Emotion Regulation Predicts Depressive Symptoms in Adolescents: A Prospective Study.

Emotion regulation as a proximal factor has been linked with depressive symptoms. However, studies have mainly focused on a limited number of strategies and have mostly been cross-sectional in design. This is particularly evident when examining the protective effects of adaptive strategies. This study aimed to investigate the prospective relationship between putatively adaptive and maladaptive emotion regulation strategies and depressive symptoms among adolescents. Additionally, a person-oriented approach was applied to identify latent classes of adolescents based on their depressive symptoms and compared these classes in terms of their adaptive and maladaptive strategies. Two waves of data from a prospective study, which included 1371 youth (mean age: 15.66 years; SD = 0.49 years; 55.1% girls), were analysed. The two points of data collection were spaced approximately half a year apart. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale, and putatively adaptive and maladaptive emotion regulation strategies were assessed with the Cognitive Emotion Regulation Questionnaire. Seven strategies (acceptance, positive refocusing, positive reappraisal, putting into perspective, self-blame, rumination, and catastrophizing) were categorised into adaptive and maladaptive factors using exploratory structural equation modeling. After controlling for gender, age, and depressive symptoms at Time 1, both maladaptive and adaptive emotion regulation strategies at Time 1 predicted depressive symptoms at Time 2. Three subgroups emerged based on the intensity of depressive symptoms across the waves: the stable low, stable moderate, and stable high depressive symptom groups. The use of maladaptive emotion regulation strategies (such as rumination, self-blame, and catastrophizing) at Time 1 was more pronounced in the stable moderate and high symptom groups compared to the stable low depressive symptom group. The comparable prospective associations between putatively adaptive and maladaptive strategies with symptoms suggest the need to identify factors that may mitigate the negative impact of maladaptive emotion regulation and/or promote adaptive emotion regulation to buffer the effects of everyday stressors.

Microstructural differences in migraine: A diffusion-tensor imaging study.

BACKGROUND: Diffusion-tensor imaging can be applied to describe the microstructural integrity of the whole brain. As findings about microstructural alterations in migraine are inconsistent, we aimed to replicate the most frequent results and assess a relationship between migraine parameters and changes in microstructure. METHODS: Diffusion-weighted MRI data of 37 migraine patients and 40 controls were collected. Two indices of diffusion of water molecules, fractional anisotropy and mean diffusivity were used in a voxel-wise analysis. Group comparisons were carried out in SPM12 using age and sex as covariates. Statistically significant results survived family-wise error correction (pFWE < 0.05). Migraine intensity, frequency, and duration were self-reported and correlated with mean fractional anisotropy and mean diffusivity values across clusters. RESULTS: Migraine patients showed significantly lower fractional anisotropy in occipital regions, and significantly higher fractional anisotropy in thirteen clusters across the brain. Mean diffusivity of migraine patients was significantly decreased in the cerebellum and pons, but it was not increased in any area. Correlation between migraine duration and fractional anisotropy was significantly positive in the frontal cortex and significantly negative in the superior parietal lobule. CONCLUSION: We suggest that microstructural integrity of the migraine brain is impaired in visual areas and shows duration-related alterations in regions of the default mode network.

Online and school bullying roles: are bully-victims more vulnerable in nonsuicidal self-injury and in psychological symptoms than bullies and victims?

BACKGROUND: Bullying leads to adverse mental health outcomes and it has also been linked to nonsuicidal self-injury (NSSI) in community adolescents. It is not clear whether different roles of bullying (bully, victim, bully-victim) are associated with NSSI, furthermore the same associations in cyberbullying are even less investigated. METHODS: The aim of the current study was to test whether students involved in school or online bullying differed from their not involved peers and from each other in psychological symptoms (externalizing and internalizing problems) and in NSSI severity (number of episodes, number of methods). Furthermore, mediation models were tested to explore the possible role of externalizing and internalizing problems in the association of school and online bullying roles with NSSI. In our study, 1011 high school students (66.07% girls; n = 668), aged between 14 and 20 years (Mage = 16.81; SD = 1.41) participated. RESULTS: Lifetime prevalence of at least one episode of NSSI was 41.05% (n = 415). Students involved in bullying used more methods of NSSI than not involved adolescents. In general, victim status was associated mostly with internalizing symptoms, while bully role was more strongly associated with externalizing problems. Bully-victims status was associated with both types of psychological problems, but this group did not show a significantly elevated NSSI severity compared to other bullying roles. Externalizing and internalizing problems mediated the relationship between bullying roles and NSSI with different paths at different roles, especially in case of current NSSI that happened in the previous month. CONCLUSIONS: Results highlight that students involved in bullying are more vulnerable to NSSI and to psychological symptoms compared to their peers who are not involved in bullying. It is suggested that bullying roles, especially bully-victim status, need to be identified in school and online settings and thus special attention should be addressed to them to reduce psychological symptoms and NSSI, for example by enhancing adaptive coping skills.

Associations between daily affective experiences, trait and daily rumination on negative and positive affect: a diary study.

BACKGROUND: Rumination has mostly been studied in relation to depression, however, it may also occur in response to positive emotions (i.e., positive rumination) and therefore may be a protective factor related to the maintenance of positive mood. OBJECTIVE: We hypothesized that daily positive and negative affect would be associated with daily positive and negative rumination even after controlling for trait-level rumination. METHOD: We carried out a diary study with university students (n = 178), where participants had to answer short surveys online about their daily affect and daily rumination every evening for 10 days. We analyzed our data with multilevel regression in R. RESULTS: Daily positive and negative affect were significantly associated with daily negative and positive rumination, while trait-level rumination scores were not. Daily and trait-level rumination were moderately correlated (r = 0.333-0.440). CONCLUSIONS: Our findings highlight that daily rumination plays a more significant role in daily emotional experiences than trait rumination across positive and negative valence domains. Daily negative affect appears to be more closely related to higher daily negative rumination than the lack of daily positive rumination, which could be relevant for intervention strategies.

A Person-Centered Approach to Adolescent Nonsuicidal Self-Injury: Predictors and Correlates in a Community Sample.

Growing incidence of nonsuicidal self-injury (NSSI) and a lack of intensive examination of NSSI variability among adolescents justify identification of latent classes based on the endorsement of different NSSI behaviors. Latent class analysis was used to detect the heterogeneity of past month NSSI among 322 high school students (73.2% female). Two interpretable latent classes emerged. The Severe/Multimethod NSSI class (39%) engaged in almost all forms of NSSI with high intensity and motivated mainly for intrapersonal reasons. The results imply that compared to Mild/Moderate NSSI group (61%), the Severe class is at greater risk for poor mental health, which can exacerbate further NSSI acts. In school settings, identifying adolescents who are vulnerable for more severe NSSI can help to interrupt NSSI trajectories to emerging adulthood.

A cross-sectional study on the quality of life in migraine and medication overuse headache in a Hungarian sample: understanding the effect of headache characteristics.

Background and purpose: Previous studies using generic and disease specific instruments showed that both migraine and medication overuse headache are associated with lower health-related quality of life (HRQoL). The aim of our study was to assess HRQoL differences in migraineurs and in patients with MOH and to examine how headache characteristics such as years with headache, aura symptoms, triptan use, headache pain severity and headache frequency are related to HRQoL. Methods: In this cross-sectional study 334 participants were examined (248 were recruited from a tertiary headache centre and 86 via advertisements). The Comp-rehensive Headache-related Quality of life Questionnaire (CHQQ) was used to measure the participants' HRQoL. Data showed normal distribution, therefore beside Chi-squared test parametric tests (e.g. independent samples t-test) were used with a two-tailed p<0.05 threshold. Linear regression models were used to determine the independent effects of sex, age, recruitment method, headache type (migraine vs. MOH) and headache characteristics (presence of aura symptoms, years with headache, headache pain severity, headache frequency and triptan use) separately for each domain and for the total score of CHQQ. Significance threshold was adopted to p0.0125 (0.05/4) to correct for multiple testing and avoid Type I error. Results: Independent samples t-tests showed that patients with MOH had significantly lower scores on all CHQQ domains than migraineurs, except on the social subscale. Results of a series of regression analyses showed that triptan use was inversely related to all the domains of HRQoL after correction for multiple testing (p<0.0125). In addition, headache pain severity was associated with lower physical (p=0.001) and total scores (p=0.002) on CHQQ subscales. Conclusion: Based on the results, different headache characteristics (but not the headache type, namely migraine or MOH) were associated with lower levels of HRQoL in patients with headache. Determining which factors play significant role in the deterioration of HRQoL is important to adequately manage different patient populations and to guide public health policies regarding health service utilization and health-care costs.

Associations between non-suicidal self-injury and negative romantic relationship life events in male justice-involved adolescents.

BACKGROUND: In the current study we investigated impulsivity and negative life events in relation to non-suicidal self-injury (NSSI) in correctional settings. METHODS: A total of 141 male justice-involved juveniles participated in our cross-sectional study, aged between 14 and 21 years old (M = 17.75; SD = 1.38). Data collection took place in correctional institutions in Hungary. A binary logistic regression was conducted to investigate possible associations between NSSI, impulsivity and negative life events. RESULTS: Lifetime prevalence of NSSI was 53.9% (N = 76). In a binary logistic regression model, only negative romantic relationship events were significantly associated with the risk of current NSSI (OR = 1.29; 95% CI = [1.06-1.56]). Other types of negative life events (family-related, friendship-related), impulsivity, age and conviction status did not have a significant role in the model. CONCLUSIONS: The results suggest that juvenile offenders should receive additional support to manage stress that is associated with negative life events, especially problems in romantic relationships. It is essential to help young inmates to find an adaptive way of reducing stress caused by negative relationship life events.

Functions of nonsuicidal self-injury in a Hungarian community adolescent sample: a psychometric investigation.

BACKGROUND: The Inventory of Statements About Self-Injury (ISAS) is a psychometrically valid tool to evaluate the motives of nonsuicidal self-injury (NSSI), but there are a few studies that test gender differences in the factor structure of the measurement. However, several differences across gender were identified in NSSI (e.g., in prevalence, methods, functions). Therefore, our study focused on further analyses of the dimensionality of the ISAS functions. METHODS: Among Hungarian adolescents with a history of NSSI (N = 418; 70.6% girls; mean age was 16.86, SD = 1.45), confirmatory factor analysis and exploratory structural equation modeling frameworks were used to test the factor structure of the ISAS part II. RESULTS: Results support the two-factor structure of the questionnaire. Intrapersonal and interpersonal motivation factors emerged in the whole sample, but this factor structure varied across gender. Among girls, intrapersonal motivation of NSSI was associated with higher loneliness, more inflexible emotion regulation, and a more pronounced level of internalizing and externalizing mental illness symptoms. CONCLUSIONS: Our findings provide sufficiently solid arguments for the need to examine NSSI functionality separately for adolescent girls and boys because there were clear gender differences in the motives underlying NSSI. In addition, precise scanning of patterns of NSSI functions may further help us to identify the most at-risk adolescents regarding self-injury.

Interaction between emotional context-guided shifting and cognitive shifting: Introduction of a novel task.

Aim: Task shifting is considered as a critical component of cognitive flexibility that underlies the ability to flexibly switch between tasks. It is measured by performance-based tasks, where participants have to select/ignore simple target stimuli such as letters, numbers, or words according to certain rules. However, in everyday life individuals need to manage and shift between more complex, often emotionally charged stimuli. Previous paradigms developed to measure affective flexibility are based on the task where the focus is to shift between emotional and non-emotional stimuli, instead of the flexible shift between emotional valences. In view of this, the aim of the present study was to develop the Emotional Shifting Task, a novel paradigm that is created with the purpose of assessing emotional flexibility abilities by means of a novel valence-specific shifting design. Furthermore, scientific discussion regarding the relationship between cognitive and emotional flexibility abilities, a connection that is rarely addressed in the literature would be addressed. Method: In the present paper, task shifting was assessed by means of the Task Switching Task while the Emotional Shifting Task method evaluated emotional flexibility abilities in an online setting. Results: The results revealed a significant, positive relationship between task shifting and emotional shifting from positive to negative images only. Furthermore, when fast and slow performers on TST were distinguished results showed that fast performers on TST were also faster on EST shift conditions in general, but not on EST non-shift condition. Conclusion: These findings indicate that cognitive and emotional flexibility abilities may be interrelated. Our results seem to indicate a connection between the two shifting abilities. (Neuropsychopharmacol Hung 2021; 23(2): 319-330).

Well-being profiles in adolescence: psychometric properties and latent profile analysis of the mental health continuum model - a methodological study.

BACKGROUND: The Adolescent Mental Health Continuum Short Form (MHC-SF) is a psychometrically valid tool to evaluate the domains of subjective well-being, but there is a lack of investigations which could distinguish subgroups with distinct subjective well-being profiles based on this measurement. Therefore, after testing the competing measurement models of the MHC-SF, our main aim was to identify subjective well-being profiles in a large adolescent sample. METHODS: On a representative Hungarian adolescent sample (N = 1572; 51% girl; mean age was 15.39, SD = 2.26) confirmatory factor analyses (CFA) and exploratory structural equation modeling (ESEM) were used to test the factor stucture of the Adolescent MHC-SF. In addition, gender invariance of the best fitting model was also tested. Latent Profile Analyses (LPA) were conducted to reveal distinct subgroups and these profiles were then compared. RESULTS: Results support the bifactor model of MHC-SF: the general and specific well-being factors which were invariant across gender. LPA yielded four subgroups, three of them have been theoretically hypothesized in previous works (i.e. flourishing, moderate mental health, languishing), but an emotionally vulnerable subgroup also emerged. Compared to the languishing group, this new subgroup demonstrated higher scores on prosocial behaviour, but had comparable level of loneliness and internalizing symptoms. CONCLUSIONS: Our results suggest that the MHC-SF is a reliable and valid instrument for assessing overall well-being and its components. In addition, the identification of young people to be at risk for low mental health may help us to tailor mental health promotion programs to their special needs.

Anticipation and violated expectation of pain are influenced by trait rumination: An fMRI study.

Rumination - as a stable tendency to focus repetitively on feelings related to distress - represents a transdiagnostic risk factor. Theories suggest altered emotional information processing as the key mechanism of rumination. However, studies on the anticipation processes in relation to rumination are scarce, even though expectation in this process is demonstrated to influence the processing of emotional stimuli. In addition, no published study has investigated violated expectation in relation to rumination yet. In the present study we examined the neural correlates of pain anticipation and perception using a fear conditioning paradigm with pain as the unconditioned stimulus in healthy subjects (N = 30). Rumination was assessed with the 10-item Ruminative Response Scale (RRS). Widespread brain activation - extending to temporal, parietal, and occipital lobes along with activation in the cingulate cortex, insula, and putamen - showed a positive correlation with rumination, supporting our hypothesis that trait rumination influences anticipatory processes. Interestingly, with violated expectation (when an unexpected, non-painful stimulus follows a pain cue compared to when an expected, painful stimulus follows the same pain cue) a negative association between rumination and activation was found in the posterior cingulate cortex, which is responsible for change detection in the environment and subsequent behavioral modification. Our results suggest that rumination is associated with increased neural response to pain perception and pain anticipation, and may deteriorate the identification of an unexpected omission of aversive stimuli. Therefore, targeting rumination in cognitive behavioral therapy of chronic pain could have a beneficial effect.

Increased activation of the pregenual anterior cingulate cortex to citalopram challenge in migraine: an fMRI study.

BACKGROUND: The anterior cingulate cortex (ACC) is a key structure of the pain processing network. Several structural and functional alterations of this brain area have been found in migraine. In addition, altered serotonergic neurotransmission has been repeatedly implicated in the pathophysiology of migraine, although the exact mechanism is not known. Thus, our aim was to investigate the relationship between acute increase of brain serotonin (5-HT) level and the activation changes of the ACC using pharmacological challenge MRI (phMRI) in migraine patients and healthy controls. METHODS: Twenty-seven pain-free healthy controls and six migraine without aura patients participated in the study. All participant attended to two phMRI sessions during which intravenous citalopram, a selective serotonin reuptake inhibitor (SSRI), or placebo (normal saline) was administered. We used region of interest analysis of ACC to compere the citalopram evoked activation changes of this area between patients and healthy participants. RESULTS: Significant difference in ACC activation was found between control and patient groups in the right pregenual ACC (pgACC) during and after citalopram infusion compared to placebo. The extracted time-series showed that pgACC activation increased in migraine patients compared to controls, especially in the first 8-10 min of citalopram infusion. CONCLUSIONS: Our results demonstrate that a small increase in 5-HT levels can lead to increased phMRI signal in the pregenual part of the ACC that is involved in processing emotional aspects of pain. This increased sensitivity of the pgACC to increased 5-HT in migraine may contribute to recurring headache attacks and increased stress-sensitivity in migraine.

A Four-Factor Model of Work Addiction: The Development of the Work Addiction Risk Test Revised.

BACKGROUND: Work has a crucial role in individuals' productivity, social life, and psychological well-being. Despite various definitions of work addiction in the literature, the number of psychometrically reliable instruments is limited. OBJECTIVES: The aim of this study was to psychometrically test and revise the factor structure of the Work Addiction Risk Test (WART), one of the most widely used instruments assessing work addiction. METHOD: The full version of the WART [Robinson, Post, & Khakee, 1992] was assessed using a nationally representative sample of Hungary (n = 2,710). To increase validity, the analyses were conducted among individuals who worked at least 40 h a week (n = 1,286, 43% women, mean age = 38.9 years, SD = 10.8). RESULTS: Using confirmatory factor analysis, the originally proposed 4- and 5-factor solutions did not have adequate model fit indices. Thus, the sample was randomly divided into 2 subsamples. Exploratory factor analysis conducted in the first half of the sample supported a 4-factor solution, which was confirmed in the other half of the sample. The Work Addiction Risk Test Revised (WART-R) comprises 17 items and 4 factors (i.e., Overcommitment, Impatience, Hard-working, and Salience). Using a latent class analysis, a cutoff score (51 points out of 68) for the high risk of work addiction was determined. Almost one in 10 participants (9.3%) were identified as being symptomatic of work addiction, and these individuals also reported an elevated level of mental distress and hostility. CONCLUSIONS: As a conclusion, the WART-R is suitable to be used as an indicator of work addiction based on clinically relevant symptom dimensions.

The Relationship Between Personality Traits, Psychopathological Symptoms, and Problematic Internet Use: A Complex Mediation Model.

BACKGROUND: There are many empirical studies that demonstrate the associations between problematic internet use, psychopathological symptoms, and personality traits. However, complex models are scarce. OBJECTIVE: The aim of this study was to build and test a mediation model based on problematic internet use, psychopathological symptoms, and personality traits. METHODS: Data were collected from a medical addiction center (43 internet addicts) and internet cafés (222 customers) in Beijing (mean age 22.45, SD 4.96 years; 239/265, 90.2% males). Path analysis was applied to test the mediation models using structural equation modeling. RESULTS: Based on the preliminary analyses (correlations and linear regression), two different models were built. In the first model, low conscientiousness and depression had a direct significant influence on problematic internet use. The indirect effect of conscientiousness-via depression-was nonsignificant. Emotional stability only affected problematic internet use indirectly, via depressive symptoms. In the second model, low conscientiousness also had a direct influence on problematic internet use, whereas the indirect path via the Global Severity Index was again nonsignificant. Emotional stability impacted problematic internet use indirectly via the Global Severity Index, whereas it had no direct effect on it, as in the first model. CONCLUSIONS: Personality traits (ie, conscientiousness as a protective factor and neuroticism as a risk factor) play a significant role in problematic internet use, both directly and indirectly (via distress level).

[Psychometric properties of the Inventory of Callous-Unemotional Traits in a high-risk sample of adolescent boy].

INTRODUCTION: The Inventory of Callous-Unemotional Traits (ICU) is one of the most widely used measures of psychopathic traits in children. Callous-unemotional (CU) traits designate an important subgroup of antisocial youth characterized by lack of empathy, guilt and remorse. The aim of the present study was to test the applicability and reliability of the self-reported ICU in a high-risk sample of adolescent boys. METHODS: Participants were 202 adolescent boys (mean age: 16.63 years; SD = 1.71) from institutional care facilities and juvenile detention centres. Confirmatory factor analyses (CFA) were conducted to investigate the factor structure of the ICU. In addition, MIMIC modelling (CFA with covariates) was applied to test the convergent validity of the ICU scores by examining relationships with externalizing symptoms (including conduct problems, hyperactivity-inattention, proactive-reactive aggression), and prosocial behaviour. RESULTS: We observed that the bifactor model with three correlated specific factors (callousness, uncaring and unemotional) and one general CU traits factor provided the best fit to the data. However, similar to previous studies, low internal consistency was found for the unemotional scale. In line with our expectations, CU traits showed positive associations with externalizing symptoms, and negative associations with prosocial behaviour. CONCLUSION: The ICU is a reliable and valid measure of callous-unemotional traits. Our results support the application of the Hungarian version of the questionnaire.

[Emotion regulation and heart rate variability]. / Érzelemszabályozás és szívritmus-variabilitás.

Heart rate variability (HRV) has been receiving increasing attention not just in medical but also in psychological research. Several studies show that mental disorders are associated with lower levels of HRV. Therefore, HRV has been considered as a transdiagnostic biomarker. The current review spreads light on the possibility that in the connection of HRV and psychopathologies the deficits of emotion regulation or disregulated emotional states can be important mediators. Accordingly, we review the results of the questionnaire-based and experimental studies examining the connection of emotion regulation and resting and/or phasic HRV.

[Iowa Gambling Task: illustration of a behavioral measurement]. / Iowa Gambling Task: egy viselkedéses méroeszköz bemutatása.

The Iowa Gambling Task is a behavioral measurement which was developed to examine decision-making based on the Somatic Marker Hypothesis. Participants have to make series of choices altogether 100 times from four decks of cards. The decks have different characteristics with regards to gains and losses. After the initial analyses - with a focus on patients with damage to the ventromedial prefrontal cortex - the tool soon became one of the most frequently used technique of measuring hot executive functions. It is also used to measure impulsivity. Structures involved in decision-making constitute the neural basis of the Task. IGT is applied in several different disorders (in connection with decision-making and impulsivity as well). In recent years different versions have been developed, and these modifications may have different effects on IGT performance, and may also influence what the Task measures exactly. With growing empirical evidence several questions have arisen in connection with the composition of the decks (gain-loss magnitude vs. frequency, prominent deck B phenomenon) which suggest to use other indexes as well besides the net scores.

Is there any difference in patterns of use and psychiatric symptom status between injectors and non-injectors of mephedrone?

OBJECTIVE: In recent years, increasing intravenous mephedrone use was reported in several countries. The aim of this study was to describe the characteristics of such a form of mephedrone use, while identifying the differences between injectors and non-injectors in patterns of mephedrone use and psychiatric symptom status. METHODS: One hundred and forty-five mephedrone users were surveyed on patterns of mephedrone use using a structured questionnaire as well as the Brief Symptom Inventory. RESULTS: Majority of users received mephedrone from acquaintances and used it in discos/parties settings regarding both first and current mephedrone use. Intranasal use was the most typical route of administration (84.4%). Injectors (11%) used the drug more frequently and in higher dosages. This group included a greater proportion of opiate users (37.5%) and showed more diffuse psychiatric symptoms. Regarding the predictors of being an injector, heroin use showed the highest odds ratio. CONCLUSIONS: Intravenous mephedrone use is associated with a higher risk of harmful drug use, elevated psychiatric symptom profile and increased possibility of mephedrone being considered as an addictive substance. These findings might be important in efficient treatment planning.

Enhancing sexual desire and experience: an investigation of the sexual correlates of gamma-hydroxybutyrate (GHB) use.

OBJECTIVE: Various studies have dealt with gamma-hydroxybutyrate's (GHB) potential role in sexual assaults, while the sexual correlates of intentional recreational GHB use have not well been highlighted. Our study aims to explore GHB's sexual effects, the patterns of choice of sexual partners, the frequency of experienced blackouts, and endured sexual or acquisitory crimes as a result of GHB use. METHODS: Sixty recreational GHB users filled out a questionnaire on experienced subjective, somatic, and sexual effects of GHB, the frequency of blackouts due to their GHB use, and items on their sexual experiences in relation to GHB use. RESULTS: Of the sample, 25.9% reported increased sexual arousal as well as more intense attraction towards their sexual partners and increased sexual openness when using GHB; 34.8% had sexual intercourse with strangers, or with others, but not with their partners when using GHB; and 8.6% were victims of acquisitory crimes, whereas 3.4% were victims of a sexual assault. Furthermore, 24.6% typically experienced blackouts when using GHB. CONCLUSION: Gamma-hydroxybutyrate seems to be a potential substitute for both stimulant and depressant substances. Increased sexual desire and disinhibition may lead to a more frequent and potentially more riskful sexual activity. Experienced blackouts need to be considered as risk factors for suffering sexual or acquisitory crimes.

The mediating effect of gaming motivation between psychiatric symptoms and problematic online gaming: an online survey.

BACKGROUND: The rapid expansion of online video gaming as a leisure time activity has led to the appearance of problematic online gaming (POG). According to the literature, POG is associated with different psychiatric symptoms (eg, depression, anxiety) and with specific gaming motives (ie, escape, achievement). Based on studies of alcohol use that suggest a mediator role of drinking motives between distal influences (eg, trauma symptoms) and drinking problems, this study examined the assumption that there is an indirect link between psychiatric distress and POG via the mediation of gaming motives. Furthermore, it was also assumed that there was a moderator effect of gender and game type preference based on the important role gender plays in POG and the structural differences between different game types. OBJECTIVE: This study had two aims. The first aim was to test the mediating role of online gaming motives between psychiatric symptoms and problematic use of online games. The second aim was to test the moderator effect of gender and game type preference in this mediation model. METHODS: An online survey was conducted on a sample of online gamers (N=3186; age: mean 21.1, SD 5.9 years; male: 2859/3186, 89.74%). The Brief Symptom Inventory (BSI), the Motives for Online Gaming Questionnaire (MOGQ), and the Problematic Online Gaming Questionnaire (POGQ) were administered to assess general psychiatric distress, online gaming motives, and problematic online game use, respectively. Structural regression analyses within structural equation modeling were used to test the proposed mediation models and multigroup analyses were used to test gender and game type differences to determine possible moderating effects. RESULTS: The mediation models fitted the data adequately. The Global Severity Index (GSI) of the BSI indicated that the level of psychiatric distress had a significant positive direct effect (standardized effect=.35, P<.001) and a significant indirect (mediating) effect on POG (standardized effect=.194, P<.001) via 2 gaming motives: escape (standardized effect=.139, P<.001) and competition (standardized effect=.046, P<.001). The comparison of the 2 main gamer types showed no significant differences in the model. However, when comparing male and female players it was found that women had (1) slightly higher escape scores (on a 5-point Likert scale: mean 2.28, SD 1.14) than men (mean 1.87, SD 0.97) and (2) a stronger association between the escape motive and problematic online gaming (standardized effect size=.64, P<.001) than men (standardized effect size=.20, P=.001). CONCLUSIONS: The results suggest that psychiatric distress is both directly and indirectly (via escape and competition motives) negatively associated with POG. Therefore, the exploration of psychiatric symptoms and gaming motives of POG can be helpful in the preparation of prevention and treatment programs.