Internet addiction of university students in the Covid-19 process.

This study delves into the intricate dynamics of internet addiction among university students, leveraging a comprehensive quantitative approach to unravel the myriad factors influencing this modern-day malaise. Utilizing logistic regression analysis, this research delineates the predictive significance of Daily Internet Usage Time (DIUT) and Communicative Internet Use Frequency (CIUF) on the propensity for internet addiction, with the analysis substantiating these variables as potent predictors. The model elucidates a significant variance in internet addiction, affirming the complexity of internet addiction as influenced by a constellation of behavioral patterns. Amidst the backdrop of the COVID-19 pandemic's exacerbation of digital dependency, this investigation sheds light on the escalation of internet use to addictive levels, prompted by prolonged isolation and the pivot to online learning platforms. This study underscores the resultant educational and psychological ramifications, highlighting a surge in addiction and its associated detriments such as diminished academic performance, social isolation, and a deterioration in mental health. Comparison of these findings with existing literature reveals a nuanced understanding of internet addiction, characterised by the interaction between individual behaviours and broader socio-economic and psychological contexts, such as the duration of daily internet use and the frequency of communicative internet use. This synthesis argues for a holistic strategy to address internet addiction, emphasizing the need for educational interventions, improving digital literacy and promoting healthy digital habits. By pinpointing the multifaceted nature of internet addiction and its predictors within the university student demographic, this research contributes to the ongoing discourse on digital dependency, proposing a multidisciplinary approach to develop resilient academic environments and support systems. It underscores the urgent need for targeted research to identify predictive factors of internet addiction, thereby enabling the formulation of effective strategies and policies for mitigating its impact on students' academic and psychological well-being. This study not only captures the complexity of internet addiction but also provides critical insights crucial for developing informed educational strategies and interventions in the digital age.

Effects of different interventions on internet addiction: a systematic review and network meta-analysis.

BACKGROUND: Globally, Internet is a recognized form of leisure, but there are growing apprehensions about the increasing number of individuals developing an addiction to it. Recent research has focused on social issues associated with internet addiction (IA). However, the treatment of IA is currently unclear. This study aimed to explore the relationship between IA treatment outcomes and different intervention strategies through systematic review and data analysis of patients who received different intervention modes. METHODS: A meta-analysis was conducted using RevMan 5.4 and Stata 14.2 on 57 literature research data from five Chinese and English databases, PubMed, Embase, Web of Science, Wanfang and CNKI. RESULT: A total of 57 randomized controlled trials (RCTs) were included in this network meta-analysis involving 3538 IA patients and 13 different interventions. The network meta-analysis results demonstrated that the top four interventions were: rTMS + CBT, drug + others, rTMS, and electro-acupuncture + CBT. CONCLUSION: Our study indicated that comprehensive therapy had an optimal therapeutic effect on IA patients and rTMS + CBT ranked first among all therapeutic indicators of intervention, indicating optimal clinical effectiveness.

Acupuncture modulates the functional connectivity among the subcortical nucleus and fronto-parietal network in adolescents with internet addiction.

BACKGROUND: Internet addiction (IA), recognized as a behavioral addiction, is emerging as a global public health problem. Acupuncture has been demonstrated to be effective in alleviating IA; however, the mechanism is not yet clear. To fill this knowledge gap, our study aimed to investigate the modulatory effects of acupuncture on the functional interactions among the addiction-related networks in adolescents with IA. METHODS: Thirty individuals with IA and thirty age- and sex-matched healthy control subjects (HCs) were recruited. Subjects with IA were given a 40-day acupuncture treatment, and resting-state functional magnetic resonance imaging (fMRI) data were collected before and after acupuncture sessions. HCs received no treatment and underwent one fMRI scan after enrollment. The intergroup differences in functional connectivity (FC) among the subcortical nucleus (SN) and fronto-parietal network (FPN) were compared between HCs and subjects with IA at baseline. Then, the intragroup FC differences between the pre- and post-treatment were analyzed in the IA group. A multiple linear regression model was further employed to fit the FC changes to symptom relief in the IA group. RESULTS: In comparison to HCs, subjects with IA exhibited significantly heightened FC within and between the SN and FPN at baseline. After 40 days of acupuncture treatment, the FC within the FPN and between the SN and FPN were significantly decreased in individuals with IA. Symptom improvement in subjects with IA was well fitted by the decrease in FC between the left midbrain and ventral prefrontal cortex and between the left thalamus and ventral anterior prefrontal cortex. CONCLUSION: These findings confirmed the modulatory effects of acupuncture on the aberrant functional interactions among the SN and FPN, which may partly reflect the neurophysiological mechanism of acupuncture for IA.

Effects of exercise or tai chi on Internet addiction in college students and the potential role of gut microbiota: A randomized controlled trial.

OBJECTIVE: This study aimed to explore the effect of exercise or tai chi on Internet addiction disorder (IAD) among college students and clarified the abundance and population changes of gut microbiota in different groups. Thus explore the potential role of gut microbiota between exercise and IAD. METHODS: A total of 93 subjects diagnosed with mild IAD were randomly assigned to the exercise group, the tai chi group, and the control group. The intervention groups received exercise or tai chi for 8 weeks and the control group was evaluated without any intervention. Fecal samples were collected after the intervention. RESULTS: 1) Analysis found a significant intervention effect with the exercise group showing an average decrease of 8.84 points on the Internet addiction test (IAT) compared with the control group (95%CI -15.41 to-2.27, P = 0.004). But there was no significant difference between the control group and the tai chi group. 2) Both exercise (P = 0.018) and tai chi (P = 0.026) could significantly relieve fatigue symptoms. 3) The relative abundance of the Betaproteobacteria, Porphyromonadaceae, Sutterellaceae, and Alistipes were significantly decreased in the exercise group compared with the control group, and the relative abundance of Escherichia was significantly increased in the exercise group. 4) The relative abundance of Betaproteobacteria, Sutterellaceae, and Escherichia had significant differences between the improved group and the no-improved group. CONCLUSION: Exercise intervention has a considerable effect on treating IAD. Exercise and tai chi might have effectiveness in relieving the symptoms of fatigue. Exercise intervention regulates the gut microflora and changes the abundance of microflora to improve IAD. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, identifier NCT05529368.

Problematic internet use in adolescents: A phenomenological study.

WHAT IS KNOWN ON THE SUBJECT?: Problematic internet use (PIU) negatively affects adolescents' lives biopsychosocially. There is limited qualitative research examining the problem of PIU in adolescents. These studies focused more on the non-clinical population. Adolescents' perceptions of the internet, their thoughts, feelings and behaviours in situations where they can and cannot access the internet have rarely been examined. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: This research provides an in-depth look at the experiences of adolescents with PIU in a clinical population. Unlike previous studies, adolescents mentioned that they turned to the internet for reasons such as lack of activity, their need to spend time with their friends and better getting along with people they met on the internet. They also described a world without internet as apocalypse, desert and grave. In this study, a holistic emphasis was placed on the thoughts, feelings and behaviours of adolescents in situations where they could and could not access the internet. This may contribute especially to mental health nurses working in clinics in terms of understanding the thought-emotion and behaviour patterns of adolescents with PIU. Adolescents also stated that their lives were affected positively and negatively as a result of PIU. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses can use activity therapy, behaviour modification: social skills, coping enhancement, parent education: adolescent, self-awareness enhancement, cognitive restructuring, emotion and behaviour management interventions to reduce the risk of PIU and the problems it causes for adolescents. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses can use activity therapy, behaviour modification: social skills, coping enhancement, parent education: adolescent, self-awareness enhancement, cognitive restructuring, emotion and behaviour management interventions to reduce the risk of PIU and the problems it causes for adolescents. ABSTRACT: INTRODUCTION: Studies on problematic internet use (PIU) are mostly on the non-clinical population. Understanding the experiences of adolescents with PIU is critical in shaping nursing interventions and improving the quality of care. AIMS: A comprehensive description of the experiences of adolescents with PIU. METHODS: In the study, descriptive phenomenology design, one of the qualitative research methods, was used. Data were collected using a personal information form and a semi-structured interview form and analysed using Giorgi's phenomenological method (n = 11). RESULTS: As a result of the content analysis, five main themes were identified: reasons of PIU, internet-related perceptions, experiences in accessing the internet, experiences in not being able to access the internet and consequences of internet use. DISCUSSION: Different from previous studies, adolescents stated that they use the internet because of their lack of activity and their need to spend time with their friends. They stated that when they could not access the internet, they thought they could never live without the internet and started quarrel.

Effects of non-pharmacological interventions on youth with internet addiction: a systematic review and meta-analysis of randomized controlled trials.

Objective: To assess the overall effectiveness of non-pharmacological interventions on internet addiction (IA) in youth. Method: Randomized controlled trials (RCTs) published from their inception to April 1, 2023 were searched in Cochrane, Embase, Medline, Web of Science, China National Knowledge Infrastructure, China Science and Technology Journal Database, Chinese BioMedical Literature Database, and WanFang Data. Two reviewers independently extracted data and evaluated bias using the Cochrane Risk of Bias tool. Results: Sixty-six studies performed from 2007 to 2023, with a total of 4,385 participants, were identified. The NPIs included group counseling, cognitive behavioral therapy, sports intervention, combined interventions, eHealth, educational intervention, positive psychology intervention, sand play intervention, and electrotherapy. The results revealed that NPIs significantly reduced IA levels (standardized mean difference, SMD: -2.01, 95% confidence interval, CI: -2.29 to -1.73, I2 = 93.0%), anxiety levels (SMD: -1.07, 95%CI: -1.41 to -0.73, I2 = 72.4%), depression levels (SMD: -1.11, 95%CI: -1.52 to -0.7, I2 = 84.3%), and SCL-90 (SMD: -0.75, 95%CI: -0.97 to -0.54, I2 = 27.7%). Subgroup analysis stratified by intervention measure showed that cognitive behavioral therapy, group counseling, sports intervention, combined intervention, educational intervention, positive psychology intervention, sandplay intervention, and mobile health were all effective in relieving symptoms of IA except electrotherapy. Conclusion: NPIs appear to be effective in the treatment of IA in youth, which would act as an alternative treatment of IA. Further studies with larger sample sizes and robust designs are needed.

Problem gambling among secondary school adolescents in Enugu, Nigeria.

Background: Adolescent problem gambling is a common behavioural issue and could be associated with internet addiction. Objectives: To determine the pattern of problem gambling and factors that predict gambling among adolescents that attended secondary schools in southeast Nigeria. Methodology: This is a cross-sectional study design. A three-stage sampling technique was used to select 796 secondary school adolescents from eight secondary schools in Enugu State, Nigeria. Results: The highest proportion of the respondents, 38.3% had problem gambling with negative consequences. There was a weak positive correlation between gambling severity index and internet addiction. (n=796, r=0.254, p<0.001). There is a very weak negative correlation between gambling severity index and age in years. (n=796, r= -0.034, p=0.331).The male respondents were 1.5 times more likely to have problem gambling when compared with the females, (AOR=1.5; (95%CI: 1.1-2.0). The respondents who have internet addiction were 3.5 times more likely to have problem gambling when compared with those who do not have an internet addiction, (AOR=3.5; 95%CI: 2.6-4.8). Conclusion: The prevalence of gambling among adolescents is high. Adolescents who had problem gambling also had internet addiction. The male respondents were more likely to have problem gambling than their female folk.

Association between religiosity or spirituality and internet addiction: A systematic review.

Introduction: The literature provides evidence of religiosity being associated with physical and mental health, and also with behavioral addictions. This systematic review examines the data on the link between religiosity or spirituality and the emerging internet addictions. Methods: A systematic literature review was conducted in the PubMed and Scopus databases to identify observational (cross-sectional, cohort, and case-control) studies conducted on adolescents and young adults to investigate the association between religiosity or spirituality and internet addiction. Of the 854 articles identified in the databases, 13 met our inclusion criteria and were included in our systematic review. Results: Eleven of the 13 studies reviewed specifically investigated religiosity and internet addiction: six found an inverse association between religiosity and internet addiction; three found no evidence of any association; and one found a direct association. One study examining both religiosity and spirituality generated mixed results. Only one study investigated spirituality unrelated to religion, and found a direct association with internet addiction. Two of three studies specifically considering internet gaming addiction found it inversely associated with high levels of religiosity, while the third found no association. Conclusion: This review supports a possible role for religiosity as a protective factor, as emerged from the majority of the studies examined. Religiosity also seemed to be associated with lower internet gaming rates among adolescents.

Changes in metabolites level in internet-addicted adolescents through exercise.

BACKGROUND: Internet addiction has been particularly prevalent among adolescents in recent years. This type of addiction, similar to drug addiction, causes dependence and disturbance in brain reward pathways. Physical activity is one way to prevent and treat some types of addiction. Aerobic exercise affects the dopaminergic and serotonergic pathways and improves the side effects of addiction. In this study, we examined the effect of eight weeks of aerobic exercise on the dopamine metabolite including homovanillic acid, L-tryptophan and 5-hydroxy indole acetic acid, which are precursors and the final product of serotonin metabolism in adolescent boys with internet addiction. MATERIALS AND METHODS: Twenty-nine healthy non-internet addicted and internet-addicted boys were selected and divided into three groups: exercising internet-addicted (G1), internet-addicted (G2), and healthy non-internet addicted (G3) groups. Before and after aerobic exercise, 24-h urine samples were collected, and the target metabolites were analyzed spectrophotometrically. RESULTS: Results showed that for pre-exercise subjects, there was a significant difference in the homovanillic acid levels in G3 as compared to G1 and G2. For post-exercise cases, the changes were significant in G1 in comparison to G2 and for G2 in comparison G3. For pre-exercise subjects, there was a significant difference in the L-tryptophan level in G3 and G1, as well as G3 and G2. CONCLUSION: It can be concluded that Aerobic exercise can improve the dopaminergic system that is disrupted by internet addiction.

Neurophysiologic Reactions during Heart Rate Variability Biofeedback Session in Adolescents with Different Risk of Internet Addiction.

The aim of this study was to determine electroencephalogram (EEG) in a session of heart rate variability biofeedback (HRV BF) in adolescents with different Internet addiction (IA) risks. In total, 100 healthy adolescents aged 16-17 years with minimal risk of IA (Group I, 35%), pronounced risk of IA (Group II, 51%), and stable pattern of IA (Group III, 14%) using the Chen Internet Addiction Scale were examined. HRV and EEG parameters were determined at baseline (5 min), and then during the short-term HRV BF session (5 min), in order to increase the total power (TP, ms2) of the HRV spectrum. Against the background of an increase in the TP and a decrease in sympathetic activity, an increase in alpha EEG was revealed, especially in Groups I and II. The greatest increase in the power of beta1-activity of EEG in the frontal, central, and temporal brain regionswas found in Groups I and II. In adolescents with a pronounced risk of IA, HRV BF is accompanied by a severe activation of the brain systems, while in persons with a stable type of IA, the least brain reactivity is shown, especially in the beta1 EEG band.

Social Exclusion, Self-Forgiveness, Mindfulness, and Internet Addiction in College Students: a Moderated Mediation Approach.

Internet addiction is a growingly prevalent behavioral addiction that causes numerous psychosocial problems. Investigating the causes and consequences of Internet addiction is fundamental to comprehend and prevent it. Therefore, the current study provided protective and promotive factors for undesired effects of social exclusion on Internet addiction. The study examined a moderated mediation model to test whether mindfulness moderated the mediating role of self-forgiveness in the association between social exclusion and Internet addiction among young adults. The participants of the present study included 358 undergraduate students attending a state university in Turkey. They ranged in age from 20 to 28 years (M = 21.89, SD = 1.95). The participants comprised 206 (57.5%) female and 152 (42.5%) male college young adults. Overall, the study findings indicated that self-forgiveness mediated the relationship between social exclusion and Internet addiction, and mindfulness moderated the mediating role of self-forgiveness in this association. Contending with negative outcomes of social exclusion and Internet addiction, and mitigating and buffering roles of self-forgiveness and mindfulness provide important implications to design prevention and intervention services for reducing Internet-related addictive behaviors.

Effects of Electroacupuncture Combined With Psychological Intervention on Depressive Status and Contingent Negative Variation in Patients With Internet Addiction Disorder: A Randomized Controlled Trial.

Background: Depressive symptoms often accompany people with Internet addiction syndrome (IAD). Acupuncture has been found to have significant advantages in improving the severity and depressive symptoms of IAD. Contingent negative variation (CNV) is a common method to explore the mechanism of neurophysiology. Objective: The purpose of this study was to observe the efficacy of electroacupuncture (EA), psychological intervention (PI), and comprehensive intervention (CI) in the treatment of depression in Internet addiction disorder (IAD), and to observe the changes of contingent negative variation (CNV) in each group. Methods: One hundred and twenty subjects diagnosed with IAD were randomly assigned to the EA group, the PI group, or the CI group. They received EA, PI, or a combination of EA and PI for 40 days. The Internet Addiction Test (IAT), the Zung Self-rating Depression Scale (SDS), and the Hamilton Depression Scale (HAMD) were evaluated for all subjects at baseline, 20th, and 40th days of treatment, while CNV data were collected at baseline and 40th days of treatment. Results: Three treatments effectively reduced IAT, SDS, and HAMD scores, and the intergroup comparison showed that CI was superior to EA, while EA was superior to PI. CNV results indicated that the CNV amplitude increased in all three groups of IAD patients after treatment. The CNV latency of point A and A-S2' wave area of the EA group and the CI group did not change significantly after treatment. Only the A-S2' wave area of the PI group increased significantly compared with the baseline period. In addition, IAD's IAT score was positively correlated with SDS and HAMD score at baseline but negatively correlated with CNV latency. After treatment, only the change of HAMD score in the CI group was negatively correlated with amplitude. Conclusion: Our results demonstrate the efficacy of acupuncture and psychological intervention in the treatment of IAD from an electrophysiological perspective. Simultaneously, the increase in CNV amplitude might be the underlying neurophysiological mechanism by which CI improves depression and cognitive function in IAD patients. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT02362698.

Molecular genetics of neurotransmitters and neuropeptides involved in Internet use disorders including first insights on a potential role of hypothalamus' oxytocin hormone.

This chapter covers the phenomenon of Internet use disorders (IUDs) and putative associations with different neurotransmitter and neuropeptide systems. Genes coding for such messengers can be seen as an important starting point in the complicated quest to understand human behavior including new phenomena such as IUDs. Therefore, a special focus of this chapter will lie on individual differences in molecular genetic underpinnings of neurotransmitter and neuropeptide systems and their associations with individual differences in tendencies towards IUDs. By shedding light on these associations, putative predisposing molecular genetic factors for the emergence and maintenance of IUDs can be carved out. Therefore, first an introduction to IUDs and a model that can guide research on putative associations of IUDs with different specific neurotransmitters and neuropeptides will be presented. Subsequently, twin studies on the heritability of IUDs are reviewed. Finally, studies on differences in molecular genetic predispositions and their associations with differences in IUDs will be presented and discussed, including targets related to the dopaminergic and serotonergic system as well as the hypothalamic neuropeptide oxytocin. The chapter closes with a conclusion about what is already known and what needs to be investigated in future studies to gain further insights into putative associations between molecular genetic markers and IUDs.

Prevalence of Insomnia and Internet Dependence Amidst the COVID 19 among the Northeast Indian Population: A Preliminary Study.

Introduction: COVID 19 pandemic lockdown affects normal daily activities making people vulnerable to sleep disorders, including insomnia and Internet addiction. The present study explores the prevalence of insomnia and Internet addiction amidst the pandemic while staying at home. Methodology: Data have been collected from 585 individuals of both sexes online through social media using a structured questionnaire that consists of insomnia severity and Internet addiction. Chi square and logistic regression analysis were done to associate the insomnia severity with Internet use behavior and addiction. Results: The overall prevalence of insomnia and subthreshold (mild) insomnia are 12.13% and 31.97%, respectively, with females had insomnia more than males. Internet addiction correlates with insomnia as staying online more than initially intended increases insomnia significantly. Conclusion: COVID 19 pandemic lockdown affects sleep health as sleep-related disorders are on the rise, which could correlate to mental health. The study further seeks attention from researchers, health experts, and related stakeholders to develop a more holistic approach to uncover the problems and promote sleeping awareness.

Effects of Logotherapy-Based Mindfulness Intervention on Internet Addiction among Adolescents during the COVID-19 Pandemic.

BACKGROUND: The global outbreak of the novel coronavirus pneumonia (COVID-19) has seriously affected people's work and lives. Disaster-related traumatic stress events increase the risk of substance abuse. Therefore, the COVID-19 outbreak, as a stress event, inevitably has a negative impact on Chinese adolescents with Internet addiction. METHODS: In 2020, 1787 copies of the questionnaire were randomly distributed among adolescents aged 12-16 years in three communities in Shandong Province, China. Among the respondents, 121 Internet addicts voluntarily participated and were divided into the experiment group (60 members) and the control group (61 members). Logotherapy-based mindfulness intervention was carried out on the experiment group. The effects of the intervention were analyzed after eight weeks of intervention. RESULTS: After the intervention, significant decreases occurred in the scores of Internet addiction and its five dimensions in the experiment group (P < 0.05), thereby implying better invention effects in the experiment group than the control group. The experiment group exhibited an increase in the positive coping score and a decrease in the negative coping score (P < 0.05). Significant decreases were found in the anxiety and depression scores in the experiment group (P < 0.05). CONCLUSION: Logotherapy-based mindfulness intervention can significantly reduce the degree of Internet addiction among adolescents during the COVID-19 period, improve their positive emotions, reduce their negative emotions, and alleviate the degree of anxiety and depression in adolescents.

Emerging Health and Education Issues Related to Internet Technologies and Addictive Problems.

This timely editorial paper outlines some of the main emerging research on technological topics on health and education approaches to Internet use-related problems before and during the beginning of coronavirus disease 2019 (COVID-19). BACKGROUND: The aim is to provide a brief overview to facilitate a rapid comprehensive and practical approach to these new trends to promote research, interventions, education, and prevention. METHODS: The rapid review includes an analysis of both health and education technologies studies on Internet use-related addiction problems included in the Special Issue "Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research" to extract recent findings and a few reflections about the development of the field before and during the first wave of the COVID-19. RESULTS: Main findings highlighted studies which tended to be empirical, with a relational type associating specific addictive problems with individual and a few contextual factors in adult populations. Psychometric studies about scales are prevalent, but predictive and mixed methods ones are starting to emerge, together with reviews about conceptualisation, measure, treatment, and prevention. CONCLUSIONS: From the arrival of Internet, our societies have converged in a global culture which has impacted health and educational domains. Internet use-related addiction problems have globally emerged and common knowledge, advances, and strategies exist to overcome challenges which are starting to be tested, and prevention interest has arisen in a pandemic situation with global health problems holistically tackled.

Association Between Internet Addiction, Depression and Sleep Quality Among Undergraduate Students of Medical and Allied Sciences.

BACKGROUND: The use of the internet is growing rapidly worldwide with easier availability and affordability in developing countries like Nepal. Apart from several benefits, it has also led to deleterious effects on certain individuals' physical and mental well-being. The present study aimed to assess the burden of internet addiction among nursing, dental and medical undergraduates at a medical school, and examine its relationship with depression and sleep quality. METHODS: A cross-sectional study among 494 students pursuing nursing, dental and medical undergraduate courses at the same medical college in Nepal was conducted. The burden of internet addiction, depression, and sleep disturbance was assessed using Young's Internet addiction test, Beck's depression inventory, and Pittsburgh Sleep Quality Index questionnaires respectively. RESULTS: The majority of respondents reported either controlled use of internet or mild problem with internet use. However, 4.7% of respondents reported significant problems due to internet use. Further, about 42.3% reported poor sleep quality, and 8.9% screened positive for depression. In both chi-square and logistic regression analyses, internet addiction was significantly associated with poor sleep quality and depression. CONCLUSION: The study shows that about half of the participants experienced at least some problems and a small but significant proportion of them reported severe problems due to internet use. This warrants the need to address the issue of internet addiction among medical and allied sciences students in Nepal. Further, internet addiction is associated with both depression and poor sleep quality, highlighting a need to develop effective interventions targeting all three problems holistically.

Structural brain changes in young males addicted to video-gaming.

Excessive video gaming has a number of psychological and social consequences. In this study, we looked at possible changes in gray and white matter and asked whether these changes are correlated to psychological measures. Twentynine players of violent videogames (mean daily playing time 4.7 h) and age matched controls were subjected to a battery of questionnaires assessing aggression, empathy, hostility, internet addiction and psychological well-being. Diffusion tensor and 3D T1-weighted MR images were obtained to examine gray (via voxel-based morphometry) and white (via tract-based spatial statistics) matter changes. Widespread regions of decreased gray matter in the players were found but no region showed increased intensity of gray matter. Density of gray matter showed a negative correlation with the total length of playing in years in the right posterior cingulate gyrus, left pre- and postcentral gyrus, right thalamus, among others. Furthermore, fractional anisotropy, a marker for white matter structure, was decreased in the left and right cingulum in the players. Both, gray and white matter changes correlated with measures of aggression, hostility, self esteem, and the degree of internet addiction. This study thus shows profound changes of brain structure as a function of excessive playing of violent video games.

Exercise as an Alternative Approach for Treating Smartphone Addiction: A Systematic Review and Meta-Analysis of Random Controlled Trials.

BACKGROUND: With the emergence of electronic products, smartphones have become an indispensable tool in our daily life. On the other hand, smartphone addiction has become a public health issue. To help reduce smartphone addiction, cost-effective interventions such as exercise are encouraged. PURPOSE: We therefore performed a systematic review and meta-analysis evaluating existing literature on the rehabilitative effects of exercise interventions for individuals with a smartphone addiction. METHODS: We searched PubMed, Web of Science, Scopus, CNKI, and Wanfang from inception to September 2019. Nine eligible randomized controlled trials (RCT) were finally included for meta-analysis (SMD represents the magnitude of effect of exercise) and their methodological quality were assessed using the PEDro scale. RESULTS: We found significant positive effects of exercise interventions (Taichi, basketball, badminton, dance, run, and bicycle) on reducing the total score (SMD = -1.30, 95% CI -1.53 to -1.07, p < 0.005, I2 = 62%) of smartphone addiction level and its four subscales (withdrawal symptom: SMD = -1.40, 95% CI -1.73 to -1.07, p < 0.001, I2 = 81%; highlight behavior: SMD = -1.95, 95% CI -2.99 to -1.66, p < 0.001, I2 = 79%; social comfort: SMD = -0.99, 95% CI -1.18 to -0.81, p = 0.27, I2 = 21%; mood change: SMD = -0.50, 95% CI 0.31 to 0.69, p = 0.25, I2 = 25%). Furthermore, we found that individuals with severe addiction level (SMD = -1.19, I2 = 0%, 95%CI:-1.19 to -0.98) benefited more from exercise engagement, as compared to those with mild to moderate addiction levels (SMD = - 0.98, I2 = 50%, 95%CI:-1.31 to -0.66); individuals with smartphone addiction who participated in exercise programs of 12 weeks and above showed significantly greater reduction on the total score (SMD = -1.70, I2 = 31.2%, 95% CI -2.04 to -1.36, p = 0.03), as compared to those who participated in less than 12 weeks of exercise intervention (SMD = -1.18, I2 = 0%, 95% CI-1.35 to -1.02, p < 0.00001). In addition, individuals with smartphone addiction who participated in exercise of closed motor skills showed significantly greater reduction on the total score (SMD = -1.22, I2 = 0 %, 95% CI -1.41 to -1.02, p = 0.56), as compared to those who participated in exercise of open motor skills (SMD = -1.17, I2 = 44%, 95% CI-1.47 to -0.0.87, p = 0.03). CONCLUSIONS: Exercise interventions may have positive effects on treating smartphone addiction and longer intervention durations may produce greater intervention effects.

Clinical efficacy of acupuncture and moxibustion in the adjuvant treatment of internet addiction disorder / 中国基层医药

Objective@#To investigate the clinical efficacy and safety of acupuncture and moxibustion in the adjuvant treatment of internet addiction disorder.@*Methods@#From January 2013 to April 2015, a total of 38 patients with internet addiction disorder were randomly selected and divided into study group(19 cases) and control group(19 cases) according to the odd and even order of hospitalize.The control group received psychological therapy, antianxiety therapy and antidepression therapy.The study group received acupuncture and moxibustion in addition to all therapies of the control group.The patients were treated for 8 weeks.Chiese Internet Addiction Scale(CIAS), Family Assessment Device(FAD), HAMD, HAMA were used to determine the internet addiction severity and social function of the two groups at baseline and the 8th weekend of treatment, and TESS at the 8th weekend of treatment.@*Results@#At the 8th weekend of treatment, the scores of CIAS, FAD, HAMA+ HAMD in the two groups were all significantly lower than baseline[(86.8±13.6)points vs.(38.3±11.5)points, t=11.872, (85.6±12.3)points vs.(54.6±18.2)points, t=7.123; (185.8±31.5)points vs.(80.6±29.4)points, t=10.643, (182.7±12.7)points vs.(110.5±32.3)points, t=9.068; (53.4±7.6)points vs.(21.7±9.7)points, t=11.215, (55.2±8.3)points vs.(35.2±8.3)points, t=7.428)](all P<0.05). At the 8th weekend of treatment, the scores of CIAS, FAD, HAMA+ HAMD in the study group were significantly lower than those in the control group(t=3.301, 2.985, 10.825, all P<0.05). There was no statistically significant difference in the incidence rate of side effects between the two groups(all P>0.05).@*Conclusion@#Acupuncture and moxibustion is effective and safe in the treatment of patients with internet addiction disorder.