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Background and aims
Behavioral addictions and bipolar disorders have a certain probability of co-occurrence. While the presence of a manic episode has been defined as an exclusion criterion for gambling disorder, no such exclusion has been formulated for Internet addiction.
Methods
A clinical sample of 368 treatment seekers presenting with excessive to addictive Internet use was screened for bipolar spectrum disorders using the Mood Disorder Questionnaire. Psychopathology was assessed by the Symptom Checklist 90R and a clinical interview was administered to screen for comorbid disorders.
Results
Comorbid bipolar disorders were more frequent in patients meeting criteria for Internet addiction (30.9%) than among the excessive users (5.6%). This subgroup showed heightened psychopathological symptoms, including substance use disorders, affective disorders and personality disorders. Further differences were found regarding frequency of Internet use regarding social networking sites and online-pornography.
Discussion
Patients with Internet addiction have a heightened probability for meeting criteria of bipolar disorders. It is not possible to draw conclusions regarding the direction of this association but it is recommended to implement screening for bipolar disorders in patients presenting with Internet addiction.
Conclusion
Similar to gambling disorder, it might prove necessary to subsume bipolar disorders as an exclusion criterion for the future criteria of Internet addiction.
Background and aims
Internet Gaming Disorder (IGD) and other Internet-related disorders (IRDs) have become growing health concerns in our today’s lives. Based on defined diagnostic criteria, IGD has been recognized as a condition for further research in the DSM-5; however, other IRDs have been excluded. Since the release of the DSM-5, representativeness and appropriateness of the nine diagnostic criteria have been debated. Although some first evidence has been published to evaluate these criteria, our knowledge is still limited. Thus, the purpose of this study was to provide data on the clinical validity of the DSM-5 criteria for IGD and other types of IRD. We were also interested in examining the additional diagnostic validity of craving that is currently not being considered in the DSM-5.
Methods
Analyses on a sample of n = 166 treatment seekers for IRDs were performed. The clinician’s diagnosis was used as a main reference for determining the DSM criteria’s diagnostic performance. Secondary criteria (depression and anxiety) were defined as indicators for the construct validity.
Results
The overall diagnostic accuracy ranged between 76.6% for deceiving and 92% for loss of control and craving. Considerable differences occurred in the degree of sensitivity and specificity between the single criteria. No particular differences were found for the applicability of the criteria to other forms of IRDs.
Discussion and conclusions
Our results confirm the validity of the DSM criteria. However, the diagnostic utility of the criterion escaping aversive moods is critically discussed. Considering craving as an additional diagnostic indicator might be recommendable.
Background and aims
Gambling disorder is a significant public health concern. Especially, male minors have been shown to gamble in a problematic way, despite legal prohibitions.
Methods
We examined representative samples of students aged from 12 to 18 years (N = 9,309) in two German federal states to provide prevalence data and clinical description of risk factors for problematic gambling.
Results
We found that about 40% of the adolescents reported engaging in gambling activities within the past 12 months and found prevalence rates of 1.7% and 2.2% for problematic gambling. Especially, use of online gambling and slot machines was found to be related to problematic gambling. Male adolescents with a migration background were of higher risk for problematic gambling and psychopathological symptoms were significantly elevated among that group.
Discussion
The results indicate that participation in gambling activities is common among underaged adolescents and that prevalence of problematic gambling exceeds rates of adults. Similarly, problematic gambling is associated with increased psychopathological strain.
Conclusion
Given that a high proportion of adult gamblers report having started gambling in adolescents, our data emphasize the need for prevention and early intervention strategies for problematic gambling.
Abstract
Objective
According to ICD-11 gaming disorder is currently defined as a behavioral addiction. While our understanding of crucial aspects of this new condition including other subtypes of internet use disorders is growing, less is known about treatment strategies and their effectiveness. Particularly, dimensions of life satisfaction and their meaning for internet use disorders are poorly investigated. The aim of this study was addressing the role of life satisfaction dimensions in a randomized controlled trial. We examined life satisfaction as an additional treatment outcome and investigated in how far life satisfaction is predictive for symptom reduction and related to personality traits.
Methods
A multicenter randomized controlled trial with three measure points (baseline, post-treatment, 6-month follow-up) was conducted based on N = 143 patients aged 17 and above meeting diagnostic criteria for internet use disorders. A cognitive-behavioral disorder specific intervention was applied in n = 72 and compared to a wait list control (n = 71). Endpoints included symptoms of internet use disorders, psychosocial functioning, and life satisfaction. Personality traits were assessed as moderating factors.
Results
Life satisfaction (η 2 = 0.106) and health satisfaction (η 2 = 0.173) significantly increased in the intervention group with large effect sizes. Decreasing symptoms of internet use disorders at follow-up were predicted by life satisfaction at post-treatment (ß = −0.51) with extraversion (B = 1.606) and openness (B = 2.069) moderating this association.
Conclusion
Life satisfaction yields additional value as a secondary treatment outcome in internet use disorders and can be therapeutically addressed in order to stabilize treatment effects in the long run. Our study indicates that existing treatment strategies might benefit from explicitly addressing and enhancing psychosocial resources in order to prevent relapses in patients.
Abstract
Rationale
As a result of concerns about predominantly online behavioral addictions, an increasing number of systematic reviews and meta-analyses (SRMA) of treatment interventions for internet use disorders (IUD) are being recorded. This review was designed to (a) systematically identify the evidence base of SRMA and to (b) critically appraise the quality of reporting according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Methods
Four databases were searched until August 2022 to systematically identify SRMA. PRISMA indicators were evaluated on a three-level response format to obtain an overall score operationalizing the quality of reporting (score range: 0–84). Additionally, the percentage of adherence to the PRISMA indicators was calculated.
Results
Reporting quality of 23 SRMA, comprising 12 systematic reviews and 11 meta-analyses was evaluated. Quality scores ranged from 25 to 77 (M: 52.91; SD: 17.46). Results of the critical appraisal revealed deviations from the PRISMA indicators, including missing information on (a) registration of a study protocol, (b) statistical synthesis methods (c) evaluation of certainty of evidence, and (d) risk of bias assessment. Eleven (47.83%) of the SRMAs partially adhered, and twelve (52.17%) completely adhered to the PRISMA indicators.
Conclusion
This first critical appraisal on the reporting quality of SRMA on treatment interventions for IUD highlights limitations of the evidence base. Inadequate reporting compromises the practical utility and validity of SRMA and may complicate ongoing efforts of consensus on evidence-based interventions for IUD. Future research should focus on sufficient and transparent reporting of the methodological approach.
