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BOOK REVIEW Substance and seduction Elisa Guerra Doce Department of Prehistoria, Arqueología
The imperative of integrating empirical and theoretical considerations when developing policy responses to Internet-gaming disorder
Commentary on: Policy responses to problematic video game use: A systematic review of current measures and future possibilities (Király et al., 2018)
This commentary proposes an integrative approach of theoretical and empirical considerations when developing policy responses to Internet-gaming disorder and when evaluating their efficacy. It complements the overview by Király et al. (2018) about preventive and treatment programs by referring to a lack of inclusion of internal factors, such as individual aspects and cognitions, and missing empirical evidence. This commentary claims the integration of current research addressing individual predisposing and maintaining factors in order to evaluate existing programs and to enhance the exchange between actors including policy. This integrative approach has the potential to develop successful preventive strategies, which could be implemented realistically and socially responsible.
Background and Aims
Most people use the Internet in a functional way to achieve certain goals and needs. However, there is an increasing number of people who experience negative consequences like loss of control and distress based on an excessive use of the Internet and its specific online applications. Some approaches postulate similarities with behavioral addictions as well as substance dependencies. They differentiate between a generalized and a specific Internet addiction, such as the pathological use of social networking sites (SIA–SNS). Prior studies particularly identified the use of applications, personal characteristics, and psychopathological symptoms as significant predictors for the development and maintenance of this phenomenon. So far, it remains unclear how psychopathological symptoms like depression and social anxiety interact with individual expectancies of Internet use and capabilities of handling the Internet, summarized as Internet literacy.
Methods
The current study (N = 334) investigated the interaction of these components in a structural equation model.
Results
The results indicate that the effects of depression and social anxiety on SIA–SNS were mediated by Internet use expectancies and self-regulation.
Discussion
Thus, Internet use expectancies seem to be crucial for SIA–SNS, which is in line with prior models.
Conclusions
SNS use may be reinforced by experienced gratification and relief from negative feelings. Individual competences in handling the Internet may be preventive for the development of SIA–SNS.
Abstract
Implicit cognitions may be involved in the development and maintenance of specific Internet use disorders such as problematic social network use (PSNU). In more detail, implicit attitude, attentional biases, approach and avoidance tendencies as well as semantic memory associations are considered relevant in the context of PSNU. This viewpoint article summarizes the available literature on implicit cognitions in PSNU. We systematically reviewed articles of implicit cognitions in PSNU from PubMed, Scopus, Web of Science, and ProQuest databases based on a targeted search strategy and assessed using predefined inclusion and exclusion criteria. The present findings suggest that specific implicit cognitions are important in the context of PSNU and therefore show parallels to other addictive behaviors. However, the empirical evidence is limited to a few studies on this topic. Implicit cognitions in PSNU should be explored in more depth and in the context of other affective and cognitive mechanisms in future work.
Aims: The present theoretical paper introduces the smartphone technology as a challenge for diagnostics in the study of Internet use disorders and reflects on the term “smartphone addiction.”
Methods: Such a reflection is carried out against the background of a literature review and the inclusion of Gaming Disorder in ICD-11.
Results: We believe that it is necessary to divide research on Internet use disorder (IUD) into a mobile and non-mobile IUD branch. This is important because certain applications such as the messenger application WhatsApp have originally been developed for smartphones and enfold their power and attractiveness mainly on mobile devices.
Discussion and conclusions: Going beyond the argumentation for distinguishing between mobile and non-mobile IUD, it is of high relevance for scientists to better describe and understand what persons are actually (over-)using. This is stressed by a number of examples, explicitly targeting not only the diverse contents used in the online world, but also the exact behavior on each platform. Among others, it matters if a person is more of an active producer of content or passive consumer of social media.
Background and aims
Unregulated Internet pornography (IP) use is discussed as a clinically significant disorder. Because of its primarily rewarding nature, IP is a predestinated target for addictive behaviors. However, not every user develops an unregulated usage pattern. In fact, most users tend to use IP recreationally. Impulsivity-related constructs have been identified as promoters of addictive behaviors. It is unclear whether these impulsivity-related constructs are specific for unregulated IP use or also play a role in recreational but frequent behaviors. In this study, we investigated impulsive tendencies (trait impulsivity, delay discounting, and cognitive style), craving toward IP, attitude regarding IP, and coping styles in individuals with recreational–occasional, recreational–frequent, and unregulated IP use.
Methods
A total of 1,498 heterosexual males participated in an online survey. Groups of individuals with recreational–occasional use (n = 333), recreational–frequent use (n = 394), and unregulated use (n = 225) of IP were identified by screening instruments.
Results
Craving and attitude regarding IP as well as delay discounting and cognitive and coping styles differed between groups. Individuals with unregulated use showed the highest scores for craving, attentional impulsivity, delay discounting, and dysfunctional coping, and lowest scores for functional coping and need for cognition. Recreational–frequent users had the most positive attitude toward IP. Motor and non-planning impulsivity did not differ between groups.
Discussion and conclusions
The results indicate that some facets of impulsivity and related factors such as craving and a more negative attitude are specific for unregulated IP users. The results are also consistent with models on specific Internet use disorders and addictive behaviors.
Abstract
Background and aims
Social-networks-use disorder is discussed as a potential further type of disorders due to addictive behaviors. Theoretical models assume cue-induced craving and disadvantageous decision making to be relevant mechanisms. This study investigates if the presentation of social-networks-related cues interferes with decision making under ambiguity.
Methods
Craving was induced with a cue-reactivity paradigm and assessed with a visual analogue scale. Participants (N = 146) played a modified Iowa Gambling Task with social-networks-related cues and neutral cues presented on the advantageous and disadvantageous decks respectively, or vice versa. Symptoms of social-networks-use disorder were measured with a modified version of the short Internet Addiction Test.
Results
Overall, participants chose options with neutral cues more often than those with social-networks-related cues, even if it was disadvantageous. There was a significant interaction between decision-making performance and Iowa Gambling Task condition in predicting symptom severity. The results indicate that choosing decks with social-networks-related cues even if it was disadvantageous is associated with higher tendencies towards a social-networks-use disorder. The interaction with cue-induced craving did not explain further variance.
Discussion and Conclusions
The results highlight the relevance of cue reactivity, decision making, and their interaction as potential mechanisms explaining tendencies towards a social-networks-use disorder. Decision making was influenced by affective responses, which could result in a higher risk of a potential addictive behavior. This is consistent with the findings from addiction research and with theoretical approaches assuming an imbalance between affective and cognitive processes in addictive behaviors.
Abstract
Background and aims
With the inclusion of gaming disorder in the ICD-11, diagnostic criteria were introduced for this relatively new disorder. These criteria may also be applied to other potential specific Internet-use disorders, which may be classified in ICD-11 as other disorders due to addictive behaviors, such as online buying-shopping disorder, online pornography-use disorder, social-networks-use disorder, and online gambling disorder. Due to the heterogeneity in existing instruments, we aimed to develop a consistent and economic measure of major types of (potential) specific Internet-use disorders based on ICD-11 criteria for gaming disorder.
Methods
The new 11-item Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) measures five behavioral addictions with the same set of items by following the principles of WHO’s ASSIST. The ACSID-11 was administered to active Internet users (N = 985) together with an adaptation of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and screeners for mental health. We used Confirmatory Factor Analyses to analyze the factor structure of ACSID-11.
Results
The assumed four-factorial structure was confirmed and was superior to the unidimensional solution. This applied to gaming disorder and to the other specific Internet-use disorders. ACSID-11 scores correlated with IGDT-10 as well as with the measures of psychological distress.
Discussion and Conclusions
The ACSID-11 seems to be suitable for the consistent assessment of (potential) specific Internet-use disorders based on ICD-11 diagnostic criteria for gaming disorder. The ACSID-11 may be a useful and economic instrument for studying various behavioral addictions with the same items and improving comparability.
Abstract
Background and aims
An increasing number of people experience negative consequences from the excessive use of different Internet applications or sites (e.g., Instagram, League of Legends, YouTube). These consequences have been referred to as specific Internet Use Disorders (IUDs). The present study aims to examine the Fear of Missing Out (FoMO) on rewarding experiences with respect to specific Internet activities. FoMO has been found to mediate the link between psychopathology and symptoms of Internet Communication Disorder (ICD). However, the role of FoMO in other IUDs is controversial.
Methods
The current study (N = 7,990) consecutively screened in vocational schools) analyzed the associations between online-specific state-FoMO, general trait-FoMO, mental health, and IUD symptoms in a structural equation model. After testing the model for the entire sample of Internet users, it was analyzed separately for the two main user groups: Social Networking Site (SNS) users and gamers.
Results
The proposed model explained 42.0% of the variance in IUD symptoms in the total sample, 46.8% for SNS users, and 32.8% for gamers. Results suggest that impaired mental health and high trait-FoMO predict IUD symptoms. For both SNS users and gamers, trait-FoMO mediated the link between low mental health and IUD, whereas state-FoMO mediated the link between trait-FoMO and IUD in both user groups.
Discussion
Our results partly support the theoretical model of specific IUDs, highlighting trait-FoMO as a predisposing fear of disconnection related to general mental health. Online-specific FoMO appears to contribute to problematic Internet use mainly because of its link to the general fear of disconnection. Moreover, the described mechanism seems to be comparable for both females and males.
Conclusions
FoMO is a multidimensional construct underlying IUD symptoms related to the use of socially gratifying, but distinct Internet applications. FoMO and psychopathology should be targeted together in prevention and treatment plans of IUDs.
Abstract
Background
Gambling and gaming disorders have been included as “disorders due to addictive behaviors” in the International Classification of Diseases (ICD-11). Other problematic behaviors may be considered as “other specified disorders due to addictive behaviors (6C5Y).”
Methods
Narrative review, experts' opinions.
Results
We suggest the following meta-level criteria for considering potential addictive behaviors as fulfilling the category of “other specified disorders due to addictive behaviors”:
1. Clinical relevance: Empirical evidence from multiple scientific studies demonstrates that the specific potential addictive behavior is clinically relevant and individuals experience negative consequences and functional impairments in daily life due to the problematic and potentially addictive behavior.
2. Theoretical embedding: Current theories and theoretical models belonging to the field of research on addictive behaviors describe and explain most appropriately the candidate phenomenon of a potential addictive behavior.
3. Empirical evidence: Data based on self-reports, clinical interviews, surveys, behavioral experiments, and, if available, biological investigations (neural, physiological, genetic) suggest that psychological (and neurobiological) mechanisms involved in other addictive behaviors are also valid for the candidate phenomenon. Varying degrees of support for problematic forms of pornography use, buying and shopping, and use of social networks are available. These conditions may fit the category of “other specified disorders due to addictive behaviors”.
Conclusion
It is important not to over-pathologize everyday-life behavior while concurrently not trivializing conditions that are of clinical importance and that deserve public health considerations. The proposed meta-level-criteria may help guide both research efforts and clinical practice.