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 Social Competence in Children: Reciprocal Effects Across Childhood.

Electronic games are popular and many children spend much time on this activity. Here we investigate whether the quantity of time children spend on gaming is related to their social development, making this the first study to examine this relationship in children. We examine prospective relations between time spent gaming and social competence in a community sample of Norwegian 6 year olds (n = 873) followed up at ages 8, 10, and 12, controlling for socioeconomic status, body mass index, and time spent gaming together with friends. Results revealed that greater social competence at both 8 and 10 years predicted less gaming 2 years later and that more age-10 gaming predicted less social competence at age 12 but only among girls.

Peer Problems and Hyperactivity-Impulsivity Among Norwegian and American Children: The Role of 5-HTTLPR.

Peer problems are linked to attention deficit hyperactivity disorder (ADHD) symptoms and the serotonin system is thought to be involved in ADHD-related behavior. Hence, from a Gene × Environment perspective, the serotonin transporter 5-HTTLPR may play a moderating role. In two large community samples, the moderating role of 5-HTTLPR was examined related to more hyperactivity-impulsivity symptoms (HI symptoms) predicted by more peer problems. In Study 1, involving 642 Norwegian children, results indicated that for s-allele carriers only, caregiver-reported peer problems at age 4 predicted more parent-reported HI symptoms at age 6. In Study 2, similar results emerged involving 482 American children. Discussion focuses on differential sensitivity to the adverse effects of poor peer relations.

Peer Rejection and Attention Deficit Hyperactivity Disorder Symptoms: Reciprocal Relations Through Ages 4, 6, and 8.

Attention deficit hyperactivity disorder (ADHD) predicts poor peer relationships. What remains unclear is whether poor peer relationships affect ADHD symptomatology. Hence, reciprocal effects of peer rejection and ADHD symptoms were examined in a community sample of 962 Norwegian children at ages 4, 6, and 8. Results showed that ADHD symptoms at age 4 predicted more peer rejection at age 6, and that peer rejection at age 4 predicted more symptoms at age 6. However, when conducting analyses on ADHD subtypes, hyperactivity-impulsivity and inattentiveness symptoms were adversely affected by peer rejection at ages 6 and 8, whereas peer rejection was unaffected by such symptoms, indicating that the effect of peer rejection on ADHD symptoms was most robust. Mediational relation were also identified.

Preschool-age problem behavior and teacher-child conflict in school: direct and moderation effects by preschool organization.

The hypothesis was tested that the new open-group Norwegian day-care centers would more than traditionally organized centers negatively affect (a) current and (b) future teacher-child relationships, and (c) the developmental legacy of preschool problem behavior. The focus was on eight hundred and fifty 4-year-olds from 153 centers who were followed up in first grade. Results of this natural quasi-experiment revealed that children from open-group centers (a) experienced less teacher-child closeness in preschool and (b) more teacher-child conflict in first grade, and (c) that high levels of preschool problem behavior forecast especially high levels of future teacher-child conflict, but only for children from open-group centers. Results highlight the importance of spatial and social organization of day care and their translational implications.

Reciprocal Relations Between Student-Teacher Relationship and Children's Behavioral Problems: Moderation by Child-Care Group Size.

In this Norwegian study, bidirectional relations between children's behavior problems and child-teacher conflict and closeness were examined, and the possibility of moderation of these associations by child-care group size was tested. Eight hundred and nineteen 4-year-old children were followed up in first grade. Results revealed reciprocal effects linking child-teacher conflict and behavior problems. Effects of child-teacher closeness on later behavior problems were moderated by group size: For children in small groups only (i.e., ≤ 15 children), greater closeness predicted reduced behavior problems in first grade. In consequence, stability of behavior problems was greater in larger than in smaller groups. Results are discussed in light of regulatory mechanisms and social learning theory, with possible implications for organization of child care.

Social exclusion predicts impaired self-regulation: a 2-year longitudinal panel study including the transition from preschool to school.

The need-to-belong theory stipulates that social exclusion (i.e., being rejected by peers) impairs the ability to self-regulate, and experimental studies with adults support this contention, at least on a short-term basis. Few studies have investigated whether social exclusion affects the development of self-regulation of children in a more enduring manner. By using data from a community sample of 762 children, we investigated reciprocal relations between social exclusion and self-regulation from age 4 to age 6. Social exclusion was reported by teachers, whereas self-regulation was reported by parents. Autoregressive latent cross-lagged analyses showed that social exclusion predicted impaired development of dispositional self-regulation and, reciprocally, that poor self-regulation predicted enhanced social exclusion. In other words, social exclusion undermines children's development of self-regulation, whereas poor self-regulation increases the likelihood of exclusion. Results illuminate the applied relevance of the need-to-belong theory.

Gaming motivation and well-being among Norwegian adult gamers: the role of gender and disability.

Introduction: Digital gaming is a popular and often social activity, also among adults. However, we need more knowledge of the social dynamics of gaming and its potential benefits for one's well-being. The current study aimed to examine gaming motivation, time spent gaming, and gaming performed together with friends, family, or romantic partner and how these aspects relate to expanded social network and well-being among men and women with and without disability. Methods: Regular players of the popular game Fortnite Battle Royale (FBR; N = 278, 48.5% women, Mage = 32.38) completed an online questionnaire assessing their motivations for playing FBR (social motivation, achievement motivation, novelty motivation), time spent gaming, whom they usually play with, their psychological well-being, and FBR's impact on their life and social network. Differentiated statistical analyses on gender and disability were performed. Results and discussion: The results showed that time spent gaming and social motivation to play were associated with larger social networks for all participants (strongest for women). More time spent gaming FBR was also associated with a positive impact on life for those with a disability. Social motivation to play was positively associated with a positive impact on life for men and those without a disability and increased well-being for women. Novelty motivation, which concerns experiencing new features in the game, was associated with a positive impact on life for women and with a decrease in well-being for those with a disability. This study demonstrated that gaming can be an essential social arena associated with positive outcomes for men, women and disabled people, who-when socially motivated-may expand their social networks through gaming.

Reciprocal Relations Between Conflicted Student-teacher Relationship and Children's Behavior Problems: Within-person Analyses from Norway and the USA.

Current evidence suggests that conflicted student-teacher relationships may increase behavior problems in children and vice-versa, but this may be due to confounding. We therefore analyzed their relation applying a within-person approach that adjusts for all time-invariant confounding effects, involving samples from Norway (n = 964, 50.9% females) and the USA (n = 1,150, 48.3% females) followed from age 4-12 years with similar measures. Increased parent-reported behavior problems forecasted increased student-teacher conflict to a similar extent in both countries (ß = 0.07, p = .010), whereas teacher-reported behavior problems predicted increased student-teacher conflict more strongly in Norway (ß = 0.14, p = .001) than in the US (ß = 0.08, p = .050). Increased teacher-child conflict also predicted increased parent-reported (ß = 0.07, p = .010), but not teacher-reported, behavior problems in both countries. Findings underscore the reciprocal relation between behavior problems and a conflictual student-teacher relationship.

Quantifying teenagers' sleep patterns and sex differences in social jetlag using at-home sleep monitoring.

Sleep plays an important role in the formative developmental processes occurring during the teenage years. At the same time, teenagers' changing bioregulatory mechanisms and psychosocial factors converge into the so-called social jetlag, a sleep timing misalignment between weekdays and weekends. The aim of this study was to quantify the course of day-to-day changes in sleep/wake patterns and sleep stage distributions, and the sex differences in social jetlag among teenagers. We observed the sleep of 156 teenagers (58.3% girls, 15-16 years) using a novel sleep monitor over the course of up to 10 consecutive days. 1323 nights of data were analyzed using multilevel modeling. On average, participants went to bed at 23:41, woke up at 07:48, slept for 7.7 h and had 85.5% sleep efficiency. Sleep stage distributions were in line with normative data. We found later sleep onset and offset, longer time in bed, sleep duration, and sleep onset latency (p = .001), greater proportion of light sleep and lower proportion of deep sleep, and poorer sleep efficiency (all p < .001) on weekend nights starting on Friday and Saturday. On Friday nights, girls had longer time awake after sleep onset (p = .020) than boys. On Friday and Saturday nights, girls fell asleep earlier (p < .001 and p = .006, respectively). On Saturday nights, girls had shorter sleep latency (p = .024), and better sleep efficiency (p = .019) than boys. In sum, teenagers' sleep patterns reflected healthy, albeit somewhat short sleep. There was convincing evidence of social jetlag, and girls exhibited less severe social jetlag than boys.

Social withdrawal and academic achievement, intertwined over years? Bidirectional effects from primary to upper secondary school.

BACKGROUND: Socially withdrawn children tend to perform poorer academically than their peers. What remains unknown, is the temporal ordering of the two phenomena. Also, substantial gender differences exist in both social withdrawal and academic achievement; thus, it is conceivable that the strength of the relation between them is gendered as well. AIMS: To investigate cross-sectional correlates and test directional effects of social withdrawal and academic achievement from primary to upper secondary school, and to examine potential gendered effects. METHODS: Prospective associations were analysed from age 6 to age 14 using biannual teacher ratings of children's social withdrawal and academic achievement in a representative community sample (n = 845), by means of random intercept cross-lagged panel modelling. RESULTS: In boys, increased academic achievement at ages 8 and 12 forecasted decreased social withdrawal 2 years later, whereas increased social withdrawal at age 10 predicted reduced academic achievement at age 12. No such effects were seen in girls. CONCLUSIONS: Social withdrawal and academic achievement are bidirectionally related among boys, but not girls. Results are discussed in light of need-to-belong theory, and practical implications for schools and teachers are illuminated.

Trends in absolute and relative educational inequalities in health during times of labour market restructuring in coastal areas: The HUNT Study, Norway.

BACKGROUND: Restructuring labour markets offers natural population-level experiments of great social epidemiological interest. Many coastal areas have endured substantial restructuring of their local labour markets following declines in small-scale fishing and transitions to new employment opportunities. It is unknown how educational inequalities in health have developed in formerly fishery-dependent communities during such restructuring. In this study, we compare trends in social inequalities in health in Norwegian coastal areas with adjacent geographical areas between 1984 and 2019. METHODS: We used cross-sectional population-based data from the Trøndelag Health Study (HUNT), collected four times: HUNT1 (1984-86), HUNT2 (1995-97), HUNT3 (2006-08) and HUNT4 (2017-19). Adults above 30 years of age were included. Using Poisson regression, we calculated absolute and relative educational inequalities in self-rated health, using slope (SII) and relative (RII) indices of inequality. RESULTS: Trends in absolute and relative inequalities in rural coastal health were generally more favourable than in adjacent geographical areas. We found a statistically significant trend of declining relative educational inequalities in self-rated health in the rural coastal population from HUNT1 to HUNT4. Absolute inequalities overall increased from HUNT1 to HUNT4, although a declining trend followed HUNT2. Nonetheless, the rural coastal population exhibited the highest prevalence of poor self-rated health across the four decades. CONCLUSIONS: Although absolute educational inequalities in self-rated health widened in all geographical areas, the smallest increase was in rural coastal areas. Relative educational inequalities narrowed in this rural coastal population. Considering the concurrent processes of large-scale investments in the Norwegian public sector and welfare schemes, increased fishing fleet safety, and employment opportunities in aquaculture, our findings do not suggest that potential positive effects on public health of this restructuring have benefitted inhabitants with higher educational attainment more than inhabitants with lower educational attainment in this rural coastal population.

Sleep Characteristics in Esport Players and Associations With Game Performance: Residual Dynamic Structural Equation Modeling.

The current study aimed to examine sleep characteristics of esport players and the stipulated effects of game performance on consecutive sleep characteristics using residual dynamic structural equation modeling (RDSEM). A sample of 27 Counterstrike players with a mean age of 18½ years participated in the current study. Sleep was detected over a period of 56 days with a Somnofy sleep monitor that utilizes an impulse radio ultra-wideband puls radar and Dopler technology, and weekly game performance was reported by the players. The results showed that esport players' sleep characteristics were in the lower levels of recommended guidelines and that sleep onset started later and sleep offset ended later in the morning compared with athletes from other traditional sports. The esport players displayed stable patterns in sleep onset, sleep offset, time in bed, sleep efficiency and non-REM respiration rates per minute (NREM RPM). On the between-person level, esport players with better game performance spent more time sleeping (r = 0.55) and scored lower on NREM RPM (r = -0.44). Unstandardized within-person cross-lagged paths showed that better game performance predicted subsequent earlier sleep offset. The within-level standardized estimates of the cross-lagged paths revealed that participants with better game performance spent subsequently more time in deep sleep (0.20), less time in light sleep (-0.14), less time in bed (-0.16), and displayed lower NREM RPM (-0.21), earlier sleep offset (-0.21), and onset (-0.09). The findings of better game performance being related to better sleep are discussed in terms of existing knowledge on how stress responses elicitated by poor performance might impact on non-REM respiration rates and sleep.

Understanding coastal public health: Employment, behavioural and psychosocial factors associated with geographical inequalities. The HUNT study, Norway.

Recent decades have shown an international trend of decline in small-scale fishing; a longstanding and vital industry for numerous coastal populations. The decline has resulted in a loss of livelihoods in many coastal communities, potentially afflicting public health. Still, knowledge about the health situation of these areas is limited. Former studies on coastal health have primarily defined coastal areas based solely on their proximity to the coast, therefore not targeting the traditional coastal communities with longstanding coastal involvement through small-scale fishing. In this paper, we aim to illuminate the health situation in these areas by introducing a more fine-grained classification of the coastal study population; considering both geographical proximity to the coast, population density and employment in fishing. Using data from the Norwegian population-based HUNT Study, we perform individual and simultaneous adjustments for employment, behavioural and psychosocial factors to assess the contributions of these factors to the association between geographical affiliation and self-rated general health. The rural coastal areas with a history of small-scale fishing show a poorer health situation compared to urban coastal, rural inland and rural fjord populations, and behavioural factors contribute the most to the observed health disparities. Our findings encourage greater focus on societal differences between coastal communities when studying coastal health.

Variations in relative health inequalities: are they a mathematical artefact?

BACKGROUND: Substantial research has documented variations in the magnitude of relative socioeconomic differences in health across European countries, and within countries, across different age groups. The aim of this paper is to examine to what extent these variations are determined by differences in the overall rate or prevalence of a health outcome across countries and age-groups in the total population. METHODS: Three surveys (European Social Survey, and two different population census-mortality registry linked longitudinal data) were used. We plotted rates of mortality and prevalence of poor self-rated health against ratios of mortality and morbidity prevalence associated with educational level. We calculated Pearson coefficients to examine the magnitude of correlations. RESULTS: We found a significant negative correlation between total mortality rates and associated rate ratios of mortality by education in the SEDHA study (r = -0.40, p = 0.04), but not in the HUNT study (r = -0.37, p = 0.06). There was a weaker but significant negative correlation between the prevalence of poor health and associated prevalence ratios by education in the European social survey (r = -0.22, p = 0.00). Correlations increased as underlying prevalence and rates increased, while they were weaker or null at low prevalence or rates. CONCLUSION: We found some evidence that the magnitude of relative inequalities in mortality and morbidity is negatively correlated with underlying morbidity prevalence and mortality rates. Although correlations are moderate, underlying morbidity prevalence and mortality rates should be taken into account in the interpretation of variations in relative health inequalities among populations.

Screen time and the development of emotion understanding from age 4 to age 8: A community study.

Recent increase in children's screen activities has raised concerns that screen time may replace face-to-face interaction, and hence impair children's development of emotion understanding. This longitudinal community study of 960 Norwegian 4-year-olds, followed up at ages 6 and 8, examined bidirectional relations between screen use and emotion understanding. Results revealed that more screen time at age 4 predicted lower levels of emotion understanding at age 6. In addition, television in children's bedroom at age 6 forecasted lower levels of emotion understanding at age 8. The effect of TV watching on emotion understanding was gender moderated, with stronger effects of TV watching observed among girls, but no significant effects detected among boys. In contrast, gaming forecasted lower level of emotion understanding in boys, not girls. Results are discussed in the light of the importance of face-to-face interaction to preserve the development of social-emotional competence among young children. Statement of contribution What is already known on this subject? We know that children's screen activities correlate with poorer social competence and with decrease of the quantity and quality of interaction with parents and siblings. The capacity to understand emotions in others is primarily learned through interaction with primary caregivers, but little is known how children's screen use influences development of emotion understanding. What the present study adds? We found that more TV watching among girls at age 4 predicted lower levels of emotion understanding at age 6. Furthermore, TV in child's bedroom at age 6 forecasted lower levels of emotion understanding at age 8.

Effects of spouses' socioeconomic characteristics on mortality among men and women in a Norwegian longitudinal study.

A partner's socioeconomic characteristics can influence one's own health. Nevertheless, little is known about the relative importance of a partner's education, occupation and income in relation to inequalities in mortality. In this study, we consider the relative contribution of these three spouse characteristics to predicting general and cause-specific mortality in men and women. Data on married persons and their spouses were taken from a Norwegian cross-sectional survey of a total county population (the Nord-Trøndelag Health Study, HUNT 1, 1984-1986). A mortality follow-up was maintained until 2003. Associations of mortality with socioeconomic indicators were assessed computing hazard ratios and Relative Index of Inequality in Cox regression. In women, a clear gradient in age-adjusted mortality rates was observed according to all husband's characteristics. In men, wife's education was most consistently associated with their mortality. After mutual adjustment for all own and spouse's socioeconomic characteristics, the effect of husband's education on women's overall mortality diminished (HR 1.07), whereas the effects of husband's occupation and income remained of similarly moderate size (HR 1.12). Wife's education persisted after adjustment as a significant and strong predictor of men's all-cause mortality (HR 1.35). Effects of partner's characteristics were mostly pronounced in cardiovascular mortality and far less in cancer mortality. In men, wife's education was the strongest and only predictor of mortality across all causes of death examined, except stroke. In women, husband's occupation was mainly related to ischemic heart disease and lung cancer mortality, while husband's income influenced mainly stroke mortality. Wife's education and husband's occupation and income were the most important predictors of mortality across partner relationships. It is suggested that men contribute to their wives' health not only by means of financial security, but also through occupational class. Further research should test our hypothesis that the effect of husband's occupation on their spouses works through occupation-related lifestyle and social prestige.

Socioeconomic inequalities in mortality and repeated measurement of explanatory risk factors in a 25 years follow-up.

BACKGROUND: Socioeconomic inequalities in mortality can be explained by different groups of risk factors. However, little is known whether repeated measurement of risk factors can provide better explanation of socioeconomic inequalities in health. Our study examines the extent to which relative educational and income inequalities in mortality might be explained by explanatory risk factors (behavioral, psychosocial, biomedical risk factors and employment) measured at two points in time, as compared to one measurement at baseline. METHODS AND FINDINGS: From the Norwegian total county population-based HUNT Study (years 1984-86 and 1995-1997, respectively) 61 513 men and women aged 25-80 (82.5% of all enrolled) were followed-up for mortality in 25 years until 2009, employing a discrete time survival analysis. Socioeconomic inequalities in mortality were observed. As compared to their highest socioeconomic counterparts, the lowest educated men had an OR (odds ratio) of 1.41 (95% CI 1.29-1.55) and for the lowest income quartile OR = 1.59 (1.48-1.571), for women OR = 1.35 (1.17-1.55), and OR = 1.40 (1.28-1.52), respectively. Baseline explanatory variables attenuated the association between education and income with mortality by 54% and 54% in men, respectively, and by 69% and 18% in women. After entering time-varying variables, this attainment increased to 63% and 59% in men, respectively, and to 25% (income) in women, with no improvement in regard to education in women. Change in biomedical factors and employment did not amend the explanation. CONCLUSIONS: Addition of a second measurement for risk factors provided only a modest improvement in explaining educational and income inequalities in mortality in Norwegian men and women. Accounting for change in behavior provided the largest improvement in explained inequalities in mortality for both men and women, as compared to measurement at baseline. Psychosocial factors explained the largest share of income inequalities in mortality for men, but repeated measurement of these factors contributed only to modest improvement in explanation. Further comparative research on the relative importance of explanatory pathways assessed over time is needed.

Preschool social exclusion, aggression, and cooperation: a longitudinal evaluation of the need-to-belong and the social-reconnection hypotheses.

The need-to-belong theory stipulates that social exclusion fosters aggression, whereas the social-reconnection hypothesis suggests that social exclusion promotes motivation to behave cooperatively. To date, empirical investigations of these contrasting views have focused on the immediate effects of social exclusion, yielding mixed results. Here we examine longer term effects of preschool social exclusion on children's functioning 2 years later. Social exclusion was reported by teachers, aggression and cooperation by parents. Cross-lagged analyses showed that greater social exclusion at age 4 predicted more aggression and less cooperation at age 6, providing support for the need-to-belong rather than social-reconnection hypothesis. Secondary analyses showed that social exclusion predicted more aggression only among children scoring above mean on aggression at age 4, indicating that aggressive behavior is amplified by social exclusion among children already behaving aggressively. No gender differences were found. Implications and limitations are discussed in a developmental context.