Prevalence and Factors Associated with Smartphone Addiction among Adolescents–A Nationwide Study in Malaysia

Smartphone ownership among adolescents is getting common in this decade especially in Malaysia;Adolescent are strongly devoted to their smartphone and this may lead to smartphone addiction.Studies have reported that smartphone addiction has become an emerging social and health problem especially among the youth in many countries however there is lack of study among adolescents in Malaysia.This study aimed to examine the prevalence and factors associated with smartphone addiction among adolescents in Malaysia.This was a cross-sectional study involving adolescents from 15 primary care clinics throughout the country.Respondents were assessed on their smartphone activities using the Malaysian short version of the Smartphone addiction scale(SAS-M-SV).Multiple logistic regression was used to determine the predictors of smartphone addiction among adolescents.The study was conducted among 921 adolescents with 49.6%male(n=457).The mean age of adolescents was 16.4±2.4 years.The ethnicity distribution were 74.6%Malay,7.3%Chinese,4.7%Indian and 13.4%other ethnicities.The prevalence of smartphone addiction was 37.1%(342/921);37.4%in male and 36.9%in female.Based on multiple logistic regression analysis,longer duration of smartphone use per week was associated with higher odds of smartphone addiction among adolescent(odd ratio=1.005%,95%confidence interval=1.000–1.009,p-value=0.039).Smartphone addiction is present in nearly four in ten adolescents in Malaysia.Adolescents who spend longer duration in smartphone usage per week were associated with higher odds of having smartphone addiction.Parents should be more alert and vigilant about this finding.Hence,parents should limit their children from spending too much of time with smartphone in order to prevent their children from getting smartphone addiction.

Determinants of internet addiction among medical students in Casablanca: a cross-sectional study

Objective:This study aimed to estimate the prevalence and determinants of Internet addiction among medical students at the Faculty of Medicine and Pharmacy of Casablanca,Morocco.Methods:This was a cross-sectional study conducted among students at the Faculty of Medicine and Pharmacy in Casablanca between October and March 2020.An online questionnaire was administered to students to collect data and internet addiction was assessed by the Young questionnaire.A score threshold≥50 was adopted to define addiction.Univariate and multivariate logistic regression analyses were used to identify factors associated with internet addiction.Results:Out of a total of 4093 FMPC students enrolled in the 2020-2021 academic year,506 agreed to participate in this study,including 303 females and 203 males.The mean addiction score assessed on the Young scale was(49.08±16.11).The prevalence of Internet addiction was 44.5%(225/506,95% CI:40% to 49%).Multiple regression analysis showed that being older than 20 years(OR=0.17,95% CI:0.40 to 0.64),being female(OR=1.70,95% CI:1.04 to 2.78),being in the dissertation year(6th year)(OR=5.17,95% CI:2.23 to 11.44),having a history of psychiatric consultation(OR=2.64,95% CI:1.34 to 5.21),having divorced parents(OR=2.64,95% CI:1.05 to 5.87),use of sleeping medication(OR=2.9,95% CI:1.05 to 3.70),sleep disorders(OR=2.06,95% CI:1.25 to 3.79),sleep deprivation(OR=2.26,95% CI:1.39 to 3.65),excessive daytime sleepiness(OR=5.39,95% CI:2.19 to 13.24),anxiety disorders(OR=1.47,95% CI:1.18 to 2.30),duration of internet connection(>4 h)(OR=11.43,95% CI:4.85 to 27.66),and having frequent conflicts with parents(OR=2.37,95% CI:1.49 to 3.79)and friends(OR=0.26,95% CI:0.11 to 0.65)were independently associated with internet addiction.Conclusion:The prevalence of Internet addiction among medical students in Casablanca remains high.Targeted action on the determinants would be of great value in prevention.

Internet addiction and problematic Internet use: A systematic review of clinical research

AIM: To provide a comprehensive overview of clinical studies on the clinical picture of Internet-use related addictions from a holistic perspective. A literature search was conducted using the database Web of Science.METHODS: Over the last 15 years, the number of Internet users has increased by 1000%, and at the same time, research on addictive Internet use has proliferated. Internet addiction has not yet been understood very well, and research on its etiology and natural history is still in its infancy. In 2013, the American Psychiatric Association included Internet Gaming Disorder in the appendix of the updated version of the Diagnostic and Statistical Manual for Mental Disorders(DSM-5) as condition that requires further research prior to official inclusion in the main manual, with important repercussions for research and treatment. To date, reviews have focused on clinical and treatment studies of Internet addiction and Internet Gaming Disorder. This arguably limits the analysis to a specific diagnosis of a potential disorder that has not yet been officially recognised in the Western world, rather than a comprehensive and inclusive investigation of Internet-use related addictions(including problematic Internet use) more generally. RESULTS: The systematic literature review identified a total of 46 relevant studies. The included studies used clinical samples, and focused on characteristics of treatment seekers and online addiction treatment. Four main types of clinical research studies were identified, namely research involving(1) treatment seeker characteristics;(2) psychopharmacotherapy;(3) psychological therapy; and(4) combined treatment. CONCLUSION: A consensus regarding diagnostic criteria and measures is needed to improve reliability across studies and to develop effective and efficient treatment approaches for treatment seekers.

P300 change and cognitive behavioral therapy in subjects with Internet addiction disorder A 3-month follow-up study

Event-related potential studies of cognitive function in addiction behaviors have focused on the P300 event-related potential component. The current study investigated the association between P300 component and Internet addiction disorder. We found that individuals with Internet addiction disorder exhibited significantly longer P300 latencies than controls （N2： P = 0.035; P3a： P = 0.031 P3b： P = 0.043） and similar P300 amplitudes compared to control participants. After 3 months of cognitive behavioral therapy, P300 latencies decreased significantly in the P3a and P3b （P3a： P = 0.045; P3b： P = 0.062）. These results suggest that deficits in cognitive function may be involved in Internet addiction disorder, and that clinical psychological treatment may be effective.

A Comparative Analysis of Psychological Disorders between Internet Addicted Students and Ordinary Internet Users in Zabol University of Medical Sciences

Nowadays, using the Internet, for academic and non-academic activities, is an integral part of students’ daily life. Studies showed that excessive use of the Internet has negative effects on physical and mental health. The present research was conducted in order to compare the psychological disorders of Internet addicted students and ordinary Internet users in Zabol University of medical sciences. It applied a causal-comparative method. Through applying purposive sampling method, 252 undergraduate and postgraduate students of Zabol University of Medical Sciences were selected in May 2015. Data collection was performed using standard questionnaires of Young’s Internet Addiction Test and the Symptom Check List 90-Revised (SCL-90-R). Data analysis was carried out using independent t-test with SPSS21. Results indicated that the Internet addicted students, compared with ordinary Internet users had more psychological disorders. Considering the high prevalence of psychological disorders in the Internet addicted students, teaching appropriate use of the Internet to students is an important factor in controlling the Internet addiction.

Establishment of the Initial Sandplay Picture System for Chinese Young Internet Addicts: Based on Valence Assessment of Normal Adolescents

To develop the initial sandplay picture system for Chinese young internet addicts (ISPSCYIA) for the diagnosis and testing studies on internet addiction, 22 pictures were selected from the used pictures of initial sandplay in existing research results of initial sandplay of Chinese young Internet addicts. 54 normal adolescents were recruited to evaluate the valence of the pictures on a nine-point scale in terms of clarity, pleasure and arousal. Results were shown that there were no significant differences between addiction pictures and non-addiction pictures in clarity, while there were significant differences in pleasure and arousal, as the scores of non-addiction pictures were higher. Correlation analysis indicated that there was obvious positive correlation among clarity, pleasure and arousal of addiction pictures & non-addiction pictures. The coefficients of internal consistency reliability and split-half reliability of 22 pictures’ scores exhibited both over 0.90. ISPSCYIA has proved typical and distinctive through valence assessment, which could be preliminarily applied to measure the characteristics of Chinese adolescents’ internet addiction.

Functional magnetic resonance imaging of internet addiction in young adults

AIM: To report the results of functional magnetic resonance imaging(f MRI) studies pertaining internet addiction disorder(IAD) in young adults.METHODS: We conducted a systematic review on Pub Med, focusing our attention on f MRI studies involving adult IAD patients, free from any comorbid psychiatric condition. The following search words were used, both alone and in combination: f MRI, internet addiction, internet dependence, functional neuroimaging. The search was conducted on April 20^(th), 2015 and yielded 58 records. Inclusion criteria were the following: Articles written in English, patients' age ≥ 18 years, patients affected by IAD, studies providing f MRI results during resting state or cognitive/emotional paradigms. Structural MRI studies, functional imaging techniques other than f MRI, studies involving adolescents, patients with comorbid psychiatric, neurological or medical conditions were excluded. By reading titles and abstracts, we excluded 30 records. By reading the full texts of the 28 remaining articles, we identified 18 papers meeting our inclusion criteria and therefore included in the qualitative synthesis.RESULTS: We found 18 studies fulfilling our inclusion criteria, 17 of them conducted in Asia, and including a total number of 666 tested subjects. The included studies reported data acquired during resting state or different paradigms, such as cue-reactivity, guessing or cognitive control tasks. The enrolled patients were usually males(95.4%) and very young(21-25 years). The most represented IAD subtype, reported in more than 85% of patients, was the internet gaming disorder, or videogame addiction. In the resting state studies, the more relevant abnormalities were localized in the superior temporal gyrus, limbic, medial frontal and parietal regions. When analyzing the task related fmri studies, we found that less than half of the papers reported behavioral differences between patients and normal controls, but all of them found significant differences in cortical and subcortical brain regions involved in cognitive control and reward processing: Orbitofrontal cortex, insula, anterior and posterior cingulate cortex, temporal and parietal regions, brain stem and caudate nucleus.CONCLUSION: IAD may seriously affect young adults' brain functions. It needs to be studied more in depth to provide a clear diagnosis and an adequate treatment.

Abnormal brain activity in adolescents with Internet addiction who attempt suicide: an assessment using functional magnetic resonance imaging

Internet addiction is associated with an increased risk of suicidal behavior and can lead to brain dysfunction among adolescents.However,whether brain dysfunction occurs in adolescents with Internet addiction who attempt suicide remains unknown.This observational cross-sectional study enrolled 41 young Internet addicts,aged from 15 to 20 years,from the Department of Psychiatry,the First Affiliated Hospital of Chongqing Medical University,China from January to May 2018.The participants included 21 individuals who attempted suicide and 20 individuals with Internet addiction without a suicidal attempt history.Brain images in the resting state were obtained by a 3.0 T magnetic resonance imaging scanner.The results showed that activity in the gyrus frontalis inferior of the right pars triangularis and the right pars opercularis was significantly increased in the suicidal attempt group compared with the non-suicidal attempt group.In the resting state,the prefrontal lobe of adolescents who had attempted suicide because of Internet addiction exhibited functional abnormalities,which may provide a new basis for studying suicide pathogenesis in Internet addicts.The study was authorized by the Ethics Committee of Chongqing Medical University,China(approval No.2017 Scientific Research Ethics(2017-157))on December 11,2017.

Impact of Internet Literacy,Internet Addiction Symptoms on Quality of Life

As a country with the largest absolute number of Internet users in the world,China has witnessed that Internet addiction is becoming a prominent issue.Young adults like university students are particularly susceptible to the lure of the Internet,and they are described as being obsessed with the Internet.According to the latest report of the China Internet Network Information Center(CNNIC),netizens aged 20-29 have become the largest group of Internet users in China,accounting for 30.7%of the total Chinese netizens.Therefore,it is very important to study the Internet use and its influence among the young,since young people have become the main body of the Chinese Internet users.Focusing on the two essential factors closely related to Internet addiction as a risk,this study attempted to find out the interrelationships between Internet literacy,Internet addiction,and young people’s quality of life.As for research method,a paper-based survey was conducted to collect data and the final sample size was 1,000.The university student sample was created from a stratified sampling procedure with proportionate allocation among the nine universities in Dalian,a coast city in northeast China.Factor analyses showed different aspects of Internet literacy and various symptoms of Internet addiction among the university students.This study found that Internet addiction had some negative influences on the university students’quality of life.Moreover,the findings showed that Internet literacy has a significant influence on Internet addiction and quality of life among these young people.Basically,those university students with higher level of Internet literacy showed lower degree of Internet addiction and higher degree of quality of life.Therefore,in the future,more attention should be paid to education and activities in order to improve young people’s Internet literacy.The findings further enrich the literature of Internet addiction,Internet literacy,as well as quality of life,and are valuable for prevention,treatment,and recovery of Internet addiction among young people.Research on Internet addiction as an emerging risk in the Chinese context is of great research significance theoretically and practically,not only because Internet addiction is becoming a prominent issue in both China and many other societies,but also because it may act as a good case to study risk issue related to Internet,youth,and everyday life.The results can be used for future studies on Internet addiction,Internet literacy,and quality of life among other subpopulations or within other social contexts.

Decreased frontal lobe function in people with Internet addiction disorder

In our previous studies, we showed that frontal lobe and brainstem functions were abnormal in online game addicts. In this study, 14 students with Internet addiction disorder and 14 matched healthy controls underwent proton-magnetic resonance spectroscopy to measure cerebral function. Results demonstrated that the ratio of N-acetylaspartate to creatine decreased, but the ratio of cho- line-containing compounds to creatine increased in the bilateral frontal lobe white matter in people with Internet addiction disorder. However, these ratios were mostly unaltered in the brainstem, suggesting that frontal lobe function decreases in people with Internet addiction disorder.

Internet Gaming Disorder and Mental Health of Children in China:A Latent Profile Analysis

In recent years,speculation of an increase in Internet Gaming Disorder(IGD)has surfaced with the growing popularity of internet gaming among Chinese children and adolescents.The detrimental impact of IGD on mental health cannot be denied,even though only a small portion of the screen-dependent population exhibits psychopathological and behavioral symptoms.The present study aimed to explore a latent profile analysis(LPA)of Internet Gaming Disorder on the mental health of Chinese school students.The data were collected from a sample of 1005 Chinese school students(49.8%male;age M=13.32,SD=1.34 years)using a paper-pencil survey through convenience sampling.LPA explored three latent profiles of internet gamers:regular gamers(62.4%),moderate gamers(28.1%),and probable disordered gamers(9.4%).Results showed that the probable disordered gamers had significantly higher levels of depression,anxiety,emotional and conduct problems,hyperactivity,and peer problem symptoms as well as lower life satisfaction,and pro-social symptoms compared to regular and moderate gamers(p<0.05).This study would be helpful to mental health professionals in designing interventions for gamers who present IGD symptoms.Future longitudinal studies should also be undertaken to assess whether mental health worsens for probable disordered gamers.

Effect of electro-acupuncture combined with psychological intervention on mental symptoms and P50 of auditory evoked potential in patients with internet addiction disorder

OBJECTIVE: To observe the therapeutic effects of electro-acupuncture(EA) combined with psychological intervention on the symptom of somzatization or obsession and mental symptom of depression or anxiety and P50 of Auditory Evoked Potential(AEP) on internet addiction disorder(IAD).METHODS: One hundred and twenty cases of IAD were randomly divided into an EA group, a psycho-intervention(PI) group and a comprehensive therapy(EA plus PI) group. Patients in the EA group were treated with EA. Patients in the PI group were treated with cognition and behavior therapy. Patients in the EA plus PI group were treated with electro-acupuncture plus psychological intervention. Scores of IAD, scores of the symptom checklist90(SCL-90), latency and amplitude of P50 of AEP were measured before and after treatment.RESULTS: The scores of IAD after treatment significantly decreased in all groups(P < 0.05), and thescores of IAD in the EA plus PI group were significantly lower than those in the other two groups(P < 0.05). The scores of SCL-90 assembled and each factor after treatment in the EA plus PI group significantly decreased(P < 0.05). After treatment in the EA plus PI group, the amplitude distance of S1P50 and S2P50(S1-S2) significantly increased(P < 0.05).CONCLUSION: EA combined with PI could relieve the mental symptoms of IAD patients, and the mechanism is possibly related to the increase of cerebrum sense perception gating function.

运动干预青少年网络成瘾的研究进展

青少年网络成瘾这一公共卫生问题正受到全社会广泛关注。本文对体育运动与网络成瘾相关文献进行梳理,分析探讨运动干预网络成瘾的影响因素及作用机制,为完善我国儿童青少年网络成瘾防治体系提供依据。研究表明,体育运动可以通过改善个体心理健康、调节个体行为表现、改善个体大脑结构和调控激素分泌来对青少年网络成瘾症状发挥作用,其中运动强度、时间、方式是影响运动干预网络成瘾效果的重要调节变量。体育运动能够有效预防和矫治青少年网络成瘾,但体育运动的强度、时间,以及对网络成瘾发挥作用的生理学机制仍有待进一步研究。我国未来相关研究应严密实验设计,完善研究方法;增加纵向追踪研究比例;结合生物科技,深入探讨运动干预网络成瘾的生理学机制;量化研究结果,增强研究科学性。

睡眠质量与抑郁症状在青少年网络成瘾与自杀意念间的链式中介作用

目的了解睡眠质量与抑郁症状在青少年网络成瘾与自杀意念间的作用,为针对性干预提供参考。方法方便选取武汉市2所中学的初中与高中学生509人,采用一般资料调查问卷、网络成瘾量表、自杀筛查量表简版、匹兹堡睡眠质量指数、流调中心抑郁量表进行问卷调查,构建并检验链式中介模型。结果青少年网络成瘾倾向占25.74%,睡眠质量较差占11.79%,有抑郁症状占27.90%,在过去1年有自杀意念占45.97%。网络成瘾直接影响自杀意念(直接效应占总效应的60.20%);睡眠质量与抑郁症状在网络成瘾与自杀意念关系中存在链式中介作用(间接效应占总效应的7.65%)。结论部分青少年存在网络成瘾倾向、睡眠不佳、抑郁症状和自杀意念。网络成瘾可直接影响自杀意念,还通过影响睡眠质量或引发抑郁症状间接对自杀意念产生影响。学校和家长应采取针对性策略应对,以保护青少年身心健康。

网络成瘾对青少年非自杀性自伤的影响:有调节的中介效应

目的:探讨网络成瘾对青少年非自杀性自伤(NSSI)的影响,检验精神病性体验在两者间的中介作用以及双元自主性的调节效应。方法:采用网络成瘾问卷、非自杀性自伤问卷、双元自主性问卷和简式版社区心理评估量表对6053名13~22岁的青少年施测。结果:①网络成瘾显著正向预测青少年NSSI(r=0.37,P<0.001);②精神病性体验在网络成瘾与NSSI间起部分中介作用(β=0.61,t=35.60,P<0.001);③双元自主性在中介路径的后半段“精神病性体验→NSSI”中起调节作用(β=-0.01,t=-11.17,P<0.05)。结论:网络成瘾不仅可以直接预测非自杀性自伤,还会通过精神病性体验对其产生间接影响,同时双元自主性对此中介路径(后半段)起调节作用。

ACT联合rTMS对青少年游戏障碍患者网瘾程度及内隐认知偏倚的影响

目的探讨接受与现实疗法(ACT)联合重复经颅磁刺激(rTMS)在青少年游戏障碍(GD)患者中的应用效果。方法选取2021年1月至2022年1月该院收治的100例青少年GD患者,按随机数字表法分为观察组和对照组,各50例。对照组采取认知行为疗法,观察组采取ACT联合rTMS,比较2组中文网络成瘾量表修订版(CIAS-R)评分、内隐认知偏倚情况和学习倦怠评分。结果2组治疗前CIAS-R各维度评分比较,差异无统计学意义(P>0.05)。观察组治疗后CIAS-R各维度评分低于对照组,差异有统计学意义(P<0.05)。2组治疗前内隐认知偏倚情况比较,差异无统计学意义(P>0.05)。2组治疗后内隐认知偏倚情况比较,差异有统计学意义(P<0.05)。2组治疗前学习倦怠各维度评分比较,差异无统计学意义(P>0.05)。观察组治疗后学习倦怠各维度评分低于对照组,差异有统计学意义(P<0.05)。结论ACT联合rTMS治疗青少年GD患者的效果显著,能降低网瘾程度,改善内隐认知偏倚和学习倦怠情况,有利于其健康成长。

氟伏沙明联合利培酮对青少年网络成瘾患者情绪障碍的疗效

目的:分析青少年网络成瘾患者应用氟伏沙明联合利培酮治疗对其情绪障碍的影响。方法:选取2022年6月~2023年6月期间本院收治的78例青少年网络成瘾患者作为研究对象,随机将患者分为对照组和研究组,各39例。对照组采用利培酮治疗;研究组在对照组基础上联合氟伏沙明治疗。分析比较两组的治疗效果、社交网络成瘾性、情绪障碍严重程度及应对方式。结果:研究组的治疗总有效率明显高于对照组(P<0.05)。治疗前,两组中文网络成瘾性量表(Revised Chen internet addiction scale,CIAS-R)评分、儿童焦虑性情绪障碍筛查表(The screen for child anxiety related emotional disorders,SCARED)评分、积极应对与消极应对评分均无明显差异(P>0.05)。治疗后,两组的CIAS-R评分、SCARED评分、消极应对评分均降低,且研究组明显低于对照组(P<0.05);两组积极应对评分明显增高,且研究组明显高于对照组(P<0.05)。结论:氟伏沙明联合利培酮治疗青少年网络成瘾,能提高临床疗效,抑制青少年网瘾程度,改善患者情绪障碍及应对方式。

Smartphone dependency and its impact on academics among medical and nursing students: A cross-sectional study

Objective:This study aimed to assess smartphone dependency and its impact on academics among medical and nursing students.Materials and Methods:A cross-sectional study was carried out on Bachelor of Medicine and Bachelor of Surgery(MBBS)and Bachelor of Science in Nursing(BScN)students in a medical teaching institute.The Smartphone Dependency Scale and self-structured questionnaire on impact of smartphone on academics were used to assess smartphone dependency and its impact on academics.A total of 436 students were selected using the total enumerative sampling technique.Data were analyzed using the descriptive(frequency,percentage,mean,and standard deviation)and inferential(t-test,Chi-square test)statistics.Results:The mean age of students was 20.6±1.29 years,81%were females,and the mean body mass index score was 21.59±3.41 kg/m2.The mean impact on academics and smartphone dependency scores was 19.92±7.01 and 48.58±11.46,respectively.The impact on academics had a significant association with student category(P<0.001)and gender(P<0.001).A significant association was found between the impact on academics(P=0.003)and smartphone dependency(P=0.05)with studying class.Conclusion:The use of smartphones is more among medical students.Students studying in the first and second years are found to be more dependent on smartphone,which caused a serious impact on their academics.Smart appliances have become mandatory in this era of technology,and it is not possible to stop its usage but negative impact of smartphones on students’academic performance needs to be addressed.Therefore,it is mandatory to organize educational seminars and workshops to promote the appropriate use of smartphones.

Causes of Internet Addiction Disorder

The Internet Addiction Disorder diagnostic manual approved by psychologists on November 8 divides Internet addiction into five categories,which are addiction to online games,pornography,social networking,Internet information and Internetshopping.