Hiperconectados: las niñas, los niños y los adolescentes en las redes sociales. El fenómeno de TikTok / Hyperconnected: children and adolescents on social media. The TikTok phenomenon

Las plataformas digitales de comunicación en red revolucionaron el modo de comunicarnos, informarnos y entretenernos; impactaron principalmente en las nuevas generaciones. La pandemia incrementó los patrones de consumo en todas las edades y sus consecuencias: sedentarismo; obesidad; alteraciones del sueño, psicológicas, cognitivas, de la memoria/atención, del rendimiento académico; comportamientos problemáticos y riesgos de ciberacoso. La actividad de las nuevas generaciones en TikTok ­una plataforma donde pueden crear, visualizar, compartir videos y retos virales­ tiene impacto en su comportamiento. Sus publicaciones generan aprobaciones, comentarios y seguidores; esto estimula el circuito dopaminérgico de recompensa, que es la base de los comportamientos adictivos. El pediatra debe conocer estas conductas para recomendar buenas prácticas de uso. Esta revisión narrativa, basada en bibliografía de PubMed Central, SciELO, recomendaciones nacionales e internacionales, tiene como objetivo informar y actualizar a los profesionales sobre la plataforma, sus características y sus recomendaciones de uso seguro.

Network communication digital platforms have revolutionized the way we communicate, get information, and entertain ourselves; they have had a major impact on the new generations. The pandemic has increased consumption patterns at all ages and its consequences: a sedentary lifestyle, obesity, sleep, psychological, cognitive, memory/attention, and academic performance disorders, problematic behaviors, and risks of cyberbullying. The activity of the new generations on TikTok ­a platform that allows them to create, view, share videos and viral challenges­ has affected their behavior. Their posts lead to likes, comments, and followers; this stimulates the dopaminergic reward system, which is the basis of addictive behaviors. Pediatricians should be aware of these behaviors in order to recommend good practices. The objective of this narrative review, based on the bibliography from PubMed Central, SciELO, national and international recommendations, is to provide information and an update to health care providers on TikTok, its characteristics, and the recommendations for safe use.

Methamphetamine: Mechanism of Action and Chinese Herbal Medicine Treatment for Its Addiction / 中国结合医学杂志

With the proliferation of synthetic drugs, research on the mechanism of action of addictive drugs and treatment methods is of great significance. Among them, methamphetamine (METH) is the most representative amphetamine synthetic drug, and the treatment of METH addiction has become an urgent medical and social problem. In recent years, the therapeutic effects of Chinese herbal medicines on METH addiction have gained widespread attention because of their non-addictiveness, multiple targets, low side effects, low cost, and other characteristics. Previous studies have identified a variety of Chinese herbal medicines with effects on METH addiction. Based on the research on METH in recent years, this article summarizes the mechanism of action of METH as the starting point and briefly reviews the Chinese herbal medicine-based treatment of METH.

Prevalence of internet addiction and associated factors in students / Prevalência de adicção em internet e fatores associados em estudantes

Objective: A cross-sectional study that estimated the prevalence of Internet Addiction and associated factors among High School and College students in Montes Claros - Minas Gerais, Brazil. Methods: Internet Addiction was evaluated through the Internet Addiction Test, and demographic, socioeconomic, and lifestyle factors, as well as internet usage profile characteristics, were examined. Descriptive analysis and the Poisson regression model were applied. Results: Of the 2,519 participants, 52.3% were considered with Internet Addiction Problems. In High School, the following factors were identified: are women and girls, age over >16, class C, alcohol consumption, impaired sleep, frequent use of social networks, and time spent connected. In Higher Education, the following factors: are women and girls, age over >23, paid activity, class C and D/E, alcohol consumption, impaired sleep, imbalanced diet, frequent use of social networks, and time spent connected. Conclusion: There was an expressive prevalence of Internet Addiction Problems, an outcome associated with the demographic, socioeconomic, lifestyle, and internet use characteristics.

Objetivo: Estudo transversal que estimou prevalência de Adicção em Internet e fatores associados entre estudantes do Ensino Médio e Superior em Montes Claros - Minas Gerais, Brasil. Métodos: A Adicção em Internet foi avaliada pelo Internet Addiction Test e se investigaram fatores demográficos, socioeconômicos, estilo de vida e perfil de uso de internet. Foram realizadas análises descritivas e modelo de regressão de Poisson. Resultados: Dos 2.519 participantes, 52,3% apresentaram problemas de Adicção em Internet. No grupo de estudantes de Ensino Médio examinado, identificaram-se os seguintes fatores: sexo feminino, idade >16, classe C, consumo de álcool, sono prejudicado, uso frequente das redes sociais e tempo de conexão. No Ensino Superior, foram constatados: sexo feminino, idade >23, atividade remunerada, classe C e D/E, consumo de álcool, sono prejudicado, alimentação não balanceada, uso frequente das redes sociais e tempo de conexão. Conclusão: Houve expressiva prevalência de Problemas com Adicção em Internet, desfecho associado a características demográficas, socioeconômicas, ao estilo de vida e ao uso da internet.

Etiopathogenesis of drug dependence: an explanatory synthesis from an epigenetic perspective / Etiopatogenia de las drogodependencias: una síntesis explicativa desde una perspectiva epigenética / Etiopatogenia das toxicodependências: uma síntese explicativa a partir de uma perspectiva epigenética

The use of substances with addictive potential is a relevant health problem. Scientific evidence suggests that the underlying mechanisms that regulate behavioral processes in addictions involve a complex interplay between genetic and environmental factors. Therefore, this narrative review aims to provide a framework to synthesize the evidence on gene-environment-agent interactions from the perspective of the natural history of the disease and the stages of the addictive process for alcohol, nicotine, cannabis, psychostimulants, and opioids. In this review, we conducted an exhaustive literature search without time limits in PubMed, Ebsco, Lilacs, and SciELO, reviewing the title and abstract we selected original articles in humans or animals that addressed the etiology of addictions according to the methodological approach of gene-environment (G-E) interaction, including articles in Spanish, English, and Portuguese. Genetic studies have revealed the critical role of epigenetic modifiers (histone acetylation) in maintaining brain homeostasis in pathological conditions and focusing on G-E interactions will also allow characterizing subgroups (based on environmental factors) at high risk for addictive behaviors that can be targeted for specific interventions, Thus, treatment strategies should encompass a combination of psychosocial interventions with gene therapy involving pharmacological manipulations of histones that may contribute to design better therapies and perhaps lead to more successful management of drug dependencies.

El consumo de sustancias con potencial adictivo es un problema relevante de salud. La evidencia científica sugiere que los mecanismos subyacentes que regulan los procesos comportamentales en las adicciones involucran un complejo interjuego entre factores genéticos y ambientales. Por lo tanto, esta revisión narrativa tiene como objetivo aportar un marco de referencia que permita sintetizar la evidencia sobre interacciones genes- ambiente-agente desde la perspectiva de la historia natural de la enfermedad y los estadios del proceso adictivo para: alcohol, nicotina, cannabis, psicoestimulantes y opioides. En esta revisión realizamos una búsqueda exhaustiva de la literatura sin límites de tiempo en PubMed, Ebsco, Lilacs y SciELO, revisando el título y el resumen se seleccionaron artículos originales en humanos o animales que abordaran la etiología de las adiciones según el enfoque metodológico de interacción entre genes y ambiente (G-A), incluyendo artículos en español, inglés y portugués. Los estudios genéticos han revelado el papel crítico de los modificadores epigenéticos (acetilación de las histonas) en mantener la homeóstasis cerebral en condiciones patológicas y enfocarse en las interacciones G-A también permitirá caracterizar subgrupos (basados en los factoresambientales) de alto riesgo para conductas adictivas que pueden ser objeto de intervenciones específicas, por lo que, las estrategias de tratamiento deben englobar una combinación de intervenciones psicosociales con terapia génica que involucren las manipulaciones farmacológicas de las histonas que pueden contribuir a diseñar mejores terapias y tal vez conducir a un manejo más exitoso de las drogodependencias.

O consumo de substâncias com potencial viciante é um relevante problema de saúde. Evidências científicas sugerem que os mecanismos subjacentes que regulam os processos comportamentais em vícios envolvem uma interação complexa entre fatores genéticos e ambientais. Portanto, esta revisão narrativa visa fornecer um quadro de referência que permita sintetizar as evidências sobre interações gene-ambiente-agente sob a perspectiva da história natural da doença e as etapas do processo de dependência para: álcool, nicotina, cannabis, psicoestimulantes e opióides. Nesta revisão, realizamos uma busca exaustiva da literatura sem limites de tempo no PubMed, Ebsco , Lilacs e SciELO, revisando o título e o resumo, foram selecionados artigos originais em humanos ou animais que abordassem a etiologia dos acréscimos de acordo com a abordagem metodológica de interação entre genes e ambiente (GA), incluindo artigos em espanhol, inglês e português. Estudos genéticos revelaram o papel crítico dos modificadores epigenéticos (acetilação de histonas) na manutenção da homeostase cerebral em condições patológicas, e o direcionamento das interações GA também permitirá caracterizar subgrupos (com base em fatores ambientais) de alto risco para comportamentos aditivos que podem ser alvo de ataques específicos. intervenções, portanto, as estratégias de tratamento devem abranger uma combinação de intervenções psicossociais com terapia gênica envolvendo manipulações farmacológicas de histonas que podem contribuir para projetar melhores terapias e talvez levar a um manejo mais bem-sucedido das dependências de drogas.

Uso y abuso de dispositivos móviles y su rol en el desarrollo de trastornos del sueño en adolescentes / Use and abuse of mobile devices and their role in the development of sleep disorders in adolescents

Las tecnologías de información y comunicación suponen un avance para la sociedad. Hoy en día, los dispositivos móviles proveen servicios convenientes para la cotidianidad, facilitando la comunicación, el ocio y las relaciones interpersonales, sin embargo, se describe que su uso excesivo influye en la aparición de síntomas como ansiedad, comportamientos adictivos y alteraciones del sueño. De todos los usuarios de estas tecnologías, los adolescentes son un grupo especialmente afectado, debido al fácil acceso a estas desde edades muy tempranas y la consecuente integración a su vida diaria. Por lo que se pretende determinar el papel del uso de dispositivos móviles en el desarrollo de trastornos del sueño en adolescentes. Pese a sus efectos deletéreos, se ha observado que el uso de estas tecnologías puede ocasionar sensación de bienestar y apoyo social en algunos usuarios, particularmente cuando promueve la interacción con sus pares. El uso excesivo de las tecnologías, en especial horas antes de dormir, se relaciona con un patrón de sueño anómalo, se ha identificado que los trastornos del sueño más prevalentes en los usuarios son el insomnio y la somnolencia diurna excesiva

Information and communication technologies represent an advance for society. Nowadays, mobile devices provide convenient services for everyday life, facilitating communication, leisure and interpersonal relationships, however, it is described that their excessive use influences the appearance of symptoms such as anxiety, addictive behaviors and sleep disturbances. Of all the users of these technologies, adolescents are a particularly affected group, due to the easy access to them from a very early age and the consequent integration into their daily lives. Therefore, it is intended to determine the role of the use of mobile devices in the development of sleep disorders in adolescents. Despite their deleterious effects, it has been observed that the use of these technologies can cause a feeling of well-being and social support in some users, particularly when it promotes interaction with their peers. The excessive use of technologies, especially hours before bed, is related to an abnormal sleep pattern, it has been identified that the most prevalent sleep disorders in users are insomnia and excessive daytime sleepiness

Workaholism and burnout among stricto sensu graduate professors / Workaholism e burnout entre docentes de pós-graduação stricto sensu

ABSTRACT OBJECTIVE To analyze the association of excessive work and compulsive work with the dimensions of the burnout syndrome in masters and doctoral professors of Languages, Literature, and Linguistics in Brazil. METHODS Cross-sectional study carried out with 585 permanent professors of stricto sensu graduate studies in Languages, Literature, and Linguistics in Brazil. Data collection took place between February and August 2019, by an online questionnaire. The outcomes of this study were the compulsive work and excessive work dimensions of the Dutch Work Addiction Scale, the Maslach Burnout Inventory TM dimensions and their associated factors, identified by multiple logistic regression models. RESULTS Professors with a high level of excessive work (29.40%) had 2.75 times the chance of high emotional exhaustion and 2.08 times the chance of high depersonalization. Regarding professors with a high level of compulsive work (8.03%), they had 4.88 times the chance of high emotional exhaustion and 2.97 times the chance of high depersonalization. No association of excessive work and compulsive work with low professional fulfillment was identified. CONCLUSION The results showed a statistically significant association of excessive work and compulsive work with high emotional exhaustion and high depersonalization, allowing managers and professors to reflect the criteria that guide their work processes, to adopt management models, institutional regulatory policies, and strategies to improve the working conditions and health of professors.

RESUMO OBJETIVO Analisar a associação entre trabalho excessivo e trabalho compulsivo com as dimensões da síndrome de burnout em docentes de mestrado e doutorado em Letras e Linguística do Brasil. MÉTODOS Estudo transversal realizado com 585 docentes permanentes de pós-graduação stricto sensu em Letras e Linguística do Brasil. A obtenção dos dados ocorreu entre fevereiro e agosto de 2019, por meio de um questionário online. Os desfechos deste estudo foram as dimensões trabalho compulsivo e trabalho excessivo da escala Dutch Work Addiction Scale, as dimensões da Maslach Burnout Inventory TM e seus fatores associados, identificados por modelos múltiplos de regressão logística. RESULTADOS Docentes com alto nível de trabalho excessivo (29,40%) apresentaram 2,75 vezes a chance de exaustão emocional alta e 2,08 vezes a chance de despersonalização alta. Quanto aos docentes com alto nível de trabalho compulsivo (8,03%), apresentaram 4,88 vezes a chance de exaustão emocional alta e 2,97 vezes a chance de despersonalização alta. Não foi identificado associação entre trabalho excessivo e trabalho compulsivo com a baixa realização profissional. CONCLUSÃO Os resultados mostraram que existe uma associação estatisticamente significativa entre trabalho excessivo e trabalho compulsivo com exaustão emocional alta e despersonalização alta, possibilitando aos gestores e docentes refletirem os critérios que norteiam seus processos laborais, a fim de adotarem modelos de gestão, políticas reguladoras institucionais e estratégias adequadas para melhorar as condições de trabalho e saúde dos docentes.

The Phubbing Scale (PS-8) in the Portuguese population: psychometric properties

Phubbing is defined as ignoring other individuals by using a mobile phone during a face-to-face conversation. The Phubbing Scale (PS) was developed to assess this practice. In this study, we analyze the psychometric properties of the 8-item version of the PS (PS-8) in the Portuguese population, providing validity evidence based on internal structure and on relationships with other variables, and examining item properties, reliability, and measurement invariance across gender. Participants were 391 Portuguese adults (132 men, 259 women) who completed a battery of questionnaires. Confirmatory factor analysis yielded satisfactory goodness-of-fit indices for the two-factor structure (communication disturbance and phone obsession), which was invariant across gender. Item homogeneity and reliability of factor scores (McDonald's omega) were satisfactory. Validity evidence based on relationships with other variables was provided by positive associations with time spent on the Internet on weekdays and at the weekend, time spent on social networking sites, number of social networks used, Internet addiction, problematic mobile phone use, Facebook intrusion, fear of missing out, and depression. These associations show the addictive component of phubbing and its relationship with mental health. The PS-8 is a short and easy-to-administer scale with adequate psychometric properties for measuring phubbing in the Portuguese population. (AU)

Workaholism and family interaction among nurses / Adição ao trabalho e interação familiar em enfermeiros

Abstract This study aims to identify the prevalence of workaholism and work-family interaction, their relationship and their variation according sociodemographic and occupational characteristics among nurses. A quantitative, descriptive, correlational and transversal study was conducted with a sample of 839 Portuguese nurses. Regarding workaholism, 27% of workaholic nurses were identified, scoring a higher mean value for excessive work. For work-family interaction, the dimensions showing the highest mean values were the negative work-family interaction and the positive family-work interaction. The variables identified as significant predictors of workaholism were the work-family interaction (39%), occupational variables (10.6%) and sociodemographic variables (1.2%). Among the occupational and professional variables, the women, age equal or less than 37 years and perception of stressful work, were highlighted. The confirmation of workaholism in nurses, as well as its predictive variables are significantly important for professionals and organizations to better understand the impact of this phenomenon, particularly in mental health and to encourage the development of programmes aiming to promote health at the workplace.

Resumo O objetivo deste estudo foi identificar a prevalência da adição ao trabalho, os níveis de interação trabalho-família e a relação destes com características sociodemográficas e laborais em enfermeiros. Estudo quantitativo, descritivo, correcional e transversal numa amostra de 839 enfermeiros de Portugal continental. Relativamente à adição ao trabalho, identificaram-se 27,1% de enfermeiros adictos, com valor médio superior no trabalho excessivo. No que respeita à interação trabalho-família, as dimensões com médias superiores foram a interação negativa trabalho-família e a interação positiva família-trabalho. As variáveis identificadas como preditores significativos da adição ao trabalho foram a interação trabalho-família (39%), as variáveis laborais (10,6%) e as sociodemográficas (1,2%). Das variáveis laborais e profissionais salienta-se o sexo feminino, idade igual ou inferior a 37 anos e a perceção de trabalho stressante. A confirmação deste fenómeno em enfermeiros, assim como, das variáveis que o podem potenciar, possibilita ao profissional e às organizações, uma maior consciencialização dos seus impactos, nomeadamente na saúde mental incentivando o desenvolvimento de programas que visem a promoção de saúde no local de trabalho.

Dependência de smartphone em adolescentes, parte 1: revisão de escopo / La dependencia de smartphone en adolescentes, parte 1: revisión del alcance / Smartphone Addiction in Adolescents, Part 1: A Scoping Review

Face a presença constante dos smartphones na vida dos adolescentes e ao aumento do tempo de tela observa-do nos últimos anos, este estudo objetivou mapear as evidências disponíveis sobre a dependência de smar-tphone em adolescentes. Trata-se da primeira parte de uma revisão de escopo. Um total de 67 artigos foram publicados entre 2009 e 2019, com um incremento de 31,74 % ao ano. A maioria das pesquisas (n=28; 41,79 %), foram desenvolvidas na Coreia do Sul, pe-la área de psicologia (n=21; 31,34 %) e pelo método transversal (n=49; 73,13 %). 14 escalas autoaplicáveis foram identificadas para o uso com adolescentes, sendo que, as mais utilizadas foram a Smartphone Addiction Proneness Scale e a Smartphone Addiction Scale- Short Version. Grande parte das escalas contempla os domí-nios: abstinência, tolerância, compulsão e efeito da dependência na vida diária.Conclui-se que a depen-dência de smartphone é um problema de saúde pública em ascensão no mundo e pode comprometer a saúde dos adolescentes. Tal construto tem sido mensurado por escalas validadas e confiáveis, porém, não foram identificados estudos brasileiros no período investigado. Portanto, faz-se necessário adaptar e validar instrumen-tos com esta população para melhor compreensão do fenômeno no Brasil

Dada la presencia constante de los teléfonos inteligentes en la vida de los adolescentes y el aumento del tiempo de pantalla observado en los últimos años, el presente estudio tuvo como objetivo mapear la evidencia disponible sobre la dependencia del smartphoneen adolescentes. Esta es una revisión del alcance. Se publicaron un total de 67 artículos entre 2009 y 2019, con un aumento del 31.74 % por año. La mayor parte de la investigación se realizó en Corea del Sur (n=28; 41,79 %), por el área de psicología (n=21; 31,34 %) y por el método transversal (n=49; 73,13 %). Se identi-ficaron catorce escalas autoaplicables para su uso con adolescentes, y las más utilizadas fueron la Smartphone Addiction Proneness Scale y la Smartphone Addiction Scale- Short Version. La mayoría de las escalas incluyen los siguientes dominios: abstinencia, tolerancia, compulsión y el efecto de la dependencia en la vida diaria. Se concluye que la dependencia de los smartphones es un problema de salud pública creciente en el mundo y puede comprometer la salud de los adolescentes. Esta construcción se ha medido mediante escalas validadas y confiables, pero no se han identificado estudios brasileños en el periodo investigado, por lo que es necesario adaptar y validar los instrumentos con esta población, para comprender mejor el fenómeno en Brasil

Given the constant presence of smartphones in adoles-cents' lives and the increase in screen time observed in recent years, this study aimed to map the evidence avail-able on adolescents' smartphone addiction. This is the first part of a scoping review. A total of 67 articles were published between 2009 and 2019, with an increase of 31.74 % per year. Most of the research was conducted in South Korea (n=28; 41.79 %), in psychology (n=21; 31.34 %) and by the cross-sectional method (n=49; 73.13 %). Fourteen self-applicable scales were identified for use with adolescents, the most used being the Smart-phone Addiction Proneness Scale and the Smartphone Addiction Scale-Short Version. Most scales include the ollowing domains: abstinence, tolerance, compulsion, and the effect of addiction on daily life. It was conclud-ed that smartphone addiction is a growing public health problem on a global scale that may compromise adoles-cents' health. This construct has been measured by val-idated and reliable scales, but no Brazilian studies have been identified in the period investigated, so it is necessary to adapt and validate instruments with this population to better understand the phenomenon in Brazil

Fatores relacionados à dependência do smartphone em adolescentes de uma região do Nordeste brasileiro / Factors related to smartphone addiction in adolescents from a region in Northeastern Brazil

Resumo Há relatos de efeitos adversos na saúde física e mental dos adolescentes associados ao uso excessivo do smartphone. O objetivo deste artigo é avaliar a dependência do smartphone e os fatores relacionados em adolescentes de uma região do Nordeste brasileiro. Trata-se de estudo transversal realizado em seis Escolas Estaduais de Educação Profissional (EEEPs), na cidade de Fortaleza, Ceará, Brasil, desenvolvido entre setembro e outubro de 2019. Participaram 286 adolescentes, entre 15 e 19 anos, que responderam cinco instrumentos de coleta. Análises bivariada e multivariada foram utilizadas para avaliar os fatores relacionados ao desfecho, pelo SPSS versão 23.0. A dependência do smartphone apresentou prevalência de 70,3%, e mostrava associação com menor idade (OR=0,583; p=0,001), menos horas de sono (OR=0,715; p=0,020), mais tempo de uso no final de semana (OR=1,115; p=0,015), queixa de dor cervical (OR=2,206; p=0,020) e suspeita de transtorno mental comum (OR=1,272; p=0,000). Evidenciou-se elevada dependência do smartphone nos adolescentes da amostra, relacionada a múltiplos fatores. Alerta-se para a importância de campanhas educativas que orientem os adolescentes, pais, educadores e profissionais de saúde para os riscos do uso excessivo de smartphones à saúde dos adolescentes.

Abstract Adverse effects on the physical and mental health of adolescents associated with excessive smartphone use have been reported. This paper aims to assess adolescent smartphone addiction and related factors in a region in Northeastern Brazil. This cross-sectional study was carried out in six State-run Professional Education Schools in Fortaleza, Ceará, Brazil, from September to October 2019 with 286 adolescents aged 15-19 years who completed five data collection instruments. Bivariate and multivariate analyses were performed to assess factors related to the outcome using SPSS version 23.0. Smartphone addiction prevalence rate was 70,3% and was associated with being underage (OR=0,583; p=0,001), fewer sleep hours (OR=0,715; p=0,020), longer use on weekends (OR=1,115; p=0,015), cervical pain (OR=2,206; p=0,020), and suspected common mental disorder (OR=1,272; p=0,000). A high smartphone addiction level was observed among adolescents in the sample and was related to multiple factors. Attention should be drawn to the importance of educational campaigns to guide adolescents, parents, educators, and health professionals about the risks of excessive smartphone use to the health of adolescents.

Predictors of gaming disorder in children and adolescents: a school-based study

Objective: To determine whether psychiatric and gaming pattern variables are associated with gaming disorder in a school-based sample. Methods: We analyzed data from the Brazilian High-Risk Cohort for Psychiatric Disorders, a community sample aged 10 to 18, using questionnaires on gaming use patterns. We applied the Gaming Addiction Scale to diagnose gaming disorder and the Development and Well-Being Behavior Assessment for other diagnoses. Results: Out of 407 subjects, 83 (20.4%) fulfilled the criteria for gaming disorder. More role-playing game players were diagnosed with gaming disorder that any other genre. Gaming disorder rates increased proportionally to the number of genres played. Playing online, being diagnosed with a mental disorder, and more hours of non-stop gaming were associated with higher rates of gaming disorder. When all variables (including age and gender) were considered in a logistic regression model, the number of genres played, the number of non-stop hours, the proportion of online games, and having a diagnosed mental disorder emerged as significant predictors of gaming disorder. Conclusion: Each variable seems to add further risk of gaming disorder among children and adolescents. Monitoring the length of gaming sessions, the number and type of genres played, time spent gaming online, and behavior changes may help parents or guardians identify unhealthy patterns of gaming behavior.

The future of precision medicine in opioid use disorder: inclusion of patient-important outcomes in clinical trials

Opioid use has reached an epidemic proportion in Canada and the United States that is mostly attributed to excess availability of prescribed opioids for pain. This excess in opioid use led to an increase in the prevalence of opioid use disorder (OUD) requiring treatment. The most common treatment recommendations include medication-assisted treatment (MAT) combined with psychosocial interventions. Clinical trials investigating the effectiveness of MAT, however, have a limited focus on effectiveness measures that overlook patient-important outcomes. Despite MAT, patients with OUD continue to suffer negative consequences of opioid use. Patient goals and personalized medicine are overlooked in clinical trials and guidelines, thus missing an opportunity to improve prognosis of OUD by considering precision medicine in addiction trials. In this mixed-methods study, patients with OUD receiving MAT (n=2,031, mean age 39.1 years [SD 10.7], 44% female) were interviewed to identify patient goals for MAT. The most frequently reported patient-important outcomes were to stop treatment (39%) and to avoid all drugs (25%). These results are inconsistent with treatment recommendations and trial outcome measures. We discuss theses inconsistencies and make recommendations to incorporate these outcomes to achieve patient-centered and personalized treatment strategies.

Políticas públicas dirigidas a personas consumidoras de drogas: Estrategias para la desestigmatización y la promoción de los derechos humanos / Public policies for people who use drugs: Strategies for the elimination of stigma and the promotion of human rights

RESUMEN El objetivo de este artículo es aportar ideas teóricas y prácticas para la mejora de las políticas de drogas actuales, basadas en un modelo biológico de la enfermedad y en la criminalización de las personas que consumen sustancias ilegales. Para ello, en primer lugar, se ofrecen alternativas para superar las bases científicas biologicistas centradas en los postulados neurocientíficos, que apoyan la idea de que en el cerebro se materializa la etiología de la adicción, y apoyar los modelos basados en las ciencias sociales, en los que el contexto y el aprendizaje social juegan un papel relevante para la descripción, el abordaje y la gestión de los diferentes usos de sustancias psicoactivas. En segundo término, se ofrecen modelos y propuestas epistemológicas, desde una perspectiva práctica, para sostener o implementar políticas y programas acorde con un abordaje más sostenible, basado en la eliminación del estigma y la promoción de la participación política de personas consumidoras de sustancias ilegales, es decir, unas políticas sobre drogas basadas en derechos humanos.

ABSTRACT This paper aims to provide theoretically informed practical proposals for the improvement of current drug policies, which are based on a biological model of disease and the criminalization of people who use drugs. First, we present alternatives to a biologically-oriented scientific conception centered around neuroscientific postulates, which support the idea that the etiology of addiction materializes in the brain, in favor of models based on the social sciences where context plays a relevant role in the description and management approaches regarding different uses of psychoactive substances. Second, epistemological models and proposals are offered from a practical perspective to sustain or implement policies and programs in accordance with a more sustainable approach based on the elimination of stigma and the promotion of political participation of people who use drugs. In short, drug policies based on human rights.

The Impact of COVID-19 pandemic on addictive behaviors: an integrative review / O impacto da pandemia COVID-19 em comportamentos aditivos: uma revisão integrativa / El impacto de la pandemia COVID-19 en las conductas adictivas: una revisión integrativa

Addictive behaviors and their impacts have been widely explored. Going through a pandemic moment requires further research since crisis situations involve higher propensity to dependency. The aim of this integrative review was to identify studies that have been conducted so as to explore behaviors related to brain's reward system in a pandemic period, which include substance addiction, internet addiction, gaming and other overusing behaviors. In order to accomplish our objective an integrative search was conducted in CAPES periodicals. Some inclusion and exclusion criteria were used to select the studies and in total (N=12) were explored independently. The results showed that there is an increasingly concern about health care systems, especially for those addicted to substances who need daily support, since addictions habits may have also increased. Behavioral addictions also increased and were exploited in some studies, especially those related to technologies, such as gaming and smartphone usage.

Comportamentos aditivos e seus impactos têm sido amplamente explorados. Passar por um momento de pandemia requer ainda mais pesquisas, pois situações de crise envolvem maior propensão a dependências. O objetivo desta revisão foi identificar estudos conduzidos que exploraram comportamentos relacionados ao sistema de recompensa cerebral em momentos de pandemia, incluindo, adição a substâncias, adição a tecnologias, jogos e outros comportamentos excessivos. Buscando alcançar nossos objetivos, uma pesquisa integrativa foi conduzida nos periódicos da CAPES. Alguns critérios de inclusão e exclusão foram utilizados para selecionar os estudos, e, no total, (N=12) foram explorados independentemente. Os resultados mostraram que existe grande preocupação com relação aos sistemas de saúde, principalmente, para as pessoas que são adictas a substâncias e necessitam de suporte diário, devido ao aumento nos hábitos de adição. Comportamentos aditivos também intensificaram e foram explorados em alguns estudos, especialmente aqueles relacionados às tecnologias, como os jogos e o uso do smartphone.

Las conductas adictivas y su impacto han sido ampliamente explorados. Pasar por una pandemia requiere más investigación, pues las situaciones de crisis implican una mayor propensión a la dependencia. El objetivo de esta revisión fue identificar los estudios realizados que exploran comportamientos relacionados con el sistema de recompensa del cerebro durante una pandemia: adicción a sustancias, adicción a Internet, juegos de azar, entre otras. Se llevó a cabo una búsqueda integrativa en las publicaciones de revistas CAPES utilizando algunos criterios de inclusión y exclusión, y se estudiaron en total (N=12) de forma independiente. Los resultados mostraron que existe una preocupación cada vez mayor por los sistemas de atención de la salud, especialmente para adictos a sustancias que necesitan apoyo diario, debido al posible aumento de los hábitos adictivos. Las adicciones comportamentales relacionadas con tecnologías también aumentaron, especialmente las relacionadas con los juegos y el uso de teléfonos inteligentes.

Prevalence and risk factors for internet gaming disorder

Objectives: To estimate the prevalence of internet gaming disorder (IGD) and associated risk factors in a sample of secondary and postsecondary students from a public federal institution of higher education (Instituto Federal de Educação, Ciência e Tecnologia) in Southern Brazil. Methods: The study included a sociodemographic questionnaire, the Beck Depression Inventory (BDI), Self-Report Questionnaire (SRQ-20), Pittsburgh Sleep Quality Index (PSQI-BR), the Mini-Social Phobia Inventory (Mini-SPIN), and the Game Addiction Scale (GAS). Finally, IGD was measured with the Brazilian version of the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), which has been psychometrically validated in this population. Results: Overall, 38.2% (n=212) of the sample exhibited IGD symptoms, with 18.2% (n=101) being classed as at-risk gamers. Regression analysis found IGD to be associated with male gender, severe depressive symptoms, poor sleep quality, increased time spent gaming, and total free time spent gaming (p < 0.001). Conclusions: The prevalence of IGD in this sample was relatively high, and associated risk factors found were similar to those previously reported in the literature. Further studies investigating the epidemiology of IGD in Brazilian samples are warranted to better understand treatment needs and inform preventive measures in this population.

O uso intensivo da internet por crianças e adolescentes no contexto da COVID-19 e os riscos para violências autoinflingidas / The intensive use of the internet by children and adolescents in the context of COVID-19 and the risks for self-inflicted violence

Resumo O presente ensaio busca discutir as implicações do isolamento social devido à pandemia do COVID-19 para o uso intensivo da internet entre crianças e adolescentes e suas possíveis consequências para a prática de violências autoinflingidas. Discutimos brevemente o potencial ansiogênico e a reprodução de um "medo global" que se consolidam com a exposição maciça e sem mediação dos conteúdos consumidos, que podem aumentar as vulnerabilidades para estresse e ideações suicidas. Centramos nosso debate sobre práticas "recreativas", denominadas de "desafios" com poder autolesivo, realizados por adolescentes no site Youtube. Essa prática revelou-se crescente a partir das medidas de isolamento social. Nossa reflexão sobre esses riscos é feita a partir da perspectiva teórica da sociabilidade digital, e suas implicações nas interações de adolescentes mediadas pela internet.

Abstract This essay aimed to discuss the implications of social isolation due to the COVID-19 pandemic for the intensive use of the internet among children and adolescents and its possible consequences for the practice of self-inflicted violence. We briefly discussed the anxiogenic potential and the reproduction of a "global fear" that are consolidated with the massive and unmediated exposure of the content consumed, which can increase the vulnerabilities to stress and suicidal ideas. We centered our debate on "recreational" practices, called "challenges" with self-harm power, carried out by teenagers on the YouTube website. This practice has been shown to increase with the social isolation measures. Our reflection on these risks builds on the theoretical perspective of digital sociability, and its implications for the internet-mediated interactions of adolescents.

Predictors of problematic smartphone use among university students

Abstract Predictors of problematic smartphone use have been found mainly in studies on elementary and high school students. Few studies have focused on predictors related to social network and messaging apps or smartphone model. Thus, the objective of our study was to identify predictors of problematic smartphone use related to demographic characteristics, loneliness, social app use, and smartphone model among university students. This cross-sectional study involved 257 Brazilian university students who answered a smartphone addiction scale, a questionnaire about smartphone usage patterns, and the Brazilian version of the UCLA-R loneliness scale. Women, iPhone owners, and users of Instagram and Snapchat had significantly higher smartphone addiction scores. We found correlations between scores for the Brazilian version of smartphone addiction scale and the importance attributed to WhatsApp, Facebook, Instagram, and Snapchat, and the Brazilian version of the UCLA-R loneliness scale. Our hierarchical regression model predicted 32.2% of the scores of the Brazilian version of the smartphone addiction scale, with the greatest increase in predictive capability by the step that added smartphone social app importance, followed by the step that added loneliness. Adding the smartphone model produced the smallest increase in predictive capability. The theoretical and practical implications of these results are discussed.

Escala de phubbing para relacionamentos amorosos: evidências de adequação psicométrica / Partner phubbing scale: evidence of psychometric adequacy / Escala de phubbing en la pareja: evidencia de adecuación psicométrica

O presente trabalho foi organizado em dois estudos e teve por objetivo adaptar e buscar evidências de validade e precisão da Escala de Phubbing para Relacionamentos Amorosos (EPRA) para o contexto brasileiro. O Estudo 1 teve a participação de 233 pessoas em relacionamento amoroso, 52,4% eram do sexo feminino, tendo média de idade de 30,9 anos (min. 18, máx. 62 e dp=9,23). pessoas enquanto o Estudo 2 contou com 217 pessoas também em relacionamento amoroso, sendo que 62,2% era do sexo feminino, tendo média de idade de 25 anos (min. 18, máx. 53 e dp=5,98). Em ambos os estudos eles responderam à EPRA e a questões sociodemográficas. Os resultados do Estudo 1 foram a nível exploratório apontando a unidimensionalidade do instrumento com consistência interna de 0,90; no Estudo 2 a análise fatorial confirmatória apontou para bom ajustamento do modelo unidimensional (CFI = 0,99; TLI = 0,99; e RMSEA (IC 90%) = 0,033) com confiabilidade de 0,88. Os dados sugerem que a EPRA é adequada para uso em pesquisas futuras sobre o partner phubbing, visto sua adequação aos parâmetros psicométricos investigados em dois momentos diferentes

This work was organized in two studies and aimed at adapting and validating the Partner Phubbing Scale for the Brazilian reality. Study 1 had the participation of 233 people in a romantic relationship, 52,4% were female, with an average age of 30,9 years (min. 18, max. 62 and SD = 9.23) while Study 2 had 217 people also in a romantic relationship, 62,2% were female, with an average age of 25 years (min. 18, max. 53 and SD = 5,98). In both studies, respondents answered the Partner Phubbing Scale and sociodemographic questions. The results of Study 1 were at the exploratory level evidencing the unidimensionality of the instrument with an internal consistency of 0,90. In Study 2, the confirmatory factor analysis evidenced a good fit of the one-dimensional model (CFI = 0,99; TLI = 0,99; e RMSEA (IC 90%) = 0,033) with reliability of 0,88. The data suggests that the Partner Phubbing Scale is suitable for future research on the phubbing partner, given its adequacy to the psychometric parameters investigated at two different times

El presente trabajo fue organizado en dos estudios y tuvo por objetivo adaptar y validar la Escala Partner Phubbing para la realidad brasileña. El estudio 1 contó con la participación de 233 personas en una relación romántica, el 52,4% eran mujeres, con una edad promedio de 30,9 años (mínimo 18, máximo 62 y DE = 9,23), mientras que el Estudio 2 tenía 217 personas también en una relación romántica, con un 62,2% de mujeres, con una edad promedio de 25 años (mínimo 18, máximo 53 y DE = 5,98). En ambos estudios respondieron a Partner PhubbingScale y a cuestiones sociodemográficas. Los resultados del Estudio 1 fueron a nivel exploratorio, apuntando la unidimensionalidad del instrumento con una consistencia interna de 0,90; en el Estudio 2 el análisis factorial confirmatorio apuntó para un buen ajuste del modelo unidimensional (CFI = 0,99, TLI = 0,99, y RMSEA (IC 90%) = 0,033) con confiabilidad de 0,88. Los datos sugieren que el Partner Phubbing Scale es adecuado para su uso en investigaciones futuras sobre el partner phubbing, visto su adecuación a los parámetros psicométricos investigados en dos momentos diferentes