Gaming disorder test: Assessing psychometric properties, prevalence, temporal stability, and invariance using a Czech two-time-point longitudinal sample.

In 2019, Gaming Disorder (GD) was acknowledged as an official diagnosis by the World Health Organization. The Gaming Disorder Test (GDT) is the most widely used tool to measure GD; however, due to its novelty, various measurement properties are still unexplored, and the number of validated language variants is still limited. The present study is the first to assess the psychometric properties of the Czech version of the GDT. Further, it focuses on its temporal prevalence and stability, gaming genre invariance, and criterion validity. A large-scale sample of adult Czech gamers collected at two points within nine months was analysed - T1 N = 5356; T2 N = 6077; longitudinal sample N = 1430. Confirmatory factor analysis (CFA), structural equation modelling (SEM), and multigroup CFA were employed to assess the measurement invariance. The study confirmed the one-factor structure of the GDT and showed that it is invariant across preferred gaming genres and the time of data collection. It showed a negative relationship with life satisfaction and a positive relationship with anxiety, even when controlling for their mutual relationships. The prevalence in the longitudinal sample was equal to or below 1.9% in each wave, but only 0.5% in the longitudinal sample (hence n = 7 participants fulfilled in both waves the criteria for GD). The study suggests that the Czech version of the GDT has good psychometric properties, including temporal stability and invariance across gaming genres, so it is suitable for the survey type and epidemiological investigation of the ICD-11's Gaming Disorder.

Alexithymia in gaming addiction and engagement.

BACKGROUND: It has been suggested that alexithymia plays a significant role in substance and behavioral addictions. However, only a handful of studies investigated this construct in relation to gaming addiction, and no study analyzed its differential effect on gaming engagement and addiction. METHODS: A total of u adult gamers (Mage = 26.04, SD = 5.78, 94 % male) completed a questionnaire that included the Toronto Alexithymia Scale (and its subscales of difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking), the Addiction-Engagement Questionnaire, and additional questions about gender, age, and time spent gaming. Structural equation modeling was used as the main analytical strategy. RESULTS: Difficulty identifying feelings (ß = 0.28) and externally oriented thinking (ß = 0.19) showed a significant positive effect on gaming addiction. Contrary to addiction, externally oriented thinking showed a significant negative effect (ß = -0.21) on gaming engagement. No other alexithymia subscales were significant. The model with alexithymia explained 32.7 % of the variance in gaming addiction while only 10.4 % of gaming engagement. CONCLUSIONS: Alexithymia is a strong predictor of gaming addiction. Gaming engagement seems to be a qualitatively different phenomenon that shows an opposite association with alexithymia than gaming addiction. However, both are related to increased time spent gaming. This suggests a need to distinguish between problematic vs. non-problematic excessive gaming as they have different associations with affect dysregulation.

Translating the user-avatar bond into depression risk: A preliminary machine learning study.

Research has shown a link between depression risk and how gamers form relationships with their in-game figure of representation, called avatar. This is reinforced by literature supporting that a gamer's connection to their avatar may provide broader insight into their mental health. Therefore, it has been argued that if properly examined, the bond between a person and their avatar may reveal information about their current or potential struggles with depression offline. To examine whether the connection with an individuals' avatars may reveal their risk for depression, longitudinal data from 565 adults/adolescents (Mage = 29.3 years, SD = 10.6) were evaluated twice (six months apart). Participants completed the User-Avatar-Bond [UAB] scale and Depression Anxiety Stress Scale to measure avatar bond and depression risk. A series of tuned and untuned artificial intelligence [AI] classifiers analyzed their responses concurrently and prospectively. This allowed the examination of whether user-avatar bond can provide cross-sectional and predictive information about depression risk. Findings revealed that AI models can learn to accurately and automatically identify depression risk cases, based on gamers' reported UAB, age, and length of gaming involvement, both at present and six months later. In particular, random forests outperformed all other AIs, while avatar immersion was shown to be the strongest training predictor. Study outcomes demonstrate that UAB can be translated into accurate, concurrent, and future, depression risk predictions via trained AI classifiers. Assessment, prevention, and practice implications are discussed in the light of these results.

Differences between problematic internet and smartphone use and their psychological risk factors in boys and girls: a network analysis.

BACKGROUND: Problematic internet and smartphone use are significant health challenges for contemporary adolescents. However, their mutual relationship is unclear because studies investigating these phenomena are scarce. The present study aimed to investigate the psychological risks and protective factors associated with problematic internet and smartphone use. METHOD: A representative sample of Slovak adolescents (N = 4070, Mage = 14.38, SDage = 0.77, 50.5% girls) from the Health Behavior in School-aged Children project was analyzed using network analysis separately for boys and girls. RESULTS: The results showed weak (for boys) and moderate (for girls) associations between problematic internet use and problematic smartphone use. Risk factors showed stronger associations with problematic internet use than problematic smartphone use, with the exception of fear of missing out, which was strongly associated with problematic smartphone use. The central nodes were externalizing problems for boys and internalizing problems, externalizing problems, and resilience for girls. CONCLUSION: The study concluded that while problematic internet use and problematic smartphone use are somewhat related, they differ at the psychological level. In addition, the phenomena are rather different between boys and girls.

Sexual Difficulties in People 50+: A Content Analysis of Sex-related Queries Posted on Professional Counseling Websites.

Although sexual activity has been found to be both important and challenging for people aged 50+, relatively little is known about the concerns that they have with respect to their sexual lives and how help-seeking behavior manifests on counseling platforms. A sample of 293 sex-related queries that Czechs aged 50+ posted on professional counseling websites were subjected to a quantitative and qualitative content analysis. The majority of posts were written by men and their dominant issues were erectile difficulties, partner's lack of interest in sex, and drug use/interaction when treating sexual difficulties and other ailments. Using a thematic analysis, the study showed that sex-related concerns were based within the context of worries about maintaining relationships and re-partnering in mid- and later life, and probing for the normal aspects of aging and the associated changes in sexual health. The online setting of the counseling websites facilitated the posting of both general and personalized queries to get oriented in problems, to triangulate with previous information, and to check the treatability of difficulties when past treatments failed. These findings suggest that online counseling puts a great demand on professionals' knowledge and understanding of the specifics of later-life sexual health.

Adolescents' problematic internet and smartphone use in (cyber)bullying experiences: A network analysis.

BACKGROUND: This study investigates both offline and online bullying perpetration and victimization in association with problematic internet use (PIU) and problematic smartphone use (PSU), while also considering the related psychosocial difficulties. METHODS: A total of 3939 adolescents (49.4% boys, aged 13-15 years) from a representative sample of schools in Slovakia was obtained from the Health Behavior in School-aged Children (HBSC) project in 2018. Due to the lack of similar complex research and the expected mutual associations among the constructs, we compared exploratory network models that provided separate estimates for boys and girls. RESULTS: The constructs formed similarly clustered networks for both genders, with a few notable differences. Unlike PIU, PSU was not associated with bullying experiences in boys or girls; however, PSU and PIU were partially related in girls. Bullying experiences formed a strong cluster in both networks. Two strong bridges were identified, and they are potential candidates for intervention in both boys and girls: first, traditional bullying victimization connected the cluster of bullying experiences to psychosocial difficulties; and, second, frequently missing sleep or meals due to internet use (behavioral salience) that is connected to the bullying cluster with PIU. CONCLUSIONS: The findings offer an indication for the preventive and interventive work of practitioners who deal with adolescents, as well as complex gender comparisons for the mutual relations of problematic internet and smartphone use, bullying experiences, and the psychosocial difficulties of youth. This study provides evidence that problematic digital media can play a role in bullying experiences irrespective of whether bullying happens offline or online.

The Role of Non-penetrative Partnered Sex Activities in the Associations Among Erectile Difficulties, Sex and Relationship Satisfaction in Men Aged 50.

Objectives: This study examined the associations among erectile difficulties, sexual satisfaction, and relationship satisfaction, and whether there is a buffering effect of non-penetrative partnered sex on relationship satisfaction in men aged 50+ who report erectile difficulties. Methods: An analysis of survey data from 431 Czech men (aged 50-96, Mdn = 64). Results: Engagement in non-penetrative partnered sex did not moderate the relationship between erectile difficulties and sexual and relationship satisfaction, but it was linked to higher sexual and relationship satisfaction. Conclusions: The buffering effect of non-penetrative practices for the link between erectile difficulties and relationship satisfaction has not been supported.

Validation of the Social Media Disorder Scale using network analysis in a large representative sample of Czech adolescents.

Background: The importance of studying the excessive use of social media in adolescents is increasing and so is the need for in-depth evaluations of the psychometric properties of the measurement tools. This study investigated the properties of the Social Media Disorder Scale (SMDS) in a large representative sample of Czech adolescents. Methods: We analyzed the representative sample of 13,377 Czech adolescents (50.9% boys), 11-16 years old, who participated in the Health Behavior in School-aged Children (HBSC) survey (2017-18), using confirmatory factor analysis (CFA) and network models. Furthermore, we evaluated the measurement invariance and constructed the validity of the SMDS. Results: We found support for a single dominant factor but not for strict unidimensionality. Several residual correlations were identified. The strongest were for: problems-conflicts-deceptions; persistence-escape; and preoccupation-tolerance-withdrawal. Girls, particularly 13- and 15-year-olds, scored higher than boys in the same age group, and 13- and 15-year-olds achieved higher scores than 11-year-olds, although some items were not invariant between the groups. The SMDS was positively related to other online activities, screen time, and falling asleep late, but negatively related to well-being and mental health. Discussion and conclusions: The SMDS showed solid psychometric properties and construct validity. However, small violations of measurement invariance were detected. Furthermore, the network analysis showed important residual relationships between the items.

Online Sex Addiction: A Qualitative Analysis of Symptoms in Treatment-Seeking Men.

Background: Problematic sexual internet use has been attracting increasing research attention in recent years. However, there is a paucity of qualitative studies about how this problem manifests on a daily basis in the clinical population and whether the phenomenon should fall within the hypersexual, compulsive-impulsive, or addictive spectrums of disorders. Methods: Twenty-three semi-structured interviews, including AICA-C clinical interviews, were conducted with men who were in treatment for problematic internet sex use (aged 22-53; Mage = 35.82). The interview structure focused on the patterns of sexual behavior in question, their development, the manifestation of symptoms, and other associated psychosocial problems. A thematic analysis was applied as the main analytical strategy. Results: Typical problematic patterns included pornography use and cybersex, together with continuous masturbation for several hours several times a week. This pattern emerged relatively early in young adulthood and became persistent for years. The majority of participants fulfilled the criteria for behavioral addiction (as defined, e.g., by the components model of addiction), with loss of control and preoccupation being the most pronounced and withdrawal symptoms being the least. Together with the onset of erectile dysfunction, negative consequences were reported as being slowly built up over years and typically in the form of deep life dissatisfaction, regret, and feelings of unfulfilled potential. Discussion and Conclusion: The Addiction model is relevant for describing the difficulties in treatment-seeking men who suffer from problematic sexual internet use. However, the manifestations of the additional criteria are nuanced. In the case of negative consequences, their onset might be very slow and not easily reflected. While there was evidence of several forms of tolerance, potential withdrawal symptoms in online sex addiction need further attention to be verified.

Eating disorders symptoms and excessive internet use in adolescents: the role of internalising and externalising problems.

BACKGROUND: Both eating disorders and excessive internet use represent significant health issues for contemporary adolescents. Yet, the link between them has seldom been investigated. We aim to study this association through their common underlying psychological factors: internalising problems and externalising problems. METHODS: A representative sample of 7,083 adolescents (Mage = 13.48 years; SDage = 1.32; 50.3% girls) from Slovakia was obtained from the Health Behaviour in School-aged Children (HBSC) project in 2018. Study variables included the Excessive Internet Use Scale (EIU) and the Strength and Difficulties Questionnaire (SDQ). Eating disorders symptoms (EDS) were assessed by SCOFF and selected items from the Eating Disorder Screen for Primary Care (ESP). Data were analysed separately for boys and girls with Structural Equation Modelling. RESULTS: There was a partial correlation between EDS and EIU (r = 0.36 for boys and r = 0.29 for girls) after controlling for the internalising and externalising of problems. Internalising and externalising problems were positively associated with EDS, while EIU was only associated with externalising problems. The results were comparable for both genders. CONCLUSION: The study provides evidence that, during adolescence, EDS and EIU are related and have a tendency to occur together. Also, they are related even when controlled for their shared underlying psychological factors, namely the emotional and attentional/behavioural difficulties.

The study found that, in adolescents, eating disorders symptoms are associated with excessive internet use even when controlled for their shared psychological factors. Self-control issues were associated with both the eating disorder symptoms and excessive internet use, while emotional issues were only associated with the eating disorder symptoms. The strength of the relationship was similar for boys and girls, even though the prevalence of eating disorders symptoms was double in girls.

Associations among Sexual Activity, Relationship Types, and Health in Mid and Later Life.

Despite a growing amount of research on sexuality in mid and later life, relatively little is known about the associations among sexual activity, relationship types, and health. This paper analyzes data from the Survey of Health, Ageing and Retirement in Europe (SHARE) for the subpopulation of respondents residing in the Czech Republic (N = 1304, 49% women; Mage = 69.1, SDage = 8.0). Hierarchical ordinal regression models showed that persons who stayed in newly formed or less traditional relationship types, such as dating, Living-Apart-Together (LAT) relationships, and cohabitation, reported a higher frequency of sexual activity than married people. Overall, the dating and LAT relationship group displayed the highest sexual frequency and the lowest incidence of chronic diseases. People in marriages and cohabitation were comparable with respect to the number of chronic diseases. The findings suggest that sexual activity is intertwined with later-life relationships and sexual frequency may vary according to the relationship type. Future research may benefit from probing the extent to which partnered sex is important for maintaining bonds between older partners with separate households.

Social constraints associated with excessive internet use in adolescents: the role of family, school, peers, and neighbourhood.

OBJECTIVES: Excessive internet use (EIU) has been studied predominantly within the context of individual risk factors. Less attention has been paid to social factors, especially in a fashion complex enough to include the multiple domains of adolescent socialization. This study examined the relationship between EIU and constraints within family, school, peer groups, and neighbourhoods, while controlling for emotional and behavioural difficulties. METHODS: This study was based on survey data from the Health Behaviour in School-aged Children study, which was conducted in Slovakia in 2018. The sample of representative adolescents totalled 8400 (mean age: 13.44 years; SDage = 1.33; 50.9% boys). RESULTS: Multiple-step linear regression revealed that, after controlling for sociodemographic factors and emotional and behavioural difficulties, peer problems had the least effect, while the constraints related to family and neighbourhood stood out as especially problematic. Combined variables explained 20% variance of EIU. CONCLUSIONS: Social constraints proved to be important factors in adolescent EIU. The important role of a problematic neighbourhood is a novel finding and suggests that it should be targeted in prevention.

The Associations between Family-Related Factors and Excessive Internet Use in Adolescents.

This study examined the relationship between Excessive Internet Use (EIU) in adolescents and their family environment, namely the family type, the family economic status, the effect of parental care, the level of parental control, the amount of parental monitoring, the quality of communication, and the time spent together. The study was based on data from an international survey, Health Behaviour in School Aged Children (HBSC), conducted in Slovakia. The sample representative for adolescents included 2547 participants (51% boys) aged 13-15. Multiple-step linear regression revealed that higher parental care and parental monitoring predicted lower EIU, while higher parental overprotection and lower socioeconomic status predicted higher EIU. The results suggest that both so-called optimal parenting (i.e., the balance of emotional warmth and protection) and the adolescent's autonomy lower the risk of EIU. Family factors explained about 14% of the variance, which suggests that aside from personal, cognitive and affective factors, a close social environment also plays an important role in adolescence EIU.

Gaming under the influence: An exploratory study.

Background and aims Association between substance use and excessive play of online games exists both in theory and research. However, no study to date examined playing online games under the influence of licit and illicit drugs. Methods We questioned a convenient online sample of 3,952 Czech online gamers on their experiences and motives of using caffeine, alcohol, tobacco, psychoactive pharmaceuticals, and illicit drugs while playing massive multiplayer online games (MMOGs). Results The results showed low prevalence of illicit drug use while playing online games. Substance use was positively associated with intensity of gaming and both addiction and engagement; psychoactive substances with stimulating effect were linked to higher engagement and gaming intensity, whereas use of sedatives was associated with higher addiction score. Substance use varied slightly with the preference of game genre. Discussion Drug use while playing appears as behavior, which is mostly not related to gaming - it concerns mostly caffeine, tobacco, alcohol, or cannabis. For some users, however, drug use was fueled by motivations toward improving their cognitive enhancement and gaming performance.

Do sleeping habits mediate the association between time spent on digital devices and school problems in adolescence?

Background: This study examined the associations of Internet and computer screen time with school difficulties and the role of sleep quality and soft and energy drinks consumption. Methods: We used data from the cross-sectional Health Behaviour in School-aged Children study collected in 2014 among Slovak adolescents (aged 11.0-15.9 years, N = 7595, 48.1% boys). We examined the inter-relations between time spent with on digital devices (time spent playing digital games or Internet use), sleeping quality (sleeping shortage, sleeping difficulties), soft/energy drinks consumption and school problems (low academic achievement, disliking school, being pressured by schoolwork and truancy), using structural equation modeling. Results: Results showed that the more time adolescents spent on digital devices during leisure time, the more school problems they had. This association was mediated by a higher consumption of soft or energy drinks and a lower quality of sleeping. The direct effect of time spent on digital devices on school problems and its indirect effect via sleeping quality were relatively small (-0.26 and -0.30, respectively, standardized solution), compared with the indirect effect of time spent on digital devices via soft/energy drinks consumption as well as sleeping quality (0.65, standardized solution). Conclusions: Time spent on digital devices is associated with school problems, with sleeping and soft/energy drinks consumption playing a substantial role in this association.

Screen-based behaviour in school-aged children with long-term illness.

BACKGROUND: Evidence is lacking on the screen-based behaviour of adolescents with a chronic condition. The aim of our study was to analyse differences in screen-based behaviour of adolescents by long-term illness, asthma and learning disabilities. METHODS: We used data from the cross-sectional Health Behaviour of School-aged Children study collected in 2014 among Slovak adolescents (age 13 to 15 years old, N = 2682, 49.7 % boys). We analysed the associations between screen-based behaviour and long-term illness, asthma and learning disabilities using logistic regression models adjusted for gender. RESULTS: We found no associations between screen-based behaviour and long-term illness, except that children with asthma had a 1.60-times higher odds of excessively playing computer games than healthy children (95 % confidence interval of odds ratio (CI): 1.11-2.30). Children with learning disabilities had 1.71-times higher odds of risky use of the Internet (95 % CI: 1.19-2.45). CONCLUSION: Adolescents with a long-term illness or with a chronic condition or a learning disability do not differ from their peers in screen-based activities. Exceptions are children with asthma and children with learning disabilities, who reported more risky screen-based behaviour.

Interpersonal dependency and online gaming addiction.

Background and aims The present study explores the relationship between social motivations and addiction to online gaming and if that possible connection can be explained by the personality traits responsible for social functioning. Methods We employ Bernstein's concept of interpersonal dependency to distinguish healthy dependency, dysfunctional detachment, and destructive overdependence, and Charlton and Danforth's conceptualisation of online gaming addiction and high engagement. An online questionnaire was administered to a self-nominated sample of 4,074 online gamers. Two regression models were constructed to separately explain gaming addiction and high engagement using social motivations to play, while controlling for age, gender, and time spent online. Results High scores on subscales measuring dysfunctional detachment and destructive overdependence were positively associated with online gaming addiction, while healthy dependency was negatively correlated with addiction scores. In contrast, the overall role of social motivation was negligible. Discussion People with healthy relationship profiles are less likely to develop problematic patterns of online gaming. High in-game engagement, although sharing some factors with addiction, was only poorly explained by the study variables, suggesting the mutual exclusiveness of addiction and engagement.

Excessive internet use in European adolescents: what determines differences in severity?

OBJECTIVES: This study investigated the differences between non-excessive, moderately excessive, and highly excessive internet use among adolescents. These differences were explored in terms of personal characteristics, psychological difficulties, environmental factors, and manner of internet use. METHODS: A representative sample was investigated, consisting of 18,709 adolescents aged 11-16 and their parents, from 25 European countries. Excessive internet use was measured using a five item scale covering following factors: salience, conflict, tolerance, withdrawal symptoms, and relapse and reinstatement. The main data analysis utilised multinomial and binary logistic regression models. RESULTS: The vast majority of respondents reported no signs of excessive internet use. Moderately excessive users (4.4%) reported higher emotional and behavioural difficulties, but also more sophisticated digital skills and a broader range of online activities. The highly excessive users (1.4%) differed from the non-excessive and moderately excessive users in their preference for online games and in having more difficulties with self-control. CONCLUSIONS: Adolescents who struggle with attention and self-control and who are inclined toward online gaming may be especially vulnerable to the otherwise uncommon phenomenon of excessive internet use.

Associations between online friendship and Internet addiction among adolescents and emerging adults.

The past decades have witnessed a dramatic increase in the number of youths using the Internet, especially for communicating with peers. Online activity can widen and strengthen the social networks of adolescents and emerging adults (Subrahmanyam & Smahel, 2011), but it also increases the risk of Internet addiction. Using a framework derived from Griffiths (2000a), this study examined associations between online friendship and Internet addiction in a representative sample (n = 394) of Czech youths ages 12-26 years (M = 18.58). Three different approaches to friendship were identified: exclusively offline, face-to-face oriented, Internet oriented, on the basis of the relative percentages of online and offline associates in participants' friendship networks. The rate of Internet addiction did not differ by age or gender but was associated with communication styles, hours spent online, and friendship approaches. The study revealed that effects between Internet addiction and approaches to friendship may be reciprocal: Being oriented toward having more online friends, preferring online communication, and spending more time online were related to increased risk of Internet addiction; on the other hand, there is an alternative causal explanation that Internet addiction and preference for online communication conditions young people's tendency to seek friendship from people met online.

Fourteen is fourteen and a girl is a girl: validating the identity of adolescent bloggers.

This study focuses on the phenomenon of lying on adolescents' weblogs. The sample consisted of 113 completed surveys out of 120 in total. The age of participants ranged between 13 and 17 years old. Interviews were conducted with 10 randomly selected participants whose answers were then verified. The results suggest not only that adolescents present personal information such as their age, gender, and place of residence but that these pieces of information are presented truthfully. Generally, the level of dishonesty was low, with young adolescents tending to lie more often about their interests. Public topics (school and life) had the most truthful answers, whereas the least truthful answers concerned intimate topics (family life, partnership). These results suggest that adolescents' blogs serve as a place where the writers can both present themselves and communicate with their peers in a way that goes beyond a traditional diary.