Investigating Parental Factors for Adolescent Problematic Gaming and Social Media Use - A Cross-sectional and Longitudinal Approach.

PURPOSE: Increasing concern has been raised on the addictive potential of digital games and socialmedia platforms, especially in adolescent users. Hence, investigating the etiology of problematic gaming (PG) and problematic social-media use (PSMU) is of great scientific and clinical interest. Parental factors have not been sufficiently addressed yet. Therefore, this study aims to investigate the predictive values of parental demographic, psychological, parenting, and role model factors for adolescent PG/PSMU. METHODS: In a representative parent-child (10-17 years) sample parental factors and adolescent PG/PSMU were assessed cross-sectionally (Ndyads = 1221) and longitudinally (Ndyads = 659) using online-questionnaires at two measurement points 14 months apart. Parental factors included parental media-use patterns, sociodemographic aspects, (digital) emotion regulation, stress perception, (digital) parental self-efficacy, and media rules. Best subset linear regression models were estimated to identify parental factors with greatest predictive values. These were included in prospective linear regression analyses. RESULTS: At the cross-sectional level, 18% of model variance predicting PG and 24% predicting PSMU could be explained by parental media-use patterns, media rules, and (digital) parental self-efficacy after controlling for adolescent age. Longitudinally, 33% of variance in the PG model and 34% of variance of the PSMU model could be explained by parental media-use patterns and parental self-efficacy after controlling for adolescent age and baseline PG/PSMU. DISCUSSION: This study is the first to differentially investigate parental factors in the context of adolescent PG/PSMU in a prospective representative parent-child study. Aspects of digital parental role modeling and parenting could be identified as promising anchors for prevention and treatment.

International Classification of Diseases-11-Based External Assessment of Social Media Use Disorder in Adolescents: Development and Validation of the Social Media Use Disorder Scale for Parents.

Social media use disorder (SMUD) is associated with substantial impairments in daily functioning, and adolescents are particularly at risk. The 11th revision of the International Classification of Diseases (ICD-11) criteria of gaming disorder (GD) could be shown to be suitable to describe SMUD in adolescents. Since adolescents' insight might be limited due to young age or symptom denial, it is essential to include their parents in the diagnostic process. The development and validation of a parental scale are, therefore, of great interest to clinicians and scientists. The Social Media Use Disorder Scale for Parents (SOMEDIS-P) was developed by clinical experts and validated in 944 parent-child dyads. Adolescents were 10-17 years old and frequently used social media (SM). Besides SM use times, standardized questionnaires were applied to assess SM use patterns according to ICD-11 and Diagnostic and Statistical Manual of Mental Disorders-5 criteria of (Internet) GD, psychological stress, and depressive symptoms in an online survey. Item structure was investigated by confirmatory factorial analysis. Receiver operating characteristic curve analyses to determine cutoff values and accordance with adolescent self-ratings were computed. A presumed two-factorial structure of SOMEDIS-P could be confirmed describing cognitive-behavioral symptoms and negative consequences. The instrument showed good to excellent internal consistency and criterion validity with moderate to strong correlations, excellent discriminatory characteristics, and moderate accordance with the adolescents' self-ratings. As the first successfully validated tool for the assessment of ICD-11-based SMUD in adolescents by parental judgment, SOMEDIS-P can make an important contribution to reliable SMUD screening in clinical practice and research.

Requirements of a Group Intervention for Adolescents with Internet Gaming Disorder in a Clinical Setting: A Qualitative Interview Study.

Internet gaming disorder (IGD) has become an important health concern in a significant proportion of adolescents. Intervention studies in this age group are scarce, mostly follow quantitative designs, and rarely consider adolescents' experiences. This study aimed to evaluate the requirements for a group therapy program for adolescents with IGD. A qualitative interview study was conducted in a German clinic for addictive disorders in childhood and adolescence with nine participants (seven IGD patients (12-18 years, M = 15.86, SD = 1.95) and two psychotherapists). The semi-structured interviews addressed helpful contents, general conditions, and suggestions for alterations for an effective group intervention. Data were analyzed using content structuring qualitative analysis. Patient interview data resulted in 234 codings with eight main categories. Expert interview data yielded 151 codings with six main categories. The following treatment components were described as effective by the participants and experts: psychoeducation, emotion management, behavior analysis and modification, social skills training, parent participation, and relapse prevention. Additionally, adolescents emphasized the importance of group functionality for coherence, feedback and rewards, content presentation, physical activity and fun. The results are a valuable addition to findings from quantitative studies on IGD interventions and an interesting starting point for further representative studies.

ICD-11-Based Assessment of Social Media Use Disorder in Adolescents: Development and Validation of the Social Media Use Disorder Scale for Adolescents.

Background: A problematic social media use (PSMU) in adolescents is a rising phenomenon often associated with higher perception of psychological stress and comorbid psychiatric disorders like depression. Since the ICD-11 introduced the very first internet-use related disorders, criteria for gaming (and online gambling) disorder can now be transferred to assess social media use disorder (SMUD). Therefore, the development and validation of a self-rating screening instrument for SMUD is of value to researchers and clinicians. Method: The previously validated ICD-11-based Gaming Disorder Scale for Adolescents (GADIS-A) was adapted to measure SMUD (Social Media Use Disorder Scale for Adolescents, SOMEDIS-A). A representative sample of 931 adolescents aged 10 to 17 years and a respective parent participated in an online study. Item structure was evaluated by factorial analyses. Validated DSM-5-based instruments to assess PSMU by self- and parental ratings (SMDS, SMDS-P), adolescent depressive symptoms (PHQ-9), and stress perception (PSS-10) as well as single items on time spent with social media (SM, frequency and duration) were applied to assess criterion validity. Discrimination between pathological and non-pathological users was examined based on ROC analyses retrieved cut-off values and the results of a latent profile analysis. Results: The new scale is best described by two factors reflecting cognitive-behavioral symptoms and associated negative consequences. The internal consistency was good to excellent. The SOMEDIS-A-sum score was positively correlated with PSMU, depression, and stress scores as well as the time spent with SM in a moderately to highly significant manner. Thus, good to excellent criterion validity is suggested. Conclusions: SOMEDIS-A is the first successfully validated instrument to assess SMUD in adolescents based on the ICD-11 criteria of GD. Thus, it can support early detection in order to prevent symptom aggravation, chronification, and secondary comorbidities. It can contribute to the development of a standardized conceptualization and its two-factorial structure offers promising new insights into the evaluation of SM usage patterns. Further examination including clinical validation is desirable.

Risk factors for prospective increase in psychological stress during COVID-19 lockdown in a representative sample of adolescents and their parents.

BACKGROUND: COVID-19 lockdown measures imposed extensive restrictions to public life. Previous studies suggest significant negative psychological consequences, but lack longitudinal data on population-based samples. AIMS: We aimed to prospectively identify increased psychological stress and associated risk factors in parent-child dyads. METHOD: We conducted a prospective, observational online study on a representative German sample of 1221 adolescents aged 10-17 years and their parents. Psychological stress and psychosocial variables were assessed before the pandemic (baseline) and 1 month after the start of lockdown (follow-up), using standardised measures. We used multilevel modelling to estimate changes in psychological stress, and logistic regression to determine demographic and psychosocial risk factors for increased psychological stress. RESULTS: The time of measurement explained 43% of the psychological stress variance. Of 731 dyads with complete data, 252 adolescents (34.5%, 95% CI 31.0-37.9) and 217 parents (29.7%, 95% CI 26.4-33.0) reported a significant increase in psychological stress. Baseline levels were lower than in dyads without increased psychological stress. Risk factors for increased psychological stress included sociodemographic (e.g. female parents, severe financial worries) and emotion regulation aspects (e.g. non-acceptance of emotional responses in parents, limited access to emotion regulation strategies in adolescents), explaining 31% of the adolescent (Nagelkerke R2 = 0.31) and 29% of the parental (Nagelkerke R2 = 0.29) model variance. CONCLUSIONS: This study is the first to prospectively show an increase in psychological stress during COVID-19 lockdown in a representative family sample. Identified demographic and psychosocial risk factors lead to relevant implications for prevention measures regarding this important public health issue.

Assessing Problematic Social Media Use in Adolescents by Parental Ratings: Development and Validation of the Social Media Disorder Scale for Parents (SMDS-P).

BACKGROUND: The problematic use of social media (SM) is a rising phenomenon, especially in adolescents. It can be assessed by self-rating screeners such as the Social Media Disorder Scale (SMDS). However, young age or symptom denial might reduce adolescent assessment accuracy. Therefore, the development and validation of a parental scale (SMDS-P) is desirable. METHOD: A representative sample of 961 parents and corresponding frequently SM-using children aged 10 to 17 years participated in an online study. Factorial analyses were performed to determine item structure. Adolescents' SMDS self-reports, SM usage time, emotional dysregulation, and academic performance were used to assess validity. The SMDS-P cut-off value was calculated by ROC-analysis. RESULTS: A one-factorial structure of the SMDS-P could be confirmed. The internal consistency was good (Cronbach's α = 0.85, McDonald's ω = 0.88) and the accordance between parental and self-ratings moderate (kappa = 0.51). SMDS-P was positively associated with adolescents' self-ratings (r = 0.68), SM usage time (r = 0.26) and frequency (ϱ = 0.16) as well as with emotional dysregulation (r = 0.35) in a highly significant manner. CONCLUSIONS: SMDS-P offers a promising new approach to assess problematic SM usage in adolescence. Further studies including clinical validations are required.

Assessing ICD-11 gaming disorder in adolescent gamers by parental ratings: Development and validation of the Gaming Disorder Scale for Parents (GADIS-P).

BACKGROUND AND AIMS: The addiction to digital games is associated with substantial impairments in daily functioning and adolescents are particularly at risk. Screening instruments for the new ICD-11 diagnosis Gaming Disorder (GD) are rare and only include self-ratings thus far. Since adolescents' insight might be limited due to young age or symptom denial, external ratings are essential. We therefore aimed to develop and validate the Gaming Disorder Scale for Parents (GADIS-P) in a representative sample of parents and young gamers. METHODS: GADIS-P was developed as an adaptation of a recently published self-rating scale. It was validated in 800 parents and their frequently gaming children between 10 and 17 years with standardized questionnaires in an online survey. Item structure was investigated by confirmatory factorial analysis. Gaming time, pathological gaming according to DSM-5, emotional dysregulation, and academic performance were used to derive criterion validity. Accordance with self-ratings was determined. ROC-Analyses were computed to determine cut-off values. RESULTS: A presumed two-factorial structure of GADIS-P could be confirmed describing cognitive-behavioral symptoms and negative consequences. The instrument showed good to excellent internal consistency (Cronbach's α = 0.89-0.92, McDonald's ω = 0.92-0.95) and criterion validity with moderate to strong correlations regarding gaming behavior (r/ϱ = 0.35-0.76), excellent discriminatory power, and moderate accordance with the adolescents' self-ratings (kappa = 0.47-0.58). DISCUSSION AND CONCLUSIONS: As the first successfully validated tool for the assessment of ICD-11 GD in adolescents by parental judgment, GADIS-P can make an important contribution to reliable GD screening in clinical and research settings.

Assessing ICD-11 Gaming Disorder in Adolescent Gamers: Development and Validation of the Gaming Disorder Scale for Adolescents (GADIS-A).

BACKGROUND: Adolescents affected by Gaming Disorder (GD) show substantial impairments in daily functioning. GD was included in the 11th revision of the International Classification of Diseases (ICD-11) as a new diagnosis coming into effect in January 2022. An instrument to screen for GD in adolescents has not yet been published and is urgently needed for scientific research and clinical practice. METHODS: In the present study, the ICD-11-based Gaming Disorder Scale for Adolescents (GADIS-A) was developed by clinical experts and scientists. It was validated with 819 frequent gamers of 10 to 17 years and a respective caregiver in an online survey. Criterion validity was examined by assessing gaming behavior, emotional dysregulation, and academic performance. Item structure was investigated by factorial analyses. ROC- and Latent Profile Analyses were computed for differentiation between GD and Non-GD. RESULTS: In line with the ICD-11 approach and accounting for cognitive-behavioral symptoms and negative consequences equally, GADIS-A items were best described by two factors. The new instrument showed excellent internal consistency, good criterion validity, and excellent discriminatory power. CONCLUSIONS: GADIS-A is the first successfully validated questionnaire to assess ICD-11 GD in adolescents. Thus, it can significantly contribute to reliably identify affected adolescents in clinical and research settings.