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The Association between Adult ADHD Symptoms and Internet Addiction among College Students: The Gender Difference

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Abstract

This study evaluated (a) the association between Internet addiction and adult ADHD; (b) which one of inattention, hyperactivity, or impulsivity was most associated with Internet addiction; and (c) whether gender modulates the association between Internet addiction and inattention, hyperactivity, or impulsivity among college students. A total of 2,793 students (937 male and 1,843 female) were recruited from eight colleges in Taiwan, and they all completed the Chen Internet Addiction Scale, Adult ADHD Self-Report Scale, and demographic data. The results demonstrated that adult ADHD was associated with Internet addiction. Attention deficit was the most associated symptom of Internet addiction, followed by impulsivity. Furthermore, the association between attention deficit and Internet addiction was more significant among female college students. Adult ADHD should be surveyed and treated among college students to decrease the vulnerability to Internet addiction, and strategies to prevent Internet addiction should be provided for college students with ADHD, especially for females.

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... Although in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) are not yet addressed as a diagnosis, smartphone addiction is considered as behavioral addiction (Kwon et al. 2013;Lin et al. 2014); Internet addiction (IA) is also known as another type of behavioral addiction. Numerous studies show that there is a significant relationship between ADHD and IA (Cao et al. 2007;Dalbudak and Evren 2014;Yen et al. 2007;Yen et al. 2009;Yoo et al. 2004). Both IA and ADHD may lead to some problems such as poor academic performances, high dropout rates (Fredriksen et al. 2014), and risky behaviors (Wolraich et al. 2005) and interpersonal relationship problems (Yen et al. 2014). ...
... Firstly, the study analyzed the differences in the smartphone addiction, temperament, and character and parenting attitudes between adolescents with ADHD and without ADHD. Regarding smartphone addiction scores, adolescents diagnosed with ADHD have scored significantly higher than those in non-ADHD, which align well with previous literature (Chassiakos et al. 2016;Greenfield 1999;Hyun et al. 2015;Ko et al. 2008;Lee et al. 2015;Yapça Kaypaklı 2017;Yen et al. 2009). These previous studies have found that ADHD is associated with smartphone addiction and technology addiction. ...
... According to Yen et al. (2007) and Yoo et al. (2004), symptoms of ADHD have been associated with Internet addiction among children and adolescents. Yen et al. (2009) demonstrated that attention deficit was the most associated symptom of Internet addiction. Individuals with ADHD have deficit in working memory, and this problem may be related to attention deficit (Castellanos and Tannock 2002). ...
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This study aims to compare smartphone addiction level, temperament, and character and parental attitudes of adolescents with and without attention deficit hyperactivity disorder (ADHD). For this purpose, 143 adolescents with and without ADHD and their parents were included in the study. Participants completed the “Smartphone Addiction Scale-Short Form,” “Junior Temperament and Character Inventory,” and “Parental Attitude Research Instrument.” According to the analysis, the smartphone addiction scores of adolescents with ADHD were significantly higher than those in without ADHD group. Both groups differed in terms of temperament and character and parental attitudes. Hierarchical regression analyses revealed that high novelty seeking and low overprotection parental attitude were significantly associated with smartphone addiction scores in ADHD group, whereas high novelty seeking and low persistence were significantly associated with smartphone addiction scores in without ADHD group. This study is exceptionally important in terms of demonstrating the relationship between ADHD and smartphone addiction. Important findings related to parental attitude and temperament and character were also revealed.
... The defining core features of ADHD are inattentiveness and hyperactivity/impulsivity. The onset of ADHD occurs during childhood, and among children diagnosed with ADHD, more than 60-80% of them have the symptoms persisting into adulthood (Matthies & Philipsen, 2016). The comorbidity rate of ADHD and Internet addiction has been reported as 37% Yen et al., 2009). It was also reported that individuals with Internet addiction had higher total ADHD symptoms scores (Yen et al., 2007). ...
... College students have been reported as a population with a higher risk for developing Internet addiction (Kuss et al., 2013;Niemz et al., 2005). Also, individuals with an ADHD diagnosis were more likely to have Internet addiction (Kim et al., 2017;Yen et al., 2009). The present study further explored the associations between the core ADHD symptoms and Internet usage related to Internet addiction, as well as the predictability of ADHD symptoms given Internet addiction as the outcome. ...
... Further, the rate of ADHD diagnosis based on the DSM-5 was higher in the Internet addiction group (15.17%) than in the non-Internet addiction group (2.67%). Other studies suggested that individuals with ADHD seem to be more susceptible to developing Internet addiction than other behavioral and emotional disorders (Chou et al., 2015;Dalbudak et al., 2015;Ko et al., 2008;Yen et al., 2009;). Though the current study did not examine other behavioral or emotional disorders, the comorbidity rate found supports the conclusion that individuals with ADHD have a higher likelihood of being addicted to the Internet. ...
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p style="text-align: justify;">This paper presents an investigation that aims to: 1) explore the relations between core symptoms of adult Attention Deficit and Hyperactivity Disorder (ADHD) and several typical Internet activities, and 2) compare the predictive power of two core symptoms of ADHD- inattention and hyperactivity/impulsivity- in predicting Internet addiction. Methods: A total of 2016 Chinese college students participated in this study. The ADHD symptoms were assessed using Conners self-rating scales and DSM-5 semi-structured interviews. Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (SCID-5) was used to exclude other psychiatric disorders. Chen’s Internet addiction scale (CIAS) was used to evaluate Internet addiction. Information about Internet activities (e.g., online gaming) was collected through a self-constructed questionnaire. Results: The ratio of Internet addiction problems among individuals with ADHD symptoms is significantly higher than in ordinary individuals (48.9% vs. 14.3%). Further, each core ADHD symptom has unique relations with different types of Internet activities. Specifically, both core ADHD symptoms are negatively associated with information downloading and online learning, and positively associated with online gaming, while online shopping is only associated with hyperactivity/impulsivity. Furthermore, both core ADHD symptoms are significant predictors of Internet addiction, especially inattention. Conclusion: College students with ADHD symptoms are at a higher risk of having Internet addiction than peers without ADHD symptoms. For individuals with ADHD symptoms and excessive online gaming and/or online shopping behaviors, the probability of having Internet addiction is even higher. These findings have important implications for identifying risk factors of Internet addiction and preventing Internet addiction in Higher Education settings.</p
... Where the construct has been examined separately, the findings appear unclear. For example, participants with IGD have produced higher scores on measures of impulsivity [32,33], while Yen et al. [34] have suggested that inattention is a greater risk factor compared to impulsivity given that technologies involving immediate response and gratification, as is the case during game-play, enable users to alleviate the sense of boredom that is often experienced by those prone to inattention. Therefore, as a contribution to the literature, the present study aims to examine the risk factors for the development of IGD, specifically, by examining impulsivity and inattention separately in a sample of gamers from the United Arab Emirates (UAE). ...
... Two primary theories have been proposed that attempt to explain the observed links between inattention and IGD. First, it has been suggested that the gaming environment provides an instantaneous response and reward system for its users [34]. This system may serve the purpose of diminishing experienced boredom, an issue that is frequently reported by users who experience difficulty with inattention [39]. ...
... This system may serve the purpose of diminishing experienced boredom, an issue that is frequently reported by users who experience difficulty with inattention [39]. Yen et al. [34] have also proposed that the access to virtual rewards received in the gaming environment may inadvertently reduce users' responsivity to potential rewards in the real world. A second potential explanation for the observed association is that gaming, as has been the case for both problematic internet use [40,41] and dependent use of smartphones [42], provides users with a means of 'escape' from their lives which may be experienced as harsh and stressful [26]. ...
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The addictive use of internet video games is now recognized as a valid diagnostic construct by both the World Health Organization and the American Psychiatric Association. A burgeoning body of preliminary evidence points to a relationship between attention deficit and hyperactivity disorder (ADHD) symptoms as being a risk factor for behaviors indicative of internet gaming disorder (IGD), however, studies have rarely examined ADHD’s two diagnostic constructs, inattention and impulsivity, separately. Moreover, IGD research is non-existent in Middle Eastern contexts. Therefore, this study examined, separately, the association of IGD with inattention and impulsivity in a sample of gamers from the United Arab Emirates. A cross-sectional survey was completed by 214 participants aged 18–33 years (mage = 20.64, SD = 4.34) who completed measures of IGD and ADHD, and self-reported daily duration of gameplay as well as a number of demographic characteristics. The pair of hierarchical linear regressions indicated that both the examined constructs, increased symptoms of inattention and impulsivity, were separately associated with elevated risk for engagement in IGD behaviors. However, these associations were not moderated by gender. These results confirm that symptoms of ADHD are indeed associated with IGD and is the first to confirm the presence of this relationship in a Middle Eastern sample.
... Üniversite öğrencileri ile yapılan epidemiyolojik araştırmalar farklılık göstermekte; orta ve yüksek risk düzeyinde internet bağımlılığı yaygınlığının sırasıyla Çin'de %11, 3 (6), Hindistan'da % 12,5 (7), Tayvan'da % 15,3 (8), Türkiye'de %16,4 (9) olduğu rapor edilmiştir. Birçok risk faktörü incelemesinde internet bağımlılığı düzeyinin cinsiyete göre değiştiği ve internetin olumsuz etkilerinin erkeklerde daha şiddetli olduğu belirtirken (8,10,11) bu çalışmaların aksine kadınlarda erkeklerden daha yüksek düzey internet bağımlılığı (12) ve bağımlılık ilişkili dikkat eksikliği sorunun olduğunu gösteren araştırmalar vardır (13). ...
... Ölçekte 26 soru ve 4 boyut (fiziksel sağlık; 7 madde, ruhsal durum; 6 madde, sosyal ilişkiler; 3 madde, çevre; 8 madde) yer almaktadır. Ölçeğin alt boyutlarına ilişkin sorular genel algılanan yaşam kalitesi (1), algılanan sağlık durumu (2) fiziksel sağlık alanı (3,4,10,15,16,17,18), ruhsal alan (5,6,7,11,19,26), sosyal ilişkiler alanı (20,21,22) ve çevre (8,9,12,13,14,23,24,25,27) şeklindedir. Ölçeğin 5'li derecelendirmesi "1: Hiç Memnun Değilim, 5: Çok Memnunum" şeklinde yapılmaktadır. ...
... Üniversite öğrencileri ile yapılan epidemiyolojik araştırmalar farklılık göstermekte; orta ve yüksek risk düzeyinde internet bağımlılığı yaygınlığının sırasıyla Çin'de %11, 3 (6), Hindistan'da % 12,5 (7), Tayvan'da % 15,3 (8), Türkiye'de %16,4 (9) olduğu rapor edilmiştir. Birçok risk faktörü incelemesinde internet bağımlılığı düzeyinin cinsiyete göre değiştiği ve internetin olumsuz etkilerinin erkeklerde daha şiddetli olduğu belirtirken (8,10,11) bu çalışmaların aksine kadınlarda erkeklerden daha yüksek düzey internet bağımlılığı (12) ve bağımlılık ilişkili dikkat eksikliği sorunun olduğunu gösteren araştırmalar vardır (13). ...
... Ölçekte 26 soru ve 4 boyut (fiziksel sağlık; 7 madde, ruhsal durum; 6 madde, sosyal ilişkiler; 3 madde, çevre; 8 madde) yer almaktadır. Ölçeğin alt boyutlarına ilişkin sorular genel algılanan yaşam kalitesi (1), algılanan sağlık durumu (2) fiziksel sağlık alanı (3,4,10,15,16,17,18), ruhsal alan (5,6,7,11,19,26), sosyal ilişkiler alanı (20,21,22) ve çevre (8,9,12,13,14,23,24,25,27) şeklindedir. Ölçeğin 5'li derecelendirmesi "1: Hiç Memnun Değilim, 5: Çok Memnunum" şeklinde yapılmaktadır. ...
... Prevalence estimates of PIU typically range between 1 and 10%, although some estimates such as those in Asia have exceeded 25% [3,[21][22][23][24][25][26][27][28][29][30]. Accumulating evidence has documented associations between PIU and the presence of one or more mental disorders [4,31,32]. ...
... fear of missing out, fear of negative evaluation) in the context of social anxiety [57]. Though generally less consistent, associations between PIU and Attention Deficit Hyperactivity Disorders (ADHD) [7,26,27,37,43,45,50,58,59], Autism Spectrum Disorders (ASD) [60][61][62], personality disorders [12,37], obsessive-compulsive disorder [7,31,37,46], and either schizophrenia, psychotic symptoms or dissociative symptoms [7,37,46,48], have also been documented. ...
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Background: Problematic internet use (PIU) is an increasingly worrisome issue, as youth population studies are establishing links with internalizing and externalizing problems. There is a need for a better understanding of psychiatric diagnostic profiles associated with this issue, as well as its unique contributions to impairment. Here, we leveraged the ongoing, large-scale Child Mind Institute Healthy Brain Network, a transdiagnostic self-referred, community sample of children and adolescents (ages 5-21), to examine the associations between PIU and psychopathology, general impairment, physical health and sleep disturbances. Methods: A total sample of 564 (190 female) participants between the ages of 7-15 (mean = 10.80, SD = 2.16), along with their parents/guardians, completed diagnostic interviews with clinicians, answered a wide range of self-report (SR) and parent-report (PR) questionnaires, including the Internet Addiction Test (IAT) and underwent physical testing as part of the Healthy Brain Network protocol. Results: PIU was positively associated with depressive disorders (SR: aOR = 2.43, CI: 1.22-4.74, p = .01; PR: aOR = 2.56, CI: 1.31-5.05, p = .01), the combined presentation of ADHD (SR: aOR = 1.91, CI: 1.14-3.22, p = .01; PR: n.s.), Autism Spectrum Disorder (SR: n.s.; PR: aOR = 2.24, CI: 1.34-3.73, p < .001), greater levels of impairment (SR: Standardized Beta = 4.63, CI: 3.06-6.20, p < .001; PR: Standardized Beta = 5.05, CI: 3.67-6.42, p < .001) and increased sleep disturbances (SR: Standardized Beta = 3.15, CI: 0.71-5.59, p = .01; PR: Standardized Beta = 3.55, CI: 1.34-5.75, p < .001), even when accounting for demographic covariates and psychiatric comorbidity. Conclusions: The association between PIU and psychopathology, as well as its impact on impairment and sleep disturbances, highlight the urgent need to gain an understanding of mechanisms in order to inform public health recommendations on internet use in U.S. youth.
... Üniversite öğrencileri ile yapılan epidemiyolojik araştırmalar farklılık göstermekte; orta ve yüksek risk düzeyinde internet bağımlılığı yaygınlığının sırasıyla Çin'de %11, 3 (6), Hindistan'da % 12,5 (7), Tayvan'da % 15,3 (8), Türkiye'de %16,4 (9) olduğu rapor edilmiştir. Birçok risk faktörü incelemesinde internet bağımlılığı düzeyinin cinsiyete göre değiştiği ve internetin olumsuz etkilerinin erkeklerde daha şiddetli olduğu belirtirken (8,10,11) bu çalışmaların aksine kadınlarda erkeklerden daha yüksek düzey internet bağımlılığı (12) ve bağımlılık ilişkili dikkat eksikliği sorunun olduğunu gösteren araştırmalar vardır (13). ...
... Ölçekte 26 soru ve 4 boyut (fiziksel sağlık; 7 madde, ruhsal durum; 6 madde, sosyal ilişkiler; 3 madde, çevre; 8 madde) yer almaktadır. Ölçeğin alt boyutlarına ilişkin sorular genel algılanan yaşam kalitesi (1), algılanan sağlık durumu (2) fiziksel sağlık alanı (3,4,10,15,16,17,18), ruhsal alan (5,6,7,11,19,26), sosyal ilişkiler alanı (20,21,22) ve çevre (8,9,12,13,14,23,24,25,27) şeklindedir. Ölçeğin 5'li derecelendirmesi "1: Hiç Memnun Değilim, 5: Çok Memnunum" şeklinde yapılmaktadır. ...
... Problematic internet use co-occurs with various psychological disorders, such as loneliness (9), lower self-esteem, depression (10) and anxiety (11). Excessive internet use is associated with attention-deficit hyperactivity disorder (ADHD) (12), resulting in poor academic performance (3). ...
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Background: The rate of internet addiction is increasing in college students. The first year at college is a particularly vulnerable period for internet addiction. Students' psychological characteristics are likely to play an important role in internet addiction. Our study aimed to assess the relationship between impulsivity, social support, depression and internet addiction among male college freshmen. Materials and Methods: The current study utilized latent profile analysis (LPA) to identify at-risk profiles among 734 college freshmen (100% male) based on their Internet Addiction Test item ratings. We compared the levels of impulsivity, social support and depression among different profiles and investigated whether these variables could predict each latent internet addiction class. Results: LPA resulted in three distinct profiles: the low internet addiction group (42.10%), the moderate internet addiction group (35.70%) and the high internet addiction group (22.20%). Impulsivity and depression increased with internet addiction severity levels, whereas social support was inversely related to the severity of internet addiction. Male freshmen with high impulsivity, low social support and high depression were more likely to be included in the high internet addiction group. Conclusion: This study highlights that impulsivity, social support and depression may predict internet addiction in male college freshmen. Our findings have important practical implications for college educators and counselors in developing interventions for internet addiction.
... Studies of Asian populations have found significantly higher prevalence rates than those of Western groups. The studies of Yen, Yen, Chen, Tang, andKo (2007, 2009) concluded that about 18 percent of Chinese high school students and about 12 percent of Chinese college students were addicted to the internet, while found that about 20 percent of Taiwanese adolescents were internet addicted. Internet addiction is clearly a large and global problem. ...
Article
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Social media companies commonly design their platforms in a way that renders them addictive. Some governments have declared internet addiction a major public health concern, and the World Health Organization has characterized excessive internet use as a growing problem. Our article shows why scholars, policy makers, and the managers of social media companies should treat social media addiction as a serious moral problem. While the benefits of social media are not negligible, we argue that social media addiction raises unique ethical concerns not raised by other, more familiar addictive products, such as alcohol and cigarettes. In particular, we argue that addicting users to social media is impermissible because it unjustifiably harms users in a way that is both demeaning and objectionably exploitative. Importantly, the attention-economy business model of social media companies strongly incentivizes them to perpetrate this wrongdoing.
... Attention deficit was the most associated symptom of Internet addiction, followed by impulsivity. [4] The other associations found in ADHD adolescents were high fun-seeking and behavioural inhibition [5] The presented case approached the tertiary speciality centre for management of issues related to gaming. ...
... Attention deficit was the most associated symptom of Internet addiction, followed by impulsivity. [4] The other associations found in ADHD adolescents were high fun-seeking and behavioural inhibition [5] The presented case approached the tertiary speciality centre for management of issues related to gaming. ...
... According to Yen, ADHD symptoms (inattention, hyperactivity and impulsivity) among ADHD patients who are also cyberaddicts would indeed appear with more intensity than in ADHD patients who are not. More specifically, inattention seems to be the most aggravated symptom of video game abuse (28). However, in our study, impulsivity appears to be the most correlated to video game addiction. ...
Article
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Video game addiction in young children is relevant, but it is especially important for children with ADHD. In order to obtain more data about the use of video games by Canadian children, and in particular by ADHD children, we explored the modalities of use (playtime, addiction score and usage by age) and compared them between ADHD and non-ADHD children. We then examined associations between addiction and ADHD symptoms and explored innovative results about the gender impact. Our study was cross-sectional, multicenter in child psychiatrist departments, exploratory and descriptive. We recruited three groups of children aged 4–12 years: the ADHD Group, the Clinical-Control Group and the Community-Control Group. For each group, the material used consisted of questionnaires completed by one of the parents. Data collection took place from December 2016 to August 2018 in Montreal (n = 280). Our study highlighted a vulnerability in ADHD children: they would exhibit more addictive behaviors with respect to video games (Addiction score: 1.1025 in ADHD Group vs. 0.6802 in Community-Control Group) and prolonged periods of use. We also observed a correlation between the severity of ADHD symptoms and excessive use of video games (p = 0.000). Children with severe ADHD showed significantly higher addiction scores and, in a multiple regression analysis a combination of gender and ADHD explained the excessive use of video games.
... In addition to school-age and adolescence, adult ADHD has attracted increasing interest because 50% to 65% of ADHD children have symptoms until adulthood and often have a Life-Long Condition [1,2]. Adult ADHD has a high risk of comorbid mental disorders, such as depression, anxiety, and substance abuse [3,4], and may be accompanied by Internet addiction [5,6] and problems with adaptation to college [7,8]. In particular, Internet addiction is a problem observed frequently in adults (5.8%) following adolescence (12.5%) in a 2014 Korean survey [9]. ...
... In a systematic review on problematic internet use and psychopathology, based on 20 articles, 75% of studies reported significant correlations with depression, 100% with symptoms of attention-deficit/hyperactivity disorder (ADHD), 57% with anxiety, and 60% with obsessivecompulsive symptoms (3). In a study conducted by Yen et al. in 2793 university students, it was reported that adult ADHD was associated with internet addiction, and the most predictive criterion for internet addiction was attention problems, followed by impulsivity (4). Generally, adolescents spend more time on the internet than adults, predisposing themselves to internet addiction (5). ...
... CIAS identifies a number of scales (compulsive symptoms), (withdrawal symptoms), (tolerance symptoms), (intrapersonal and health problems), (time management problems), but in this work we used only the general, final indicator of Internet addiction. The levels of Internet addicted behavior are as follows: from 27 points to 42 -none; 43 -64 points -propensity to develop Internet-dependent behavior / pre-addictive stage; finally, from 65 points and above -a statement of Internet-dependent behavior (behavior with a component of Internet abuse) [12][13]. ...
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This article is devoted to the study of the characteristics of socio-psychological adaptation of high school students with different levels of Internet addiction. The paper examines the phenomenon of Internet addiction as a variation of behavioral addiction in the context of information security. The study involved 120 high school students from municipal educational institutions in Moscow. Two diagnostic methods were used: Chen Internet Addiction Scale - CIAS adapted by V.L. Malygina, K.A. Feklisova; Test of Personal Adjustment by Carl R. Rogers, Rosalind F. Dymond (adapted by A.K. Osnitsky). As a result of the conducted empirical research, significant differences in the components of socio-psychological adaptation of schoolchildren with different levels of Internet addiction have been shown; it has also been proved that Internet addiction acts as a predictor of adaptation of high school students.
... Children with a shortage of self-control may experience worsened ADHD symptoms. Second, obtaining rewards quickly and gaining easy access to the Internet may weaken attention and behavioral control in the real world [34]. Compared to the Internet environment, real activities require the investment of time to obtain rewards; as such, children can become restless and distracted by not being rewarded. ...
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Problematic Internet use (PIU), hyperactivity/inattention, and depressive symptoms are comorbid problems in adolescence, but the causal relationships among these issues are unclear. To assess the relationships among PIU, hyperactivity/inattention, and depressive symptoms in adolescents in the general population. This longitudinal cohort study used data from the Tokyo Teen Cohort study in Tokyo, Japan, for two years between October 2012 and January 2015. Of the 3171 pairs of children and parents, 3007 pairs continued to participate in the second wave of the Tokyo Teen Cohort study. A total of 3007 children were included in the analysis (mean [standard deviation] age, 9.7 [0.4] years; 1418 women [47.2%]. Cross-lagged panel analysis revealed that PIU at timepoint 1 was significantly associated with hyperactivity/inattention at timepoint 2 (β = 0.03; 95% confidence interval (CI) 0.01–0.06), and hyperactivity/inattention at timepoint 1 was also significantly associated with PIU at timepoint 2 (β = 0.07; 95% CI 0.04–0.10), even after adjustments were made for depressive symptoms. Furthermore, PIU at timepoint 1 was significantly associated with depressive symptoms at timepoint 2 (β = 0.05; 95% CI 0.01–0.12), and depressive symptoms at timepoint 1 were also significantly associated with PIU at timepoint 2 (β = 0.05; 95% CI 0.02–0.07), even after adjustments were made for hyperactivity/inattention. These results support the bidirectional relationships among PIU, hyperactivity/inattention, and depressive symptoms. PIU may be a target to improve hyperactivity/inattention and depressive symptoms in adolescents.
... In the literature, PIU has been shown to have a stronger relationship with the severity of inattention symptoms as opposed to hyperactivity/impulsivity symptoms (Reuter M, 2015;Yen, Yen, Chen, Tang, & Ko, 2009;Yilmaz et al., 2015); however, conflicting findings also exist (Gunes et al., 2018). This closer relationship between PIU and inattention symptoms is somewhat similar to the findings of other addiction disorders, which may indicate the shared neurobiological mechanisms of addiction (Frodl, 2010;Molina & Pelham, 2003). ...
Aim: To evaluate the relationships between problematic internet use (PIU) and psychiatric comorbid disorders and internet use habits in a clinical sample of adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: This cross-sectional study included 95 adolescents with ADHD. Problematic behaviors and symptoms related to internet use were evaluated via Young's Internet Addiction Scale (YIAS), and subjects with a YIAS score of ≥50 were categorized as PIU while those with a score of <50 were defined as normal internet use (NIU). The two groups were compared with respect to demographics and psychometric tests. While psychiatric disorders were examined by a semistructured instrument, self-report and parent-report scales were used to assess other individual and clinical characteristics of participants. Results: 33.7% (n = 32) of the participants were determined to have PIU. There was no gender (p = .058) or age (p = .426) difference between the PIU and NIU groups. Current presence of social phobia (p = .035) and history of major depressive disorder (p = .006) were more frequent in the PIU group than the NIU group. Multivariable regression analysis revealed that PIU was independently associated with online gaming (OR: 2.375, 95% CI: 1.532-3.681), e-mail use (OR: 1.864, 95% CI: 1.170-2.971), social networking (OR: 1.834, 95% CI: 1.156-2.910), and Social Phobia Scale for Children and Adolescents (SPSCA) score (OR: 1.058, 95% CI: 1.020-1.098). Conclusion: PIU may be common among adolescents with ADHD. The severity of social phobia and particular online activities (playing online games, e-mailing, social networking) may be associated with a higher risk of PIU in adolescents with ADHD.
... The fact that smartphones are always accessible distinguishes this addiction from other addiction types, and this addiction is a threat to individuals and society (Kahyaoğlu-Süt, Kurt, Uzal & Özdilek, 2016). Such behavioral addictions have not only side effects (Yen et al., 2009), but also psychological and physical effects such as hand and neck pain, sleep problems and visual disorders (Kuyucu, 2017). Studies of adolescents and university students' smartphone addiction have reported: that problematic phone use is a function of an extrovert personality type (Salehan & Nagehban, 2013), that there are significant relationships between smartphone addiction and negative emotions (Chen et al., 2016), that social extroversion and anxiety increase smartphone addiction (Hong et al., 2012), that smartphone addiction negatively affects academic performance (Jacobsen & Forste, 2011;Samaha & Hawi, 2016;Seo, Park, Kim & Park, 2016), and that smartphone addiction can cause depression and anxiety, which in turn can result in sleep disorders (Demirci, Akgönül & Akpınar, 2015). ...
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Preservice teachers prepare for a profession that requires intense communication and interaction. They are expected to gain competencies in their profession in this process. These competencies include the technical knowledge particular to the profession, and communication and social skills. It is thus important to investigate the factors that affect the academic and social interaction, the learning environment and the psycho-social development of university students, and in particular, preservice teachers. This study aims to investigate the relationship among preservice teachers’ social support perceptions, interaction anxiety and smartphone addiction. The students from the faculty of education and the students with the pedagogical formation training in İnönü University during the 2017-2018 academic year constituted the population of the study and the participants were 496 preservice teachers who were selected from this population using the random sampling technique. Hypotheses were developed to investigate the relationship among the research variables. After testing the hypotheses, the results indicated that the preservice teachers’ social support perceptions and interaction anxiety significantly predicts their smartphone addiction, that their social support perceptions significantly predict their interaction anxiety, and that their interaction anxiety has a mediator effect on the relationship between their social support perceptions and smartphone addiction.
... Thus, we included questions in the AHQ-2 that specifically were framed in a more positive or negative manner to explore these aspects. Because both the Ozel-Kizil (2016) HS and the original AHQ contained mostly negative items, one might conclude that HF is a negative trait in people with ADHD which, of note, may correspond to things like internet addiction which is also higher in adults with ADHD (Yen et al., 2009). However, adding positive questions and then testing to see if people high in HF also report high positive HF suggests that HF may have both positive and negative facets. ...
Thesis
http://deepblue.lib.umich.edu/bitstream/2027.42/169422/1/quynht.pdf
... The present network analysis further showed that females had a higher rate of internet addiction than males. The findings are aligned with some prior literature showing that females as compared with males had significantly higher level of internet addiction (Chiu et al., 2013;Ha & Hwang, 2014;Yen et al., 2009). A possible reason for the higher level of internet addiction in females than males could be explained by the I-PACE model (Brand et al., 2016). ...
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The Internet Disorder Scale-Short Form (IDS9-SF) is a validated instrument assessing internet disorder which modified the internet gaming disorder criteria proposed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, the relationships between the nine items in the IDS9-SF are rarely investigated. The present study used network analysis to investigate the features of the IDS9-SF among three populations in Bangladesh, Iran, and Pakistan. Data were collected (N = 1901; 957 [50.3%] females; 666 [35.0%] Pakistani, 533 [28.1%] Bangladesh, and 702 [36.9%] Iranians) using an online survey platform (e.g., Google Forms). All the participants completed the IDS9-SF. The central-stability-coefficients of the nine IDS9-SF items were 0.71, 0.89, 0.96, 0.98, 0.98, 1.00, 0.67, 0.79, and 0.91, respectively. The node centrality was stable and interpretable in the network. The Network Comparison Test (NCT) showed that the network structure had no significant differences among Pakistani, Bangladeshi, and Iranian participants (p-values = 0.172 to 0.371). Researchers may also use the IDS9-SF to estimate underlying internet addiction for their target participants and further explore and investigate the phenomenon related to internet addiction. Supplementary information: The online version contains supplementary material available at 10.1007/s12144-022-03284-8.
... Specifically, Yoo et al. (12) found a significant link between PIU and ADHD in children and showed that ADHD was an important risk factor for PIU. Similar results have also been found with adults (13). Furthermore, results of a meta-analysis conducted in 2017 indicated that individuals with PIU are two and a half times more likely to be diagnosed with ADHD (prevalence ranging from 19.5 to 42.5%) compared with individuals without PIU (prevalence ranging from 4.6 to 15.2%) (14). ...
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The co-occurrence of attention-deficit/hyperactivity disorder (ADHD) and problematic Internet use (PIU) is associated with increased severity of PIU and poorer treatment outcomes. The main objective of this study was to examine the association between PIU and adult ADHD symptoms and determine whether adult ADHD symptoms were a predictor of PIU in the general adult population. We also examined the potential mediating role of the dimensional psychopathological factors, including anxiety, depression, impulsivity, and emotion regulation, in this relationship. To achieve these aims, we recruited 532 regular Internet users online from the general adult population. The participants completed an online questionnaire assessing PIU (Internet Addiction Test), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), adult ADHD symptoms (Adult ADHD Self-Report Scale-V1.1), emotion regulation (Emotion Regulation Questionnaire), and impulsivity (UPPS-P Impulsive Behavior Scale). We conducted a multiple regression analysis to determine the predictors of PIU and mediation analyses to identify the psychopathological mediators of the association between adult ADHD symptoms and PIU. PIU was observed in 17.9% of our sample. A significantly higher proportion of respondents with PIU screened positive for adult ADHD symptoms compared to respondents without PIU (50.5 vs. 21.7%; p < 0.001). Individuals with PIU reported significantly higher scores than those without PIU for anxiety and depressive symptoms, impulsivity, and the emotion regulation strategy of expressive suppression. Additionally, they had significantly lower scores than those without PIU on cognitive reappraisal than non-problematic Internet users. In addition to adult ADHD symptoms, the multiple regression analysis revealed that PIU was also positively predicted by depressive symptoms, positive urgency, lack of perseverance, and expressive suppression, and is negatively predicted by cognitive reappraisal and negative urgency. The mediation analysis showed that lack of perseverance, positive urgency, and depressive and anxiety symptoms were partial mediators of the relationship between adult ADHD symptoms and PIU. Our results highlight the significant co-occurrence of PIU and adult ADHD symptoms. This study also provides support for a theoretical model in which impulsivity dimensions, emotion regulation strategies, as well as the tendency to anxiety and depressive symptoms, may play a mediating role in this co-occurrence. In summary, the findings emphasize the need to assess these psychological characteristics in problematic Internet users, as they can be a factor of clinical complexity, as well as the importance of targeting them as part of integrated interventions for both adult ADHD symptoms and PIU.
... Adolescents with high IGDs reported greater anxiety, depressive symptomatology, hostility, impulsivity, and social skills deficits and worse family functioning than the other two groups. Previous studies suggested that IGDs is associated with external symptoms such as impulsivity, attention deficit hyperactivity disorder (Yen, Yen, Chen, Tang, & Ko, 2009), aggressiveness, and hostility (Chiu, Lee, & Huang, 2004;Coyne, Padilla-Walker, Stockdale, & Day, 2011;Mehroof & Griffiths, 2010), as well as with internal symptoms such as depressive mood (Bavelier et al., 2011) and social anxiety (Cole & Hooley, 2013;Porter, Starcevic, Berle, & Fenech, 2010). Additionally, social factors, such as deficits in social skills and poor parental care, may increase the risk of developing IGDs (Sugaya et al., 2019). ...
Article
Three hypotheses have been suggested to explain factors underlying Internet gaming disorder symptoms (IGDs): the comorbidity hypothesis highlights the presence of further psychopathologies; the dilution effect hypothesis is associated with a low level of self-regulation; and the interpersonal impairment hypothesis focuses on the associations of social deficits. Anxiety and depression (comorbidity), impulsivity and hostility (self-regulation), social skills and family functioning (interpersonal impairment), and time spent gaming, both during the week and on the weekend, were assessed. Participants were 946 young people (51.5% males) aged from 11 to 18. Preliminary correlations indicated that higher scores in anxiety, impulsiveness, hostility, and social skills deficit and lower scores in family functioning and more time spent gaming were associated with IGDs. The proposed theoretical model had a good fit to the data, revealing that anxiety and time spent gaming on the weekend had a direct association with IGDs. Social skills and family functioning showed an indirect relationship with IGDs, whereas impulsivity only showed a direct association with time spent gaming during the week. However, a different set of variables was associated with IGDs depending on the gender. In girls, the significant variables associated with IGDs were time spent playing video games during the week and on the weekend, higher anxiety, and lower family functioning. In boys, direct associations between higher anxiety and hostility, social skill deficits, and time spent gaming on the weekend were found. Results support the three hypotheses, but their applicability varied according to gender. The comorbidity hypothesis was slightly superior for girls, whereas the dilution effect hypothesis was superior for boys. The factors involved in IGDs should be taken into account when designing interventions to prevent symptoms and their consequences.
... Technology affects all walks of their life hence, it is imperative to think about the emotional well-being of such students along with their physical and mental health. Attention deficiency has been found to be the most associated symptom of Internet addiction, followed by impulsivity (Yen, J. Y. et al., 2009). ...
Conference Paper
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Emotional Awareness is an integral component of Emotional Intelligence which is one of the most sought after skills today therefore the need to instill it in young college students who have become technophiles and digital addicts, has become monumental. Yoga being the ancient art form aimed at managing the complexities of mind and identifying the dissociated 'witness-consciousness' as unaffected by the actions of the mind and everyday suffering, has been persistently claimed to have an uplifting effect on the Emotional intelligence and Emotional awareness of an individual. This review examines the impact of Yoga on Emotional awareness in technologically addict college students by panning on the existing research involving Emotional Intelligence, Emotional Awareness and Yoga.
... One recent study explored IA in relation to the health-related quality of life, a measure that indexes physical and psychological health, and found that participants with IA scored lower in both health domains [33]. Furthermore, while the prevalence of IA is usually shown to be higher in males [1], the gender-related differences in the associations between IA and health remain underexplored [34]. ...
Article
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Background Internet Addiction (IA) is often shown to be associated with health issues, but no study explicitly examined a possible gradient in the association between different levels of IA and health. This study aimed to examine if the levels of IA had a graded relationship with poor sleep quality, psychological distress, and self-rated health among university students in Bangladesh. Methods In this cross-sectional study, a sample of 625 students from six universities/colleges responded to an online survey that contained measures of internet addiction test (IAT), general health questionnaire (GHQ-12), sleep quality, and self-rated health. Modified Poisson regression models were fitted to estimate the adjusted risk ratios (RR) and confidence intervals (CI) of the associations between IA and health outcomes. Results The IA levels were associated with each of the three health outcomes in a linear fashion. Compared to the lowest IA quintile, the highest quintile remained associated with an increased risk of poor-quality sleeping (RR: 1.77; 95% CI: 1.26, 2.48), psychological distress (RR: 2.09; 95% CI: 1.55, 2.82), and worse self-rated health (RR: 1.46; 95% CI: 1.09, 1.96) after adjusting for socio-demographic covariates. There were also dose-response associations between IAT z-scores and health outcomes. The association between IAT z-scores and psychological distress was significantly stronger in males compared to females (p-value for interaction<0.05). Conclusions The study found strong gradients between levels of addiction to internet and health outcomes, suggesting that increased health risks may exist even at lower levels of internet addiction. The findings highlight the need for departure of current research from a focus on the classic dichotomy of problematic versus not problematic internet use and a move toward recognizing the potential hierarchical effects of IA on health.
... Whereas some reports have suggested that ADHD features are predictors of IGD, others have shown that IGD behaviors emphasize ADHD symptoms [50,52], and that excessive gambling could be a way of escaping reality in people with ADHD [53]. An interesting study by Yen et al. [54] found that attention deficit and impulsivity were the two most commonly associated symptoms linking ADHD and IGD in college students, and that this association was stronger in females than males. ...
Article
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Internet gaming disorder (IGD) has been included in the 2013 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a condition in need of further study, and gaming disorder was recognized by the World Health Organization as a mental disorder in the International Classification of Disease (ICD-11) of 2018. IGD has different characteristics in the two sexes and is more prevalent in males than females. However, even if the female gamer population is constantly growing, the majority of available studies analyzed only males, or the data were not analyzed by sex. To better elucidate sex differences in IGD, we selectively reviewed research publications that evaluated IGD separately for males and females collected in approximately one hundred publications over the past 20 years. The available data in this narrative review indicate that IGD is strongly dimorphic by sex for both its psychological features and the involvement of different brain areas. Impulsivity, low self-control, anxiety, emotion dysregulation, and depression are some of the psychological features associated with IGD that show a sex dimorphism. At the same time, IGD and its psychological alterations are strongly correlated to dimorphic functional characteristics in relevant brain areas, as evidenced by fMRI. More research is needed to better understand sex differences in IGD. Animal models could help to elucidate the neurological basis of this disorder.
... For example, Generation Z children began regularly watching television by 3 months of age [94] compared to 4 years of age for Generation X children [95]. Previous research indicates that earlier and longer exposures to screen time are associated with increased risk of psychiatric conditions (i.e., attentional problems and hyperactivity, anxiety, and depression) [19,39], further suggesting that Generation Z children would be more likely to exhibit learning and memory impairments when compared to Generation X children. ...
Article
Converging evidence from biopsychosocial research in humans and animals demonstrates that chronic sensory stimulation (via excessive screen exposure) affects brain development increasing the risk of cognitive, emotional, and behavioural disorders in adolescents and young adults. Emerging evidence suggests that some of these effects are similar to those seen in adults with symptoms of mild cognitive impairment (MCI) in the early stages of dementia, including impaired concentration, orientation, acquisition of recent memories (anterograde amnesia), recall of past memories (retrograde amnesia), social functioning, and self-care. Excessive screen time is known to alter gray matter and white volumes in the brain, increase the risk of mental disorders, and impair acquisition of memories and learning which are known risk factors for dementia. Chronic sensory overstimulation (i.e., excessive screen time) during brain development increases the risk of accelerated neurodegeneration in adulthood (i.e., amnesia, early onset dementia). This relationship is affected by several mediating/moderating factors (e.g., IQ decline, learning impairments and mental illness). We hypothesize that excessive screen exposure during critical periods of development in Generation Z will lead to mild cognitive impairments in early to middle adulthood resulting in substantially increased rates of early onset dementia in later adulthood. We predict that from 2060 to 2100, the rates of Alzheimer’s disease and related dementias (ADRD) will increase significantly, far above the Centres for Disease Control (CDC) projected estimates of a two-fold increase, to upwards of a four-to-six-fold increase. The CDC estimates are based entirely on factors related to the age, sex, race and ethnicity of individuals born before 1950 who did not have access to mobile digital technology during critical periods of brain development. Compared to previous generations, the average 17–19-year-old spends approximately 6 hours a day on mobile digital devices (MDD) (smartphones, tablets, and laptop computers) whereas individuals born before 1950 at the same age spent zero. Our estimates include the documented effects of excessive screen time on individuals born after 1980, Millennials and Generation Z, who will be the majority of individuals ≥65 years old. An estimated 4-to-6-fold increase in rates of ADRD post-2060 will result in widespread societal and economic distress and the complete collapse of already overburdened healthcare systems in developed countries. Preventative measures must be set in place immediately including investments and interventions in public education, social policy, laws, and healthcare.
... Male adolescents have shown a higher prevalence rate of internet addiction and a more severe internet gaming disorder relative to females [41][42][43]. Conversely, females relative to males demonstrated a more significant association between attention deficits and internet addiction as well as a higher risk of mobile phone addiction [44][45][46]. Other studies have provided evidence for potential sex-specific relations between childhood trauma and addictive behavior. ...
Article
Internet addiction is associated with a range of psychological risk factors such as childhood trauma and depression. Studies have also suggested sex differences in internet and other behavioral addictions. However, it remains unclear how childhood trauma, depression and internet addiction inter-relate differently between the sexes. A total of 1749 adolescents and young adults aged 12-27 participated in a survey of sociodemographic characteristics and standardized assessments to evaluate internet addiction (Internet Addiction Test), childhood trauma (Childhood Trauma Questionnaire) and depression (Beck Depression Inventory). Mediation and path analyses were used to examine the relationship between childhood trauma, depression and internet addiction. Internet-addicted females relative to males showed more severe depression but the control participants showed the opposite. Childhood trauma was associated with depression for both internet-addicted males and females; however, internet-addicted females but not males showed significant associations between depression and the severity of internet addiction as well as between childhood trauma and the severity of internet addiction. Further, in females, depression mediated the correlations between all types of childhood trauma and the severity of internet addiction. A path analysis suggested that sexual abuse and emotional neglect contributed most significantly to internet addiction when all types of childhood trauma were examined in one model. The findings suggest sex differences in the relationship between childhood trauma, depression and internet addiction. Childhood trauma contributes to internet addiction through depression only in females. The findings may guide future prevention and intervention strategies of internet addiction.
... It was revealed that symptoms of depression and ADHD were significantly associated with internet addiction, although the powers of significance were low, whereas no significant relationship was observed for smartphone addiction in this study. Similar to previous research [44,45], we found that ADHD symptoms positively predicted internet addiction. This finding demonstrates the necessity to assess and treat comorbidities associated with internet addiction. ...
Article
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Internet and smartphone addiction have become important social issues. Various studies have demonstrated their association with clinical and psychological factors, including depression, anxiety, aggression, anger expression, and behavioral inhibition, and behavioral activation systems. However, these two addictions are also highly correlated with each other, so the consideration of the relationship between internet and smartphone addiction can enhance the analysis. In this study, we considered the copula regression model to regress the bivariate addictions on clinical and psychological factors. Real data analysis with 555 students (age range: 14–15 years; males, N = 295; females, N = 265) from South Korean public middle schools is illustrated. By fitting the copula regression model, we investigated the dependency between internet and smartphone addiction and determined the risk factors associated with the two addictions. Furthermore, by comparing the model fits of the copula model with linear regression and generalized linear models, the best copula model was proposed in terms of goodness of fit. Our findings revealed that internet and smartphone addiction are not separate problems, and that associations between them should be considered. Psychological factors, such as anxiety, the behavioral inhibition system, and aggression were also significantly associated with both addictions, while ADHD symptoms were related to internet addiction only. We emphasize the need to establish policies on the prevention, management, and education of addiction.
... Excessive gaming [96] has also been reported. It is not clear whether this association is stronger in males or females or if it is equivalent across the sexes [93,94,97]. A large webbased survey of adult internet behaviours and psychopathology in Norway found that elevated ADHD symptoms were associated with increased addictive technological behaviours, including social media use and gaming [98]. ...
Article
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Background: There is evidence to suggest that the broad discrepancy in the ratio of males to females with diagnosed ADHD is due, at least in part, to lack of recognition and/or referral bias in females. Studies suggest that females with ADHD present with differences in their profile of symptoms, comorbidity and associated functioning compared with males. This consensus aims to provide a better understanding of females with ADHD in order to improve recognition and referral. Comprehensive assessment and appropriate treatment is hoped to enhance longer-term clinical outcomes and patient wellbeing for females with ADHD. Methods: The United Kingdom ADHD Partnership hosted a meeting of experts to discuss symptom presentation, triggers for referral, assessment, treatment and multi-agency liaison for females with ADHD across the lifespan. Results: A consensus was reached offering practical guidance to support medical and mental health practitioners working with females with ADHD. The potential challenges of working with this patient group were identified, as well as specific barriers that may hinder recognition. These included symptomatic differences, gender biases, comorbidities and the compensatory strategies that may mask or overshadow underlying symptoms of ADHD. Furthermore, we determined the broader needs of these patients and considered how multi-agency liaison may provide the support to meet them. Conclusions: This practical approach based upon expert consensus will inform effective identification, treatment and support of girls and women with ADHD. It is important to move away from the prevalent perspective that ADHD is a behavioural disorder and attend to the more subtle and/or internalised presentation that is common in females. It is essential to adopt a lifespan model of care to support the complex transitions experienced by females that occur in parallel to change in clinical presentation and social circumstances. Treatment with pharmacological and psychological interventions is expected to have a positive impact leading to increased productivity, decreased resource utilization and most importantly, improved long-term outcomes for girls and women.
Article
Objective Suicidal ideation (SI) among college students is frequently reported. However, the mediating role of depressive and anxiety symptoms between attention-deficit/hyperactivity disorder (ADHD) symptoms and SI has yet to be explored among college students. Method A cross-sectional survey of college freshmen in China was conducted between October 2018 and December 2018. Standardized questionnaires were used to collect information on basic sociodemographic characteristics, including SI, ADHD symptoms, and anxiety and depressive symptoms. A structural equation model (SEM) was then constructed. Results A total of 904 college freshmen were included in the analysis. The prevalence of ADHD symptoms and lifetime SI were 11.9% (95% CI: 9.9%–14.2%) and 29.2% (95% CI: 26.3%–32.2%), respectively. The SEM revealed that there were no direct paths from inattention, executive dysfunction, and hyperactivity to SI. Under the mediating role of anxiety and depressive symptoms, executive dysfunction (β = 0.011, p < 0.05) and hyperactivity (β = 0.015, p < 0.05) had indirect relationships with the risk of SI, and the role of inattention was not identified. Depressive and anxiety symptoms had direct influences on increasing SI. There also were indirect effects from anxiety symptoms to SI, which were mediated by depressive symptoms (β = 0.023, p < 0.001). Conclusions The current study indicated the indirect relationships between ADHD symptoms and SI among college freshmen. The results of the indirect relationships could provide useful clues for clinical treatment and school-based prevention that aims to improve college students’ mental well-being.
Chapter
In the era of digital technology, the internet has its significant role in sprouting vulnerability toward the different form of addictions and psychiatric disorders as well as providing the platform to manage them effectively. The internet provides ready access to illicit drugs, nonprescription medications which facilitate a sale of controlled substances over the Internet without a valid prescription which contributed to the rise of several forms of addictions. Studies have linked the severity of Problematic Internet Use to increase chances of substance Use disorder. Utilization of internet for longer durations serves as a booster for behavioral addictions like online gambling. Web based interventions on the positive side provides a cost effective, readily accessible and user-friendly platform to reach out majority of patients to help them in seeking treatment of Addictions and various psychiatric disorders. The aim of this chapter is to discuss the contribution of the internet in a positive and negative way to develop as well as resolve Psychiatric disorder.
Article
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Attention-deficit-hyperactivity disorder (ADHD) is the most commonly diagnosed childhood disorder characterised by inattention, hyperactivity/impulsivity, or both. Some of the key traits of ADHD have previously been linked to addictive and problematic behaviours. The aim of the present study was to examine the relationship between problematic mobile phone use, smartphone addiction risk and ADHD symptoms in an adult population. A sample of 273 healthy adult volunteers completed the Adult ADHD Self-Report Scale (ASRS), the Mobile Phone Problem Usage Scale (MPPUS), and the Smartphone Addiction Scale (SAS). A significant positive correlation was found between the ASRS and both scales. More specifically, inattention symptoms and age predicted smartphone addiction risk and problematic mobile phone use. Our results suggest that there is a positive relationship between ADHD traits and problematic mobile phone use. In particular, younger adults with higher level of inattention symptoms could be at higher risk of developing smartphone addiction. The implication of our findings for theoretical frameworks of problematic mobile phone use and clinical practice are discussed.
Article
The widespread application of technology devices creates opportunities to interrupt real-time communication and interactions, which is referred to as “technoference”. This study is aimed at determining whether the interference in parent-child relationships increases the risk of adolescents' smartphone addiction among adolescents, and at examining the role of cognitive factors in this relationship. A total of 1,354 high school students from Hubei Province of China participated in this study. The participants responded to perceived technoference, attentional control, internal state awareness (ISA), and smartphone addiction. According to the results, the positive association between technology device interference in parent-child relationships and adolescents' smartphone addiction was partially mediated by attentional control. Moreover, the correlation between attentional control and smartphone addiction becomes stronger as the level of ISA increased.
Article
This review aims to establish the cognitive processing of patients with attention-deficit hyperactive disorder (ADHD) across age. Functional magnetic resonance imaging (fMRI) studies on children and adult populations were conducted, thus delineating deficits that could have been maintained and ameliorated across age. This allowed for the examination of the correlation between patterns of brain activation and the corresponding development of functional heterogeneity in ADHD. A systematic literature search of fMRI studies on ADHD was conducted using the PubMed and Scopus electronic databases based on PRISMA guidelines. References and citations were verified in Scopus database. The present study has identified 14 studies on children, 16 studies on adults, and one study on both populations of ADHD consisting of 1,371 participants. Functional heterogeneity is present in ADHD across age, which can manifest either as different brain activation patterns, intra-subject variability, or both. This is shown in the increased role of the frontal regions and the specialized network in adults with ADHD from inefficient non-specific activation in childhood. Functional heterogeneity may manifest when delayed maturation is insufficient to normalize frontal lobe functions.
Article
Internet use disorder (IUD) is generally conceptualized as a fast-growing behavioral addiction. Several structural and functional brain alterations have been revealed in this condition, but previous behavioral studies indicated that language systems may also be impaired. We used a silent word generation task to induce brain activation in Broca’s area and other parts of the language system. Blood-oxygen-level-dependent activation analysis and psychophysiological interaction analysis were applied to assess functional brain changes. IUD was measured by the Problematic Internet Use Questionnaire and two additional questions concerning usage time and subjective rating of addiction. According to our key findings, areas strongly related to the default mode network were altered in IUD during the task. Moreover, Broca’s area showed altered functional connectivity with other language network and occipital areas in IUD. These findings may address the neural background of decreased verbal fluency performance previously reported in the literature, and we emphasize that beside the brain’s reward and inhibitory control systems, the language system is the next candidate to be involved in the pathogenesis of IUD.
Chapter
Internet usage represents a risky opportunity for the youngest. Due to its social, communicative and emotional function in adolescents' lives, it may provide benefits and facilitations to their relationships. On the other hand, the excessive use of the Internet can harmfully affect their daily routines, with negative effects on their psychological state. Considering the widespread use of the Internet in everyday life during this developmental stage, the authors question the applicability of the concept of “addiction” and provide empirical data about the adaption of a useful instrument to measure problematic relationships with the Internet. The establishment of a cut-off procedure is proposed for screening purpose to identify at risk and problematic users. Moreover, differences by gender and age are explored and discussed. A comprehensive model of the Problematic Relationships with the Internet is presented and analyzed in comparison with the main perspectives and measures in literature.
Article
Background Internet addiction(IA) is now very common. However, few studies have explored the sex differences in risk factors for IA, especially among Chinese college students. This study aimed to investigate the sex differences in prevalence, risk factors and clinical correlates of IA among Chinese college students. Methods A total of 8098 college students from Hunan province were recruited using a cross-sectional design and a convenience sampling method. Each student filled out the survey online anonymously, which collected their information on their socio-demographics, internet addiction(Revised Chinese internet addiction scale;CIAS-R), ADHD(Wender Utah Rating Scale and World Health Organization (WHO) Adult ADHD Self-Report Scale v 1.1 Symptom Checklist), depression(Self-reporting Depression Scale;SDS), insomnia(Athens Insomnia Scale;AIS), anxiety(Self-Rating Anxiety Scale;SAS) and suicidal behaviors through WeChat. Results Overall, the prevalence of IA in males and females was 7.21%(259/3592) and 8.17%(368/4506), respectively. Multivariate logistic regression analysis revealed that suicidal ideation[odds ratio (OR),1.557;95% confidence interval (CI),1.083-2.240], suicide attempts(OR,2.081;95%CI:1.271-3.409), ADHD(OR,6.487;95%CI,4.697-8.959) and insomnia(OR,2.596;95%CI,1.910-3.529) were independent risk factors for male IA after controlling for confounding variables. Nationality(OR,1.507;95%CI,1.058-2.145), suicidal ideation(OR,2.012;95%CI,1.532-2.641), depression(OR,1.771;95%CI:1.071-2.930), ADHD(OR,4.497; 95%CI,3.285-6.158) and insomnia(OR,2.356;95%CI,1.813-3.061) were independent risk factors for female IA. Limitation No causal relationships could be drawn due to the cross-sectional design. Conclusions This study shows IA is common among both sexes. IA is significantly associated with ADHD, insomnia and suicidal behaviors in both male and female students, indicating the importance of screening IA and addressing ADHD, insomnia and suicidal behaviors to improve the mental health of college students and better prevent suicide in both sexes.
Article
Background: Although attention-deficit/hyperactivity disorder (ADHD) symptoms were identified as a key risk factor for Internet gaming disorder (IGD), the effect of ADHD comorbidity on longitudinal course of IGD in the clinical population remains to be further examined. This study aimed to investigate whether ADHD comorbidity in IGD patients affects the recovery, recurrence rates, and trajectories of IGD symptoms, and examine the relationship between the changes in IGD and ADHD symptoms. Methods: The study included 128 IGD patients without any psychiatric comorbidities (pure-IGD group) and 127 IGD patients with comorbid ADHD (ADHD-IGD group) aged 11 to 42 years. IGD and ADHD were diagnosed according to DSM-5 criteria at enrollment. Participants were offered 8-week treatment with additional care provided as needed and followed up over a 3-year period. IGD diagnosis was reassessed annually and used as a dichotomous outcome. The severity of IGD and ADHD symptoms was measured using the Young Internet Addiction Scale and the Korean ADHD rating scale, respectively, at baseline and each annual follow-up. Results: The recovery rates of IGD by Year 3 were 60% and 93% in ADHD-IGD and in pure-IGD groups, respectively. The ADHD-IGD group showed lower rates of recovery, higher odds of recurrence within 1 year, and higher severity of IGD symptoms over time than the pure-IGD group. Family environment was also associated with the trajectories of IGD symptoms. The changes in ADHD symptoms were significantly associated with the changes in IGD symptoms. Conclusions: This study found that ADHD comorbidity in IGD patients was associated with poor clinical course of IGD and that the changes in ADHD symptoms were associated with the changes in IGD symptoms over time. Our findings suggest that evaluation and treatment of ADHD symptoms and family environment in IGD patients may be important in improving the prognosis of IGD.
Article
Objective Alexithymia has been implicated as a risk factor for problematic substance use and other excessive behaviours including internet addiction . Impulsiveness has also been identified as a likely predisposing factor for excessive behaviours. However, as impulsivity is often elevated in alexithymia, the degree of independence of these factors in relation to excessive internet use is unclear. Method The present study assessed contributions of alexithymia, impulsivity and negative affect to variance in internet addiction symptoms in 116 internet-using female university students. Participants completed the following instruments online: demographics, Toronto Alexithymia Scale-20, Barratt Impulsiveness Scale-11, Internet Addiction Test and the Depression Anxiety Stress Scales-21. Results Measures were significantly intercorrelated in expected directions. Hierarchical regression indicated that although both alexithymia and impulsivity were highly significant predictors of internet addiction symptoms after controlling for demographic covariates, the contribution of alexithymia became nonsignificant after adding impulsivity to the model. The final model explained 37% of variance in internet addiction symptoms. Multiple mediation modelling indicated that both impulsivity and negative affect fully mediated the association of alexithymia with internet addiction symptoms. Conclusions Impulsivity and negative affect may account for the link between alexithymia and internet addiction symptoms in young women at university. KEY POINTS What is already known about this topic: • Alexithymia and impulsivity have been linked to a variety of addictive behaviors including internet addiction. • Alexithymia and impulsivity have been reported to independently predict excessive alcohol use in regression models. • Alexithymia may reflect deficient interoception and corresponding poor internal awareness of overconsumption cues in alcohol use. What this topic adds: • In female university students, alexithymia, impulsivity, and negative affect were significant positive predictors of internet addiction symptoms in a regression model. • Alexithymia was no longer significant after adding impulsivity to the model. • Multiple mediation modelling indicated that impulsivity and negative affect fully mediated the association of alexithymia with internet addiction symptoms.
Article
Background Excessive smartphone use is a new and debated phenomenon frequently mentioned in the context of behavioral addiction, showing both shared and distinct traits when compared to pathological gaming and gambling. Objective The aim of this study is to describe excessive smartphone use and associated factors among adolescents, focusing on comparisons between boys and girls. Methods This study was based on data collected through a large-scale public health survey distributed in 2016 to pupils in the 9th grade of primary school and those in the 2nd grade of secondary school. Bayesian binomial regression models, with weakly informative priors, were used to examine whether the frequency of associated factors differed between those who reported excessive smartphone use and those who did not. Results The overall response rate was 77% (9143/11,868) among 9th grade pupils and 73.4% (7949/10,832) among 2nd grade pupils, resulting in a total of 17,092 responses. Based on the estimated median absolute percentage differences, along with associated odds ratios, we found that excessive smartphone use was associated with the use of cigarettes, alcohol, and other substances. The reporting of anxiety and worry along with feeling low more than once a week consistently increased the odds of excessive smartphone use among girls, whereas anxiety and worry elevated the odds of excessive smartphone use among boys. The reporting of less than 7 hours of sleep per night was associated with excessive smartphone use in all 4 study groups. Conclusions The results varied across gender and grade in terms of robustness and the size of estimated difference. However, excessive smartphone use was associated with a higher frequency of multiple suspected associated factors, including ever having tried smoking, alcohol, or other substances; poor sleep; and often feeling low and feeling anxious. This study sheds light on some features and distinctions of a potentially problematic behavior among adolescents.
Article
Objective: Despite the rapid increase in problematic media device use, relatively little is known about specific characteristics and extent of problematic media device and how they relate to different psychological features. Methods: Data extracted from the Panel Korea Study for the Child Cohort Study were used. At the age of 9 years, media device addiction severity was assessed using the K-scale, and children's behavioral outcomes were assessed using the Child Behavior Checklist. Among children with problematic media device use (n=339), we performed latent profile analysis using the K-scale to identify subtypes of problematic media device use, and then compared the child behavioral problems and executive function according to the different subtypes of problematic media device use. Results: Children with problematic media device use were divided into class 1 (n=51), class 2 (n=138), and class 3 (n=150). Compared with classes 2 and 3, class 1 had more severe problematic media device use, including daily activity disturbance, withdrawal, and tolerance. Class 1 had the most serious behavioral problems and executive function difficulties among classes. Class 2 had greater daily activity disturbance and tolerance than those of class 3, but executive function showed no significant difference between the two classes. In logistic regression analysis, behavioral problems except for somatization were more common in class 1 than in the control group. Conclusion: Results suggest that problematic media device use is associated with significant behavioral problem and executive function difficulties and underscore the need for further clinical and research attention for these specific subgroup members.
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Background Internet addiction has surfaced as a significant concern to public health in these unprecedented Covid19 times due to social distancing and lockdown. This study aims to determine the burden of internet addiction and related psychosocial factors among the Pakistani population amidst COVID-19 Methods An analytical cross-sectional survey was broadcasted on internet via google form link which was completed by 1145 Pakistani residents. The outcome variable was Internet addiction and was assessed using the "Young's Internet Addiction Test" (IAT). In addition, symptoms of depression, anxiety, and stress were evaluated using the "Depression, Anxiety, and Stress Scale-21" (DASS-21). The multinomial logistic regression was applied, and adjusted odds ratio along with 95% confidence intervals were reported for significant factors associated with Internet addiction. Results The majority of participants were females and youth (between ages 20–24 years). The prevalence of problematic-internet-users (PIU) and addictive-internet-users (AIU) was 27.3% and 11.3%, respectively. The odds of extremely severe anxiety among AIU were approximately three times (Adj OR: 2.6 (1.1–7.1) followed by the odds of having extremely severe depression was 3.14 (95% C.I.: 1.53–6.44) times greater among PIUand odds of extremely severe stress being about five times higher among AIU (Adj OR: 5.42 (1.66–17.68)) as compared to normal-internet-user (NIU). Conclusion Amid Covid 19, the burden of internet addiction was discovered to have surged among the Pakistani populace. This study found that gender, marital status, depression, stress, anxiety, work situation, and mood changes amidst the pandemic are significantly associated with problematic and addictive internet use.
Article
Objective We aimed to understand the challenging effect of the pandemic on children and adolescents with ADHD. Methods 100 children and adolescents with ADHD aged 7–18 years were included in the study. They were evaluated in terms of internet addiction diagnostic criteria. Symptom severity was assessed using the CBCL, CPRS, and SNAP-IV. Results We found that 42% spent less time outdoors, and 26% spent more time watching TV. 57% had increased internet use and 28% were diagnosed as having internet addiction. There was a significant difference in terms of symptom severity between the groups depending on whether the children took part in sports activity before the pandemic. Conclusions Children and adolescents with ADHD have experienced challenges in many areas, especially internet use in the pandemic. The positive long-term effects of exercise in children with ADHD are thought to be protective in terms of symptom management during the COVID-19 pandemic.
Article
Основанный на концепции британского экзистенциального психолога Р. Лэйнга конструкт невоплощенности в интернете (Н. В. Коптева, А. Ю. Калугин, Л. Я. Дорфман) посредством одноименной методики сопоставляется с системообразующим последствием нормативного применения интернета – изменением психологических границ в методике их оценки (МИГ-ТС-2) Е. И. Рассказовой, В. А. Емелина, А. Ш. Тхостова. Выявлены взаимосвязи измерений невоплощенности в интернете с параметрами изменения психологических границ, которые могут свидетельствовать о том, что искусственное технологическое разделение между ментальным Я и физическим телом пользователя создает предпосылки путаницы на границе между Я и не Я. Расширение и размывание границ интернет-пользователя усиливают его виртуализацию и соответствующие ей переживания деперсонализации, утраты реальности независимо от того, оправдывает или не оправдывает технология его ожидания достижимости и контролируемости окружающих людей, объектов и информации. Мотивация предпочтения интернета, связанная с возможностями, которые открывают независимость от физического тела и измененные границы, в значительной мере совпадает. Простота и легкость развоплощенного технологического способа бытия в расширенных, размытых границах придают привлекательность сети и объясняют связь невоплощенности с интернет-зависимостью, которую можно представить как искажение нормативного технологического развоплощения в случае проблемной пользовательской активности.
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Objective: Attention deficit hyperactivity disorder (ADHD) is a genetically predisposed neurodevelopmental disorder. Although it has been stated that the incidence of mental disorders in the families of children with ADHD has increased, data on behavioral addictions is insufficient. This study aimed to investigate the relationship between risky internet use and behavioral addictions accessed via the internet and impulsivity in parents of children with ADHD. Method: The parents of 65 children diagnosed with ADHD in Department of Child and Adolescent Psychiatry and the parents of 64 children who did not have any mental disorders were included. Wender Utah Rating Scale, Barratt Impulsivity Scale-11 (BIS), Young's Internet Addiction Test short form, Smartphone Addiction Scale short form, Internet Gaming Disorder Scale (IGDS) were administered to the participants. Results: Parents of children with ADHD and the control group were similar in terms of sociodemographic characteristics. The mean scores of the IGDS mood modification, conflict, relapse, withdrawal subgroups and total scores of the parents with a child with ADHD were higher than the control group (p=0.02, p=0.03, p=0.03, p=0.03, p=0.02, respectively). There was a positive correlation between IGDS and BIS in parents of children with ADHD (rb=0.33; p<0.001). Conclusion: This study determined that internet gaming habits were higher in parents of children with ADHD, and these habits were associated with impulsivity. Recognition and treatment of mental disorders such as impulsivity and behavioral addictions in the families of children with ADHD will also contribute to the treatment of children.
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Internet Gaming Disorder (IGD) has become a significant issue in mental healthcare over the past decades as the number of people engaging in excessive and unhealthy gaming increases with each year. Despite its inclusion in the 5th Edition of Diagnostic Statistical Manual and the development of a number of treatment methods that have been designed and tested for IGD, treatment remains a challenge. This review attempts to give an overview of the current state of IGD and its treatment with a specific focus on the potential of technology-based solutions, such as web-based programs, mobile applications, and virtual reality. The review also highlights the need for additional work in the area of treatment development for IGD and the preliminary evidence for the usefulness and importance of technology-based treatment methods which offer unique advantages, such as accessibility, scalability, and cost-effectiveness, over other existing treatment options.
Chapter
The term “behavioral” addiction defines some syndromes that are similar to substance addiction but that are characterized by a behavioral focus instead of the ingestion of a psychoactive substance.
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In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. (46 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This paper reports the results from two waves of studies on the development of Chinese Internet Addiction Scale (CIAS) and its revision (CIAS-R). Based upon the conception framework adapted from other traditional addiction disorders such like pathological gambling and substance addictions, the tendency of Internet addiction was presumably characterized with two aspects of behavioral manifestation, i.e., core symptoms and related problems. In study 1, the original items of the CIAS depicting core symptoms and related problems of the Internet addiction were thus generated through focused interview and derived from the diagnostic criteria of other well-defined addiction disorders. The CIAS, background questionnaire eliciting data on basic demographics, weekly on-line hours, habitual domains, and experience of Internet utilization were administered in a traditional paper and pencil manner to a random sample of students of National Taiwan University (N=1336) Factor analysis, correlation analysis, and t-test were utilized to analyze data. The results show that: The CIAS is an appealing and reliable test with satisfactory test-retest reliability and internal consistency. Correlation analyses yield significantly positive correlation of total scale and subscale scores of CIAS with weekly Internet hours, but not with experience of Internet utilization. Moreover, high-risk students show different attitudes toward Internet use and addiction from the normal. In study 2, the CIAS-R, with modification of item wording as well as addition and elimination of some items, were administered to another wave of random subjects at National Taiwan University (N=1975). Same procedure and analyses were applied. It results in a better factor structure in CIAS-R, with similarly satisfactory psychometric properties. Future research concerning scale revision as well as possible psychopathological approach to Internet addiction will be discussed accordingly.
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The aims of this study were to develop diagnostic criteria of Internet addiction for college students (DC-IA-C) with diagnostic interviews and to establish the optimal cutoff points of the Chen Internet Addiction Scale (CIAS) for the purposes of screening for and making the diagnosis of Internet addiction. A total of 216 college students (132 male and 84 female) were recruited in the study. The results demonstrated that 5/6 cutoff points of criteria A in DC-IA-C had the best diagnostic accuracy (95.9%). Besides, 63/64 and 67/68 cutoff points of the CIAS were evaluated to be the best screening and diagnostic cutoff points, respectively. The DC-IA-C can provide health care professionals with a means to diagnose and communicate about Internet addiction among college students, and the screening and diagnostic cutoff points of CIAS could provide a screening instrument or a discriminative instrument in surveys for Internet addiction among college students.
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In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators.
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The etiology of the high prevalence of substance use disorders in patients with severe mental illness (schizophrenia or bipolar disorder) is unclear. We review the evidence of different theories of increased comorbidity, organized according to four general models: common factor models, secondary substance use disorder models, secondary psychiatric disorder models, and bidirectional models. Among common factor models, evidence suggests that antisocial personality disorder accounts for some increased comorbidity. Among secondary substance use disorder models, there is support for the supersensitivity model, which posits that biological vulnerability of psychiatric disorders results in sensitivity to small amounts of alcohol and drugs, leading to substance use disorders. There is minimal support for the self-medication model, but the accumulation of multiple risk factors related to mental illness, including dysphoria, may increase the risk of substance use disorder. Secondary psychiatric disorder models remain to be convincingly demonstrated. Bidirectional models have not been systematically examined. Further clarification of etiologic factors, including the identification of subtypes of dual diagnosis, may have implications for developing more effective prevention efforts and treatment.
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The substantial discrepancy in the male-to-female ratio between clinic-referred (10 to 1) and community (3 to 1) samples of children with attention deficit hyperactivity disorder (ADHD) suggests that gender differences may be operant in the phenotypic expression of ADHD. In this study the authors systematically examined the impact of gender on the clinical features of ADHD in a group of children referred to a clinic. The study included 140 boys and 140 girls with ADHD and 120 boys and 122 girls without ADHD as comparison subjects. All subjects were systematically assessed with structured diagnostic interviews and neuropsychological batteries for subtypes of ADHD as well as emotional, school, intellectual, interpersonal, and family functioning. Girls with ADHD were more likely than boys to have the predominantly inattentive type of ADHD, less likely to have a learning disability, and less likely to manifest problems in school or in their spare time. In addition, girls with ADHD were at less risk for comorbid major depression, conduct disorder, and oppositional defiant disorder than boys with ADHD. A statistically significant gender-by-ADHD interaction was identified for comorbid substance use disorders as well. The lower likelihood for girls to manifest psychiatric, cognitive, and functional impairment than boys could result in gender-based referral bias unfavorable to girls with ADHD.
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Research on attention-deficit/hyperactivity disorder (ADHD), a highly prevalent and controversial condition, has, for the most part, been descriptive and atheoretical. The imperative to discover the genetic and environmental risk factors for ADHD is motivating the search for quantifiable intermediate constructs, termed endophenotypes. In this selective review, we conclude that such endophenotypes should be solidly grounded in the neurosciences. We propose that three such endophenotypes — a specific abnormality in reward-related circuitry that leads to shortened delay gradients, deficits in temporal processing that result in high intrasubject intertrial variability, and deficits in working memory — are most amenable to integrative collaborative approaches that aim to uncover the causes of ADHD.
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A self-report screening scale of adult attention-deficit/hyperactivity disorder (ADHD), the World Health Organization (WHO) Adult ADHD Self-Report Scale (ASRS) was developed in conjunction with revision of the WHO Composite International Diagnostic Interview (CIDI). The current report presents data on concordance of the ASRS and of a short-form ASRS screener with blind clinical diagnoses in a community sample. The ASRS includes 18 questions about frequency of recent DSM-IV Criterion A symptoms of adult ADHD. The ASRS screener consists of six out of these 18 questions that were selected based on stepwise logistic regression to optimize concordance with the clinical classification. ASRS responses were compared to blind clinical ratings of DSM-IV adult ADHD in a sample of 154 respondents who previously participated in the US National Comorbidity Survey Replication (NCS-R), oversampling those who reported childhood ADHD and adult persistence. Each ASRS symptom measure was significantly related to the comparable clinical symptom rating, but varied substantially in concordance (Cohen's kappa in the range 0.16-0.81). Optimal scoring to predict clinical syndrome classifications was to sum unweighted dichotomous responses across all 18 ASRS questions. However, because of the wide variation in symptom-level concordance, the unweighted six-question ASRS screener outperformed the unweighted 18-question ASRS in sensitivity (68.7% v. 56.3%), specificity (99.5% v. 98.3%), total classification accuracy (97.9% v. 96.2%), and kappa (0.76 v. 0.58). Clinical calibration in larger samples might show that a weighted version of the 18-question ASRS outperforms the six-question ASRS screener. Until that time, however, the unweighted screener should be preferred to the full ASRS, both in community surveys and in clinical outreach and case-finding initiatives.
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Patients with attention deficit hyperactivity disorder (ADHD) and a medication history have shown abnormal brain activation in prefrontal and striatal brain regions during cognitive challenge. Previous findings have been confounded, however, by potential long-term effects of stimulant medication exposure and group discrepancies in task performance. The aim of this study was to investigate whether medication-naive adolescents with ADHD would still show abnormal brain activation in prefrontal brain regions during motor response inhibition in a task designed to control for intergroup performance discrepancies. Rapid, event-related functional magnetic resonance imaging was used to compare brain activation in 16 medication-naive ADHD adolescents and 21 IQ-, age-, and sex-matched healthy comparison volunteers during a challenging, idiosyncratically adjusted task that required withholding of a triggered motor response. The design, which manipulated task parameters to force each subject to fail on 50% of trials, ensured that subjects worked at the edge of their own inhibitory performance, thereby controlling for intersubject and intergroup performance discrepancies and furthermore allowing for investigation of differences in brain activation related to inhibition and inhibition failure. Medication-naive adolescents with ADHD showed significantly reduced brain activation in the right inferior prefrontal cortex during successful motor response inhibition and in the precuneus and posterior cingulate gyrus during inhibition failure, both of which correlated with behavioral scores of ADHD. The study shows that abnormal brain activation during inhibitory challenge in ADHD is specific to the disorder, since it persists when medication history and performance discrepancies are excluded.
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Most studies of attention-deficit/hyperactivity disorder (ADHD) have focused on the combined type and emphasized a core problem in response inhibition. It is proposed here that the core problem in the truly inattentive type of ADHD (not simply the subthreshold combined type) is in working memory. It is further proposed that laboratory measures, such as complex-span and dual-task dichotic listening tasks, can detect this. Children with the truly inattentive type of ADHD, rather than being distractible, may instead be easily bored, their problem being more in motivation (underarousal) than in inhibitory control. Much converging evidence points to a primary disturbance in the striatum (a frontal-striatal loop) in the combined type of ADHD. It is proposed here that the primary disturbance in truly inattentive-type ADHD (ADD) is in the cortex (a frontal-parietal loop). Finally, it is posited that these are not two different types of ADHD, but two different disorders with different cognitive and behavioral profiles, different patterns of comorbidities, different responses to medication, and different underlying neurobiologies.
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Despite growing interest in adult attention deficit hyperactivity disorder (ADHD), little is known about its prevalence or correlates. A screen for adult ADHD was included in a probability subsample (N=3,199) of 18-44-year-old respondents in the National Comorbidity Survey Replication, a nationally representative household survey that used a lay-administered diagnostic interview to assess a wide range of DSM-IV disorders. Blinded clinical follow-up interviews of adult ADHD were carried out with 154 respondents, oversampling those with positive screen results. Multiple imputation was used to estimate prevalence and correlates of clinician-assessed adult ADHD. The estimated prevalence of current adult ADHD was 4.4%. Significant correlates included being male, previously married, unemployed, and non-Hispanic white. Adult ADHD was highly comorbid with many other DSM-IV disorders assessed in the survey and was associated with substantial role impairment. The majority of cases were untreated, although many individuals had obtained treatment for other comorbid mental and substance-related disorders. Efforts are needed to increase the detection and treatment of adult ADHD. Research is needed to determine whether effective treatment would reduce the onset, persistence, and severity of disorders that co-occur with adult ADHD.
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The validity of the six-question World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener was assessed in a sample of subscribers to a large health plan in the US. A convenience subsample of 668 subscribers was administered the ASRS Screener twice to assess test-retest reliability and then a third time in conjunction with a clinical interviewer for DSM-IV adult ADHD. The data were weighted to adjust for discrepancies between the sample and the population on socio-demographics and past medical claims. Internal consistency reliability of the continuous ASRS Screener was in the range 0.63-0.72 and test-retest reliability (Pearson correlations) in the range 0.58-0.77. A four-category version The ASRS Screener had strong concordance with clinician diagnoses, with an area under the receiver operating characteristic curve (AUC) of 0.90. The brevity and ability to discriminate DSM-IV cases from non-cases make the six-question ASRS Screener attractive for use both in community epidemiological surveys and in clinical outreach and case-finding initiatives.
Article
Objective: Despite growing interest in adult attention deficit hyperactivity disorder (ADHD), little is known about its prevalence or correlates. Method: A screen for adult ADHD was included in a probability subsample (N=3,199) of 18-44-year-old respondents in the National Comorbidity Survey Replication, a nationally representative household survey that used a lay-administered diagnostic interview to assess a wide range of DSM-IV disorders. Blinded clinical follow-up interviews of adult ADHD were carried out with 154 respondents, oversampling those with positive screen results. Multiple imputation was used to estimate prevalence and correlates of clinician-assessed adult ADHD. Results: The estimated prevalence of current adult ADHD was 4.4%. Significant correlates included being male, previously married, unemployed, and non-Hispanic white. Adult ADHD was highly comorbid with many other DSM-IV disorders assessed in the survey and was associated with substantial role impairment. The majority of cases were untreated, although many individuals had obtained treatment for other comorbid mental and substance-related disorders. Conclusions: Efforts are needed to increase the detection and treatment of adult ADHD. Research is needed to determine whether effective treatment would reduce the onset, persistence, and severity of disorders that co-occur with adult ADHD.
Article
Abstract  The objective of this study was to evaluate the relationship between attention deficit-hyperactivity/impulsivity symptoms and Internet addiction. In total, 535 elementary school students (264 boys, 271 girls; mean age, 11.0 ± 1.0 years) were recruited. The presence or severity of Internet addiction was assessed by the Young's Internet Addiction test. Parents and teachers of the children completed the DuPaul's attention deficit hyperactivity disorder (ADHD) rating scale (ARS; Korean version, K-ARS) and Child Behavior Checklists. Children with the highest and lowest quartiles in K-ARS scores were defined to be in ADHD and non-ADHD groups, respectively. Five children (0.9%) met criteria for a definite Internet addiction and 75 children (14.0%) met criteria for a probable Internet addiction. K-ARS scores had significant positive correlations with Young's Internet Addiction test scores. The Internet addiction group had higher total scores of K-ARS and ADHD-related subcategories in the Child Behavior Checklists than the non-addiction group. The ADHD group had higher Internet addiction scores compared with the non-ADHD group. Therefore, significant associations have been found between the level of ADHD symptoms and the severity of Internet addiction in children. In addition, current findings suggest that the presence of ADHD symptoms, both in inattention and hyperactivity-impulsivity domains, may be one of the important risk factors for Internet addiction.
Article
This study surveyed 277 undergraduate Internet users, a population considered to be high risk for pathological Internet use (PIU), to assess incidence of PIU as well as characteristics of the Internet and of users associated with PIU. Pathological use was determined by responses to 13 questions which assessed evidence that Internet use was causing academic, work or interpersonal problems, distress, tolerance symptoms, and mood-altering use of the Internet. Approximately one-quarter of students (27.2%) reported no symptoms (NO) while 64.7% reported one to three symptoms (Limited Symptoms) and 8.1% reported four or more symptoms (PIU). Based on popular stereotypes as well as previous research, it was predicted that pathological Internet users would more likely be males, technologically sophisticated, use real-time interactive activities such as online games and chat lines, and feel comfortable and competent online. Further, it was hypothesized that pathological users would be more likely to be lonely and to be socially disinhibited online. Partial confirmation of this model was obtained. Pathological users were more likely to be males and to use online games as well as technologically sophisticated sites, but there was no difference in Internet Relay Chat use. Although reported comfort and competence with the Internet was in the expected direction, differences were not significant. Pathological users scored significantly higher on the UCLA Loneliness Scale, and were socially disinhibited online.
Article
To evaluate the predictors of persistence and the timing of remission of attention-deficit hyperactivity disorder (ADHD). Subjects were 6- to 17-year old Caucasian, non-Hispanic boys with and without ADHD. DSM-III-R structured diagnostic interviews and blind raters were used to examine psychiatric diagnoses, cognitive achievement, social, school, and family functioning at a 4-year follow-up assessment. At the 4-year follow-up assessment, 85% of children with ADHD continued to have the disorder and 15% remitted. Of those who remitted, half did so in childhood and the other half in adolescence. Predictors of persistence were familiality of ADHD, psychosocial adversity, and comorbidity with conduct, mood, and anxiety disorders. The findings prospectively confirm that the majority of children with ADHD will continue to express the disorder 4 years later. For a minority of children, ADHD was a transient disorder that remits early in development. In addition, we have shown that persistence of ADHD is predictable. Familiality, adversity, and psychiatric comorbidity may be clinically useful predictors of which children with ADHD are at risk for a persistent disorder.
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Contrary to empirical reports of inhibitory dysfunction in ADHD, parental reports suggest that when playing computer games, the inhibitory abilities of children with ADHD are unimpaired. This small-scale preliminary investigation into this phenomenon looks at inhibition of an ongoing response and activity exhibited by children with ADHD between 6 and 14 years old on two commercially available games, on the Conners's Continuous Performance Test II (CPT II), and on a more game-like version of the same task that incorporates characteristics commonly found in commercially available computer games. The performance of participants with ADHD on commercially available games is equivalent to that of typically developing participants and is significantly better on the more game-like version of the CPT II.
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In this report, we provide an evidence-based overview of attention-deficit/hyperactivity disorder (ADHD), including diagnosis, prevalence, developmental expression of symptoms, persistence, the heterogeneity of functional outcome, impairment in afflicted adults, psychiatric comorbidity, pathophysiology, genetics, psychosocial and biologic risk factors, and neurobiology. Attention-deficit/hyperactivity disorder is an early-onset, highly prevalent neurobehavioral disorder, with genetic, environmental, and biologic etiologies, that persists into adolescence and adulthood in a sizable majority of afflicted children of both sexes. It is characterized by behavioral symptoms of inattention, hyperactivity, and impulsivity across the life cycle and is associated with considerable morbidity and disability. Comorbidity is a distinct clinical feature of both childhood and adult ADHD. Although its etiology remains unclear, emerging evidence documents its strong neurobiologic and genetic underpinnings. Despite the high diagnostic reliability and the robust evidence of the validity of ADHD, there are many underlying issues that remain to be resolved. These include establishing developmentally appropriate diagnostic criteria at older ages, further elaborating the impact of gender on symptom expression, and examining risk and protective factors in relationship to prevention or amelioration of ADHD as well as related functional impairments.
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To: (1) determine the association between Internet addiction and depression, self-reported symptoms of attention deficit and hyperactivity disorder (ADHD), social phobia, and hostility for adolescents; and (2) evaluate the sex differences of association between Internet addiction and the above-mentioned psychiatric symptoms among adolescents. A total of 2114 students (1204 male and 910 female) were recruited for the study. Internet addiction, symptoms of ADHD, depression, social phobia, and hostility were evaluated by the self-report questionnaire. The results demonstrated that adolescents with Internet addiction had higher ADHD symptoms, depression, social phobia, and hostility. Higher ADHD symptoms, depression, and hostility are associated with Internet addiction in male adolescents, and only higher ADHD symptoms and depression are associated with Internet addiction in female students. These results suggest that Internet addiction is associated with symptoms of ADHD and depressive disorders. However, hostility was associated with Internet addiction only in males. Effective evaluation of, and treatment for ADHD and depressive disorders are required for adolescents with Internet addiction. More attention should be paid to male adolescents with high hostility in intervention of Internet addiction.
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During infancy and early childhood, children develop their ability to regulate their own emotions and behavior. This development of self-regulatory mechanisms has been considered to be the crucial link between genetic predisposition, early experience, and later adult functioning in society. This paper brings together the updated empirical findings related to the role of attention and the maturation of brain frontal areas in self-regulation. It reviews viewpoints and evidence of disciplines such as developmental psychology, cognitive neuroscience, social psychology, and neurobiology. It examines the causes of individual differences in self-regulation and the effects of those differences on the social and academic functioning of the individual. The consequences of failure in self-regulation are illustrated by focusing on the attention deficit/hyperactivity disorder (ADHD), including a detailed review of the animal models related to this disorder. Finally, some initial evidence suggesting the possibility of fostering self-regulation through training of attention is presented.
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This study was aimed to evaluate the association between Internet addiction and depressive disorder, social phobia and adult attention-deficit/hyperactivity disorder (ADHD) in a sample of Taiwanese college students; and examine gender differences in the psychiatric comorbidity of Internet addiction in this student population. Two hundred sixteen college students (132 males, 84 females) were recruited. Internet addiction, major depressive disorder, dysthymic disorder, social phobia, and adult ADHD of all participants were diagnosed based on psychiatric diagnostic interview. This study revealed that adult ADHD and depressive disorders were associated with Internet addiction among college students. However, depressive disorders were associated with Internet addiction in the males but not the females. With these results, it seems reasonable to suggest that effective evaluation of, and treatment for, adult ADHD and depressive disorders is required for college students with Internet addiction.
Proposed diagnostic cri-teria and the screening and diagnosing tool of Internet ad-diction in college students. Comprehensive Psychiatry
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Ko CH, Yen JY, Chen SH, et al. Proposed diagnostic cri-teria and the screening and diagnosing tool of Internet ad-diction in college students. Comprehensive Psychiatry. In press.