The co-occurrence between symptoms of internet gaming disorder and psychiatric disorders in childhood and adolescence: prospective relations or common causes?

BACKGROUND: Internet gaming disorder (IGD) is highlighted as a condition for further study in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). Some studies indicate that IGD appears comorbid with other psychiatric disorders. We examine concurrent and prospective links between symptoms of IGD and symptoms of common psychiatric disorders in childhood and adolescence to determine whether observed comorbidity is a result of (a) reciprocal relations or (b) common underlying causes. METHODS: A community sample (n = 702) of Norwegian children completed the Internet Gaming Disorder Interview (IGDI) to assess DSM-5 defined IGD symptoms at ages 10, 12 and 14 years. The Child and Adolescent Psychiatric Assessment (CAPA) assessed symptoms of depression, anxiety, attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) at the same time points. RESULTS: A Random Intercept Cross-lagged Panel Model (RI-CLPM), which captures pure within-person changes and adjusts for all unmeasured time-invariant factors (e.g., genetics, parent education) revealed no associations between IGD symptoms and psychopathology, except that increased IGD symptoms at ages 10 and 12 predicted decreased symptoms of anxiety two years later. CONCLUSIONS: No support emerged for concurrent or prospective relations between IGD and psychiatric symptoms, except in one case: increased IGD symptoms forecasted reduction in anxiety symptoms. Observed co-occurrence between IGD symptoms and mental health problems can mainly be attributed to common underlying factors.

Time spent gaming and psychiatric symptoms in childhood: cross-sectional associations and longitudinal effects.

There is sparse knowledge on how the amount of gaming overlaps with-and is longitudinally related to-psychiatric symptoms of ADHD and emotional problems throughout early and middle childhood. In this prospective study of 791 Norwegian children, we investigated the amount of electronic gaming at ages 6, 8, and 10 while also measuring DSM symptoms of such disorders. Cross-lagged longitudinal analyses showed that more ADHD symptoms at age 8 predicted more gaming at age 10, whereas gaming did not predict more psychiatric symptoms, controlled for gender and socio-economic status. Cross-sectional overlaps between gaming and symptoms were marginal but nonetheless increased with each age level. Hence, time spent gaming did not forecast more psychiatric problems at these ages, but children with more ADHD symptoms were more likely to increase their amount of gaming throughout middle childhood. Results indicate that the sheer amount of gaming is not harmful to children's mental health, but that poorly regulated children become more attracted to games throughout childhood. Findings are discussed in light of the coexistence of problematic gaming and psychiatric problems reported among adolescents and adults, as well as the potential beneficial psychological outcomes from gaming.

Secure attachment promotes the development of effortful control in boys.

Although effortful control (EC), a regulatory aspect of temperament, is associated with a wide range of developmental outcomes, knowledge about EC promoters is scarce. This study explored whether secure attachment promoted the development of EC from preschool to school age in a community sample of 903 Norwegian children. EC was measured using the parent-reported Children's Behavior Questionnaire at four (T1) and six (T2) years of age, and attachment was measured using the Manchester Child Attachment Story Task at T1. Previous research has indicated that a child's gender and socioeconomic status are possible covariates of EC; hence, these factors were included in the analyses. Despite considerable rank-order stability in EC, secure attachment contributed to an increase in EC. Furthermore, gender moderated the effect of attachment: secure attachment promoted EC in boys only. These findings emphasize preschool boys' need for emotional security to facilitate effortful capacities in their transition to school.

Catechol-O-methyltransferase Val158Met genotype moderates the effect of disorganized attachment on social development in young children.

Children with histories of disorganized attachment exhibit diverse problems, possibly because disorganization takes at least two distinctive forms as children age: controlling-punitive and controlling-caregiving. This variation in the developmental legacy of disorganization has been attributed primarily to variations in children's rearing experiences. Here an alternative explanation of these divergent sequelae of disorganization is evaluated: one focused on genotype. Structural equation modeling was applied to data on 704 Norwegian children to test whether the catechol-O-methyltransferase Val158Met genotype moderates the effect of disorganized attachment, which was measured dimensionally at 4 years of age using the Manchester Child Attachment Story Task, on changes in aggressive behavior and social competence from ages 4 to 6. Children who scored high on disorganization and were homozygous for the valine allele displayed significantly greater increases in aggression and decreases in self-oriented social skills (e.g., self-regulation and assertiveness) over time than did their disorganized counterparts carrying the methionine allele, whereas disorganized children carrying the methionine allele increased their other-oriented social skill (e.g., cooperation and responsibility) scores more than did valine-homozygous children. These results are consistent with the controlling-punitive and controlling-caregiving behaviors observed in disorganized children, suggesting that the children's genotype contributed to variations in the social development of disorganized children.

Running to get "lost"? Two types of escapism in recreational running and their relations to exercise dependence and subjective well-being.

Escapism is a fundamental motivation in many forms of activity engagements. At its core, escapism is "a habitual diversion of the mind … as an escape from reality or routine". Accordingly, escapism may entail many adaptive and maladaptive psychological antecedents, covariates, and outcomes. However, few studies have been conducted on escapism as a motivational mindset in running. Here, in a sample of recreational runners (N = 227), we applied a two-dimensional model of escapism, comprising self-expansion (adaptive escapism) and self-suppression (maladaptive escapism), and examined how they were related to exercise dependence and subjective well-being. First, confirmatory factor analyses showed that the escapism dimensions were highly diversifiable in the sample. Then, correlational analyses showed that self-expansion was positively correlated to subjective well-being, whereas self-suppression was negatively related to well-being. Self-suppression was more strongly related to exercise dependence compared to self-expansion. Finally, path analyses evidenced an explanatory role of self-expansion and self-suppression in the inverse relationship between exercise dependence and well-being. In conclusion, the present findings support escapism as a relevant framework for understanding the relationship between exercise dependence in running and subjective well-being.

Symptoms of Internet Gaming Disorder in Youth: Predictors and Comorbidity.

Internet gaming disorder (IGD) was included in the Addendum to DSM-5 as a condition for further study. Studies of community samples using a diagnostic interview are lacking, and evaluations of the proposed symptoms, comorbidities, and predictors of IGD are scarce. To provide such information participants in a Norwegian prospective community study were assessed with a clinical interview at age 10 years. Symptoms of other psychiatric disorders were measured with the Child and Adolescent Psychiatric Assessment at ages 8 and 10 (n = 740). Children, parents, and teachers provided information on demographics, temperament, intelligence, executive functions, self-concept, social skills, victimization, emotion regulation, family climate, and parenting. Results indicated that IGD was present in 1.7% (95% confidence interval, 0.7-2.7) of the participants (3.0% boys and 0.5% girls). Factor analysis revealed two factors: heavy involvement and negative consequences. The positive predictive value of withdrawal, tolerance, and unsuccessful attempts to control gaming symptoms to the disorder was low. Symptoms of other common disorders correlated weakly with IGD-symptoms (i.e., from r = 0.07 to r = 0.15). Upon adjusting for gender and gaming at age 8, only limited social and emotion regulation skills at age 8 predicted more age-10 IGD symptoms. In conclusion, IGD is already present in a small percentage of Norwegian 10-year olds. At least three of the proposed symptoms -- withdrawal, tolerance and unsuccessful attempts to control gaming -- merit further study given their weak associations with the disorder. Symptoms of IGD are only marginally associated with symptoms of other psychiatric disorders and only predicted by social skills and emotion regulation deficits.

Change in parenting, change in student-teacher relationships, and oxytocin receptor gene (OXTR): Testing a gene-×-environment (G×E) hypothesis in two samples.

Prior research suggests that parenting affects children's relationships, including those with teachers, although there is variation across individuals in such effects. Given evidence suggesting that oxytocin may be particularly important for the quality of social relationships, we tested the hypotheses (a) that change in parenting from 4 to 6 years of age influences and predicts change in the student-teacher relationship from 6 to 8 years of age and (b) that this effect is moderated by a polymorphism related to the child's oxytocin receptor gene (OXTR), rs53576. In 2 studies, participants included, respectively, 652 socioeconomically diverse Norwegian children from a community sample (50.8% male; mean age of 54.9 months at first assessment) and 559 such children from 8 different U.S. locales (49.0% male; approximately 54 months at the first assessment). Norwegian results showed that change in parenting predicted change in student-teacher relationships, but only in the case of children homozygous for the A allele of rs53576 and in a manner consistent with differential-susceptibility theory: for AA carriers, when parenting changed for the worse, so did children's relationship with teachers, whereas when parenting changed for the better, the teacher-child relationships improved accordingly. Such G×E findings could not be replicated in the American sample. Results are discussed in terms of 2 contrasting models of Person-×-Environment interaction (differential susceptibility and diathesis stress) and potential reasons for failure to replicate. (PsycINFO Database Record

Child exposure to serious life events, COMT, and aggression: Testing differential susceptibility theory.

Both genetic and environmental factors contribute to individual differences in aggression. Catechol-O-methyltransferase Val158Met (COMT), a common, functional polymorphism, has been implicated in aggression and aggression traits, as have childhood experiences of adversity. It is unknown whether these effects are additive or interactional and, in the case of interaction, whether they conform to a diathesis-stress or differential susceptibility model. We examined Gene × Environment interactions between COMT and serious life events on measures of childhood aggression and contrasted these 2 models. The sample was composed of community children (N = 704); 355 were boys, and the mean age was 54.8 months (SD = 3.0). The children were genotyped for COMT rs4680 and assessed for serious life events and by teacher-rated aggression. Regression analysis showed no main effects of COMT and serious life events on aggression. However, a significant interactive effect of childhood serious life events and COMT genotype was observed: Children who had faced many serious life events and were Val homozygotes exhibited more aggression (p = .02) than did their Met-carrying counterparts. Notably, in the absence of serious life events, Val homozygotes displayed significantly lower aggression scores than did Met carriers (p = .03). When tested, this constellation of findings conformed to the differential susceptibility hypothesis: In this case, Val homozygotes are more malleable to the effect of serious life events on aggression and not simply more vulnerable to the negative effect of having experienced many serious life events.