Socio-ecological Barriers to Leisure Time Physical Activity in Spanish Wheelchair Users With Spinal Cord Injury: Associations With Sociodemographic Characteristics and Functional Independence.

OBJECTIVE: (1) To assess prevalence and severity of socio-ecological barriers to leisure time physical activity (LTPA) in a sample of adults with spinal cord injury (SCI); (2) to examine the association of these barriers with sociodemographic characteristics and functional independence (FI); and (3) to explore which socio-ecological levels of barriers might be associated with LTPA. DESIGN: Cross-sectional study. SETTING: Neurorehabilitation Hospital specialized in SCI. PARTICIPANTS: 207 wheelchair users with SCI living in the community who attended a comprehensive check-up (22.7% women, 47.5±10.7 mean age; N=207). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The short version of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments was used to measure socio-ecological barriers to LTPA. The Spinal Cord Independence Measure III was used to measure FI. The Physical Activity Recall Assessment for People with SCI was used to quantify LTPA. Several multiple linear regression models were computed to examine the associations between socio-ecological barriers and sociodemographic factors, LTPA and FI. RESULTS: A high prevalence of barriers to LTPA was found. Seven of these barriers (2 intrapersonal, 3 organizational, and 2 community) were present for >60% of the participants. Intrapersonal and organizational barriers had a higher effect on participants with lower FI and women. Interpersonal barriers were higher for older participants and with lower FI, while community barriers were higher for unemployed participants. Finally, intrapersonal and interpersonal barriers were negatively associated with LTPA, and FI revealed as a moderator of the intrapersonal barriers-LTPA relation. CONCLUSIONS: Given their high prevalence and their association with LTPA, the development of interventions targeting socio-ecological barriers to LTPA in people with SCI becomes crucial. The associations of these barriers with FI and sociodemographic characteristics should also be considered for these interventions to be as specific and effective as possible.

Psychosocial Outcomes Associated With Types and Intensities of Physical Activity in People With Spinal Cord Injury: The Mediating Role of Self-Efficacy and Functionality.

BACKGROUND: Low rates of participation and quality of life (QoL) and high rates of psychological distress are common in spinal cord injury (SCI) population. Research has supported the mediating role of self-efficacy and functionality in improving psychosocial outcomes. Furthermore, evidence supports the impact of physical activity (PA) on psychosocial variables, but little is known about the types and intensities of PA. The objective of this study was to determine whether functionality and/or general self-efficacy (GSE) mediate the relationships between the various types of PA: (1) lifestyle and (2) leisure-time physical activity (LTPA); and various intensities of PA: (1) mild, (2) moderate, and (3) heavy PA with participation, psychological distress, and perception of QoL. METHODS: The Physical Activity Recall Assessment for SCI, and measures of functionality, GSE, participation, psychological distress, and perception of QoL were administered to 159 participants. Path analysis was performed using Jeffrey's Amazing Statistics Program. RESULTS: GSE significantly mediated, and functionality partially significantly mediated, the relationship between LTPA and psychosocial outcomes. GSE and functionality did not mediate the relationship between lifestyle activity and psychosocial outcomes. CONCLUSIONS: It is recommended that people with SCI perform LTPA on a regular basis to achieve psychosocial benefits. These programs should be accompanied by strategies to improve GSE.

Stress and suicide risk among adolescents: the role of problematic internet use, gaming disorder and emotional regulation.

BACKGROUND: Previous studies have associated videogame playing and social media use with suicidal behaviors together with lower stress coping or poor emotion regulation strategies. Due to the inconclusive evidence regarding the factors associated with suicidal behavior, the present study aimed to overcome the limitations of previous research and explored the relationship between adolescent stress, problematic internet use (PIU), gaming disorder (GD), and emotional regulation (ER) in a cross-section design. It was hypothesized that stress would have a direct effect on suicide risk (SR) as well as being mediated by PIU, GD, and ER. METHODS: The participants comprised 430 adolescents (58.4% male) aged between 16 and 19 years. They completed an online survey including the Mobile-Related Experiences Questionnaire, Internet Gaming Disorder Scale-Short Form, Meta-Mood Trait Repair Scale, and Spanish version of the Suicidal Behaviors Questionnaire. RESULTS: A total of 34.2% of the adolescents (N = 147) were at risk for SR. Results also indicated that 30,7% had experienced suicidal ideation at some point in their life, 12.1% had at least one plan to die by suicide, and 5.1% had attempted suicide. Results of path analysis confirmed that stress appeared to be a risk factor for suicide, but that its effects were not mediated by PIU. However, ER and GD mediated the effect of stress on SR. The results suggest that stress is a main risk factor for suicide, especially among adolescents with poor emotional regulation or problematic gaming. CONCLUSIONS: Considering the prevalence of suicide among adolescents, the results of the present study suggest that suicide prevention programs should include emotional regulation strategies, stress coping, and videogaming management skills in the early stages of high school. Providing these protective resources to adolescents will help them face the stressful and changing situations typical of adolescence and will help them to attain greater well-being and satisfaction with life.

The relationship between suicidal behavior and perceived stress: The role of cognitive emotional regulation and problematic alcohol use in Spanish adolescents.

Suicidal behavior has become an important public health problem, correlating with stress and emotional deficits in recent research. This study examined the relationship between perceived stress and suicidal behavior risk, testing the mediating roles of cognitive emotion regulation and impulsivity, and the moderating role of problematic alcohol use in stress-suicidal behavior association in a sample of 121 Spanish adolescents surveyed online. Results showed positive and significant associations between perceived stress and suicidal behavior risk, as well a mediation role of adaptive cognitive emotion regulation strategies and a moderation role of problematic alcohol use between perceived stress and suicidal behavior risk, supporting stress as an influential factor in suicidal behavior. Our findings emphasize adaptive emotional regulation strategies in stressful situations, as well as the importance of promoting responsible alcohol consumption to decrease suicide risk in adolescents. Additionally, they contribute to effective educational suicide prevention programs for young people.

Forest bathing and hiking benefits for mental health during the COVID-19 pandemic in Mediterranean regions.

Forest bathing (FB) has evidenced positive effects on individuals' mental health and well-being, but its benefits have mainly been studied in Asian biomes. The present study aimed to evaluate whether its benefits are also generalisable to other forests and biomes of the world, such as the Mediterranean. Eighty-six healthy adults of the general population were assessed before and after a FB near Barcelona (Spain) during the COVID-19 pandemic. A control-hiking group of participants was also analysed to contrast the FB effects on anxiety, affect, mood states and mindfulness. Results show that the guided practice of FB in Mediterranean-Catalan forests increases mindfulness states and positive affect and reduces anxiety and negative affect, with effect sizes being large to very large. Hiking also induced significant changes in all variables tested, but FB showed higher effect sizes. An exploratory analysis also revealed a different profile of the FB participants compared to the hiking practitioners, being highly educated women living in urban areas and with lower basal levels of psychological well-being. Accordingly, it is concluded that both Mediterranean FB and hiking (to a lesser degree) might be cost-effective strategies to promote and restore psychological well-being after the COVID-19 pandemic and to promote sustainable tourism in Mediterranean biomes of the European forested and protected areas.

The Spanish Version of the Video Game Functional Assessment-Revised.

It is estimated that 16.8 million in Spain (41% female) are involved in gaming, and approximately 8.3% of Spanish gamers are problematic gamers (i.e., endorsing five or more of the nine criteria for Internet Gaming Disorder [IGD]). Given the high prevalence of IGD in Spain, this study evaluated construct validity and concurrent validity of the Spanish Version of the Video Game Functional Assessment-Revised (SP-VGFA-R), by examining the correlational coefficients with the nine-item Internet Gaming Disorder Scale-Short-Form (IGDS9-SF). A total of 434 adults 18 years of age or older participated in the study (15.1% female). Results showed that the SP-VGFA-R was positively and significantly associated with the IGDS9-SF (bivariate coefficients ranging from 0.411 to 0.610). Four distinct factors in the SP-VGFA-R were identified in confirmatory factor analysis, including (a) social attention, (b) tangible/intangible rewards, (c) escape/avoidance of demands or pain, and (d) sensory stimulation. Other findings showed that IGDS9-SF scores increased as (a) the escape/avoidance of demands or pain function increased and (b) two or more function scores increased. The SP-VGFA-R can be used in combination with the IGDS9-SF to assess Spanish gamers with IGD internationally, and to develop evidence-based behavioral interventions.

Internet Addiction Test research through a cross-cultural perspective: Spain, USA and Colombia. / La investigación del Internet Addiction Test desde una perspectiva intercultural: España, Estados Unidos y Colombia.

Internet users worldwide often experience problems related to their Internet use, and although culture has an important influence over how people communicate, what they value, and therefore how they use the Internet, little cross-cultural research on the subject of problematic Internet use has been carried out. The Internet Addiction Test (IAT), the most common measurement tool for this purpose, has been used in various countries. In this study we compared and analyzed the cross-cultural results found in the most recent research on the IAT factor analysis. We found that in countries with two or more studies, results are often replicated, suggesting that cultural context influences Internet behaviors. We conducted our own IAT factor analysis studies in three countries - Spain, USA, and Colombia - with a total of 1,273 participants. We compared our results with those from previous studies in the same countries and found similar results. The most notable finding was that all the IAT factor analyses, both ours and the previous ones in the same regions, contained a factor related to loss of control/time management problems and another factor related to emotional/psychological problems, thereby suggesting that impulse control problems and unfulfilled emotional needs are the most important components in the development of problematic Internet use in various countries around the world. Future research on problematic Internet use should focus on these aspects.

Los usuarios de Internet frecuentemente experimentan problemas relacionados con su uso de Internet y, aunque la cultura tiene una influencia importante en la forma en que las personas se comunican, en lo que valoran y, por lo tanto, en cómo utilizan Internet, hay escasas publicaciones sobre investigación intercultural del uso problemático de Internet. La herramienta más común para medir dicho uso, el Internet Addiction Test (IAT) se ha utilizado en varios países. En este estudio comparamos los resultados interculturales de las investigaciones más recientes sobre el análisis factorial del IAT. Encontramos que los resultados a menudo se replican en países con dos o más estudios, lo que sugiere que el contexto cultural influye en los comportamientos en Internet. Llevamos a cabo nuestros propios estudios de análisis factorial del IAT en tres países (España, EE. UU. y Colombia) con 1.273 participantes. Al comparar nuestros resultados con los de estudios anteriores, encontramos que nuestros resultados fueron similares a los de estudios anteriores. El hallazgo más notable fue que todos los análisis factoriales de IAT, tanto los nuestros como los anteriores en las mismas regiones, contenían un factor relacionado con la pérdida de control/problemas de gestión del tiempo y otro factor relacionado con problemas emocionales/psicológicos, lo que sugiere que el control de impulsos y las necesidades emocionales no satisfechas son componentes importantes en el desarrollo del uso problemático de Internet en todo el mundo. La investigación futura sobre el uso problemático de Internet debería centrarse en estos aspectos.

Effect of the Frustration of Psychological Needs on Addictive Behaviors in Mobile Videogamers-The Mediating Role of Use Expectancies and Time Spent Gaming.

Casual videogames (CVGs), played on smartphones, are becoming increasingly popular, especially among females and adults. Whereas the addictive potential of online (computer) videogames is well-established, there is yet insufficient evidence for Internet gaming disorder (IGD) in mobile gamers and for the mediating role of some mechanisms involved. The aim of this study is to investigate the impact of the frustration of psychological needs on mobile videogamers' addictive behavior as well as the role of cognitions (game-use expectancies) and behaviors (time spent playing) through a hypothesized serial mediation model, while controlling for important correlates, such as game genre, age, gender and payment during play. A total of 471 mobile game users (211 males) with an average age of 21.73 replied to an online survey containing sociodemographic and game variables, the Need Satisfaction and Frustration Scale (NSFS), the Internet Gaming Disorder Scale-Short Form (IGDS9-SF) and a slightly modified version of the Internet Use Expectancies Scale (IUES). The results corroborate the negative effects of need frustration on IGD among mobile gamers and clarify the role of time spent playing and game-use expectancies in the development of IGD, highlighting the important role of cognitions in this relationship. We conclude that both the time spent playing and game-use expectancies should be important targets for clinical interventions, even though they are not included in the diagnostic criteria.

Problematic Use of the Internet and Smartphones in University Students: 2006-2017.

It has been more than a decade since a concern about the addictive use of the Internet and mobile phones was first expressed, and its possible inclusion into the lists of mental disorders has recently become a popular topic of scientific discussion. Thus, it seems to be a fitting moment to investigate the prevalence of this issue over time. The aim of the present study was to analyze the prevalence of the perception of problematic Internet and smartphone use in young people over the period 2006-2017. To this end, a questionnaire on Internet use habits and two questionnaires on the negative consequences of Internet and smartphone use were administered to a sample of 792 university students. The scores were then compared with the results of former studies that had used these questionnaires. The perception of problematic Internet and mobile phone use has increased over the last decade, social networks are considered responsible for this increase, and females are perceived to be more affected than males. The current study shows how strong smartphone and Internet addiction and social media overlap. Participants from 2017 report higher negative consequences of both Internet and mobile phone use than those from 2006, but long-term observations show a decrease in problematic use after a sharp increase in 2013. We conclude that the diagnosis of technological addictions is influenced by both time and social and culture changes.

Depression in Individuals With Traumatic and Nontraumatic Spinal Cord Injury Living in the Community.

OBJECTIVE: To assess depression in a sample of individuals with spinal cord injury (SCI) living in the community, and to determine the prevalence of probable major depressive disorder (PMDD) among those with traumatic spinal cord injury (T-SCI) and those with nontraumatic spinal cord injury (NT-SCI). DESIGN: Cross-sectional. SETTING: Data were collected on individuals with SCI now living in the community, who completed a comprehensive follow-up assessment at the hospital. PARTICIPANTS: Individuals with T-SCI or NT-SCI (N=831) completed the Patient Health Questionnaire-9 (PHQ-9) and were included. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The PHQ-9 was used to detect the presence of PMDD and to measure the severity of the depression. RESULTS: The most frequent etiology of SCI was T-SCI (66.9%). Overall, 16.2% of participants met the criteria for PMDD; however, a higher prevalence was noted for individuals with NT-SCI (21.1%) than for individuals with T-SCI (13.8%). Risk factors between T-SCI and NT-SCI did not differ greatly. Female sex, chronic pain, and lower levels of/difficulties in participation were associated with the presence of PMDD. CONCLUSIONS: PMDD appears to occur at a higher rate in individuals with NT-SCI, with greater symptom severity. The finding that problems with participation are directly associated with depression raises the need for specific treatment goals, with the aim of empowering individuals with SCI to reintegrate into the community. Potential stress factors (eg, environmental barriers, limited participation options) should be addressed accordingly.

Negative consequences from heavy social networking in adolescents: The mediating role of fear of missing out.

Social networking sites (SNS) are especially attractive for adolescents, but it has also been shown that these users can suffer from negative psychological consequences when using these sites excessively. We analyze the role of fear of missing out (FOMO) and intensity of SNS use for explaining the link between psychopathological symptoms and negative consequences of SNS use via mobile devices. In an online survey, 1468 Spanish-speaking Latin-American social media users between 16 and 18 years old completed the Hospital Anxiety and Depression Scale (HADS), the Social Networking Intensity scale (SNI), the FOMO scale (FOMOs), and a questionnaire on negative consequences of using SNS via mobile device (CERM). Using structural equation modeling, it was found that both FOMO and SNI mediate the link between psychopathology and CERM, but by different mechanisms. Additionally, for girls, feeling depressed seems to trigger higher SNS involvement. For boys, anxiety triggers higher SNS involvement.

The problematic use of Information and Communication Technologies (ICT) in adolescents by the cross sectional JOITIC study.

BACKGROUND: The emerging field of Information and Communications Technology (ICT) has brought about new interaction styles. Its excessive use may lead to addictive behaviours. The objective is to determine the prevalence of the problematic use of ICT such as Internet, mobile phones and video games, among adolescents enrolled in mandatory Secondary Education (ESO in Spanish) and to examine associated factors. METHODS: Cross sectional, multi-centric descriptive study. POPULATION: 5538 students enrolled in years one to four of ESO at 28 schools in the Vallès Occidental region (Barcelona, Spain). DATA COLLECTION: self-administered socio-demographic and ICT access questionnaire, and validated questionnaires on experiences related to the use of the Internet, mobile phones and video games (CERI, CERM, CERV). RESULTS: Questionnaires were collected from 5,538 adolescents between the ages of 12 and 20 (77.3 % of the total response), 48.6 % were females. Problematic use of the Internet was observed in 13.6 % of the surveyed individuals; problematic use of mobile phones in 2.4 % and problematic use in video games in 6.2 %. Problematic Internet use was associated with female students, tobacco consumption, a background of binge drinking, the use of cannabis or other drugs, poor academic performance, poor family relationships and an intensive use of the computer. Factors associated with the problematic use of mobile phones were the consumption of other drugs and an intensive use of these devices. Frequent problems with video game use have been associated with male students, the consumption of other drugs, poor academic performance, poor family relationships and an intensive use of these games. CONCLUSIONS: This study offers information on the prevalence of addictive behaviours of the Internet, mobile phones and video game use. The problematic use of these ICT devices has been related to the consumption of drugs, poor academic performance and poor family relationships. This intensive use may constitute a risk marker for ICT addiction.

Video gamers of League of Legends: The role of passion in abusive use and in performance.

There is growing concern about the addictive potential of Massively Multiplayer Online Role Playing Games (MMORPG). The Multiplayer Online Battle Arena (MOBA) is a new genre, poorly studied but very popular, in which performance holds priority over immersion. The aim of the current study was to explore the influence of passion both on abuse and performance, using the dualistic model of passion. A total of 369 participants completed an online questionnaire that included problematic use and the Passion Scale. From players' nicknames, performance statistics were obtained. The results show that harmonious passion is a protector from negative consequences. On the other hand, obsessive passion predicts negative consequences and use of videogames for evasion. Obsessive passion also predicts better performance. These results suggest that distinguishing the two kinds of passion is important because they influence vulnerability to developing maladaptive behaviors and also players' performance.

Los juegos Massively Multiplayer Online Role Playing Games (MMORPG) han suscitado preocupación por su potencial adictivo. Los  Multiplayer Online Battle Arena (MOBA) son un nuevo género poco estudiado, pero que goza de gran popularidad, en el que prima el rendimiento por encima de la inmersión. El objetivo del presente estudio era explorar qué influencia tenía la pasión tanto en el rendimiento como en el uso abusivo a partir del Modelo Dual de la Pasión. Un total de 369 participantes completaron un cuestionario en línea que incluía usos abusivos y la Escala de la Pasión. A partir del alías del jugador se obtuvieron estadísticas de rendimiento. Los resultados muestran que la pasión armónica es un protector de sufrir consecuencias negativas de jugar. Por otro lado, la pasión obsesiva predice consecuencias negativas  y el uso para la evasión. La pasión obsesiva también predice mejores resultados de rendimiento. Estos resultados sugieren que el tipo de pasión de los videojugadores es importante, ya que influye en la vulnerabilidad de sufrir conductas desadaptativas y en el rendimiento del jugador.

Psychometric properties of the Spanish version of the Passion Scale.

BACKGROUND: Passion has been shown to be involved in psychological processes that emerge in diverse human activities like physical activity and sports, work, leisure, videogaming, pathological gambling, and interpersonal relationships. We aimed to present evidence of validity and internal consistency of the Passion Scale in Spanish based on the Dualistic Model of Passion, comprising harmonious and obsessive dimensions. METHOD: The sample comprised 1,007 participants (350 females and 657 males), aged 16-65 (Md= 30.0 years). Exploratory Structural Equation Modeling (ESEM), measurement invariance and Multiple-Cause-Multiple-Indicator models (MIMIC) were used. RESULTS: Fit for the ESEM 2-factor solution was acceptable. Near full or partial measurement invariance across sex, type of activity, and age was supported. Relationships between both harmonious and obsessive dimensions and the external variables considered (age, sex, and criterion items) reasonably replicated those found in previous studies. Both scale scores showed adequate internal consistency (α = .81). CONCLUSIONS: Empirical evidence for the validity and internal consistency of the Spanish version of the Passion Scale is satisfactory and reveals that the scale is comparable to the English and French versions. Therefore, the Passion Scale can be used in research conducted in Spanish.

Relationship between passion and motivation for gaming in players of massively multiplayer online role-playing games.

Passion represents one of the factors involved in online video gaming. However, it remains unclear how passion affects the way gamers are involved in massively multiplayer online role-playing games (MMORPGs). The objective of the present study was to analyze the relationships between passions and motivations for online game playing. A total of 410 MMORPG players completed an online questionnaire including motives for gaming and the Passion Scale. Results indicated that passionate gamers were interested in relating with others through the game and exhibited a high degree of interest in discovery of the game, gaining leadership and prestige but little interest in escape from reality. However, some differences were observed with respect to the role of the two types of passion in the different types of motivation. Specifically, harmonious passion (HP) predicted higher levels of exploration, socialization, and achievement, in that order, while obsessive passion (OP) predicted higher levels of dissociation, achievement, and socialization. The present findings suggest that HP and OP predict different ways of engaging in MMORPGs and confirm that passion is a useful construct to help understand different motivational patterns demonstrated by MMORPG players.

[The Questionnaire of Experiences Associated with Video games (CERV): an instrument to detect the problematic use of video games in Spanish adolescents]. / El Cuestionario de Experiencias Relacionadas con los Videojuegos (CERV): un instrumento para detectar el uso problemático de videojuegos en adolescentes españoles.

The aim of this study is to validate the Video Game-Related Experiences Questionnaire (CERV in Spanish). The questionnaire consists of 17 items, developed from the CERI (Internet-Related Experiences Questionnaire - Beranuy and cols.), and assesses the problematic use of non-massive video games. It was validated for adolescents in Compulsory Secondary Education. To validate the questionnaire, a confirmatory factor analysis (CFA) and an internal consistency analysis were carried out. The factor structure shows two factors: (a) Psychological dependence and use for evasion; and (b) Negative consequences of using video games. Two cut-off points were established for people with no problems in their use of video games (NP), with potential problems in their use of video games (PP), and with serious problems in their use of video games (SP). Results show that there is higher prevalence among males and that problematic use decreases with age. The CERV seems to be a good instrument for the screening of adolescents with difficulties deriving from video game use. Further research should relate problematic video game use with difficulties in other life domains, such as the academic field.

Interaction with the game and motivation among players of massively multiplayer online role-playing games.

Knowledge about users interacting with Massively Multiplayer Online Role-Playing Games (MMORPG) is fundamental in order to prevent their potential negative effects on behavior. For this reason, the present study analyzed the relationship between styles of play and motivations. An online questionnaire asking for socio-demographic details, playing style, characteristics of the game played and motivations for playing, was answered by 430 Spanish-speaking MMORPG players (45.1% males). The identified profile for players, far away from the stereotype of an adolescent, consisted in a person who mainly plays on PvP (Player versus Player) servers, choosing the type of game according to his experience. Regarding motivations, they were interested in relating with other players through the game (Socialization), in discovering the game's possibilities and development of its adventures (Exploration), to a lesser extent in leadership and prestige (Achievement) and, lastly, identification with an avatar and escape from reality (Dissociation). Although part of the reason for playing was escapism and/or stress relief, the main motivation had a social nature. We conclude that MMORPG offer an attractive environment for a broad spectrum of people, and we have not been able to confirm the stereotype of a loner avoiding reality, taking refuge in games.

The perception of causes of accidents in mountain sports: a study based on the experiences of victims.

Each year, accidents involving mountain sports have many repercussions, including alarming public opinion and society. This study outlines the results of a qualitative study on the responses of 135 survivors of accidents that took place while mountaineering, climbing, downhill skiing and ski mountaineering, hiking, cross-country biking, and mountain racing. A content analysis was performed on the textual data obtained from the responses to an online survey. The identified causes were: environmental events, equipment, medical events, behavioral events, and time pressure, but they appear combined in different ways for the analyzed disciplines. Results show that for downhill skiing, direct causes of accidents were mainly behavioral: excessive speed, skiing errors, and fatigue. For ski mountaineering, direct causes were errors in decision-making and skiing. In mountaineering, precursors were unfavorable conditions, fatigue, lack of preparation, and skill errors. In climbing, difficulty is an omnipresent feature, but the precursors are mainly errors. Our results highlight the multi-causal nature of accidents that take place when practicing mountain sports. Finally, we examine the need to promote a mountain sports culture that highlights safety and injury prevention.