The Mediating Effects of Perceived Family Support in the Relationship Between Anxiety and Problematic Smartphone Use: A Cross-Cultural Validation.

ABSTRACT: Problematic smartphone use (PSU) is frequently considered a public health issue, especially in East Asia and Europe. Yet, there is a paucity of research focusing on cultural and familial determinants of PSU. This cross-cultural study aimed to investigate smartphone usage patterns and possible mediating effects of perceived family support (PFS) from a stress-coping perspective. Convenience samples of 790 Chinese and 439 Belgian undergraduates completed an online survey that focused on sociodemographics and psychological variables ( i.e. , anxiety, depression, PFS, and PSU). In both samples, PSU was positively associated with anxiety and depression, and negatively associated with PFS. However, after controlling for sex and age in structural equation models, the consistent mediating effects of PFS were only found between anxiety and PSU in both cultural settings. These findings suggest that psychological interventions that take into account familial factors could be helpful for young people presenting with anxiety and PSU.

Spatial frequency processing and its modulation by emotional content in severe alcohol use disorder.

RATIONALE: Visuo-perceptive deficits in severe alcohol use disorder (SAUD) remain little understood, notably regarding the respective involvement of the two main human visual streams, i.e., magnocellular (MC) and parvocellular (PC) pathways, in these deficits. Besides, in healthy populations, low-level visual perception can adapt depending on the nature of visual cues, among which emotional features, but this MC and PC pathway adaptation to emotional content is unexplored in SAUD. OBJECTIVES: To assess MC and PC functioning as well as their emotional modulations in SAUD. METHODS: We used sensitivity indices (d') and repeated-measures analyses of variance to compare orientation judgments of Gabor patches sampled at various MC- and PC-related spatial frequencies in 35 individuals with SAUD and 38 matched healthy controls. We then explored how emotional content modulated performances by introducing neutral or fearful face cues immediately before the Gabor patches and added the type of cue in the analyses. RESULTS: SAUD patients showed a general reduction in sensitivity across all spatial frequencies, indicating impoverished processing of both coarse and fine-scale visual content. However, we observed selective impairments depending on facial cues: individuals with SAUD processed intermediate spatial frequencies less efficiently than healthy controls following neutral faces, whereas group differences emerged for the highest spatial frequencies following fearful faces. Altogether, SAUD was associated with mixed MC and PC deficits that may vary according to emotional content, in line with a flexible but suboptimal use of low-level visual content. Such subtle alterations could have implications for everyday life's complex visual judgments.

Visual abilities in Severe Alcohol Use Disorder: Preserved spatial but impaired temporal resolution.

Visuospatial impairments have long been reported in Severe Alcohol Use Disorder but remain poorly understood, notably regarding the involvement of magnocellular (MC) and parvocellular (PC) pathways. This empirical gap hampers the understanding of the implications of these visual changes, especially since the MC and PC pathways are thought to sustain central bottom-up and top-down processes during cognitive processing. They thus influence our ability to efficiently monitor our environment and make the most effective decisions. To overcome this limitation, we measured PC-inferred spatial and MC-inferred temporal resolution in 35 individuals with SAUD and 30 healthy controls. We used Landolt circles displaying small apertures outside the sensitivity range of MC cells or flickering at a temporal frequency exceeding PC sensitivity. We found evidence of preserved PC spatial resolution combined with impaired MC temporal resolution in SAUD. We also measured how spatial and temporal sensitivity is influenced by the prior presentation of fearful faces - as emotional content could favor MC processing over PC one - but found no evidence of emotional modulation in either group. This spatio-temporal dissociation implies that individuals with SAUD may process visual details efficiently but perceive rapidly updating visual information at a slower pace. This deficit has implications for the tracking of rapidly changing stimuli in experimental tasks, but also for the decoding of crucial everyday visual incentives such as faces, whose micro-expressions vary continuously. Future studies should further specify the visual profile of individuals with SAUD to incorporate disparate findings within a theoretically grounded model of vision.

Alcohol-related attentional biases in recently detoxified inpatients with severe alcohol use disorder: an eye-tracking approach.

BACKGROUND: Dominant theoretical models consider that attentional biases (AB) towards alcohol-related stimuli play a key role in the development and maintenance of alcohol use disorder (AUD). Their assessment has however showed high inconsistencies and has been mostly based on unreliable behavioral measures. This study evaluated the presence and extent of alcohol-related AB in recently detoxified inpatients with severe AUD by combining the visual probe task (VPT) paradigm with eye-tracking measures, known to improve the VPT reliability in subclinical populations. METHODS: We recruited 24 patients and 27 matched healthy controls. They performed the VPT (measuring reaction time when processing visual targets preceded by alcoholic and matched non-alcoholic pictures) combined with eye-tracking measures (dwell time, first fixation direction/duration, second fixation direction) during two sessions. Estimates of internal consistency, split-half reliability, and test-retest reliability were measured. RESULTS: Patients showed shorter dwell time for alcohol cues (p = .004, d=.853) and reduced number of fixations towards alcohol after a first fixation on non-alcohol cues (p = .012, d=.758) compared to controls. These findings suggest the presence of alcohol-related avoidance AB in detoxified patients with severe AUD. The VPT achieved excellent reliability for these eye-tracking measures. Reaction times and first fixation measures did not indicate any AB pattern and showed poor reliability. CONCLUSIONS: The VPT, when combined with dwell time and second fixation direction, constitutes a reliable method for assessing AB in detoxified patients. It showed the presence of an alcohol-related avoidance bias in this clinical population, in contradiction with the approach bias predicted by theoretical models.

Maladaptive player-game relationships in problematic gaming and gaming disorder: A systematic review.

While certain player vulnerabilities are known to increase risk of gaming disorder (GD), the topic of maladaptive player × game relationships in GD has received limited attention. This review aimed to: (1) identify game types associated with GD symptomatology; and (2) evaluate individual differences (e.g., age, personality, depression) in the relationship between gaming and GD symptomatology. A systematic review of six databases identified 23 studies of the relations between game types and GD, including 13 studies employing multivariate analyses. Player vulnerabilities implicated in GD included impulsivity, risk-taking, psychopathological symptoms (e.g., depression, anxiety), and stronger gaming motivations (e.g., escapism, achievement). MMORPG involvement had the strongest positive association with GD. Problematic MMORPG players tend to have a socially anxious profile and may be attracted to the work-like roles and conventions of this genre. Problematic players of shooters tend to score higher on measures of sensation-seeking and impulsivity than other players. These findings suggest that GD may develop more readily and at more severe levels in complex, endless, socially driven games, irrespective of person-level characteristics. Some player vulnerabilities may selectively increase risk of GD for certain game types. Further research should investigate different player-game interactions to refine current models and interventions for GD.

Escaping reality through videogames is linked to an implicit preference for virtual over real-life stimuli.

BACKGROUND: From the theory of compensatory Internet use, escapism through videogames may constitute a coping strategy that is sometimes helpful but, in some cases, maladaptive. To date, however, evidence supporting this view has been gathered only through the use of explicit self-reported questionnaires, which are known to be biased. Accordingly, the aim of the current study was to test whether the escapism motive is related to a preference for the virtual environment. METHOD: A laboratory task that allowed the measurement of implicit attitudes, namely, the Affect Misattribution Procedure, was created with stimuli from real world and videogames. The task was administered online with a series of questionnaire and completed by 273 online gamers from the community. RESULTS: Participants had more positive attitudes toward pictures depicting virtual environments than toward those depicting real environments. Furthermore, participants who frequently used videogames to escape real life and were highly engaged in video gaming had a more pronounced positive implicit attitude toward virtual environments. DISCUSSION: This study contributes to a better understanding of the psychological processes underlying escapism in videogames and calls for a refinement of the escapism construct, which can be related to both problematic (i.e., potential coping strategy) and nonproblematic patterns of videogame use. Among the limitations, it should be noted that the selection of stimuli related to videogames is restricted to one genre of game, and that the participants' environment could not be controlled due to the online design.

Ten-Item Internet Gaming Disorder Test (IGDT-10): Measurement invariance and cross-cultural validation across seven language-based samples.

The Ten-Item Internet Gaming Disorder Test (IGDT-10) is a short screening instrument developed to assess Internet gaming disorder (IGD) as proposed in the Diagnostic and Statistical Manual of MentalDisorders, fifth edition (DSM-5), adopting a concise, clear, and consistent item-wording. According to initial studies conducted in 2014, the instrument showed promising psychometric characteristics. The present study tested the psychometric properties, including language and gender invariance, in a large international sample of online gamers. In this study, data were collected from 7,193 participants comprising Hungarian (n = 3,924), Iranian (n = 791), English-speaking (n = 754), French-speaking (n = 421), Norwegian (n = 195), Czech (n = 496), and Peruvian (n = 612) online gamers via gaming-related websites and gaming-related social-networking-site groups. A unidimensional factor structure provided a good fit to the data in all language-based samples. In addition, results indicated both language and gender invariance on the level of scalar invariance. Criterion and construct validity of the IGDT-10 was supported by its strong association with the Problematic Online Gaming Questionnaire and moderate association with weekly gaming time, psychopathological symptoms, and impulsivity. The proportions of each sample that met the cut-off score on the IGDT-10 varied between 1.61% and 4.48% in the individual samples, except for the Peruvian sample (13.44%). The IGDT-10 shows robust psychometric properties and appears suitable for conducting cross-cultural and gender comparisons across seven languages. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Disentangling the role of users' preferences and impulsivity traits in problematic Facebook use.

The use of social network sites (SNSs) has grown dramatically. Numerous studies have shown that SNS users may suffer from excessive use, associated with addictive-like symptoms. With a focus on the popular SNS Facebook (FB), our aims in the current study were twofold: First, to explore the heterogeneity of FB usage and determine which kind of FB activity predicts problematic usage; second, to test whether specific impulsivity facets predict problematic use of FB. To this end, a sample of FB users (N = 676) completed an online survey assessing usage preferences (e.g., types of activities performed), symptoms of problematic FB use and impulsivity traits. Results indicated that specific usage preferences (updating one's status, gaming via FB, and using notifications) and impulsive traits (positive and negative urgency, lack of perseverance) are associated to problematic FB use. This study underscores that labels such as FB "addiction" are misleading and that focusing on the actual activities performed on SNSs is crucial when considering dysfunctional usage. Furthermore, this study clarified the role of impulsivity in problematic FB use by building on a theoretically driven model of impulsivity that assumes its multidimensional nature. The current findings have identifiable theoretical and public health implications.

Interference with Processing Negative Stimuli in Problematic Internet Users: Preliminary Evidence from an Emotional Stroop Task.

Although it has been proposed that problematic Internet use (PIU) may represent a dysfunctional coping strategy in response to negative emotional states, there is a lack of experimental studies that directly test how individuals with PIU process emotional stimuli. In this study, we used an emotional Stroop task to examine the implicit bias toward positive and negative words in a sample of 100 individuals (54 females) who also completed questionnaires assessing PIU and current affect states. A significant interaction was observed between PIU and emotional Stroop effects (ESEs), with participants who displayed prominent PIU symptoms showing higher ESEs for negative words compared to other participants. No significant differences were found on the ESEs for positive words among participants. These findings suggest that PIU may be linked to a specific emotional interference with processing negative stimuli, thus supporting the view that PIU is a dysfunctional strategy to cope with negative affect. A potential treatment implication for individuals with PIU includes a need to enhance the capacity to process and regulate negative feelings.

A weak scientific basis for gaming disorder: Let us err on the side of caution.

We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.

Passion or addiction? Correlates of healthy versus problematic use of videogames in a sample of French-speaking regular players.

A criticism of current diagnostic approaches to gaming disorder is that they fail to take into account that high and repeated engagement is not problematic per se, nor is it necessarily associated with adverse consequences. To tackle this controversy, we used Confirmatory Factor Analysis (CFA) to test, in regular gamers (N = 268), whether high (but healthy) engagement can be distinguished from problematic engagement by using the Addiction-Engagement Questionnaire (Charlton & Danforth, 2007). We then tested whether differential relationships exist between the engagement and addiction constructs, DSM-5 criteria for Internet gaming disorder (IGD), and psychological factors linked to gaming use and misuse (self-reported impulsivity, motives to play, and depression). Results indicated that a model holding engagement and addiction as two distinct, but related, constructs fits the data well. Second, we showed that although both constructs are linked to the number of IGD criteria endorsed, the relationship is more pronounced for the addiction construct. Third, a differential pattern of correlations was observed with the other study variables, further supporting the need to distinguish the two constructs. Our study emphasizes that research is needed to refine the diagnostic approach to gaming disorder to avoid conflating healthy passion with pathological behavior.

Emotionally laden impulsivity interacts with affect in predicting addictive use of online sexual activity in men.

The interest in studying addictive use of online sexual activities (OSA) has grown sharply over the last decade. Despite the burgeoning number of studies conceptualizing the excessive use of OSA as an addictive disorder, few have tested its relations to impulsivity, which is known to constitute a hallmark of addictive behaviors. To address this missing gap in the literature, we tested the relationships between addictive OSA use, impulsivity traits, and affect among a convenience sample of men (N=182; age, M=29.17, SD = 9.34), building upon a theoretically driven model that distinguishes the various facets of impulsivity. Results showed that negative urgency (an impulsivity trait reflecting the tendency to act rashly in negative emotional states) and negative affect interact in predicting addictive OSA use. These results highlight the pivotal role played by negative urgency and negative affect in addictive OSA use, supporting the relevance of psychological interventions that focus on improving emotional regulation (e.g., to reduce negative affect and learn healthier coping strategies) to mitigate excessive use of OSA.

Established risk factors for addiction fail to discriminate between healthy gamers and gamers endorsing DSM-5 Internet gaming disorder.

Background and aims The DSM-5 includes criteria for diagnosing Internet gaming disorder (IGD) that are adapted from substance abuse and widely used in research and clinical contexts, although evidence supporting their validity remains scarce. This study compared online gamers who do or do not endorse IGD criteria regarding self-control-related abilities (impulsivity, inhibitory control, and decision-making), considered the hallmarks of addictive behaviors. Method A double approach was adopted to distinguish pathological from recreational gamers: The first is the classic DSM-5 approach (≥5 criteria required to endorse the IGD diagnosis), and the second consists in using latent class analysis (LCA) for IGD criteria to distinguish gamers' subgroups. We computed comparisons separately for each approach. Ninety-seven volunteer gamers from the community were recruited. Self-reported questionnaires were used to measure demographic- and game-related characteristics, problematic online gaming (with the Problematic Online Gaming Questionnaire), impulsivity (with the UPPS-P Impulsive Behavior Scale), and depression (with the Beck Depression Inventory-II). Experimental tasks were used to measure inhibitory control (Hybrid-Stop Task) and decision-making abilities (Game of Dice Task). Results Thirty-two participants met IGD criteria (33% of the sample), whereas LCA identified two groups of gamers [pathological (35%) and recreational]. Comparisons that used both approaches (DSM-5 and LCA) failed to identify significant differences regarding all constructs except for variables related to actual or problematic gaming behaviors. Discussion The validity of IGD criteria is questioned, mostly with respect to their relevance in distinguishing high engagement from pathological involvement in video games.

Scholars' open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal.

Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world.

Impulsivity in Multiplayer Online Battle Arena Gamers: Preliminary Results on Experimental and Self-Report Measures.

Background and aims Multiplayer Online Battle Arena (MOBA) games have become the most popular type of video games played worldwide, superseding the playing of Massively Multiplayer Online Role-Playing Games and First-Person Shooter games. However, empirical studies focusing on the use and abuse of MOBA games are still very limited, particularly regarding impulsivity, which is an indicator of addictive states but has not yet been explored in MOBA games. In this context, the objective of the present study is to explore the associations between impulsivity and symptoms of addictive use of MOBA games in a sample of highly involved League of Legends (LoL, currently the most popular MOBA game) gamers. Methods Thirty-six LoL gamers were recruited and completed both experimental (Single Key Impulsivity Paradigm) and self-reported impulsivity assessments (s-UPPS-P Impulsive Behavior Scale, Barratt Impulsiveness Scale), in addition to an assessment of problematic video game use (Problematic Online Gaming Questionnaire). Results Results showed links between impulsivity-related constructs and signs of excessive MOBA game involvement. Findings indicated that impaired ability to postpone rewards in an experimental laboratory task was strongly related to problematic patterns of MOBA game involvement. Although less consistent, several associations were also found between self-reported impulsivity traits and signs of excessive MOBA game involvement. Conclusions Despite these results are preliminary and based upon a small (self-selected) sample, the present study highlights potential psychological factors related to the addictive use of MOBA games.

Prevalence and characteristics of addictive behaviors in a community sample: A latent class analysis.

While addictions to substances such as alcohol, tobacco, and other drugs have been extensively investigated, interest has been growing in potential non-substance-related addictive behaviors (e.g., excessive gambling, buying or playing video games). In the current study, we sought to determine the prevalence and characteristics of a wide range of addictive behaviors in a general population sample and to identify reliable subgroups of individuals displaying addictive behaviors. Seven hundred seventy participants completed an online survey. The survey screened for the presence and characteristics of the main recognized substance and behavioral addictions (alcohol, tobacco, cannabis, other drugs, gambling, compulsive shopping, intensive exercise, Internet and mobile phone overuse, intensive work involvement, and overeating) in a three-month period. Key aspects of addiction were measured for each reported behavior, including negative outcomes, emotional triggers (positive and negative emotional contexts), search for stimulation or pleasure, loss of control, and cognitive salience. Latent class analysis allowed us to identify three theoretically and clinically relevant subgroups of individuals. The first class groups problematic users, i.e., addiction-prone individuals. The second class groups at-risk users who frequently engage in potentially addictive behaviors to regulate emotional states (especially overinvolvement in common behaviors such as eating, working, or buying). The third class groups individuals who are not prone to addictive behaviors. The existence of different groups in the population sheds new light on the distinction between problematic and non-problematic addiction-like behaviors.