Friday, December 22, 2017

Research on Smart Phone and Internet Addiction

Recent Studies on Smart Phone Addiction and Nomophobia

Zou Z, Wang H, d'Oleire Uquillas F, Wang X, Ding J, Chen H. Definition of Substance and Non-substance Addiction. Adv Exp Med Biol. 2017;1010:21-41.

Abstract

Substance addiction (or drug addiction) is a neuropsychiatric disorder characterized by a recurring desire to continue taking the drug despite harmful consequences. Non-substance addiction (or behavioral addiction) covers pathological gambling, food addiction, internet addiction, and mobile phone addiction. Their definition is similar to drug addiction but they differ from each other in specific domains. This review aims to provide a brief overview of past and current definitions of substance and non-substance addiction, and also touches on the topic of diagnosing drug addiction and non-drug addiction, ultimately aiming to further the understanding of the key concepts needed for a foundation to study the biological and psychological underpinnings of addiction disorders.


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Gao T, Xiang YT, Zhang H, Zhang Z, Mei S. Neuroticism and quality of life: Multiple mediating effects of smartphone addiction and depression. Psychiatry Res. 2017 Dec;258:457-461. doi: 10.1016/j.psychres.2017.08.074.

Abstract

The purposes of this study were to investigate the mediating effect of smartphone addiction and depression on neuroticism and quality of life. Self-reported measures of neuroticism, smart-phone addiction, depression, and quality of life were administered to 722 Chinese university students. Results showed smartphone addiction and depression were both significantly affected neuroticism and quality of life. The direct effect of neuroticism on quality of life was significant, and the chain-mediating effect of smartphone addiction and depression was also significant. In conclusion, neuroticism, smartphone addiction, and depression are important variables that worsen quality of life.


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Kim HJ, Min JY, Kim HJ, Min KB. Accident risk associated with smartphone addiction: A study on university students in Korea. J Behav Addict. 2017 Nov 3:1-9. doi: 10.1556/2006.6.2017.070.

Abstract

Background and aims: The smartphone is one of the most popular devices, with the average smartphone usage at 162 min/day and the average length of phone usage at 15.79 hr/week. Although significant concerns have been made about the health effects of smartphone addiction, the relationship between smartphone addiction and accidents has rarely been studied. We examined the association between smartphone addiction and accidents among South Korean university students.
Methods: A total of 608 college students completed an online survey that included their experience of accidents (total number; traffic accidents; falls/slips; bumps/collisions; being trapped in the subway, impalement, cuts, and exit wounds; and burns or electric shocks), their use of smartphone, the type of smartphone content they most frequently used, and other variables of interests. Smartphone addiction was estimated using Smartphone Addiction Proneness Scale, a standardized measure developed by the National Institution in Korea.
Results: Compared with normal users, participants who were addicted to smartphones were more likely to have experienced any accidents (OR = 1.90, 95% CI: 1.26-2.86), falling from height/slipping (OR = 2.08, 95% CI: 1.10-3.91), and bumps/collisions (OR = 1.83, 95% CI: 1.16-2.87). The proportion of participants who used their smartphones mainly for entertainment was significantly high in both the accident (38.76%) and smartphone addiction (36.40%) groups.
Discussion and conclusions: We suggest that smartphone addiction was significantly associated with total accident, falling/slipping, and bumps/collisions. This finding highlighted the need for increased awareness of the risk of accidents with smartphone addiction.


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Wolniewicz CA, Tiamiyu MF, Weeks JW, Elhai JD. Problematic smartphone use and relations with negative affect, fear of missing out, and fear of negative and positive evaluation. Psychiatry Res. 2017 Sep 25. pii: S0165-1781(17)30901-0. doi: 10.1016/j.psychres.2017.09.058.

Abstract

For many individuals, excessive smartphone use interferes with everyday life. In the present study, we recruited a non-clinical sample of 296 participants for a cross-sectional survey of problematic smartphone use, social and non-social smartphone use, and psychopathology-related constructs including negative affect, fear of negative and positive evaluation, and fear of missing out (FoMO). Results demonstrated that FoMO was most strongly related to both problematic smartphone use and social smartphone use relative to negative affect and fears of negative and positive evaluation, and these relations held when controlling for age and gender. Furthermore, FoMO (cross-sectionally) mediated relations between both fear of negative and positive evaluation with both problematic and social smartphone use. Theoretical implications are considered with regard to developing problematic smartphone use.



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Han S, Kim KJ, Kim JH. Understanding Nomophobia: Structural Equation Modeling and Semantic Network Analysis of Smartphone Separation Anxiety. Cyberpsychol Behav Soc Netw. 2017 Jul;20(7):419-427. doi: 10.1089/cyber.2017.0113.

Abstract

This study explicates nomophobia by developing a research model that identifies several determinants of smartphone separation anxiety and by conducting semantic network analyses on smartphone users' verbal descriptions of the meaning of their smartphones. Structural equation modeling of the proposed model indicates that personal memories evoked by smartphones encourage users to extend their identity onto their devices. When users perceive smartphones as their extended selves, they are more likely to get attached to the devices, which, in turn, leads to nomophobia by heightening the phone proximity-seeking tendency. This finding is also supplemented by the results of the semantic network analyses revealing that the words related to memory, self, and proximity-seeking are indeed more frequently used in the high, compared with low, nomophobia group.


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Lee H, Kim JW, Choi TY. Risk Factors for Smartphone Addiction in Korean Adolescents: Smartphone Use Patterns. J Korean Med Sci. 2017 Oct;32(10):1674-1679. doi: 10.3346/jkms.2017.32.10.1674.
Abstract
With widespread use of the smartphone, clinical evidence for smartphone addiction remains unclear. Against this background, we analyzed the effect of smartphone use patterns on smartphone addiction in Korean adolescents. A total of 370 middle school students participated. The severity of smartphone addiction was measured through clinical interviews and the Korean Smartphone Addiction Proneness Scale. As a result, 50 (13.5%) were in the smartphone addiction group and 320 (86.5%) were in the healthy group. To investigate the effect of smartphone use patterns on smartphone addiction, we performed self-report questionnaires that assessed the following items: smartphone functions mostly used, purpose of use, problematic use, and parental attitude regarding smartphone use. For smartphone functions mostly used, the addiction group showed significantly higher scores in "Online chat." For the purpose of use, the addiction group showed significantly higher "habitual use," "pleasure," "communication," "games," "stress relief," "ubiquitous trait," and "not to be left out." For problematic use, the addiction group showed significantly higher scores on "preoccupation," "tolerance," "lack of control," "withdrawal," "mood modification," "conflict," "lies," "excessive use," and "loss of interest." For parental attitude regarding children's smartphone use, the addiction group showed significantly higher scores in "parental punishment." Binary logistic regression analysis indicated that "female," "use for learning," "use for ubiquitous trait," "preoccupation," and "conflict" were significantly correlated with smartphone addiction. This study demonstrated that the risk factors for smartphone addiction were being female, preoccupation, conflict, and use for ubiquitous trait; the protective factor was use for learning. Future studies will be required to reveal the additional clinical evidence of the disease entity for smartphone addiction.
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Kuss DJ, Griffiths MD. Social Networking Sites and Addiction: Ten Lessons Learned. Int J Environ Res Public Health. 2017 Mar 17;14(3). pii: E311. doi: 10.3390/ijerph14030311.
Abstract
Online social networking sites (SNSs) have gained increasing popularity in the last decade, with individuals engaging in SNSs to connect with others who share similar interests. The perceived need to be online may result in compulsive use of SNSs, which in extreme cases may result in symptoms and consequences traditionally associated with substance-related addictions. In order to present new insights into online social networking and addiction, in this paper, 10 lessons learned concerning online social networking sites and addiction based on the insights derived from recent empirical research will be presented. These are: (i) social networking and social media use are not the same; (ii) social networking is eclectic; (iii) social networking is a way of being; (iv) individuals can become addicted to using social networking sites; (v) Facebook addiction is only one example of SNS addiction; (vi) fear of missing out (FOMO) may be part of SNS addiction; (vii) smartphone addiction may be part of SNS addiction; (viii) nomophobia may be part of SNS addiction; (ix) there are sociodemographic differences in SNS addiction; and (x) there are methodological problems with research to date. These are discussed in turn. Recommendations for research and clinical applications are provided.

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De-Sola Gutiérrez J, Rodríguez de Fonseca F, Rubio G. Cell-Phone Addiction: A Review. Front Psychiatry. 2016 Oct 24;7:175.

Abstract

We present a review of the studies that have been published about addiction to cell phones. We analyze the concept of cell-phone addiction as well as its prevalence, study methodologies, psychological features, and associated psychiatric comorbidities. Research in this field has generally evolved from a global view of the cell phone as a device to its analysis via applications and contents. The diversity of criteria and methodological approaches that have been used is notable, as is a certain lack of conceptual delimitation that has resulted in a broad spread of prevalent data. There is a consensus about the existence of cell-phone addiction, but the delimitation and criteria used by various researchers vary. Cell-phone addiction shows a distinct user profile that differentiates it from Internet addiction. Without evidence pointing to the influence of cultural level and socioeconomic status, the pattern of abuse is greatest among young people, primarily females. Intercultural and geographical differences have not been sufficiently studied. The problematic use of cell phones has been associated with personality variables, such as extraversion, neuroticism, self-esteem, impulsivity, self-identity, and self-image. Similarly, sleep disturbance, anxiety, stress, and, to a lesser extent, depression, which are also associated with Internet abuse, have been associated with problematic cell-phone use. In addition, the present review reveals the coexistence relationship between problematic cell-phone use and substance use such as tobacco and alcohol.

https://www.ncbi.nlm.nih.gov/pubmed/27822187

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Bragazzi NL, Del Puente G. A proposal for including nomophobia in the new DSM-V. Psychol Res Behav Manag. 2014 May 16;7:155-60. doi: 10.2147/PRBM.S41386.

Abstract

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is considered to be the gold standard manual for assessing the psychiatric diseases and is currently in its fourth version (DSM-IV), while a fifth (DSM-V) has just been released in May 2013. The DSM-V Anxiety Work Group has put forward recommendations to modify the criteria for diagnosing specific phobias. In this manuscript, we propose to consider the inclusion of nomophobia in the DSM-V, and we make a comprehensive overview of the existing literature, discussing the clinical relevance of this pathology, its epidemiological features, the available psychometric scales, and the proposed treatment. Even though nomophobia has not been included in the DSM-V, much more attention is paid to the psychopathological effects of the new media, and the interest in this topic will increase in the near future, together with the attention and caution not to hypercodify as pathological normal behaviors.

Open source paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4036142/

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Hussain Z. Smartphone Use, Addiction, Narcissism, and Personality: A Mixed Methods Investigation.International Journal of Cyber Behavior, Psychology and Learning. 5(1):17-32. 2015.

Abstract

There are increasing numbers of people who are now using smartphones. Consequently, there is a risk of addiction to certain web applications such as social networking sites (SNSs) which are easily accessible via smartphones. There is also the risk of an increase in narcissism amongst users of SNSs. 
The present study set out to investigate the relationship between smartphone use, narcissistic tendencies and personality as predictors of smartphone addiction. The study also aimed to investigate the distinction between addiction specificity and co-occurrence in smartphone addiction via qualitative data and discover why people continue to use smartphones in banned areas. A self-selected sample of 256 smartphone users (Mean age = 29.2, SD = 9.49) completed an online survey. The results revealed that 13.3% of the sample was classified as addicted to smartphones. Higher narcissism scores and neuroticism levels were linked to addiction. Three themes of; social relations, smartphone dependence and self-serving personalities emerged from the qualitative data. Interpretation of qualitative data supports addiction specificity of the smartphone. It is suggested smartphones encourage narcissism, even in non-narcissistic users. In turn, this increased use in banned areas. Future research needs to gather more in-depth qualitative data, addiction scale comparisons and comparison of use with and without SNS access. It is advised that prospective buyers of smartphones be pre-warned of the potential addictive properties of new technology.


Recent Study on Social Networking Site Disorder

Pontes HM. Investigating the differential effects of social networking site addiction and Internet gaming disorder on psychological health. J Behav Addict. 2017 Nov 13:1-10. doi: 10.1556/2006.6.2017.075.

Abstract

Background and aims: Previous studies focused on examining the interrelationships between social networking site (SNS) addiction and Internet gaming disorder (IGD) in isolation. Moreover, little is known about the potential simultaneous differential effects of SNS addiction and IGD on psychological health. This study investigated the interplay between these two technological addictions and ascertained how they can uniquely and distinctively contribute to increasing psychiatric distress when accounting for potential effects stemming from sociodemographic and technology-related variables.
Methods: A sample of 509 adolescents (53.5% males) aged 10-18 years (mean = 13.02, SD = 1.64) were recruited.
Results: It was found that key demographic variables can play a distinct role in explaining SNS addiction and IGD. Furthermore, it was found that SNS addiction and IGD can augment the symptoms of each other, and simultaneously contribute to deterioration of overall psychological health in a similar fashion, further highlighting potentially common etiological and clinical course between these two phenomena. Finally, the detrimental effects of IGD on psychological health were found to be slightly more pronounced than those produced by SNS addiction, a finding that warrants additional scientific scrutiny.
Discussion and conclusion: The implications of these results are further discussed in light of the existing evidence and debates regarding the status of technological addictions as primary and secondary disorders.



Recent Studies on Internet Gaming Disorder

Wang HR, Cho H, Kim DJ. Prevalence and correlates of comorbid depression in a nonclinical online sample with DSM-5 internet gaming disorder. J Affect Disord. 2018 Jan 15;226:1-5. doi: 10.1016/j.jad.2017.08.005.

Abstract

BACKGROUND: We investigated the prevalence and correlates of comorbid depression among patients with internet gaming disorder using the Internet Gaming Disorder scale (IGD-9) and the Patient Health Questionnaire-9 (PHQ-9) among nonclinical online survey respondents.
METHODS: Korean adolescents and adults from 14 to 39 years of age were selected. We compared internet gaming use patterns and sociodemographic and clinical variables between patients with internet gaming disorder who had depression and those without depression.
RESULTS: In 2016, 7200 people participated in an online survey. Respondents with internet gaming disorder that was comorbid with depression were older, more often female, had greater Internet Addiction Test total scores, Alcohol Use Disorder Identification Test total scores, Generalized Anxiety Disorder Scale-7 total scores, Fagerstrom Test for Nicotine Dependence total scores, and higher Dickman Dysfunctional Impulsivity Instrument dysfunctional subscale scores than those without depression. The binary logistic regression analysis revealed that female gender, problematic alcohol use, anxiety, and a past history of psychiatric counseling or treatment due to internet gaming use were significant predictors for comorbid depression among participants with internet gaming disorder.
CONCLUSION: Depression was a common comorbidity of internet gaming disorder. Internet gaming disorder with comorbid depression was related to more serious psychiatric phenomenology and a greater psychiatric burden.


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Stockdale L, Coyne SM. Video game addiction in emerging adulthood: Cross-sectional evidence of pathology in video game addicts as compared to matched healthy controls. J Affect Disord. 2018 Jan 1;225:265-272. doi: 10.1016/j.jad.2017.08.045.

Abstract

BACKGROUND: The Internet Gaming Disorder Scale (IGDS) is a widely used measure of video game addiction, a pathology affecting a small percentage of all people who play video games. Emerging adult males are significantly more likely to be video game addicts. Few researchers have examined how people who qualify as video game addicts based on the IGDS compared to matched controls based on age, gender, race, and marital status.
METHOD: The current study compared IGDS video game addicts to matched non-addicts in terms of their mental, physical, social-emotional health using self-report, survey methods.
RESULTS: Addicts had poorer mental health and cognitive functioning including poorer impulse control and ADHD symptoms compared to controls. Additionally, addicts displayed increased emotional difficulties including increased depression and anxiety, felt more socially isolated, and were more likely to display internet pornography pathological use symptoms. Female video game addicts were at unique risk for negative outcomes.
LIMITATIONS: The sample for this study was undergraduate college students and self-report measures were used.
CONCLUSIONS: Participants who met the IGDS criteria for video game addiction displayed poorer emotional, physical, mental, and social health, adding to the growing evidence that video game addictions are a valid phenomenon.


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Paik SH, Cho H, Chun JW, Jeong JE, Kim DJ. Gaming Device Usage Patterns Predict Internet Gaming Disorder: Comparison across Different Gaming Device Usage Patterns. Int J Environ Res Public Health. 2017 Dec 5;14(12). pii: E1512. doi: 10.3390/ijerph14121512.

Abstract

Gaming behaviors have been significantly influenced by smartphones. This study was designed to explore gaming behaviors and clinical characteristics across different gaming device usage patterns and the role of the patterns on Internet gaming disorder (IGD). Responders of an online survey regarding smartphone and online game usage were classified by different gaming device usage patterns: (1) individuals who played only computer games; (2) individuals who played computer games more than smartphone games; (3) individuals who played computer and smartphone games evenly; (4) individuals who played smartphone games more than computer games; (5) individuals who played only smartphone games. Data on demographics, gaming-related behaviors, and scales for Internet and smartphone addiction, depression, anxiety disorder, and substance use were collected. Combined users, especially those who played computer and smartphone games evenly, had higher prevalence of IGD, depression, anxiety disorder, and substance use disorder. These subjects were more prone to develop IGD than reference group (computer only gamers) (B = 0.457, odds ratio = 1.579). Smartphone only gamers had the lowest prevalence of IGD, spent the least time and money on gaming, and showed lowest scores of Internet and smartphone addiction. Our findings suggest that gaming device usage patterns may be associated with the occurrence, course, and prognosis of IGD.


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Du X, Yang Y, Gao P, Qi X, Du G, et al. Compensatory increase of functional connectivity density in adolescents with internet gaming disorder. Brain Imaging Behav. 2017 Dec;11(6):1901-1909. doi: 10.1007/s11682-016-9655-x.

Abstract

Behavioral studies have demonstrated visual attention bias and working memory deficits in individuals with internet gaming disorder (IGD). Neuroimaging studies demonstrated that individuals with IGD presented abnormalities in brain structures and functions including resting-state functional connectivity (rsFC) disturbance. However, most previous studies investigated IGD-related rsFC alterations by using hypothesis-driven methods with priori selection of a region of interest, which cannot provide a full picture of the rsFC changes in IGD individuals. In this study, we recruited 27 male IGD adolescents and 35 demographically matched healthy controls (HCs) to investigate abnormal connective property of each voxel within whole brain of IGD adolescents using resting-state functional connectivity density (rsFCD) method, and further to evaluate the relationship between altered rsFCD and behavioral performances of visual attention and working memory. The results exhibited no significant intergroup difference in behavioral performance (visual working memory and attention). The IGD adolescents exhibited higher global/long-range rsFCD in the bilateral dorsal lateral prefrontal cortex (DLPFC) and the right inferior temporal cortex (ITC)/fusiform compared with the HCs. Although no significant correlation survived after Bonferroni correction, higher global/long-range rsFCD of the bilateral DLPFC was correlated with the Young's internet addiction test (IAT) score and/or behavioral performance in IGD adolescents using an uncorrected threshold of P < 0.05. In conclusion, IGD adolescents demonstrated increased rsFCD in the brain regions involved in working memory, spatial orientation and attention processing, which indicated that increased rsFCD may reflect a compensatory mechanism for maintaining the normal behavioral performance in IGD adolescents compared with the HCs.


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Zhai J, Luo L, Qiu L, Kang Y, Liu B, et al. The topological organization of white matter network in internet gaming disorder individuals. Brain Imaging Behav. 2017 Dec;11(6):1769-1778. doi: 10.1007/s11682-016-9652-0.

Abstract

White matter (WM) integrity abnormalities had been reported in Internet gaming disorder (IGD). Diffusion tensor imaging (DTI) tractography allows identification of WM tracts, potentially providing information about the integrity and organization of relevant underlying WM fiber tracts' architectures, which has been used to investigate the connectivity of cortical and subcortical structures in several brain disorders. Unfortunately, relatively little is known about the thoroughly circuit-level characterization of topological property changes of WM network with IGD. Sixteen right-hand adolescents with IGD participated in our study, according to the diagnostic criteria of IGD in DSM-5. Meanwhile, 16 age and gender-matched healthy controls were also enrolled. DTI tractography was employed to generate brain WM networks in IGD individuals and healthy controls. The 90 cortical and subcortical regions derived from AAL template were chosen as the nodes. The network parameters (i.e., Network strength, clustering coefficient, shortest path length, global efficiency, local efficiency, regional efficiency) were calculated and then correlated with the Internet addiction test (IAT) scores in IGD. IGD group showed decreased global efficiency, local efficiency and increased shortest path length. Further analysis revealed the reduced nodal efficiency in frontal cortex, anterior cingulate cortex and pallidium in IGD. In addition, the global efficiency of WM network was correlated with the IAT scores in IGD (r = -0.5927; p = 0.0155). We reported the abnormal topological organization of WM network in IGD and the association with the severity of IGD, which may provide new insights into the neural mechanism of IGD from WM network level.

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Zajac K, Ginley MK, Chang R, Petry NM. Treatments for Internet gaming disorder and Internet addiction: A systematic review. Psychol Addict Behav. 2017 Dec;31(8):979-994. doi: 10.1037/adb0000315. Epub 2017 Sep 18.

Abstract

Problems related to excessive use of the Internet and video games have recently captured the interests of both researchers and clinicians. The goals of this review are to summarize the literature on treatment effectiveness for these problems and to determine whether any treatments meet the minimum requirement of an evidence-based treatment as defined by Chambless et al. (1998). Studies of treatments for Internet gaming disorder (IGD) and Internet addiction were examined separately, as past studies have linked IGD to more severe outcomes. The systematic review identified 26 studies meeting predefined criteria; 13 focused on treatments for IGD and 13 on Internet addiction. The results highlighted a paucity of well-designed treatment outcome studies and limited evidence for the effectiveness of any treatment modality. Studies were limited by methodological flaws, including small sample sizes, lack of control groups, and little information on treatment adherence, among other problems. In addition, the field is beset by a lack of consistent definitions of and established instruments to measure IGD and Internet addiction. The results of this review highlight the need for additional work in the area of treatment development and evaluation for IGD and Internet addiction. Attention to methodological concerns identified within this review should improve subsequent research related to treating these conditions, and ultimately outcomes of patients suffering from them.