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  • 1. Aarseth, Espen
    et al.
    Bean, Anthony M.
    Boonen, Huub
    Carras, Michelle Colder
    Coulson, Mark
    Das, Dimitri
    Deleuze, Jory
    Dunkels, Elza
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Edman, Johan
    Ferguson, Christopher J.
    Haagsma, Maria C.
    Bergmark, Karin Helmersson
    Hussain, Zaheer
    Jansz, Jeroen
    Kardefelt-Winther, Daniel
    Kutner, Lawrence
    Markey, Patrick
    Nielsen, Rune Kristian Lundedal
    Prause, Nicole
    Przybylski, Andrew
    Quandt, Thorsten
    Schimmenti, Adriano
    Starcevic, Vladan
    Stutman, Gabrielle
    Van Looy, Jan
    Van Rooij, Antonius J.
    Scholars' open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal2017In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 6, no 3, p. 267-270Article in journal (Other academic)
    Abstract [en]

    Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world.

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  • 2. Aarseth, Espen
    et al.
    Edman, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Helmersson Bergmark, Karin
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    van Rooij, Antonius J.
    Scholars’ open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal2017In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 6, no 3, p. 267-270Article in journal (Other academic)
    Abstract [en]

    Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world.

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  • 3.
    Alimoradi, Zainab
    et al.
    Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Imani, Vida
    Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Griffiths, Mark D
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Social media addiction and sexual dysfunction among Iranian women: The mediating role of intimacy and social support.2019In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 8, no 2, p. 318-325Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Social media use has become increasingly popular among Internet users. Given the widespread use of social media on smartphones, there is an increasing need for research examining the impact of the use of such technologies on sexual relationships and their constructs such as intimacy, satisfaction, and sexual function. However, little is known about the underlying mechanism why social media addiction impacts on sexual distress. This study investigated whether two constructs (intimacy and perceived social support) were mediators in the association of social media addiction and sexual distress among married women.

    METHODS: A prospective study was conducted where all participants (N = 938; mean age = 36.5 years) completed the Bergen Social Media Addiction Scale to assess social media addiction, the Female Sexual Distress Scale - Revised to assess sexual distress, the Unidimensional Relationship Closeness Scale to assess intimacy, and the Multidimensional Scale of Perceived Social Support to assess perceived social support.

    RESULTS: The results showed that social media addiction had direct and indirect (via intimacy and perceived social support) effects on sexual function and sexual distress.

    DISCUSSION AND CONCLUSIONS: The findings of this study facilitate a better understanding of how problematic engaging to social media can affect couples' intimacy, perceived social support, and constructs of sexual function. Consequently, sexual counseling should be considered an essential element for assessing individual behaviors in the context of social media use.

  • 4. Bickl, Andreas M.
    et al.
    Schwarzkopf, Larissa
    Loy, Johanna K.
    Grüne, Bettina
    Braun-Michl, Barbara
    Sleczka, Pawel
    Cisneros Örnberg, Jenny
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany; Eötvös Loránd University, Hungary.
    Changes in gambling behaviour and related problems in clients seeking help in outpatient addiction care: Results from a 36-month follow-up study in Bavaria2021In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 10, no 3, p. 690-700Article in journal (Refereed)
    Abstract [en]

    Background and aim: Evidence on the course of gambling disorder (GD) in clients seeking help from outpatient addiction care facilities is sparse. To close this knowledge gap, this longitudinal one-armed cohort study portrays the development of GD in help-seeking clients over a 3-year timeframe.

    Methods: We investigated changes in severity of GD as well as in gambling frequency and intensity in 145 gamblers in outpatient treatment in Bavaria using generalized estimation equations (GEEs). To investigate potentially different trajectories between study participants with and without migration background (MB), additional analyses were applied with time*migration interaction. All analyses were adjusted for age, gender, education, electronic gambling machine (EGM) gambling, MB, GD, related help sought before and treatment status.

    Results: Within the entire study population, improvements in severity of GD (reduction of 39.2%), gambling intensity (reduction of 75.6%) and gambling frequency (reduction of 77.0%) were observed between baseline and 36 months of follow-up. The declines were most pronounced between baseline and follow-up 1 and stabilized thereafter. Participants with MB improved consistently less than participants without MB.

    Discussion and conclusion: Our study suggests that severity of GD and gambling patterns improve in the context of outpatient treatment. The beneficial results furthermore persist for 36 months after treatment termination. As clients with MB seem to profit less than clients without MB, improvements in outpatient gambling services to the specific needs of this clientele are required.

  • 5. Braun, Barbara
    et al.
    Ludwig, Monika
    Sleczka, Pawel
    Buehringer, Gerhard
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Gamblers seeking treatment: Who does and who doesn't?2014In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 3, no 3, p. 189-198Article in journal (Refereed)
    Abstract [en]

    Background and aims: As only a minority of pathological gamblers (PGr) presents for treatment, further knowledge about help-seeking behavior is required in order to enhance treatment utilization. The present study investigated factors associated with treatment participation in gamblers in Germany. As subclinical pathological gamblers (SPGr, fulfilling one to four DSM-IV-criteria) are target of early intervention due to high risk of transition to pathological gambling, they were subject of special interest. Methods: The study analyzed data from a general population survey (n = 234, SPGr: n = 198, PGr: n = 36) and a treatment study (n = 329, SPGr: n = 22, PGr: n = 307). A two-step weighting procedure was applied to ensure comparability of samples. Investigated factors included socio-demographic variables, gambling behavior, symptoms of pathological gambling and substance use. Results: In PGr, regular employment and non-German nationality were positively associated with being in treatment while gambling on the Internet and gaming machines and fulfilling more DSM-IV-criteria lowered the odds. In SPGr, treatment attendance was negatively associated with married status and alcohol consumption and positively associated with older age, higher stakes, more fulfilled DSM-IV criteria and regular smoking. Conclusions: In accordance to expectations more severe gambling problems and higher problem awareness and/or external pressure might facilitate treatment entry. There are groups with lower chances of being in treatment: women, ethnic minorities, and SPGr. We propose target group specific offers, use of Internet-based methods as possible adaptions and/or extensions of treatment offers that could enhance treatment attendance.

  • 6.
    Bäcklund, Christian
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation.
    Elbe, Pia
    Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation. Department of Radiation Sciences, Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Sweden.
    Gavelin, Hanna M.
    Department of Psychology, Umeå University, Sweden.
    Eriksson Sörman, Daniel
    Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation.
    Ljungberg, Jessica K.
    Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation.
    Gaming motivations and gaming disorder symptoms: A systematic review and meta-analysis2022In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 11, no 3, p. 667-688Article, review/survey (Refereed)
    Abstract [en]

    Background and aims: The present systematic review and meta-analysis aimed to synthesize the available literature on the relationship between gaming motivations and gaming disorder symptoms. Specifically, to (1) explore what gaming motivation questionnaires and classifications are used in studies on gaming disorder symptoms and (2) investigate the relationship between motivational factors and symptoms of gaming disorder. Method: An electronic database search was conducted via EBSCO (MEDLINE and PsycINFO) and the Web of Science Core Collection. All studies using validated measurements on gaming disorder symptoms and gaming motivations and available correlation coefficients of the relationship between gaming disorder and gaming motivations were included. The meta-analyses were conducted using a random-effects model. Results: In total, 49 studies (k = 58 independent sub-samples), including 51,440 participants, out of which 46 studies (k = 55 sub-samples, n = 49,192 participants) provided data for the meta-analysis. The synthesis identified fourteen different gaming motivation instruments, seven unique motivation models, and 26 motivational factors. The meta-analysis showed statistically significant associations between gaming disorder symptoms and 23 out of 26 motivational factors, with the majority of the pooled mean effect sizes ranging from small to moderate. Moreover, large heterogeneity was observed, and the calculated prediction intervals indicated substantial variation in effects across populations and settings. Motivations related to emotional escape were robustly associated with gaming disorder symptoms. Discussion and conclusions: The present meta-analysis reinforces the importance of motivational factors in understanding problematic gaming behavior. The analysis showed significant heterogeneity in most outcomes, warranting further investigation.

  • 7.
    Bäcklund, Christian
    et al.
    Department of Health, Education and Technology, Luleå University of Technology, Laboratorievägen 14, Luleå, Sweden.
    Elbe, Pia
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Department of Health, Education and Technology, Luleå University of Technology, Laboratorievägen 14, Luleå, Sweden.
    Gavelin, Hanna M.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Eriksson Sörman, Daniel
    Department of Health, Education and Technology, Luleå University of Technology, Laboratorievägen 14, Luleå, Sweden.
    Ljungberg, Jessica K.
    Department of Health, Education and Technology, Luleå University of Technology, Laboratorievägen 14, Luleå, Sweden.
    Gaming motivations and gaming disorder symptoms: A systematic review and meta-analysis2022In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 11, no 3, p. 667-688Article, review/survey (Refereed)
    Abstract [en]

    Background and aims: The present systematic review and meta-analysis aimed to synthesize the available literature on the relationship between gaming motivations and gaming disorder symptoms. Specifically, to (1) explore what gaming motivation questionnaires and classifications are used in studies on gaming disorder symptoms and (2) investigate the relationship between motivational factors and symptoms of gaming disorder.

    Method: An electronic database search was conducted via EBSCO (MEDLINE and PsycINFO) and the Web of Science Core Collection. All studies using validated measurements on gaming disorder symptoms and gaming motivations and available correlation coefficients of the relationship between gaming disorder and gaming motivations were included. The meta-analyses were conducted using a random-effects model.

    Results: In total, 49 studies (k = 58 independent sub-samples), including 51,440 participants, out of which 46 studies (k = 55 sub-samples, n = 49,192 participants) provided data for the meta-analysis. The synthesis identified fourteen different gaming motivation instruments, seven unique motivation models, and 26 motivational factors. The meta-analysis showed statistically significant associations between gaming disorder symptoms and 23 out of 26 motivational factors, with the majority of the pooled mean effect sizes ranging from small to moderate. Moreover, large heterogeneity was observed, and the calculated prediction intervals indicated substantial variation in effects across populations and settings. Motivations related to emotional escape were robustly associated with gaming disorder symptoms.

    Discussion and conclusions: The present meta-analysis reinforces the importance of motivational factors in understanding problematic gaming behavior. The analysis showed significant heterogeneity in most outcomes, warranting further investigation.

    Registration detail: PROSPERO (CRD42020220050).

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  • 8.
    Chang, K. -C
    et al.
    Department Of General Psychiatry, Jianan Psychiatric Center, Ministry Of Health And Welfare, Tainan, Taiwan.
    Chang, Y. -H
    Institute Of Genomics And Bioinformatics, National Chung Hsing University, Taichung, Taiwan.
    Yen, C. -F
    Department Of Psychiatry, School Of Medicine College Of Medicine, Kaohsiung Medical University, Kaohsiung, 802, Taiwan.
    Chen, J. -S
    Department Of Medical Research, E-Da Hospital, Kaohsiung, 824, Taiwan.
    Chen, P. -J
    Department Of Medical Research, E-Da Hospital, Kaohsiung City, 824005, Taiwan.
    Lin, C. -Y
    Institute Of Allied Health Sciences, College Of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
    Griffiths, M. D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Potenza, M. N.
    Departments Of Psychiatry And Neuroscience, Child Study Center, School Of Medicine, Yale University, New Haven, CT, United States.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science.
    A longitudinal study of the effects of problematic smartphone use on social functioning among people with schizophrenia: Mediating roles for sleep quality and self-stigma2022In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 11, no 2, p. 567-576Article in journal (Refereed)
    Abstract [en]

    Background and aims: Individuals with schizophrenia may often experience poor sleep, self-stigma, impaired social functions, and problematic smartphone use. However, the temporal relationships between these factors have not been investigated. The present study used a longitudinal design to examine potential mediating roles of poor sleep and self-stigma in associations between problematic smartphone use and impaired social functions among individuals with schizophrenia. Methods: From April 2019 to August 2021, 193 individuals with schizophrenia (mean [SD] age = 41.34 [9.01] years; 88 [45.6%] males) were recruited and asked to complete three psychometric scales: the Smartphone Application-Based Addiction Scale to assess problematic smartphone use; the Pittsburgh Sleep Quality Index to assess sleep quality; and the Self-Stigma Scale-Short Scale to assess self-stigma. Social functioning was evaluated by a psychiatrist using the Personal and Social Performance Scale. All measures were assessed five times (one baseline and four follow-ups) at three-month intervals between assessments. Results: General estimating equations found that problematic smartphone use (coefficient =-0.096, SE = 0.021; P < 0.001), sleep quality (coefficient =-0.134, SE = 0.038; P < 0.001), and self-stigma (coefficient =-0.612, SE = 0.192; P = 0.001) were significant statistical predictors for social functioning. Moreover, sleep quality and self-stigma mediated associations between problematic smartphone use and social functioning. Conclusion: Problematic smartphone use appears to impact social functioning longitudinally among individuals with schizophrenia via poor sleep and self-stigma concerns. Interventions aimed at reducing problematic smartphone use, improving sleep, and addressing self-stigma may help improve social functioning among individuals with schizophrenia.

  • 9. Chatzittofis, Andreas
    et al.
    Savard, Josephine
    Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Arver, Stefan
    Görts Öberg, Katarina
    Hallberg, Jonas
    Nordström, Peter
    Jokinen, Jussi
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Interpersonal violence, early life adversity, and suicidal behavior in hypersexual men2017In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 6, no 2, p. 187-193Article in journal (Refereed)
    Abstract [en]

    Background and aims: There are significant gaps in knowledge regarding the role of childhood adversity, interpersonal violence, and suicidal behavior in hypersexual disorder (HD). The aim of this study was to investigate interpersonal violence in hypersexual men compared with healthy volunteers and the experience of violence in relation to suicidal behavior. Methods: This case-control study includes 67 male patients with HD and 40 healthy male volunteers. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) and the Karolinska Interpersonal Violence Scale (KIVS) were used for assessing early life adversity and interpersonal violence in childhood and in adult life. Suicidal behavior (attempts and ideation) was assessed with the Mini-International Neuropsychiatric Interview (version 6.0) and the Montgomery-Asberg Depression Rating Scale - Self-rating. Results: Hypersexual men reported more exposure to violence in childhood and more violent behavior as adults compared with healthy volunteers. Suicide attempters (n = 8, 12%) reported higher KIVS total score, more used violence as a child, more exposure to violence as an adult as well as higher score on CTQ-SF subscale measuring sexual abuse (SA) compared with hypersexual men without suicide attempt. Discussion: Hypersexuality was associated with interpersonal violence with higher total scores in patients with a history of suicide attempt. The KIVS subscale exposure to interpersonal violence as a child was validated using the CTQ-SF but can be complemented with questions focusing on SA for full assessment of early life adversity. Conclusion: Childhood adversity is an important factor in HD and interpersonal violence might be related to suicidal behavior in hypersexual men.

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  • 10.
    Chen, I. -H
    et al.
    School of Education Science, Minnan Normal University, Zhangzhou, 363000, China.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science.
    Leung, H.
    UOW College Hong Kong, Community College of City University, Kowloon Tong, Hong Kong.
    Potenza, M. N.
    Departments of Psychiatry and Neuroscience, Child Study Center, School of Medicine, Yale University, New Haven, CT, United States.
    Su, J. -A
    Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital at Chiayi, Puzi City, Taiwan.
    Lin, C. -Y
    Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Griffiths, M. D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Comparing generalized and specific problematic smartphone/internet use: Longitudinal relationships between smartphone applicationbased addiction and social media addiction and psychological distress2020In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 9, no 2, p. 410-419Article in journal (Refereed)
    Abstract [en]

    Background and aims: The literature has proposed two types of problematic smartphone/internet use: generalized problematic use and specific problematic use. However, longitudinal findings on the associations between the two types of problematic use and psychological distress are lacking among EastAsians. The present study examined temporal associations between both generalized and specific problematic use of the smartphone/internet, and psychological distress.

    Methods: Hong Kong University students (N = 308; 100 males; mean age = 23.75 years; SD ± 5.15) were recruited with followups at three, six, and nine months after baseline assessment. All participants completed the Smartphone Application-Based Addiction Scale (for generalized problematic smartphone/internet use), the Bergen Social Media Addiction Scale (for specific problematic smartphone/internet use), and the Hospital Anxiety and Depression Scale (for psychological distress) in each assessment. Latent growth modeling (LGM) was constructed to understand temporal associations between generalized/specific problematic use and psychological distress.

    Results: The LGM suggested that the intercept of generalized problematic use was significantly associated with the intercept of psychological distress (standardized coefficient [β] = 0.32; P < 0.01). The growth of generalized problematic use was significantly associated with the growth of psychological distress (β = 0.51; P < 0.01). Moreover, the intercept of specific problematic use was significantly associated with the intercept of psychological distress (β = 0.28; P < 0.01) and the growth of psychological distress (β = 0.37; P < 0.01).

    Conclusion: The initial level of problematic use of smartphone/internet increased the psychological distress among university students. Helping young adults address problematic use of the smartphone/internet may prevent psychological distress.

  • 11.
    Chen, I-Hua
    et al.
    Qufu Normal Univ, Chinese Acad Educ Big Data, Qufu, Shandong, Peoples R China..
    Chen, Chao-Ying
    Chang Gung Univ, Sch Phys Therapy, Taoyuan, Taiwan.;Chang Gung Univ, Coll Med, Grad Inst Rehabil Sci, Taoyuan, Taiwan..
    Liu, Chieh-Hsiu
    Natl Cheng Kung Univ Hosp, Res Ctr Clin Med, Dept Geriatr & Gerontol, Tainan, Taiwan..
    Ahorsu, Daniel Kwasi
    Hong Kong Polytech Univ, Fac Hlth & Social Sci, Dept Rehabil Sci, Hung Hom, Hong Kong, Peoples R China..
    Griffiths, Mark D.
    Nottingham Trent Univ, Psychol Dept, Int Gaming Res Unit, Nottingham, England..
    Chen, Yu-Pin
    Taipei Med Univ, Wan Fang Hosp, Dept Orthoped Surg, Taipei, Taiwan.;Taipei Med Univ, Coll Med, Sch Med, Dept Orthoped Surg, Taipei, Taiwan..
    Kuo, Yi-Jie
    Taipei Med Univ, Wan Fang Hosp, Dept Orthoped Surg, Taipei, Taiwan.;Taipei Med Univ, Coll Med, Sch Med, Dept Orthoped Surg, Taipei, Taiwan..
    Lin, Chung-Ying
    Natl Cheng Kung Univ, Coll Med, Inst Allied Hlth Sci, Tainan, Taiwan.;Natl Cheng Kung Univ, Coll Med, Dept Occupat Therapy, Tainan, Taiwan.;Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Publ Hlth, Tainan, Taiwan..
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Qazvin Univ Med Sci, Social Determinants Hlth Res Ctr, Res Inst Prevent Noncommunicable Dis, Qazvin 3419759811, Iran.;Jonkoping Univ, Sch Hlth & Welf, Dept Nursing, Jonkoping, Sweden..
    Wang, Shu-Mei
    Hong Kong Polytech Univ, Fac Hlth & Social Sci, Dept Rehabil Sci, Hung Hom, Hong Kong, Peoples R China..
    Internet addiction and psychological distress among Chinese schoolchildren before and during the COVID-19 outbreak: A latent class analysis2021In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 10, no 3, p. 731-746Article in journal (Refereed)
    Abstract [en]

    Background and aims: The present longitudinal study examined the changes in problematic internet use (problematic smartphone use, problematic social media use, and problematic gaming) and changes in COVID-19-related psychological distress (fear of COVID-19 and worry concerning COVID-19) across three time-points (before the COVID-19 outbreak, during the initial stages of the COVID-19 outbreak, and during the COVID-19 outbreak recovery period). Methods: A total of 504 Chinese schoolchildren completed measures concerning problematic internet use and psychological distress across three time points. Latent class analysis (LCA) was used to classify participants into three groups of problematic internet use comprising Group 1 (lowest level), Group 2 (moderate level), and Group 3 (highest level). Results: Statistical analyses showed that as problematic use of internet-related activities declined among Group 3 participants across the three time points, participants in Group 1 and Group 2 had increased problematic use of internet-related activities. Although there was no between-group difference in relation to worrying concerning COVID-19 infection, Groups 2 and 3 had significantly higher levels of fear of COVID-19 than Group 1 during the COVID-19 recovery period. Regression analysis showed that change in problematic internet use predicted fear of COVID-19 during the recovery period. Conclusion: The varied levels of problematic internet use among schoolchildren reflect different changing trends of additive behaviors during COVID-19 outbreak and recovery periods.

  • 12.
    Chen, I-Hua
    et al.
    School of Education Science, Minnan Normal University, Zhangzhou, China.
    Chen, Chao-Ying
    School of Physical Therapy, Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Griffiths, Mark D.
    Psychology Department, International Gaming Research Unit, Nottingham Trent University, Nottingham, United Kingdom.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong; Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Li, Xu-Dong
    Gaogeng Nine-year School, Qionglai, China.
    Tsang, Hector W. H.
    Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Problematic internet-related behaviors mediate the associations between levels of internet engagement and distress among schoolchildren during COVID-19 lockdown: A longitudinal structural equation modeling study2021In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 10, no 1, p. 135-148Article in journal (Refereed)
    Abstract [en]

    Background and aims: Due to the rapid spread of the novel coronavirus disease 2019 (COVID-19), policies based on the nature of “spatial distancing” have been implemented and have resulted in school suspensions and online learning among schoolchildren. In order to examine the impact of such policies on schoolchildren, the aims of the present study were to (i) assess changes in the level of engagement in three internet-related activities (smartphone use, social media use, and gaming) before and during the COVID-19 outbreak, including prolonged and problematic engagement in these activities; (ii) investigate the differences of psychological distress before and after COVID-19 outbreak; and (iii) to use structural equation modeling to investigate the mediating roles of problematic internet-related behaviors in the causal relationships of psychological distress and time spent on internet-related activities.

    Methods: Self-report measures were used to assess internet-related activities and psychological distress. Time spent on internet-related activities, problematic use of internet-related activities, and psychological distress were collected from primary school students (N = 535; 265 boys; M age = 10.32 years [SD = 0.84]). The data were first collected before the COVID-19 outbreak (i.e., early November 2019) and then collected again during the school suspension due to COVID-19 outbreak (i.e., end of March 2020) for comparisons of changes.

    Results: Schoolchildren spent significantly more time on the smartphone (increased 1.02 h daily; P < 0.001) and social media (increased 0.73 h daily; P < 0.001) but not gaming (increased 0.14 h daily; P = 0.07) during the school suspension compared to the baseline. Schoolchildren who increased by 15 or 30 min daily on internet-related activities showed an increased level of psychological distress. The association between problematic use of social media and psychological distress was stronger during the school suspension (β = 0.584) than at the baseline (β = 0.451; P < 0.001).

    Conclusion: Increased problematic use of internet-related activities among schoolchildren was associated with greater psychological distress. Parents should therefore monitor internet-related activities and psychological distress of their children to support their mental health.

  • 13.
    Görts, Per
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Savard, Josephine
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
    Görts-Öberg, Katarina
    Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
    Dhejne, Cecilia
    Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
    Arver, Stefan
    Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
    Jokinen, Jussi
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Ingvar, Martin
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Abé, Christoph
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; 5Quantify Research, Stockholm, Sweden.
    Structural brain differences related to compulsive sexual behavior disorder2023In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 12, no 1, p. 278-287Article in journal (Refereed)
    Abstract [en]

    Background and aims: Compulsive sexual behavior disorder (CSBD) has been included as an impulse control disorder in the International Classification of Diseases (ICD-11). However, the neurobiological mechanisms underlying CSBD remain largely unknown, and given previous indications of addiction-like mechanisms at play, the aim of the present study was to investigate if CSBD is associated with structural brain differences in regions involved in reward processing.

    Methods: We analyzed structural MRI data of 22 male CSBD patients (mean = 38.7 years, SD = 11.7) and 20 matched healthy controls (HC; mean = 37.6 years, SD = 8.5). Main outcome measures were regional cortical thickness and surface area. We also tested for case-control differences in subcortical structures and the effects of demographic and clinical variables, such as CSBD symptom severity, on neuroimaging outcomes. Moreover, we explored case-control differences in regions outside our hypothesis including white matter.

    Results: CSBD patients had significantly lower cortical surface area in right posterior cingulate cortex than HC. We found negative correlations between right posterior cingulate area and CSBD symptoms scores. There were no group differences in subcortical volume.

    Conclusions: Our findings suggest that CSBD is associated with structural brain differences, which contributes to a better understanding of CSBD and encourages further clarifications of the neurobiological mechanisms underlying the disorder.

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  • 14.
    Hu, Yan
    et al.
    Blekinge Institute of Technology, Faculty of Computing, Department of Creative Technologies.
    Sundstedt, Veronica
    Blekinge Institute of Technology, Faculty of Computing, Department of Creative Technologies.
    Exploring Biometrics as an Evaluation Technique for Digital Game Addiction Prevention2018In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 7, p. 15-15Article in journal (Other academic)
  • 15.
    Huang, P. -C
    et al.
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Chen, J. -S
    Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan.
    Potenza, M. N.
    Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.
    Griffiths, M. D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Chen, J. -K
    Department of Social Work, Chinese University of Hong Kong, New Territories, Hong Kong.
    Lin, Y. -C
    Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, Taiwan.
    Hung, C. -H
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    O'Brien, K. S.
    School of Social Sciences, Monash University, Melbourne, 3800, Australia.
    Lin, C. -Y
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Temporal associations between physical activity and three types of problematic use of the internet: A six-month longitudinal study2022In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 11, no 4, p. 1055-1067Article in journal (Refereed)
    Abstract [en]

    Background and aims: Internet use has become an important part of daily living. However, for a minority it may become problematic. Moreover, problematic use of the Internet/smartphone (PUIS) has been associated with low physical activity. The present study investigated the temporal associations between three types of PUIS (i.e., problematic smartphone use [PSPU], problematic social media use [PSMU] and problematic gaming [PG]) and physical activity among Taiwanese university students. Methods: A six-month longitudinal survey study comprising three time points for assessments was conducted. From the original 974 participants, a total of 452 completed all three waves of an online survey comprising the International Physical Activity Questionnaire Short Form (IPAQ-SF) assessing physical activity level, Smartphone Application-Based Addiction Scale (SABAS) assessing PSPU, Bergen Social Media Addiction Scale (BSMAS) assessing PSMU, and Internet Gaming Disorder Short Form (IGDS9-SF) assessing PG. Results: The linear mixed effects model found positive temporal associations of PSMU and PG with physical activity level (PSMU: B = 85.88, SE = 26.24; P = 0.001; PG: B = 36.81, SE = 15.17; P = 0.02). PSPU was not associated with physical activity level (B = 40.54, SE = 22.99; P = 0.08). Additionally, the prevalence rates were 44.4% for at-risk/PSPU, 24.6% for at-risk/PSMU, and 12.3% for at-risk/PG. Discussion and Conclusions: PSMU and PG unexpectedly demonstrated correlations with higher physical activity level. The nature of these relationships warrants additional investigation into the underlying mechanisms in order to promote healthy lifestyles among university students.

  • 16.
    Jokinen, Jussi
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Boström, Adrian
    Chatzittofis, Andreas
    Görts Öberg, Katarina
    Flanagan, John N.
    Arver, Stefan
    Schiöth, Helgi
    Methylation of the HPA axis related genes in men with hypersexual disorder2017In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 6, p. 23-23Article in journal (Refereed)
    Abstract [en]

    Background and aims: Hypersexual Disorder (HD) defined as non-paraphilic sexual desire disorder with components of compulsivity, impulsivity and behavioral addiction, was proposed as a diagnosis in the DSM 5. Some overlapping features between HD and substance use disorder including common neurotransmitter systems and dysregulated hypothalamic-pituitary-adrenal (HPA) axis function have been reported. In this study, comprising 67 male patients diagnosed with HD and 39 healthy male volunteers, we aimed to identify HPA-axis coupled CpG-sites, in which modifications of the epigenetic profile are associated with hypersexuality. Methods: The genome-wide methylation pattern was measured in whole blood using the Illumina Infinium Methylation EPIC BeadChip, measuring the methylation state of over 850 K CpG sites. Prior to analysis, the global DNA methylation pattern was pre-processed according to standard protocols and adjusted for white blood cell type heterogeneity. We included CpG sites located within 2000 bp of the transcriptional start site of the following HPAaxis coupled genes: Corticotropin releasing hormone (CRH), corticotropin releasing hormone binding protein (CRHBP), corticotropin releasing hormone receptor 1 (CRHR1), corticotropin releasing hormone receptor 2 (CRHR2), FKBP5 and the glucocorticoid receptor (NR3C1). We performed multiple linear regression models of methylation M-values to a categorical variable of hypersexuality, adjusting for depression, DST non-suppression status, Childhood Trauma Questionnaire total score and plasma levels of TNF-alpha and IL-6. Results: 76 individual CpG sites were tested, and four of these were nominally significant (p < 0.05), associated with the genes CRH, CRHR2 and NR3C1. Cg23409074 – located 48 bp upstream of the TSS of the CRH gene – was significantly hypomethylated in hypersexual patients after corrections for multiple testing using the FDR-method. Methylation levels of cg23409074 were positively correlated with gene expression of the CRH gene in an independent cohort of 11 healthy male subjects. Conclusions: CRH is an important integrator of neuroendocrine stress responses in the brain, modulating behavior and the autonomic nervous system. Our results show epigenetic changes in CRH gene related to hypersexual disorder in men.

  • 17.
    Jokinen, Jussi
    et al.
    Karolinska Inst, Dept Clin Neurosci Psychiat, Stockholm, Sweden.;Umea Univ, Dept Clin Sci Psychiat, Umea, Sweden..
    Boström, Adrian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Chatzittofis, Andreas
    Karolinska Inst, Dept Clin Neurosci Psychiat, Stockholm, Sweden..
    Oberg, Katarina Gorts
    Karolinska Inst, Dept Med, Stockholm, Sweden..
    Flanagan, John N.
    Karolinska Inst, Dept Med, Stockholm, Sweden..
    Arver, Stefan
    Karolinska Inst, Dept Med, Stockholm, Sweden..
    Schiöth, Helgi B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Methylation of the HPA axis related genes in men with hypersexual disorder2017In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 6, no Suppl. 1, p. 23-23Article in journal (Other academic)
  • 18.
    Jonsson, Jakob
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology. Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Sweden.
    Hodgins, David C.
    Lyckberg, Axel
    Currie, Shawn
    Young, Matthew M.
    Pallesen, Ståle
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    In search of lower risk gambling levels using behavioral data from a gambling monopolist2022In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 11, no 3, p. 890-899Article in journal (Refereed)
    Abstract [en]

    Background and aims: Lower-risk recommendations for avoiding gambling harm have been developed as a primary prevention measure, using self-reported prevalence survey data. The aim of this study was to conduct similar analyses using gambling company player data.

    Methods: The sample (N = 35,753) were Norsk Tipping website customers. Gambling indicators were frequency, expenditure, duration, number of gambling formats and wager. Harm indicators (financial. social, emotional, harms in two or more areas) were derived from the GamTest self-assessment instrument. Receiver operating characteristics (ROC) curves were performed separately for each of the five gambling indicators for each of the four harm indicators.

    Results: ROC areas under the curve were between 0.55 and 0.68. Suggested monthly lower-risk limits were less than 8.7 days, expenditure less than 54 €, duration less than 72–83 min, number of gambling formats less than 3 and wager less than 118–140€. Most risk curves showed a rather stable harm level up to a certain point, from which the increase in harm was fairly linear.

    Discussion: The suggested lower-risk limits in the present study are higher than limits based on prevalence studies. There was a significant number of gamblers (5–10%) experiencing harm at gambling levels well below the suggested cut-offs and the risk increase at certain consumption levels.

    Conclusions: Risk of harm occurs at all levels of gambling involvement within the specific gambling commercial environment assessed in an increasingly available gambling market where most people gamble in multiple commercial environments, minimizing harm is important for all customers.

  • 19.
    King, Daniel L.
    et al.
    College of Education, Psychology & Social Work, Flinders University, Australia.
    Nogueira-López, Abel
    University of León, Léon, Spain; Institute of Psychology, University of Lausanne, Lausanne, Switzerland.
    Galanis, Christina R.
    College of Education, Psychology & Social Work, Flinders University, Australia.
    Hamamura, Toshitaka
    College of Education, Psychology & Social Work, Flinders University, Australia.
    Bäcklund, Christian
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Giardina, Alessandro
    Institute of Psychology, University of Lausanne, Lausanne, Switzerland.
    Billieux, Joël
    Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland.
    Delfabbro, Paul H.
    School of Psychology, University of Adelaide, Australia.
    Reconsidering item response categories in gaming disorder symptoms measurement2023In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 12, no 4, p. 873-877Article in journal (Refereed)
    Abstract [en]

    Gaming disorder (GD) screening often involves self-report survey measures to detect the presence of symptoms. Studies have shown that gamers' responses vary greatly across survey items. Some symptoms, such as preoccupation and tolerance, are frequently reported by highly engaged but non-problematic gamers, and therefore these symptoms are thought to lack specificity and are suggested to be less important in classification decisions. We argue that the influence of response categories (e.g., dichotomous responses, such as "yes" or "no" or frequency categories, such as "rarely" and "often") on item responses has been relatively underexplored despite potentially contributing significantly to the psychometric performance of items and scales. In short, the type of item response may be just as important to symptom reporting as the content of survey questions. We propose some practical alternatives to currently used item categories across GD tools. Research should examine the performance of different response categories, including whether certain response categories aid respondents&apos; comprehension and insight, and better capture pathological behaviours and harms.

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  • 20.
    Liberg, Benny
    et al.
    Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden.
    Görts-Öberg, Katarina
    Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Huddinge, Sweden.
    Jokinen, Jussi
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Savard, Josephine
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Karolinska University Hospital, Stockholm, Sweden.
    Dhejne, Cecilia
    Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Huddinge, Sweden.
    Arver, Stefan
    Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Huddinge, Sweden.
    Fuss, Johannes
    Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany.
    Ingvar, Martin
    Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden.
    Abé, Christoph
    Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden; Quantify Research, Stockholm, Sweden.
    Neural and behavioral correlates of sexual stimuli anticipation point to addiction-like mechanisms in compulsive sexual behavior disorder2022In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 11, no 2, p. 520-532Article in journal (Refereed)
    Abstract [en]

    Background and aims: Compulsive sexual behavior disorder (CSBD) is characterized by persistent patterns of failure to control sexual impulses resulting in repetitive sexual behavior, pursued despite adverse consequences. Despite previous indications of addiction-like mechanisms and the recent impulse-control disorder classification in the International Classification of Diseases (ICD-11), the neurobiological processes underlying CSBD are unknown.

    Methods: We designed and applied a behavioral paradigm aimed at disentangling processes related to anticipation and viewing of erotic stimuli. In 22 male CSBD patients (age: M = 38.7, SD = 11.7) and 20 healthy male controls (HC, age: M = 37.6, SD = 8.5), we measured behavioral responses and neural activity during functional magnetic resonance imaging (fMRI). The main outcomes were response time differences between erotic and non-erotic trials and ventral striatum (VS) activity during anticipation of visual stimuli. We related these outcomes with each other, to CSBD diagnosis, and symptom severity.

    Results: We found robust case-control differences on behavioral level, where CSBD patients showed larger response time differences between erotic and non-erotic trials than HC. The task induced reliable main activations within each group. While we did not observe significant group differences in VS activity, VS activity during anticipation correlated with response time differences and self-ratings for anticipation of erotic stimuli.

    Discussion and Conclusions: Our results support the validity and applicability of the developed task and suggest that CSBD is associated with altered behavioral correlates of anticipation, which were associated with ventral striatum activity during anticipation of erotic stimuli. This supports the idea that addiction-like mechanisms play a role in CSBD.

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  • 21.
    Lin, Chung-Ying
    et al.
    Hong Kong Polytech University, Peoples R China.
    Brostrom, Anders
    Jonköping University, Sweden.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Griffiths, Mark D.
    Nottingham Trent University, England.
    Pakpour, Amir H.
    Qazvin University of Medical Science, Iran.
    Psychometric validation of the Persian Bergen Social Media Addiction Scale using classic test theory and Rasch models2017In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 6, no 4, p. 620-629Article in journal (Refereed)
    Abstract [en]

    Background and aims: The Bergen Social Media Addiction Scale (BSMAS), a six-item self-report scale that is a brief and effective psychometric instrument for assessing at-risk social media addiction on the Internet. However, its psychometric properties in Persian have never been examined and no studies have applied Rasch analysis for the psychometric testing. This study aimed to verify the construct validity of the Persian BSMAS using confirmatory factor analysis (CFA) and Rasch models among 2,676 Iranian adolescents. Methods: In addition to construct validity, measurement invariance in CFA and differential item functioning (DIF) in Rasch analysis across gender were tested for in the Persian BSMAS. Results: Both CFA [comparative fit index (CFI) = 0.993; Tucker-Lewis index (TLI) = 0.989; root mean square error of approximation (RMSEA) = 0.057; standardized root mean square residual (SRMR) = 0.039] and Rasch (infit MnSq = 0.88-1.28; outfit MnSq = 0.86-1.22) confirmed the unidimensionality of the BSMAS. Moreover, measurement invariance was supported in multigroup CFA including metric invariance (Delta CFI = -0.001; Delta SRMR = 0.003; Delta RMSEA = -0.005) and scalar invariance (Delta CFI = -0.002; Delta SRMR = 0.005; Delta RMSEA = 0.001) across gender. No item displayed DIF (DIF contrast = -0.48 to 0.24) in Rasch across gender. Conclusions: Given the Persian BSMAS was unidimensional, it is concluded that the instrument can be used to assess how an adolescent is addicted to social media on the Internet. Moreover, users of the instrument may comfortably compare the sum scores of the BSMAS across gender.

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  • 22.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Nilsen, Per
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center (SDH), Qazvin University of Medical Sciences, Shahid Bahonar Blvd, Qazvin, Iran.
    Psychometric validation of the Persian bergen social media addiction scale using classic test theory and Rasch models2017In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 6, no 4, p. 620-629Article in journal (Refereed)
    Abstract [en]

    Background and aims: The Bergen Social Media Addiction Scale (BSMAS), a six-item self-report scale that is a brief and effective psychometric instrument for assessing at-risk social media addiction on the Internet. However, its psychometric properties in Persian have never been examined and no studies have applied Rasch analysis for the psychometric testing. This study aimed to verify the construct validity of the Persian BSMAS using confirmatory factor analysis (CFA) and Rasch models among 2,676 Iranian adolescents.

    Methods: In addition to construct validity, measurement invariance in CFA and differential item functioning (DIF) in Rasch analysis across gender were tested for in the Persian BSMAS.

    Results: Both CFA [comparative fit index (CFI) = 0.993; Tucker-Lewis index (TLI) = 0.989; root mean square error of approximation (RMSEA) = 0.057; standardized root mean square residual (SRMR) = 0.039] and Rasch (infit MnSq = 0.88-1.28; outfit MnSq = 0.86-1.22) confirmed the unidimensionality of the BSMAS. Moreover, measurement invariance was supported in multigroup CFA including metric invariance (ΔCFI = .0.001; ΔSRMR = 0.003; ΔRMSEA = .0.005) and scalar invariance (ΔCFI = .0.002; ΔSRMR = 0.005; ΔRMSEA = 0.001) across gender. No item displayed DIF (DIF contrast = .0.48 to 0.24) in Rasch across gender.

    Conclusions: Given the Persian BSMAS was unidimensional, it is concluded that the instrument can be used to assess how an adolescent is addicted to social media on the Internet. Moreover, users of the instrument may comfortably compare the sum scores of the BSMAS across gender.

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  • 23.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Ganji, Maryam
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
    Pontes, Halley M
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK.
    Imani, Vida
    Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Psychometric evaluation of the Persian Internet Disorder Scale among adolescents.2018In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 7, no 3, p. 665-675Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Given the growing epidemiological research interest concerning Internet addiction, brief instruments with a robust theoretical basis are warranted. The Internet Disorder Scale (IDS-15) is one such instrument that can be used to quickly assess the Internet addiction in an individual. However, only two language versions of the IDS-15 have been developed. This study translated the IDS-15 into Persian and examined its psychometric properties using comprehensive psychometric testing.

    METHODS: After ensuring the linguistic validity of the Persian IDS-15, 1,272 adolescents (mean age = 15.53 years; 728 males) completed the IDS-15, Depression Anxiety Stress Scale (DASS), Internet Gaming Disorder Scale - Short Form (IGDS9-SF), and the Bergen Social Media Addiction Scale (BSMAS). Confirmatory factor analysis (CFA), Rasch models, regression analysis, and latent profile analysis (LPA) were carried out to test the psychometric properties of the Persian IDS-15.

    RESULTS: Both CFA and Rasch supported the construct validity of the Persian IDS-15. Multigroup analysis in CFA and differential item functioning in Rasch indicated that male and female adolescents interpreted the IDS-15 items similarly. Regression analysis showed that the IDS-15 correlated with IGDS9-SF and BSMAS (ΔR2 = .12 and .36, respectively) is stronger than the DASS (ΔR2 = .03-.05). LPA based on IDS-15 suggests three subgroups for the sample. Significant differences in depression, anxiety, IGDS9-SF, and BSMAS were found among the three LPA subgroups.

    CONCLUSION: The Persian IDS-15 has robust psychometric properties as evidenced by both classical test theory and Rasch analysis.

  • 24.
    Lin, Chung-Ying
    et al.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University , Hung Hom, Hong Kong.
    Griffiths, Mark D
    International Gaming Research Unit, Psychology Department, Nottingham Trent University , Nottingham, UK.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center, Qazvin University of Medical Sciences , Qazvin, Iran..
    Psychometric evaluation of Persian Nomophobia Questionnaire: Differential item functioning and measurement invariance across gender.2018In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 7, no 1, p. 100-108Article in journal (Refereed)
    Abstract [en]

    Background and aims

    Research examining problematic mobile phone use has increased markedly over the past 5 years and has been related to "no mobile phone phobia" (so-called nomophobia). The 20-item Nomophobia Questionnaire (NMP-Q) is the only instrument that assesses nomophobia with an underlying theoretical structure and robust psychometric testing. This study aimed to confirm the construct validity of the Persian NMP-Q using Rasch and confirmatory factor analysis (CFA) models.

    Methods

    After ensuring the linguistic validity, Rasch models were used to examine the unidimensionality of each Persian NMP-Q factor among 3,216 Iranian adolescents and CFAs were used to confirm its four-factor structure. Differential item functioning (DIF) and multigroup CFA were used to examine whether males and females interpreted the NMP-Q similarly, including item content and NMP-Q structure.

    Results

    Each factor was unidimensional according to the Rach findings, and the four-factor structure was supported by CFA. Two items did not quite fit the Rasch models (Item 14: "I would be nervous because I could not know if someone had tried to get a hold of me;" Item 9: "If I could not check my smartphone for a while, I would feel a desire to check it"). No DIF items were found across gender and measurement invariance was supported in multigroup CFA across gender.

    Conclusions

    Due to the satisfactory psychometric properties, it is concluded that the Persian NMP-Q can be used to assess nomophobia among adolescents. Moreover, NMP-Q users may compare its scores between genders in the knowledge that there are no score differences contributed by different understandings of NMP-Q items.

  • 25. Ludwig, Monika
    et al.
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Müller, Stefanie
    Braun, Barbara
    Bühringer, Gerhard
    Has gambling changed after major amendments of gambling regulations in Germany? A propensity score analysis2012In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 1, no 4, p. 151-161Article in journal (Refereed)
    Abstract [en]

    Aims: This study examined changes in general population gambling in the light of two major amendments of the German gambling regulation, the Fifth Amendment of the German Gambling Ordinance (AGO) for commercial amusement machines with prizes (AWP) and the State Treaty on Gambling (STG) for gambling activities subject to the state monopoly. Methods: Applying cross-sectional data from the 2006 and 2009 Epidemiological Survey of Substance Abuse (ESA), propensity-score-matched samples of 7,970 subjects and 3,624 12-month gamblers aged 18-64 years were used for analyses. Logistic regression was employed to examine changes in gambling controlling for possible confounding variables. Results: Overall participation in state gambling activities, participation in lotto as well as TV lottery decreased and gambling on Internet card games increased. No changes were found for any other gambling activity, 12-month prevalence of any gambling and pathological gambling. While weekly gambling declined, overall multiple gambling increased. Effects were similar in the total sample and among current gamblers. Conclusions: Prohibiting specific gambling activities, e. g., Internet gambling, seem to be insufficient approaches to change gambling behavior. Supply reduction might need to be enhanced by changes in game characteristics and implementation of early intervention measures. However, long-term consequences are uncertain and further monitoring is needed.

  • 26. Mansson, Viktor
    et al.
    Molander, Olof
    Jayaram-Lindstrom, Nitya
    Andrade, Jackie
    Berman, Anne H.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Craving to Gamble and Craving for Alcohol: A protocol for a comparative phenomenological Study2018In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 7, no 1Article in journal (Refereed)
  • 27. Motka, Franziska
    et al.
    Grüne, Bettina
    Sleczka, Pawel
    Braun, Barbara
    Cisneros Örnberg, Jenny
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. IFT Institut für Therapieforschung, Germany; ELTE Eötvös Loránd University, Hungary.
    Who uses self-exclusion to regulate problem gambling? A systematic literature review2018In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 7, no 4, p. 903-916Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Self-exclusion programs offer an intervention for individuals with problem gambling behavior. However, these programs are insufficiently used. This review describes sociodemographic features and gambling behavior of self-excluders as well as goals and motives for initiating self-exclusion from terrestrial and online gambling. In addition, use of further professional help and barriers to self-exclusion are examined.METHODS: Based on systematic literature search and quality assessment, n = 16 original studies (13 quantitative, 2 qualitative, and 1 mixed method) published between 1997 and 2017 in English or German language were analyzed. Results are presented for online and terrestrial gambling separately.RESULTS: Online self-excluders were on average 10 years younger than terrestrial self-excluders. Self-exclusion was mainly motivated by financial problems, followed by feelings of losing control and problems with significant others. Financial problems and significant others were less important for online than for terrestrial gamblers. Main barriers for self-exclusion were complicated enrollment processes, lack of complete exclusion from all venues, little support from venue staff, and lack of adequate information on self-exclusion programs. Both self-excluders from terrestrial and online gambling had negative attitudes toward the need of professional addiction care.CONCLUSION: To exploit the full potential of self-exclusion as a measure of gambler protection, its acceptance and its utilization need to be increased by target-group-specific information addressing financial issues and the role of significant others, simplifying the administrative processes, facilitating self-exclusion at an early stage of the gambling career, offering self-determined exclusion durations, and promoting additional use of professional addiction care.

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  • 28.
    Savard, Josephine
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. ANOVA, Karolinska University Hospital, Stockholm, Sweden.
    Hirvikoski, Tatja
    Görts Öberg, Katarina
    Dhejne, Cecilia
    Rahm, Christoffer
    Jokinen, Jussi
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
    Impulsivity in Compulsive Sexual Behavior Disorder and Pedophilic Disorder2021In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 10, no 3, p. 839-847Article in journal (Refereed)
    Abstract [en]

    Background and aims: Impulsivity is regarded as a risk factor for sexual crime reoffending, and a suggested core feature in Compulsive Sexual Behavior Disorder. The aim of this study was to explore clinical (e.g. neurodevelopmental disorders), behavioral and neurocognitive dimensions of impulsivity in disorders of problematic sexuality, and the possible correlation between sexual compulsivity and impulsivity.

    Methods: Men with Compulsive Sexual Behavior Disorder (n = 20), and Pedophilic Disorder (n = 55), enrolled in two separate drug trials in a specialized Swedish sexual medicine outpatient clinic, as well as healthy male controls (n = 57) were assessed with the Hypersexual Behavior Inventory (HBI) for sexual compulsivity, and with the Barratt Impulsiveness Scale (BIS) and Connors' Continuous Performance Test-II (CPT-II) for impulsivity. Psychiatric comorbidity information was extracted from interviews and patient case files.

    Results: Approximately a quarter of the clinical groups had Attention-Deficit/Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder. Both clinical groups reported more compulsive sexuality (r = 0.73-0.75) and attentional impulsivity (r = 0.36-0.38) than controls (P < 0.05). Based on results on univariate correlation analysis, BIS attentional score, ADHD, and Commissions T-score from CPT-II were entered in a multiple linear regression model, which accounted for 15% of the variance in HBI score (P < 0.0001). BIS attentional score was the only independent positive predictor of HBI (P = 0.001).

    Discussion: Self-rated attentional impulsivity is an important associated factor of compulsive sexuality, even after controlling for ADHD. Psychiatric comorbidity and compulsive sexuality are common in Pedophilic Disorder.

    Conclusion: Neurodevelopmental disorders and attentional impulsivity - including suitable interventions - should be further investigated in both disorders.

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  • 29. Sleczka, Pavel
    et al.
    Braun, Barbara
    Piontek, Daniela
    Bühringer, Gerhard
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, München, Germany.
    DSM-5 criteria for gambling disorder: Underlying structure and applicability to specific groups of gamblers2015In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 4, no 4, p. 226-235Article in journal (Refereed)
    Abstract [en]

    Background and Aims: DSM-5 provides nine diagnostic criteria for gambling disorder. All criteria have a pre-assumed equal diagnostic impact and are applied to all individuals and groups in an equal manner. The aims of the study are to analyse the structure underlying the diagnosis and to assess whether DSM-5 is equally applicable to different groups of gamblers. 

    Methods: Data from the 2009 German Epidemiological Survey of Substance Abuse and from a study on slot machine gamblers were used. Item Response Theory analysis was applied to estimate discrimination and severity parameters of the criteria. With the use of Differential Item Functioning analysis, potential criterion biases were analysed. We analysed data from 107 participants from the general population sample and 376 participants from the slot machine gamblers' sample who answered a 19-item diagnostic questionnaire based on the DSM criteria for gambling disorder. 

    Results: A single underlying factor, the severity of gambling disorder, was identified in both samples. In the general population sample the criteria of preoccupation and chasing were least severe and showed low discriminatory power. Bailout, withdrawal and jeopardized matters criteria had highest severity and discriminatory power. The comparison of the two samples revealed two criterion biases in the preoccupation and tolerance criteria. 

    Conclusions: The structure underlying the criteria is unidimensional but the disorder is manifested differently depending on disorder severity. The assumed equal impact of each criterion lacks support in the findings. The DSM-5 criteria measure a partially different construct in slot machine gamblers than in gamblers in the general population.

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  • 30. Sleczka, Pawel
    et al.
    Braun, Barbara
    Grüne, Bettina
    Bühringer, Gerhard
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Proactive coping and gambling disorder among young men2016In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 5, no 4, p. 639-648Article in journal (Refereed)
    Abstract [en]

    Objectives: Male sex, young age, and frequent gambling are considered as risk factors for gambling disorder (GD) and stress might be one of the triggers of gambling behavior among problem gamblers. Conversely, well-developed coping with stress might counteract gambling problems. The Proactive Coping Theory provides a promising approach for the further development of preventive and treatment measures. The objective of the study was to investigate different facets of proactive coping (PC) in young male gamblers.

    Methods: Young men from Bavaria were recruited via the Munich citizens’ registry (n = 2,588) and Facebook invitations (n  = 105). In total, 173 out of 398 individuals were positively screened for frequent gambling and/or signs of related problems and completed the baseline questionnaire of the Munich Leisure-time Study. Factors investigated include gambling problems, PC, impulsiveness, social support, and psychological distress.

    Results: Gambling problems were associated with lower levels of preventive coping as well as of adaptive reaction delay. The associations were also significant when controlled for impulsiveness and general psychological distress. Preventive coping moderated the association between social support and gambling problems.

    Discussion and conclusions: Young men with gambling problems less frequently prevent the occurrence of stressors and more often react hasty when these occur. While the investigated group reported good social support, this factor was negatively associated with GD only among individuals with good preventive coping. Preventive coping poses a useful construct for selective prevention and treatment as it can be modified in professional interventions.

  • 31. Sleczka, Pawel
    et al.
    Braun-Michl, Barbara
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Institut für Therapieforschung, Germany; ELTE Eötvös Loránd University, Hungary.
    Gamblers' attitudes towards money and their relationship to gambling disorder among young men2020In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 9, no 3, p. 744-755Article in journal (Refereed)
    Abstract [en]

    Background and aims: Money plays a central role in gambling, and understanding the different attitudes of gamblers towards it might benefit both prevention and treatment of gambling-related problems. This study describes the development of a new German measure of attitudes to money and the differences in these attitudes between male non-gamblers, occasional, frequent and problem gamblers. Furthermore, it investigates the cross-sectional and longitudinal associations between attitudes towards money and the severity of gambling disorder.

    Methods: An online study was conducted among 2,584 men aged 18–25 years, recruited via the Munich citizen registry. Additionally, a sample of n = 105 Facebook users was included in part of the analyses. Frequent and problem gamblers were invited to a 12-month follow-up. Apart from gambling participation and related problems, the questionnaire included items from existing scales measuring attitudes to money.

    Results: Three factors underlying a new 12-item German Scale of Money Attitudes (SMAG) were identified: success, budgeting and evil. Compared with other groups, participants reporting any gambling problems scored highest in success and lowest in budgeting. Budgeting was associated with gambling-related problems in both cross-sectional and longitudinal analyses and strengthened the relationship between associating money with success and gambling disorder.

    Discussion: For problem gamblers, money is important as a personal symbol of success. This attitude has an especially negative effect on gambling-related problems in individuals who handle money irresponsibly. Spending and winning money might play an important role in maintaining self-esteem among gamblers and thus hinder their attempts to quit.

  • 32. Strizek, Julian
    et al.
    Atzendorf, Josefine
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Institut für Therapieforschung, Germany; ELTE Eötvös Loránd University, Hungary.
    Monshouwer, Karin
    Puhm, Alexandra
    Uhl, Alfred
    Perceived problems with adolescent online gaming: National differences and correlations with substance use2020In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 9, no 3, p. 629-641Article in journal (Refereed)
    Abstract [en]

    Background: Not much is known about the correlation between gaming problems and substance use across different countries. This paper presents cross-national analyses of different gaming indicators and their relationship to substance use. Methods: Based on data from the 2015 ESPAD study, differences in the relationship between gaming and substance use across 35 countries were analysed using multi-level logistic regression, using substance use as an individual level predictor, economic wealth as a country-level predictor and a combined problem gaming indicator as the outcome. Results: Multi-level logistic regressions revealed significant correlations between individual substance use and gaming problems, which varied across countries and were moderated by economic wealth. Students who used alcohol, tobacco or cannabis and who lived in high-income countries had a smaller risk of scoring positively on a combined problem gaming indicator than students who used alcohol, tobacco or cannabis and who lived in less prosperous countries. Discussion: Different gaming indicators varied substantially across countries, with self-perceived gaming problems being more common in countries with a low prevalence of gaming. Significant cross-level effects demonstrate the need to take the societal context into account when the relationship between problem gaming and substance use is analysed. Prevention measures need to take the fact into account that patterns of substance use among problem gamers vary across countries.

  • 33.
    Van Rooij, Antonius J.
    et al.
    Trimbos Inst, Dept Children & Risky Behav, Da Costakade 45, NL-3521 VS Utrecht, Netherlands.
    Ferguson, Christopher J.
    Stetson Univ, Dept Psychol, 421 N Woodland Blvd, Deland, FL 32723 USA.
    Carras, Michelle Colder
    Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental Hlth, 624 N Broadway, Baltimore, MD 21205 USA.
    Kardefelt-Winther, Daniel
    Karolinska Inst, Dept Clin Neurosci, Tomtebodavagen 18A, S-17176 Stockholm, Sweden.
    Shi, Jing
    Univ Toronto, Rehabil Sci Inst, 937-500 Univ Ave, Toronto, ON, Canada;Ctr Addict & Mental Hlth, Inst Mental Hlth Policy Res, Toronto, ON, Canada.
    Aarseth, Espen
    IT Univ Copenhagen, Ctr Comp Games Res, Copenhagen, Denmark.
    Bean, Anthony M.
    Framingham State Univ, Dept Psychol, Framingham, MA USA.
    Bergmark, Karin Helmersson
    Stockholm Univ, Dept Sociol, Stockholm, Sweden.
    Brus, Anne
    Roskilde Univ, Dept People & Technol, Roskilde, Denmark.
    Coulson, Mark
    Middlesex Univ, Dept Psychol, London, England.
    Deleuze, Jory
    UCL, Dept Psychol, Louvain, Belgium.
    Dullur, Pravin
    Western Sydney Univ, Sch Med, Penrith, NSW, Australia.
    Dunkels, Elza
    Umea Univ, Dept Appl Educ Sci, Umea, Sweden.
    Edman, Johan
    Stockholm Univ, Dept Criminol, Stockholm, Sweden.
    Elson, Malte
    Ruhr Univ Bochum, Psychol Human Technol Interact Grp, Bochum, Germany.
    Etchells, Peter J.
    Bath Spa Univ, Dept Psychol, Bath, Avon, England.
    Fiskaali, Anne
    Aarhus Univ, Dept Psychol & Behav Sci, Aarhus, Denmark.
    Granic, Isabela
    Radboud Univ Nijmegen, Dev Psychopathol, Nijmegen, Netherlands.
    Jansz, Jeroen
    Erasmus Univ, ERMeCC, Dept Media & Commun, Rotterdam, Netherlands.
    Karlsen, Faltin
    Kristiania Univ Coll, Westerdals Dept Film & Media, Oslo, Norway.
    Kaye, Linda K.
    Edge Hill Univ, Dept Psychol, Ormskirk, England.
    Kirsh, Bonnie
    Univ Toronto, Rehabil Sci Inst, 937-500 Univ Ave, Toronto, ON, Canada;Univ Toronto, Dept Occupat Sci & Occupat Therapy, Toronto, ON, Canada;Univ Toronto, Dept Psychiat, Toronto, ON, Canada.
    Lieberoth, Andreas
    Aarhus Univ, Danish Sch Educ, Dept Educ Psychol, Aarhus, Denmark.
    Markey, Patrick
    Villanova Univ, Dept Psychol, Villanova, PA 19085 USA.
    Mills, Kathryn L.
    Univ Oregon, Dept Psychol, Eugene, OR 97403 USA.
    Nielsen, Rune Kristian Lundedal
    IT Univ Copenhagen, Ctr Comp Games Res, Copenhagen, Denmark.
    Orben, Amy
    Univ Oxford, Dept Expt Psychol, Oxford, England.
    Poulsen, Arne
    Roskilde Univ, Dept People & Technol, Roskilde, Denmark.
    Prause, Nicole
    Liberos LLC, Los Angeles, CA USA.
    Prax, Patrick
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Department of Game Design.
    Quandt, Thorsten
    Univ Munster, Dept Commun, Munster, Germany.
    Schimmenti, Adriano
    UKE Kore Univ Enna, Dept Human & Social Sci, Enna, Italy.
    Starcevic, Vladan
    Univ Sydney, Discipline Psychiat, Sydney, NSW, Australia.
    Stutman, Gabrielle
    Turner, Nigel E.
    Ctr Addict & Mental Hlth, Inst Mental Hlth Policy Res, Toronto, ON, Canada.
    Van Looy, Jan
    Univ Ghent, Mict, IMEC, Dept Commun Sci, Ghent, Belgium.
    Przybylski, Andrew K.
    Univ Oxford, Dept Expt Psychol, Oxford, England;Univ Oxford, Oxford Internet Inst, 1 St Giles Oxford, Oxford OX1 3JS, England.
    A weak scientific basis for gaming disorder: Let us err on the side of caution2018In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 7, no 1, p. 1-9Article in journal (Refereed)
    Abstract [en]

    We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.

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  • 34. Van Rooij, Antonius J.
    et al.
    Ferguson, Christopher J.
    Carras, Michelle Colder
    Kardefelt-Winther, Daniel
    Shi, Jing
    Aarseth, Espen
    Bean, Anthony M.
    Bergmark, Karin Helmersson
    Brus, Anne
    Coulson, Mark
    Deleuze, Jory
    Dullur, Pravin
    Dunkels, Elza
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Edman, Johan
    Elson, Malte
    Etchells, Peter J.
    Fiskaali, Anne
    Granic, Isabela
    Jansz, Jeroen
    Karlsen, Faltin
    Kaye, Linda K.
    Kirsh, Bonnie
    Lieberoth, Andreas
    Markey, Patrick
    Mills, Kathryn L.
    Nielsen, Rune Kristian Lundedal
    Orben, Amy
    Poulsen, Arne
    Prause, Nicole
    Prax, Patrick
    Quandt, Thorsten
    Schimmenti, Adriano
    Starcevic, Vladan
    Stutman, Gabrielle
    Turner, Nigel E.
    Van Looy, Jan
    Przybylski, Andrew K.
    A weak scientific basis for gaming disorder: Let us err on the side of caution2018In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 7, no 1, p. 1-9Article in journal (Refereed)
    Abstract [en]

    We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.

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  • 35. Van Rooij, Antonius J.
    et al.
    Ferguson, Christopher J.
    Colder Carras, Michelle
    Kardefelt-Winther, Daniel
    Shi, Jing
    Aarseth, Espen
    Bean, Anthony M.
    Helmersson Bergmark, Karin
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Brus, Anne
    Coulson, Mark
    Deleuze, Jory
    Dullur, Pravin
    Dunkels, Elza
    Edman, Johan
    Stockholm University, Faculty of Social Sciences, Department of Criminology.
    Elson, Malte
    Etchells, Peter J.
    Fiskaali, Anne
    Granic, Isabela
    Jansz, Jeroen
    Karlsen, Faltin
    Kaye, Linda K.
    Kirsh, Bonnie
    Lieberoth, Andreas
    Markey, Patrick
    Mills, Kathryn L.
    Lundedal Nielsen, Rune Kristian
    Orben, Amy
    Poulsen, Arne
    Prause, Nicole
    Prax, Patrick
    Quandt, Thorsten
    Schimmenti, Adriano
    Starcevic, Vladan
    Stutman, Gabrielle
    Turner, Nigel E.
    Van Looy, Jan
    Przybylski, Andrew K.
    A weak scientific basis for gaming disorder: Let us err on the side of caution2018In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 7, no 1, p. 1-9Article in journal (Refereed)
    Abstract [en]

    We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.

  • 36.
    Wu, Tzu-Yi
    et al.
    Acad Sinica, Taiwan.
    Lin, Chung-Ying
    Hong Kong Polytech Univ, Peoples Republic of China.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Griffiths, Mark D.
    Nottingham Trent Univ, UK.
    Brostrom, Anders
    Jönköping University, Sweden.
    Pakpour, Amir H.
    Qazvin Univ Med Sci, Iran;Jönköping University.
    Psychometric validation of the Persian nine-item Internet Gaming Disorder Scale - Short Form: Does gender and hours spent online gaming affect the interpretations of item descriptions?2017In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 6, no 2, p. 256-263Article in journal (Refereed)
    Abstract [en]

    Background and aims: The nine-item Internet Gaming Disorder Scale -Short Form (IGDS-SF9) is brief and effective to evaluate Internet Gaming Disorder (IGD) severity. Although its scores show promising psychometric properties, less is known about whether different groups of gamers interpret the items similarly. This study aimed to verify the construct validity of the Persian IGDS-SF9 and examine the scores in relation to gender and hours spent online gaming among 2,363 Iranian adolescents. Methods: Confirmatory factor analysis (CFA) and Rasch analysis were used to examine the construct validity of the IGDS-SF9. The effects of gender and time spent online gaming per week were investigated by multigroup CFA and Rasch differential item functioning (DIF). Results: The unidimensionality of the IGDS-SF9 was supported in both CFA and Rasch. However, Item 4 (fail to control or cease gaming activities) displayed DIF (DIF contrast = 0.55) slightly over the recommended cutoff in Rasch but was invariant in multigroup CFA across gender. Items 4 (DIF contrast = -0.67) and 9 (jeopardize or lose an important thing because of gaming activity; DIF contrast = 0.61) displayed DIF in Rasch and were non-invariant in multigroup CFA across time spent online gaming. Conclusions: Given the Persian IGDS-SF9 was unidimensional, it is concluded that the instrument can be used to assess IGD severity. However, users of the instrument are cautioned concerning the comparisons of the sum scores of the IGDS-SF9 across gender and across adolescents spending different amounts of time online gaming.

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  • 37.
    Wu, Tzu-Yi
    et al.
    Institute of Economics, Academia Sinica, Taipei, Taiwan.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center (SDH), Qazvin University of Medical Sciences, Shahid Bahonar Blvd., Qazvin, Iran.
    Psychometric validation of the Persian nine-item Internet Gaming Disorder Scale - Short Form: Does gender and hours spent online gaming affect the interpretations of item descriptions?2017In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 6, no 2, p. 256-263Article in journal (Refereed)
    Abstract [en]

    Background and aims: The nine-item Internet Gaming Disorder Scale -Short Form (IGDS-SF9) is brief and effective to evaluate Internet Gaming Disorder (IGD) severity. Although its scores show promising psychometric properties, less is known about whether different groups of gamers interpret the items similarly. This study aimed to verify the construct validity of the Persian IGDS-SF9 and examine the scores in relation to gender and hours spent online gaming among 2,363 Iranian adolescents.

    Methods: Confirmatory factor analysis (CFA) and Rasch analysis were used to examine the construct validity of the IGDS-SF9. The effects of gender and time spent online gaming per week were investigated by multigroup CFA and Rasch differential item functioning (DIF).

    Results: The unidimensionality of the IGDS-SF9 was supported in both CFA and Rasch. However, Item 4 (fail to control or cease gaming activities) displayed DIF (DIF contrast = 0.55) slightly over the recommended cutoff in Rasch but was invariant in multigroup CFA across gender. Items 4 (DIF contrast = -0.67) and 9 (jeopardize or lose an important thing because of gaming activity; DIF contrast = 0.61) displayed DIF in Rasch and were non-invariant in multigroup CFA across time spent online gaming.

    Conclusions: Given the Persian IGDS-SF9 was unidimensional, it is concluded that the instrument can be used to assess IGD severity. However, users of the instrument are cautioned concerning the comparisons of the sum scores of the IGDS-SF9 across gender and across adolescents spending different amounts of time online gaming.

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  • 38. Wullinger, Pia M.
    et al.
    Bickl, Andreas M.
    Loy, Johanna K.
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany; Eötvöos Loránd University, Hungary.
    Schwarzkopf, Larissa
    Longitudinal associations between psychiatric comorbidity and the severity of gambling disorder: Results from a 36-month follow-up study of clients in Bavarian outpatient addiction care2023In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 12, no 2, p. 535-546Article in journal (Refereed)
    Abstract [en]

    Background and aims: Individuals with gambling disorder (GD) often suffer from psychiatric comorbidities. Previous studies demonstrated greater severity of GD among gamblers with psychiatric comorbidities. However, evidence on the association between psychiatric comorbidity and course of GD severity during and after outpatient treatment is sparse. This study analyses data from a longitudinal one-armed cohort study on outpatient addiction care clients over three years. Methods: We investigated the course of GD severity using data from 123 clients in 28 outpatient addiction care facilities in Bavaria using generalized estimation equations (GEE). We applied time* interaction analyses to examine different development profiles in participants with and without (1) affective disorders, or (2) anxiety disorders, and (3) to account for the co-occurrence of both. Results: All participants benefitted from outpatient gambling treatment. Improvement in GD severity was poorer in participants with anxiety disorders compared to participants without anxiety disorders. The co-occurrence of affective and anxiety disorders was linked to a less favourable course of GD than the presence of affective disorders alone. However, the combined occurrence of both disorders was more favourable than the presence of anxiety disorders alone. Discussion and conclusions: Our study suggests that clients with GD, with and without psychiatric comorbidities, benefit from outpatient gambling care. Psychiatric comorbidity, especially comorbid anxiety disorders, seems to be negatively associated with the course of GD within outpatient gambling care. Addressing psychiatric comorbidity within the treatment of GD and offering individualised help are required to meet the needs of this clientele.

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