Public Health Approach to Problems Related to Excessive and Addictive Use of the Internet and Digital Media.

Purpose of Review: Advances in digital technology and media have provided convenience and advantages in all areas of our daily lives. However, there is a risk of excessive and addictive use, which increases the risk of addiction as a disease and other related mental and physical problems. This article reviews the public health approach to problems related to excessive and addictive use of the Internet and digital media. Recent Findings: The public health model views addiction as the result of interactions among individuals, digital media, and the environment; therefore, interventions should aim to reduce risk factors and increase protective factors in these three areas. This includes developing and providing evidence-based services according to each individual's problem type and severity. Regarding interventions for digital media and the environment, restricting accessibility and regulating content may be necessary. This calls for an integrative, comprehensive, and continuous intervention strategy, and to achieve such a framework, we need to establish an information system to monitor the magnitude and patterns of related problems. Summary: This review suggests a surveillance system that provides a list of evidence-based policies from the public health perspective. Suggestions for an advanced international information, policy, and monitoring system are discussed.

The influence of multidimensional deprivation on problem drinking developmental trajectory among young adults: a longitudinal study using latent class growth analysis.

BACKGROUND: Many young people in Korea today experience deprivation in various areas of life. The social determinants of health approach maintains that social factors play an important role in an individual's physical and mental health. This study aimed to investigate the problem drinking trajectory of young Korean people and identify the effects of multidimensional deprivation on problem drinking. METHODS: The study used data from 2012 to 2018 found in the Korea Welfare Panel Study. Latent class growth analysis was performed to determine the number of trajectories of problem drinking. After identifying latent classes, a multinomial logistic regression analysis was utilized to examine multidimensional deprivation as a predictor of class membership. RESULTS: Latent class analysis yielded three groups: (1) a low-level maintenance group (low level of alcohol use maintained at the low level), (2) a moderate-level increasing group (moderate level of problem drinking with a moderate increase in problem drinking), and (3) a risky drinking increasing group (high level of problem drinking with a rapid increase in problem drinking). Results from multinomial logistic regression showed that deprivation in housing and social deprivation increased the probability of belonging to the risky drinking increasing group compared to other reference groups. CONCLUSION: The study speaks to the need to establish appropriate intervention strategies according to the level and changes in the pattern of alcohol use. The implications of housing and social deprivation concerning problem drinking among young Korean people are also discussed.

Socioeconomic resources and quality of life in alcohol use disorder patients: the mediating effects of social support and depression.

BACKGROUND: Quality of life (QoL) has recently attracted increased attention as a major indicator of the recovery from alcohol use disorder (AUD). This study investigated the mediating effects of social support and depression for the relationship between socioeconomic resources and QoL among people with AUD in South Korea. METHODS: Patients across South Korea who had been diagnosed with AUD in the previous year (n = 404) and were registered at hospitals and addiction management centers were surveyed. The participants ranged in age from 19 to 65 years. Structural equation modeling was performed, using stable residence, income, stable employment, social support, depression, and QoL as predictors. Bootstrapping analysis was performed to test for mediating effects. RESULTS: The socioeconomic resources income (ß = .297, p < .001), stable employment (ß = .131, p < .01), and stable residence (ß = .091, p < .05) showed statistically significant and positive relationships with social support. However, none of these were significantly related to depression. Social support showed a significant and negative relationship with depression (ß = -.172, p < .001). Income positively and directly influenced QoL (ß = .148, p < .001). All three socioeconomic resources indirectly influenced depression through social support, which, in turn, influenced QoL. This suggests that socioeconomic resources directly influence QoL and indirectly influence it through social support. CONCLUSION: These findings suggest that social support has an important role in improving the QoL of people with AUD. Furthermore, socioeconomic resources, such as having a stable residence, employment, and income, are necessary for recovery from alcohol addiction.

Personal Factors, Internet Characteristics, and Environmental Factors Contributing to Adolescent Internet Addiction: A Public Health Perspective.

Individual characteristics, family- and school-related variables, and environmental variables have equal importance in understanding Internet addiction. Most previous studies on Internet addiction have focused on individual factors; those that considered environmental influence typically only examined the proximal environment. Effective prevention and intervention of Internet addiction require a framework that integrates individual- and environmental-level factors. This study examined the relationships between personal factors, family/school factors, perceived Internet characteristics, and environmental variables as they contribute to Internet addiction among adolescents based on the public health model. A representative sample of 1628 junior high school students from 56 regions in Seoul and Gyeonggi-do participated in the study via questionnaires with the cooperation of the Ministry of Health and Welfare and the district office of education. The study analyzed psychological factors, family cohesion, attitudes toward academic activities, Internet characteristics, accessibility to PC cafés, and exposure to Internet game advertising. About 6% of the adolescents were categorized as being in the severely addicted group. Between-group comparisons showed that the addicted group had started using the Internet earlier; had higher levels of depression, compulsivity, and aggressiveness as well as lower family cohesion; and reported higher accessibility to PC cafés and exposure to Internet game advertising. Multiple logistic regression indicated that for adolescents, environmental factors had a greater influence than family or school-related factors. Policy implications for prevention and intervention are discussed.

The Mutual Relationship Between Men's Drinking and Depression: A 4-Year Longitudinal Analysis.

AIMS: The purpose of the current study was to examine the longitudinal reciprocal relationship between depression and drinking among male adults from the general population. METHODS: This study used a panel dataset from the Korean Welfare Panel (from 2011 to 2014). The subjects were 2511 male adults aged between 20 and 65 years. Based on the Korean Version of the Alcohol Use Disorders Identification Test (AUDIT-K) scores, 2191 subjects were categorized as the control group (AUDIT-K < 12) and 320 subjects were categorized as the problem drinking group (AUDIT-K ≥ 12). An autoregressive cross-lagged modelling analysis was performed to investigate the mutual relationship between problem drinking and depression measured consecutively over time. RESULTS: The results indicated that alcohol drinking and depression were stable over time. In the control group, there was no significant causal relationship between problem drinking and depression while in the problem drinking group, drinking in the previous year significantly influenced depression in the following second, third and fourth years. CONCLUSION: This study compared normal versus problem drinkers and showed a 4-year mutual causal relationship between depression and drinking. No longitudinal interaction between drinking and depression occurred in normal drinkers, while drinking intensified depression over time in problem drinkers. SHORT SUMMARY: This study found that problem drinking was a risk factor for development of depression. Therefore, more attention should be given to problem alcohol use in the general population and evaluation of past alcohol use history in patients with depressive disorders.

Understanding service use and victim patterns associated with re-reports of alleged maltreatment perpetrators.

Despite the fact that the goal of child welfare is to impact the caregiver's behavior rather than the child's, research on recurrence at the alleged perpetrator level is scant compared to research on child level recurrence. No prior studies both controlled for services participation by the caregiver and explored whether a recurrence happens with the same child. This study helps fill the gap by analyzing caregivers who are alleged perpetrators and later recurrence of abuse or neglect. In-home child welfare services were initially associated with lower recidivism but this effect moderates over time. Receipt of AFDC at study start did not impact likelihood of recidivism but receipt of AFDC (or later TANF) after the first report appears to lower the risk of recurrence. Among low income women, a history of mental health or substance abuse treatment was associated with higher recurrence. Among re-reports of alleged perpetrators, nearly 45% had at least one new child on the report. Caucasian and older perpetrators were less likely to have an alleged recurrence involving a new child. Women with mental health (but not substance abuse) treatment histories and those who had child welfare services after the first report were more likely to be re-reported for alleged maltreatment of a new child.

HIV/AIDS knowledge, attitudes, related behaviors, and sources of information among Korean adolescents.

To examine HIV/AIDS knowledge, attitudes, related behaviors, and sources of HIV/AIDS information among high school-aged students in South Korea. One thousand and seventy-seven students (586 females and 491 males) from 5 high schools from 5 representative school districts participated in the survey. A self-administered questionnaire measuring knowledge (19 true-false items), attitudes (4 items, 5-point Likert-type scale), sources of information (6 items, yes/no), and sexual behaviors (8 items, yes/no) was utilized. The level of HIV/AIDS knowledge among Korean adolescents was moderate, with the mean scores of 13.93 out of 19 for males and 13.35 for females (p < .01). Attitudes toward persons with HIV/AIDS were negative, with the mean scores of 3.06 for males and 3.09 for females. Of 42 respondents (4.4%) who had engaged in sexual intercourse, 18 (40%) had used condoms. Almost half of the total respondents reported they were not concerned about HIV/AIDS (46.0%), and 94.4% indicated the need for receiving HIV prevention education in the future. The respondents identified TV (52.5%) and school classes (32.1%) as the two major sources of information on HIV/AIDS. Only a few pointed to their parents (1.3%) as a source of information. This preliminary study summarizes the current status of prevention education on HIV/AIDS available in Korea and can provide implications for developing more differentiated intervention strategies specific to culture, age, and gender.

Substantiation and recidivism.

This article reports rates of recidivism among initially substantiated and initially unsubstantiated child maltreatment events to determine if substantiation status is associated with higher risk of recidivism. This is an important question given recent concerns that unsubstantiated cases may have as high or almost as high a risk of recidivism as do substantiated cases. The data are analyzed at both the victim level and the case level, divided by type of maltreatment, and followed for 4.5 years. The data used are administrative and combine a series of state databases with census data. Analyses are performed at the bivariate and multivariate (Cox proportional hazards model) levels. The main finding is that unsubstantiated cases are at high risk for recidivism, in many cases as high a risk as substantiated cases. Implications for practice, policy, and research are presented with a focus on the importance of providing preventative services to unsubstantiated cases.

Cross-type recidivism among child maltreatment victims and perpetrators.

OBJECTIVE: This study investigated the extent to which child maltreatment victims and perpetrators were reported for different types of maltreatment over time (cross-type recidivism). Second, this study examined whether certain individual, community or child welfare service variables were associated with a tendency for the first recidivism event to be the same as the initial report among cases involving sexual abuse, physical abuse and neglect. METHOD: Statewide administrative data on child abuse reporting at the child and perpetrator levels were linked to data on child welfare services and census information to examine cross-type recidivism prospectively for 4.5 years. Analyses include descriptive and logistic regression techniques. RESULTS: There was substantial cross-type recidivism at both the child and perpetrator levels, with neglect being the most common recidivism type. Among neglect cases, "lack of supervision" was the most frequent subtype at time of re-report regardless of the initial subtype of neglect reported. Predictors of remaining within-type varied by the type of maltreatment initially reported and by perpetrator compared to child-level analyses. For example, among physical abuse cases, older child victims were more likely to remain within-type, while the opposite was true for neglect. CONCLUSIONS: Cross-type recidivism is common among re-reported cases of maltreatment. Non-neglect cases that re-reported to child welfare agencies are likely to return for neglect. Child welfare risk assessment, service provision, and research on children and families with a recidivism event should be focused neglect and on broad areas of need and risk rather than rely on typologies based on the index event. Researchers attempting to model recurrent maltreatment should consider recurrence at the child and perpetrator levels separately.