Brain responses to decision-making in easy and hard choices in internet gaming disorder: Implications for irrepressible gaming behaviours.

BACKGROUND: Impaired decision-making was observed in internet gaming disorder (IGD), however, these studies did not differentiate 'hard' to 'easy' decisions, and only the 'hard' decision-making could reveal the mechanism underlying this issue. METHODS: We recruited forty-eight individuals with IGD and forty-six recreational internet game users (RGUs) as a control group in this study. fMRI data were collected when they were finishing a value-matching delayed discount task (DDT), which included easy and hard decisions judging based on the indifference points of every participant. The correlations between brain responses during DDT and IGD severity and the effective connectivity between brain regions were calculated. RESULTS: Compared to RGUs, IGD subjects showed enhanced activation in the orbitofrontal cortex (OFC) when facing hard choices, and this feature was associated with IGD severity. In addition, individuals with IGD showed increased effective connectivity from the OFC to the dorsolateral prefrontal cortex and the OFC to the occipital lobe and decreased effective connectivity from the occipital lobe to the OFC. CONCLUSION: The current study showed that the abnormal activation in the OFC was associated with IGD severity and higher OFC-DLPFC/OFC-occipital lobe effective connectivity and lower occipital lobe-OFC effective connectivity when individuals with IGD faced different choices in the DDT. These findings suggest the neural mechanisms of impulsive decision-making in individuals with IGD due to dysfunction with subjective evaluation and dysfunction of the connection with the executive control system.

Neural correlates of problematic gaming in adolescents: A systematic review of structural and functional magnetic resonance imaging studies.

Problematic gaming in adolescents is associated with neural alterations in structural and functional imaging studies. Especially frontal regions, associated with cognitive control functions, as well as temporoparietal areas, responsible for attention processes and self-concepts, and frontolimbic and subcortical regions, connected to emotion regulation and reward processing, are affected. The differences provide a further explanation for addictive disorders and emphasize the importance of interventions that address executive and cognitive-affective deficits.

The contributions of social comparison to social network site addiction.

Excessive use of social network sites (SNSs) can often lead to negative consequences of frequent upward social comparisons despite having the social network platform to present users in a favorable light. However, the existing literature gives little evidence to social comparison related antecedents and consequents of uncontrollable use of SNSs. The present study aimed to investigate the contributions of social comparison to SNS addiction. In Study 1, using a convenient sample in Austria (n = 103), we showed that the tendency to engage in social comparisons of ability (but not of opinion) predicted self-reported SNS addiction over and above the feelings of relative deprivation on social support and status. SNS addiction mediated the relations between social comparison of ability and stress, but not self-esteem. In Study 2, using a broad sample of participants in Austria (n = 500), we replicated the findings observed in Study 1 and showed that contrastive upward social comparison emotions (i.e., envy, depression) mediated the relation between SNS addiction and lower self-esteem whereas the contrastive downward social comparison emotion (i.e., contentment) mediated the relation between SNS addiction and higher self-esteem. Our findings suggest that SNS addiction closely relates to psychological constructs relevant to social comparison, mediates the link between social comparison of ability and detrimental consequences (i.e., stress, well-being) and demonstrate how social comparison emotions relate to both positive and negative associations between SNS addiction and self-esteem.

Persistent dependent behaviour is accompanied by dynamic switching between the ventral and dorsal striatal connections in internet gaming disorder.

Cross-sectional studies have suggested that functional heterogeneity within the striatum in individuals with addictive behaviours may involve the transition from ventral to dorsal partitions; however, due to limitations of the cross-sectional design, whether the contribution of this transition to addiction was confused by individual differences remains unclear, especially for internet gaming disorder (IGD). Longitudinal functional magnetic resonance imaging (fMRI) data from 22 IGD subjects and 18 healthy controls were collected at baseline and more than 6 months later. We examined the connectivity features of subregions within the striatum between these two scans. Based on the results, we further performed dynamic causal modelling to explore the directional effect between regions and used these key features for data classification in machine learning to test the replicability of the results. Compared with controls, IGD subjects exhibited decreased functional connectivity between the left dorsal striatum (putamen) and the left insula, whereas connectivity between the right ventral striatum (nucleus accumbens [Nacc]) and the left insula was relatively stable over time. An inhibitory effective connectivity from the left putamen to the right Nacc was found in IGD subjects during the follow-up scan. Using the above features, the classification accuracy of the training model developed with the follow-up was better than that of the model based on the initial scan. Persistent IGD status was accompanied by a switch in the locus of control within the striatum, which provided new insights into association between IGD and drug addiction.

Altered intrinsic connectivity distribution in internet gaming disorder and its associations with psychotherapy treatment outcomes.

Alterations in brain connectivity have been implicated in internet gaming disorder (IGD). However, little is known about alterations in whole-brain connectivity and their associations with long-term treatment outcomes. Here, we used a relatively new analytic approach, intrinsic connectivity distribution (ICD) analysis, to examine brain connectivity in 74 IGD participants and 41 matched healthy controls (HCs) and conducted post hoc seed-based resting-state functional connectivity (rsFC) analyses based on the ICD findings. We also examined how these findings related to outcomes involving a craving behavioral intervention (CBI) for IGD. IGD participants showed less whole-brain connectivity in the left angular gyrus and ventromedial prefrontal cortex (vmPFC) compared with HC participants. Seed-based rsFC analyses revealed that the left angular gyrus in the IGD group showed less connectivity with areas involved in the default-mode network and greater connectivity with areas in the salience and executive control networks. CBI was associated with improved connectivity within regions in the default-mode network and regions across the default-mode and salience networks. ICD-identified connectivity differences in the left angular gyrus and vmPFC were related to changes in craving and severity of addiction 6 months after the intervention. The findings suggest that IGD is associated with alterations in brain connectivity that may be sensitive to interventions. Thus, the findings have implications for understanding mechanisms underlying CBI effects and for further treatment development.

The role of the insula in internet gaming disorder.

Internet gaming disorder (IGD) is a concerning issue that requires further research. Here, we seek to examine its neural etiology with an emphasis on the role of the insula. To do so, we relied on the tripartite neurocognitive model of addictive behaviors as applied to IGD. We hypothesized that (a) video game cues will elicit stronger reward system activation and weaker prefrontal activation in gamers vs controls, (b) the IGD scores of gamers will be positively associated with activation of the reward system and negatively with activation of prefrontal regions, (c) deprivation from video gaming will result in increased activation of the insula, when gamers are exposed to video game cues vs to neutral cues, and (d) in deprivation conditions, there will be positive and negative coupling, respectively, between activation of the insula and the reward and prefrontal regions in gamers. We tested these hypotheses with a design with one between-subjects factor (gamers vs controls) and two within-subjects factors: stimuli (gaming vs neutral; for all participants) and session (deprivation vs satiety; only for gamers). Findings based on functional magnetic resonance imaging (fMRI; applied to all 52 subjects, 26 gamers, and 26 controls) and psychophysiological interaction (PPI; applied to the 26 gamers) engaged in a video reactivity task supported our assertions. The IGD score positively correlated with activity in the right ventral striatum and negatively with activity in the right dorsolateral prefrontal cortex (DLPFC). Left insular cortex activity was the highest when observing video gaming cues under deprivation. Lastly, there was an increased coupling between the left insula and left ventral striatum and a decreased coupling with left DLPFC when observing video gaming cues compared with when watching control videos in the deprivation condition.

The Mediating Effect of Depressive Symptoms on the Relationship between Adverse Childhood Experiences and Problematic Internet Use in Children and Adolescents.

The purpose of this study was to evaluate the mediating effect of depressive symptoms on the relationship between adverse childhood experiences (ACEs) and problematic internet use. The study participants were 180 students between the ages of 9 and 18 years. Path analysis was performed to measure the relationships among ACEs, depressive symptoms and problematic internet use. ACEs significantly affected depressive symptoms (standardized regression weight, 0.36; P < 0.01), and depressive symptoms also affected problematic internet use (standardized regression weight, 0.40; P < 0.01). We found that depressive symptoms had a significant mediating effect on the relationship between problematic internet use and ACEs. The management of depressive symptoms would be important to prevent problematic internet use in children and adolescents with ACEs.

Structural and functional correlates of smartphone addiction.

Popularity and availability of smartphones have dramatically increased in the past years. This trend is accompanied by increased concerns regarding potentially adverse effects of excessive smartphone use, particularly with respect to physical and mental health. Recently, the term "smartphone addiction" (SPA) has been introduced to describe smartphone-related addictive behavior and associated physical and psychosocial impairment. Here, we used structural and functional magnetic resonance imaging (MRI) at 3 T to investigate gray matter volume (GMV) and intrinsic neural activity in individuals with SPA (n = 22) compared to a control group (n = 26). SPA was assessed using the Smartphone Addiction Inventory (SPAI), GMV was investigated by means of voxel-based morphometry, and intrinsic neural activity was measured by the amplitude of low frequency fluctuations (ALFF). Compared to controls, individuals with SPA showed lower GMV in left anterior insula, inferior temporal and parahippocampal cortex (p < 0.001, uncorrected for height, followed by correction for spatial extent). Lower intrinsic activity in SPA was found in the right anterior cingulate cortex (ACC). A significant negative association was found between SPAI and both ACC volume and activity. In addition, a significant negative association between SPAI scores and left orbitofrontal GMV was found. This study provides first evidence for distinct structural and functional correlates of behavioral addiction in individuals meeting psychometric criteria for SPA. Given their widespread use and increasing popularity, the present study questions the harmlessness of smartphones, at least in individuals that may be at increased risk for developing smartphone-related addictive behaviors.