Diminished Frontal Theta Activity During Gaming in Young Adults With Internet Gaming Disorder

Cognitive control is essential for flexible, top-down, goal-directed behavior. Individuals with Internet gaming disorder (IGD) are characterized by impaired prefrontal cortex function and cognitive control. This results in an increase in stimulus-driven habitual behavior, particularly related to pathological gaming. In the present study, we investigated the electroencephalographic (EEG) activity in individuals with IGD. Twenty-four individuals with IGD and 35 healthy control (HC) subjects were recruited. We analyzed their EEG activity while the subjects played their favorite game (30-40 min duration). We compared the band power between the two groups. During gaming, the left frontal theta, alpha, and beta band activities were lower in subjects with IGD than in HCs. Moreover, the left frontal theta power negatively correlated with IGD severity. These results indicate that left frontal theta power could be used as a neurophysiological biomarker for the detection of diminished cognitive control patterns in individuals with IGD.ope

Preference for Different Types of Food in Women with Bulimia Nervosa and Binge Eating Disorder

Objective ： Recurrent episodes of binge eating are a cardinal symptom of both bulimia nervosa (BN) and binge eating disorder (BED). However, the type of food consumed during binge eating varies among individuals. We investigated what types of foods were preferred by women with recurrent binge eating episodes, and compared the differences between BN and BED. Methods ： We selected 30 photographs, which included four different types of food to stimulate appetite : 1) desserts/snacks, 2) meat, 3) fruits/vegetables, 4) rice/pasta, and 5) stationary objects as a control condition. Each type was composed of six different items. After six hours of fasting, 39 participants (15 BN, 12 BED, and12 healthy controls) were instructed to score their appetite using Likert scales from 1 to 7 for each photograph. Results ： The BN group reported stronger appetite response to photographs of desserts/snacks, while the BED group and healthy controls reported stronger appetite response to photographs of rice/pasta and meat. Statistical analysis showed that the mean appetite rank to desserts/snacks were significantly higher in BN group compared to BED group and healthy controls (Kruskal- Wallis test ; BN=26.4 ; BED=19.2 ; Control=15.5 ; p=0.047). The differences between groups for other types of food were not significant. Conclusion : Women with BN showed a stronger preference for desserts/snacks, while women with BED demonstrated no difference with the healthy control group. They ranked photographs of meat (beef, pork and poultry) highest. This suggests that there are different trigger foods contributing to binge episodes between bulimia nervosa and binge eating disorder

Identifying Predictors of Non-Suicidal Self-Injuries in Individuals with Eating Disorders

Purpose: Nearly one third of all patients with an eating disorder (ED) present with non-suicidal self-injury (NSSI). Although it is necessary to pay attention clinically to NSSI in ED patients due to an increased suicidal risk, there are limited data on potential predictors of NSSI in ED. We conducted this study to uncover predictors of NSSI in ED. Materials and methods: A total of 1355 ED patients who visited an ED clinic was evaluated through structured interviews by psychiatrists. The demographic and clinical characteristics of ED patients with NSSI (NSSI group) and ED patients without NSSI (non-NSSI group) were analyzed to identify potential predictors of NSSI in ED. Results: Among all ED individuals, 242 (17.9%) reported a history of NSSI. Compared to the non-NSSI group, the NSSI group reported more severe eating symptomatology, more comorbid psychiatric disease, and more suicidal risk. Comorbid alcohol use disorder, depressive disorder, purging behavior, history of suicide attempt, and rumination symptoms were uncovered as predictors of NSSI in ED. Conclusion: The findings of the study are meaningful in that they highlight predictors of NSSI in ED in a large clinical sample. Understanding risk factors of NSSI and offering appropriate interventions are important to preventing suicidality in ED.ope

Two Alcoholisms: Abuse And Dependence: Nosology issues from the Epidemiological studies of Alcoholism in Korea

This article, (1) reviews nosological issues of the distinction between alcohol abuse and alcohol dependence; (2) discusses the Korean epidemiological trends of alcohol abuse and alcohol dependence. Psychiatric epidemiological studies of Korean population that provided clues to the validity and cross-cultural applicability of alcohol abuse and alcohol dependence were reviewed. Alcohol use disorder has been the most common mental disorder in Korea. However, during the last 20 years, the prevalence rates of the two alcohol use disorders have grown in opposite directions. The lifetime prevalence rate of alcohol abuse has fallen from 12.06% to 7.11%, conversely, the lifetime prevalence rate of alcohol dependence has slightly increased from 9.92% to 10.20%. Nosological issues, such as the vulnerability of alcohol abuse to social environments, the hierarchical structure of the DSM-IV and the prevailing Korean concepts of abuse and dependence, were reviewed as factors to be considered in explaining these findings. Alcohol dependence outranks alcohol abuse and is now the main alcohol use disorder in Korea. But, there are still nosological issues that need to be assessed and considered, such as the validity of alcohol dependence in subpopulations and the heterogeneity of the DSM-IV alcohol dependence category.ope

Nurse Staffing and Health Outcomes of Psychiatric Inpatients: A Secondary Analysis of National Health Insurance Claims Data

Purpose: The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. Methods: The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. Results: Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. Conclusion: Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.ope

The neural correlates of priming emotion and reward systems for conflict processing in alcoholics

Emotional dysregulation in alcoholism (ALC) may result from disturbed inhibitory mechanisms. We therefore tested emotion and alcohol cue reactivity and inhibitory processes using negative priming. To test the neural correlates of cue reactivity and negative priming, 26 ALC and 26 age-matched controls underwent functional MRI performing a Stroop color match-to-sample task. In cue reactivity trials, task-irrelevant emotion and alcohol-related pictures were interspersed between color samples and color words. In negative priming trials, pictures primed the semantic content of an alcohol or emotion Stroop word. Behaviorally, both groups showed response facilitation to picture cue trials and response inhibition to primed trials. For cue reactivity to emotion and alcohol pictures, ALC showed midbrain-limbic activation. By contrast, controls activated frontoparietal executive control regions. Greater midbrain-hippocampal activation in ALC correlated with higher amounts of lifetime alcohol consumption and higher anxiety. With negative priming, ALC exhibited frontal cortical but not midbrain-hippocampal activation, similar to the pattern observed in controls. Higher frontal activation to alcohol-priming correlated with less craving and to emotion-priming with fewer depressive symptoms. The findings suggest that neurofunctional systems in ALC can be primed to deal with upcoming emotion- and alcohol-related conflict and can overcome the prepotent midbrain-limbic cue reactivity response.ope

Gray matter differences in the anterior cingulate and orbitofrontal cortex of young adults with Internet gaming disorder: Surface-based morphometry

Background and aims Altered risk/reward decision-making is suggested to predispose individuals with Internet gaming disorder (IGD) to pursue short-term pleasure, despite long-term negative consequences. The anterior cingulate cortex (ACC) and the orbitofrontal cortex (OFC) play important roles in risk/reward decision-making. This study investigated gray matter differences in the ACC and OFC of young adults with and without IGD using surface-based morphometry (SBM). Methods We examined 45 young male adults with IGD and 35 age-matched male controls. We performed region of interest (ROI)-based analyses for cortical thickness and gray matter volume (GMV) in the ACC and OFC. We also conducted whole-brain vertex-wise analysis of cortical thickness to complement the ROI-based analysis. Results IGD subjects had thinner cortices in the right rostral ACC, right lateral OFC, and left pars orbitalis than controls. We also found smaller GMV in the right caudal ACC and left pars orbitalis in IGD subjects. Thinner cortex of the right lateral OFC in IGD subjects correlated with higher cognitive impulsivity. Whole-brain analysis in IGD subjects revealed thinner cortex in the right supplementary motor area, left frontal eye field, superior parietal lobule, and posterior cingulate cortex. Conclusions Individuals with IGD had a thinner cortex and a smaller GMV in the ACC and OFC, which are critical areas for evaluating reward values, error processing, and adjusting behavior. In addition, in behavioral control-related brain regions, including frontoparietal areas, they also had thinner cortices. These gray matter differences may contribute to IGD pathophysiology through altered risk/reward decision-making and diminished behavioral control.ope

Social media use and mental health during the COVID-19 pandemic in young adults: a meta-analysis of 14 cross-sectional studies

Background: Public isolated due to the early quarantine regarding coronavirus disease 2019 (COVID-19) increasingly used more social media platforms. Contradictory claims regarding the effect of social media use on mental health needs to be resolved. The purpose of the study was to summarise the association between the time spent on social media platform during the COVID-19 quarantine and mental health outcomes (i.e., anxiety and depression). Methods: Studies were screened from the PubMed, Embase, and Cochrane Library databases. Regarding eligibility criteria, studies conducted after the declaration of the pandemic, studies that measured mental health symptoms with validated tools, and studies that presented quantitative results were eligible. The studies after retrieval evaluated the association between time spent on social media platform and mental health outcomes (i.e. anxiety and depression). The pooled estimates of retrieved studies were summarised in odds ratios (ORs). Data analyses included a random-effect model and an assessment of inter-study heterogeneity. Quality assessment was conducted by two independent researchers using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). This meta-analysis review was registered in PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ , registration No CRD42021260223, 15 June 2021). Results: Fourteen studies were included. The increase in the time spent using social media platforms were associated with anxiety symptoms in overall studies (pooled OR = 1.55, 95% CI: 1.30-1.85), and the heterogeneity between studies was mild (I2 = 26.77%). Similarly, the increase in social media use time was also associated with depressive symptoms (pooled OR = 1.43, 95% CI: 1.30-1.85), and the heterogeneity between studies was moderate (I2 = 67.16%). For sensitivity analysis, the results of analysis including only the "High quality" studies after quality assessment were similar to those of the overall study with low heterogeneity (anxiety: pooled OR = 1.45, 95% CI: 1.21-1.96, I2 = 0.00%; depression: pooled OR = 1.42, 95% CI: 0.69-2.90, I2 = 0.00%). Conclusions: The analysis demonstrated that the excessive time spent on social media platform was associated with a greater likelihood of having symptoms of anxiety and depression.ope

Altered Functional Connectivity of the Salience Network in Problematic Smartphone Users

Smartphones provide convenience in everyday life. Smartphones, however, can elicit adverse effects when used excessively. The purpose of this study was to examine the underlying neurobiological alterations that arise from problematic smartphone use. We performed resting state seed-based functional connectivity (FC) analysis of 44 problematic smartphone users and 54 healthy controls. This analysis assessed the salience, central executive, default mode, and affective networks. Compared to controls, problematic smartphone users showed enhanced FC within the salience network and between the salience and default mode network. Moreover, we observed decreased FC between the salience and central executive network in problematic smartphone users, compared to controls. These results imply that problematic smartphone use is associated with aberrant FC in key brain networks. Our results suggest that changes in FC of key networks centered around the salience network might be associated with problematic smartphone use.ope

Validation of the Korean version of the eating disorder inventory-2: psychometric properties and cross-cultural comparision

PURPOSE: The purpose of the present study was to examine the validity and reliability of the Korean version of the Eating Disorder Inventory-2 (EDI-2) in Korean patients with eating disorders and healthy controls, and to investigate cultural differences of EDI-2 between a Korean group and a North American standardization sample. MATERIALS AND METHODS: The Korean version of the EDI-2 was prepared after comprehensive clinical assessment of Korean patients with eating disorders (n=327) as well as female undergraduates (n=176). Results were compared between eating disorder subgroups (anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified) and those of a North American standardization sample and healthy controls. RESULTS: The results showed that the Korean EDI-2 had adequate internal consistency (0.77-0.93) and discriminated well between patients with eating disorders and healthy controls on all subscales. Significant differences in EDI-2 subscale scores between the eating disorder groups and the healthy control group were observed; however, there was no discernible difference among the eating disorder subgroups. When compared with a North American standardization sample, the Korean control group showed significantly higher scores for drive for thinness and asceticism. When patient groups were compared, the Korean group showed significantly lower scores for perfectionism. CONCLUSION: As expected, the results accurately reflected psychometric properties of the Korean version of EDI-2 for eating disorder patients in Korea. These findings also suggest that common characteristics for the eating disorder exist as a whole rather than with significant difference between each subgroup. In addition, significant differences between the Korean and the North American groups for both patients and controls also demonstrated specific cultural differences.ope