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Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective

Commentary on: A weak scientific basis for gaming disorder: Let us err on the side of caution (van Rooij et al., 2018)

Journal of Behavioral Addictions
Authors:
Hans-Jürgen Rumpf
,
Sophia Achab
,
Joël Billieux
,
Henrietta Bowden-Jones
,
Natacha Carragher
,
Zsolt Demetrovics
,
Susumu Higuchi
,
Daniel L. King
,
Karl Mann
,
Marc Potenza
,
John B. Saunders
,
Max Abbott
,
Atul Ambekar
,
Osman Tolga Aricak
,
Sawitri Assanangkornchai
,
Norharlina Bahar
,
Guilherme Borges
,
Matthias Brand
,
Elda Mei-Lo Chan
,
Thomas Chung
,
Jeff Derevensky
,
Ahmad El Kashef
,
Michael Farrell
,
Naomi A. Fineberg
,
Claudia Gandin
,
Douglas A. Gentile
,
Mark D. Griffiths
,
Anna E. Goudriaan
,
Marie Grall-Bronnec
,
Wei Hao
,
David C. Hodgins
,
Patrick Ip
,
Orsolya Király
,
Hae Kook Lee
,
Daria Kuss
,
Jeroen S. Lemmens
,
Jiang Long
,
Olatz Lopez-Fernandez
,
Satoko Mihara
,
Nancy M. Petry
,
Halley M. Pontes
,
Afarin Rahimi-Movaghar
,
Florian Rehbein
,
Jürgen Rehm
,
Emanuele Scafato
,
Manoi Sharma
,
Daniel Spritzer
,
Dan J. Stein
,
Philip Tam
,
Aviv Weinstein
,
Hans-Ulrich Wittchen
,
Klaus Wölfling
,
Daniele Zullino
, and
Vladimir Poznyak

that are more readily reimbursed. Of concern, the recent statement opposed to GD by a vocal minority affiliated with the Society for Media Psychology and Technology, Division 46 of the American Psychological Association ( 2018 ) may serve as a

Open access
Journal of Behavioral Addictions
Authors:
Euihyeon Na
,
Inyoung Choi
,
Taek-Ho Lee
,
Hyeseon Lee
,
Mi Jung Rho
,
Hyun Cho
,
Dong Jin Jung
, and
Dai-Jin Kim

Background and aims

Although Internet gaming disorder (IGD) has been investigated in detail, minimal research has been conducted regarding the influence of different game genres on IGD. The aim of this study is to compare the characteristics of members of game genre-specific groups with IGD and to identify factors associated with IGD status in each group in a large sample of adults.

Methods

Internet games were categorized into four genres: real-time strategy games, massive multiplayer online role-playing games (MMORPG), sport games, and first-person shooter (FPS) games. Participants (n = 2,923) who usually played one of these games completed an anonymous online survey that collected sociodemographic, game usage pattern, and psychopathological assessment data.

Results

MMORPG and FPS game players more frequently met the criteria for IGD than participants in the other two groups. Differences between the IGD-suspected gamers within the genre-specific groups were observed for a few items, such as average game-playing time and the subscales of the behavioral activation system; however, the factors that contributed to the development of IGD within each game genre-specific group were found to be considerably different.

Discussion and conclusions

The findings of this study suggest that IGD is a stable psychiatric diagnosis encompassing users of a broad range of game genres. In addition, the development of strategies for the prevention of and early intervention on individuals at high risk for developing IGD may require consideration of the distinct characteristics identified as effective predictors of IGD in users of each game genre.

Open access

Background and aims

This large-scale study aimed to test (a) associations of problematic Internet use (PIU) and sleep disturbance with suicidal ideation and suicide attempts among Chinese adolescents and (b) whether sleep disturbance mediates the association between PIU and suicidal behavior.

Methods

Data were drawn from the 2017 National School-based Chinese Adolescents Health Survey. A total of 20,895 students’ questionnaires were qualified for analysis. The Young’s Internet Addiction Test was used to assess PIU, and level of sleep disturbance was measured by the Pittsburgh Sleep Quality Index. Multilevel logistic regression models and path models were utilized in analyses.

Results

Of the total sample, 2,864 (13.7%) reported having suicidal ideation, and 537 (2.6%) reported having suicide attempts. After adjusting for control variables and sleep disturbance, PIU was associated with an increased risk of suicidal ideation (AOR = 1.04, 95% CI = 1.03−1.04) and suicide attempts (AOR = 1.03, 95% CI = 1.02−1.04). Findings of the path models showed that the standardized indirect effects of PIU on suicidal ideation (standardized β estimate = 0.092, 95% CI = 0.082−0.102) and on suicide attempts (standardized β estimate = 0.082, 95% CI = 0.068−0.096) through sleep disturbance were significant. Conversely, sleep disturbance significantly mediated the association of suicidal behavior on PIU.

Discussion and conclusions

There may be a complex transactional association between PIU, sleep disturbance, and suicidal behavior. The estimates of the mediator role of sleep disturbance provide evidence for the current understanding of the mechanism of the association between PIU and suicidal behavior. Possible concomitant treatment services for PIU, sleep disturbance, and suicidal behavior were recommended.

Open access

Background and aims

Despite indications that the dark triad of personality might be associated with Internet-use disorder (IUD), research about these associations is lacking.

Methods

Two studies were performed to grasp the links between these variables. In the first study, a sample consisting of N = 468 participants (n = 130 males) filled in the Short Dark Triad Questionnaire to assess scores in the dark triad of personality and the short Internet Addiction Test to assess tendencies toward unspecified IUD. In the second study, another independent sample of N = 472 participants (n = 143 males) filled in the same questionnaires plus items about specific forms of IUD.

Results

Traits Machiavellianism and psychopathy were positively linked to tendencies toward unspecified IUD in both samples and males and females. Regarding the associations between tendencies toward specific IUDs and the dark triad of personality, no significant associations were found in males (at least not passing correction procedures for multiple testing). In females, trait Machiavellianism/psychopathy and tendencies toward Internet-shopping disorder, trait psychopathy, and tendencies toward Internet-pornography-use disorder as well as trait Machiavellianism and tendencies toward Internet-communication disorder were significantly positively correlated [at least one of the (sub)scales assessing the respective specific IUD was significantly associated with the respective dark triad trait even after correction procedures for multiple testing]. No robust pattern of associations between trait narcissism and unspecified/specific forms of IUD could be observed across (sub)samples.

Discussion and conclusions

These results indicate positive associations of the traits Machiavellianism and psychopathy (on a subclinical level) with tendencies toward IUD, especially unspecified IUD. The associations with tendencies toward specific forms of IUD seem more complex with differential personality correlates for each specific IUD. These associations need to be replicated.

Open access
Journal of Behavioral Addictions
Authors:
Diego Cuppone
,
Luis J. Gómez Pérez
,
Stefano Cardullo
,
Nicola Cellini
,
Michela Sarlo
,
Silvia Soldatesca
,
Sonia Chindamo
,
Graziella Madeo
, and
Luigi Gallimberti

Abstract

Background

Several behaviors, besides consumption of psychoactive substances, produce short-term reward that may lead to persistent aberrant behavior despite adverse consequences. Growing evidence suggests that these behaviors warrant consideration as nonsubstance or “behavioral” addictions, such as pathological gambling, internet gaming disorder and internet addiction.

Case presentation

Here, we report two cases of behavioral addictions (BA), compulsive sexual behavior disorder for online porn use and internet gaming disorder. A 57-years-old male referred a loss of control over his online pornography use, started 15 years before, while a 21-years-old male university student reported an excessive online gaming activity undermining his academic productivity and social life. Both patients underwent a high-frequency repetitive transcranial magnetic stimulation (rTMS) protocol over the left dorsolateral prefrontal cortex (l-DLPFC) in a multidisciplinary therapeutic setting. A decrease of addictive symptoms and an improvement of executive control were observed in both cases.

Discussion

Starting from these clinical observations, we provide a systematic review of the literature suggesting that BAs share similar neurobiological mechanisms to those underlying substance use disorders (SUD). Moreover, we discuss whether neurocircuit-based interventions, such as rTMS, might represent a potential effective treatment for BAs.

Open access
Journal of Psychedelic Studies
Authors:
Giordano Novak Rossi
,
Eduardo José Crevelin
,
Gabriela de Oliveira Silveira
,
Maria Eugênia Costa Queiroz
,
Mauricio Yonamine
,
Jaime Eduardo Cecilio Hallak
, and
Rafael Guimarães Dos Santos
Open access
Sleep Spindles & Cortical Up States
Authors:
Róbert Bódizs
,
Ferenc Gombos
,
Péter P. Ujma
,
Sára Szakadát
,
Piroska Sándor
,
Péter Simor
,
Adrián Pótári
,
Boris’ Nikolai Konrad
,
Lisa Genzel
,
Axel Steiger
,
Martin Dresler
, and
Ilona Kovács

Females and males differ in several features of their spindle oscillations, as well as in the hemispheric lateralization of their neurocognitive processes. In addition, the hemispheric lateralization of cognitive functions was shown to vary in an age-dependent manner. In spite of the above knowledge, data on the hemispheric lateralization of these oscillatory phenomena are scarce and no sex differences or age effects in the hemispheric lateralization of sleep spindles were reported. Here, we aim to fill this gap by the description of the hemispheric lateralization of sleep spindles in healthy human subjects. Data sets from three research groups were unified (N = 251, age range: 4−69 years, 122 females) in this retrospective multicenter study. The amplitude, density, and duration of slow (frontally dominant) and fast (centroparietally dominant) spindles were analyzed using the individual adjustment method. Hemispheric lateralization was quantified by the (L − R)/mean (L, R) index. Orbitofronto-temporo-occipital and parietal fast sleep spindle measures are left lateralized, while prefrontal spindle amplitude is characterized by right hemispheric dominance. Left lateralization of fast spindle density and duration in the temporal and orbitofrontal regions, respectively, increases as a function of age in males, but not in females. In turn, females are characterized by higher left hemispheric dominance in occipitally measured fast spindle durations as compared with males. Sleep spindles are asymmetrically distributed over the two hemispheres. This phenomenon is sexually dimorphic and region-specific perhaps indexing sex differences in neurocognitive architectures.

Open access

Sleep-disordered breathing (SDB) is a prevalent sleep disorder among young children and is associated with daytime impairments, such as behavioral dysregulation, affective symptoms, and reduced cognitive performance. Microstructural changes of non-rapid eye movement sleep, particularly the reduction of slow frequency oscillations during slow-wave sleep (SWS) might be associated with impaired learning among children with SDB. In this study, we investigated the associations between learning capacity, overnight memory retention, and post-learning, spectral power density of SWS within a clinical sample of children (n = 27) with SDB. Participants performed a declarative (the “War of the Ghosts”) and a non-declarative (the “Alternating Serial Reaction Time”) memory task at night, before their clinical (nighttime polysomnographic) evaluation. Memory retention was assessed in the morning. Overnight changes in performance in the declarative and non-declarative task were not related to relative spectral power measures of SWS. Nevertheless, declarative learning capacity was positively correlated with relative delta (1.25–4 Hz) and negatively with relative theta (4.25–8 Hz) power. Although statistical learning was not associated with spectral power, general skill learning was positively associated with delta and negatively associated with theta power. Associations in case of declarative learning remained significant beyond the influence of age; however, in case of general skill learning the associations with delta and theta power were explained by age. These findings indicate that among children with SDB, oscillations within the delta and theta band during SWS are associated with declarative learning capacity, but are independent from non-declarative, statistical learning.

Open access

Abstract

Background and Aims

Internet Gaming Disorder, a subtype of Internet Addiction, is now classified in Section 3 of the DSM-5. Cognitive behavioral therapy (CBT) has been suggested in treating Internet addiction as this modality has been shown to be an effective treatment for similar impulse control disorders. Given the daily and necessary use of the Internet and technology in general compared to other compulsive syndromes, a specialized form of CBT has been developed called Cognitive-Behavioral Therapy for Internet Addiction (CBT-IA). CBT-IA is a comprehensive three phase approach that includes behavior modification to control compulsive Internet use, cognitive restructuring to identify, challenge, and modify cognitive distortions that lead to addictive use, and harm reduction techniques to address and treat co-morbid issues associated with the disorder.

Methods

As the first model of its kind, this study examines 128 clients to measure treatment outcomes using CBT-IA. Clients were evaluated using the Internet Addiction Test (IAT) to classify subjects and were administered twelve weekly sessions of CBT-IA. Treatment outcomes were measured at the end of the twelve weeks, one-month, three months and at six month post-treatment.

Results

Results showed that over 95% of clients were able to manage symptoms at the end of the twelve weeks and 78% sustained recovery six months following treatment.

Discussion and Conclusions

Results found that CBT-IA was effective at ameliorating symptoms associated with Internet addiction after twelve weekly sessions and consistently over one-month, three months, and six months after therapy. Further research implications such as investigating long-term outcome effects of the model with larger client populations and treatment differences among the subtypes of Internet addiction or with other cultural populations using CBT-IA are discussed.

Open access

A sikeres idősödés és a róla alkotott különböző elképzelések gyakran képezik kutatások alapját. Az utóbbi évtizedekben a kritériumok megalkotásától eljutottunk addig, hogy ma már folyamatában vizsgáljuk és írjuk le a sikeres öregedést. A kutatások nagyobb része azonban még mindig azon veszteségekre koncentrál, melyek az időskorban szükségszerűen megszaporodnak. Több vizsgálati eredmény is megerősítette ugyanakkor, hogy az elkerülhetetlen veszteségek ellenére az idős emberek nagyobb része szubjektív jóllétről számol be. A sikeres idősödést leíró folyamat egyik vezető modellje, a Baltes és Baltes által megalkotott, Szelekció–Optimalizáció–Kompenzáció (SOC) -elmélet. Baltes és munkatársai az elsők között voltak, akik a sikeres idősödést folyamatában írták le, és nem pusztán a végpontok meghatározásával. Elképzelésük szerint az idősödés egyfajta változékony egyensúly a kor veszteségei és nyereségei között. A szelekció során olyan célokat választunk ki, melyek fontosak számunkra. Az optimalizáció folyamata révén irányítjuk és megszerezzük a szükséges erőforrásokat, pl. új képességek kifejlesztésével vagy egyéb útvonalak találásával, mely a célok sikeres elérését alapozza meg. Amikor az erőforrások elvesznek, mennyiségük lecsökken (mint időskorban), kompenzációs stratégiák válnak szükségessé a célok eléréséhez. Ilyen kompenzáció például a különféle segédeszközök, mint hallókészülék, kerekesszék alkalmazása. A SOC-modell áttekintést ad arról a folyamatról, ahogy az idős emberek nemcsak szembenéznek a veszteségekkel, hanem aktívan megküzdenek a korral megjelenő sokféle kihívással, és sikerrel veszik az akadályokat. Mindezen tényezők miatt a SOC-modell kifejezetten alkalmas a sikeres idősödés magyarázatára.

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