The Prevalence of Impulse Control Disorders and Behavioral Addictions in Eating Disorders: A Systematic Review and Meta-Analysis

Aim: Individuals with eating disorders (EDs) may present with impulse control disorders (ICDs) and behavioral addictions (BAs), which may result in additional suffering and treatment resistance. However, the prevalence of ICDs and BAs in EDs has not been systematically examined. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of ICDs and BAs in ED samples.Methods: A comprehensive electronic database search of the peer-reviewed literature was conducted in the following online databases: MEDLINE, PsycINFO, Embase, and CINAHL from their inception to May 2021. We restricted review eligibility to research studies reporting prevalence for ICDs or BAs in individuals with diagnosed EDs. The outcome for this review was the prevalence of ICDs or BAs in individuals with EDs. A series of random-effects meta-analyses were performed on eligible studies to estimate the pooled proportions and 95% confidence intervals (CIs).Results: Thirty-five studies met the inclusion criteria, including a total of 9,646 individuals identified as having an ED, 18 of these studies specifically examined ICDs/BAs in AN, BN, and BED. Random-effects pooled estimates demonstrated that the comorbid prevalence of any ICD was 22%. The prevalence of comorbid pathological/compulsive buying was highest (19%), followed by kleptomania (18%), pathological internet use (12%), intermittent explosive disorder (4%), trichotillomania (3%), and gambling disorder (2%). In addition, the prevalence of stealing/shoplifting behaviors was 30% in those with EDs.Conclusion: This is the first meta-analysis on the comorbid prevalence of EDs and ICDs/BAs. We found a moderate prevalence for these comorbid conditions, with approximately one out of five individuals with an ED also displaying a comorbid ICD/BA. Although causal inferences cannot be drawn, the numbers strongly suggest that clinical screening/monitoring of ICDs/BAs should be part of the clinical routine in cohorts with EDs. ED settings need either the capacity to manage these disorders or adequate access to relevant services. Further investigations are needed to reveal common underlying pathomechanisms.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier: CRD42020202044.

Relationship Between Big Five Personality and Pathological Internet Use: Mediating Effects of Loneliness and Depression

Pathological Internet use will have a serious impact on normal individual study and work and has become one of the most important factors hindering the growth and development of contemporary college students. The purpose of this study was to examine the mechanisms of loneliness and depression in the relationship between the Big Five personality traits and pathological Internet use (PIU). A total of 1,179 college students were studied using the Chinese version of the Big Five Personality Scale, Loneliness Scale, Depression Scale, and Pathological Internet Use Scale. The results showed that loneliness partially mediated the relationship between extraversion and PIU and completely mediated the relationship between agreeableness and PIU and neuroticism and PIU. Depression completely mediated the relationship between agreeableness and PIU, neuroticism completely mediated the relationship with PIU, and sense of responsibility partially mediated the relationship with PIU. This study revealed the relationship between different personality traits and PIU and the mediating role of loneliness and depression, suggesting that we should carry out targeted interventions on PIU for college students with different personality traits.

The role of loneliness in university students’ pathological Internet use – a web survey study on the moderating effect of social web application use

The present study investigated the role of social web application use in the association between loneliness and pathological Internet use. A sample of university students (n = 445) completed an online survey of their loneliness and Internet use, including an assessment of pathological Internet use level. Based on existing theory and empirical findings, loneliness was expected to be indirectly associated with pathological Internet use through social-compensatory Internet use motives. The strength of this indirect effect was hypothesized to be moderated by levels of social web application use. Results pointed to the specificity of social-compensatory use motives in mediating loneliness effects on pathological Internet use, while the size of these effects was moderated by quantity of social web application use. Findings suggest that lonely people with higher levels of social web activity show a stronger social-compensatory use orientation, which translates to higher levels of pathological Internet use. Implications and limitations of these findings are discussed and several suggestions for future studies are made.

When Does a Lot Become Too Much? A Q Methodological Investigation of UK Student Perceptions of Digital Addiction

Despite the benefits of the internet and other digital technology, the online world has been associated with a negative impact on university student wellbeing. Many university students report symptoms of pathological internet use. Internationally, further research is needed to understand what student users of technology perceive to be problematic internet and/or digital use. The current study explores the range of perceptions that university students hold about ‘digital addiction’. We recruited 33 participants from a UK university into a Q-methodology study. Participants sorted, ranked, and commented on fifty-two statements representing the concourse of ‘things written or said about digital addiction’. The statements were identified from a comprehensive search of a wide variety of sources (e.g., newspapers, academic articles, blogs, and YouTube). Principal Component Analysis was used to identify four distinct viewpoints of ‘digital addiction’: (I) digital addiction is differentiated by the negative consequences experienced by addicted individuals; (II) digital addiction comes from our fascination with the online world; (III) digital addiction is an attempt to escape real world problems and impacts on mental health and relationships; (IV) digital addiction is defined by the amount of time we spend online. All four viewpoints share the perception that people do not realize they are digitally addicted because using and having digital devices on you at all times has become the social norm. There was also overall agreement that that those with ‘addictive personalities’ were more likely to be ‘digitally addicted’. Despite these similarities, complexity and contradictions within the viewpoints surrounding what digital addiction is and how it might be defined are apparent. The information found in this study provides important suggestions of how we might frame prevention and early intervention messages to engage students and ensure they develop the skills necessary to successfully manage their digital lives.

Epidemiology and Phenomenology of Compulsive Use of Technology: The Technological Saturation of South African Youth

Modern technological advancements are increasingly reconstituting virtually every facet of social interaction. While technology plays a significant role in many people’s lives, it appears to pose interminable drawbacks, especially among the youth. This article seeks to go beyond emphasising the utopia wrought by these disruptive innovations, by looking at how technologically saturated South Africa’s youth are. This study took a qualitative approach. Focus group interviews encapsulated the viewpoints of the target population selected from four multipurpose community centres in KwaZulu-Natal (KZN), South Africa. Grohol’s model of pathological internet use was found relevant to determine the compulsive use of technology by the youth in South Africa. Data analysis was done using thematic categorisation. The findings show that the youth have adopted a variety of information and communication technologies (ICTs) for different purposes. Findings also reveal that technology advancements not only offer an easier and quicker way to share information, but also contribute to sociability by providing a way to communicate with distant friends and family. Notwithstanding the negative side of technology, ICTs have positive impacts on today’s youth, namely bringing people together as well as enhancing their social and educational abilities. However, if used without discretion, technology can create a less interactive generation. The youth seem to be so fixated on technology that it affects their social life. It can be concluded that South Africa’s youth are saturated by technology. However, this saturation comes with both negative and positive consequences; some have become technologically savvy while others seem to be negatively affected.

Gender prevalence and pattern structure of various online behaviors among adolescents in Abakan

Summary. The increased maladaptive Internet use and associated psychosomatic disorders in modern adolescents is an urgent medical problem. The aim of the study was to research the gender prevalence and pattern structure of various types of online behavior in adolescents from Abakan (Khakassia). Material and methods. A one-time screening examination of random samples of students from 4 schools in the city of Abakan was carried out from April to May 2019. It was examined 1360 adolescents (49.5% of boys and 50.5% of girls) aged 12-18 years (mean age 14.7 ± 1.3). Online behavior was assessed using the Chen Internet Addiction Scale (CIAS) based on the total CIAS score. There were 2 groups (boys and girls) for the indicators to be analyzed, with the data processed using the “Statistica 12” program. Results. Adaptive Internet use (AIU) is typical for 56.5% of Abakan adolescents, Non-adaptive maladaptive (NIU) — for 37.6% and Internet-dependent, pathological Internet use (PIU) — for 5.9%. The incidence and pattern structure of various types of online behavior are associated with gender. The prevalence of maladaptive types of online behavior is higher among girls: non-adaptive (42.4% versus 32.8% in boys) and pathological (8.0% versus 3.7%). There are significant gender differences in the Com, Wit, Tol scales, key symptoms of Internet addiction (KSIA), Problems Associated with Internet Addiction (PAIA) and the total CIAS score of the Chen scale. Girls have higher average scores for all subscales of the Chen questionnaire, i.e. both key symptoms of Internet addiction, and the total CIAS score. Conclusion. The prevalence of maladaptive types of online behavior among adolescents in Abakan and also a high association with gender confirm the relevance of the problem and indicate the further research in the given area is needed.

The Impact of Peer Attachment on Left-Behind Children’s Pathological Internet Use: A Moderated Mediating Effect Model

The aim of this study was to determine how left-behind children’s perceived personal rejection and emotional intelligence impact on the relationship between their peer attachment and pathological Internet use in China. Using the cluster random sampling method, a total of 406 left-behind children (aging 12.76 ± 2.13) from six rural primary and secondary schools in mainland China were recruited for the study (202 males and 204 females). The results of the analysis indicated that peer attachment negatively predicted left-behind children’s pathological Internet use. Perceived personal rejection had a mediating effect on the relationship between peer attachment and pathological Internet use, whereas emotional intelligence had a moderating effect on the relationships between peer attachment and perceived personal rejection and between peer attachment and pathological Internet use among these children. Moreover, peer attachment had a greater negative impact on the perceived personal rejection and pathological Internet use of left-behind children with high emotional intelligence compared with those of students with low emotional intelligence. These findings reveal the need for more support and interventions aimed at strengthening peer attachment and emotional intelligence of left-behind primary and secondary children and reducing their perceptions of personal rejection, which, in turn, reduces their pathological Internet use.

mRNA Levels of MAOA and 5-HT2A Receptor in Patients With Pathological Internet Use: Correlations With Comorbid Symptoms

Objective: Uncontrolled internet use may lead to the emergence of pathological internet use (PIU). PIU has become a global public health concern that can cause a range of psychotic symptoms, including anxiety, depression, and impulse control disorder. To date, we know very little about the principal biological factors related to PIU. Monoamine oxidase type A (MAOA) and serotonin (5-HT) 5-HT2A receptor (5-HT2AR) play critical roles in the development of behavioural and drug addictions. Thus, the aim of this study was to measure the relative expression of mRNA of MAOA and 5-HT2AR in peripheral blood mononuclear cells (PBMCs) of patients with PIU and to determine the correlations between these biological indicators and the comorbid symptoms of patients with PIU.Methods: In this study, the mRNA of MAOA and 5-HT2AR was detected using real-time PCR in PBMCs of the patients with PIU (n = 24) and healthy controls (HCs, n = 25). The relationship between the mRNA levels of MAOA and 5-HT2AR and clinical symptoms in patients with PIU was further investigated.Results: MAOA mRNA in PBMCs was significantly upregulated in patients with PIU compared with that in HCs. mRNA levels of 5-HT2AR were not found to differ significantly between HCs and patients with PIU. Correlation analyses further revealed a significant positive correlation between the relative expression of MAOA mRNA in PBMCs of patients with PIU and the Young's Internet Addiction Test and Self-Rating Depression Scale scores.Conclusion: The present study revealed upregulated expression of MAOA mRNA in patients with PIU and an association between the expression of MAOA mRNA and clinical symptoms of PIU, suggesting that the neurobiological changes may be similar between PIU and substance addiction. Additionally, this study demonstrated a potential association between comorbid symptoms and mRNA levels of MAOA.