age is a predictive factor for different types of problematic Internet use. Therefore, coverage by specific diagnostic and preventive activities is a special task for experts in media pedagogy. The aim of the research was to show the scale of the FOMO phenomenon among Polish adolescents. The research covered 979 adolescents aged 13–18 years. The research was conducted with the use of the questionnaire “Social Media Use and the Fear of Missing Out (FoMO)” throughout Poland in the school year 2018–2019. On the basis of the collected data it was noted that: 1) the most frequent symptom of FOMO is the use of social networking sites just before bedtime (about 70% of respondents) and just after waking up (about 50% of respondents); 2) About 30% of respondents are classified as possessing strong FOMO characteristics, about 43.5% have an average FOMO level, 26.5% have a problem-free use of SNS; 3) All FOMO factors coexist at medium or high levels; 4) Girls have a slightly higher FOMO level than boys; 5) Variables related to place of residence, type of school, grade average, and subjective sense of wealth are related to FOMO intensity. FOMO is an important challenge for education, the prevention of risky behaviour in cyberspace, and the development of the information society.
Addictive online behaviors have come under increasing research scrutiny in the past two decades, culminating in the recent inclusion of gaming disorder as a distinct entity in the 11th Revision of the International Classification of Diseases (ICD-11) (1). Beyond gaming, a number of distinct problematic behaviors have been linked with poor mental health (2, 3), academic underachievement and vocational struggles (4), and described in distinct geographical areas and across cultural settings (5-7). The widespread adoption of online applications for communication and recreation has caused the wider public health discussion and concern (2). While our over-reliance on technology grows, so does the possibility that exposure to online applications can have pervasive health consequences, particularly in a time when societies have specifically restructured to fight against the COVID-19 pandemic: by embracing the online milieu for work, relationships, and entertainment (8). Although treatment options are available for some time now (9, 10), what has been less understood has been how online addiction and technology overuse may lead to significant consequences to society, including but not exhaustively, impact on quality of life, productivity and collateral costs to the health system. In this special issue, the wider impact to the general health and well-being of the affected individuals was put under examination with the goal of exploring the effects of online addictive behaviors, including but not limited to, online gaming and social media, to the burden on the individual's general health and well-being. Of special interest was how this burden carries over to the macro level in the workplace, the educational system and also the health system, with general productivity loss, missed opportunities at work and education, and increased use of the health services. We were pleased to receive a number of high-quality studies reporting on this burden and helping the exploration of cost-effectiveness of treatment modalities and highlight the need for investment in health services tailored to population needs. It is important to note that online addiction is not an artificial construct that originated from psychological research but rather was a concept that sought to include complaints from patients and their families in order to better understand their source and provide help; in this respect a very important contribution in this Research Topic is the one made by Gjoneska et al. who present a conceptual framework and a template for citizen involvement in research on online addiction; the authors highlight four ethical aspects for citizen involvement, driven by community case studies that were conducted in six European countries. With regards to the impact of online addiction on general health, Mylona et al. examined in a
Introduction: Little is known about the impact of restrictive measures during the COVID-19 pandemic on self-image and engagement in exercise and other coping strategies alongside the use of image and performance-enhancing drugs (IPEDs) to boost performance and appearance. Objectives: To assess the role of anxiety about appearance and self-compassion on the practice of physical exercise and use of IPEDs during lockdown. Methods: An international online questionnaire was carried out using the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), and the Self-Compassion Scale (SCS) in addition to questions on the use of IPEDs. Results: The sample consisted of 3,161 (65% female) adults from Italy (41.1%), Spain (15.7%), the United Kingdom (UK) (12.0%), Lithuania (11.6%), Portugal (10.5%), Japan (5.5%), and Hungary (3.5%). The mean age was 35.05 years ( SD = 12.10). Overall, 4.3% of the participants were found to engage in excessive or problematic exercise with peaks registered in the UK (11.0%) and Spain (5.4%). The sample reported the use of a wide range of drugs and medicines to boost image and performance (28%) and maintained use during the lockdown, mostly in Hungary (56.6%), Japan (46.8%), and the UK (33.8%), with 6.4% who started to use a new drug. Significant appearance anxiety levels were found across the sample, with 18.1% in Italy, 16.9% in Japan, and 16.7% in Portugal. Logistic regression models revealed a strong association between physical exercise and IPED use. Anxiety about appearance also significantly increased the probability of using IPEDs. However, self-compassion did not significantly predict such behavior. Anxiety about appearance and self-compassion were non-significant predictors associated with engaging in physical exercise. Discussion and Conclusion: This study identified risks of problematic exercising and appearance anxiety among the general population during the COVID-19 lockdown period across all the participating countries with significant gender differences. Such behaviors were positively associated with the unsupervised use of IPEDs, although no interaction between physical exercise and appearance anxiety was observed. Further considerations are needed to explore the impact of socially restrictive measures among vulnerable groups, and the implementation of more targeted responses.
Citizens and scientists can work together to improve the collective well-being, if citizens are inspired to help the advancement of science, and researchers motivated to listen to the voices of citizens. The benefits of such collaboration are increasingly recognized by both citizens and scientists, as reflected in the growing number of related publications and initiatives. This is especially relevant for emerging areas of research, where early involvement of citizens could help to envision, prioritize, and plan prospective studies. The Problematic Usage of the Internet (PUI) is one such area, which is fast becoming a public mental health concern. However, there remains a lack of clarity regarding the practical guidelines and ethical requirements for citizen involvement at the earliest stages of PUI. In our paper, we propose a conceptual framework and a template for initial involvement of citizens in PUI. They are derived from our community case studies, conducted in six European countries (Georgia, Greece, Malta, North Macedonia, Portugal, and Spain) and consisting of consultation with diverse groups of interested citizens (students, parents, teachers, and health professionals). Informed by our consultation exercises, we also highlight four ethical aspects for citizen involvement in the research on PUI or novel disciplines in general. They follow simple guiding principles to ensure that scientists will: enable a long-term commitment and inclusive opportunities for citizens, challenge established power hierarchies, and support collaboration, co-production and co-authorship with citizens. We believe that the proposed practical guidelines and ethical considerations, provide a valuable foundation on which to advance our understanding and generate international strategies for citizen involvement in PUI.
Background: Problematic internet use (PIU) is a serious global mental health issue that especially manifested during the Coronavirus disease (COVID-19) pandemic. Engagement in PIU as an impulsive coping with mental distress may pose a long-lasting threat to develop anxiety and depressive disorders. The first aim of our study was to investigate the prevalence of PIU and mental distress symptoms during the COVID-19 pandemic among university students in Lithuania. The second aim was to test the hypothesis that PIU affects anxiety and depressive symptoms through the mediating role of impulsivity. Methods: The cross-sectional study was comprised of 619 university students (92.9% females and 7.1% males) with a mean age of 22 ± 3 years who participated in an online survey from May to November, 2020. Participants completed the following scales: the Problematic Internet Use Questionnaire-9, the Generalized Anxiety Disorder Questionnaire-7, the Patient Health Questionnaire-9, and the Barratt Impulsiveness Scale-11. K-means cluster analysis and one-way multivariate analysis of variance were used for group comparison in terms of internet use time and habit change during COVID-19 pandemic. Structural equation modeling was applied to examine the mediating effect of impulsivity in association between PIU and mental distress, while controlling for age. Results: In sum, 45.1% of the participants reported PIU and 38.1% had markedly expressed symptoms of anxiety while 43.6% of the students reported moderate to severe depressive symptoms. During the COVID-19 pandemic 76% of the students reported at least moderate increase in their internet use time. Anxiety and depressive symptoms were significantly higher in the group of frequent internet users. The results of the structural equational modeling analysis showed a statistically significant effect of PIU on subjective anxiety symptoms and the statistically significant effect of PIU on subjective depression symptoms, both mediated via impulsivity. Conclusions: During COVID-19 pandemic, PIU, anxiety and depression symptoms are highly prevalent among students. Findings also suggest that relationships between PIU, anxiety and depressive symptoms are mediated via impulsivity. These results underscore the importance of the inclusion of impulsivity factor in the studies analyzing longitudinal effects of PIU on mental distress during COVID-19 pandemic.
The informational age is marked by the Internet and the media as key factors, with complex mutual interactions. However, they are recognized to increasingly produce negative consequences, such as Problematic Internet Use (PIU) and its inadequate media portrayal. This study represents a comprehensive approach on the media portrayal of PIU via content analysis of national daily newspapers in eight countries from the Eurasian continent. The cross-sectional research included predefined intervals in 2014 and 2018. The search retrieved 212 articles with balanced distribution for designated periods, and predominant publishing in the largest countries. The results revealed that the articles with neutral narratives and national scopes are the most frequent, while the coverage on youth risks (like cyberbullying and excessive social media use) is predominant. This study is a pioneer attempt to give multinational and multi-layered portrayal on the stories that grab the media attention, dictate public interest and guide health policies.
Objectives: To date, there is no reliable instrument which could be used to assess problematic Internet use (PIU) in Lithuania. The nine-item Problematic Internet Use Questionnaire (PIUQ-9) previously validated in multiple countries, could be a potential tool for measuring PIU severity. The main objective of the present study was to explore the psychometric properties of the Lithuanian version of the questionnaire. Methods: A total of 272 students (17% men, mean age 27±9 years) completed the PIUQ-9, the Patient Health Questionnaire (PHQ) and answered questions about the impairment of daily functioning caused by PIU in an online survey. Results: A confirmatory factor analysis indicated that a bi-factor model with one general factor “general problem” and two-specific factors “obsession” and “neglect + control disorder” fitted the data well. The presence of a strong global factor was supported by the common variance index in the bi-factor model indicating that the “general problem” factor explained 67.7% of common variance. The multiple indicators multiple causes (MIMIC) model showed that psychiatric symptoms (β=0.25) had a moderate, while impairment due to PIU (β=0.41) had a moderate-to-strong direct effect on the factor “general problem” supporting the construct validity of the scale. Conclusion: The Lithuanian version of the PIUQ-9 has appropriate psychometric properties to be used in measuring PIU severity in student samples.
Eating disorders are widespread illnesses with significant impact. There is growing concern about how those at risk of eating disorders overuse online resources to their detriment. We conducted a pre-registered systematic review and meta-analysis of studies examining Problematic Usage of the Internet (PUI) and eating disorders. The meta-analysis comprised n=32,295 participants, in which PUI was correlated with significant eating disorder psychopathology Pearson r=0.22 (s.e.=0.04, p<0.001), body dissatisfaction r=0.16 (s.e.=0.02, p<0.001), drive-for-thinness r=0.16 (s.e.=0.04, p<0.001) and dietary restraint r=0.18 (s.e.=0.03). Effects were not moderated by gender, PUI facet or study quality. Results are in support of PUI impacting significantly on vulnerable populations towards the development or maintenance of eating disorder psychopathology; males may be equally vulnerable to these potential effects. Prospective and experimental studies in the field suggest that small but significant effects exist and may have accumulative influence over time and across all age groups. Those findings are important to expand our understanding of PUI as a multifaceted concept and its impact on multiple levels of ascertainment of eating disorder psychopathology.
As a response to the COVID-19 pandemic, many governments have introduced steps such as spatial distancing and “staying at home” to curb its spread and impact. The fear resulting from the disease, the ‘lockdown’ situation, high levels of uncertainty regarding the future, and financial insecurity raise the level of stress, anxiety, and depression experienced by people all around the world. Psychoactive substances and other reinforcing behaviors (e.g., gambling, video gaming, watching pornography) are often used to reduce stress and anxiety and/or to alleviate depressed mood. The tendency to use such substances and engage in such behaviors in an excessive manner as putative coping strategies in crises like the COVID-19 pandemic is considerable. Moreover, the importance of information and communications technology (ICT) is even higher in the present crisis than usual. ICT has been crucial in keeping parts of the economy going, allowing large groups of people to work and study from home, enhancing social connectedness, providing greatly needed entertainment, etc. Although for the vast majority ICT use is adaptive and should not be pathologized, a subgroup of vulnerable individuals are at risk of developing problematic usage patterns. The present consensus guidance discusses these risks and makes some practical recommendations that may help diminish them.
Objective Problematic internet users suffer from impairment in a variety of cognitive domains. Research suggests that COMT haplotypes exert differential effects on cognition. We sought to investigate differences in the genetic profiles of problematic internet users and whether those could shed light on potential cognitive differences. Methods We recruited 206 non-treatment seeking participants with heightened impulsive traits and obtained cross-sectional demographic, clinical, and cognitive data as well as the genetic haplotypes of COMT rs4680 and rs4818. We identified 24 participants who presented with problematic internet use (PIU) and compared PIU and non-PIU participants using one-way analysis of variance (ANOVA) and chi square as appropriate. Results PIU was associated with worse performance on decision making, rapid visual processing, and spatial working memory tasks. Genetic variants were associated with altered cognitive performance, but rates of PIU did not statistically differ for particular haplotypes of COMT. Conclusion This study indicates that PIU is characterized by deficits in decision making and working memory domains; it also provides evidence for elevated impulsive responses and impaired target detection on a sustained attention task, which is a novel area worth exploring further in future work. The effects observed in the genetic influences on cognition of PIU subjects imply that the genetic heritable components of PIU may not lie within the genetic loci influencing COMT function and cognitive performance; or that the genetic component in PIU involves many genetic polymorphisms each conferring only a small effect.
The inclusion of gaming disorder (GD) as an official diagnosis in the ICD-11 was a significant milestone for the field. However, the optimal measurement approaches for GD are currently unclear. This comprehensive systematic review aimed to identify and evaluate all available English-language GD tools and their corresponding evidence. A search of PsychINFO, PsychArticles, ScienceDirect, Scopus, Web of Science, and Google Scholar identified 32 tools employed in 320 studies (N=462,249 participants). The evaluation framework examined tools in relation to: (1) conceptual and practical considerations; (2) alignment with DSM-5 and ICD-11 criteria; (3) type and quantity of studies and samples; and (4) psychometric properties. The evaluation showed that GD instrumentation has proliferated, with 2.5 tools, on average, published annually since 2013. Coverage of DSM-5 and ICD-11 criteria was inconsistent, especially for the criterion of continued use despite harm. Tools converge on the importance of screening for impaired control over gaming and functional impairment. Overall, no single tool was found to be clearly superior, but the AICA-Sgaming, GAS-7, IGDT-10, IGDS9-SF, and Lemmens IGD-9 scales had greater evidential support for their psychometric properties. The GD field would benefit from a standard international tool to identify gaming-related harms across the spectrum of maladaptive gaming behaviors. Keywords: Gaming disorder; Behavioral Addiction; Screening; Assessment; ICD-11; DSM-5
Celem artykułu było zdiagnozowanie skali zjawiska problematycznego użytkowania internetu (PIU) oraz problematycznego użytkowania portali społecznościowych (SNS). Badania zrealizowano w Polsce w 2017 na próbie 2670 adolescentów (średnia wieku=15,43, przy odchyleniu standardowym 1,5). W ramach badań wykorzystano test PIU oraz skalę użytkowania Facebooka z Bergen. Analizując wyniki zauważono, że 2,2% młodych osób posiada wszystkie faktory PIU, natomiast około 8% połowę faktorów świadczących o PIU. Ponadto mimo, że dziewczęta o wiele intensywniej użytkują SNS, około 25% z nich nie posiada żadnego symptomu PIU. Obecne formy profilaktyki szkolnej i rodzinnej (kontrola rodzicielska) w grupie adolescentów nie przyczyniają się do obniżenia PIU. Grupa adolescentów jest niehomogeniczna; osoby używające internetu w sposób intensywny, mające podwyższone faktory PIU stanowią tylko jej część. Zjawisko PIU, uzależnienia od internetu oraz współwystępujących zaburzeń podlega obecnie intensywniej analizie w zakresie wyodrębnienia kluczowych predykatorów, pozwalających na trafną i rzetelną diagnozę zarówno w perspektywie indywidulanej jak i makrospołecznej.
Problematic Internet use (PIU) is one of the most notable of all Internet threats. Young people are one of the groups at particular risk of PIU. PIU has become a research and educational priority due to its scale and the accompanying shifts in the media pedagogy paradigm. PIU is also the subject of many discussions and raises many methodological questions. The goal of the present study was to highlight the scale of PIU, and its accompanying protective factors related to interests, emotions and offline time spent on developing hobbies and passions. The study was conducted in 2016 in Poland, among 663 school students aged 17.93 (SD = 1.46), by means of triangulation of quantitative research methods. The scale of PIU was determined using a shortened version of Young's Internet Addiction test. Warning symptoms of PIU were found in 23.52% of the respondents ("yellow light"), whereas full PIU can be observed in 5.88% of the students (the results are independent of gender). Thus, the stereotypical view that PIU is common is not true. PIU is connected with negative emotions offline (mostly boredom and a lack of self-control) and too little time spent on developing passions and interests. PIU presents a challenge in terms of both research and prevention. Depending on the criteria adopted, the scale of young people at risk of PIU changes. PIU is connected with offline activities. Failure to provide effective media education (focused on strengthening self-control when using new media) and neglecting individual passions and interests intensify PIU. Further discussion of the key factors that would allow PIU to be more clearly determined is also necessary. Keywords youths • Internet addiction • family • problematic Internet use • free time • Poland Inspiration to create the text is participation of the research team in COST action-European Network for Problematic Usage of the Internet CA16207 Correspondence to Łukasz Tomczyk, PhD,
Problematic internet use is common, functionally impairing, and in need of further study. Its relationship with obsessive-compulsive and impulsive disorders is unclear. Our objective was to evaluate whether problematic internet use can be predicted from recognised forms of impulsive and compulsive traits and symptomatology. We recruited volunteers aged 18 and older using media advertisements at two sites (Chicago USA, and Stellenbosch, South Africa) to complete an extensive online survey. State-of-the-art out-of-sample evaluation of machine learning predictive models was used, which included Logistic Regression, Random Forests and Naïve Bayes. Problematic internet use was identified using the Internet Addiction Test (IAT). 2006 complete cases were analysed, of whom 181 (9.0%) had moderate/severe problematic internet use. Using Logistic Regression and Naïve Bayes we produced a classification prediction with a receiver operating characteristic area under the curve (ROC-AUC) of 0.83 (SD 0.03) whereas using a Random Forests algorithm the prediction ROC-AUC was 0.84 (SD 0.03) [all three models superior to baseline models p < 0.0001]. The models showed robust transfer between the study sites in all validation sets [p < 0.0001]. Prediction of problematic internet use was possible using specific measures of impulsivity and compulsivity in a population of volunteers. Moreover, this study offers proof-of-concept in support of using machine learning in psychiatry to demonstrate replicability of results across geographically and culturally distinct settings.
Background and aims: Problematic internet use (PIU; otherwise known as Internet Addiction) is a growing problem in modern societies. There is scarce knowledge of the demographic variables and specific internet activities associated with PIU and a limited understanding of how PIU should be conceptualized. Our aim was to identify specific internet activities associated with PIU and explore the moderating role of age and gender in those associations. Methods: We recruited 1749 participants aged 18 and above via media advertisements in an Internet-based survey at two sites, one in the US, and one in South Africa; we utilized Lasso regression for the analysis. Results: Specific internet activities were associated with higher problematic internet use scores, including general surfing (lasso β: 2.1), internet gaming (β: 0.6), online shopping (β: 1.4), use of online auction websites (β: 0.027), social networking (β: 0.46) and use of online pornography (β: 1.0). Age moderated the relationship between PIU and role-playing-games (β: 0.33), online gambling (β: 0.15), use of auction websites (β: 0.35) and streaming media (β: 0.35), with older age associated with higher levels of PIU. There was inconclusive evidence for gender and gender × internet activities being associated with problematic internet use scores. Attention-deficit hyperactivity disorder (ADHD) and social anxiety disorder were associated with high PIU scores in young participants (age ≤ 25, β: 0.35 and 0.65 respectively), whereas generalized anxiety disorder (GAD) and obsessive-compulsive disorder (OCD) were associated with high PIU scores in the older participants (age > 55, β: 6.4 and 4.3 respectively). Conclusions: Many types of online behavior (e.g. shopping, pornography, general surfing) bear a stronger relationship with maladaptive use of the internet than gaming supporting the diagnostic classification of problematic internet use as a multifaceted disorder. Furthermore, internet activities and psychiatric diagnoses associated with problematic internet use vary with age, with public health implications.
Background and aims Problematic Internet use (PIU) is commonplace but is not yet recognized as a formal mental disorder. Excessive Internet use could result from other conditions such as gambling disorder. The aim of the study was to assess the impact of impulsive–compulsive comorbidities on the presentation of PIU, defined using Young’s Diagnostic Questionnaire. Methods A total of 123 adults aged 18–29 years were recruited using media advertisements, and attended the research center for a detailed psychiatric assessment, including interviews, completion of questionnaires, and neuropsychological testing. Participants were classified into three groups: PIU with no comorbid impulsive/compulsive disorders (n = 18), PIU with one or more comorbid impulsive/compulsive disorders (n = 37), and healthy controls who did not have any mental health diagnoses (n = 67). Differences between the three groups were characterized in terms of demographic, clinical, and cognitive variables. Effect sizes for overall effects of group were also reported. Results The three groups did not significantly differ on age, gender, levels of education, nicotine consumption, or alcohol use (small effect sizes). Quality of life was significantly impaired in PIU irrespective of whether or not individuals had comorbid impulsive/compulsive disorders (large effect size). However, impaired response inhibition and decision-making were only identified in PIU with impulsive/compulsive comorbidities (medium effect sizes). Discussion and conclusions Most people with PIU will have one or more other impulsive/compulsive disorders, but PIU can occur without such comorbidities and still present with impaired quality of life. Response inhibition and decision-making appear to be disproportionately impacted in the case of PIU comorbid with other impulsive/compulsive conditions, which may account for some of the inconsistencies in the existing literature. Large scale international collaborations are required to validate PIU and further assess its clinical, cognitive, and biological sequelae.
Research into problematic use of the Internet (PUI) is scarce and fragmented across different cultures and age groups. Better understanding of the psychopathology and brain-basis of different forms of PUI is required to determine accurate diagnosis, prediction of prognosis, and support the development of effective interventional approaches.
This chapter examines characteristics of information and communication technology (ICT) and face-to-face communication and their associations with subjective wellbeing among students. The participants were N=500 students who reported average time they spent in face- to-face (FtF) and ICT communications. They also reported dominant communication in two types of communication contexts (communication purpose and persons involved in communication) and estimated their happiness and life satisfaction. Students spent more time in FtF communication than in ICT. Those who spent more time in FtF communication with friends were happier and more satisfied with their lives. FtF communication was dominant when meeting new people, for personal talk, and for flirting, while ICT communication was dominant for casual and informative chat. Students most frequently communicated with close persons FtF. Students who use dominantly FtF communication for personal talk and with people from their private lives (i.e., parents, friends, partners) were happier and more satisfied with their lives.
The Internet is now all-pervasive across much of the globe. While it has positive uses (e.g. prompt access to information, rapid news dissemination), many individuals develop Problematic Use of the Internet (PUI), an umbrella term incorporating a range of repetitive impairing behaviours. The Internet can act as a conduit for, and may contribute to, functionally impairing behaviours including excessive and compulsive video gaming, compulsive sexual behaviour, buying, gambling, streaming or social networks use. There is growing public and National health authority concern about the health and societal costs of PUI across the lifespan. Gaming Disorder is being considered for inclusion as a mental disorder in diagnostic classification systems, and was listed in the ICD-11 version released for consideration by Member States (http://www.who.int/classifications/icd/revision/timeline/en/). More research is needed into disorder definitions, validation of clinical tools, prevalence, clinical parameters, brain-based biology, socio-health-economic impact, and empirically validated intervention and policy approaches. Potential cultural differences in the magnitudes and natures of types and patterns of PUI need to be better understood, to inform optimal health policy and service development. To this end, the EU under Horizon 2020 has launched a new four-year European Cooperation in Science and Technology (COST) Action Programme (CA 16207), bringing together scientists and clinicians from across the fields of impulsive, compulsive, and addictive disorders, to advance networked interdisciplinary research into PUI across Europe and beyond, ultimately seeking to inform regulatory policies and clinical practice. This paper describes nine critical and achievable research priorities identified by the Network, needed in order to advance understanding of PUI, with a view towards identifying vulnerable individuals for early intervention. The network shall enable collaborative research networks, shared multinational databases, multicentre studies and joint publications.