The association between traumatic experiences and substance and behavioral addictions in late adolescence: A role for PTSD and cPTSD as potential mediators.

BACKGROUND & AIM: Traumatic experiences (TEs) are a risk factor for behavioral and substance addictions (SBAs). However, the role of post-traumatic stress disorder (PTSD) and complex PTSD (cPTSD) deserves further elucidation. The present study assesses the association between different types of TEs on cannabis, alcohol, gambling, and problematic internet use in late adolescents. Furthermore, this study aims at evaluating the role of PTSD and cPTSD as potential mediators. METHODS: An observational cross-sectional study was conducted on one thousand ten late adolescents (510 males, 498 females; age: mean = 18.7, SD = 0.65). Data regarding intentional (iTEs) and unintentional TEs (uTEs), cannabis, alcohol, gambling and problematic use of the internet (PIU), PTSD, and cPTSD were collected. Association between TEs, SBAs, and PTSD/cPTSD symptoms were explored by means of logistic regressions. Mediation was assessed using a path analysis. RESULTS: uTEs were associated with cannabis use (OR = 1.34 [1.13,1.59]) and alcohol use (OR = 1.21 [1.10,1.35]), iTEs were associated with cannabis use (OR = 1.15 [1.06,1.25]), alcohol use (OR = 1.08 [1.02,1.13]), and PIU (OR = 1.17 [1.10,1.24]). PTSD was associated with alcohol use (OR = 1.59 [1.03,2.46]) and PIU (OR = 1.92 [1.18,3.13]). cPTSD was associated with cannabis use (OR = 3.54 [1.56,8.04]) and PIU (OR = 5.13 [2.71,9.70]). cPTSD mediated 58.75% of the total effect of iTEs on cannabis. Regarding PIU, PTSD mediated 68.18% of the effect of uTEs; the effect of iTEs on PIU was mediated by 65.5% via cPTSD and 34.45% via PTSD. CONCLUSION: cPTSD and SBAs show a complex pattern of association. A thorough assessment of stress-related conditions, including cPTSD, is of pivotal importance in treating SBAs.

A survey of the adoption and perception of mobile health applications among community pharmacists in Malaysia.

OBJECTIVES: To determine the adoption and perception of mobile health (mHealth) applications among community pharmacists in Malaysia. METHODS: A cross-sectional survey using a self-administered questionnaire was conducted with 300 community pharmacists in the Klang Valley, Malaysia using a stratified sampling approach. The questionnaire consisted of 36 questions with three sections: demographic data, adoption of mHealth applications and perception towards mHealth applications. Descriptive and inferential tests as well as exploratory factor analysis were used to analyse the data. KEY FINDINGS: Adoption of mHealth applications by community pharmacists for both professional and personal use was relatively high at 79.7%. Utilised mHealth applications were primarily from the medical references category, while applications for patient monitoring, personal care and fitness were used to a lesser degree. Among mHealth application users, only 65.7% recommended them to their patients. Overall perception towards mHealth applications was positive, but perception towards the benefits and favour of mHealth applications for their patients was lower. This was corroborated by the factor analysis, which identified four main factors explaining 59.9% of variance in the dataset. These factors were perception towards use in their own professional practice, perception on benefits and use in their patients, perception on specific features of mHealth applications, and reliability of mHealth applications. CONCLUSIONS: Adoption of mHealth applications among community pharmacists in Malaysia is high. Community pharmacists are more likely to use mHealth applications professionally and personally but less likely to recommend them to patients due to less favourable perceptions on how patients will benefit from mHealth applications.

Digital Competence, Use, Actions and Time Dedicated to Digital Devices: Repercussions on the Interpersonal Relationships of Spanish Adolescents.

Digital media play a fundamental role in the social, emotional, and cognitive development of adolescents, since they involve a very significant use and investment of time at this age. The objectives of this work are twofold: analyze the use of the Internet and digital devices by Spanish young people outside school, and the time they use them and their attitude towards the use of digital devices, as well as to identify the effects of the use of internet and digital devices on social and interpersonal relationships. The sample is composed of 35,943 students of Compulsory Secondary Education, from different Spanish high schools that participated in the PISA 2018 Report. The data provided by this study confirm the widespread consumption of digital devices. Identified as actions that they carry out every day were: the use of online chat, use of social networks to contact their friends, and surfing the internet for fun. Regarding the attitude towards digital devices, the participants say they feel comfortable using digital devices and discovering new applications or games. However, we also found as one of the most relevant results of this study the fact that participants say they feel bad if they do not have internet connection.

Family Factors Associated with Problematic Use of the Internet in Children: A Scoping Review.

Background: Problematic use of the internet (PUI) is a growing concern, particularly in the young population. Family factors influence internet use among children in negative ways. This study examined the existing literature on familial or parental factors related to PUI in children. Methods: A scoping review was conducted in EBSCOhost, PubMed, ScienceDirect, JSTOR, Biomed Central, VHL Regional Portal, Cochrane Library, Emerald Insight, and Oxford Academic Journal databases. Studies reporting data on family factors associated with PUI in children, published in English in the 10 years to July 2020 were included. The following data were extracted from each paper by two independent reviewers: methodology and demographic, familial, psychiatric, and behavioral correlates of PUI in children. Results: Sixty-nine studies fulfilled the eligibility criteria. Three themes emerged: parenting, parental mental health, and intrafamilial demographic correlates of PUI in children. Parenting styles, parental mediation, and parent-child attachment were the major parenting correlates. Conclusion: Literature on significant familial and parental factors associated with PUI in children is scarce. More research is required to identify the interactions of familial and parental factors with PUI in children, to develop informed management strategies to address this issue.

Problematic Use of the Internet Mediates the Association between Reduced Mentalization and Suicidal Ideation: A Cross-Sectional Study in Young Adults.

Suicide is a major public health problem, and it is urgent to investigate its underlying clinical and psychological concomitants. It has been suggested that low mentalization skills and problematic use of the internet (PUI) are factors that can play a role in suicidal behaviors. It is possible that poor mentalization skills contribute to leading to forms of PUI, which, in turn, can represent triggers for suicidal ideation (SI). We tested this hypothesis through a quantitative and cross-sectional study on a sample (n = 623) of young adults (age range: 18−34). Self-report measures investigating symptoms related to Social Media Addiction (SMA), Internet Gaming Disorder (IGD), mentalization capacity, and SI were used. A single mediation analysis with two mediators was carried out to evaluate the direct and indirect effects of mentalization on SI through the mediating role of SMA- and IGD-related symptoms, controlling for potential confounding factors (e.g., socio-demographic and addiction-related variables). The four explored variables were significantly associated with each other (all p < 0.001) across all subjects; the mediational model showed that the total effect of mentalization on SI was significant (B = −0.821, SE = 0.092 (95% CI: −1.001; −0.641)) and that both SMA- (B = −0.073, SE = 0.034 (95% CI: −0.145; −0.008)) and IGD-related symptoms (B = 0.046, SE = 0.027 (95% CI: −0.107; −0.001)) were significant mediators of such association. Our findings support the possibility that PUI severity plays a relevant role in mediating the association between low mentalization skills and levels of SI.

Determinants of internet use by school-age children: The challenges for Mexico during the COVID-19 pandemic.

The COVID-19 pandemic has further highlighted the deep digital divide in Mexico and the enormous challenge faced by its education system in continuing to educate the country's students while under confinement. The objective of this article was to examine the determinants of internet access, use and productive uses for school-age children in households of different socioeconomic levels. The Heckman selection model was estimated based on data taken from the Encuesta Nacional sobre Disponibilidad y Uso de Tecnologías de la Información en los Hogares (ENDUTIH or National Survey on the Availability and Use of Information Technologies in the Household) 2018. The results obtained show that the probability of having children internet accessing and usage patterns (homework, courses, and blogs) depends on level of schooling, economic status, digital skills, and place of residence, as well as the presence of electronic devices and infomediaries in the household. These findings suggest the urgent need to redesign current ICT policy with a long-term integrated vision that guarantees access to ICTs and their productive use for students immersed in an ecosystem of educational innovation for the XXI century.

The association of problematic use of social media and online videogames with aggression is mediated by insomnia severity: A cross-sectional study in a sample of 18- to 24-year-old individuals.

One of the worrying concomitants of problematic use of Internet (PUI) is aggression. Although the mechanisms underlying such link have not been completely clarified, it has been suggested that problematic use of social media and online videogames (i.e., two common forms of PUI among young adults) lead to increased sleep disturbances which, in turn, represent a relevant trigger for aggression. We have tested this hypothesis in a sample (N = 480) of young individuals (351 females and 129 males; mean age: 21.76 ± 1.92 years; range: 18-24). Self-report measures investigating symptoms related to social media addiction (SMA), Internet gaming disorder (IGD), insomnia severity, and aggression were used. Mediational models analyzing the direct and indirect associations of SMA- and IGD-related symptoms on aggression severity through insomnia-related symptoms were performed controlling for confounding factors. The models showed that the total effects of SMA-related symptoms (B = 0.018; p = .010) and of IGD-related symptoms (B = 0.018; p = .041) on aggression severity were significant and that these associations were mediated by insomnia-related symptoms (respectively, p < .001 and p = .003). Our findings support the potential mediating role of insomnia severity in the association of SMA- and IGD-related disturbances with levels of aggression.

Gender differences in the acceptance of wife-beating in Nigeria: evidence from the 2018 Demographic and Health Survey.

The world over, more than one-third of women have been victims of either physical or sexual violence, or both, most of which are perpetrated by intimate partners. Intimate partner violence (IPV) has negative consequences for women's health, socio-economic and psychological wellbeing. Similarly, acceptance of IPV has negative implications for its spread, sympathy for victims, and utilisation of antenatal and postnatal healthcare services among women. This study investigates the influence of age, education, location, religion, marriage type, employment, wealth level, extramarital sex, smoking, internet use, media exposure and decision making on the justification of IPV, and how the associations vary between men and women. The study utilised the 2018 Nigeria's Demographic and Health Survey. The data analysed was comprised of 8,018 men and 28,888 women who were married or living with a partner. It was found that women are more likely to accept IPV than men (AOR: 1.627). Educational difference between spouses influences women's experience of and acceptance of IPV. Overall, being young, being uneducated, living in the north, being Muslim, being polygamous, being employed, being poor, having extra-marital sex, being a smoker, not having access to internet, and not being exposed to the media increased the odds of IPV justification. However, while Muslim women had higher odds of accepting IPV than Christians (AOR: 1.587), Muslim men have lower likelihood of IPV justification than Christian men (AOR: 0.759). Gender differences also exist in the influence of age, marriage type, employment, extra-marital sex, smoking, media exposure and decision making. This study underscores the importance of applying differing intervention programmes to men and women where necessary.

Genetics of OCD and Related Disorders; Searching for Shared Factors.

Obsessive compulsive disorder (OCD) and several other obsessive-compulsive related disorders (OCRDs) including hoarding disorder, body dysmorphic disorder (BDD), skin picking disorder, trichotillomania and the newly arising public health conditions of online gaming and gambling disorders, under the umbrella of Problematic Usage of the Internet (PUI), not only share some common phenotypes, but there is evidence to suggest share some genetic risk factors. The simple fact that these disorders segregate within families points to this notion. However, the current data are still scarce. This chapter focuses on identifying the shared genetic factors. To address this question, a systematic review of the literature investigating genetic findings in OCD and OCRDs including PUI was conducted, with a focus on their genetic similarities. Greater knowledge of the specific genetic risks shared among OCRDs would be expected to open new avenues in the understanding of the biological mechanisms causing the development of these phenotypes, as well as provide opportunities to develop new animal and cellular models testing new therapy avenues.

Prevalence of internet addiction in healthcare professionals: Systematic review and meta-analysis.

BACKGROUND: Internet addition is becoming increasingly recognised as an important mental health problem. AIM: This study examined prevalence of internet addiction in healthcare professionals. METHOD: Systematic literature review was undertaken of June 4, 2020 with goal to identify studies that evaluated prevalence of internet addiction or problematic internet use in medical professionals. Reported associations with other mental health symptoms were also considered. RESULTS: Prevalence of internet addiction was studied in medical residents only (n = 770; three studies), faculty members only (n = 69; one study), nurses only (n = 564; one study) and mixed samples of medical professionals (n = 415; three studies). Pooled prevalence rate of internet addiction in 1,818 healthcare professionals was 9.7% (95% confidence interval: 5.8%-13.6%). Internet addiction was associated with greater mental symptom burden and fatigue of healthcare workers. CONCLUSION: Internet addiction is present in healthcare professionals, however, to a lesser extent than in medical students suggesting that increasing clinical responsibilities and increasing age can be important moderators of risk for internet addiction. Internet addiction is associated with greater burden of unfavourable mental health outcomes of healthcare professionals. Further studies exploring global burden of internet addiction in healthcare professionals and possible impact of internet addiction on work performance of healthcare professionals are encouraged.

The effects of parental control and warmth on problematic internet use in adolescents: A prospective cohort study.

Background and aims: Problematic internet use (PIU) is a highly prevalent condition with severe adverse effects. The literature suggests that parent-child bonding and parental behavioral control exert protective effects against PIU. However, the most relevant studies rely on simplistic measurement of parenting, cross-sectional designs and mixed-aged samples. Our study analyzed the effect of maternal and paternal parenting on PIU by using a prospective design and a cohort sample of same-aged children. Methods: Data from 1,019 Czech 12-year-old sixth-graders who were followed until ninth grade were used. Maternal and paternal responsiveness and strictness were reported by children using the Parental Acceptance-Rejection Questionnaire (PARQ) and the Parental Control Scale (PCS). PIU was measured by the Excessive Internet Use Scale (EIUS). Results: The self-reported PIU prevalence in nine-graders (15-year-old) was 8.1%. Parenting, reported by adolescents 18 months before PIU screening, showed significant relationships with PIU: parental responsiveness was negatively and moderately associated, while maternal strictness showed a weak positive association; the authoritative parenting style in both parents decreased PIU, with a PIU probability of 3.21%, while a combination of maternal authoritarian and paternal neglectful parenting was associated with PIU probability as high as 20.9%. Discussion and conclusions: The self-reported prevalence of PIU in Czech adolescents was found to be high. The effects of parenting on PIU were similar to the effects of parenting on other problematic behavior among adolescents. Our findings showed the need for interventions to prevent PIU by helping parents to apply optimal parenting styles.

Assessment of internet usage for health-related information among clients utilizing primary health care services.

OBJECTIVE: This study aimed to identify the frequency and goals of Internet usage to access health-related information among primary health care service clients. METHODS: The study was conducted in a primary health care centre with a sample of 788 adults. The data were collected through a questionnaire developed by the researchers. RESULTS: The results showed that 81% (n = 640) of the participants used the Internet. All Internet user participants reported that they used the Internet to access health-related information. Of the participants, 67% reported that they used the Internet primarily to obtain information about diseases with 94% reporting that they found the online information reliable and 92% reported that they did not confirm the information they obtained online. The frequency of Internet use to obtain health-related information increased with increase in the level of education of participants. Participants with higher education found the online information to be more reliable and comprehensible. The results showed that while the use of Internet to obtain health-related information was high, the information presented online was not always checked for accuracy. CONCLUSION: Hence, provision of current and evidence-based information on health-related websites is crucial to preserve community health care.

Eficacia académica percibida, crianza, uso de internet y comportamiento en la adolescencia / Achievement perceived, parenting, internet use and adolescent behavior

Resumen El uso intensivo de internet puede contribuir a desarrollar disfunciones psicosociales graves en la adolescencia. El objetivo de esta investigación es analizar las relaciones de la percepción de eficacia académica con el uso de internet para ocio, los estilos de crianza y los problemas exteriorizados e interiorizados en la adolescencia (agresividad proactiva, reactiva, física y verbal, afiliación a pares rebeldes e inestabilidad emocional). Han participado 762 adolescentes de 12 a 17 años (M = 13.69; DT = 1.40; varones 52.8%). Utilizan internet en tiempo de ocio entre cero y 98 horas semanales, de ahí que la población se haya distribuido en cuartiles. Las variables se han obtenido a través de pruebas estandarizadas. Los análisis estadísticos se basan en metodología descriptiva y predictiva. Los resultados han permitido obtener tres conclusiones. Primera, el número de horas de internet para fines recreativos se relaciona con una peor eficacia académica percibida. Segunda, los adolescentes que usan Internet intensamente perciben más permisividad de los padres y menos apoyo y comunicación por parte de los padres. Estos adolescentes presentan más riesgo de conectarse con pares rebeldes y tienen índices más altos de inestabilidad emocional y agresividad (reactiva, proactiva, física y verbal). Tercera, la paternidad más punitiva, la agresividad y la afiliación a pares rebeldes aumentan el uso intensivo de Internet. Esta investigación corrobora la necesidad de una formación adecuada, dirigida a fomentar el apoyo y la comunicación paterno-filial para educar el uso racional y responsable de internet de ambos, padres y adolescentes.

Abstract The intensive use of the Internet can contribute to the development of serious psychosocial dysfunctions in adolescents. The purpose of this research is to analyze the relationships between achievement perceived with the leisure use of the internet, parenting, and externalized and internalized problems during adolescence (aggressiveness reactive, proactive, physical and verbal, affiliation with deviant peers and emotional instability). The sample is made of 762 adolescents from 12 to 17 years old (M = 13.69, SD = 1.40), with 52.8% of males and 47.2% of females. The use of internet in leisure time is between 0-98 hours per week. Hence the population has been distributed in quartiles. The variables have been obtained through standardized tests. Statistical analyzes are descriptive and predictive methodology. The analyses carried out have allowed us to obtain three conclusions. First, the number of hours of internet for recreational purposes is related to worse achievement perceived of the adolescent. Second, it has been found that adolescents who use Internet intensively greater perceived permissiveness of the parents and a lower support and communication with them. These adolescents present an increased risk of joining deviant peers and have higher rates of emotional instability and aggressiveness (reactive, proactive, and physical and verbal). Third, more punitive parenting, aggressiveness and affiliation with deviant peers boost the intensive use of the internet. This empirical research corroborates the need for adequate training aimed at fostering parental-child support and communication to educate the rational and responsible use of the Internet by both parents and adolescents.

Behaviors Associated with Internet Use in Military Medical Students and Residents.

INTRODUCTION: Problematic use of video games, social media, and Internet-related activities may be associated with sleep deprivation and poor work performance. The Internet Addiction Test was given to military medical and nursing students and housestaff to assess problematic Internet use. METHODS: Medical and nursing students at the Uniformed Services University of the Health Sciences and residents from Naval Medical Center San Diego were contacted via email (n = 1,000) and given a survey that included the Internet Addiction Test (IAT) and questions asking about other specific lifestyle variables. Individuals who received an Internet Addiction Score (IAS) ≥50 were identified as likely experiencing harmful effects of Internet addiction (IA). RESULTS: Of 399 surveys submitted, 68 were omitted due to gross incompletion or failing to finish the entirety of the IAT. Of the participants included, 205 (61.1%) were male and 125 (37.9%) were female. The mean age was 28.6 years old (S.D. = 5.1 years). In regards to training status, completed surveys were assessed for 94 medical residents, 221 School of Medicine students, and 16 Graduate School of Nursing students. Our survey showed 5.5% of the participants (n = 18) indicated problems with Internet use that are concerning for IA. CONCLUSIONS: The study results indicated that our population showed problematic Internet use in the lower range of global estimates of IA. Rates of IA further decreased between medical students and residents. Multiple lifestyle variables were significantly associated with IA score and may serve as indicators of a higher score. Interestingly, the use of social media during sleeping hours was most significantly associated with increased IAS. This paper discusses IA among military medical and nursing trainees and how problematic Internet use may affect work performance and force readiness.

What, where and when? Using Google Trends and Google to investigate patient needs and inform pharmacy practice.

OBJECTIVES: The aim was to provide a comprehensive overview (using pertinent examples) of the various ways that Google Trends and Google data could inform pharmacy practice. The objectives were to: examine what type of information people search for in relation to a common class of medicines; ascertain where people are directed to (websites) following an initial search for a medicine or medical condition; and establish information about when they search. METHODS: The methodology differed depending on whether Google Trends or Google was being interrogated, but the search domain was always limited to the United Kingdom. Google Trends was queried, typically for a 5-year time frame, and data downloaded for many search inputs relating to medical conditions (self-treatable and non-self-treatable) and medicines (bought over-the-counter and prescribed). Google was queried and data collected for searches related to 'antibiotics'. KEY FINDINGS: Google Trends revealed a previously unknown seasonality pattern for irritable bowel syndrome. Related searches for 'antibiotics' revealed a high level of interest in the appropriateness of concomitant alcohol consumption and queries about what antibiotics are. Largely, people were being directed to reputable websites following their initial search input about a prescription-only medicine. However, searches for over-the-counter medicines were more likely to lead to commercial domains. CONCLUSIONS: This is one of the first studies to investigate use of Google Trends and Google in a pharmacy-specific context. It is relevant for practice as it could inform marketing strategies, public health policy and help tailor patient advice and counselling.

Are Adolescents Engaged in the Problematic Use of Social Networking Sites More Involved in Peer Aggression and Victimization?

The problematic use of social networking sites is becoming a major public health concern. Previous research has found that adolescents who engage in a problematic use of social networking sites are likely to show maladjustment problems. However, little is known about its links with peer aggression and victimization. The main goal of this study was to analyze the relationship between problematic use of online social networking sites, peer aggression -overt vs. relational and reactive vs. instrumental-, and peer victimization -overt physical and verbal, and relational-, taking into account gender and age (in early and mid-adolescence). Participants were selected using randomized cluster sampling considering school and class as clusters. A battery of instruments was applied to 1,952 adolescents' secondary students from Spain (Andalusia) (50.4% boys), aged 11 to 16 (M = 14.07, SD = 1.39). Results showed that girls and 14-16 adolescents were more involved in a problematic use of online social networking sites. Furthermore, adolescents with high problematic use of online social networking sites were more involved in overt-reactive and instrumental-and relational-reactive and instrumental-aggressive behaviors, and self-reported higher levels of overt-physical and verbal-and relational victimization. Even though boys indicated higher levels of all types of victimization, girls with high problematic use of online social networking sites scored the highest on relational victimization. Relating to age, early adolescents (aged 11-14) with higher problematic use of online social networking sites reported the highest levels of overt verbal and relational victimization. Overall, results suggested the co-occurrence of problematic use of online social networking sites, peer aggression and victimization. In addition, results showed the influence that gender and age had on peer victimization. This study highlights the continuity between offline and online domains with regard to maladjustment problems in adolescence.

Use of internet by the teaching faculty of Peshawar Medical College, Peshawar, Khyber Pakhtunkhwa, Pakistan.

This study was planned to examine the hard and soft form of learning resources available on the internet accessed by the teaching faculty. This study was conducted at the Peshawar Medical College, Peshawar, Pakistan from January 2to April 2017. As the target population was not too large, no sampling technique was employed and census-based approach was adopted. For data collection, the pre-tested questionnaire was distributed among 115 faculty members of both basic and clinical sciences groups with a response rate of 66(57.39%). Data was analysed using SPSS. Among the respondents, 38(57.6%) were males and 28(42.4%) were females. A majority 51 (77.27%) of the respondents used the internet for teaching and research. Library was the most frequently 22 (33.33%) used place for the internet use. Low internet speed, virus on computers and a lack of modern trainings were the major barriers. E-journals, e-books, online databases and theses and dissertations were the major sources consulted by the participants.