Validation of the ACSID-11 for consistent screening of specific Internet-use disorders based on ICD-11 criteria for gaming disorder: A multitrait-multimethod approach.

INTRODUCTION: With the inclusion of gaming disorder in the ICD-11, diagnostic criteria were introduced for this relatively new disorder. These criteria may be applied to other potential specific Internet-use disorders. The 11-item Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) was developed for consistent screening of gaming disorder, online buying-shopping disorder, online pornography-use disorder, social networks-use disorder, and online gambling disorder. This study tested the construct validity of the ACSID-11, including convergent and divergent measures. METHODS: The ACSID-11 measures five behavioral addictions with the same set of items by following the principles of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ACSID-11 was administered to a convenience sample of active Internet users (N = 1597) together with validated and established measures of each specific Internet-use disorder along with screeners for mental health. Included are the Ten-Item Internet Gaming Disorder Test (IGDT-10), the Bergen Shopping Addiction Scale (BSAS), the Problematic Pornography Consumption Scale (PPCS), the Bergen Social Media Addiction Scale (BSMAS) and the Berlin Inventory of Gambling behavior - Screening (BIG-S). The ACSID-11 was compared convergently and divergently through a multitrait-multimethod approach along with contingency tables with the other Internet-use disorder screeners. RESULTS: The multitrait-multimethod results shows that each behavior assessed with the ACSID-11 has moderate to strong correlations (r's from 0.462 to 0.609) with the scores of the corresponding established measures and, furthermore, positive correlations (r's from 0.122 to 0.434) with measures of psychological distress and further shows that the ACSID-11 can be used for a comprehensive assessment of different behaviors. The contingency tables reveal large divergences between the ACSID-11 and other screening instruments concerning the classification of problematic specific Internet use based on the given cut-off values. CONCLUSION: The current work provides additional validation for the ACSID-11. Accordingly, this tool can be considered as reliable and valid for the simultaneous assessment of different Internet-use disorders: gaming disorder, online buying-shopping disorder, online pornography use disorder, social networks use disorder, and online gambling disorder. With a subsequent clinical validation of the scale and the proposed cut-off score, the ACSID-11 will be a thoroughly validated useful screening tool for clinical practice.

Digital Phenotypes for Early Detection of Internet Gaming Disorder in Adolescent Students: Explorative Data-Driven Study.

BACKGROUND: Limited awareness, social stigma, and access to mental health professionals hinder early detection and intervention of internet gaming disorder (IGD), which has emerged as a significant concern among young individuals. Prevalence estimates vary between 0.7% and 15.6%, and its recognition in the International Classification of Diseases, 11th Revision and Diagnostic and Statistical Manual of Mental Disorders, 5th Edition underscores its impact on academic functioning, social isolation, and mental health challenges. OBJECTIVE: This study aimed to uncover digital phenotypes for the early detection of IGD among adolescents in learning settings. By leveraging sensor data collected from student tablets, the overarching objective is to incorporate these digital indicators into daily school activities to establish these markers as a mental health screening tool, facilitating the early identification and intervention for IGD cases. METHODS: A total of 168 voluntary participants were engaged, consisting of 85 students with IGD and 83 students without IGD. There were 53% (89/168) female and 47% (79/168) male individuals, all within the age range of 13-14 years. The individual students learned their Korean literature and mathematics lessons on their personal tablets, with sensor data being automatically collected. Multiple regression with bootstrapping and multivariate ANOVA were used, prioritizing interpretability over predictability, for cross-validation purposes. RESULTS: A negative correlation between IGD Scale (IGDS) scores and learning outcomes emerged (r166=-0.15; P=.047), suggesting that higher IGDS scores were associated with lower learning outcomes. Multiple regression identified 5 key indicators linked to IGD, explaining 23% of the IGDS score variance: stroke acceleration (ß=.33; P<.001), time interval between keys (ß=-0.26; P=.01), word spacing (ß=-0.25; P<.001), deletion (ß=-0.24; P<.001), and horizontal length of strokes (ß=-0.21; P=.02). Multivariate ANOVA cross-validated these findings, revealing significant differences in digital phenotypes between potential IGD and non-IGD groups. The average effect size, measured by Cohen d, across the indicators was 0.40, indicating a moderate effect. Notable distinctions included faster stroke acceleration (Cohen d=0.68; P=<.001), reduced word spacing (Cohen d=.57; P=<.001), decreased deletion behavior (Cohen d=0.33; P=.04), and longer horizontal strokes (Cohen d=0.34; P=.03) in students with potential IGD compared to their counterparts without IGD. CONCLUSIONS: The aggregated findings show a negative correlation between IGD and learning performance, highlighting the effectiveness of digital markers in detecting IGD. This underscores the importance of digital phenotyping in advancing mental health care within educational settings. As schools adopt a 1-device-per-student framework, digital phenotyping emerges as a promising early detection method for IGD. This shift could transform clinical approaches from reactive to proactive measures.

Measurement Invariance of the Lemmens Internet Gaming Disorder Scale-9 Across Age, Gender, and Respondents.

Although Internet gaming disorder (IGD) has gained increased attention in scientific, clinical, and community contexts, there is still a lack of consensus regarding the best assessment tools (i.e., self-report or other reports) for assessing its symptoms. The present study aimed to investigate the reliability, validity, and measurement invariance of both versions (youth and parent) of The Lemmens Internet Gaming Disorder Scale-9. To achieve this goal, we recruited between June and October 2019 from five Romanian highschools a total of 697 adolescents (11-19 years old) and one of their parents (N = 391). The internal consistency was good in both versions of the instrument (α = 0.772 for the youth version and α = 0.781 for the parent version). Construct validity assessed through confirmatory factor analysis showed support for the one factor structure of the scales, while multigroup confirmatory factor analysis endorsed the invariance across age, gender, and respondents (i.e., parent vs. youth report). The current research identifies both IGD scales to be reliable and valid, arguing for their utility for assessing IGD symptomatology among adolescents. Implications for theory, assessment, and future directions are discussed.

Validation of the Thai Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) among young adults.

BACKGROUND: The Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) is a consistent and comprehensive instrument to assess symptoms of specific internet-use disorders including those related to gaming, shopping, pornography use disorder, social networks use and gambling considering criteria in the eleventh revision of the International Classification of Diseases (ICD-11). However, to date, there is little evidence supporting instruments assessing major types of specific internet use disorders in Thailand. The aim of this present study was to assess the psychometric properties of the ACSID-11 among Thai young adults. METHODS: A total of 612 participants were recruited. A confirmatory factor analysis (CFA) examined construct validity of the ACSID-11. Cronbach's α and McDonald's ω were used to assess reliability of the ACSID-11. Pearson correlations examined relationships between ACSID-11 domains and Internet Gaming Disorder Scale-Short Form (IGDS9-SF) scores. RESULTS: The CFA supported validity of the Thai version of the ACSID-11 and a four-factor structure. Specific domains of the Thai ACSID-11, particularly gaming, were positively and significantly correlated with IGDS9-SF scores. CONCLUSIONS: Data indicate that the Thai version of the ACSID-11 is a valid and reliable instrument to assess major types of specific internet use disorders. Additional studies are needed to further examine the validity and reliability of the Thai ACSID-11.

Determination of the cutoff point for Smartphone Application-Based Addiction Scale for adolescents: a latent profile analysis.

BACKGROUNDS: The Smartphone Application-Based Addiction Scale (SABAS) is a validated 6-item measurement tool for assessing problematic smartphone use (PSU). However, the absence of established cutoff points for SABAS hinders its utilities. This study aimed to determine the optimal cutoff point for SABAS through latent profile analysis (LPA) and receiver operating characteristic curve (ROC) analyses among 63, 205. Chinese adolescents. Additionally, the study explored whether PSU screening with SABAS could effectively capture problematic social media use (PSMU) and internet gaming disorder (IGD). METHOD: We recruited 63,205. adolescents using cluster sampling. Validated questionnaires were used to assess PSMU, IGD, and mental health (depression, anxiety, sleep disturbances, well-being, resilience, and externalizing and internalizing problems). RESULTS: LPA identified a 3-class model for PSU, including low-risk users (38.6%, n = 24,388.), middle-risk users (42.5%, n = 26,885.), and high-risk users (18.9%, n = 11,932.). High-risk users were regarded as "PSU cases" in ROC analysis, which demonstrated an optimal cut-off point of 23 (sensitivity: 98.1%, specificity: 96.8%). According to the cutoff point, 21.1% (n = 13,317.) were identified as PSU. PSU adolescents displayed higher PSMU, IGD, and worse mental health. PSU screening effectively captured IGD (sensitivity: 86.8%, specificity: 84.5%) and PSMU (sensitivity: 84.5%, specificity: 80.2%). CONCLUSION: A potential ideal threshold for utilizing SABAS to identify PSU could be 23 (out of 36). Employing SABAS as a screening tool for PSU holds the potential to reliably pinpoint both IGD and PSMU.

Problematic internet gaming and non-suicidal self-injury in Chinese adolescents: Moderating and mediating roles of anxiety.

INTRODUCTION: Despite consistent reports of the association between problematic internet gaming (PIG) and non-suicidal self-injury (NSSI), an increase in PIG does not necessarily lead to increased NSSI. This apparent paradox indicates the presence of other mediators and moderators in the PIG-NSSI association. This study aimed to investigate the role of anxiety as a potential moderating and mediating factor of the PIG-NSSI association in Chinese adolescents. METHODS: A cross-sectional study was conducted among 10,479 Chinese adolescents (50.5% male; age range, 9-18 years). Standardized self-report questionnaires were used to assess the severity of PIG, anxiety, and NSSI. Spearman correlation and multiple linear regression were applied to examine the relationships among PIG, anxiety, and NSSI. Both moderating and mediating effects of anxiety were assessed using Hayes' methods. RESULTS: PIG, anxiety symptoms, and NSSI significantly correlated with one another. Anxiety significantly moderated the relationship between PIG and NSSI [B = 0.002, standard error (SE) = 0.000, p < 0.001], and it partially mediated the PIG-NSSI association [B = 0.017, SE = 0.001, 95% confidence interval (CI) 0.014-0.021]. Social concern and concentration were the two dimensions of anxiety that exerted the strongest mediation effect (B = 0.017, SE = 0.002, 95% CI 0.014-0.020). CONCLUSIONS: Adolescents with PIG and high anxiety are likely to suffer more severe NSSI and may benefit from interventions to reduce anxiety symptoms.

Eye movement verification and evaluation of initial sandplay picture system for internet addiction symptoms in Chinese adolescents.

BACKGROUND: Sandplay therapy is a psychotherapeutic technique, based on the psychoanalytic theory of the unconscious. Nearly a century after it was developed, sandplay can now be applied for the initial diagnosis tools for sand players. The goal of the current research is to demonstrate the role of sandplay in identifying internet-addicted adolescents in China. The study aims to evaluate the reliability and validity for sandplay as a diagnosis and evaluation tool for internet addiction symptoms, and to verify the consistency that exists between results based on sandplay pictures and those based on the Pathological Internet Usage Scale for Adolescents (APIUS). METHODS: The research was conducted with a 2 × 2 mixed factorial design - two types of participants (addicts and non-addicts) and two types of sandplay pictures (pictures for addicts and pictures for non-addicts). An absolute recognition-judgment paradigm was used along with eye movement evaluations to evaluate the existing initial sandplay picture system for internet addiction symptoms (22 sandplay pictures, 11 related to addicts and 11 related to non-addicts, respectively). Sixty Chinese adolescents were selected as the participants (30 as addicts and 30 as non-addicts) according to the APIUS. RESULTS: (1) The initial sandplay pictures for internet addicts are clearly preferred by Chinese internet-addicted adolescents, which are more familiar and easier to process; (2) Such pictures have a higher level of emotional arousal and cognitive resonance for the addicts; (3) Track and heat maps indicate that young internet addicts mainly fixate on the initial sandplay pictures for internet addicts. CONCLUSION: This initial sandplay picture system can be used to screen and identify young Chinese internet addicts based on symptoms, and the evaluation results are consistent with those based on the APIUS.

Relationship between Materialism and Social Networking Site Addiction among Adolescents: A Moderated Mediation Model.

Materialism has been consistently linked to Internet-related addictions, including compulsive online shopping, problematic online gaming, and excessive smartphone use; however, the relationship between materialism and social networking site (SNS) addiction has remained unclear. Thus, this study aims to examine the association between materialism and SNS addiction and investigate the mediating effect of fatalism and moderating effect of self-concept clarity in this relationship among 703 Chinese adolescents. Materialism was significantly positively associated with SNS addiction in adolescents, and fatalism partially mediated this association. Moreover, self-concept clarity moderated the direct and indirect relationships between materialism and SNS addiction. Specifically, for adolescents with low (versus high) self-concept clarity, those who also had high levels of materialism were more likely to develop fatalistic beliefs and showed further symptoms of SNS addiction. This study's findings imply that decreasing materialism and fatalism and developing self-concept clarity might be effective interventions for reducing SNS addiction among adolescents.

Validity, reliability, and correlates of the Smartphone Addiction Scale-Short Version among Japanese adults.

BACKGROUND: The short version of the smartphone addiction scale (SAS-SV) is widely used to measure problematic smartphone use (PSU). This study examined the validity and reliability of the SAS-SV among Japanese adults, as well as cross-sectional and longitudinal associations with relevant mental health traits and problems. METHODS: Datasets from a larger project on smartphone use and mental health were used to conduct two studies. Participants were adults aged over 20 years who carried a smartphone. RESULTS: Study 1 (n = 99,156) showed the acceptable internal consistency and structural validity of the SAS-SV with a bifactor model with three factors. For the test-retest reliability of the SAS-SV, the intraclass correlation coefficient (ICC) was .70, 95% CI [.69, 70], when the SAS-SV was measured seven and twelve months apart (n = 20,389). Study 2 (n = 3419) revealed that when measured concurrently, the SAS-SV was strongly positively correlated with another measure of PSU and moderately correlated with smartphone use time, problematic internet use (PIU), depression, the attentional factor of impulsiveness, and symptoms related to attention-deficit hyperactivity disorder and obsessive-compulsive disorder. When measured 12 months apart, the SAS-SV was positively strongly associated with another measure of PSU and PIU and moderately associated with depression. DISCUSSION: The structural validity of the SAS-SV appeared acceptable among Japanese adults with the bifactor model. The reliability of the SAS-SV was demonstrated in the subsequent seven- and twelve-month associations. CONCLUSION: The cross-sectional and longitudinal associations of the SAS-SV provided further evidence regarding PSU characteristics.

Psychometric properties of the Smartphone Addiction Inventory - Short Form (SPAI-SF) in Brazilian adolescents.

The Smartphone Addiction Inventory - Short Form (SPAI-SF) is shorter version (10 items) of the original version of SPAI (26 items). In this study, we aimed to: (i) adapt and test the internal structure of the SPAI-SF, using confirmatory factor analysis (CFA), multigroup confirmatory factor analysis (MGCFA), and network analysis; (ii) analyze the internal consistency, temporal stability, criterion, predictive and construct validities of the SPAI-SF. A total of 392 adolescents (M = 12.76; SD = 1.00) completed the following measures: demographic questionnaire, SPAI-SF, Smartphone Addiction Scale - Short Version (SAS-SV), and the Internet Addiction Test (IAT). The CFA showed good fit indices with the original four factors, and MGCFA indicated measurement invariance for gender. Network analysis provided an understanding of the core symptoms of problematic smartphone use (PSU) for both boys and girls. The intraclass correlation coefficient (ICC) was 0.865 (95% CI: 0.841 - 0.887) and indicated a robust temporal stability. The instrument demonstrated acceptable overall reliability measured by Cronbach's alpha and McDonald's Omega criteria (α = 0.722; ω = 0.725) and did not show floor and ceiling effects. The scale's significant correlations demonstrated convergent and criterion validities of the SPAI-SF with SAS-SV, IAT, and Smartphone usage data. The SPAI-SF is a reliable instrument to detect PSU in adolescents.

Development and Psychometric Evaluation of a DSM-V-Based Social Networking Site Use Disorder Test: The SNS-DT-10.

While the problematic use of Social Networking Sites (SNS) has been observed in some individuals, few validated and widely accepted measures are available to assess and screen for problematic use. This is an attempt at adapting the Diagnostic and Statistical Manual of Mental Disorders-based Internet Gaming Disorder Test-10 (IGDT-10) measure to assess SNS use disorder and problematic SNS use in the form of the SNS use disorder Test-10 (SNS-DT-10) questionnaire, and assessing its validity and reliability. The study was conducted in three phases: First, the IGDT-10 questionnaire was translated and adapted to assess SNS use disorder, and content validity was assessed. Then, a sample of 126 students from the Tehran University of Medical Sciences was used to determine internal consistency and construct validity using confirmatory factor analysis. Finally, retest data from 87 participants were used to estimate test-retest reliability. Item content validity indices were above .80 and scale content validity indices surpassed .83. The root mean square error of approximation for the 1-factor model was .04 and the comparative fit and Tucker-Lewis fit indices were .97 and .96, respectively, indicating appropriate construct validity. The intra-class correlation coefficient of the number of positive criteria for SNS use disorder was .81 and the Kappa coefficients for SNS use disorder and problematic SNS use were .85 and .57. Cronbach's alpha was .79 for the entire questionnaire. Overall, the SNS-DT-10 questionnaire has appropriate content and construct validity, internal consistency, and test-retest reliability. Further validation of this questionnaire in larger and more diverse samples and comparison with professional clinical diagnostic interviews are warranted.

Functional impairment, insight, and comparison between criteria for gaming disorder in the International Classification of Diseases, 11 Edition and internet gaming disorder in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Aim: This study evaluated the consistency between the International Classification of Diseases, 11th Edition (ICD-11) for gaming disorder (ICD-11-GD) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for internet gaming disorder (DSM-5-IGD). Moreover, the functional impairment of participants and their insight of their GD were evaluated. Methods: We recruited 60 participants with GD, 45 participants who engaged in hazardous gaming (HG), and 120 controls based on a diagnostic interview. Their operationalization of functional impairment and stage of change were evaluated by interviews and questionnaires, including the Brief Gaming Negative Consequence Scale (BGNCS). Results: We observed satisfactory consistency (kappa value = 0.80) with a diagnostic accuracy of 91.5% between the ICD-11-GD and DSM-5-IGD criteria. Furthermore, 16 participants with IGD in DSM-5 were determined to have HG based on the ICD-11 criteria. Participants of GD group experienced impaired functioning in their health (96.7%), career (73.3%), social life (61.6%), academic performance (36.7%), and job performance (35%). Moreover, a proportion of them were in the pre-contemplation (25.0%), contemplation (61.7%), preparation (10%), and action stages (3.3%). Conclusion: There is a good consistency between ICD-11-GD and DSM-5-IGD criteria. The ICD-11 criteria have a high threshold for diagnosing GD. HG criteria could compensate for this high threshold and identify individuals with a gaming-related functional impairment who require help. Most of the participants with GD were in the early stage of change. Interventions to promote their insight are essential. The BGNCS can be used to examine the negative consequences of gaming and aid mental health professionals in assessing functional impairment.

Addiction Symptom Network of Young Internet Users: Network Analysis.

BACKGROUND: An increasing number of people are becoming addicted to the internet as a result of overuse. The Internet Addiction Test (IAT) is a popular tool for evaluating internet use behaviors. The interaction between different symptoms and the relationship between IAT and clinical diagnostic criteria are not well understood. OBJECTIVE: This study aimed to explore the core symptoms of internet addiction (IA) and the correlation between different symptoms of the IA symptom network. Network analysis was also conducted to explore the association between the IAT scale and the Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) criteria for IA. METHODS: We recruited 4480 internet users (aged 14-24 years), and they completed the IAT. The final analysis included 63.50% (2845/4480) of the participants after screening the submitted questionnaires. Participants were classified into IA group and non-IA (NIA) group. By using partial correlation with Lasso regularization networks, we identified the core symptoms of IA in each group and compared the group differences in network properties (strength, closeness, and betweenness). Then, we analyzed the symptom networks of the DSM-5 diagnostic criteria and IAT scale for IA. RESULTS: A total of 12.47% (355/2845) of the patients were in the IA group and 87.52% (2490/2845) of the patients were in the NIA group, and both groups were evaluated for the following nodes: IAT_06 (school work suffers; strength=0.511), IAT_08 (job performance suffers; strength=0.531), IAT_15 (fantasize about being on the web; strength=0.474), IAT_17 (fail to stop being on the web; strength=0.526), and IAT_12 (fear about boredom if offline; strength=0.502). The IA groups had a stronger edge between IAT_09 (defensive or secretive about being on the web) and IAT_18 (hidden web time) than the NIA groups. The items in DSM-5 had a strong association with IAT_12 (weight=-0.066), IAT_15 (weight=-0.081), IAT_17 (weight=-0.106), IAT_09 (weight=-0.198), and IAT_18 (weight=-0.052). CONCLUSIONS: The internet use symptom network of the IA group is significantly different from that of the NIA group. Nodes IAT_06 (school work affected) and IAT_08 (work performance affected) are the resulting symptoms affected by other symptoms, whereas nodes IAT_12 (fear about boredom if offline), IAT_17 (inability to stop being on the web), and IAT_15 (fantasize about being on the web) are key symptoms that activate other symptoms of IA and are strongly linked to the inability to control the intention to play games in the DSM-5.

Think-aloud analysis of commonly used screening instruments for Internet use disorders: The CIUS, the IGDT-10, and the BSMAS.

Background: Despite the constant publication of new screening instruments for Internet use disorders (IUD), little is known about their content validity. This study aimed to identify potential mismatches between the items' intention and young adults' interpretation of these items when answering three screening instruments that are commonly used in research and clinical settings: The Compulsive Internet Use Scale (CIUS), the 10 Item-Internet Gaming Disorder Test (IGDT-10), and the Bergen Social Media Addiction Scale (BSMAS). Methods: In total, 30 vocational students (50% female, age = 21.3; SD = 2.1) took part in individual think-aloud interviews. All participants were asked to report their thoughts while completing the CIUS. In addition, participants who reported online games (OG) as their main Internet activity (n = 11) answered the IGDT-10. Participants who reported social networks (SN) as their main Internet activity (n = 18) answered the BSMAS. One participant used OG and SN equally and completed both screening instruments. All interviews were audio-recorded, transcribed, and content-analysed. Results: Overall, four potential sources for errors were identified: (1) High scorings were often not congruent with the underlying diagnostic criteria. In particular, such discrepancies were found in items aimed to assess dysfunctional emotional regulation strategies and cognitive involvement. (2) Some participants were uncertain which time frame or Internet activity should be considered in their answers. (3) Long and complex items led to the building of mean values or the choice of the middle answer category. (4) Some wordings were perceived to be outdated and difficult to understand. Discussion: These findings might help to provide recommendations on how to improve screening instruments for IUD. Most important, items should more clearly distinguish between Internet use as a "normal" leisure activity and Internet use that leads to functional impairments in daily life.

Psychometric evaluation of the internet addiction test in India.

The Internet Addiction Test is a widely used assessment of symptoms of internet addiction. Although originally proposed as assessing different components of internet addiction, research has been mixed in terms of its factor structure. This study is the first to examine the psychometric properties of the IAT in an Indian population. A large sample (N = 2700) of Indians living in the Southern city of India were recruited door-to-door and completed the IAT and other validity measures. In Study 1, an exploratory factor analysis (n = 1375) indicated a one-factor structure, with 13 items measuring symptoms of internet addiction. This short-form IAT showed construct and convergent validity by correlating with higher daily internet use, higher scores on measures of problematic internet gaming, social media use, and smartphone use, and functional impact. In Study 2, confirmatory factor analysis (n = 1375) indicted this one-factor structure was a good fit to the data, and the correlations with validity measures were replicated. This short-form IAT appears to be valid as a measure of one underlying factor of problematic internet use in young Indian adults.

Adaptation and psychometric properties of an Arabic version of the smartphone addiction scale (SAS) in the context of Saudi Arabia.

BACKGROUND: The growing accessibility to smartphones has raised concerns about addictive patterns associated with these technologies. A Smartphone Addiction Scale has been developed to assess individuals' smartphone addiction. However, the psychometric properties of the Smartphone Addiction Scale are scarce in the context of Saudi Arabia. AIMS: This study aimed to translate and adapt the Smartphone Addiction Scale (SAS) to Arabic and examine the psychometric properties of the Arabic scale in the context of Saudi Arabia. METHODS: Forward and backward translations were performed on the English SAS, as recommended by the World Health Organization (WHO, 2016). The translated version was initially administered to 20 students in a pilot study. In the full study, a sample of 624 participants (52.5% females, mean age = 25 years) responded to questionnaires containing SAS, the Hospital Anxiety and Depression Scale, and the Smartphone Application-Based Addiction Scale. The survey was sent via online platforms in order to reach as many and diverse participants as possible. Exploratory and confirmatory factor analyses were conducted. RESULTS: The EFA resulted in a structure of six factors and the CFA indicated that the 6-factor model (daily disturbance, positive anticipation, withdrawal, cyberspace-oriented relationships, overuse, and tolerance) had a good fit in Saudi Arabia (CFI = 0.92, TLI = 0.90, RMSEA = 0.04, SRMR = 0.04). The scale was also gender invariant and exhibited adequate reliability and convergent and concurrent validity. CONCLUSIONS: The SAS is a reliable and valid measure that can be used to assess smartphone addiction in Saudi Arabia.

Effectiveness of a mobile app-based educational intervention to treat internet gaming disorder among Iranian adolescents: study protocol for a randomized controlled trial.

BACKGROUND: The use of video games, a hobby for many teenagers in their leisure time, has brought with it a new potential for concerns. Internet gaming disorder (IGD) is a mental condition classified as a disorder due to addictive behaviors. It may include use of video games, both online and offline. Consequences of IGD may include introversion, social anxiety, mood swings, loneliness, sleep problems, behavioral problems, depression, low self-esteem, and increased violence. In order to design an app-based intervention for adolescents, a transtheoretical model (TTM) has been used. This widely used model in the field of behavioral change is also practical for health education programs. In addition, cognitive-behavioral therapy (CBT) has been used to make people more aware of their behaviors, feelings and thoughts and how to achieve behavioral change. The present study seeks to determine the effectiveness of this app-based intervention in in the treatment of IGD among adolescents. METHOD: In this single-blinded, randomized, controlled trial, 206 high-school adolescents aged 13 to 18 years in Qazvin city will be recruited. Eligible adolescents will be randomly assigned into intervention and control groups. Eight consecutive sessions delivered over 2 months and based on the TTM and CBT will be delivered through the `app (named HAPPYTEEN) to the intervention group. The control group will receive a sleep hygiene intervention (8 consecutive sessions for 2 months) via the app. Data collection tools include the Internet Gaming Disorder Scale, Insomnia Severity Index, Depression, Anxiety, and Stress Scales, Stages of Change Questionnaire, Decision Balance, and Self-Efficacy. The study measures will be completed at baseline, post intervention, and 1 month and 3 months after the intervention. DISCUSSION: The results of this intervention could be used as adjunct therapy for adolescents with IGD. TRIAL REGISTRATION: Clinical Trial Registration Center of Iran (IRCT) IRCT20181226042140N1 . Registered on June 9, 2020.

Network analyses of internet gaming disorder symptoms and their links with different types of motivation.

The study used regularized partial correlation network analysis (EBICglasso) to examine the structure of DSM-5 internet gaming disorder (IGD) symptoms (network 1); and the associations of the IGD symptoms in the network with different types of motivation as defined in the self-determination theory i.e., intrinsic motivation (engaging in an activity for something unrelated to the activity), identified regulation (engaging in the activity because it aligns with one's values and/or goals), external regulation (engagement in activity being driven by external rewards and/or approval), and amotivation (engaging in an activity without often understanding why) (network 2). Participants were 968 adults from the general community. They completed self-rating questionnaires covering IGD symptoms and different types of motivation. The findings for network 1 showed mostly positive connections between the symptoms within the IGD network. The most central symptom was loss of control, followed by continuation, withdrawal symptoms, and tolerance. In general, these symptoms were more strongly connected with each other than with the rest of the IGD symptoms. The findings for network 2 showed that the different types of motivation were connected differently with the different IGD symptoms. For instance, the likeliest motivation for the preoccupation and escape symptoms is intrinsic motivation, and for negative consequences, it is low identified regulation. Overall, the findings showed a novel understanding of the structure of the IGD symptoms, and the motivations underlying them. The clinical implications of the findings for assessment and treatment of IGD are discussed.

Development and validation of a nine-item short screening test for ICD-11 gaming disorder (GAMES test) and estimation of the prevalence in the general young population.

BACKGROUND AND AIMS: A definition of gaming disorder (GD) was introduced in ICD-11. The purpose of this study was to develop a short screening test for GD, utilizing a reference GD group. It also sought to estimate the prevalence of GD among individuals, representative of the general young population in Japan. METHODS: Two hundred eighty one men and women selected from the general population, aged between 10 and 29 years, and 44 treatment seekers at our center completed a self-reported questionnaire comprising candidate questions for the screening test. The reference group with ICD-11 GD was established, based on face-to-face interviews with behavioral addiction experts, using a diagnostic interview instrument. The questions in the screening test were selected to best differentiate those who had GD from those who did not, and the cutoff value was determined using the Youden index. RESULTS: A nine-item screening test (GAMES test) was developed. The sensitivity and specificity of the test were both 98% and the positive predictive value in the study sample was 91%. The GAMES test comprised two factors, showed high internal consistency and was highly reproducible. The estimated prevalence of GD among the general young population was 7.6% (95% confidence interval; 6.6-8.7%) for males and 2.5% (1.9-3.2%) for females, with a combined prevalence of 5.1% (4.5-5.8%). DISCUSSION AND CONCLUSION: The GAMES test shows high validity and reliability for screening of ICD-11 GD. The estimated prevalence of 5.1% among the general young population was comparable to the pooled estimates of young people globally.