Preventive Interventions for Internet Addiction in Young Children: Systematic Review.

BACKGROUND: In this digital age, children typically start using the internet in early childhood. Studies highlighted that young children are vulnerable to internet addiction due to personal limitations and social influence (eg, family and school). Internet addiction can have long-term harmful effects on children's health and well-being. The high risk of internet addiction for vulnerable populations like young children has raised questions about how best to prevent the problem. OBJECTIVE: This review study aimed to investigate the existing interventions and explore future directions to prevent or reduce internet addiction risks in children younger than 12 years. METHODS: The systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched for relevant literature from 4 research databases (Scopus, Web of Science, PubMed, and PsycINFO). We included 14 primary studies discussing the interventions to prevent or reduce internet addiction risks in young children and their efficacy outcomes. RESULTS: The preventive interventions identified were categorized into four approaches as follows: (1) children's education, (2) parenting strategy, (3) strategic physical activity, and (4) counseling. Ten interventions showed promising efficacy in preventing or reducing internet addiction risks with small-to-medium effect sizes. Interventions that enhance children's competencies in having appropriate online behaviors and literacy were more likely to show better efficacy than interventions that force children to reduce screen time. Interventions that shift children's focus from online activities to real-world activities also showed promising efficacy in reducing engagement with the internet, thereby preventing addictive behaviors. We also identified the limitations of each approach (eg, temporariness, accessibility, and implementation) as valuable considerations in developing future interventions. CONCLUSIONS: The findings suggest the need to develop more sustainable and accessible interventions to encourage healthy online behaviors through education, appropriate parenting strategies, and substitutive activities to prevent children's overdependence on the internet. Developing digital tools and social support systems can be beneficial to improve the capability, efficiency, and accessibility of the interventions. Future interventions also need to consider their appropriateness within familial context or culture and provide adequate implementation training. Last, policy makers and experts can also contribute by making design guidelines to prevent digital product developers from making products that can encourage overuse in children.

More grateful, less addicted! Understanding how gratitude affects online gaming addiction among Chinese college students: a three-wave multiple mediation model.

BACKGROUND: Online game addiction has become a prominent public concern, particularly among emerging adults, warranting in-depth investigation. Despite prior cross-sectional research indicating a negative correlation between gratitude and online gaming addiction, a dearth of longitudinal research exists in this area. Furthermore, the underlying mechanisms that explain the link between gratitude and online gaming addiction remain poorly understood, highlighting a critical research gap in the field. METHODS: To bridge this gap, our study adopted a three-wave longitudinal design and constructed a multiple mediation model. Over the course of one year, data was collected from a sample of Chinese undergraduates, with 319 students participating at Time 1, 305 at Time 2, and 292 at Time 3. Participants were administered online self-report surveys, enabling the acquisition of valuable data regarding their levels of gratitude, online game addiction, self-control, and loneliness. RESULTS: The findings revealed a negative correlation between gratitude measured at Time 1 and online game addiction assessed at Time 3. Further analysis demonstrated that both self-control and loneliness played multiple mediating roles at Time 2 in the link between gratitude and online game addiction. CONCLUSION: These research findings shed light on the underlying mechanisms between gratitude and online game addiction, which provide implications for developing interventions (e.g., interventions based on gratitude) for reducing young adults' online game addiction.

Effectiveness of Cognitive Behavioral Therapy-Based Intervention in Preventing Gaming Disorder and Unspecified Internet Use Disorder in Adolescents: A Cluster Randomized Clinical Trial.

Importance: Behavioral addictions were introduced as novel mental disorders in the International Classification of Diseases, 11th Revision, based on evidence that human behavior itself can become addictive, similar to addiction to substances. However, previous studies on prevention of gaming disorder and unspecified internet use disorder lacked randomization, follow-up measurements, and diagnostic interviews that assessed incidence rates; this trial was intended to fill this gap. Objectives: To investigate whether the PROTECT (Professioneller Umgang mit technischen Medien [Professional Use of Technical Media]) intervention can reduce the symptom severity and prevent full syndrome and subthreshold onset of gaming disorder and unspecified internet use disorder in at-risk adolescents. Design, Setting, and Participants: A multicenter cluster randomized clinical trial conducted recruitment, screening, intervention delivery, and data collection among at-risk adolescents aged 12 to 18 years in 33 high schools in Germany. Inclusion criteria for the study and symptom severity analyses were elevated symptoms of gaming disorder and unspecified internet use disorder. A subsample that met the inclusion criteria for incidence analyses (no full syndrome of gaming disorder or unspecified internet use disorder, depression, or anxiety at baseline) was analyzed for illness onset. Participants were randomized to either the PROTECT intervention group or the assessment-only control group. Participants were assessed at baseline, 1-month follow-up, 4-month follow-up, and 12-month follow-up between October 1, 2015, and September 30, 2018. Based on intent-to-treat principle, data analyses were conducted from February 8, 2019, to May 7, 2021. Interventions: PROTECT, a theory-driven, manualized, cognitive behavioral therapy-based indicated preventive group intervention that is delivered in 4 sessions by trained psychologists. It targets changes in addictive reward processing and pathological cognitive mechanisms. Main Outcomes and Measures: The primary outcome was symptom severity (measured by CSAS [Computerspielabhängigkeitsskala], a modified German video game dependency scale with a score range of 0-56 [higher scores indicating greater pathology]) along with incidence rates (assessed by a structured clinical interview) after 12 months. Secondary outcomes were comorbid psychopathology and problem behaviors. Results: A total of 422 at-risk adolescents (mean [SD] age, 15.11 [2.01] years; 229 female participants [54.3%]) were randomized to either the PROTECT intervention group (n = 167; mean [SD] risk score, 29.05 [6.98]) or the assessment-only control group (n = 255; mean [SD] risk score, 26.21 [5.01]) and were included in the symptom severity analyses. Compared with the control group, the PROTECT group showed a significantly greater reduction in symptom severity of gaming disorder or unspecified internet use disorder (γ11 = -0.128; 95% CI, -0.246 to -0.011; P = .03), reflecting a 39.8% vs 27.7% reduction of symptoms with an effect size of Cohen d = 0.67 (baseline vs 12-month follow-up) for the PROTECT group. Differences in incidence rates did not reach statistical significance. The PROTECT group showed a significantly greater decrease in procrastination (γ11 = -0.458; 95% CI, -0.735 to -0.180; P < .001) over 12 months, but no significant differences were found for other secondary outcomes. Conclusions and Relevance: Results of this trial showed that the PROTECT intervention effectively reduced symptoms of gaming disorder and unspecified internet use disorder over 12 months. The intervention did not change incidence rates of gaming disorder or unspecified internet use disorder. Trial Registration: ClinicalTrials.gov Identifier: NCT02907658.

Prevenção de "brincadeiras perigosas" na internet: experiência da atuação do Instituto DimiCuida em ambientes digitais / Prevention of "dangerous games" on the Internet: the experience of the DimiCuida Institute line of action in digital environments

Resumo As "brincadeiras perigosas" ("desafios online") fazem parte da cultura digital, atraindo milhares de crianças e adolescentes e causando severos danos à saúde. Este artigo buscou analisar a experiência do Instituto DimiCuida (IDC), em Fortaleza (CE), ação pioneira de prevenção de desafios online danosos à saúde, que se disseminam em diferentes ambientes da Web 2.0. O estudo teve como objetivos específicos analisar a emergência do Instituto; identificar os principais parceiros envolvidos, os ambientes digitais e analógicos onde atuam; além de entender as estratégias de prevenção desenvolvidas. Trata-se de um estudo de caso baseado em análise documental. O acervo, extraído de diversas plataformas digitais, foi processado com o Atlas Ti e submetido à análise temática. O IDC emerge da ressignificação existencial e política de uma experiência de luto e tem como característica enfatizar alternativas às atividades online, tendo como foco central a escola e seus agentes. Por se tratar de um campo em construção e sem referência precedente de atuação, a prevenção realizada nos ambientes digitais pouco explora a linguagem e recursos da internet, aposta no controle parental e pouco leva em consideração as experiências de corpo e as performances identitárias envolvidas nos desafios.

Abstract "Dangerous games" ("online challenges") are part of the digital culture, attracting thousands of children and adolescents and causing severe damage to their health. This study aimed to analyze the experience of the DimiCuida Institute (DCI) in Fortaleza, state of Ceará, Brazil, a pioneering initiative to prevent online challenges, disseminated in different Web 2.0 environments, which can harm young people's health. The specific objectives of this study sought to analyze the emergence of the Institute; identify the main partners involved in its network, assess the digital and analog environments in which they operate; and understand the prevention strategies developed. This is a case study based on document analysis. Our data, extracted from several digital platforms, was processed with Atlas Ti and subjected to thematic analysis. The DCI emerges from the existential and political resignification of a bereavement experience and is characterized by emphasizing alternatives to online activities, especially focusing on schools and their agents. Since this is still a field under construction and without previous references for lines of action, the prevention carried out in digital environments scarcely explores the language and resources of the Internet, betting on parental control and scarcely considering the experiences of the body and identity performances involved in the challenges.

The efficacy of a training program for social skills in reducing addictive Internet behaviors among Palestinian university students

Abstract Background: For youth in geopolitically at-risk environments, such as Palestine, the issues related to Internet overuse and addictions are complex. Youth residing in the occupied territories of Palestine as in other highly militarized zones have high levels of environmental stressors (e.g., militarization, poverty, lack of employment opportunities, cultural pressures, etc.) and few chemical or social outlets such as alcohol, intoxicants, and leisure activities. As such, the easily accessible and unrestricted opportunities for stress-reducing social contact of social media can lead easily to excessive and maladaptive Internet use. Therefore, interventions directly aimed at awareness and education on how to manage Internet use are critical for addressing these issues in high risk populations. Aims: The purpose of the current study was to test the efficacy of a time-limited group training program aimed at improving social skills and reducing addictive Internet behaviors among university students. Methods and results: The sample consisted of 30 university students who self-reported high scores on an Internet addiction scale. Participants were randomly assigned to either wait list or treatment group (15 in each condition). Results demonstrated that using a social skills training program over an 8-week period improved the level of social skills and reduced addictive Internet behaviors significantly in those who experienced the intervention when compared with a wait list control group. Conclusions: These findings support the implementation of time limited training programs targeting social skills and addictive patterns of Internet use with university students identified with high levels of Internet addictive behaviors.

Effect of internet use and electronic game-play on academic performance of Australian children.

This study examined the association of internet use, and electronic game-play with academic performance respectively on weekdays and weekends in Australian children. It also assessed whether addiction tendency to internet and game-play is associated with academic performance. Overall, 1704 children of 11-17-year-olds from young minds matter (YMM), a cross-sectional nationwide survey, were analysed. The generalized linear regression models adjusted for survey weights were applied to investigate the association between internet use, and electronic-gaming with academic performance (measured by NAPLAN-National standard score). About 70% of the sample spent > 2 h/day using the internet and nearly 30% played electronic-games for > 2 h/day. Internet users during weekdays (> 4 h/day) were less likely to get higher scores in reading and numeracy, and internet use on weekends (> 2-4 h/day) was positively associated with academic performance. In contrast, 16% of electronic gamers were more likely to get better reading scores on weekdays compared to those who did not. Addiction tendency to internet and electronic-gaming is found to be adversely associated with academic achievement. Further, results indicated the need for parental monitoring and/or self-regulation to limit the timing and duration of internet use/electronic-gaming to overcome the detrimental effects of internet use and electronic game-play on academic achievement.

Worry and Permissive Parenting in Association with the Development of Internet Addiction in Children.

The Internet has experienced a rapid increase in use globally. Specifically, more than 90% of Hong Kong's citizens use the Internet, and 70% of children in the age group of 6-17 years have daily access to it. However, internet addiction could pose serious social and health issues. Therefore, conducting research to investigate its causes and risk factors is fundamental. The current study examined the relationship between worry and Internet addiction among children in Hong Kong and investigated the moderating effect of the permissive parenting style on such a relationship. The participants consisted of 227 fourth- and fifth-grade students (120 males, 52.9%) with a mean age of 9.55 (standard deviation (SD) = 0.58) in Hong Kong. Each participant was asked to complete the questionnaires, including the Internet Addiction Test for Internet addiction, the Penn State Worry Questionnaire for Children for worry, and the Parental Authority Questionnaire for the permissive parenting style. The results indicated that worry was related to greater Internet addiction among children. Furthermore, there was a moderating effect of the permissive parenting style such that the positive association between worry and Internet addiction was stronger when the permissive parenting style was higher. Our findings imply that parenting styles are influential in the prevention of Internet addiction.

Does Digital Detox Work? Exploring the Role of Digital Detox Applications for Problematic Smartphone Use and Well-Being of Young Adults Using Multigroup Analysis.

The constant availability of social networking sites (SNSs) on smartphones has an enormous distracting potential and may lead to problematic usage behavior, especially among younger age groups. In this context, an emerging trend of using so-called digital detox applications (apps; e.g., iOS Screen Time) can be witnessed, which allows users to monitor and limit their smartphone use as well as to consciously disconnect for a certain period of time. However, it remains unclear whether digital detox apps can indeed reduce negative consequences of using SNSs such as problematic smartphone use (PSU) and decreased well-being. Drawing from self-regulation theory, we investigated the relationships between using SNSs, PSU, and well-being among a sample of 500 young adults between 18 and 35 years of age. We used multigroup analysis to compare digital detox app users and nonusers. Results revealed that a high proportion of young adults use digital detox apps (41.7 percent). Among those who did not use such apps, using SNSs was positively associated with PSU, which was negatively related to well-being. Among digital detox app users, we found no such relationship. Thus, digital detox apps seem to be a valuable tool to prevent harmful effects of using SNSs on well-being among young people by reducing the risk of using the smartphone compulsively.

[Development and Effect of a Smartphone Overdependence Prevention Program for University Students Based on Self-Determination Theory].

PURPOSE: This study aimed to develop a smartphone overdependence prevention program for college students based on the self-determination theory (SDT) and evaluate its effectiveness. METHODS: A non-equivalent control group repeated measures design was used for the study. Participants were 64 university freshmen (experimental group: 29, control group: 35). The developed program consists of eight sessions conducted twice a week. The program was designed to promote autonomy, competence, and relatedness the three elements of the basic psychological needs of self-determination theory. The participants were assessed before the program, immediately after, and 1 and 3 months after the program. Data were collected from April 23 to September 14, 2018 and analyzed by performing a Chi-square test, Fisher's exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 23.0. RESULTS: This study showed improvement in the basic psychological needs (F=3.90, p=.010) in the experimental group compared to the control group. Specifically, competence (F=2.93, p=.035), relatedness (F=2.89, p=.045), and self-regulatory ability (F=3.11, p=.028) improved significantly. CONCLUSION: Study findings indicate that the smartphone overdependence prevention program based on the Self-determination theory could be an effective intervention for improving basic psychological needs and self-regulation ability. Therefore, this program could be an efficient strategy for smartphone overdependence prevention in university students.