Tridimensional personality of adolescents with internet addiction and substance use experience.

OBJECTIVE: This study aimed to examine the differences in personality characteristics between adolescents with and without Internet addiction and substance use experience as defined by the Tridimensional Personality Questionnaire (TPQ), and to compare personality characteristics among groups of adolescents with both Internet addiction and substance use experience (comorbid group), those with only Internet addition (Internet addiction group), those with only substance use experience (substance experience group), and those without Internet addiction or substance use experience (control group). METHOD: In the cross-sectional investigation, we recruited 3662 students (2328 boys and 1334 girls) from high schools in southern Taiwan. Our investigation was conducted using the TPQ, the Chen Internet Addiction Scale, and Questionnaires for Experience in Substance Use. RESULTS: Adolescents with Internet addiction were more likely to have substance use experience. High novelty seeking (NS), high harm avoidance (HA), and low reward dependence (RD) predicted a higher proportion of adolescents with Internet addiction. High NS, low HA, and low RD predicted a higher proportion of adolescents with substance use experience. Of the 4 groups, the Internet addiction group had the highest HA scores and the comorbid group had the lowest HA scores. CONCLUSION: Adolescents with high NS and low RD should be provided with effective strategies for preventing Internet addiction and substance use. In addition, the Internet addiction group and the comorbid group should be provided with different preventative strategies focused on HA.     

Multi-dimensional discriminative factors for Internet addiction among adolescents regarding gender and age

Aims:  The aim of the present study was to examine the discriminative effects of sociodemographic, individual, family, peers, and school life factors on Internet addiction in Taiwanese adolescents.
Methods:  A total of 8941 adolescents were recruited and completed the questionnaires. Multi-dimensional discriminative factors for Internet addiction were examined using chi-squared automatic interaction detection for gender and sex.
Results:  Depression and low family monitoring were the discriminative factors for Internet addiction in all four gender- and age-specified groups of adolescents. Low connectedness to school, high family conflict, having friends with habitual alcohol drinking, and living in rural areas also had discriminative effects on adolescent Internet addiction in adolescents of different gender and age.
Conclusions:  Multi-dimensional factors were able to discriminate between those adolescents with and without Internet addiction. It is suggested that parents and health and educational professionals monitor the Internet-using behaviors of adolescents who have the factors discriminating for Internet addiction identified in the present study.     

Internet overuse and excessive daytime sleepiness in adolescents

Aim:  The purpose of this study was to examine the association of Internet overuse with excessive daytime sleepiness (EDS).
Methods:  A total of 2336 high school students in South Korea (boys, 57.5%; girls, 42.5%) completed the structured questionnaire. The severity of Internet addiction was evaluated using Young's Internet addiction test.
Results:  The proportions of boys who were classified as Internet addicts and possible Internet addicts were 2.5% and 53.7%, respectively. For girls, the corresponding proportions were 1.9% and 38.9%, respectively. The prevalence of EDS was 11.2% (boys, 11.2%; girls, 11.1%). When Internet addicts were compared with non-addicts, they consisted of more boys, drank alcohol more, and considered their own health condition as poor. But smoking was not related with Internet addiction. The prevalence rate of EDS for Internet addicts was 37.7%, whereas that for possible Internet addicts and non-addicts was 13.9% and 7.4%, respectively. The prevalence of insomnia, witnessed snoring, apnea, teeth grinding, and nightmares was highest in Internet addicts, middle in possible addicts, and lowest in non-addicts. With adjustment for duration of Internet use, duration of sleep time, age, gender, smoking, taking painkillers due to headache, insomnia symptoms, witnessed apnea, and nightmares, the odds of EDS were 5.2-fold greater (95% confidence interval [CI]: 2.7–10.2) in Internet addicts and 1.9-fold greater (95%CI: 1.4–2.6) in possible Internet addicts compared to non-addicts.
Conclusion:  Internet addiction is strongly associated with EDS in adolescents. Clinicians should consider examining Internet addiction in adolescent cases of EDS.     

The association between harmful alcohol use and Internet addiction among college students: Comparison of personality

Aims:  This study aimed to (i) evaluate the association between Internet addiction and harmful alcohol use, and (ii) evaluate the associated personality characteristics of Internet addiction as well as harmful alcohol use.
Methods:  A total of 2453 college students were invited to complete the Chen Internet Addiction Scale, Behavior Inhibition System and Behavior Approach System Scale(BIS/BAS scale), and the Alcohol Use Disorders Identification Test from May 2005 to May 2006.
Results:  The results demonstrated Internet addiction was associated with harmful alcohol use among college students. College students with Internet addiction had higher scores on the BIS and BAS fun-seeking subscales. However, college students with harmful alcohol use had higher scores on the BAS drive and fun-seeking subscales, and lower scores on the BIS subscale.
Conclusions:  Internet addiction is associated with harmful alcohol use. Furthermore, fun seeking was the shared characteristic of these two problem behaviors and might contribute to the association. However, further studies are necessary to evaluate the underlying mechanisms accounting for the association between Internet addiction and harmful alcohol use.     

The relationship between parental mediation and Internet addiction among adolescents,and the association with cyberbullying and depression

ObjectiveThis study examined the relationships between parental mediation and Internet addiction, and the connections to cyberbullying, substance use, and depression among adolescents.MethodThe study involved 1808 junior high school students who completed a questionnaire in Taiwan in 2013.ResultsMultiple logistic regression analysis results showed that adolescents who perceived lower levels of parental attachment were more likely to experience Internet addiction, cyberbullying, smoking, and depression, while adolescents who reported higher levels of parental restrictive mediation were less likely to experience Internet addiction or to engage in cyberbullying. Adolescent Internet addiction was associated with cyberbullying victimization/perpetration, smoking, consumption of alcohol, and depression.ConclusionInternet addiction by adolescents was associated with cyberbullying, substance use and depression, while parental restrictive mediation was associated with reductions in adolescent Internet addiction and cyberbullying.     

Assessing the Effects of Maternal Symptoms and Homelessness on the Mental Health Problems in their Children

Objective:  This study examines the longitudinal association between measures of child well being and maternal posttraumatic stress disorder symptoms, homelessness, substance abuse, and other psychiatric conditions.
Method:  A sample of 142 mothers who were veterans of the US armed forces were assessed at program entry and every three months thereafter for one year. A repeated-measures with mixed-effects analytic strategy was used to assess the association of children's mental health, school enrolment and attendance with measures of maternal psychiatric symptoms and homelessness.
Results:  Significant associations between mothers' psychiatric symptoms and child well-being were identified. However, the multivariable mixed-models suggest that increased depression and anxiety symptoms among children were associated primarily with mothers' PTSD, and not depression, symptoms.
Conclusions:  These findings provide evidence of an association between maternal and child mental health and may suggest that treating maternal PTSD symptoms may also benefit children, regardless of whether the child was also exposed to the traumatic experience.     

The association between Internet addiction and psychiatric disorder: a review of the literature

Internet addiction is a newly emergent disorder. It has been found to be associated with a variety of psychiatric disorders. Information about such coexisting psychiatric disorders is essential to understand the mechanism of Internet addiction. In this review, we have recruited articles mentioning coexisting psychiatric disorders of Internet addiction from the PubMed database as at November 3, 2009. We describe the updated results for such disorders of Internet addiction, which include substance use disorder, attention-deficit hyperactivity disorder, depression, hostility, and social anxiety disorder. We also provide discussion for possible mechanisms accounting for the coexistence of psychiatric disorders and Internet addiction. The review might suggest that combined psychiatric disorders mentioned above should be evaluated and treated to prevent their deteriorating effect on the prognosis of Internet addiction. On the other hand, Internet addiction should be paid more attention to when treating people with these coexisting psychiatric disorders of Internet addiction. Additionally, we also suggest future necessary research directions that could provide further important information for the understanding of this issue.     

Psychotic boys performing well in school are at increased risk of suicidal ideation

Aim:  This study investigated how the level of school performance is associated with suicidal behavior and psychiatric disorders among adolescent psychiatric inpatients aged 12–17 years.
Methods:  Data were collected from 508 adolescents (300 girls, 208 boys; age 12–17 years) admitted to inpatient psychiatric hospitalization between April 2001 and March 2006. Information on the adolescents' school performance, suicidal ideation, suicide attempts and self-mutilation as well as psychiatric DSM-IV diagnoses was obtained using the Schedule for Affective Disorder and Schizophrenia for School-Age Children.
Results:  An elevated risk of suicidal ideation (OR = 3.6, 95% CI 1.3–10.2, P  = 0.017) and of psychotic disorders (OR = 3.2, 95% CI 1.0–10.0, P  = 0.048) was observed among male adolescents performing well in school. In addition, adolescents with poor school performance had an increased likelihood of substance-related disorder both in boys (OR = 2.6, 95% CI 1.1–6.1, P  = 0.027) and girls (OR = 2.5, 95% CI 1.2–5.1, P  = 0.011).
Conclusions:  Our findings indicate that psychotic inpatient male adolescents performing well in school are at an elevated risk of suicidal ideation. Although good school performance is often considered a marker of high intelligence and good general ability, symptoms of major psychiatric disorders and suicidality need to be taken very seriously among adolescents performing well in school.     

Gender Differences in Internet Addiction Associated with Psychological Health Indicators Among Adolescents Using a National Web-based Survey

Internet addiction, especially its prevalence among adolescents and its predictors, has been the focus of much research. Few studies have investigated gender differences in the relationship between Internet addiction and psychological health among adolescents. The present study investigated gender differences in Internet addiction associated with self-rated health, subjective happiness, and depressive symptoms among Korean adolescents aged 12 to 18 years using a nationally representative dataset. Data from 56,086 students (28,712 boys and 27,374 girls) from 400 middle schools and 400 high schools were analyzed. We found that 2.8 % of the students (3.6 % boys and 1.9 % girls) were addicted users, and the prevalence of Internet addiction was higher in boys than in girls. In multiple logistic regression analysis, three psychological health indicators including poor self-rated health, subjective unhappiness, and depressive symptoms were significantly related with Internet addiction in boys and girls. Girls with emotional difficulties such as subjective unhappiness or depressive symptoms had much higher risks of Internet addiction than did boys with similar problems. Further attention should be given to developing Internet addiction prevention and intervention programs that are tailored to fit boys’ and girls’ different needs.     

Quetiapine in bipolar disorder and cocaine dependence

Objective:  Bipolar disorder is associated with the highest rates of substance abuse of any psychiatric illness. Therefore, treatments that stabilize mood and decrease drug use or cravings are of great interest. Atypical antipsychotics are in widespread use in patients with bipolar disorder. However, minimal data are available on their use in bipolar patients with comorbid substance abuse.
Methods:  Open-label, add-on, quetiapine therapy was examined for 12 weeks in 17 outpatients with bipolar disorder and cocaine dependence. Subjects were evaluated with a structured clinical interview; Hamilton Depression Rating (HDRS), Young Mania Rating (YMRS), Brief Psychiatric Rating (BPRS) scales; and Cocaine Craving Questionnaire (CCQ). Urine samples and self-reported drug use were also obtained. Data were analyzed using a last observation carried forward method on all subjects given medication at baseline.
Results:  Significant improvement from baseline to exit was observed in HDRS, YMRS, BPRS and CCQ scores (p ≤ 0.05). Dollars spent on cocaine and days/week of cocaine use decreased non-significantly, and urine drug screens did not change significantly from baseline to exit. Quetiapine was well tolerated, with no subjects to our knowledge discontinuing because of side-effects.
Conclusions:  The use of quetiapine was associated with substantial improvement in psychiatric symptoms and cocaine cravings. The findings are promising and suggest larger controlled trials of quetiapine are needed in this population.     

The association of parental alcohol abuse and depression with severe emotional and behavioural problems in adolescents: a clinical study

BACKGROUND: Earlier studies have indicated associations between parental psychiatric problems, such as depression, and substance abuse and adolescent problems. AIMS: This study aimed to determine whether parental psychiatric problems are associated with problems and problem behaviour in adolescents in a clinical sample. METHODS: The study subjects were 70 outpatient adolescents (age 13-18 years, boys 30%) and their parents. The adolescents were assessed using the structural clinical interview for DSM-III-R (SCID) and a semi-structured questionnaire, and the parents were interviewed using a semi-structured questionnaire. RESULTS: Maternal alcohol abuse and depression were associated with serious problems, especially among girls, and paternal alcohol abuse was associated with adolescent health-compromising behaviour. Maternal depression and alcohol abuse had no association with adolescent health-compromising behaviour. Maternal depression without alcohol abuse was associated with the diagnosis of major depressive disorder in adolescents, but not with other adolescent problems, while paternal depression without alcohol abuse was not associated with any adolescent problems. CONCLUSIONS: Despite the small study sample, these findings indicate that parental psychiatric problems and alcohol abuse are correlated with adolescent psychological problems and should be considered and assessed when assessing adolescents.     

Pain in Adolescent Psychiatric Patients

Background:  Little is known about the extent of pain among adolescent psychiatric patients, and the relationships with psychosocial factors and psychiatric symptoms.
Method:  A representative sample of 129 adolescent patients were assessed with measures including the Youth Self-Report, the Mood and Feelings Questionnaire, and instruments assessing self-perceptions, coping styles, stresses, sociodemographic factors, and childhood abuse.
Results:  More than half of the adolescents (54%) reported to be bothered currently by frequent pain. Frequent pain correlated with depression, self-harm, suicide attempt, and with ruminative and emotion oriented coping. Adolescents suffering from frequent pain had more often experienced childhood abuse/neglect. A stepwise multiple regression analysis revealed that depression, alcohol intoxication and childhood neglect were the strongest concurrent predictors of frequent pain.
Conclusions:  Clinicians should ask child and adolescent psychiatric patients about pain, and be aware of possible connections with abuse/neglect, depression and suicidality.     

The association of Internet addiction symptoms with anxiety,depression and self-esteem among adolescents with attention-deficit/hyperactivity disorder

Background

The aims of this study were to examine the associations of the severity of Internet addiction symptoms with various dimensions of anxiety (physical anxiety symptoms, harm avoidance, social anxiety, and separation/panic) and depression symptoms (depressed affect, somatic symptoms, interpersonal problems, and positive affect) and self-esteem among adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) in Taiwan.

Method

A total of 287 adolescents aged between 11 and 18 years who had been diagnosed with ADHD participated in this study. Their severity of Internet addiction symptoms was assessed using the Chen Internet Addiction Scale. Anxiety and depression symptoms and self-esteem were assessed using the Taiwanese version of the Multidimensional Anxiety Scale for Children (MASC-T), the Center for Epidemiological Studies Depression Scale (CES-D), and the Rosenberg Self-Esteem Scale (RSES), respectively. The association between the severity of Internet addiction symptoms and anxiety and depression symptoms and self-esteem were examined using multiple regression analyses.

Results

The results indicated that higher physical symptoms and lower harm avoidance scores on the MASC-T, higher somatic discomfort/retarded activity scores on the CES-D, and lower self-esteem scores on the RSES were significantly associated with more severe Internet addiction symptoms.

Conclusions

Prevention and intervention programs for Internet addiction in adolescents with ADHD should take anxiety, depression, and self-esteem into consideration.     

The relationship between impulsivity and Internet addiction in a sample of Chinese adolescents.

OBJECTIVE: Previous studies regarding Internet addiction have investigated associated psychological variables such as shyness, loneliness, self-consciousness, anxiety, depression and interpersonal relations. Few studies about the relationship between Internet Addiction and impulsivity have been done. This study aimed to assess whether Internet addiction is related to impulsivity among Chinese adolescents. METHOD: This study was performed in two stages. We screened for the presence of Internet Addiction among 2620 high school students(age ranging from 12years to 18years) from four high schools of Changsha City using Diagnostic Questionnaire for Internet Addiction (YDQ). According to the modified YDQ criteria by Beard, 64 students were diagnosed as Internet addiction. Excluding current psychiatric comorbidity, 50 students who were diagnosed as Internet Addiction (mean age, 14.8+/-1.4years) and 50 normal students in Internet usage(mean age, 14.5+/-1.8years) were included in a case control study. The two groups were assessed using Barratt Impulsiveness Scale 11 (BIS-11) and behavioral measure of impulsivity (GoStop Impulsivity Paradigm). RESULTS: Sixty-four students met the modified YDQ criteria by Beard, of whom 14 students suffered from comorbid psychiatric disorders, especially comorbid ADHD. The Internet Addiction group had significantly higher scores on the BIS-11 subscales of Attentional key, Motor key, and Total scores than the control group (P<0.05). The Internet Addiction group scored higher than the control group on the failure to inhibit responses of GoStop Impulsivity Paradigm (P<0.05). There was a significant positive correlation between YDQ scores and BIS-11subscales and the number of failure to inhibit responses of GoStop Impulsivity Paradigm. CONCLUSION: This study suggests that adolescents with Internet addiction exhibit more impulsivity than controls and have various comorbid psychiatric disorders, which could be associated with the psychopathology of Internet addiction.     

Psychosocial Risk Factors Associated with Internet Addiction in Korea

Objective

The aim of this study was to examine the prevalence of Internet addiction in middle school students and to identify associated psychosocial risk factors and depression.

Methods

This study was part of a larger epidemiological study on childhood psychiatric disorders conducted in Osan, a city of Republic of Korea. We used IAS for internet addiction, K-YSR for subjects'' emotional and behavioral problems and K-CDI for depressive symptoms. We used the data of n=1217 completed cases. We put on independent variables, which are sex, age, smoking and alcohol experiences, economic status, age of first Internet use, K-YSR and K-CDI score.

Results

The subjects consisted of addicted users (2.38%), over users (36.89%) and normal Internet users (60.72%). Attention problems, sex, delinquent problems, K-CDI scores, thought problems, age and aggressive behavior were predictable variables of internet addiction. Age of initial Internet use negatively predicted Internet addiction.

Conclusion

This result showed similar to other researches about sociodemographic, emotional or behavioral factors related to internet addiction. Generally, subjects with more severe internet addiction had more emotional or behavioral problems. It means that they already have had various difficulties when we found internet addiction of adolescents. Therefore it is necessary to evaluate whether the subjects have any emotional or behavioral troubles and to intervene to prevent internet addiction.     

Suicide attempts in adult patients with idiopathic generalized epilepsy

Aims:  To study clinical features of adult patients with idiopathic generalized epilepsy with special attention to suicidal behavior.
Methods:  We reviewed the medical records of 145 consecutive adult patients with electro-clinically confirmed idiopathic generalized epilepsy and identified those with a history of at least one attempted suicide. Clinical variables in relation to their epilepsy and psychiatric conditions were analyzed.
Results:  Seven patients (4.8%) had a history of suicide attempts with drug overdose, and one of these patients committed suicide after multiple attempts. All attempts were made interictally without direct relation to their epileptic seizures. All had at least one co-morbid mental disorder (two with dual diagnosis). Although their psychiatric diagnoses varied, they all appeared to have increased emotional instability and poor impulse control. Only one patient's attempt was directly associated with her co-morbid depression.
Conclusions:  Physicians managing people with epilepsies should be aware of psychiatric disturbances and suicidal behavior in idiopathic generalized epilepsy.     

Proposed diagnostic criteria of Internet addiction for adolescents

The aims of the present study were to develop diagnostic criteria of Internet addiction for adolescents and to examine the discriminating potential and validity of diagnostic criteria by an empirical community study among adolescent populations. We developed 13 candidate diagnostic criteria for characteristic symptoms of Internet addiction in adolescents. A total of 468 adolescents completed the Chen Internet Addiction Scale (CIAS) and were systematically assessed for Internet-using behaviors by seven psychiatrists using the diagnostic interview schedule. The sensitivity, specificity, and diagnostic accuracy of the 13 candidate diagnostic criteria were analyzed with references to the interviewers' global clinical impressions and CIAS results. The cutoff point of the diagnostic criteria to differentiate the Internet-addicted subjects with nonaddicted ones was then determined by the best diagnostic accuracy and the receiver operating characteristic curve. This study selected nine of the 13 candidate diagnostic criteria to construct the diagnostic criteria of Internet addiction for adolescents, which were composed of three main criteria: characteristic symptoms of Internet addiction, functional impairment secondary to Internet use, and exclusive criteria. The diagnostic criteria had high diagnostic accuracy, specificity, negative predictive value, accepted sensitivity, and accepted positive predictive rate. The validity of the diagnostic criteria proposed in this study was further confirmed by comparing the demographic and Internet-using characteristics between those with and without Internet addiction. The diagnostic criteria for Internet addiction can provide health care professionals with a means to communicate and make comparisons of clinical cases.     

Health service utilization in patients with major depression and co-morbid pain

Aims:  Patients with depression often have co-morbid pain symptoms. However, rates of service utilization by psychiatric in-patients with co-morbid pain symptoms are unknown. The purpose of this study is to estimate whether patients with major depression and co-morbid pain access medical treatment for their pain as much as their counterparts with psychiatric diagnoses other than major depression.
Methods:  A total of 103 patients (62 female; 41 male) were assessed for a diagnosis of major depression applying a psychiatric clinical interview followed by a self-report pain questionnaire, which assessed physical pain in psychiatric patients.
Results:  Patients with major depression reported higher rates of pain symptoms in the past 6 and 12 months than their counterparts with a psychiatric diagnosis other than major depression. Analysis of variance showed that patients with depression were less likely to attend medical and specialist services for their pain symptoms than their counterparts. On the contrary, depressed patients with pain attended more frequently general in-patient services than non-depressed patients with pain.
Conclusions:  Patients with depression suffer high rates of pain symptoms, but are at higher risk of not accessing appropriate services suggesting inadequate service utilization. The results have implications for screening and health care delivery for psychiatric patients with pain.     

Validation of the Chinese version of the Mood Disorder Questionnaire in a psychiatric population in Hong Kong

Aims:  The aim of the present study was to determine the validity of a Chinese version of the Mood Disorder Questionnaire (MDQ) as a screening instrument for bipolar disorder in a psychiatric outpatient population in Hong Kong.
Methods:  A total of 185 patients primarily being treated for mood disorders were asked to fill in the Chinese MDQ and supply other personal data during their scheduled clinic visit. The mean age was 43.0 years and 65.9% were female. A subsample of 102 randomly selected subjects, stratified by the MDQ symptom score, received a telephone-based Structured Clinical Interview for DSM-IV (SCID). Sixty-two patients (60.8%) were suffering from bipolar disorder (bipolar I, n  = 48; bipolar II, n  = 9; bipolar disorder not otherwise specified, n  = 5), 35 (34.3%) from depressive disorder, and one (1.0%) from substance dependence, while four (3.9%) were unaffected by either mood or alcohol/substance use disorder. The internal consistency, factor structure and operating characteristics of the Chinese MDQ were analyzed.
Results:  The internal consistency of the Chinese MDQ, evaluated using Cronbach alpha, was 0.82. Principal component analysis with varimax rotation indicated an 'energized-activity' factor and an 'irritability-racing thoughts' factor, which explained 47.2% of the rotated variance. The optimal cut-off was seven or more manic symptoms occurring within the same time period, which yielded a sensitivity of 0.73 and a specificity of 0.88 for detecting bipolar disorder. An additional criterion that the symptoms cause impairment resulted in significant loss of sensitivity.
Conclusion:  The Chinese MDQ is a valid screening instrument for bipolar disorder in a psychiatric outpatient population.     

Outcome of Self-Reported Functional-Somatic Symptoms in a Community Sample of Adolescents

It is unclear if functional-somatic symptoms in adolescents increase the risk for future psychiatric disorders. Therefore, the outcome and continuity of adolescent self-reported functional-somatic symptoms in young adulthood were assessed. Self-reported data on functional-somatic symptoms from an ongoing epidemiological study in children started in 1983 were analyzed. Participants were adolescents aged 11–18 who filled out standardized questionnaires in 1989 and 1991 and who were reassessed in 1997 when they were young adults between ages 19 and 26. Outcome measures were research psychiatric diagnoses and self-reported functional-somatic symptoms in 1997. Functional-somatic symptoms were associated with other measures of psychopathology in adolescents. Adolescents with specific functional-somatic symptoms tended to report the same symptom along with other symptoms at follow-up. Adolescent self-reported functional-somatic symptoms did not increase the risk for future psychiatric disorders. Young adults with functional-somatic complaints were diagnosed more often than controls with depressive disorders and anxiety disorders, but not with antisocial personality disorders and substance use disorders. Adolescent self-reported functional-somatic symptoms were common and enduring but were not predictive for psychiatric disorders in young adulthood. Adolescents and young adults who complain of multiple functional-somatic complaints should be assessed for the presence of a psychiatric disorder particularly depression or anxiety.