Natural course of behavioral addictions: A 5-year longitudinal study

BACKGROUND: Resolving the theoretical controversy on the labeling of an increasing number of excessive behaviors as behavioral addictions may also be facilitated by more empirical data on these behavioral problems. For instance, an essential issue to the classification of psychiatric disorders is information on their natural course. However, longitudinal research on the chronic vs. episodic nature of behavioral addictions is scarce. The aim of the present study, therefore, was to provide data on prevalence, substance use comorbidity, and five-year trajectories of six excessive behaviors—namely exercising, sexual behavior, shopping, online chatting, video gaming, and eating. METHODS: Analyses were based on the data of the Quinte Longitudinal Study, where a cohort of 4,121 adults from Ontario, Canada was followed for 5 years (2006 to 2011). The response rate was 21.3%, while retention rate was 93.9%. To assess the occurrence of each problem behavior, a single self-diagnostic question asked people whether their over-involvement in the behavior had caused significant problems for them in the past 12 months. To assess the severity of each problem behavior reported, the Behavioral Addiction Measure was administered. A mixed design ANOVA was used to investigate symptom trajectories over time for each problem behavior and whether these symptom trajectories varied as a function of sex. RESULTS: The large majority of people reported having problematic over-involvement for just one of these behaviors and just in a single time period. A main effect of time was found for each problem behavior, indicating a moderately strong decrease in symptom severity across time. The time x sex interaction was insignificant in each model indicating that the decreasing trend is similar for males and females. The data also showed that help seeking was very low in the case of excessive sexual behavior, shopping, online chatting, and video gaming but substantially more prevalent in the case of excessive eating and exercising. CONCLUSIONS: The present results indicate that self-identified excessive exercising, sexual behavior, shopping, online chatting, video gaming, and/or eating tend to be fairly transient for most people. This aspect of the results is inconsistent with conceptualizations of addictions as progressive in nature, unless treated. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-015-0383-3) contains supplementary material, which is available to authorized users

Should we protect people with ADHD from playing? A review on the association between Attention-Deficit/Hyperactivity Disorder and Internet Gaming Disorder.

Introdução: Desde a introdução da Perturbação do Jogo pela Internet (PJI) na 5ª edição do Manual de Diagnóstico e Estatística das Perturbações Mentais (DSM-5), tem-se assistido a um rápido desenvolvimento da literatura sobre este assunto. Vários estudos têm abordado as comorbilidades associadas ao jogo patológico, mas poucos se focam especificamente na Perturbação de Hiperatividade e Défice de Atenção (PHDA). Esta monografia tem como objetivo rever o conhecimento atual sobre a associação entre PHDA e jogo patológico, assim como as lacunas existentes. Métodos: Foi realizada uma pesquisa de artigos em inglês na Pubmed até à data de Setembro de 2019 sobre jogo patológico e PHDA. Literatura adicional sobre o uso excessivo da internet foi também incluída quando o conteúdo sobre jogo era relevante. Foram discutidas as variáveis que influenciam a associação, mecanismos subjacentes e consequências futuras. Resultados: Os estudos publicados desde a DSM-5 revelam que os doentes com PHDA têm um OR de jogo patológico entre 1.27 e 13.51. Na figura 1 encontram-se os fatores que parecem mediar esta associação: impulsividade, hostilidade, desatenção, défice de competências sociais e pobre controlo inibitório. A explicação neurobiológica baseia-se na falta de dopamina caraterística da PHDA e que é suprimida pelo jogo, quando este ativa o sistema de recompensa cerebral dopaminérgico. Como resultado da associação das duas patologias, surge um ciclo vicioso que pode afetar negativamente várias dimensões da vida do doente com PHDA, salientando a importância do controlo do tempo de jogo. Conclusão: A PHDA parece aumentar o risco de jogo patológico quando comparado com a população saudável, no entanto a direccionalidade da associação ainda não é clara devido a limitações metodológicas dos estudos.Introduction: Since Internet Gaming Disorder was included in the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there is a growing body of literature concerning this issue. Most studies have focused generally on the comorbidities linked to pathological gaming, while there have been a few focusing specifically on Attention-Deficit/Hyperactivity Disorder (ADHD). This review aims to review the knowledge concerning the association between ADHD and pathological gaming and the existing gaps. Methods: Relevant literature on data included in this review were identified through a search of Pubmed in relation to pathological gaming and ADHD for articles in English until September 2019. Additional literature about internet addiction was included when gaming content was considered relevant. Variables influencing the association, underlying mechanisms and consequences in the future were also discussed. Results: Since DSM-5 included IGD, the OR for pathological gaming in ADHD ranged between 1.27 and 13.51. Figure 1 shows the possible factors mediating this association. The literature proposes impulsivity, hostility, inattention, social skills deficits and poor inhibitory control as mediators, based on ADHD lack of dopamine suppressed by gaming, when it activates brain's dopamine reward system. The association between ADHD symptoms and gaming disorder suggests a vicious cycle that can negatively affect varied life dimensions, raising the importance of controlling time playing of ADHD patients. Conclusions: Attention-Deficit/Hyperactivity Disorder seems to increase the risk of pathological gaming when compared to healthy population, but the directionality remains unclear because of methodological weaknesses in the studies

Preventing harmful Internet use-related addiction problems in Europe: a literature review and policy options

Internet use-related addiction problems are increasingly being recognized on a European scale due to international health organizations considering gaming addiction. In April 2013, the American Psychiatric Association recognized Internet Gaming Disorder in the fifth Diagnostic and Statistical Manual of Mental Disorders, and in April 2018, the World Health Organization included Gaming Disorder in the eleventh International Classification of Diseases. However, findings on these problems within this period are lacking in Europe, and a preventive approach is missing globally. A detailed critical literature review was conducted using PsycINFO and Web of Science in this five-year period. A total of 19 studies were reviewed and problems identified were: generalized Internet addiction and online gaming and gambling addictions across seven European countries (i.e., Spain, Germany, France, Italy, Greece, The Netherlands, and Denmark). The individuals with problematic use were found to be educated adolescents, usually young males with comorbid disorders, and gaming and gambling disorders were implicated in the most severe cases. Cognitive behavioral therapy was the main treatment, sometimes combined with a systemic approach for adolescents. Prevalence, high-risk populations, and factors contributing to these addiction problems are discussed, and a set of policy options are developed for this region. The implications for early detection, diagnosis, treatment, and prevention in Europe are considered

Variations In Video Game Play Habits And Beliefs Over Time

Psychological research about the consequences of playing video games has grown exponentially, correlating to the exponential growth of the video game industry. In the past decade, a major impetus has related to the concept of video game addiction, pathological gaming, or Internet Gaming Disorder. While the presence of this problem is widely accepted and there is growing knowledge about the factors contributing to its development and perpetuation, there is minimal research speaking to intervention. The primary purpose of the present study was to identify a potential pathway to educate members of the gaming community about pathological gaming, with the hope that some of these educated members would recognize their own struggles and seek help. Secondary to that purpose was the intention of identifying factors correlating with awareness of pathological gaming problems and influencing help-seeking behavior among pathological gamers. To pursue these goals, an online survey was made available to avid gamers (N=881) through reddit.com. The survey contained questions about demographic factors, video game play habits and history, pathological gaming, and mental health factors (anxiety, depression, stress, ADHD). Participants completed the survey, then were exposed to a three minute intervention period (wait period, neutral support group, pathological gaming support group, diagnostic awareness lecture) before being asked to again complete the pathological gaming questionnaire. Participants were invited to a one-month follow up to assess changes in pathological gaming awareness and any efforts to engage in help-seeking behavior. Results did not find significant main effects across intervention conditions for awareness of pathological gaming or pursuit of help-seeking behavior. However, nearly 20% of those participating in the one month follow up reported engaging in some form of help-seeking behavior. Tendencies to engage in help seeking behavior were best predicted by self-reported level of pathological gaming and inattentiveness. Thus, there is considerable benefit to increase awareness of pathological gaming and it is important to recognize that ADHD may be a critically impactful factor for increasing the risk of developing pathological gaming

Internet Gaming Disorder in Adolescents With Psychiatric Disorder: Two Case Reports Using a Developmental Framework

Internet gaming disorder (IGD) has been a controversial entity with various opinions about its clinical relevance as an independent mental disorder. This debate has also included discussions about the relationships between problematic gaming, various psychiatric disorders, and personality traits and dimensions. This paper outlines a developmental-theory based model of Internet gaming misuse inspired by the treatment of two adolescent inpatients. The two clinical vignettes illustrate distinct developmental pathways: an “internalized pathway” via the development of social anxiety, emotional and behavioral avoidance; and an “externalized pathway” with a low level of emotional regulation strategies and impulsivity. In both clinical cases, attachment issues played a key role to understand the specific associations of risk and maintaining factors for IGD, and gaming behaviors may be seen as specific forms of maladaptive self-regulatory strategies for these two youths. These clinical observations support the assumption that gaming use problematic in adolescents should be viewed with a developmental approach, including key aspects of emotional development that represent significant targets for therapeutic interventions

Perceived Social Norms in Relation to Internet Gaming and Problems among College Students

To better understand college student’s gaming behavior, the present study used an online survey to investigate how college students’ Internet gaming and problems relate to the perceived descriptive and perceived injunctive social norms they hold. It was hypothesized that college students would report higher perceived descriptive norms for Internet gaming frequency and expenditure than their own self-reported behaviors. It was also hypothesized that both perceived descriptive norms and perceived injunctive norms would have a positive relation with Internet gaming frequency and problems. These hypotheses were partially supported. College students reported higher perceived descriptive norms for Internet gaming frequency and expenditure than their own reported behaviors. Additionally, it was found that gaming frequency was positively associated with perceived injunctive norms and Internet gaming problems. Gender differences were found. These findings provide recommendations for Internet gaming problem intervention

Patterns of Internet Use among Saudi Public Adults: A Cross Sectional Study

Background: Internet has emerged as an integral part of most people’s daily lives globally. Current research indicated that some internet users worldwide experience personal and professional tribulations due to the time they spent online. Objectives: The aim of this study was to examine patterns of internet use among Saudi adults in central region of Kingdom of Saudi Arabia. Methods: A descriptive correlation, cross – sectional research design was utilized to conduct the current study on a convenience sample of 678 adults who were recruited from public areas of highest community assembly points such as shopping malls, parks, outpatient clinics waiting areas high schools, colleges and universities and gave voluntary consent to participate in the study. Participants were asked to complete the two part questionnaire survey including participant’s demographic background and Internet Addiction Test (IAT) Young (1998). An explanation about the purpose and the nature of the study was offered for each individual potential participant. Subjects were assured about the confidentiality of the collected data and that it will be only used by the researcher for the purpose of the current study. Data were analyzed using SPSS version 18. Results: Average daily internet use among participants ranged between 30 minutes to 24 hours per day (M = 7.03, SD+ 4.97). Hundred percent of the participants reported that they have internet access at home while 70.8% have internet access at work and 61.7% of the participants had mobile internet access all time. More than 50% of the participants reported that they often lose sleep due to late-night log-ins or found themselves saying “just a few more minutes” when on-line. Internet use among Saudi participants included in the current study didn’t negatively impact their grades or school works because of the amount of time they spend on-line (less than 25% of the study participants). Majority of the participants didn’t try to hide how long they’ve been on-line (more than 75%), and more than 50% of the participants didn’t use the internet to form new relationships with fellow on-line users. Conclusion: Although the identified percentage of Saudi adult participants fitting to the category of internet addiction is very low but still the results show that major percentage of participants had occasional problems which can be considered as a bridge to internet addiction. Accordingly there is a need to gain insight into the problem and develop and expand awareness about the harmful consequences of maladaptive internet use through interactive programs and mass media. Keywords: internet addiction, pathological internet use, problematic internet use, maladaptive internet us

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

This Special Issue presents some of the main emerging research on technological topics of health and education approaches to Internet use-related problems, before and during the beginning of coronavirus disease 2019 (COVID-19). The objective is to provide an overview to facilitate a comprehensive and practical approach to these new trends to promote research, interventions, education, and prevention. It contains 40 papers, four reviews and thirty-five empirical papers and an editorial introducing everything in a rapid review format. Overall, the empirical ones are of a relational type, associating specific behavioral addictive problems with individual factors, and a few with contextual factors, generally in adult populations. Many have adapted scales to measure these problems, and a few cover experiments and mixed methods studies. The reviews tend to be about the concepts and measures of these problems, intervention options, and prevention. In summary, it seems that these are a global culture trend impacting health and educational domains. Internet use-related addiction problems have emerged in almost all societies, and strategies to cope with them are under development to offer solutions to these contemporary challenges, especially during the pandemic situation that has highlighted the global health problems that we have, and how to holistically tackle them