Clinical psychology of Internet addiction: a review of its conceptualization, prevalence, neuronal processes, and implications for treatment

Research into Internet addiction (IA) has grown rapidly over the last decade. The topic has generated a great deal of debate, particularly in relation to how IA can be defined conceptually as well as the many methodological limitations. The present review aims to further elaborate and clarify issues that are relevant to IA research in a number of areas including: definition and characterization, incidence and prevalence rates, associated neuronal processes, and implications for treatment, prevention, and patient-specific considerations. It is concluded that there is no consensual definition for IA. Prevalence rates among nationally representative samples across several countries vary greatly (from 1% to 18.7%), most likely reflecting the lack of methodological consistency and conceptual rigor of the studies. The overlaps between IA and other more traditional substance-based addictions and the possible neural substrates implicated in IA are also highlighted. In terms of treatment and prevention, both psychological and pharmacological treatments are examined in light of existing evidence alongside particular aspects inherent to the patient perspective. Based on the evidence analyzed, it is concluded that IA may pose a serious health hazard to a minority of people

Nomofobia na população portuguesa em contexto pandémico: estudo comparativo antes e durante a pandemia COVID-19

Background and Aim: Nomophobia (no mobile phone) is defined as a digital era phobia characterized by an excessive fear of not being able to use the cell phone. In the COVID-19 pandemic context, there was an intensification of information and communication technology. The current study aimed to explore differences in nomophobia levels during the COVID-19 pandemic and those evidenced before the pandemic situation. Additionally, we sought to analyze the relationship between nomophobia and variables such as the frequency of use of screens for professional purposes, the use of cell phone management, and to what extent the pandemic made screen use a recurrent practice. We hypothesize that the fact that most of the daily activities took place at home (e.g., teleworking, online classes), there is a global decrease of nomophobia levels. Methods: Cross-sectional study. The sample comprised 288 participants from the general population in a pandemic situation and 500 participants who took part in a survey conducted before the pandemic. All participants completed online the European Portuguese version of the Nomophobia Questionnaire. Results: The nomophobia levels observed during the pandemic situation were lower compared to the pre-pandemic period. There were no statistically significant differences in nomophobia levels by sex, marital status, or recurrent use of the screen. Nomophobia was not associated with age, use of screens for professional purposes, or mobile phone management. Conclusions: Given that most activities occurred at home (e.g., teleworking, online classes), the nomophobia levels during the Covid-19 pandemic were lower. This seems to be related to the global decrease of the fear of not being able to communicate through the smartphone, losing connectivity, not being able to access information and the fear of not having a Wi-Fi signal or running out of battery.Contexto e Objetivo: A nomofobia (no mobile phone) é definida como uma fobia da era digital que se traduz num medo excessivo de ficar impedido de usar o telemóvel. No contexto da pandemia COVID-19, observou-se a intensificação do uso das tecnologias de informação e comunicação. Este estudo pretendeu explorar a existência de diferenças nos níveis de nomofobia experienciados durante a pandemia, comparando-os com os evidenciados antes da pandemia. Adicionalmente, procurou-se analisar a relação entre a nomofobia e variáveis como a frequência do uso dos ecrãs na atividade profissional, o recurso ao gerenciador do telemóvel e em que medida a pandemia tornou o uso do ecrã uma prática recorrente. Hipotetiza-se que, em virtude da maioria das atividades ocorrer no domicílio (teletrabalho, aulas online), se observe uma diminuição global da nomofobia. Métodos: Estudo de desenho transversal. Participaram 288 indivíduos da população geral em situação de pandemia e 500 indivíduos de uma amostra recolhida previamente à pandemia. Todos os participantes preencheram online o European Portuguese Version of the Nomophobia Questionnaire. Resultados: Os níveis de nomofobia observados durante a pandemia foram mais reduzidos comparativamente aos do período pré-pandemia. Não se observaram diferenças estatisticamente significativas nos níveis de nomofobia em função do sexo, estado civil ou prática recorrente do uso do ecrã. A nomofobia não se mostrou associada à idade, uso dos ecrãs para efeitos profissionais ou recurso ao gerenciador do telemóvel. Conclusões: Em virtude da maioria das atividades ocorrerem em casa (teletrabalho, aulas online), os níveis de nomofobia observados em situação de pandemia foram mais reduzidos. Estes parecem estar relacionados com a diminuição global do medo de não poder comunicar através do telemóvel, perder conectividade, não poder aceder à informação e recear não ter sinal Wi-Fi ou ficar sem bateria

The relationship between personality traits, psychopathological symptoms, and problematic internet use: a complex mediation model

Background: There are many empirical studies that demonstrate the associations between problematic internet use, psychopathological symptoms, and personality traits. However, complex models are scarce. Objective: The aim of this study was to build and test a mediation model based on problematic internet use, psychopathological symptoms, and personality traits. Methods: Data were collected from a medical addiction center (43 internet addicts) and internet cafés (222 customers) in Beijing (Mean age = 22.45 years, SD = 4.96; 90.2% males). Path analysis was applied to test the mediation models using structural equation modelling. Results: Based on the preliminary analyses (correlations and linear regression), two different models were built. In the first model, low conscientiousness and depression had a direct significant influence on problematic internet use. The indirect effect of conscientiousness – via depression – was non-significant. Emotional stability only affected problematic internet use indirectly, via depressive symptoms. In the second model, low conscientiousness also had a direct influence on problematic internet use, while the indirect path via the Global Severity Index was again non-significant. Emotional stability impacted problematic internet use indirectly via the Global Severity Index, while it had no direct effect on it, as in the first model. Conclusion: Personality traits (i.e., conscientiousness as a protective factor and neuroticism as a risk factor) play a significant role in problematic internet use, both directly and indirectly (via distress level)

The relationship between personality traits, psychopathological symptoms, and problematic internet use: a complex mediation model

Background: There are many empirical studies that demonstrate the associations between problematic internet use, psychopathological symptoms, and personality traits. However, complex models are scarce. Objective: The aim of this study was to build and test a mediation model based on problematic internet use, psychopathological symptoms, and personality traits. Methods: Data were collected from a medical addiction center (43 internet addicts) and internet cafés (222 customers) in Beijing (Mean age = 22.45 years, SD = 4.96; 90.2% males). Path analysis was applied to test the mediation models using structural equation modelling. Results: Based on the preliminary analyses (correlations and linear regression), two different models were built. In the first model, low conscientiousness and depression had a direct significant influence on problematic internet use. The indirect effect of conscientiousness – via depression – was non-significant. Emotional stability only affected problematic internet use indirectly, via depressive symptoms. In the second model, low conscientiousness also had a direct influence on problematic internet use, while the indirect path via the Global Severity Index was again non-significant. Emotional stability impacted problematic internet use indirectly via the Global Severity Index, while it had no direct effect on it, as in the first model. Conclusion: Personality traits (i.e., conscientiousness as a protective factor and neuroticism as a risk factor) play a significant role in problematic internet use, both directly and indirectly (via distress level)

Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) model

AbstractWithin the last two decades, many studies have addressed the clinical phenomenon of Internet-use disorders, with a particular focus on Internet-gaming disorder. Based on previous theoretical considerations and empirical findings, we suggest an Interaction of Person-Affect-Cognition-Execution (I-PACE) model of specific Internet-use disorders. The I-PACE model is a theoretical framework for the processes underlying the development and maintenance of an addictive use of certain Internet applications or sites promoting gaming, gambling, pornography viewing, shopping, or communication. The model is composed as a process model. Specific Internet-use disorders are considered to be the consequence of interactions between predisposing factors, such as neurobiological and psychological constitutions, moderators, such as coping styles and Internet-related cognitive biases, and mediators, such as affective and cognitive responses to situational triggers in combination with reduced executive functioning. Conditioning processes may strengthen these associations within an addiction process. Although the hypotheses regarding the mechanisms underlying the development and maintenance of specific Internet-use disorders, summarized in the I-PACE model, must be further tested empirically, implications for treatment interventions are suggested

Fear of Missing Out and Collegiate Alcohol Use: An Examination of Relationship and Direction

Collegiate alcohol abuse is an ongoing problem in the United States (Core Institute, 2014). While there have been numerous investigations into this concern, the precise nature of what motivates alcohol misuse in this population still contains areas of uncertainty. One such area could be the newly identified phenomenon known as Fear of Missing Out (FoMO). Research into FoMO demonstrates it as a motivator for individuals to seek socially rewarding experiences (Przybylski et al., 2013); this characteristic indicates it as a potential risk factor for collegiate alcohol abuse. When considering alcohol’s ubiquitous nature as a social facilitator in college campuses, these trait characteristics raise the concern that college students high in FoMO would be at an elevated risk for alcohol abuse. Therefore, the present study sought to examine the relationship between FoMO and collegiate alcohol use. Specifically, this investigation sought to determine if FoMO predicted how likely an individual was to drink, as well as their levels of alcohol craving. Additionally, this experiment sought to replicate initial demographic characteristics of FoMO, as well as assessing its relationship to individual psychological need satisfaction. Results of the present study did not identify a link between FoMO and self-reported drinking likelihood, but did identify FoMO as a predictor of alcohol craving. Interestingly, additional analyses failed to replicate Przybylski et al.’s (2013) finding that males report higher levels of FoMO than females and also failed to link FoMO to overall psychological need satisfaction. These findings represent several areas for continued investigation

Συσχέτιση συμπεριφοράς εξάρτησης από το διαδίκτυο με την αγχώδη και καταθλιπτική συμπτωματολογία και τη συμπτωματολογία ΔΕΠ-Υ σε νέους 17 έως 26 ετών

Σκοπός της παρούσας μελέτης είναι η διερεύνηση της συσχέτισης της συμπεριφοράς εξάρτησης από το διαδίκτυο με την αγχώδη και καταθλιπτική συμπτωματολογία και τη συμπτωματολογία διαταραχής ελλειμματικής προσοχής-υπερκινητικότητας στους νέους ηλικίας από 17 έως 26 ετών που απευθύνονται στο Τμήμα Προβληματικής Χρήσης Διαδικτύου της Μονάδας Απεξάρτησης 18 ΑΝΩ του Ψυχιατρικού Νοσοκομείου Αττικής. Στην έρευνα συμμετείχαν 181 άτομα ηλικίας από 17 έως 26 ετών (Μ.Ο.=21,6, Τ.Α.=2,57). Τα ερωτηματολόγια που χορηγήθηκαν ήταν το Ερωτηματολόγιο Εξάρτησης από το Διαδίκτυο (Internet Addiction Test) και η Ελληνική Κλίμακα για την Προβληματική Χρήση του Διαδικτύου για την εκτίμηση της εξάρτησης από το διαδίκτυο (Greek Problematic Internet Use Scale), η Αναθεωρημένη Κλίμακα 90 Συμπτωμάτων (Symptom Checklist-90-R), για την αξιολόγηση της αγχώδους συμπτωματολογίας, η Κλίμακας του Beck II για τη μέτρηση της καταθλιπτικής συμπτωματολογίας και το Διαγνωστικό Εργαλείο για την Διαταραχή Ελλειμματικής Προσοχής-Υπερκινητικότητας στους Ενήλικες (Instrumente zur Diagnose der Adulten ADHS). Από την ανάλυση των ερευνητικών δεδομένων προέκυψε στατιστικά σημαντική μέτρια θετική συσχέτιση μεταξύ της εξάρτησης από το διαδίκτυο και της έντασης των συμπτωμάτων της διαταραχής ελλειμματικής προσοχής και του άγχους και θετική ασθενής με τα συμπτώματα της κατάθλιψης. Παρατηρήθηκαν διαφορές στην ένταση των συμπτωμάτων μεταξύ των κανονικών και παθολογικών χρηστών, με τους παθολογικούς χρήστες να εμφανίζουν εντονότερα συμπτώματα άγχους, κατάθλιψης και ελλειμματικής προσοχής-υπερκινητικότητας. Δεν παρατηρήθηκε στατιστικά σημαντική συσχέτιση μεταξύ της εξάρτησης και της ηλικίας, του φύλου, του ακαδημαϊκού επιπέδου, των ετών χρήσης του διαδικτύου και της εφαρμογής κατάχρησης. Τέλος, οι εβδομαδιαίες ώρες χρήσης φάνηκε να σχετίζονται με την ένταση των συμπτωμάτων εθισμού, με τους χρήστες που αφιερώνουν περισσότερες ώρες στο διαδίκτυο ανά εβδομάδα να εμφανίζονται και περισσότερο εθισμένοι. Συμπερασματικά, διαφαίνεται ότι η ένταση των συμπτωμάτων εξάρτησης σχετίζεται με την ένταση των συμπτωμάτων των υπόλοιπων εξεταζόμενων διαταραχών και οι ώρες χρήσης του διαδικτύου επηρεάζουν το βαθμό εξάρτησης από το διαδίκτυο.The purpose of the present study was to investigate the relationship between internet addiction and anxiety symptomatology, depressive symptomatology and symptoms of Attention Deficit Hyperactivity Disorder of the user. Participants were 181 internet users aged between 17 and 26 years (Mean=21.6, SD=2.6) who approached the Department for Problematic Use of the Internet, Addiction Unit “18ANO” in the Psychiatric Hospital Of Attica. The Internet Addiction Test (IAT) and the Greek Problematic Internet Use Scale (GPIUS) were used for the assessment of internet addiction, the Symptom Checklist-90-R (SCL-90-R) was administered for the evaluation of anxiety, the Beck II Depression Inventory for depressive symptomatology and the Instrumente zur Diagnose der Adulten ADHS for Attention Deficit Hyperactivity Disorder. The analysis of the survey data showed moderate positive statistically significant association between internet addiction and anxiety symptomatology and Attention Deficit Hyperactivity Disorder, and mild between internet addiction and depressive symptomatology. Statistically significant differences were observed between participants with normal use of the internet and users with pathological internet use, with pathological users presenting more intense symptoms of anxiety, depression and ADHD. There was no statistically significant association between internet addiction and age, gender, educational level, years of internet use and application of misuse. Finally, the number of hours of internet use per week correlated with severity of internet addiction, with users who spent more time online showing increased symptomatology of internet addiction. To conclude, severity of internet addiction correlates with severity of anxiety and depressive symptomatology as well as ADHD and internet addiction is affected by the amount of time spent online

Perfil de población de riesgo de Trastorno Limítrofe de Personalidad en Uruguay. Cuando lo inestable se comporta como estable

El trastorno limítrofe de la personalidad es altamente prevalente e influye en el funcionamiento social del individuo, definido por un patrón de inestabilidad emocional, distorsión en la autoimagen y en las relaciones sociales, sentimientos de vacío y una alta impulsividad, que conlleva a conductas auto-destructivas (López-Ibor et al., 2002). El diseño de investigación es transeccional correlacional-causal (Hernández Sampieri et al., 2010), realizando un muestreo representativo nacional de residentes en Uruguay mayores de edad, de 1961 sujetos. Se utilizan los siguientes instrumentos: cuestionario sociodemográfico ad-hoc, INSE (CINVE, 2012), SA-45 (Sandín et al., 2008), NEO-FFI (Costa & McCrae, 2008), ZKPQ-50-CC (Póo et al., 2013) y TCI-140 (C. R. Cloninger et al., 1994). Se utiliza el TCI-140 para definir la sub-muestra con riesgo de padecer TLP (grupo clínico), y se analiza el perfil de dicho grupo clínico con respecto a las variables: edad, sexo, rasgos de personalidad, lugar de residencia y crianza, nivel socio-económico y síntomas psicopatológicos. Se obtiene una prevalencia de población con riesgo de padecer TLP del 2,2 %. Se exponen solo los resultados con significación estadística. No se halló relación entre el riesgo de TLP y las variables sexo, edad, lugar de crianza y lugar de residencia. En el grupo clínico se observó un menor nivel socioeconómico, mayores puntuaciones en todas las dimensiones psicopatológicas evaluadas, excepto Síntomas Fóbicos (SA-45), y diferencias en función de género: en mujeres, puntuaciones más altas en Evitación del Daño, Cooperación (TCI-140), Sensitividad Interpersonal y Síntomas Somáticos (SA-45)

The psychometrics of Internet addiction and Internet Gaming Disorder: a step towards measurement unification

Previous research on gaming addiction and Internet addiction (IA) has relied on inconsistent definitions and theoretical frameworks to define these constructs, and has negatively impacted on their assessment. However, the American Psychiatric Association (APA) included 'Internet Gaming Disorder' (IGD) as a tentative disorder in need of further investigation in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Following this preliminary recognition of gaming addiction as potential disorder, unification and standardisation in the field in terms of assessment became possible given that the DSM-5 provided a set of official criteria defining IGD that could be implemented in future research. The research in this thesis substantially contributes to knowledge by (i) systematically reviewing the inconsistencies in the psychometric assessment of IGD and IA, (ii) developing a new potentially unifying standardised psychometric assessment framework for both disorders, and (iii) identifying potential risk factors for IGD and IA. A cross-sectional design was employed across all empirical studies (Study 1, N = 1,003; Study 2, N = 1,060; Study 3, N = 1,105; Study 4, N = 1,100), and the data were analysed using structural equation modelling (i.e., measurement model and latent profile analysis), alongside traditional bivariate statistical modelling. The results indicated that, at a theoretical level, the use of inconsistent assessment tools to investigate IGD and IA has hindered progress in the field. At an empirical level, the Internet Gaming Disorder Test (IGD-20 Test) and the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) were developed to assess IGD, and the Internet Disorder Scale (IDS-15) and the Internet Disorder Scale–Short Form (IDS9-SF) were developed to assess IA based on the IGD conceptualisation provided by the APA in the DSM-5. Overall, the research in this thesis confirms the usefulness of the utilisation of the IGD framework and the psychometric tools developed as a potential avenue to overcome the shortcomings related to previous heterogeneity issues in the assessment of both IGD and IA